Bill Text: IL HB3893 | 2011-2012 | 97th General Assembly | Enrolled

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Creates the Consumer Alternatives Program Act. Directs the Department of Human Services to implement the Consumer Alternatives Program to prevent or avoid the unnecessary institutional care treatment of individuals with mental disorders or a co-occurring disorder of mental illness and substance abuse or addiction and to provide cost effective, community alternatives and supports that enable these individuals to live successfully in the community. Requires implementation of the Program during fiscal year 2013. Makes implementation of the Program dependent upon funds appropriated by the General Assembly. Provides that participants in the program may receive certain services such as a comprehensive evaluation that includes an assessment of skills, abilities, and potential for living in the community and work placement; family or individual support services; case coordination services; and vocational training. Prohibits the denial of program services because of age, sex, ethnic origin, marital status, ability to pay (except when contrary to law), degree of disability, or illness. Requires the Department of Commerce and Economic Opportunity to assist the Department of Human Services in developing housing assistance programs aimed at promoting the ability of individuals with a mental disorder to move from institutions to the most integrated community residence. Effective July 1, 2012.

Spectrum: Strong Partisan Bill (Democrat 16-1)

Status: (Passed) 2012-08-24 - Public Act . . . . . . . . . 97-1061 [HB3893 Detail]

Download: Illinois-2011-HB3893-Enrolled.html

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AN ACT concerning health.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Alcoholism and Other Drug Abuse and
Dependency Act is amended by changing Section 1-10 as follows:
(20 ILCS 301/1-10)
Sec. 1-10. Definitions. As used in this Act, unless the
context clearly indicates otherwise, the following words and
terms have the following meanings:
"Act" means the Alcoholism and Other Drug Abuse and
Dependency Act.
"Addict" means a person who exhibits the disease known as
"addiction".
"Addiction" means a disease process characterized by the
continued use of a specific psycho-active substance despite
physical, psychological or social harm. The term also describes
the advanced stages of chemical dependency.
"Administrator" means a person responsible for
administration of a program.
"Alcoholic" means a person who exhibits the disease known
as "alcoholism".
"Alcoholism" means a chronic and progressive disease or
illness characterized by preoccupation with and loss of control

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over the consumption of alcohol, and the use of alcohol despite
adverse consequences. Typically, combinations of the following
tendencies are also present: periodic or chronic intoxication;
physical disability; impaired emotional, occupational or
social adjustment; tendency toward relapse; a detrimental
effect on the individual, his family and society; psychological
dependence; and physical dependence. Alcoholism is also known
as addiction to alcohol. Alcoholism is described and further
categorized in clinical detail in the DSM and the ICD.
"Array of services" means assistance to individuals,
families and communities in response to alcohol or other drug
abuse or dependency. The array of services includes, but is not
limited to: prevention assistance for communities and schools;
case finding, assessment and intervention to help individuals
stop abusing alcohol or other drugs; a uniform screening,
assessment, and evaluation process including criteria for
substance use disorders and mental disorders or co-occurring
substance use and mental health disorders; case management;
detoxification to aid individuals in physically withdrawing
from alcohol or other drugs; short-term and long-term treatment
and support services to help individuals and family members
begin the process of recovery; prescription and dispensing of
the drug methadone or other medications as an adjunct to
treatment; relapse prevention services; education and
counseling for children or other co-dependents of alcoholics or
other drug abusers or addicts. For purposes of this Section, a

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uniform screening, assessment, and evaluation process refers
to a process that includes an appropriate evaluation and, as
warranted, a referral. "Uniform" does not mean the use of a
singular instrument, tool, or process that all must utilize.
"Case management" means those services which will assist
individuals in gaining access to needed social, educational,
medical, treatment and other services.
"Children of alcoholics or drug addicts or abusers of
alcohol and other drugs" means the minor or adult children of
individuals who have abused or been dependent upon alcohol or
other drugs. These children may or may not become dependent
upon alcohol or other drugs themselves; however, they are
physically, psychologically, and behaviorally at high risk of
developing the illness. Children of alcoholics and other drug
abusers experience emotional and other problems, and benefit
from prevention and treatment services provided by funded and
non-funded agencies licensed by the Department.
"Co-dependents" means individuals who are involved in the
lives of and are affected by people who are dependent upon
alcohol and other drugs. Co-dependents compulsively engage in
behaviors that cause them to suffer adverse physical,
emotional, familial, social, behavioral, vocational, and legal
consequences as they attempt to cope with the alcohol or drug
dependent person. People who become co-dependents include
spouses, parents, siblings, and friends of alcohol or drug
dependent people. Co-dependents benefit from prevention and

