Amends the Nursing Home Care Act. Replaces provisions concerning serious mental illness rescreening. Provides that all persons admitted to a nursing home facility with a diagnosis of serious mental illness shall receive a follow-up visit within 60 days after admission and shall receive a resident review by the Department of Human Services or its designee promptly after a significant change in the resident's physical or mental condition. Provides that the Department of Human Services shall ensure there are no conflicts of interest for pre-admission screeners.
Amends the Medical Assistance Article of the Illinois Public Aid Code. In provisions concerning non-emergency transportation services for medical assistance recipients, removes a requirement that facilities complete a Physician Certification Statement prior to ordering non-emergency transportation services for a patient. Instead, requires the Department of Healthcare and Family Services to develop, subject to federal approval, a Uniform Non-Emergency Transportation Certification Form (form) for non-emergency transportation. Provides that the form shall be the only form used by and required of all facilities, physicians, transportation providers, and transportation brokers whenever a patient or person covered by the medical assistance program is being transported from a facility or personal residence and requires non-emergency transportation. Makes corresponding changes to the Nursing Home Care Act and the Hospital Licensing Act. Further amends the Medical Assistance Article with a provision authorizing transportation brokers to use a network of independent driver providers for the delivery of covered transportation services. Provides that transportation brokers and participating independent driver providers shall be subject to the same driver credentialing and licensing standards and provider registration requirements as transportation network companies (TNC) and TNC drivers enrolled in the Impact Medicaid Program Advanced Cloud Technology system. With respect to the Department's Business Enterprise Program requirements for Medicaid managed care organizations (MCO), requires each MCO to submit only one Letter of Intent that consolidates and sets forth all pending transportation services from all BEP-certified transportation providers contracted with the MCO. Requires the Department to permit a MCO's transportation broker to attest to the accuracy of all claims for services provided by a contracted transportation provider.
Amends the Program of All-Inclusive Care for the Elderly Act. Provides that to ensure that organizations contracted to implement the Program of All-Inclusive Care for the Elderly (PACE) program meet the needs of PACE participants, the Department of Healthcare and Family Services shall reform the rate-setting methodology for the PACE program by establishing a blended rate structure based on a 30% Home and Community-Based Services and 70% Skilled Nursing Facility case-mix which is a more accurate proportion of the comparable population expected to reside in an institution or the community if not enrolled in PACE. Requires the blended rate structure to more accurately reflect the comprehensive nature of care provided by PACE organizations and address the unique needs of PACE participants as a higher risk/acuity population with expected higher costs and frailty than comparable populations. Provides that when developing rates under the blended rate structure, the Department must consider not only the standard cost experiences of PACE participants but also the unique characteristics and specific care needs of the PACE population as well as any additional State plan services or populations that are not included in the State's Medicaid managed care contracts but are required under the PACE program.
Amends the Assisted Living and Shared Housing Act, the Nursing Home Care Act, the MC/DD Act, the ID/DD Community Care Act, and the Illinois Public Aid Code. Provides that the administrator of a facility or establishment under any of those Acts shall ensure that the facility or establishment has an automated external defibrillator and policies and procedures for the rendering of automated external defibrillation in the facility or establishment. Provides course requirements for persons certified to provide automated external defibrillation. Provides that a facility or establishment shall contract with or employ a physician who shall be the automated external defibrillation medical director for the facility or establishment and who shall oversee and coordinate specified requirements.
Amends the Genetic Information Privacy Act. Removes language exempting insurers that are issuing a long-term care policy from specified provisions. Provides that, with regard to any policy, contract, or plan offered, entered into, issued, amended, or renewed on or after January 1, 2026 by a health insurer, life insurer, or long-term care insurer authorized to transact insurance in this State, a health insurer, life insurer, or long-term care insurer may not: (1) cancel, limit, or deny coverage or establish differentials in premium rates based on a person's genetic information; or (2) require or solicit an individual's genetic information, use an individual's genetic test results, or consider an individual's decisions or actions relating to genetic information or a genetic test in any manner for any insurance purpose. Provides that the provisions may not be construed as preventing a life insurer or long-term care insurer from accessing an individual's medical record as part of an application exam. Provides that nothing in the provisions prohibits a life insurer or long-term care insurer from considering a medical diagnosis included in an individual's medical record, even if the diagnosis is based on the results of a genetic test. Effective July 1, 2025.
