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| Public Act 096-0799 |
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AN ACT concerning public aid.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Public Aid Code is amended by | ||||
changing Sections 5-24 and 12-4.201 as follows:
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(305 ILCS 5/5-24)
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(Section scheduled to be repealed on January 1, 2014)
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Sec. 5-24. Disease management programs and services for
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chronic conditions; pilot project.
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(a) In this Section, "disease management programs and
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services" means services administered to patients in order to | ||||
improve
their overall health and to prevent clinical | ||||
exacerbations and
complications, using cost-effective, | ||||
evidence-based practice
guidelines and patient self-management | ||||
strategies. Disease
management programs and services include | ||||
all of the following:
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(1) A population identification process.
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(2) Evidence-based or consensus-based clinical | ||||
practice
guidelines, risk identification, and matching of | ||||
interventions with
clinical need.
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(3) Patient self-management and disease education.
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(4) Process and outcomes measurement, evaluation, | ||||
management, and
reporting.
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(b) Subject to appropriations, the Department of | ||
Healthcare and Family Services may
undertake a pilot project to | ||
study patient outcomes, for patients with chronic
diseases or | ||
patients at risk of low birth weight or premature birth, | ||
associated with the use of disease management programs and | ||
services
for chronic condition management. "Chronic diseases" | ||
include, but are not
limited to, diabetes, congestive heart | ||
failure, and chronic obstructive
pulmonary disease. Low birth | ||
weight and premature birth include all medical and other | ||
conditions that lead to poor birth outcomes or problematic | ||
pregnancies.
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(c) The disease management programs and services pilot
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project shall examine whether chronic disease management | ||
programs and
services for patients with specific chronic | ||
conditions do any or all
of the following:
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(1) Improve the patient's overall health in a more | ||
expeditious
manner.
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(2) Lower costs in other aspects of the medical | ||
assistance program, such
as hospital admissions, days in | ||
skilled nursing homes, emergency room
visits, or more | ||
frequent physician office visits.
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(d) In carrying out the pilot project, the Department of | ||
Healthcare and Family Services shall
examine all relevant | ||
scientific literature and shall consult with
health care | ||
practitioners including, but not limited to, physicians,
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surgeons, registered pharmacists, and registered nurses.
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(e) The Department of Healthcare and Family Services shall | ||
consult with medical experts,
disease advocacy groups, and | ||
academic institutions to develop criteria
to be used in | ||
selecting a vendor for the pilot project.
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(f) The Department of Healthcare and Family Services may | ||
adopt rules to implement this
Section.
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(g) This Section is repealed 10 years after the effective | ||
date of this
amendatory Act of the 93rd General Assembly.
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(Source: P.A. 95-331, eff. 8-21-07.)
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(305 ILCS 5/12-4.201)
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Sec. 12-4.201. (a) Data warehouse concerning medical and | ||
related
services. The Department of Healthcare and Family | ||
Services may purchase services and
materials associated with | ||
the costs of developing and implementing a data
warehouse | ||
comprised of management and decision making information in
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regard to the liability associated with, and utilization of, | ||
medical and
related services, out of moneys available for that | ||
purpose. | ||
(b) The Department of Healthcare and Family Services shall | ||
perform all necessary administrative functions to expand its | ||
linearly-scalable data warehouse to encompass other healthcare | ||
data sources at both the Department of Human Services and the | ||
Department of Public Health. The Department of Healthcare and | ||
Family Services shall leverage the inherent capabilities of the | ||
data warehouse to accomplish this expansion with marginal | ||
additional technical administration. The purpose of
this | ||
expansion is to allow for programmatic review and analysis | ||
including the interrelatedness among the various healthcare | ||
programs in order to ascertain effectiveness toward, and | ||
ultimate impact on, clients. Beginning
July 1, 2005, the | ||
Department of Healthcare and Family Services (formerly | ||
Department of Public Aid) shall supply quarterly reports to the | ||
Commission on Government Forecasting and Accountability | ||
detailing progress toward this mandate.
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(c) The Department of Healthcare and Family Services (HFS), | ||
the Illinois Department of Public Health, the Illinois | ||
Department of Human Services, and the Division of Specialized | ||
Care for Children, University of Illinois at Chicago, with | ||
necessary support from the Department of Central Management | ||
Services, shall integrate into the medical data warehouse | ||
individual record level data owned by one of these agencies | ||
that pertains to maternal and child health, including the | ||
following data sets:
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(1) Vital Records as they relate to births, birth | ||
outcomes, and deaths. | ||
(2) Adverse Pregnancy Outcomes Reporting System | ||
(APORS). | ||
(3) Genetics/Newborn Screenings/SIDS. | ||
(4) Cornerstone (WIC, FCM, Teen Parents, | ||
Immunization). | ||
(5) HFS medical claims data. | ||
(6) I-CARE. | ||
(7) Children with Special Healthcare Needs Data. | ||
By September 1, 2009, the departments of Healthcare and | ||
Family Services, Public Health, and Human Services and the | ||
Division of Specialized Care for Children shall jointly prepare | ||
a work plan for fully integrating these data sets into the | ||
medical data warehouse. The work plan shall provide an overall | ||
project design, including defining a mutually acceptable | ||
transfer format for each discrete data set, the data update | ||
frequency, and a single method of data transfer for each data | ||
set. By October 1, 2009, the Department of Public Health shall | ||
grant to the Department of Healthcare and Family Services | ||
complete access to all vital records data. The Department of | ||
Public Health shall prepare a report detailing that this task | ||
has been accomplished and submit this report to the Commission | ||
on Government Forecasting and Accountability by October 15, | ||
2009. By March 1, 2010, the data sets shall be completely | ||
loaded into the medical data warehouse. By July 1, 2010, data | ||
from the various sources shall be processed so as to be | ||
compatible with other data in the medical data warehouse and | ||
available for analysis in an integrated manner. | ||
With the cooperation of the other agencies, HFS shall | ||
submit status reports on the progress of these efforts to the | ||
Governor and the General Assembly no later than October 1, 2009 | ||
and April 1, 2010, with a final report due no later than | ||
November 1, 2010. | ||
On an ongoing basis, the 4 agencies shall review the | ||
feasibility of adding data from additional sources to the | ||
warehouse. Such review may take into account the cost | ||
effectiveness of adding the data, the utility of adding data | ||
that is not available as identifiable individual record level | ||
data, the requirements related to adding data owned by another | ||
entity or not available in electronic form, whether sharing of | ||
the data is otherwise prohibited by law and the resources | ||
required and available for effecting the addition. | ||
The departments shall use analysis of the data in the | ||
medical data warehouse to improve maternal and child health | ||
outcomes, and in particular improve birth outcomes, and to | ||
reduce racial health disparities in this area. | ||
All access and use of the data shall be in compliance with | ||
all applicable federal and State laws, regulations, and | ||
mandates. | ||
Notwithstanding anything in this Section, data | ||
incorporated into the data warehouse shall remain subject to | ||
the same provisions of law regarding confidentiality and use | ||
restrictions as they are subject to in the control of the | ||
contributing agency. The Department of Healthcare and Family | ||
Services shall develop measures to ensure that the interplay of | ||
the several data sets contributed to the data warehouse does | ||
not lead to the use or release of data from the data warehouse | ||
that would not otherwise be subject to use or release under | ||
State or federal law. | ||
(Source: P.A. 94-267, eff. 7-19-05; 95-331, eff. 8-21-07.)
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Section 99. Effective date. This Act takes effect upon | ||
becoming law.
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