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treatment services provided by agencies licensed by the
Department.
"Controlled substance" means any substance or immediate
precursor which is enumerated in the schedules of Article II of
the Illinois Controlled Substances Act or the Cannabis Control
Act.
"Crime of violence" means any of the following crimes:
murder, voluntary manslaughter, criminal sexual assault,
aggravated criminal sexual assault, predatory criminal sexual
assault of a child, armed robbery, robbery, arson, kidnapping,
aggravated battery, aggravated arson, or any other felony which
involves the use or threat of physical force or violence
against another individual.
"Department" means the Illinois Department of Human
Services as successor to the former Department of Alcoholism
and Substance Abuse.
"Designated program" means a program designated by the
Department to provide services described in subsection (c) or
(d) of Section 15-10 of this Act. A designated program's
primary function is screening, assessing, referring and
tracking clients identified by the criminal justice system, and
the program agrees to apply statewide the standards, uniform
criteria and procedures established by the Department pursuant
to such designation.
"Detoxification" means the process of allowing an
individual to safely withdraw from a drug in a controlled

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environment.
"DSM" means the most current edition of the Diagnostic and
Statistical Manual of Mental Disorders.
"D.U.I." means driving under the influence of alcohol or
other substances which may cause impairment of driving ability.
"Facility" means the building or premises which are used
for the provision of licensable program services, including
support services, as set forth by rule.
"ICD" means the most current edition of the International
Classification of Diseases.
"Incapacitated" means that a person is unconscious or
otherwise exhibits, by overt behavior or by extreme physical
debilitation, an inability to care for his own needs or to
recognize the obvious danger of his situation or to make
rational decisions with respect to his need for treatment.
"Intermediary person" means a person with expertise
relative to addiction, alcoholism, and the abuse of alcohol or
other drugs who may be called on to assist the police in
carrying out enforcement or other activities with respect to
persons who abuse or are dependent on alcohol or other drugs.
"Intervention" means readily accessible activities which
assist individuals and their partners or family members in
coping with the immediate problems of alcohol and other drug
abuse or dependency, and in reducing their alcohol and other
drug use. Intervention can facilitate emotional and social
stability, and involves referring people for further treatment

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as needed.
"Intoxicated person" means a person whose mental or
physical functioning is substantially impaired as a result of
the current effects of alcohol or other drugs within the body.
"Local advisory council" means an alcohol and substance
abuse body established in a county, township or community area,
which represents public and private entities having an interest
in the prevention and treatment of alcoholism or other drug
abuse.
"Off-site services" means licensable program services or
activities which are conducted at a location separate from the
primary service location of the provider, and which services
are operated by a program or entity licensed under this Act.
"Person" means any individual, firm, group, association,
partnership, corporation, trust, government or governmental
subdivision or agency.
"Prevention" means an interactive process of individuals,
families, schools, religious organizations, communities and
regional, state and national organizations to reduce
alcoholism, prevent the use of illegal drugs and the abuse of
legal drugs by persons of all ages, prevent the use of alcohol
by minors, build the capacities of individuals and systems, and
promote healthy environments, lifestyles and behaviors.
"Program" means a licensable or fundable activity or
service, or a coordinated range of such activities or services,
as the Department may establish by rule.

