Full Text of SB0582 102nd General Assembly
SB0582 102ND GENERAL ASSEMBLY |
| | 102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022 SB0582 Introduced 2/24/2021, by Sen. Michael E. Hastings SYNOPSIS AS INTRODUCED: |
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305 ILCS 5/5-19 | from Ch. 23, par. 5-19 |
410 ILCS 527/15 | |
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Amends the Illinois Public Aid Code. Provides that, to ensure full access to the benefits set forth in provisions regarding the Healthy Kids Program, on and after January 1, 2022, the Department of Healthcare and Family Services shall ensure that provider and hospital reimbursements for immunization as required under the provisions are no lower than the Medicare reimbursement rate. Amends the Immunization Data Registry Act. Provides that health care providers, physician's designees, or pharmacist's designees shall (rather than may) provide immunization data to be entered into the immunization data registry. Removes language providing that the immunization data need not be provided if the patient or the patient's parent or guardian, if the patient is less than 18 years of age, has completed and filed with the provider, physician's designee, or pharmacist's designee a written immunization data exemption form. Provides that the written information and the immunization data exemption forms must include information that the health care provider shall (rather than may) report immunization data to the Department of Public Health to be entered into the immunization data registry. Removes language requiring the Department to distribute to health care providers, upon
request, specified written information. Effective January 1, 2022.
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| | A BILL FOR |
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| 1 | | AN ACT concerning health.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Illinois Public Aid Code is amended by | 5 | | changing Section 5-19 as follows:
| 6 | | (305 ILCS 5/5-19) (from Ch. 23, par. 5-19)
| 7 | | Sec. 5-19. Healthy Kids Program.
| 8 | | (a) Any child under the age of 21 eligible to receive | 9 | | Medical Assistance
from the Illinois Department under Article | 10 | | V of this Code shall be eligible
for Early and Periodic | 11 | | Screening, Diagnosis and Treatment services provided
by the | 12 | | Healthy Kids Program of the Illinois Department under the | 13 | | Social
Security Act, 42 U.S.C. 1396d(r).
| 14 | | (b) Enrollment of Children in Medicaid. The Illinois | 15 | | Department shall
provide for receipt and initial processing of | 16 | | applications for Medical
Assistance for all pregnant women and | 17 | | children under the age of 21 at
locations in addition to those | 18 | | used for processing applications for cash
assistance, | 19 | | including disproportionate share hospitals, federally | 20 | | qualified
health centers and other sites as selected by the | 21 | | Illinois Department.
| 22 | | (c) Healthy Kids Examinations. The Illinois Department | 23 | | shall consider
any examination of a child eligible for the |
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| 1 | | Healthy Kids services provided
by a medical provider meeting | 2 | | the requirements and complying with the rules
and regulations | 3 | | of the Illinois Department to be reimbursed as a Healthy
Kids | 4 | | examination.
| 5 | | (d) Medical Screening Examinations.
| 6 | | (1) The Illinois Department shall insure Medicaid | 7 | | coverage for
periodic health, vision, hearing, and dental | 8 | | screenings for children
eligible for Healthy Kids services | 9 | | scheduled from a child's birth up until
the child turns 21 | 10 | | years. The Illinois Department shall pay for vision,
| 11 | | hearing, dental and health screening examinations for any | 12 | | child eligible
for Healthy Kids services by qualified | 13 | | providers at intervals established
by Department rules.
| 14 | | (2) The Illinois Department shall pay for an | 15 | | interperiodic health,
vision, hearing, or dental screening | 16 | | examination for any child eligible
for Healthy Kids | 17 | | services whenever an examination is:
| 18 | | (A) requested by a child's parent, guardian, or
| 19 | | custodian, or is determined to be necessary or | 20 | | appropriate by social
services, developmental, health, | 21 | | or educational personnel; or
| 22 | | (B) necessary for enrollment in school; or
| 23 | | (C) necessary for enrollment in a licensed day | 24 | | care program,
including Head Start; or
| 25 | | (D) necessary for placement in a licensed child | 26 | | welfare facility,
including a foster home, group home |
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| 1 | | or child care institution; or
| 2 | | (E) necessary for attendance at a camping program; | 3 | | or
| 4 | | (F) necessary for participation in an organized | 5 | | athletic program; or
| 6 | | (G) necessary for enrollment in an early childhood | 7 | | education program
recognized by the Illinois State | 8 | | Board of Education; or
| 9 | | (H) necessary for participation in a Women, | 10 | | Infant, and Children
(WIC) program; or
| 11 | | (I) deemed appropriate by the Illinois Department.
