103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB5417

 

Introduced 2/9/2024, by Rep. Kelly M. Cassidy

 

SYNOPSIS AS INTRODUCED:
 
See Index

    Amends the Department of Public Health Act. Establishes the role of HIV Treatment Innovation Coordinator to be housed within the Department. Provides that the Department shall create and fill the Coordinator role within 6 months after the effective date of the amendatory Act. Requires the Coordinator to develop and execute a comprehensive strategy to adopt a Rapid Start model for HIV treatment as the standard of care. Requires compensation and benefits for the Coordinator be at the Program Director level. Describes the specific job responsibilities of the Coordinator. Amends the Illinois Insurance Code. Provides that an individual or group policy of accident and health insurance amended, delivered, issued, or renewed in this State on or after January 1, 2025 shall provide coverage for home test kits for sexually transmitted infections, including any laboratory costs of processing the home test kit, that are deemed medically necessary or appropriate and ordered directly by a clinician or furnished through a standing order for patient use based on clinical guidelines and individual patient health needs. Makes a conforming change to the Illinois Public Aid Code regarding coverage for home test kits for sexually transmitted infections. Amends the AIDS Confidentiality Act. Creates the Illinois AIDS Drug Assistance Program. Provides that Illinois AIDS Drug Assistance Program applications shall be processed within 72 hours after the time of submission. Provides for conditional approval of Illinois AIDS Drug Assistance Program applications within 24 hours after time of submission. Requires Illinois AIDS Drug Assistance Program applicants to document residency within the State of Illinois. Provides for 8 Rapid Start for HIV Treatment pilot sites established by the Department of Public Health. Provides that the Department shall publish a report on the operation of the pilot program 15 months after the pilot sites have launched. Establishes requirements for the report, requires that the report be shared with the General Assembly, the Governor's Office, and requires that the report be made available on the Department's Internet website. Amends the County Jail Act. Creates new annual adult correctional facility public inspection report requirements on the topics of HIV and AIDS.


LRB103 39489 CES 69685 b

 

 

A BILL FOR

 

HB5417LRB103 39489 CES 69685 b

1    AN ACT concerning health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Department of Public Health Act is amended
5by adding Section 6.5 as follows:
 
6    (20 ILCS 2305/6.5 new)
7    Sec. 6.5. HIV Treatment Innovation Coordinator.
8    (a) Within 6 months after the effective date of this
9amendatory Act of the 103rd General Assembly, the Department
10of Public Health shall create and fill the position of "HIV
11Treatment Innovation Coordinator" within the HIV Section and
12shall employ a full-time person to serve in this position. The
13HIV Treatment Innovation Coordinator shall develop and execute
14a comprehensive strategy to adopt a Rapid Start model for HIV
15treatment as the standard of care, aligning with industry
16standards informed by the most current guidance of the Centers
17for Disease Control and Prevention on HIV care and treatment.
18    (b) The HIV Treatment Innovation Coordinator employed by
19the Department shall be compensated at a rate that is
20comparable to the rate of compensation for a Program Director
21and shall be provided benefits similar to those of a Program
22Director. The HIV Treatment Innovation Coordinator shall also
23be provided similar means and resources as those supplied to a

 

 

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1Program Director. The Department shall not modify any current
2position to meet these requirements. The position of HIV
3Treatment Innovation Coordinator shall be created and filled
4anew, as set forth in this Section.
5    (c) The HIV Treatment Innovation Coordinator shall have
6the following responsibilities:
7        (1) The Coordinator shall develop and execute a
8    comprehensive strategy for the adoption of the Rapid Start
9    model for HIV treatment, aligning with public health
10    objectives outlined in the Getting to Zero Illinois Plan,
11    including the process and qualifications for choosing the
12    8 rapid start pilots.
13        (2) The Coordinator shall support the launch of 8
14    rapid start pilots within 12 months after the effective
15    date of this amendatory Act of the 103rd General Assembly.
16        (3) The Coordinator shall establish coordination
17    efforts between pilot sites and health care providers,
18    community organizations, and stakeholders for the
19    successful implementation of the Rapid Start for HIV
20    treatment model.
21        (4) The Coordinator shall provide educational
22    resources, technical assistance, and training to
23    healthcare professionals at pilot sites to ensure a
24    thorough understanding and effective implementation of
25    Rapid Start for HIV treatment protocols.
26        (5) The Coordinator shall facilitate regular data

