State of Illinois
90th General Assembly
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90_HB3144

      305 ILCS 5/5-19           from Ch. 23, par. 5-19
          Amends the Illinois Public Aid Code by making a stylistic
      change to the Section concerning the Healthy Kids Program.
                                                     LRB9011148MWpc
                                               LRB9011148MWpc
 1        AN ACT to amend the Illinois Public Aid Code by  changing
 2    Section 5-19.
 3        Be  it  enacted  by  the People of the State of Illinois,
 4    represented in the General Assembly:
 5        Section 5.  The Illinois Public Aid Code  is  amended  by
 6    changing Section 5-19 as follows:
 7        (305 ILCS 5/5-19) (from Ch. 23, par. 5-19)
 8        Sec. 5-19.  Healthy Kids Program.
 9        (a)  Any  child  under  the age of 21 eligible to receive
10    Medical Assistance from the Illinois Department under Article
11    V of this Code shall  be  eligible  for  Early  and  Periodic
12    Screening,  Diagnosis  and Treatment services provided by the
13    Healthy Kids Program of the  Illinois  Department  under  the
14    Social Security Act, 42 U.S.C. 1396d(r).
15        (b)  Enrollment  of  Children  in Medicaid.  The Illinois
16    Department shall provide for receipt and  initial  processing
17    of applications for Medical Assistance for all pregnant women
18    and  children under the age of 21 at locations in addition to
19    those used for processing applications for  cash  assistance,
20    including   disproportionate   share   hospitals,   federally
21    qualified  health  centers and other sites as selected by the
22    Illinois Department.
23        (c)  Healthy Kids Examinations.  The Illinois  Department
24    shall  consider  any  examination of a child eligible for the
25    Healthy Kids services provided by a medical provider  meeting
26    the requirements and complying with the rules and regulations
27    of the Illinois Department to be reimbursed as a Healthy Kids
28    examination.
29        (d)  Medical Screening Examinations.
30             (1)  The  Illinois  Department shall insure Medicaid
31        coverage for periodic health, vision, hearing, and dental
                            -2-                LRB9011148MWpc
 1        screenings  for  children  eligible  for   Healthy   Kids
 2        services  scheduled  from  a  child's  birth up until the
 3        child turns 21 years. The Illinois Department  shall  pay
 4        for   vision,   hearing,   dental  and  health  screening
 5        examinations for any  child  eligible  for  Healthy  Kids
 6        services  by qualified providers at intervals established
 7        by Department rules.
 8             (2)  The  Illinois  Department  shall  pay  for   an
 9        interperiodic   health,   vision,   hearing,   or  dental
10        screening examination for any child eligible for  Healthy
11        Kids services whenever an examination is:
12                  (A)  requested  by  a child's parent, guardian,
13             or custodian, or is determined to  be  necessary  or
14             appropriate   by   social  services,  developmental,
15             health, or educational personnel; or
16                  (B)  necessary for enrollment in school; or
17                  (C)  necessary for enrollment in a licensed day
18             care program, including Head Start; or
19                  (D)  necessary  for  placement  in  a  licensed
20             child welfare facility,  including  a  foster  home,
21             group home or child care institution; or
22                  (E)  necessary  for  attendance  at  a  camping
23             program; or
24                  (F)  necessary    for   participation   in   an
25             organized athletic program; or
26                  (G)  necessary  for  enrollment  in  an   early
27             childhood   education   program  recognized  by  the
28             Illinois State Board of Education; or
29                  (H)  necessary for participation  in  a  Women,
30             Infant, and Children (WIC) program; or
31                  (I)  deemed   appropriate   by   the   Illinois
32             Department.
33        (e)  Minimum  Screening  Protocols  For  Periodic  Health
34    Screening  Examinations.   Health Screening Examinations must
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 1    include the following services:
 2             (1)  Comprehensive Health and Development Assessment
 3        including:
 4                  (A)  Development/Mental     Health/Psychosocial
 5             Assessment; and
 6                  (B)  Assessment of nutritional status including
 7             tests for iron deficiency and anemia for children at
 8             the following ages: 9 months, 2 years, 8 years,  and
 9             18 years;
10             (2)  Comprehensive unclothed physical exam;
11             (3)  Appropriate  immunizations  at  a  minimum,  as
12        required  by  the  Secretary  of  the  United States U.S.
13        Department of Health and Human Services under  42  U.S.C.
14        1396d(r).
15             (4)  Appropriate  laboratory  tests  including blood
16        lead levels appropriate for age and risk factors.
17                  (A)  Anemia test.
18                  (B)  Sickle cell test.