| 12 | | (e) Minimum Screening Protocols For Periodic Health | 13 | | Screening
Examinations. Health Screening Examinations must | 14 | | include the following
services:
| 15 | | (1) Comprehensive Health and Development Assessment | 16 | | including:
| 17 | | (A) Development/Mental Health/Psychosocial | 18 | | Assessment; and
| 19 | | (B) Assessment of nutritional status including | 20 | | tests for iron
deficiency and anemia for children at | 21 | | the following ages: 9 months, 2
years, 8 years, and 18 | 22 | | years;
| 23 | | (2) Comprehensive unclothed physical exam;
| 24 | | (3) Appropriate immunizations at a minimum, as | 25 | | required by the
Secretary of the U.S. Department of Health | 26 | | and Human Services under
42 U.S.C. 1396d(r).
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| 1 | | (4) Appropriate laboratory tests including blood lead | 2 | | levels
appropriate for age and risk factors.
| 3 | | (A) Anemia test.
| 4 | | (B) Sickle cell test.
| 5 | | (C) Tuberculin test at 12 months of age and every | 6 | | 1-2 years
thereafter unless the treating health care | 7 | | professional determines that
testing is medically | 8 | | contraindicated.
| 9 | | (D) Other -- The Illinois Department shall insure | 10 | | that testing for
HIV, drug exposure, and sexually | 11 | | transmitted diseases is provided for as
clinically | 12 | | indicated.
| 13 | | (5) Health Education. The Illinois Department shall | 14 | | require providers
to provide anticipatory guidance as | 15 | | recommended by the American Academy of
Pediatrics.
| 16 | | (6) Vision Screening. The Illinois Department shall | 17 | | require providers
to provide vision screenings consistent | 18 | | with those set forth in the
Department of Public Health's | 19 | | Administrative Rules.
| 20 | | (7) Hearing Screening. The Illinois Department shall | 21 | | require providers
to provide hearing screenings consistent | 22 | | with those set forth in the
Department of Public Health's | 23 | | Administrative Rules.
| 24 | | (8) Dental Screening. The Illinois Department shall | 25 | | require
providers to provide dental screenings consistent | 26 | | with those set forth in the
Department of Public Health's |
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| 1 | | Administrative Rules.
| 2 | | (f) Covered Medical Services. The Illinois Department | 3 | | shall provide
coverage for all necessary health care, | 4 | | diagnostic services, treatment and
other measures to correct | 5 | | or ameliorate defects, physical and mental
illnesses, and | 6 | | conditions whether discovered by the screening services or
not | 7 | | for all children eligible for Medical Assistance under Article | 8 | | V of
this Code.
| 9 | | (g) Notice of Healthy Kids Services.
| 10 | | (1) The Illinois Department shall inform any child | 11 | | eligible for Healthy
Kids services and the child's family | 12 | | about the benefits provided under the
Healthy Kids | 13 | | Program, including, but not limited to, the following: | 14 | | what
services are available under Healthy Kids, including | 15 | | discussion of the
periodicity schedules and immunization | 16 | | schedules, that services are
provided at no cost to | 17 | | eligible children, the benefits of preventive health
care, | 18 | | where the services are available, how to obtain them, and | 19 | | that
necessary transportation and scheduling assistance is | 20 | | available.
| 21 | | (2) The Illinois Department shall widely disseminate | 22 | | information
regarding the availability of the Healthy Kids | 23 | | Program throughout the State
by outreach activities which | 24 | | shall include, but not be limited to, (i) the
development | 25 | | of cooperation agreements with local school districts, | 26 | | public
health agencies, clinics, hospitals and other |
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| 1 | | health care providers,
including developmental disability | 2 | | and mental health providers, and with
charities, to notify | 3 | | the constituents of each of the Program and assist
| 4 | | individuals, as feasible, with applying for the Program, | 5 | | (ii) using the
media for public service announcements and | 6 | | advertisements of the Program,
and (iii) developing | 7 | | posters advertising the Program for display in
hospital | 8 | | and clinic waiting rooms.
| 9 | | (3) The Illinois Department shall utilize accepted | 10 | | methods for
informing persons who are illiterate, blind, | 11 | | deaf, or cannot understand the
English language, including | 12 | | but not limited to public services announcements
and | 13 | | advertisements in the foreign language media of radio, | 14 | | television and
newspapers.