 

 

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1    collection from Rapid Start for HIV treatment pilot sites
2    to optimize service delivery and monitor equitable access
3    to communities disproportionately impacted by HIV/AIDS.
4        (6) The Coordinator shall be responsible for the
5    management and allocation of resources dedicated to the
6    implementation of the Rapid Start for HIV treatment model,
7    including technical assistance, capacity building, and
8    grant management.
9        (7) The Coordinator shall be responsible for creating
10    and disseminating the report on the operation of the pilot
11    program 15 months after the pilot sites have launched as
12    required under the AIDS Confidentiality Act. The report
13    shall include:
14            (i) the number of enrolled participants; and
15            (ii) the length of time from initial diagnosis or
16        referral to the start of HIV treatment, and, when
17        available, the length of time during which
18        participants were able to achieve an undetectable
19        viral load.
20    Data shall also include demographic data on the racial,
21ethnic, age, sex, disability status, sexual orientation,
22gender identity, and primary or preferred language of program
23participants in accordance with the Data Governance and
24Organization to Support Equity and Racial Justice Act. The
25report shall include the Department's recommendations
26concerning the continued operation of the Rapid Start for HIV

 

 

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1treatment pilot program and its expansion or progress towards
2becoming the standard of care for HIV treatment. The contents
3of the report shall be in accordance with the AIDS
4Confidentiality Act. The Coordinator shall share the report
5with the Illinois General Assembly, the Governor's Office and
6shall make it publicly available on the Department of Public
7Health's Internet website.
8    Implementation of this Section is subject to
9appropriations made to the Illinois Department of Public
10Health for this purpose.
 
11    Section 10. The Illinois Insurance Code is amended by
12adding Section 356z.71 as follows:
 
13    (215 ILCS 5/356z.71 new)
14    Sec. 356z.71. Coverage for home test kits for sexually
15transmitted infections (STIs).
16    (a) As used in this Section, "home test kit" means a
17product used for a test recommended by the federal Centers for
18Disease Control and Prevention guidelines or the United States
19Preventive Services Task Force that has received a certificate
20of waiver under the Clinical Laboratory Improvement Amendments
21to the federal Public Health Services Act, has been cleared or
22approved by the United States Food and Drug Administration, or
23has been developed by a laboratory in accordance with
24established regulations and quality standards, to allow

 

 

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1individuals to self-collect specimens for STIs, including HIV,
2remotely at a location outside of a clinical setting.
3    (b) An individual or group policy of accident and health
4insurance amended, delivered, issued, or renewed in this State
5after January 1, 2025 shall provide coverage for home test
6kits for sexually transmitted infections, including any
7laboratory costs of processing the kit, that are deemed
8medically necessary or appropriate and ordered directly by a
9clinician or furnished through a standing order for patient
10use based on clinical guidelines and individual patient health
11needs.
12        (1) A commercial health care plan is required to cover
13    the services outlined in this subsection when ordered for
14    an enrollee by an in-network provider.
15        (2) Except as otherwise provided in this subsection, a
16    policy subject to this subsection shall not impose a
17    deductible, coinsurance, copayment, or any other
18    cost-sharing requirement on the coverage provided. The
19    provisions of this subsection do not apply to coverage of
20    procedures to the extent such coverage would disqualify a
21    high-deductible health plan from eligibility for a health
22    savings account pursuant to the federal Internal Revenue
23    Code, 26 U.S.C. 223.
24        (3) Except as otherwise authorized under this Section,
25    a policy shall not impose any restrictions or delays on
26    the coverage required under this Section.

