Illinois 2023-2024 Regular Session

Illinois Senate Bill SB0726 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	Public Act 103-0885
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3	2		SB0726 Enrolled LRB103 03199 CPF 48205 b
4		-	AN ACT concerning health.
5		-	Be it enacted by the People of the State of Illinois,
6		-	represented in the General Assembly:
7		-	Section 5. The School Code is amended by changing and
8		-	renumbering Section 2-3.196, as added by Public Act 103-546,
9		-	as follows:
10		-	(105 ILCS 5/2-3.203)
11		-	Sec. 2-3.203 2-3.196. Mental health screenings.
12		-	(a) On or before December 15, 2023, the State Board of
13		-	Education, in consultation with the Children's Behavioral
14		-	Health Transformation Officer, Children's Behavioral Health
15		-	Transformation Team, and the Office of the Governor, shall
16		-	file a report with the Governor and the General Assembly that
17		-	includes recommendations for implementation of mental health
18		-	screenings in schools for students enrolled in kindergarten
19		-	through grade 12. This report must include a landscape scan of
20		-	current district-wide screenings, recommendations for
21		-	screening tools, training for staff, and linkage and referral
22		-	for identified students.
23		-	(b) On or before October 1, 2024, the State Board of
24		-	Education, in consultation with the Children's Behavioral
25		-	Health Transformation Team, the Office of the Governor, and
26		-	relevant stakeholders as needed shall release a strategy that
	3	+	1 AN ACT concerning health.
	4	+	2 Be it enacted by the People of the State of Illinois,
	5	+	3 represented in the General Assembly:
	6	+	4 Section 5. The School Code is amended by changing and
	7	+	5 renumbering Section 2-3.196, as added by Public Act 103-546,
	8	+	6 as follows:
	9	+	7 (105 ILCS 5/2-3.203)
	10	+	8 Sec. 2-3.203 2-3.196. Mental health screenings.
	11	+	9 (a) On or before December 15, 2023, the State Board of
	12	+	10 Education, in consultation with the Children's Behavioral
	13	+	11 Health Transformation Officer, Children's Behavioral Health
	14	+	12 Transformation Team, and the Office of the Governor, shall
	15	+	13 file a report with the Governor and the General Assembly that
	16	+	14 includes recommendations for implementation of mental health
	17	+	15 screenings in schools for students enrolled in kindergarten
	18	+	16 through grade 12. This report must include a landscape scan of
	19	+	17 current district-wide screenings, recommendations for
	20	+	18 screening tools, training for staff, and linkage and referral
	21	+	19 for identified students.
	22	+	20 (b) On or before October 1, 2024, the State Board of
	23	+	21 Education, in consultation with the Children's Behavioral
	24	+	22 Health Transformation Team, the Office of the Governor, and
	25	+	23 relevant stakeholders as needed shall release a strategy that
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33		-	includes a tool for measuring capacity and readiness to
34		-	implement universal mental health screening of students. The
35		-	strategy shall build upon existing efforts to understand
36		-	district needs for resources, technology, training, and
37		-	infrastructure supports. The strategy shall include a
38		-	framework for supporting districts in a phased approach to
39		-	implement universal mental health screenings. The State Board
40		-	of Education shall issue a report to the Governor and the
41		-	General Assembly on school district readiness and plan for
42		-	phased approach to universal mental health screening of
43		-	students on or before April 1, 2025.
44		-	(Source: P.A. 103-546, eff. 8-11-23; revised 9-25-23.)
45		-	(105 ILCS 155/Act rep.)
46		-	Section 10. The Wellness Checks in Schools Program Act is
47		-	repealed.
48		-	Section 15. The Illinois Public Aid Code is amended by
49		-	changing Section 5-30.1 as follows:
50		-	(305 ILCS 5/5-30.1)
51		-	Sec. 5-30.1. Managed care protections.
52		-	(a) As used in this Section:
53		-	"Managed care organization" or "MCO" means any entity
54		-	which contracts with the Department to provide services where
55		-	payment for medical services is made on a capitated basis.
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	34	+	1 includes a tool for measuring capacity and readiness to
	35	+	2 implement universal mental health screening of students. The
	36	+	3 strategy shall build upon existing efforts to understand
	37	+	4 district needs for resources, technology, training, and
	38	+	5 infrastructure supports. The strategy shall include a
	39	+	6 framework for supporting districts in a phased approach to
	40	+	7 implement universal mental health screenings. The State Board
	41	+	8 of Education shall issue a report to the Governor and the
	42	+	9 General Assembly on school district readiness and plan for
	43	+	10 phased approach to universal mental health screening of
	44	+	11 students on or before April 1, 2025.
	45	+	12 (Source: P.A. 103-546, eff. 8-11-23; revised 9-25-23.)
	46	+	13 (105 ILCS 155/Act rep.)
	47	+	14 Section 10. The Wellness Checks in Schools Program Act is
	48	+	15 repealed.
	49	+	16 Section 15. The Illinois Public Aid Code is amended by
	50	+	17 changing Section 5-30.1 as follows:
	51	+	18 (305 ILCS 5/5-30.1)
	52	+	19 Sec. 5-30.1. Managed care protections.
	53	+	20 (a) As used in this Section:
	54	+	21 "Managed care organization" or "MCO" means any entity
	55	+	22 which contracts with the Department to provide services where
	56	+	23 payment for medical services is made on a capitated basis.
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57	58
58		-	"Emergency services" include:
59		-	(1) emergency services, as defined by Section 10 of
60		-	the Managed Care Reform and Patient Rights Act;
61		-	(2) emergency medical screening examinations, as
62		-	defined by Section 10 of the Managed Care Reform and
63		-	Patient Rights Act;
64		-	(3) post-stabilization medical services, as defined by
65		-	Section 10 of the Managed Care Reform and Patient Rights
66		-	Act; and
67		-	(4) emergency medical conditions, as defined by
68		-	Section 10 of the Managed Care Reform and Patient Rights
69		-	Act.
70		-	(b) As provided by Section 5-16.12, managed care
71		-	organizations are subject to the provisions of the Managed
72		-	Care Reform and Patient Rights Act.
73		-	(c) An MCO shall pay any provider of emergency services
74		-	that does not have in effect a contract with the contracted
75		-	Medicaid MCO. The default rate of reimbursement shall be the
76		-	rate paid under Illinois Medicaid fee-for-service program
77		-	methodology, including all policy adjusters, including but not
78		-	limited to Medicaid High Volume Adjustments, Medicaid
79		-	Percentage Adjustments, Outpatient High Volume Adjustments,
80		-	and all outlier add-on adjustments to the extent such
81		-	adjustments are incorporated in the development of the
82		-	applicable MCO capitated rates.
83		-	(d) An MCO shall pay for all post-stabilization services
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86		-	as a covered service in any of the following situations:
87		-	(1) the MCO authorized such services;
88		-	(2) such services were administered to maintain the
89		-	enrollee's stabilized condition within one hour after a
90		-	request to the MCO for authorization of further
91		-	post-stabilization services;
92		-	(3) the MCO did not respond to a request to authorize
93		-	such services within one hour;
94		-	(4) the MCO could not be contacted; or
95		-	(5) the MCO and the treating provider, if the treating
96		-	provider is a non-affiliated provider, could not reach an
97		-	agreement concerning the enrollee's care and an affiliated
98		-	provider was unavailable for a consultation, in which case
99		-	the MCO must pay for such services rendered by the
100		-	treating non-affiliated provider until an affiliated
101		-	provider was reached and either concurred with the
102		-	treating non-affiliated provider's plan of care or assumed
103		-	responsibility for the enrollee's care. Such payment shall
104		-	be made at the default rate of reimbursement paid under
105		-	Illinois Medicaid fee-for-service program methodology,
106		-	including all policy adjusters, including but not limited
107		-	to Medicaid High Volume Adjustments, Medicaid Percentage
108		-	Adjustments, Outpatient High Volume Adjustments and all
109		-	outlier add-on adjustments to the extent that such
110		-	adjustments are incorporated in the development of the
111		-	applicable MCO capitated rates.
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114		-	(e) The following requirements apply to MCOs in
115		-	determining payment for all emergency services:
116		-	(1) MCOs shall not impose any requirements for prior
117		-	approval of emergency services.
118		-	(2) The MCO shall cover emergency services provided to
119		-	enrollees who are temporarily away from their residence
120		-	and outside the contracting area to the extent that the
121		-	enrollees would be entitled to the emergency services if
122		-	they still were within the contracting area.
123		-	(3) The MCO shall have no obligation to cover medical
124		-	services provided on an emergency basis that are not
125		-	covered services under the contract.
126		-	(4) The MCO shall not condition coverage for emergency
127		-	services on the treating provider notifying the MCO of the
128		-	enrollee's screening and treatment within 10 days after
129		-	presentation for emergency services.
130		-	(5) The determination of the attending emergency
131		-	physician, or the provider actually treating the enrollee,
132		-	of whether an enrollee is sufficiently stabilized for
133		-	discharge or transfer to another facility, shall be
134		-	binding on the MCO. The MCO shall cover emergency services
135		-	for all enrollees whether the emergency services are
136		-	provided by an affiliated or non-affiliated provider.
137		-	(6) The MCO's financial responsibility for
138		-	post-stabilization care services it has not pre-approved
139		-	ends when:
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	67	+	1 "Emergency services" include:
	68	+	2 (1) emergency services, as defined by Section 10 of
	69	+	3 the Managed Care Reform and Patient Rights Act;
	70	+	4 (2) emergency medical screening examinations, as
	71	+	5 defined by Section 10 of the Managed Care Reform and
	72	+	6 Patient Rights Act;
	73	+	7 (3) post-stabilization medical services, as defined by
	74	+	8 Section 10 of the Managed Care Reform and Patient Rights
	75	+	9 Act; and
	76	+	10 (4) emergency medical conditions, as defined by
	77	+	11 Section 10 of the Managed Care Reform and Patient Rights
	78	+	12 Act.