| 15 | | (4) The Illinois Department shall provide notice of | 16 | | the Healthy Kids
Program to every child eligible for | 17 | | Healthy Kids services and his or her
family at the | 18 | | following times:
| 19 | | (A) orally by the intake worker and in writing at | 20 | | the time of
application for Medical Assistance;
| 21 | | (B) at the time the applicant is informed that he | 22 | | or she is eligible
for Medical Assistance benefits; | 23 | | and
| 24 | | (C) at least 20 days before the date of any | 25 | | periodic health, vision,
hearing, and dental | 26 | | examination for any child eligible for Healthy Kids
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| 1 | | services. Notice given under this subparagraph (C) | 2 | | must state that a
screening examination is due under | 3 | | the periodicity schedules and must
advise the eligible | 4 | | child and his or her family that the Illinois
| 5 | | Department will provide assistance in scheduling an | 6 | | appointment and
arranging medical transportation.
| 7 | | (h) Data Collection. The Illinois Department shall collect | 8 | | data in a
usable form to track utilization of Healthy Kids | 9 | | screening examinations by
children eligible for Healthy Kids | 10 | | services, including but not limited to
data showing screening | 11 | | examinations and immunizations received, a summary
of | 12 | | follow-up treatment received by children eligible for Healthy | 13 | | Kids
services and the number of children receiving dental, | 14 | | hearing and vision
services.
| 15 | | (i) On and after July 1, 2012, the Department shall reduce | 16 | | any rate of reimbursement for services or other payments or | 17 | | alter any methodologies authorized by this Code to reduce any | 18 | | rate of reimbursement for services or other payments in | 19 | | accordance with Section 5-5e. | 20 | | (j) To ensure full access to the benefits set forth in this | 21 | | Section, on and after January 1, 2022, the Illinois Department | 22 | | shall ensure that provider and hospital reimbursements for | 23 | | immunization as required under this Section are no lower than | 24 | | the Medicare reimbursement rate. | 25 | | (Source: P.A. 97-689, eff. 6-14-12.)
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| 1 | | Section 10. The Immunization Data Registry Act is amended | 2 | | by changing Section 15 as follows: | 3 | | (410 ILCS 527/15)
| 4 | | Sec. 15. Provision of immunization data to registry; | 5 | | exemption forms;
written information on immunization registry.
| 6 | | (a) A health care provider, physician's designee, or | 7 | | pharmacist's
designee shall may provide immunization data to | 8 | | be entered into the immunization data
registry in a manner | 9 | | prescribed by the Department and for the
purposes allowed | 10 | | under this Act unless the patient or the patient's parent or | 11 | | guardian, if the patient is less than
18 years of age,
has | 12 | | completed and filed with the provider, physician's designee, | 13 | | or
pharmacist's designee a written immunization data exemption | 14 | | form . | 15 | | (b) The Department shall create and provide copies of
| 16 | | immunization data exemption forms to health care providers who | 17 | | are authorized to
administer immunizations and
individuals
who | 18 | | request the form.
The forms shall also be accessible from the | 19 | | immunization data registry system itself. | 20 | | (c) The Department shall distribute to health care | 21 | | providers, upon
request, written information to be | 22 | | disseminated to patients that
describes the immunization data | 23 | | registry. The written information
and the immunization data | 24 | | exemption forms must include all of the following information:
| 25 | | (1) A description of the immunization data registry |
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| 1 | | and its purpose. | 2 | | (2) That the health care provider shall may report | 3 | | immunization data to the Department to be entered into the
| 4 | | immunization data registry.
| 5 | | (3) (Blank) That the patient or the patient's parent | 6 | | or guardian, if the
patient is less than 18 years of age, | 7 | | has a right to
exempt disclosure of immunization data to | 8 | | the registry and may
prevent disclosure by signing an | 9 | | immunization data exemption
form .
| 10 | | (4) (Blank) That the patient or the patient's parent | 11 | | or guardian, if the
patient is less than 18 years of age, | 12 | | may have the
individual's information removed from the | 13 | | immunization data
registry .
| 14 | | (5) (Blank) Instructions on how to have the | 15 | | information removed .
| 16 | | (Source: P.A. 97-117, eff. 7-14-11.)
| 17 | | Section 99. Effective date. This Act takes effect January | 18 | | 1, 2022.
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