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"Recovery" means the long-term, often life-long, process
in which an addicted person changes the way in which he makes
decisions and establishes personal and life priorities. The
evolution of this decision-making and priority-setting process
is generally manifested by an obvious improvement in the
individual's life and lifestyle and by his overcoming the abuse
of or dependence on alcohol or other drugs. Recovery is also
generally manifested by prolonged periods of abstinence from
addictive chemicals which are not medically supervised.
Recovery is the goal of treatment.
"Rehabilitation" means a process whereby those clinical
services necessary and appropriate for improving an
individual's life and lifestyle and for overcoming his or her
abuse of or dependency upon alcohol or other drugs, or both,
are delivered in an appropriate setting and manner as defined
in rules established by the Department.
"Relapse" means a process which is manifested by a
progressive pattern of behavior that reactivates the symptoms
of a disease or creates debilitating conditions in an
individual who has experienced remission from addiction or
alcoholism.
"Secretary" means the Secretary of Human Services or his or
her designee.
"Substance abuse" or "abuse" means a pattern of use of
alcohol or other drugs with the potential of leading to
immediate functional problems or to alcoholism or other drug

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dependency, or to the use of alcohol and/or other drugs solely
for purposes of intoxication. The term also means the use of
illegal drugs by persons of any age, and the use of alcohol by
persons under the age of 21.
"Treatment" means the broad range of emergency,
outpatient, intermediate and residential services and care
(including assessment, diagnosis, medical, psychiatric,
psychological and social services, care and counseling, and
aftercare) which may be extended to individuals who abuse or
are dependent on alcohol or other drugs or families of those
persons.
(Source: P.A. 89-202, eff. 7-21-95; 89-428, eff. 12-13-95;
89-462, eff. 5-29-96; 89-507, eff. 7-1-97; 90-14, eff. 7-1-97;
90-135, eff. 7-22-97.)
Section 8. The Illinois Public Aid Code is amended by
changing Section 5-5 as follows:
(305 ILCS 5/5-5) (from Ch. 23, par. 5-5)
Sec. 5-5. Medical services. The Illinois Department, by
rule, shall determine the quantity and quality of and the rate
of reimbursement for the medical assistance for which payment
will be authorized, and the medical services to be provided,
which may include all or part of the following: (1) inpatient
hospital services; (2) outpatient hospital services; (3) other
laboratory and X-ray services; (4) skilled nursing home

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services; (5) physicians' services whether furnished in the
office, the patient's home, a hospital, a skilled nursing home,
or elsewhere; (6) medical care, or any other type of remedial
care furnished by licensed practitioners; (7) home health care
services; (8) private duty nursing service; (9) clinic
services; (10) dental services, including prevention and
treatment of periodontal disease and dental caries disease for
pregnant women, provided by an individual licensed to practice
dentistry or dental surgery; for purposes of this item (10),
"dental services" means diagnostic, preventive, or corrective
procedures provided by or under the supervision of a dentist in
the practice of his or her profession; (11) physical therapy
and related services; (12) prescribed drugs, dentures, and
prosthetic devices; and eyeglasses prescribed by a physician
skilled in the diseases of the eye, or by an optometrist,
whichever the person may select; (13) other diagnostic,
screening, preventive, and rehabilitative services, including
to ensure that the individual's need for intervention or
treatment of mental disorders or substance use disorders or
co-occurring mental health and substance use disorders is
determined using a uniform screening, assessment, and
evaluation process inclusive of criteria, for children and
adults; for purposes of this item (13), a uniform screening,
assessment, and evaluation process refers to a process that
includes an appropriate evaluation and, as warranted, a
referral; "uniform" does not mean the use of a singular

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instrument, tool, or process that all must utilize; (14)
transportation and such other expenses as may be necessary;
(15) medical treatment of sexual assault survivors, as defined
in Section 1a of the Sexual Assault Survivors Emergency
Treatment Act, for injuries sustained as a result of the sexual
assault, including examinations and laboratory tests to
discover evidence which may be used in criminal proceedings
arising from the sexual assault; (16) the diagnosis and
treatment of sickle cell anemia; and (17) any other medical
care, and any other type of remedial care recognized under the
laws of this State, but not including abortions, or induced
miscarriages or premature births, unless, in the opinion of a
physician, such procedures are necessary for the preservation
of the life of the woman seeking such treatment, or except an
induced premature birth intended to produce a live viable child
and such procedure is necessary for the health of the mother or
her unborn child. The Illinois Department, by rule, shall
prohibit any physician from providing medical assistance to
anyone eligible therefor under this Code where such physician
has been found guilty of performing an abortion procedure in a
wilful and wanton manner upon a woman who was not pregnant at
the time such abortion procedure was performed. The term "any
other type of remedial care" shall include nursing care and
nursing home service for persons who rely on treatment by
spiritual means alone through prayer for healing.
Notwithstanding any other provision of this Section, a