 

 

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1        (4) If a plan or issuer uses a network of providers,
2    nothing in this Section shall be construed to require
3    coverage or to prohibit the plan or issuer from imposing
4    cost-sharing for items or services described in this
5    Section that are provided or delivered by an
6    out-of-network provider, unless the plan or issuer does
7    not have in its network a provider who is able to or is
8    willing to provide the applicable items or services.
 
9    Section 15. The Illinois Public Aid Code is amended by
10changing Section 5-16.8 as follows:
 
11    (305 ILCS 5/5-16.8)
12    Sec. 5-16.8. Required health benefits. The medical
13assistance program shall (i) provide the post-mastectomy care
14benefits required to be covered by a policy of accident and
15health insurance under Section 356t and the coverage required
16under Sections 356g.5, 356q, 356u, 356w, 356x, 356z.6,
17356z.26, 356z.29, 356z.32, 356z.33, 356z.34, 356z.35, 356z.46,
18356z.47, 356z.51, 356z.53, 356z.56, 356z.59, 356z.60, and
19356z.61, 356z.64, 356z.67, and 356z.71 of the Illinois
20Insurance Code, (ii) be subject to the provisions of Sections
21356z.19, 356z.44, 356z.49, 364.01, 370c, and 370c.1 of the
22Illinois Insurance Code, and (iii) be subject to the
23provisions of subsection (d-5) of Section 10 of the Network
24Adequacy and Transparency Act.

 

 

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1    The Department, by rule, shall adopt a model similar to
2the requirements of Section 356z.39 of the Illinois Insurance
3Code.
4    On and after July 1, 2012, the Department shall reduce any
5rate of reimbursement for services or other payments or alter
6any methodologies authorized by this Code to reduce any rate
7of reimbursement for services or other payments in accordance
8with Section 5-5e.
9    To ensure full access to the benefits set forth in this
10Section, on and after January 1, 2016, the Department shall
11ensure that provider and hospital reimbursement for
12post-mastectomy care benefits required under this Section are
13no lower than the Medicare reimbursement rate.
14(Source: P.A. 102-30, eff. 1-1-22; 102-144, eff. 1-1-22;
15102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-530, eff.
161-1-22; 102-642, eff. 1-1-22; 102-804, eff. 1-1-23; 102-813,
17eff. 5-13-22; 102-816, eff. 1-1-23; 102-1093, eff. 1-1-23;
18102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff.
191-1-24; 103-420, eff. 1-1-24; revised 12-15-23.)
 
20    Section 20. The AIDS Confidentiality Act is amended by
21adding Section 5.6 as follows:
 
22    (410 ILCS 305/5.6 new)
23    Sec. 5.6. Illinois AIDS Drug Assistance Program.
24    (a) The purpose of this Section is to expand and assist

 

 

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1with implementation of the Rapid Start for HIV treatment
2model. The pilot sites will allow the development of a
3coordinated system of health care services to provide timely
4and quality HIV treatment. This will occur by increasing the
5capacity of the Department of Public Health and build toward
6establishing the Rapid Start model as the standard of care for
7HIV treatment. This program shall be known as the Illinois
8AIDS Drug Assistance Program or Illinois ADAP.
9    (b) In this Section:
10    "Conditional approval" means Illinois ADAP approval within
1124 hours and allows for attestation of eligibility
12requirements. An applicant seeking conditional approval must
13document residency in the State of Illinois.
14    "Rapid Start for HIV Treatment" means initiating
15antiretroviral therapy within 7 days after initial diagnosis
16or within 7 days after referral to HIV medical care as defined
17by the Centers for Disease Control and Prevention
18recommendations for HIV treatment.
19    (c) Once a complete Illinois AIDS Drug Assistance Program
20application is submitted with all necessary supporting
21documents, processing of the application shall occur within 72
22hours after the time of submission.
23    (d) Illinois ADAP shall establish a pathway for
24conditional approval of Illinois ADAP enrollment, with the
25requirement that applicants then submit a full Illinois ADAP
26application within 30 days after receiving conditional

 

 