	79	+	13 (b) As provided by Section 5-16.12, managed care
	80	+	14 organizations are subject to the provisions of the Managed
	81	+	15 Care Reform and Patient Rights Act.
	82	+	16 (c) An MCO shall pay any provider of emergency services
	83	+	17 that does not have in effect a contract with the contracted
	84	+	18 Medicaid MCO. The default rate of reimbursement shall be the
	85	+	19 rate paid under Illinois Medicaid fee-for-service program
	86	+	20 methodology, including all policy adjusters, including but not
	87	+	21 limited to Medicaid High Volume Adjustments, Medicaid
	88	+	22 Percentage Adjustments, Outpatient High Volume Adjustments,
	89	+	23 and all outlier add-on adjustments to the extent such
	90	+	24 adjustments are incorporated in the development of the
	91	+	25 applicable MCO capitated rates.
	92	+	26 (d) An MCO shall pay for all post-stabilization services
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142		-	(A) a plan physician with privileges at the
143		-	treating hospital assumes responsibility for the
144		-	enrollee's care;
145		-	(B) a plan physician assumes responsibility for
146		-	the enrollee's care through transfer;
147		-	(C) a contracting entity representative and the
148		-	treating physician reach an agreement concerning the
149		-	enrollee's care; or
150		-	(D) the enrollee is discharged.
151		-	(f) Network adequacy and transparency.
152		-	(1) The Department shall:
153		-	(A) ensure that an adequate provider network is in
154		-	place, taking into consideration health professional
155		-	shortage areas and medically underserved areas;
156		-	(B) publicly release an explanation of its process
157		-	for analyzing network adequacy;
158		-	(C) periodically ensure that an MCO continues to
159		-	have an adequate network in place;
160		-	(D) require MCOs, including Medicaid Managed Care
161		-	Entities as defined in Section 5-30.2, to meet
162		-	provider directory requirements under Section 5-30.3;
163		-	(E) require MCOs to ensure that any
164		-	Medicaid-certified provider under contract with an MCO
165		-	and previously submitted on a roster on the date of
166		-	service is paid for any medically necessary,
167		-	Medicaid-covered, and authorized service rendered to
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170		-	any of the MCO's enrollees, regardless of inclusion on
171		-	the MCO's published and publicly available directory
172		-	of available providers; and
173		-	(F) require MCOs, including Medicaid Managed Care
174		-	Entities as defined in Section 5-30.2, to meet each of
175		-	the requirements under subsection (d-5) of Section 10
176		-	of the Network Adequacy and Transparency Act; with
177		-	necessary exceptions to the MCO's network to ensure
178		-	that admission and treatment with a provider or at a
179		-	treatment facility in accordance with the network
180		-	adequacy standards in paragraph (3) of subsection
181		-	(d-5) of Section 10 of the Network Adequacy and
182		-	Transparency Act is limited to providers or facilities
183		-	that are Medicaid certified.
184		-	(2) Each MCO shall confirm its receipt of information
185		-	submitted specific to physician or dentist additions or
186		-	physician or dentist deletions from the MCO's provider
187		-	network within 3 days after receiving all required
188		-	information from contracted physicians or dentists, and
189		-	electronic physician and dental directories must be
190		-	updated consistent with current rules as published by the
191		-	Centers for Medicare and Medicaid Services or its
192		-	successor agency.
193		-	(g) Timely payment of claims.
194		-	(1) The MCO shall pay a claim within 30 days of
195		-	receiving a claim that contains all the essential
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198		-	information needed to adjudicate the claim.
199		-	(2) The MCO shall notify the billing party of its
200		-	inability to adjudicate a claim within 30 days of
201		-	receiving that claim.
202		-	(3) The MCO shall pay a penalty that is at least equal
203		-	to the timely payment interest penalty imposed under
204		-	Section 368a of the Illinois Insurance Code for any claims
205		-	not timely paid.
206		-	(A) When an MCO is required to pay a timely payment
207		-	interest penalty to a provider, the MCO must calculate
208		-	and pay the timely payment interest penalty that is
209		-	due to the provider within 30 days after the payment of
210		-	the claim. In no event shall a provider be required to
211		-	request or apply for payment of any owed timely
212		-	payment interest penalties.
213		-	(B) Such payments shall be reported separately
214		-	from the claim payment for services rendered to the
215		-	MCO's enrollee and clearly identified as interest
216		-	payments.
217		-	(4)(A) The Department shall require MCOs to expedite
218		-	payments to providers identified on the Department's
219		-	expedited provider list, determined in accordance with 89
220		-	Ill. Adm. Code 140.71(b), on a schedule at least as
221		-	frequently as the providers are paid under the
222		-	Department's fee-for-service expedited provider schedule.
223		-	(B) Compliance with the expedited provider requirement
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	103	+	1 as a covered service in any of the following situations:
	104	+	2 (1) the MCO authorized such services;
	105	+	3 (2) such services were administered to maintain the
	106	+	4 enrollee's stabilized condition within one hour after a
	107	+	5 request to the MCO for authorization of further
	108	+	6 post-stabilization services;
	109	+	7 (3) the MCO did not respond to a request to authorize
	110	+	8 such services within one hour;
	111	+	9 (4) the MCO could not be contacted; or
	112	+	10 (5) the MCO and the treating provider, if the treating
	113	+	11 provider is a non-affiliated provider, could not reach an
	114	+	12 agreement concerning the enrollee's care and an affiliated
	115	+	13 provider was unavailable for a consultation, in which case
	116	+	14 the MCO must pay for such services rendered by the
	117	+	15 treating non-affiliated provider until an affiliated
	118	+	16 provider was reached and either concurred with the
	119	+	17 treating non-affiliated provider's plan of care or assumed
	120	+	18 responsibility for the enrollee's care. Such payment shall
	121	+	19 be made at the default rate of reimbursement paid under
	122	+	20 Illinois Medicaid fee-for-service program methodology,
	123	+	21 including all policy adjusters, including but not limited
	124	+	22 to Medicaid High Volume Adjustments, Medicaid Percentage
	125	+	23 Adjustments, Outpatient High Volume Adjustments and all
	126	+	24 outlier add-on adjustments to the extent that such
	127	+	25 adjustments are incorporated in the development of the
	128	+	26 applicable MCO capitated rates.
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225	130
226		-	may be satisfied by an MCO through the use of a Periodic
227		-	Interim Payment (PIP) program that has been mutually
228		-	agreed to and documented between the MCO and the provider,
229		-	if the PIP program ensures that any expedited provider
230		-	receives regular and periodic payments based on prior
231		-	period payment experience from that MCO. Total payments
232		-	under the PIP program may be reconciled against future PIP
233		-	payments on a schedule mutually agreed to between the MCO
234		-	and the provider.
235		-	(C) The Department shall share at least monthly its
236		-	expedited provider list and the frequency with which it
237		-	pays providers on the expedited list.
238		-	(g-5) Recognizing that the rapid transformation of the
239		-	Illinois Medicaid program may have unintended operational
240		-	challenges for both payers and providers:
241		-	(1) in no instance shall a medically necessary covered
242		-	service rendered in good faith, based upon eligibility
243		-	information documented by the provider, be denied coverage
244		-	or diminished in payment amount if the eligibility or
245		-	coverage information available at the time the service was
246		-	rendered is later found to be inaccurate in the assignment
247		-	of coverage responsibility between MCOs or the
248		-	fee-for-service system, except for instances when an
249		-	individual is deemed to have not been eligible for
250		-	coverage under the Illinois Medicaid program; and
251		-	(2) the Department shall, by December 31, 2016, adopt
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254		-	rules establishing policies that shall be included in the
255		-	Medicaid managed care policy and procedures manual
256		-	addressing payment resolutions in situations in which a
257		-	provider renders services based upon information obtained
258		-	after verifying a patient's eligibility and coverage plan
259		-	through either the Department's current enrollment system
260		-	or a system operated by the coverage plan identified by
261		-	the patient presenting for services:
262		-	(A) such medically necessary covered services
263		-	shall be considered rendered in good faith;
264		-	(B) such policies and procedures shall be
265		-	developed in consultation with industry
266		-	representatives of the Medicaid managed care health
267		-	plans and representatives of provider associations
268		-	representing the majority of providers within the
269		-	identified provider industry; and
270		-	(C) such rules shall be published for a review and
271		-	comment period of no less than 30 days on the
272		-	Department's website with final rules remaining
273		-	available on the Department's website.
274		-	The rules on payment resolutions shall include, but
275		-	not be limited to:
276		-	(A) the extension of the timely filing period;
277		-	(B) retroactive prior authorizations; and
278		-	(C) guaranteed minimum payment rate of no less
279		-	than the current, as of the date of service,
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282		-	fee-for-service rate, plus all applicable add-ons,
283		-	when the resulting service relationship is out of
284		-	network.
285		-	The rules shall be applicable for both MCO coverage
286		-	and fee-for-service coverage.
287		-	If the fee-for-service system is ultimately determined to
288		-	have been responsible for coverage on the date of service, the
289		-	Department shall provide for an extended period for claims
290		-	submission outside the standard timely filing requirements.
291		-	(g-6) MCO Performance Metrics Report.
292		-	(1) The Department shall publish, on at least a
293		-	quarterly basis, each MCO's operational performance,
294		-	including, but not limited to, the following categories of
295		-	metrics:
296		-	(A) claims payment, including timeliness and
297		-	accuracy;
298		-	(B) prior authorizations;
299		-	(C) grievance and appeals;
300		-	(D) utilization statistics;
301		-	(E) provider disputes;
302		-	(F) provider credentialing; and
303		-	(G) member and provider customer service.
304		-	(2) The Department shall ensure that the metrics
305		-	report is accessible to providers online by January 1,
306		-	2017.
