Healthcare

Amends the Medicare-Medicaid Alignment Initiative (MMAI) Nursing Home Residents' Managed Care Rights Law of the Illinois Public Aid Code. Provides that the Article applies to a fully integrated dual eligible special needs plan and any managed care plan for persons who are dually eligible for Medicare and Medicaid. Adds to the definition of "Demonstration Project", a fully integrated dual eligible special needs plan and any managed care plan for persons who are dually eligible for Medicare and Medicaid. Provides that the Department of Healthcare and Family Services shall provide each managed care organization with the quarterly facility-specific nursing component (instead of RUG-IV nursing component) per diem along with any add-ons for enhanced care services, support component per diem, and capital component per diem effective for each nursing home under contract with the managed care organization. Effective immediately.

Amends the Children's Mental Health Act. In provisions concerning the Children's Mental Health Partnership, makes changes to the Partnership's list of duties to include (i) reviewing or facilitating needs assessments (rather than conducting research assessments) to better understand the challenges and gaps of programs, services, and policies related to children's mental health; (ii) monitoring policy development related to children's mental health in Illinois at the local, State, and federal level; and (iii) regularly reviewing aggregate and de-identified data on the need for children's behavioral health services in Illinois that is collected by the Behavioral Health Care and Ongoing Navigation (BEACON) portal to ensure that system transformation can continue to be driven by data. Provides that the Partnership's membership shall include public members who reflect a diversity of sexual orientation; and that all Partnership members shall serve without compensation and with no entitlement to reimbursement for expenses incurred in the performance of their duties. Removes a provision permitting the Partnership to convene study groups. Expands the membership of the adjunct council to include up to 10 youth aged 16 to 25 (rather than up to 6 youth aged 14 to 25) and up to 4 (rather than a minimum of 4) representatives of 4 different community-based organizations that focus on youth mental health. Makes other changes.

Amends the Mental Health and Developmental Disabilities Administrative Act and the Rehabilitation of Persons with Disabilities Act. Required the Department of Human Services to provide informational materials about the Senator Scott Bennett ABLE Program to: persons who are placed in a facility licensed under the ID/DD Community Care Act, the MC/DD Act, or the Specialized Mental Health Rehabilitation Act of 2013; persons with disabilities who receive services funded by or administered in conjunction with the Department, including, but not limited to, home and community based services, home-based support services, PUNS services, home care services, and services at a Center for Independent Living. Provides that the informational materials shall be provided when a person first enrolls for such services and as part of any annual process required for the person to maintain eligibility for such services. Requires the Office of the State Treasurer to prepare and deliver the informational materials in an electronic format to the Department and distribute the materials to eligible persons.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides medical assistance coverage for sickle cell disease (rather than sickle cell anemia).

Creates the Sexual Orientation, Gender Identity, and Gender Expression in Long-Term Care Bill of Rights Act. Establishes rights for a client who lives in a long-term care facility, or who receives home care services from a home care provider, from discrimination on the basis of actual or perceived sex, actual or perceived sexual orientation, actual or perceived gender identity, actual or perceived gender expression, or actual or perceived HIV status. Provides that an aggrieved person may enforce violations of the Act against a long-term care facility or a home care provider and the staff of the long-term care facility or home care provider through a civil action. Sets forth provisions concerning gender identity in client records; required training for all long-term care facilities and home care providers; arbitration agreements; interpretation of the Act; and enforcement of rights, including civil penalties and other administrative actions. Amends the Assisted Living and Shared Housing Act, the Nursing Home Care Act, and the Home Health, Home Services, and Home Nursing Agency Licensing Act to require compliance with the Sexual orientation, Gender Identity, and Gender Expression in Long-Term Care Bill of Rights Act. Amends the Adult Protective Services Act to include intentional misgendering and unlawful discrimination in the definition of "abuse".