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1approval.
2    (e) The Department of Public Health shall establish 8
3Rapid Start for HIV Treatment pilot sites. Upon referral from
4an HIV testing site, the program shall provide funding for and
5coordination of health care services to support treatment
6goals. The program shall provide ancillary services,
7pharmaceutical drug assistance, and case management services
8to participants while the appropriate transition is made for
9continuity of care within the Rapid Start for HIV treatment
10model timeline. The Department may adopt rules to implement
11this pilot program in accordance with industry standards
12informed by the most current Centers for Disease Control and
13Prevention guidance on HIV care and treatment.
14    (f) The Pilot sites shall abide by the following
15principles:
16        (1) Nothing About Us Without Us: Pilot site programs
17    and services shall be formulated with transparency,
18    community involvement, and direct ongoing input by people
19    living with and vulnerable to HIV.
20        (2) Equity: Pilot site programs and services shall
21    provide equitable support, services, and resources to all
22    participants and ensure accessibility to the greatest
23    extent possible. They shall also be established in
24    underserved communities.
25        (3) Self-Determination: Pilot site programs and
26    services shall prioritize individual dignity and autonomy

 

 

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1    in decision-making while encouraging people to connect
2    with additional services that promote health and
3    well-being.
4        (4) Reduce Stigma: Pilot site programs and services
5    shall affirm the humanity and dignity of people living
6    with or vulnerable to HIV and shall operate in a way that
7    is welcoming to reduce stigma and build trust.
8        (5) Safe Spaces: Pilot site programs and services
9    shall prioritize relationship-building and trust among
10    partners, staff, and participants to create safe spaces.
11    (g) The Department, in cooperation with the lead agency
12designated under subsection (c), shall publish a report on the
13operation of the pilot program 15 months after the pilot sites
14have launched. The Department shall share the report with the
15General Assembly and the Governor's Office and shall make it
16publicly available on its Internet website. The report shall
17include:
18        (1) the number offers made for enrollment;
19        (2) the number of enrolled participants;
20        (3) the number and reasons of patients declined for
21    service; and
22        (4) the length of time from initial diagnosis or
23    referral to the start of HIV treatment, and, when
24    available, the length of time participants were able to
25    achieve an undetectable viral load.
26    Data shall also include demographic data on the racial,

 

 

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1ethnic, age, sex, disability status, sexual orientation,
2gender identity, and primary or preferred language of program
3participants in accordance with the Data Governance and
4Organization to Support Equity and Racial Justice Act. The
5report shall include the Department's recommendations
6concerning the continued operation of the Rapid Start for HIV
7treatment pilot program and its expansion or progress towards
8becoming the standard of care for HIV treatment. The contents
9of the report shall be in accordance with the AIDS
10Confidentiality Act.
11    Implementation of this Section is subject to
12appropriations made to the Illinois Department of Public
13Health for this purpose.
 
14    Section 25. The County Jail Act is amended by changing
15Section 17.10 as follows:
 
16    (730 ILCS 125/17.10)
17    Sec. 17.10. Requirements in connection with HIV/AIDS.
18    (a) In each county other than Cook, during the medical
19admissions exam, the warden of the jail, a correctional
20officer at the jail, or a member of the jail medical staff must
21provide the prisoner with appropriate written information
22concerning human immunodeficiency virus (HIV) and acquired
23immunodeficiency syndrome (AIDS). The Department of Public
24Health and community-based organizations certified to provide

 

 

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1HIV/AIDS testing must provide these informational materials to
2the warden at no cost to the county. The warden, a correctional
3officer, or a member of the jail medical staff must inform the
4prisoner of the option of being tested for infection with HIV
5by a certified local community-based agency or other available
6medical provider at no charge to the prisoner.
7    (b) In Cook County, during the medical admissions exam, an
8employee of the Cook County Health & Hospitals System must
9provide the prisoner with appropriate information in writing,
10verbally or by video or other electronic means concerning
11human immunodeficiency virus (HIV) and acquired
12immunodeficiency syndrome (AIDS) and must also provide the
13prisoner with option of testing for infection with HIV or any
14other identified causative agent of AIDS, as well as
15counseling in connection with such testing. The Cook County
16Health & Hospitals System may provide the inmate with opt-out
17human immunodeficiency virus (HIV) testing, as defined in
18Section 4 of the AIDS Confidentiality Act, unless the inmate
19refuses. If opt-out HIV testing is conducted, the Cook County
20Health & Hospitals System shall place signs in English,
21Spanish, and other languages as needed in multiple, highly
22visible locations in the area where HIV testing is conducted
23informing inmates that they will be tested for HIV unless they
24refuse, and refusal or acceptance of testing shall be
25documented in the inmate's medical record. Pre-test
26information shall be provided to the inmate and informed