307		-	(3) The metrics shall be developed in consultation
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	139	+	1 (e) The following requirements apply to MCOs in
	140	+	2 determining payment for all emergency services:
	141	+	3 (1) MCOs shall not impose any requirements for prior
	142	+	4 approval of emergency services.
	143	+	5 (2) The MCO shall cover emergency services provided to
	144	+	6 enrollees who are temporarily away from their residence
	145	+	7 and outside the contracting area to the extent that the
	146	+	8 enrollees would be entitled to the emergency services if
	147	+	9 they still were within the contracting area.
	148	+	10 (3) The MCO shall have no obligation to cover medical
	149	+	11 services provided on an emergency basis that are not
	150	+	12 covered services under the contract.
	151	+	13 (4) The MCO shall not condition coverage for emergency
	152	+	14 services on the treating provider notifying the MCO of the
	153	+	15 enrollee's screening and treatment within 10 days after
	154	+	16 presentation for emergency services.
	155	+	17 (5) The determination of the attending emergency
	156	+	18 physician, or the provider actually treating the enrollee,
	157	+	19 of whether an enrollee is sufficiently stabilized for
	158	+	20 discharge or transfer to another facility, shall be
	159	+	21 binding on the MCO. The MCO shall cover emergency services
	160	+	22 for all enrollees whether the emergency services are
	161	+	23 provided by an affiliated or non-affiliated provider.
	162	+	24 (6) The MCO's financial responsibility for
	163	+	25 post-stabilization care services it has not pre-approved
	164	+	26 ends when:
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309	166
310		-	with industry representatives of the Medicaid managed care
311		-	health plans and representatives of associations
312		-	representing the majority of providers within the
313		-	identified industry.
314		-	(4) Metrics shall be defined and incorporated into the
315		-	applicable Managed Care Policy Manual issued by the
316		-	Department.
317		-	(g-7) MCO claims processing and performance analysis. In
318		-	order to monitor MCO payments to hospital providers, pursuant
319		-	to Public Act 100-580, the Department shall post an analysis
320		-	of MCO claims processing and payment performance on its
321		-	website every 6 months. Such analysis shall include a review
322		-	and evaluation of a representative sample of hospital claims
323		-	that are rejected and denied for clean and unclean claims and
324		-	the top 5 reasons for such actions and timeliness of claims
325		-	adjudication, which identifies the percentage of claims
326		-	adjudicated within 30, 60, 90, and over 90 days, and the dollar
327		-	amounts associated with those claims.
328		-	(g-8) Dispute resolution process. The Department shall
329		-	maintain a provider complaint portal through which a provider
330		-	can submit to the Department unresolved disputes with an MCO.
331		-	An unresolved dispute means an MCO's decision that denies in
332		-	whole or in part a claim for reimbursement to a provider for
333		-	health care services rendered by the provider to an enrollee
334		-	of the MCO with which the provider disagrees. Disputes shall
335		-	not be submitted to the portal until the provider has availed
336	167
337	168
338		-	itself of the MCO's internal dispute resolution process.
339		-	Disputes that are submitted to the MCO internal dispute
340		-	resolution process may be submitted to the Department of
341		-	Healthcare and Family Services' complaint portal no sooner
342		-	than 30 days after submitting to the MCO's internal process
343		-	and not later than 30 days after the unsatisfactory resolution
344		-	of the internal MCO process or 60 days after submitting the
345		-	dispute to the MCO internal process. Multiple claim disputes
346		-	involving the same MCO may be submitted in one complaint,
347		-	regardless of whether the claims are for different enrollees,
348		-	when the specific reason for non-payment of the claims
349		-	involves a common question of fact or policy. Within 10
350		-	business days of receipt of a complaint, the Department shall
351		-	present such disputes to the appropriate MCO, which shall then
352		-	have 30 days to issue its written proposal to resolve the
353		-	dispute. The Department may grant one 30-day extension of this
354		-	time frame to one of the parties to resolve the dispute. If the
355		-	dispute remains unresolved at the end of this time frame or the
356		-	provider is not satisfied with the MCO's written proposal to
357		-	resolve the dispute, the provider may, within 30 days, request
358		-	the Department to review the dispute and make a final
359		-	determination. Within 30 days of the request for Department
360		-	review of the dispute, both the provider and the MCO shall
361		-	present all relevant information to the Department for
362		-	resolution and make individuals with knowledge of the issues
363		-	available to the Department for further inquiry if needed.
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365	172
366		-	Within 30 days of receiving the relevant information on the
367		-	dispute, or the lapse of the period for submitting such
368		-	information, the Department shall issue a written decision on
369		-	the dispute based on contractual terms between the provider
370		-	and the MCO, contractual terms between the MCO and the
371		-	Department of Healthcare and Family Services and applicable
372		-	Medicaid policy. The decision of the Department shall be
373		-	final. By January 1, 2020, the Department shall establish by
374		-	rule further details of this dispute resolution process.
375		-	Disputes between MCOs and providers presented to the
376		-	Department for resolution are not contested cases, as defined
377		-	in Section 1-30 of the Illinois Administrative Procedure Act,
378		-	conferring any right to an administrative hearing.
379		-	(g-9)(1) The Department shall publish annually on its
380		-	website a report on the calculation of each managed care
381		-	organization's medical loss ratio showing the following:
382		-	(A) Premium revenue, with appropriate adjustments.
383		-	(B) Benefit expense, setting forth the aggregate
384		-	amount spent for the following:
385		-	(i) Direct paid claims.
386		-	(ii) Subcapitation payments.
387		-	(iii) Other claim payments.
388		-	(iv) Direct reserves.
389		-	(v) Gross recoveries.
390		-	(vi) Expenses for activities that improve health
391		-	care quality as allowed by the Department.
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	175	+	1 (A) a plan physician with privileges at the
	176	+	2 treating hospital assumes responsibility for the
	177	+	3 enrollee's care;
	178	+	4 (B) a plan physician assumes responsibility for
	179	+	5 the enrollee's care through transfer;
	180	+	6 (C) a contracting entity representative and the
	181	+	7 treating physician reach an agreement concerning the
	182	+	8 enrollee's care; or
	183	+	9 (D) the enrollee is discharged.
	184	+	10 (f) Network adequacy and transparency.
	185	+	11 (1) The Department shall:
	186	+	12 (A) ensure that an adequate provider network is in
	187	+	13 place, taking into consideration health professional
	188	+	14 shortage areas and medically underserved areas;
	189	+	15 (B) publicly release an explanation of its process
	190	+	16 for analyzing network adequacy;
	191	+	17 (C) periodically ensure that an MCO continues to
	192	+	18 have an adequate network in place;
	193	+	19 (D) require MCOs, including Medicaid Managed Care
	194	+	20 Entities as defined in Section 5-30.2, to meet
	195	+	21 provider directory requirements under Section 5-30.3;
	196	+	22 (E) require MCOs to ensure that any
	197	+	23 Medicaid-certified provider under contract with an MCO
	198	+	24 and previously submitted on a roster on the date of
	199	+	25 service is paid for any medically necessary,
	200	+	26 Medicaid-covered, and authorized service rendered to
392	201
393	202
394		-	(2) The medical loss ratio shall be calculated consistent
395		-	with federal law and regulation following a claims runout
396		-	period determined by the Department.
397		-	(g-10)(1) "Liability effective date" means the date on
398		-	which an MCO becomes responsible for payment for medically
399		-	necessary and covered services rendered by a provider to one
400		-	of its enrollees in accordance with the contract terms between
401		-	the MCO and the provider. The liability effective date shall
402		-	be the later of:
403		-	(A) The execution date of a network participation
404		-	contract agreement.
405		-	(B) The date the provider or its representative
406		-	submits to the MCO the complete and accurate standardized
407		-	roster form for the provider in the format approved by the
408		-	Department.
409		-	(C) The provider effective date contained within the
410		-	Department's provider enrollment subsystem within the
411		-	Illinois Medicaid Program Advanced Cloud Technology
412		-	(IMPACT) System.
413		-	(2) The standardized roster form may be submitted to the
414		-	MCO at the same time that the provider submits an enrollment
415		-	application to the Department through IMPACT.
416		-	(3) By October 1, 2019, the Department shall require all
417		-	MCOs to update their provider directory with information for
418		-	new practitioners of existing contracted providers within 30
419		-	days of receipt of a complete and accurate standardized roster
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421	204
422		-	template in the format approved by the Department provided
423		-	that the provider is effective in the Department's provider
424		-	enrollment subsystem within the IMPACT system. Such provider
425		-	directory shall be readily accessible for purposes of
426		-	selecting an approved health care provider and comply with all
427		-	other federal and State requirements.
428		-	(g-11) The Department shall work with relevant
429		-	stakeholders on the development of operational guidelines to
430		-	enhance and improve operational performance of Illinois'
431		-	Medicaid managed care program, including, but not limited to,
432		-	improving provider billing practices, reducing claim
433		-	rejections and inappropriate payment denials, and
434		-	standardizing processes, procedures, definitions, and response
435		-	timelines, with the goal of reducing provider and MCO
436		-	administrative burdens and conflict. The Department shall
437		-	include a report on the progress of these program improvements
438		-	and other topics in its Fiscal Year 2020 annual report to the
439		-	General Assembly.
440		-	(g-12) Notwithstanding any other provision of law, if the
441		-	Department or an MCO requires submission of a claim for
442		-	payment in a non-electronic format, a provider shall always be
443		-	afforded a period of no less than 90 business days, as a
444		-	correction period, following any notification of rejection by
445		-	either the Department or the MCO to correct errors or
446		-	omissions in the original submission.