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comprehensive tobacco use cessation program that includes
purchasing prescription drugs or prescription medical devices
approved by the Food and Drug Administration shall be covered
under the medical assistance program under this Article for
persons who are otherwise eligible for assistance under this
Article.
Notwithstanding any other provision of this Code, the
Illinois Department may not require, as a condition of payment
for any laboratory test authorized under this Article, that a
physician's handwritten signature appear on the laboratory
test order form. The Illinois Department may, however, impose
other appropriate requirements regarding laboratory test order
documentation.
The Department of Healthcare and Family Services shall
provide the following services to persons eligible for
assistance under this Article who are participating in
education, training or employment programs operated by the
Department of Human Services as successor to the Department of
Public Aid:
(1) dental services provided by or under the
supervision of a dentist; and
(2) eyeglasses prescribed by a physician skilled in the
diseases of the eye, or by an optometrist, whichever the
person may select.
Notwithstanding any other provision of this Code and
subject to federal approval, the Department may adopt rules to

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allow a dentist who is volunteering his or her service at no
cost to render dental services through an enrolled
not-for-profit health clinic without the dentist personally
enrolling as a participating provider in the medical assistance
program. A not-for-profit health clinic shall include a public
health clinic or Federally Qualified Health Center or other
enrolled provider, as determined by the Department, through
which dental services covered under this Section are performed.
The Department shall establish a process for payment of claims
for reimbursement for covered dental services rendered under
this provision.
The Illinois Department, by rule, may distinguish and
classify the medical services to be provided only in accordance
with the classes of persons designated in Section 5-2.
The Department of Healthcare and Family Services must
provide coverage and reimbursement for amino acid-based
elemental formulas, regardless of delivery method, for the
diagnosis and treatment of (i) eosinophilic disorders and (ii)
short bowel syndrome when the prescribing physician has issued
a written order stating that the amino acid-based elemental
formula is medically necessary.
The Illinois Department shall authorize the provision of,
and shall authorize payment for, screening by low-dose
mammography for the presence of occult breast cancer for women
35 years of age or older who are eligible for medical
assistance under this Article, as follows:

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(A) A baseline mammogram for women 35 to 39 years of
age.
(B) An annual mammogram for women 40 years of age or
older.
(C) A mammogram at the age and intervals considered
medically necessary by the woman's health care provider for
women under 40 years of age and having a family history of
breast cancer, prior personal history of breast cancer,
positive genetic testing, or other risk factors.
(D) A comprehensive ultrasound screening of an entire
breast or breasts if a mammogram demonstrates
heterogeneous or dense breast tissue, when medically
necessary as determined by a physician licensed to practice
medicine in all of its branches.
All screenings shall include a physical breast exam,
instruction on self-examination and information regarding the
frequency of self-examination and its value as a preventative
tool. For purposes of this Section, "low-dose mammography"
means the x-ray examination of the breast using equipment
dedicated specifically for mammography, including the x-ray
tube, filter, compression device, and image receptor, with an
average radiation exposure delivery of less than one rad per
breast for 2 views of an average size breast. The term also
includes digital mammography.
On and after January 1, 2012, providers participating in a
quality improvement program approved by the Department shall be

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reimbursed for screening and diagnostic mammography at the same
rate as the Medicare program's rates, including the increased
reimbursement for digital mammography.
The Department shall convene an expert panel including
representatives of hospitals, free-standing mammography
facilities, and doctors, including radiologists, to establish
quality standards.
Subject to federal approval, the Department shall
establish a rate methodology for mammography at federally
qualified health centers and other encounter-rate clinics.
These clinics or centers may also collaborate with other
hospital-based mammography facilities.
The Department shall establish a methodology to remind
women who are age-appropriate for screening mammography, but
who have not received a mammogram within the previous 18
months, of the importance and benefit of screening mammography.
The Department shall establish a performance goal for
primary care providers with respect to their female patients
over age 40 receiving an annual mammogram. This performance
goal shall be used to provide additional reimbursement in the
form of a quality performance bonus to primary care providers
who meet that goal.
The Department shall devise a means of case-managing or
patient navigation for beneficiaries diagnosed with breast
cancer. This program shall initially operate as a pilot program
in areas of the State with the highest incidence of mortality