Amends the Unified Code of Corrections. Provides within 24 hours of admission to a correctional institution or facility of the Department of Corrections, each committed person shall be screened for substance use disorders as part of an initial and ongoing substance use screening and assessment process. Provides that this process includes screening and assessment for opioid use disorders. Provides that if at any time a committed person screens positive as having or being at risk for an opioid use disorder, is diagnosed with an opioid use disorder or is exhibiting symptoms of withdrawal from an opioid use disorder, and medication assisted treatment is clinically indicated by a licensed physician, a licensed physician assistant, or a licensed nurse practitioner, then the individual may consent to commence medications for opioid use disorder, which shall be provided by the Department. Provides that the committed person shall be authorized to receive the medication immediately and for as long as clinically indicated. Provides that upon reentry, the Department shall provide an individual participating in medication assisted treatment with a referral to a community-based provider who may assist the individual with continued medications for opioid use disorder and medication assisted treatment care.

Creates the Protective Medical Equipment Freedom Act. Provides that all individual in the State have the right to wear protective medical equipment in any place of public accommodation where they have a lawful right to be without obligation to disclose health status or any other protected information, and no person, entity, or authority shall deny, restrict, or infringe upon this right. Provides that operators and public officials shall not discriminate against or penalize medical device wearers for exercising their right to wear protective medical equipment. Provides that discrimination under the Act includes, but is not limited to: denial of service; eviction from premises; any form of harassment to remove or refrain from wearing such equipment for any amount of time; specified actions taken by employers; and provision of unequal goods, services, facilities, advantages, or accommodations. Sets forth provisions concerning the protection against retaliation, the exceptions for security requirements, operational safety, age and identity restricted products, and financial institution customer identification, and an undue hardship exemption. Effective immediately.

Amends the Emergency Medical Services (EMS) Systems Act. Makes changes to defined terms. Replaces references to Primary Stroke Centers with Stroke Centers. Provides that a hospital that no longer meets nationally recognized, evidence-based standards for Stroke Centers, loses its Stroke Center certification, or has any change to its designation level shall notify the Department of Public Health and the Regional EMS Advisory Committee within 5 business days. Requires the Department to consult with the State Stroke Advisory Subcommittee for the adoption or deletion of approved stroke designation levels. Provides that the approved stroke designation levels shall coincide with the stroke designation levels recognized by Department-approved certifying bodies. Requires the Department to establish reporting requirements for designated Stroke Centers to capture information using new or existing electronic reporting tools for statewide data collection and certification purposes. Removes provisions concerning previous Stroke Center designations. Makes other changes.

Amends the Nursing Home Care Act and the Assisted Living and Shared Housing Act. Requires the Department of Public Health to hold semiannual joint training sessions for surveyors, nursing home providers, and assisted living establishment providers. Provides that the Department shall include the State long-term care ombudsman, or the State long-term care ombudsman's designee, and representatives of each nursing home provider association and assisted living provider association in the State in the planning process to create the topics and content of the joint training sessions as well as the coordination and presentations for the joint training sessions. Provides that, at least annually, a joint training session shall include, but not be limited to, regional citation patterns relating to complaints, standards, and outcomes in the nursing home and assisted living survey process. Requires the Department to develop standardized training for establishments to prevent common citations in the assisted living survey process.

Amends the Illinois Insurance Code. Establishes reimbursement rates for mental health and substance use disorder treatment services for all group or individual policies of accident and health insurance or managed care plans that are amended, delivered, issued, or renewed on or after January 1, 2027 or for any contracted third party administering the behavioral health benefits for the insurer. Requires a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2026 or any contracted third party administering the behavioral health benefits for the insurer to cover certain medically necessary mental health and substance use disorder treatment services. Provides that, if the Department of Insurance determines that an insurer or a contracted third party administering the behavioral health benefits for the insurer has violated a provision concerning mental health and substance use parity, the Department shall by order assess a civil penalty of $1,000 for each violation. Excludes certain health care plans serving Medicaid populations who are enrolled under the Illinois Public Aid Code or under the Children's Health Insurance Program Act from provisions concerning mental health and substance use parity. Requires the Department to review the impact of the proposed mental health and substance abuse mandate on network adequacy for mental health and substance use disorder treatment and access to affordable mental health and substance use care. Permits the Department to examine out-of-network utilization and out-of-pocket costs for insureds for mental health and substance use treatment and services for all plans to compare with in-network utilization. Amends the State Employees Group Insurance Act of 1971, the Counties Code, the Illinois Municipal Code, and the School Code to require coverage under those provisions. Effective immediately.