447		-	Under no circumstances, either by an MCO or under the
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449	208
450		-	State's fee-for-service system, shall a provider be denied
451		-	payment for failure to comply with any timely submission
452		-	requirements under this Code or under any existing contract,
453		-	unless the non-electronic format claim submission occurs after
454		-	the initial 180 days following the latest date of service on
455		-	the claim, or after the 90 business days correction period
456		-	following notification to the provider of rejection or denial
457		-	of payment.
458		-	(h) The Department shall not expand mandatory MCO
459		-	enrollment into new counties beyond those counties already
460		-	designated by the Department as of June 1, 2014 for the
461		-	individuals whose eligibility for medical assistance is not
462		-	the seniors or people with disabilities population until the
463		-	Department provides an opportunity for accountable care
464		-	entities and MCOs to participate in such newly designated
465		-	counties.
466		-	(h-5) Leading indicator data sharing. By January 1, 2024,
467		-	the Department shall obtain input from the Department of Human
468		-	Services, the Department of Juvenile Justice, the Department
469		-	of Children and Family Services, the State Board of Education,
470		-	managed care organizations, providers, and clinical experts to
471		-	identify and analyze key indicators and data elements that can
472		-	be used in an analysis of lead indicators from assessments and
473		-	data sets available to the Department that can be shared with
474		-	managed care organizations and similar care coordination
475		-	entities contracted with the Department as leading indicators
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	211	+	1 any of the MCO's enrollees, regardless of inclusion on
	212	+	2 the MCO's published and publicly available directory
	213	+	3 of available providers; and
	214	+	4 (F) require MCOs, including Medicaid Managed Care
	215	+	5 Entities as defined in Section 5-30.2, to meet each of
	216	+	6 the requirements under subsection (d-5) of Section 10
	217	+	7 of the Network Adequacy and Transparency Act; with
	218	+	8 necessary exceptions to the MCO's network to ensure
	219	+	9 that admission and treatment with a provider or at a
	220	+	10 treatment facility in accordance with the network
	221	+	11 adequacy standards in paragraph (3) of subsection
	222	+	12 (d-5) of Section 10 of the Network Adequacy and
	223	+	13 Transparency Act is limited to providers or facilities
	224	+	14 that are Medicaid certified.
	225	+	15 (2) Each MCO shall confirm its receipt of information
	226	+	16 submitted specific to physician or dentist additions or
	227	+	17 physician or dentist deletions from the MCO's provider
	228	+	18 network within 3 days after receiving all required
	229	+	19 information from contracted physicians or dentists, and
	230	+	20 electronic physician and dental directories must be
	231	+	21 updated consistent with current rules as published by the
	232	+	22 Centers for Medicare and Medicaid Services or its
	233	+	23 successor agency.
	234	+	24 (g) Timely payment of claims.
	235	+	25 (1) The MCO shall pay a claim within 30 days of
	236	+	26 receiving a claim that contains all the essential
476	237
477	238
478		-	for elevated behavioral health crisis risk for children,
479		-	including data sets such as the Illinois Medicaid
480		-	Comprehensive Assessment of Needs and Strengths (IM-CANS),
481		-	calls made to the State's Crisis and Referral Entry Services
482		-	(CARES) hotline, health services information from Health and
483		-	Human Services Innovators, or other data sets that may include
484		-	key indicators. The workgroup shall complete its
485		-	recommendations for leading indicator data elements on or
486		-	before September 1, 2024. To the extent permitted by State and
487		-	federal law, the identified leading indicators shall be shared
488		-	with managed care organizations and similar care coordination
489		-	entities contracted with the Department on or before December
490		-	1, 2024 within 6 months of identification for the purpose of
491		-	improving care coordination with the early detection of
492		-	elevated risk. Leading indicators shall be reassessed annually
493		-	with stakeholder input. The Department shall implement
494		-	guidance to managed care organizations and similar care
495		-	coordination entities contracted with the Department, so that
496		-	the managed care organizations and care coordination entities
497		-	respond to lead indicators with services and interventions
498		-	that are designed to help stabilize the child.
499		-	(i) The requirements of this Section apply to contracts
500		-	with accountable care entities and MCOs entered into, amended,
501		-	or renewed after June 16, 2014 (the effective date of Public
502		-	Act 98-651).
503		-	(j) Health care information released to managed care
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505	240
506		-	organizations. A health care provider shall release to a
507		-	Medicaid managed care organization, upon request, and subject
508		-	to the Health Insurance Portability and Accountability Act of
509		-	1996 and any other law applicable to the release of health
510		-	information, the health care information of the MCO's
511		-	enrollee, if the enrollee has completed and signed a general
512		-	release form that grants to the health care provider
513		-	permission to release the recipient's health care information
514		-	to the recipient's insurance carrier.
515		-	(k) The Department of Healthcare and Family Services,
516		-	managed care organizations, a statewide organization
517		-	representing hospitals, and a statewide organization
518		-	representing safety-net hospitals shall explore ways to
519		-	support billing departments in safety-net hospitals.
520		-	(l) The requirements of this Section added by Public Act
521		-	102-4 shall apply to services provided on or after the first
522		-	day of the month that begins 60 days after April 27, 2021 (the
523		-	effective date of Public Act 102-4).
524		-	(Source: P.A. 102-4, eff. 4-27-21; 102-43, eff. 7-6-21;
525		-	102-144, eff. 1-1-22; 102-454, eff. 8-20-21; 102-813, eff.
526		-	5-13-22; 103-546, eff. 8-11-23.)
527		-	Section 20. The Children's Mental Health Act is amended by
528		-	changing Section 5 as follows:
529		-	(405 ILCS 49/5)
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531	244
532		-	Sec. 5. Children's Mental Health Partnership; Children's
533		-	Mental Health Plan.
534		-	(a) The Children's Mental Health Partnership (hereafter
535		-	referred to as "the Partnership") created under Public Act
536		-	93-495 and continued under Public Act 102-899 shall advise
537		-	State agencies and the Children's Behavioral Health
538		-	Transformation Initiative on designing and implementing
539		-	short-term and long-term strategies to provide comprehensive
540		-	and coordinated services for children from birth to age 25 and
541		-	their families with the goal of addressing children's mental
542		-	health needs across a full continuum of care, including social
543		-	determinants of health, prevention, early identification, and
544		-	treatment. The recommended strategies shall build upon the
545		-	recommendations in the Children's Mental Health Plan of 2022
546		-	and may include, but are not limited to, recommendations
547		-	regarding the following:
548		-	(1) Increasing public awareness on issues connected to
549		-	children's mental health and wellness to decrease stigma,
550		-	promote acceptance, and strengthen the ability of
551		-	children, families, and communities to access supports.
552		-	(2) Coordination of programs, services, and policies
553		-	across child-serving State agencies to best monitor and
554		-	assess spending, as well as foster innovation of adaptive
555		-	or new practices.
556		-	(3) Funding and resources for children's mental health
557		-	prevention, early identification, and treatment across
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	247	+	1 information needed to adjudicate the claim.
	248	+	2 (2) The MCO shall notify the billing party of its
	249	+	3 inability to adjudicate a claim within 30 days of
	250	+	4 receiving that claim.
	251	+	5 (3) The MCO shall pay a penalty that is at least equal
	252	+	6 to the timely payment interest penalty imposed under
	253	+	7 Section 368a of the Illinois Insurance Code for any claims
	254	+	8 not timely paid.
	255	+	9 (A) When an MCO is required to pay a timely payment
	256	+	10 interest penalty to a provider, the MCO must calculate
	257	+	11 and pay the timely payment interest penalty that is
	258	+	12 due to the provider within 30 days after the payment of
	259	+	13 the claim. In no event shall a provider be required to
	260	+	14 request or apply for payment of any owed timely
	261	+	15 payment interest penalties.
	262	+	16 (B) Such payments shall be reported separately
	263	+	17 from the claim payment for services rendered to the
	264	+	18 MCO's enrollee and clearly identified as interest
	265	+	19 payments.
	266	+	20 (4)(A) The Department shall require MCOs to expedite
	267	+	21 payments to providers identified on the Department's
	268	+	22 expedited provider list, determined in accordance with 89
	269	+	23 Ill. Adm. Code 140.71(b), on a schedule at least as
	270	+	24 frequently as the providers are paid under the
	271	+	25 Department's fee-for-service expedited provider schedule.
	272	+	26 (B) Compliance with the expedited provider requirement
558	273
559	274
560		-	child-serving State agencies.
561		-	(4) Facilitation of research on best practices and
562		-	model programs and dissemination of this information to
563		-	State policymakers, practitioners, and the general public.
564		-	(5) Monitoring programs, services, and policies
565		-	addressing children's mental health and wellness.
566		-	(6) Growing, retaining, diversifying, and supporting
567		-	the child-serving workforce, with special emphasis on
568		-	professional development around child and family mental
569		-	health and wellness services.
570		-	(7) Supporting the design, implementation, and
571		-	evaluation of a quality-driven children's mental health
572		-	system of care across all child services that prevents
573		-	mental health concerns and mitigates trauma.
574		-	(8) Improving the system to more effectively meet the
575		-	emergency and residential placement needs for all children
576		-	with severe mental and behavioral challenges.
577		-	(b) The Partnership shall have the responsibility of
578		-	developing and updating the Children's Mental Health Plan and
579		-	advising the relevant State agencies on implementation of the
580		-	Plan. The Children's Mental Health Partnership shall be
581		-	comprised of the following members:
582		-	(1) The Governor or his or her designee.
583		-	(2) The Attorney General or his or her designee.
584		-	(3) The Secretary of the Department of Human Services
585		-	or his or her designee.
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587	276
588		-	(4) The State Superintendent of Education or his or
589		-	her designee.
590		-	(5) The Director of the Department of Children and
591		-	Family Services or his or her designee.
592		-	(6) The Director of the Department of Healthcare and
593		-	Family Services or his or her designee.
594		-	(7) The Director of the Department of Public Health or
595		-	his or her designee.
596		-	(8) The Director of the Department of Juvenile Justice
597		-	or his or her designee.