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related to breast cancer. At least one pilot program site shall
be in the metropolitan Chicago area and at least one site shall
be outside the metropolitan Chicago area. An evaluation of the
pilot program shall be carried out measuring health outcomes
and cost of care for those served by the pilot program compared
to similarly situated patients who are not served by the pilot
program.
Any medical or health care provider shall immediately
recommend, to any pregnant woman who is being provided prenatal
services and is suspected of drug abuse or is addicted as
defined in the Alcoholism and Other Drug Abuse and Dependency
Act, referral to a local substance abuse treatment provider
licensed by the Department of Human Services or to a licensed
hospital which provides substance abuse treatment services.
The Department of Healthcare and Family Services shall assure
coverage for the cost of treatment of the drug abuse or
addiction for pregnant recipients in accordance with the
Illinois Medicaid Program in conjunction with the Department of
Human Services.
All medical providers providing medical assistance to
pregnant women under this Code shall receive information from
the Department on the availability of services under the Drug
Free Families with a Future or any comparable program providing
case management services for addicted women, including
information on appropriate referrals for other social services
that may be needed by addicted women in addition to treatment

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for addiction.
The Illinois Department, in cooperation with the
Departments of Human Services (as successor to the Department
of Alcoholism and Substance Abuse) and Public Health, through a
public awareness campaign, may provide information concerning
treatment for alcoholism and drug abuse and addiction, prenatal
health care, and other pertinent programs directed at reducing
the number of drug-affected infants born to recipients of
medical assistance.
Neither the Department of Healthcare and Family Services
nor the Department of Human Services shall sanction the
recipient solely on the basis of her substance abuse.
The Illinois Department shall establish such regulations
governing the dispensing of health services under this Article
as it shall deem appropriate. The Department should seek the
advice of formal professional advisory committees appointed by
the Director of the Illinois Department for the purpose of
providing regular advice on policy and administrative matters,
information dissemination and educational activities for
medical and health care providers, and consistency in
procedures to the Illinois Department.
Notwithstanding any other provision of law, a health care
provider under the medical assistance program may elect, in
lieu of receiving direct payment for services provided under
that program, to participate in the State Employees Deferred
Compensation Plan adopted under Article 24 of the Illinois

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Pension Code. A health care provider who elects to participate
in the plan does not have a cause of action against the State
for any damages allegedly suffered by the provider as a result
of any delay by the State in crediting the amount of any
contribution to the provider's plan account.
The Illinois Department may develop and contract with
Partnerships of medical providers to arrange medical services
for persons eligible under Section 5-2 of this Code.
Implementation of this Section may be by demonstration projects
in certain geographic areas. The Partnership shall be
represented by a sponsor organization. The Department, by rule,
shall develop qualifications for sponsors of Partnerships.
Nothing in this Section shall be construed to require that the
sponsor organization be a medical organization.
The sponsor must negotiate formal written contracts with
medical providers for physician services, inpatient and
outpatient hospital care, home health services, treatment for
alcoholism and substance abuse, and other services determined
necessary by the Illinois Department by rule for delivery by
Partnerships. Physician services must include prenatal and
obstetrical care. The Illinois Department shall reimburse
medical services delivered by Partnership providers to clients
in target areas according to provisions of this Article and the
Illinois Health Finance Reform Act, except that:
(1) Physicians participating in a Partnership and
providing certain services, which shall be determined by

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the Illinois Department, to persons in areas covered by the
Partnership may receive an additional surcharge for such
services.
(2) The Department may elect to consider and negotiate
financial incentives to encourage the development of
Partnerships and the efficient delivery of medical care.
(3) Persons receiving medical services through
Partnerships may receive medical and case management
services above the level usually offered through the
medical assistance program.
Medical providers shall be required to meet certain
qualifications to participate in Partnerships to ensure the
delivery of high quality medical services. These
qualifications shall be determined by rule of the Illinois
Department and may be higher than qualifications for
participation in the medical assistance program. Partnership
sponsors may prescribe reasonable additional qualifications
for participation by medical providers, only with the prior
written approval of the Illinois Department.
Nothing in this Section shall limit the free choice of
practitioners, hospitals, and other providers of medical
services by clients. In order to ensure patient freedom of
choice, the Illinois Department shall immediately promulgate
all rules and take all other necessary actions so that provided
services may be accessed from therapeutically certified
optometrists to the full extent of the Illinois Optometric