19                  (C)  Tuberculin test at 12 months  of  age  and
20             every  1-2  years  thereafter  unless  the  treating
21             health  care professional determines that testing is
22             medically contraindicated.
23                  (D)  Other --  The  Illinois  Department  shall
24             insure  that  testing  for  HIV,  drug exposure, and
25             sexually transmitted diseases  is  provided  for  as
26             clinically indicated.
27             (5)  Health   Education.   The  Illinois  Department
28        shall require providers to provide anticipatory  guidance
29        as recommended by the American Academy of Pediatrics.
30             (6)  Vision   Screening.   The  Illinois  Department
31        shall require  providers  to  provide  vision  screenings
32        consistent  with  those  set  forth  in the Department of
33        Public Health's Administrative Rules.
34             (7)  Hearing  Screening.   The  Illinois  Department
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 1        shall require providers  to  provide  hearing  screenings
 2        consistent  with  those  set  forth  in the Department of
 3        Public Health's Administrative Rules.
 4             (8)  Dental  Screening.   The  Illinois   Department
 5        shall  require  providers  to  provide  dental screenings
 6        consistent with those set  forth  in  the  Department  of
 7        Public Health's Administrative Rules.
 8        (f)  Covered  Medical  Services.  The Illinois Department
 9    shall  provide  coverage  for  all  necessary  health   care,
10    diagnostic  services, treatment and other measures to correct
11    or ameliorate defects, physical  and  mental  illnesses,  and
12    conditions  whether  discovered  by the screening services or
13    not for all children eligible for  Medical  Assistance  under
14    Article V of this Code.
15        (g)  Notice of Healthy Kids Services.
16             (1)  The  Illinois Department shall inform any child
17        eligible for Healthy Kids services and the child's family
18        about  the  benefits  provided  under  the  Healthy  Kids
19        Program, including, but not limited  to,  the  following:
20        what services are available under Healthy Kids, including
21        discussion  of the periodicity schedules and immunization
22        schedules, that services  are  provided  at  no  cost  to
23        eligible  children,  the  benefits  of  preventive health
24        care, where the services are  available,  how  to  obtain
25        them,  and  that  necessary transportation and scheduling
26        assistance is available.
27             (2)  The   Illinois    Department    shall    widely
28        disseminate information regarding the availability of the
29        Healthy  Kids  Program  throughout  the State by outreach
30        activities which shall include, but not  be  limited  to,
31        (i)  the development of cooperation agreements with local
32        school  districts,  public  health   agencies,   clinics,
33        hospitals  and  other  health  care  providers, including
34        developmental disability and mental health providers, and
                            -5-                LRB9011148MWpc
 1        with charities, to notify the constituents of each of the
 2        Program  and  assist  individuals,  as   feasible,   with
 3        applying for the Program, (ii) using the media for public
 4        service  announcements and advertisements of the Program,
 5        and (iii) developing posters advertising the Program  for
 6        display in hospital and clinic waiting rooms.
 7             (3)  The  Illinois Department shall utilize accepted
 8        methods for informing persons who are illiterate,  blind,
 9        deaf,   or   cannot   understand  the  English  language,
10        including   but   not   limited   to   public    services
11        announcements  and advertisements in the foreign language
12        media of radio, television and newspapers.
13             (4)  The Illinois Department shall provide notice of
14        the Healthy Kids Program  to  every  child  eligible  for
15        Healthy  Kids  services  and  his  or  her  family at the
16        following times:
17                  (A)  orally by the intake worker and in writing
18             at the time of application for Medical Assistance;
19                  (B)  at the time the applicant is informed that
20             he  or  she  is  eligible  for  Medical   Assistance
21             benefits; and
22                  (C)  at  least  20  days before the date of any
23             periodic  health,  vision,   hearing,   and   dental
24             examination  for any child eligible for Healthy Kids
25             services. Notice given under this  subparagraph  (C)
26             must state that a screening examination is due under
27             the   periodicity  schedules  and  must  advise  the
28             eligible child  and  his  or  her  family  that  the
29             Illinois   Department  will  provide  assistance  in
30             scheduling  an  appointment  and  arranging  medical
31             transportation.
32        (h)  Data  Collection.   The  Illinois  Department  shall
33    collect data in a usable form to track utilization of Healthy
34    Kids screening examinations by children eligible for  Healthy
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 1    Kids  services,  including  but  not  limited to data showing
 2    screening examinations and immunizations received, a  summary
 3    of  follow-up  treatment  received  by  children eligible for
 4    Healthy Kids services and the number  of  children  receiving
 5    dental, hearing and vision services.
 6    (Source: P.A. 87-630; 87-895.)

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