598		-	(9) The Executive Director of the Governor's Office of
599		-	Early Childhood Development or his or her designee.
600		-	(10) The Director of the Criminal Justice Information
601		-	Authority or his or her designee.
602		-	(11) One member of the General Assembly appointed by
603		-	the Speaker of the House.
604		-	(12) One member of the General Assembly appointed by
605		-	the President of the Senate.
606		-	(13) One member of the General Assembly appointed by
607		-	the Minority Leader of the Senate.
608		-	(14) One member of the General Assembly appointed by
609		-	the Minority Leader of the House.
610		-	(15) Up to 25 representatives from the public
611		-	reflecting a diversity of age, gender identity, race,
612		-	ethnicity, socioeconomic status, and geographic location,
613		-	to be appointed by the Governor. Those public members
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615	280
616		-	appointed under this paragraph must include, but are not
617		-	limited to:
618		-	(A) a family member or individual with lived
619		-	experience in the children's mental health system;
620		-	(B) a child advocate;
621		-	(C) a community mental health expert,
622		-	practitioner, or provider;
623		-	(D) a representative of a statewide association
624		-	representing a majority of hospitals in the State;
625		-	(E) an early childhood expert or practitioner;
626		-	(F) a representative from the K-12 school system;
627		-	(G) a representative from the healthcare sector;
628		-	(H) a substance use prevention expert or
629		-	practitioner, or a representative of a statewide
630		-	association representing community-based mental health
631		-	substance use disorder treatment providers in the
632		-	State;
633		-	(I) a violence prevention expert or practitioner;
634		-	(J) a representative from the juvenile justice
635		-	system;
636		-	(K) a school social worker; and
637		-	(L) a representative of a statewide organization
638		-	representing pediatricians.
639		-	(16) Two co-chairs appointed by the Governor, one
640		-	being a representative from the public and one being the
641		-	Director of Public Health a representative from the State.
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	283	+	1 may be satisfied by an MCO through the use of a Periodic
	284	+	2 Interim Payment (PIP) program that has been mutually
	285	+	3 agreed to and documented between the MCO and the provider,
	286	+	4 if the PIP program ensures that any expedited provider
	287	+	5 receives regular and periodic payments based on prior
	288	+	6 period payment experience from that MCO. Total payments
	289	+	7 under the PIP program may be reconciled against future PIP
	290	+	8 payments on a schedule mutually agreed to between the MCO
	291	+	9 and the provider.
	292	+	10 (C) The Department shall share at least monthly its
	293	+	11 expedited provider list and the frequency with which it
	294	+	12 pays providers on the expedited list.
	295	+	13 (g-5) Recognizing that the rapid transformation of the
	296	+	14 Illinois Medicaid program may have unintended operational
	297	+	15 challenges for both payers and providers:
	298	+	16 (1) in no instance shall a medically necessary covered
	299	+	17 service rendered in good faith, based upon eligibility
	300	+	18 information documented by the provider, be denied coverage
	301	+	19 or diminished in payment amount if the eligibility or
	302	+	20 coverage information available at the time the service was
	303	+	21 rendered is later found to be inaccurate in the assignment
	304	+	22 of coverage responsibility between MCOs or the
	305	+	23 fee-for-service system, except for instances when an
	306	+	24 individual is deemed to have not been eligible for
	307	+	25 coverage under the Illinois Medicaid program; and
	308	+	26 (2) the Department shall, by December 31, 2016, adopt
642	309
643	310
644		-	The members appointed by the Governor shall be appointed
645		-	for 4 years with one opportunity for reappointment, except as
646		-	otherwise provided for in this subsection. Members who were
647		-	appointed by the Governor and are serving on January 1, 2023
648		-	(the effective date of Public Act 102-899) shall maintain
649		-	their appointment until the term of their appointment has
650		-	expired. For new appointments made pursuant to Public Act
651		-	102-899, members shall be appointed for one-year, 2-year, or
652		-	4-year terms, as determined by the Governor, with no more than
653		-	9 of the Governor's new or existing appointees serving the
654		-	same term. Those new appointments serving a one-year or 2-year
655		-	term may be appointed to 2 additional 4-year terms. If a
656		-	vacancy occurs in the Partnership membership, the vacancy
657		-	shall be filled in the same manner as the original appointment
658		-	for the remainder of the term.
659		-	The Partnership shall be convened no later than January
660		-	31, 2023 to discuss the changes in Public Act 102-899.
661		-	The members of the Partnership shall serve without
662		-	compensation but may be entitled to reimbursement for all
663		-	necessary expenses incurred in the performance of their
664		-	official duties as members of the Partnership from funds
665		-	appropriated for that purpose.
666		-	The Partnership may convene and appoint special committees
667		-	or study groups to operate under the direction of the
668		-	Partnership. Persons appointed to such special committees or
669		-	study groups shall only receive reimbursement for reasonable
670	311
671	312
672		-	expenses.
673		-	(b-5) The Partnership shall include an adjunct council
674		-	comprised of no more than 6 youth aged 14 to 25 and 4
675		-	representatives of 4 different community-based organizations
676		-	that focus on youth mental health. Of the community-based
677		-	organizations that focus on youth mental health, one of the
678		-	community-based organizations shall be led by an
679		-	LGBTQ-identified person, one of the community-based
680		-	organizations shall be led by a person of color, and one of the
681		-	community-based organizations shall be led by a woman. Of the
682		-	representatives appointed to the council from the
683		-	community-based organizations, at least one representative
684		-	shall be LGBTQ-identified, at least one representative shall
685		-	be a person of color, and at least one representative shall be
686		-	a woman. The council members shall be appointed by the Chair of
687		-	the Partnership and shall reflect the racial, gender identity,
688		-	sexual orientation, ability, socioeconomic, ethnic, and
689		-	geographic diversity of the State, including rural, suburban,
690		-	and urban appointees. The council shall make recommendations
691		-	to the Partnership regarding youth mental health, including,
692		-	but not limited to, identifying barriers to youth feeling
693		-	supported by and empowered by the system of mental health and
694		-	treatment providers, barriers perceived by youth in accessing
695		-	mental health services, gaps in the mental health system,
696		-	available resources in schools, including youth's perceptions
697		-	and experiences with outreach personnel, agency websites, and
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699	316
700		-	informational materials, methods to destigmatize mental health
701		-	services, and how to improve State policy concerning student
702		-	mental health. The mental health system may include services
703		-	for substance use disorders and addiction. The council shall
704		-	meet at least 4 times annually.
705		-	(c) (Blank).
706		-	(d) The Illinois Children's Mental Health Partnership has
707		-	the following powers and duties:
708		-	(1) Conducting research assessments to determine the
709		-	needs and gaps of programs, services, and policies that
710		-	touch children's mental health.
711		-	(2) Developing policy statements for interagency
712		-	cooperation to cover all aspects of mental health
713		-	delivery, including social determinants of health,
714		-	prevention, early identification, and treatment.
715		-	(3) Recommending policies and providing information on
716		-	effective programs for delivery of mental health services.
717		-	(4) Using funding from federal, State, or
718		-	philanthropic partners, to fund pilot programs or research
719		-	activities to resource innovative practices by
720		-	organizational partners that will address children's
721		-	mental health. However, the Partnership may not provide
722		-	direct services.
723		-	(4.1) The Partnership shall work with community
724		-	networks and the Children's Behavioral Health
725		-	Transformation Initiative team to implement a community
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	319	+	1 rules establishing policies that shall be included in the
	320	+	2 Medicaid managed care policy and procedures manual
	321	+	3 addressing payment resolutions in situations in which a
	322	+	4 provider renders services based upon information obtained
	323	+	5 after verifying a patient's eligibility and coverage plan
	324	+	6 through either the Department's current enrollment system
	325	+	7 or a system operated by the coverage plan identified by
	326	+	8 the patient presenting for services:
	327	+	9 (A) such medically necessary covered services
	328	+	10 shall be considered rendered in good faith;
	329	+	11 (B) such policies and procedures shall be
	330	+	12 developed in consultation with industry
	331	+	13 representatives of the Medicaid managed care health
	332	+	14 plans and representatives of provider associations
	333	+	15 representing the majority of providers within the
	334	+	16 identified provider industry; and
	335	+	17 (C) such rules shall be published for a review and
	336	+	18 comment period of no less than 30 days on the
	337	+	19 Department's website with final rules remaining
	338	+	20 available on the Department's website.
	339	+	21 The rules on payment resolutions shall include, but
	340	+	22 not be limited to:
	341	+	23 (A) the extension of the timely filing period;
	342	+	24 (B) retroactive prior authorizations; and
	343	+	25 (C) guaranteed minimum payment rate of no less
	344	+	26 than the current, as of the date of service,
726	345
727	346
728		-	needs assessment, that will raise awareness of gaps in
729		-	existing community-based services for youth.
730		-	(5) Submitting an annual report, on or before December
731		-	30 of each year, to the Governor and the General Assembly
732		-	on the progress of the Plan, any recommendations regarding
733		-	State policies, laws, or rules necessary to fulfill the
734		-	purposes of the Act, and any additional recommendations
735		-	regarding mental or behavioral health that the Partnership
736		-	deems necessary.
737		-	(6) (Blank). Employing an Executive Director and
738		-	setting the compensation of the Executive Director and
739		-	other such employees and technical assistance as it deems
740		-	necessary to carry out its duties under this Section.
741		-	The Partnership may designate a fiscal and administrative
742		-	agent that can accept funds to carry out its duties as outlined
743		-	in this Section.
744		-	The Department of Public Health Healthcare and Family
745		-	Services shall provide technical and administrative support
746		-	for the Partnership.
747		-	(e) The Partnership may accept monetary gifts or grants
748		-	from the federal government or any agency thereof, from any
749		-	charitable foundation or professional association, or from any
750		-	reputable source for implementation of any program necessary
751		-	or desirable to carry out the powers and duties as defined
752		-	under this Section.