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Practice Act of 1987 without discriminating between service
providers.
The Department shall apply for a waiver from the United
States Health Care Financing Administration to allow for the
implementation of Partnerships under this Section.
The Illinois Department shall require health care
providers to maintain records that document the medical care
and services provided to recipients of Medical Assistance under
this Article. Such records must be retained for a period of not
less than 6 years from the date of service or as provided by
applicable State law, whichever period is longer, except that
if an audit is initiated within the required retention period
then the records must be retained until the audit is completed
and every exception is resolved. The Illinois Department shall
require health care providers to make available, when
authorized by the patient, in writing, the medical records in a
timely fashion to other health care providers who are treating
or serving persons eligible for Medical Assistance under this
Article. All dispensers of medical services shall be required
to maintain and retain business and professional records
sufficient to fully and accurately document the nature, scope,
details and receipt of the health care provided to persons
eligible for medical assistance under this Code, in accordance
with regulations promulgated by the Illinois Department. The
rules and regulations shall require that proof of the receipt
of prescription drugs, dentures, prosthetic devices and

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eyeglasses by eligible persons under this Section accompany
each claim for reimbursement submitted by the dispenser of such
medical services. No such claims for reimbursement shall be
approved for payment by the Illinois Department without such
proof of receipt, unless the Illinois Department shall have put
into effect and shall be operating a system of post-payment
audit and review which shall, on a sampling basis, be deemed
adequate by the Illinois Department to assure that such drugs,
dentures, prosthetic devices and eyeglasses for which payment
is being made are actually being received by eligible
recipients. Within 90 days after the effective date of this
amendatory Act of 1984, the Illinois Department shall establish
a current list of acquisition costs for all prosthetic devices
and any other items recognized as medical equipment and
supplies reimbursable under this Article and shall update such
list on a quarterly basis, except that the acquisition costs of
all prescription drugs shall be updated no less frequently than
every 30 days as required by Section 5-5.12.
The rules and regulations of the Illinois Department shall
require that a written statement including the required opinion
of a physician shall accompany any claim for reimbursement for
abortions, or induced miscarriages or premature births. This
statement shall indicate what procedures were used in providing
such medical services.
The Illinois Department shall require all dispensers of
medical services, other than an individual practitioner or

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group of practitioners, desiring to participate in the Medical
Assistance program established under this Article to disclose
all financial, beneficial, ownership, equity, surety or other
interests in any and all firms, corporations, partnerships,
associations, business enterprises, joint ventures, agencies,
institutions or other legal entities providing any form of
health care services in this State under this Article.
The Illinois Department may require that all dispensers of
medical services desiring to participate in the medical
assistance program established under this Article disclose,
under such terms and conditions as the Illinois Department may
by rule establish, all inquiries from clients and attorneys
regarding medical bills paid by the Illinois Department, which
inquiries could indicate potential existence of claims or liens
for the Illinois Department.
Enrollment of a vendor that provides non-emergency medical
transportation, defined by the Department by rule, shall be
conditional for 180 days. During that time, the Department of
Healthcare and Family Services may terminate the vendor's
eligibility to participate in the medical assistance program
without cause. That termination of eligibility is not subject
to the Department's hearing process.
The Illinois Department shall establish policies,
procedures, standards and criteria by rule for the acquisition,
repair and replacement of orthotic and prosthetic devices and
durable medical equipment. Such rules shall provide, but not be

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limited to, the following services: (1) immediate repair or
replacement of such devices by recipients without medical
authorization; and (2) rental, lease, purchase or
lease-purchase of durable medical equipment in a
cost-effective manner, taking into consideration the
recipient's medical prognosis, the extent of the recipient's
needs, and the requirements and costs for maintaining such
equipment. Such rules shall enable a recipient to temporarily
acquire and use alternative or substitute devices or equipment
pending repairs or replacements of any device or equipment
previously authorized for such recipient by the Department.
The Department shall execute, relative to the nursing home
prescreening project, written inter-agency agreements with the
Department of Human Services and the Department on Aging, to
effect the following: (i) intake procedures and common
eligibility criteria for those persons who are receiving
non-institutional services; and (ii) the establishment and
development of non-institutional services in areas of the State
where they are not currently available or are undeveloped.
The Illinois Department shall develop and operate, in
cooperation with other State Departments and agencies and in
compliance with applicable federal laws and regulations,
appropriate and effective systems of health care evaluation and
programs for monitoring of utilization of health care services
and facilities, as it affects persons eligible for medical
assistance under this Code.