Amends the Nursing Home Care Act. Adds infection preventionists, minimum data set assessment nurses, other social workers, certified nursing assistant interns, and medication aides to the list of direct care staff used to compute staff to resident ratios. Provides that, except as otherwise provided by law, 100% of the hours worked by the specified staff shall be counted toward the staff to resident ratio. Provides that no monetary penalties shall be imposed unless the variance between a facility's minimum staffing ratios and the Department of Public Health's computations exceeds 20%. Removes a provision prohibiting waiver of a monetary penalty for non-compliance. In provisions concerning reporting requirements for facilities that violate the minimum staffing requirements, provides that the facility must have a variance that exceeds 20% of the requirements. Makes other changes. Effective immediately.
Amends the Nursing Home Care Act. Adds infection preventionists, minimum data set assessment nurses, other social workers, certified nursing assistant interns, and medication aides to the list of direct care staff used to compute staff to resident ratios. Provides that, except as otherwise provided by law, 100% of the hours worked by the specified staff shall be counted toward the staff to resident ratio. Provides that no monetary penalties shall be imposed unless the variance between a facility's minimum staffing ratios and the Department of Public Health's computations exceeds 20%. Removes a provision prohibiting waiver of a monetary penalty for non-compliance. In provisions concerning reporting requirements for facilities that violate the minimum staffing requirements, provides that the facility must have a variance that exceeds 20% of the requirements. Makes other changes. Effective immediately.
Amends the Illinois Food, Drug and Cosmetic Act. Provides that any health care practitioner authorized by applicable law to issue prescriptions for Schedule II controlled substances shall, prior to issuing an initial prescription for a Schedule II controlled substance or any other opioid pain reliever during a course of treatment for acute or chronic pain shall discuss with the patient or the patient's parent or guardian, if the patient is under 18 years of age and is not an emancipated minor, the risks associated with the drugs being described. Provides that the discussion required by this provision shall take place before issuing an initial prescription, and again prior to issuing the third prescription during a course of treatment. Provides that the prescribing health care practitioner shall include a note in the patient's medical record that the patient or the patient's parent or guardian, as applicable, has discussed with the practitioner the risks of developing a physical or psychological dependence on the controlled dangerous substance and on alternative treatments that may be available. Provides that these provisions do not apply to prescriptions for a patient who is currently in an active treatment for cancer, receiving hospice care from a licensed hospice or palliative care provider, for a patient who is a resident of a long-term care facility, or to any medications being prescribed for use in the treatment of substance abuse or opioid dependence.
Amends the Assisted Living and Shared Housing Act, the Nursing Home Care Act, the MC/DD Act, the ID/DD Community Care Act, and the Illinois Public Aid Code. Provides that the administrator of a facility or establishment under any of those Acts shall ensure that the facility or establishment has an automated external defibrillator and policies and procedures for the rendering of automated external defibrillation in the facility or establishment. Provides course requirements for persons certified to provide automated external defibrillation. Provides that a facility or establishment shall contract with or employ a physician who shall be the automated external defibrillation medical director for the facility or establishment and who shall oversee and coordinate specified requirements.
Amends the Assisted Living and Shared Housing Act. Requires individual residents to be assessed prior to admission using assessment tools that are approved or recommended by recognized Alzheimer's and dementia care experts, ensuring that the tools are validated for accurately identifying and evaluating cognitive impairments related to Alzheimer's disease and other forms of dementia. Provides that these tools shall be reviewed and updated as needed to align with current best practices and clinical standards in dementia care.