753		-	(f) On or before January 1, 2027, the Partnership shall
754	347
755	348
756		-	submit recommendations to the Governor and General Assembly
757		-	that includes recommended updates to the Act to reflect the
758		-	current mental health landscape in this State.
759		-	(Source: P.A. 102-16, eff. 6-17-21; 102-116, eff. 7-23-21;
760		-	102-899, eff. 1-1-23; 102-1034, eff. 1-1-23; 103-154, eff.
761		-	6-30-23.)
762		-	Section 25. The Interagency Children's Behavioral Health
763		-	Services Act is amended by adding Section 6 as follows:
764		-	(405 ILCS 165/6 new)
765		-	Sec. 6. Personal support workers. The Children's
766		-	Behavioral Health Transformation Team in collaboration with
767		-	the Department of Human Services shall develop a program to
768		-	provide one-on-one in-home respite behavioral health aids to
769		-	youth requiring intensive supervision due to behavioral health
770		-	needs.
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	355	+	1 fee-for-service rate, plus all applicable add-ons,
	356	+	2 when the resulting service relationship is out of
	357	+	3 network.
	358	+	4 The rules shall be applicable for both MCO coverage
	359	+	5 and fee-for-service coverage.
	360	+	6 If the fee-for-service system is ultimately determined to
	361	+	7 have been responsible for coverage on the date of service, the
	362	+	8 Department shall provide for an extended period for claims
	363	+	9 submission outside the standard timely filing requirements.
	364	+	10 (g-6) MCO Performance Metrics Report.
	365	+	11 (1) The Department shall publish, on at least a
	366	+	12 quarterly basis, each MCO's operational performance,
	367	+	13 including, but not limited to, the following categories of
	368	+	14 metrics:
	369	+	15 (A) claims payment, including timeliness and
	370	+	16 accuracy;
	371	+	17 (B) prior authorizations;
	372	+	18 (C) grievance and appeals;
	373	+	19 (D) utilization statistics;
	374	+	20 (E) provider disputes;
	375	+	21 (F) provider credentialing; and
	376	+	22 (G) member and provider customer service.
	377	+	23 (2) The Department shall ensure that the metrics
	378	+	24 report is accessible to providers online by January 1,
	379	+	25 2017.
	380	+	26 (3) The metrics shall be developed in consultation
	381	+
	382	+
	383	+
	384	+
	385	+
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	387	+
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	391	+	1 with industry representatives of the Medicaid managed care
	392	+	2 health plans and representatives of associations
	393	+	3 representing the majority of providers within the
	394	+	4 identified industry.
	395	+	5 (4) Metrics shall be defined and incorporated into the
	396	+	6 applicable Managed Care Policy Manual issued by the
	397	+	7 Department.
	398	+	8 (g-7) MCO claims processing and performance analysis. In
	399	+	9 order to monitor MCO payments to hospital providers, pursuant
	400	+	10 to Public Act 100-580, the Department shall post an analysis
	401	+	11 of MCO claims processing and payment performance on its
	402	+	12 website every 6 months. Such analysis shall include a review
	403	+	13 and evaluation of a representative sample of hospital claims
	404	+	14 that are rejected and denied for clean and unclean claims and
	405	+	15 the top 5 reasons for such actions and timeliness of claims
	406	+	16 adjudication, which identifies the percentage of claims
	407	+	17 adjudicated within 30, 60, 90, and over 90 days, and the dollar
	408	+	18 amounts associated with those claims.
	409	+	19 (g-8) Dispute resolution process. The Department shall
	410	+	20 maintain a provider complaint portal through which a provider
	411	+	21 can submit to the Department unresolved disputes with an MCO.
	412	+	22 An unresolved dispute means an MCO's decision that denies in
	413	+	23 whole or in part a claim for reimbursement to a provider for
	414	+	24 health care services rendered by the provider to an enrollee
	415	+	25 of the MCO with which the provider disagrees. Disputes shall
	416	+	26 not be submitted to the portal until the provider has availed
	417	+
	418	+
	419	+
	420	+
	421	+
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	423	+
	424	+
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	427	+	1 itself of the MCO's internal dispute resolution process.
	428	+	2 Disputes that are submitted to the MCO internal dispute
	429	+	3 resolution process may be submitted to the Department of
	430	+	4 Healthcare and Family Services' complaint portal no sooner
	431	+	5 than 30 days after submitting to the MCO's internal process
	432	+	6 and not later than 30 days after the unsatisfactory resolution
	433	+	7 of the internal MCO process or 60 days after submitting the
	434	+	8 dispute to the MCO internal process. Multiple claim disputes
	435	+	9 involving the same MCO may be submitted in one complaint,
	436	+	10 regardless of whether the claims are for different enrollees,
	437	+	11 when the specific reason for non-payment of the claims
	438	+	12 involves a common question of fact or policy. Within 10
	439	+	13 business days of receipt of a complaint, the Department shall
	440	+	14 present such disputes to the appropriate MCO, which shall then
	441	+	15 have 30 days to issue its written proposal to resolve the
	442	+	16 dispute. The Department may grant one 30-day extension of this
	443	+	17 time frame to one of the parties to resolve the dispute. If the
	444	+	18 dispute remains unresolved at the end of this time frame or the
	445	+	19 provider is not satisfied with the MCO's written proposal to
	446	+	20 resolve the dispute, the provider may, within 30 days, request
	447	+	21 the Department to review the dispute and make a final
	448	+	22 determination. Within 30 days of the request for Department
	449	+	23 review of the dispute, both the provider and the MCO shall
	450	+	24 present all relevant information to the Department for
	451	+	25 resolution and make individuals with knowledge of the issues
	452	+	26 available to the Department for further inquiry if needed.
	453	+
	454	+
	455	+
	456	+
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	459	+
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	463	+	1 Within 30 days of receiving the relevant information on the
	464	+	2 dispute, or the lapse of the period for submitting such
	465	+	3 information, the Department shall issue a written decision on
	466	+	4 the dispute based on contractual terms between the provider
	467	+	5 and the MCO, contractual terms between the MCO and the
	468	+	6 Department of Healthcare and Family Services and applicable
	469	+	7 Medicaid policy. The decision of the Department shall be
	470	+	8 final. By January 1, 2020, the Department shall establish by
	471	+	9 rule further details of this dispute resolution process.
	472	+	10 Disputes between MCOs and providers presented to the
	473	+	11 Department for resolution are not contested cases, as defined
	474	+	12 in Section 1-30 of the Illinois Administrative Procedure Act,
	475	+	13 conferring any right to an administrative hearing.
	476	+	14 (g-9)(1) The Department shall publish annually on its
	477	+	15 website a report on the calculation of each managed care
	478	+	16 organization's medical loss ratio showing the following:
	479	+	17 (A) Premium revenue, with appropriate adjustments.
	480	+	18 (B) Benefit expense, setting forth the aggregate
	481	+	19 amount spent for the following:
	482	+	20 (i) Direct paid claims.
	483	+	21 (ii) Subcapitation payments.
	484	+	22 (iii) Other claim payments.
	485	+	23 (iv) Direct reserves.
	486	+	24 (v) Gross recoveries.
	487	+	25 (vi) Expenses for activities that improve health
	488	+	26 care quality as allowed by the Department.
	489	+
	490	+
	491	+
	492	+
	493	+
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	495	+
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	499	+	1 (2) The medical loss ratio shall be calculated consistent
	500	+	2 with federal law and regulation following a claims runout
	501	+	3 period determined by the Department.
	502	+	4 (g-10)(1) "Liability effective date" means the date on
	503	+	5 which an MCO becomes responsible for payment for medically
	504	+	6 necessary and covered services rendered by a provider to one
	505	+	7 of its enrollees in accordance with the contract terms between
	506	+	8 the MCO and the provider. The liability effective date shall
	507	+	9 be the later of:
	508	+	10 (A) The execution date of a network participation
	509	+	11 contract agreement.
	510	+	12 (B) The date the provider or its representative
	511	+	13 submits to the MCO the complete and accurate standardized
	512	+	14 roster form for the provider in the format approved by the
	513	+	15 Department.
	514	+	16 (C) The provider effective date contained within the
	515	+	17 Department's provider enrollment subsystem within the
	516	+	18 Illinois Medicaid Program Advanced Cloud Technology
	517	+	19 (IMPACT) System.
	518	+	20 (2) The standardized roster form may be submitted to the
	519	+	21 MCO at the same time that the provider submits an enrollment
	520	+	22 application to the Department through IMPACT.
	521	+	23 (3) By October 1, 2019, the Department shall require all
	522	+	24 MCOs to update their provider directory with information for
	523	+	25 new practitioners of existing contracted providers within 30
	524	+	26 days of receipt of a complete and accurate standardized roster
	525	+
	526	+
	527	+
	528	+
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	531	+
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	535	+	1 template in the format approved by the Department provided
	536	+	2 that the provider is effective in the Department's provider
	537	+	3 enrollment subsystem within the IMPACT system. Such provider
	538	+	4 directory shall be readily accessible for purposes of
	539	+	5 selecting an approved health care provider and comply with all
	540	+	6 other federal and State requirements.
	541	+	7 (g-11) The Department shall work with relevant
	542	+	8 stakeholders on the development of operational guidelines to
	543	+	9 enhance and improve operational performance of Illinois'
	544	+	10 Medicaid managed care program, including, but not limited to,
	545	+	11 improving provider billing practices, reducing claim
	546	+	12 rejections and inappropriate payment denials, and
	547	+	13 standardizing processes, procedures, definitions, and response
	548	+	14 timelines, with the goal of reducing provider and MCO
	549	+	15 administrative burdens and conflict. The Department shall
	550	+	16 include a report on the progress of these program improvements
	551	+	17 and other topics in its Fiscal Year 2020 annual report to the
	552	+	18 General Assembly.