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The Illinois Department shall report annually to the
General Assembly, no later than the second Friday in April of
1979 and each year thereafter, in regard to:
(a) actual statistics and trends in utilization of
medical services by public aid recipients;
(b) actual statistics and trends in the provision of
the various medical services by medical vendors;
(c) current rate structures and proposed changes in
those rate structures for the various medical vendors; and
(d) efforts at utilization review and control by the
Illinois Department.
The period covered by each report shall be the 3 years
ending on the June 30 prior to the report. The report shall
include suggested legislation for consideration by the General
Assembly. The filing of one copy of the report with the
Speaker, one copy with the Minority Leader and one copy with
the Clerk of the House of Representatives, one copy with the
President, one copy with the Minority Leader and one copy with
the Secretary of the Senate, one copy with the Legislative
Research Unit, and such additional copies with the State
Government Report Distribution Center for the General Assembly
as is required under paragraph (t) of Section 7 of the State
Library Act shall be deemed sufficient to comply with this
Section.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance

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with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 96-156, eff. 1-1-10; 96-806, eff. 7-1-10; 96-926,
eff. 1-1-11; 96-1000, eff. 7-2-10; 97-48, eff. 6-28-11; 97-638,
eff. 1-1-12.)
Section 10. The Community Services Act is amended by
changing Section 2 as follows:
(405 ILCS 30/2) (from Ch. 91 1/2, par. 902)
Sec. 2. Community Services System. Services should be
planned, developed, delivered and evaluated as part of a
comprehensive and coordinated system. The Department of Human
Services shall encourage the establishment of services in each
area of the State which cover the services categories described
below. What specific services are provided under each service
category shall be based on local needs; special attention shall
be given to unserved and underserved populations, including
children and youth, racial and ethnic minorities, and the
elderly. The service categories shall include:
(a) Prevention: services designed primarily to reduce the
incidence and ameliorate the severity of developmental
disabilities, mental illness and alcohol and drug dependence;
(b) Client Assessment and Diagnosis: services designed to

HB3893 Enrolled - 25 - LRB097 14519 KTG 60158 b
identify persons with developmental disabilities, mental
illness and alcohol and drug dependency; to determine the
extent of the disability and the level of functioning; to
ensure that the individual's need for treatment of mental
disorders or substance use disorders or co-occurring substance
use and mental health disorders is determined using a uniform
screening, assessment, and evaluation process inclusive of
criteria; for purposes of this subsection (b), a uniform
screening, assessment, and evaluation process refers to a
process that includes an appropriate evaluation and, as
warranted, a referral; "uniform" does not mean the use of a
singular instrument, tool, or process that all must utilize;
information obtained through client evaluation can be used in
individual treatment and habilitation plans; to assure
appropriate placement and to assist in program evaluation;
(c) Case Coordination: services to provide information and
assistance to disabled persons to insure that they obtain
needed services provided by the private and public sectors;
case coordination services should be available to individuals
whose functioning level or history of institutional recidivism
or long-term care indicate that such assistance is required for
successful community living;
(d) Crisis and Emergency: services to assist individuals
and their families through crisis periods, to stabilize
individuals under stress and to prevent unnecessary
institutionalization;

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(e) Treatment, Habilitation and Support: services designed
to help individuals develop skills which promote independence
and improved levels of social and vocational functioning and
personal growth; and to provide non-treatment support services
which are necessary for successful community living;
(f) Community Residential Alternatives to Institutional
Settings: services to provide living arrangements for persons
unable to live independently; the level of supervision,
services provided and length of stay at community residential
alternatives will vary by the type of program and the needs and
functioning level of the residents; other services may be
provided in a community residential alternative which promote
the acquisition of independent living skills and integration
with the community.
(Source: P.A. 89-507, eff. 7-1-97.)
Section 99. Effective date. This Act takes effect upon
becoming law.