 

 

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1consent obtained from the inmate as required in subsection (q)
2of Section 3 and Section 5 of the AIDS Confidentiality Act. The
3Cook County Health & Hospitals System shall follow procedures
4established by the Department of Public Health to conduct HIV
5testing and testing to confirm positive HIV test results. All
6aspects of HIV testing shall comply with the requirements of
7the AIDS Confidentiality Act, including delivery of test
8results, as determined by the Cook County Health & Hospitals
9System in consultation with the Illinois Department of Public
10Health. Nothing in this Section shall require the Cook County
11Health & Hospitals System to offer HIV testing to inmates who
12are known to be infected with HIV. The Department of Public
13Health and community-based organizations certified to provide
14HIV/AIDS testing may provide these informational materials to
15the Bureau at no cost to the county. The testing provided under
16this subsection (b) shall consist of a test approved by the
17Illinois Department of Public Health to determine the presence
18of HIV infection, based upon recommendations of the United
19States Centers for Disease Control and Prevention. If the test
20result is positive, a reliable supplemental test based upon
21recommendations of the United States Centers for Disease
22Control and Prevention shall be administered.
23    (b-5) The Department of Corrections shall include the
24following information in the annual adult correctional
25facility public inspection report for each county:
26        (1) whether the warden of the jail, a correctional

 

 

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1    officer at the jail, or a member of the jail medical staff
2    provide the prisoner with appropriate written information
3    concerning HIV and AIDS during the medical admissions
4    exam;
5        (2) whether the warden, a correctional officer, or a
6    member of the jail medical staff informs the prisoner of
7    the option of being tested for infection with HIV by a
8    certified local community-based agency or other available
9    medical provider at no charge to the prisoner;
10        (3) whether the warden of the jail makes appropriate
11    written information or visual aids concerning HIV/AIDS
12    available to every visitor to the jail;
13        (4) whether the warden of the jail has contacted the
14    Department of Public Health or community-based
15    organizations certified to provide HIV/AIDS testing to
16    obtain informational materials within the past year;
17        (5) for Cook County, whether an employee of the Cook
18    County Health and Hospitals System provides the prisoner
19    with appropriate information in writing, verbally, or by
20    video or other electronic means concerning HIV and AIDS
21    during the medical admissions exam; and
22        (6) for Cook County, whether an employee of the Cook
23    County Health and Hospitals System provides the prisoner
24    with the option of testing for infection with HIV or any
25    other identified causative agent of AIDS, as well as
26    counseling in connection with such testing;

 

 

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1    The Department of Public Health and community-based
2organizations certified to provide HIV/AIDS testing shall
3provide these informational materials to the warden at no cost
4to the office of the county sheriff.
5    (c) In each county, the warden of the jail must make
6appropriate written information concerning HIV/AIDS available
7to every visitor to the jail. This information must include
8information concerning persons or entities to contact for
9local counseling and testing. The Department of Public Health
10and community-based organizations certified to provide
11HIV/AIDS testing must provide these informational materials to
12the warden at no cost to the office of the county sheriff.
13    (d) Implementation of this Section is subject to
14appropriation.
15(Source: P.A. 97-244, eff. 8-4-11; 97-323, eff. 8-12-11;
1697-813, eff. 7-13-12; 98-1046, eff. 1-1-15.)

 

 

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1 INDEX
2 Statutes amended in order of appearance
3    20 ILCS 2305/6.5 new
4    215 ILCS 5/356z.71 new
5    305 ILCS 5/5-16.8
6    410 ILCS 305/5.6 new
7    730 ILCS 125/17.10