	553	+	19 (g-12) Notwithstanding any other provision of law, if the
	554	+	20 Department or an MCO requires submission of a claim for
	555	+	21 payment in a non-electronic format, a provider shall always be
	556	+	22 afforded a period of no less than 90 business days, as a
	557	+	23 correction period, following any notification of rejection by
	558	+	24 either the Department or the MCO to correct errors or
	559	+	25 omissions in the original submission.
	560	+	26 Under no circumstances, either by an MCO or under the
	561	+
	562	+
	563	+
	564	+
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	567	+
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	571	+	1 State's fee-for-service system, shall a provider be denied
	572	+	2 payment for failure to comply with any timely submission
	573	+	3 requirements under this Code or under any existing contract,
	574	+	4 unless the non-electronic format claim submission occurs after
	575	+	5 the initial 180 days following the latest date of service on
	576	+	6 the claim, or after the 90 business days correction period
	577	+	7 following notification to the provider of rejection or denial
	578	+	8 of payment.
	579	+	9 (h) The Department shall not expand mandatory MCO
	580	+	10 enrollment into new counties beyond those counties already
	581	+	11 designated by the Department as of June 1, 2014 for the
	582	+	12 individuals whose eligibility for medical assistance is not
	583	+	13 the seniors or people with disabilities population until the
	584	+	14 Department provides an opportunity for accountable care
	585	+	15 entities and MCOs to participate in such newly designated
	586	+	16 counties.
	587	+	17 (h-5) Leading indicator data sharing. By January 1, 2024,
	588	+	18 the Department shall obtain input from the Department of Human
	589	+	19 Services, the Department of Juvenile Justice, the Department
	590	+	20 of Children and Family Services, the State Board of Education,
	591	+	21 managed care organizations, providers, and clinical experts to
	592	+	22 identify and analyze key indicators and data elements that can
	593	+	23 be used in an analysis of lead indicators from assessments and
	594	+	24 data sets available to the Department that can be shared with
	595	+	25 managed care organizations and similar care coordination
	596	+	26 entities contracted with the Department as leading indicators
	597	+
	598	+
	599	+
	600	+
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	603	+
	604	+
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	607	+	1 for elevated behavioral health crisis risk for children,
	608	+	2 including data sets such as the Illinois Medicaid
	609	+	3 Comprehensive Assessment of Needs and Strengths (IM-CANS),
	610	+	4 calls made to the State's Crisis and Referral Entry Services
	611	+	5 (CARES) hotline, health services information from Health and
	612	+	6 Human Services Innovators, or other data sets that may include
	613	+	7 key indicators. The workgroup shall complete its
	614	+	8 recommendations for leading indicator data elements on or
	615	+	9 before September 1, 2024. To the extent permitted by State and
	616	+	10 federal law, the identified leading indicators shall be shared
	617	+	11 with managed care organizations and similar care coordination
	618	+	12 entities contracted with the Department on or before December
	619	+	13 1, 2024 within 6 months of identification for the purpose of
	620	+	14 improving care coordination with the early detection of
	621	+	15 elevated risk. Leading indicators shall be reassessed annually
	622	+	16 with stakeholder input. The Department shall implement
	623	+	17 guidance to managed care organizations and similar care
	624	+	18 coordination entities contracted with the Department, so that
	625	+	19 the managed care organizations and care coordination entities
	626	+	20 respond to lead indicators with services and interventions
	627	+	21 that are designed to help stabilize the child.
	628	+	22 (i) The requirements of this Section apply to contracts
	629	+	23 with accountable care entities and MCOs entered into, amended,
	630	+	24 or renewed after June 16, 2014 (the effective date of Public
	631	+	25 Act 98-651).
	632	+	26 (j) Health care information released to managed care
	633	+
	634	+
	635	+
	636	+
	637	+
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	639	+
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	643	+	1 organizations. A health care provider shall release to a
	644	+	2 Medicaid managed care organization, upon request, and subject
	645	+	3 to the Health Insurance Portability and Accountability Act of
	646	+	4 1996 and any other law applicable to the release of health
	647	+	5 information, the health care information of the MCO's
	648	+	6 enrollee, if the enrollee has completed and signed a general
	649	+	7 release form that grants to the health care provider
	650	+	8 permission to release the recipient's health care information
	651	+	9 to the recipient's insurance carrier.
	652	+	10 (k) The Department of Healthcare and Family Services,
	653	+	11 managed care organizations, a statewide organization
	654	+	12 representing hospitals, and a statewide organization
	655	+	13 representing safety-net hospitals shall explore ways to
	656	+	14 support billing departments in safety-net hospitals.
	657	+	15 (l) The requirements of this Section added by Public Act
	658	+	16 102-4 shall apply to services provided on or after the first
	659	+	17 day of the month that begins 60 days after April 27, 2021 (the
	660	+	18 effective date of Public Act 102-4).
	661	+	19 (Source: P.A. 102-4, eff. 4-27-21; 102-43, eff. 7-6-21;
	662	+	20 102-144, eff. 1-1-22; 102-454, eff. 8-20-21; 102-813, eff.
	663	+	21 5-13-22; 103-546, eff. 8-11-23.)
	664	+	22 Section 20. The Children's Mental Health Act is amended by
	665	+	23 changing Section 5 as follows:
	666	+	24 (405 ILCS 49/5)
	667	+
	668	+
	669	+
	670	+
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	673	+
	674	+
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	677	+	1 Sec. 5. Children's Mental Health Partnership; Children's
	678	+	2 Mental Health Plan.
	679	+	3 (a) The Children's Mental Health Partnership (hereafter
	680	+	4 referred to as "the Partnership") created under Public Act
	681	+	5 93-495 and continued under Public Act 102-899 shall advise
	682	+	6 State agencies and the Children's Behavioral Health
	683	+	7 Transformation Initiative on designing and implementing
	684	+	8 short-term and long-term strategies to provide comprehensive
	685	+	9 and coordinated services for children from birth to age 25 and
	686	+	10 their families with the goal of addressing children's mental
	687	+	11 health needs across a full continuum of care, including social
	688	+	12 determinants of health, prevention, early identification, and
	689	+	13 treatment. The recommended strategies shall build upon the
	690	+	14 recommendations in the Children's Mental Health Plan of 2022
	691	+	15 and may include, but are not limited to, recommendations
	692	+	16 regarding the following:
	693	+	17 (1) Increasing public awareness on issues connected to
	694	+	18 children's mental health and wellness to decrease stigma,
	695	+	19 promote acceptance, and strengthen the ability of
	696	+	20 children, families, and communities to access supports.
	697	+	21 (2) Coordination of programs, services, and policies
	698	+	22 across child-serving State agencies to best monitor and
	699	+	23 assess spending, as well as foster innovation of adaptive
	700	+	24 or new practices.
	701	+	25 (3) Funding and resources for children's mental health
	702	+	26 prevention, early identification, and treatment across
	703	+
	704	+
	705	+
	706	+
	707	+
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	709	+
	710	+
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	713	+	1 child-serving State agencies.
	714	+	2 (4) Facilitation of research on best practices and
	715	+	3 model programs and dissemination of this information to
	716	+	4 State policymakers, practitioners, and the general public.
	717	+	5 (5) Monitoring programs, services, and policies
	718	+	6 addressing children's mental health and wellness.
	719	+	7 (6) Growing, retaining, diversifying, and supporting
	720	+	8 the child-serving workforce, with special emphasis on
	721	+	9 professional development around child and family mental
	722	+	10 health and wellness services.
	723	+	11 (7) Supporting the design, implementation, and
	724	+	12 evaluation of a quality-driven children's mental health
	725	+	13 system of care across all child services that prevents
	726	+	14 mental health concerns and mitigates trauma.
	727	+	15 (8) Improving the system to more effectively meet the
	728	+	16 emergency and residential placement needs for all children
	729	+	17 with severe mental and behavioral challenges.
	730	+	18 (b) The Partnership shall have the responsibility of
	731	+	19 developing and updating the Children's Mental Health Plan and
	732	+	20 advising the relevant State agencies on implementation of the
	733	+	21 Plan. The Children's Mental Health Partnership shall be
	734	+	22 comprised of the following members:
	735	+	23 (1) The Governor or his or her designee.
	736	+	24 (2) The Attorney General or his or her designee.
	737	+	25 (3) The Secretary of the Department of Human Services
	738	+	26 or his or her designee.
	739	+
	740	+
	741	+
	742	+
	743	+
	744	+	SB0726 Enrolled - 21 - LRB103 03199 CPF 48205 b
	745	+
	746	+
	747	+	SB0726 Enrolled- 22 -LRB103 03199 CPF 48205 b SB0726 Enrolled - 22 - LRB103 03199 CPF 48205 b
	748	+	SB0726 Enrolled - 22 - LRB103 03199 CPF 48205 b
	749	+	1 (4) The State Superintendent of Education or his or
	750	+	2 her designee.
	751	+	3 (5) The Director of the Department of Children and
	752	+	4 Family Services or his or her designee.
	753	+	5 (6) The Director of the Department of Healthcare and
	754	+	6 Family Services or his or her designee.
	755	+	7 (7) The Director of the Department of Public Health or
	756	+	8 his or her designee.
	757	+	9 (8) The Director of the Department of Juvenile Justice
	758	+	10 or his or her designee.
	759	+	11 (9) The Executive Director of the Governor's Office of
	760	+	12 Early Childhood Development or his or her designee.
	761	+	13 (10) The Director of the Criminal Justice Information
	762	+	14 Authority or his or her designee.
	763	+	15 (11) One member of the General Assembly appointed by
	764	+	16 the Speaker of the House.
	765	+	17 (12) One member of the General Assembly appointed by
	766	+	18 the President of the Senate.
	767	+	19 (13) One member of the General Assembly appointed by
	768	+	20 the Minority Leader of the Senate.
	769	+	21 (14) One member of the General Assembly appointed by
	770	+	22 the Minority Leader of the House.
	771	+	23 (15) Up to 25 representatives from the public
	772	+	24 reflecting a diversity of age, gender identity, race,
	773	+	25 ethnicity, socioeconomic status, and geographic location,
	774	+	26 to be appointed by the Governor. Those public members
	775	+
	776	+
	777	+
	778	+
	779	+
	780	+	SB0726 Enrolled - 22 - LRB103 03199 CPF 48205 b
	781	+
	782	+
	783	+	SB0726 Enrolled- 23 -LRB103 03199 CPF 48205 b SB0726 Enrolled - 23 - LRB103 03199 CPF 48205 b
	784	+	SB0726 Enrolled - 23 - LRB103 03199 CPF 48205 b
	785	+	1 appointed under this paragraph must include, but are not
	786	+	2 limited to:
	787	+	3 (A) a family member or individual with lived
	788	+	4 experience in the children's mental health system;
	789	+	5 (B) a child advocate;
	790	+	6 (C) a community mental health expert,
	791	+	7 practitioner, or provider;
	792	+	8 (D) a representative of a statewide association
	793	+	9 representing a majority of hospitals in the State;
	794	+	10 (E) an early childhood expert or practitioner;
	795	+	11 (F) a representative from the K-12 school system;
	796	+	12 (G) a representative from the healthcare sector;
	797	+	13 (H) a substance use prevention expert or
	798	+	14 practitioner, or a representative of a statewide
	799	+	15 association representing community-based mental health
	800	+	16 substance use disorder treatment providers in the
	801	+	17 State;
	802	+	18 (I) a violence prevention expert or practitioner;
	803	+	19 (J) a representative from the juvenile justice
	804	+	20 system;
	805	+	21 (K) a school social worker; and
	806	+	22 (L) a representative of a statewide organization
	807	+	23 representing pediatricians.
	808	+	24 (16) Two co-chairs appointed by the Governor, one
	809	+	25 being a representative from the public and one being the
	810	+	26 Director of Public Health a representative from the State.
	811	+
	812	+
	813	+
	814	+
	815	+
	816	+	SB0726 Enrolled - 23 - LRB103 03199 CPF 48205 b
	817	+
	818	+
	819	+	SB0726 Enrolled- 24 -LRB103 03199 CPF 48205 b SB0726 Enrolled - 24 - LRB103 03199 CPF 48205 b
	820	+	SB0726 Enrolled - 24 - LRB103 03199 CPF 48205 b
	821	+	1 The members appointed by the Governor shall be appointed
	822	+	2 for 4 years with one opportunity for reappointment, except as
	823	+	3 otherwise provided for in this subsection. Members who were
	824	+	4 appointed by the Governor and are serving on January 1, 2023
	825	+	5 (the effective date of Public Act 102-899) shall maintain
	826	+	6 their appointment until the term of their appointment has
	827	+	7 expired. For new appointments made pursuant to Public Act
	828	+	8 102-899, members shall be appointed for one-year, 2-year, or
	829	+	9 4-year terms, as determined by the Governor, with no more than
	830	+	10 9 of the Governor's new or existing appointees serving the
	831	+	11 same term. Those new appointments serving a one-year or 2-year
	832	+	12 term may be appointed to 2 additional 4-year terms. If a
	833	+	13 vacancy occurs in the Partnership membership, the vacancy
	834	+	14 shall be filled in the same manner as the original appointment
	835	+	15 for the remainder of the term.
	836	+	16 The Partnership shall be convened no later than January
	837	+	17 31, 2023 to discuss the changes in Public Act 102-899.
	838	+	18 The members of the Partnership shall serve without
	839	+	19 compensation but may be entitled to reimbursement for all
	840	+	20 necessary expenses incurred in the performance of their
	841	+	21 official duties as members of the Partnership from funds
	842	+	22 appropriated for that purpose.
	843	+	23 The Partnership may convene and appoint special committees
	844	+	24 or study groups to operate under the direction of the
	845	+	25 Partnership. Persons appointed to such special committees or
	846	+	26 study groups shall only receive reimbursement for reasonable
	847	+
	848	+
	849	+
	850	+
	851	+
	852	+	SB0726 Enrolled - 24 - LRB103 03199 CPF 48205 b
	853	+
	854	+
	855	+	SB0726 Enrolled- 25 -LRB103 03199 CPF 48205 b SB0726 Enrolled - 25 - LRB103 03199 CPF 48205 b
	856	+	SB0726 Enrolled - 25 - LRB103 03199 CPF 48205 b
	857	+	1 expenses.
	858	+	2 (b-5) The Partnership shall include an adjunct council
	859	+	3 comprised of no more than 6 youth aged 14 to 25 and 4
	860	+	4 representatives of 4 different community-based organizations
	861	+	5 that focus on youth mental health. Of the community-based
	862	+	6 organizations that focus on youth mental health, one of the
	863	+	7 community-based organizations shall be led by an
	864	+	8 LGBTQ-identified person, one of the community-based
	865	+	9 organizations shall be led by a person of color, and one of the
	866	+	10 community-based organizations shall be led by a woman. Of the
	867	+	11 representatives appointed to the council from the
	868	+	12 community-based organizations, at least one representative
	869	+	13 shall be LGBTQ-identified, at least one representative shall
	870	+	14 be a person of color, and at least one representative shall be
	871	+	15 a woman. The council members shall be appointed by the Chair of
	872	+	16 the Partnership and shall reflect the racial, gender identity,
	873	+	17 sexual orientation, ability, socioeconomic, ethnic, and
	874	+	18 geographic diversity of the State, including rural, suburban,
	875	+	19 and urban appointees. The council shall make recommendations
	876	+	20 to the Partnership regarding youth mental health, including,
	877	+	21 but not limited to, identifying barriers to youth feeling
	878	+	22 supported by and empowered by the system of mental health and
	879	+	23 treatment providers, barriers perceived by youth in accessing
	880	+	24 mental health services, gaps in the mental health system,
	881	+	25 available resources in schools, including youth's perceptions
	882	+	26 and experiences with outreach personnel, agency websites, and
	883	+
	884	+
	885	+
	886	+
	887	+
	888	+	SB0726 Enrolled - 25 - LRB103 03199 CPF 48205 b
	889	+
	890	+
	891	+	SB0726 Enrolled- 26 -LRB103 03199 CPF 48205 b SB0726 Enrolled - 26 - LRB103 03199 CPF 48205 b
	892	+	SB0726 Enrolled - 26 - LRB103 03199 CPF 48205 b
	893	+	1 informational materials, methods to destigmatize mental health
	894	+	2 services, and how to improve State policy concerning student
	895	+	3 mental health. The mental health system may include services
	896	+	4 for substance use disorders and addiction. The council shall
	897	+	5 meet at least 4 times annually.
	898	+	6 (c) (Blank).
	899	+	7 (d) The Illinois Children's Mental Health Partnership has
	900	+	8 the following powers and duties:
	901	+	9 (1) Conducting research assessments to determine the
	902	+	10 needs and gaps of programs, services, and policies that
	903	+	11 touch children's mental health.
	904	+	12 (2) Developing policy statements for interagency
	905	+	13 cooperation to cover all aspects of mental health
	906	+	14 delivery, including social determinants of health,
	907	+	15 prevention, early identification, and treatment.
	908	+	16 (3) Recommending policies and providing information on
	909	+	17 effective programs for delivery of mental health services.
	910	+	18 (4) Using funding from federal, State, or
	911	+	19 philanthropic partners, to fund pilot programs or research
	912	+	20 activities to resource innovative practices by
	913	+	21 organizational partners that will address children's
	914	+	22 mental health. However, the Partnership may not provide
	915	+	23 direct services.
	916	+	24 (4.1) The Partnership shall work with community
	917	+	25 networks and the Children's Behavioral Health
	918	+	26 Transformation Initiative team to implement a community
	919	+
	920	+
	921	+
	922	+
	923	+
	924	+	SB0726 Enrolled - 26 - LRB103 03199 CPF 48205 b
	925	+
	926	+
	927	+	SB0726 Enrolled- 27 -LRB103 03199 CPF 48205 b SB0726 Enrolled - 27 - LRB103 03199 CPF 48205 b
	928	+	SB0726 Enrolled - 27 - LRB103 03199 CPF 48205 b
	929	+	1 needs assessment, that will raise awareness of gaps in
	930	+	2 existing community-based services for youth.
	931	+	3 (5) Submitting an annual report, on or before December
	932	+	4 30 of each year, to the Governor and the General Assembly
	933	+	5 on the progress of the Plan, any recommendations regarding
	934	+	6 State policies, laws, or rules necessary to fulfill the
	935	+	7 purposes of the Act, and any additional recommendations
	936	+	8 regarding mental or behavioral health that the Partnership
	937	+	9 deems necessary.
	938	+	10 (6) (Blank). Employing an Executive Director and
	939	+	11 setting the compensation of the Executive Director and
	940	+	12 other such employees and technical assistance as it deems
	941	+	13 necessary to carry out its duties under this Section.
	942	+	14 The Partnership may designate a fiscal and administrative
	943	+	15 agent that can accept funds to carry out its duties as outlined
	944	+	16 in this Section.
	945	+	17 The Department of Public Health Healthcare and Family
	946	+	18 Services shall provide technical and administrative support
	947	+	19 for the Partnership.
	948	+	20 (e) The Partnership may accept monetary gifts or grants
	949	+	21 from the federal government or any agency thereof, from any
	950	+	22 charitable foundation or professional association, or from any
	951	+	23 reputable source for implementation of any program necessary
	952	+	24 or desirable to carry out the powers and duties as defined
	953	+	25 under this Section.
	954	+	26 (f) On or before January 1, 2027, the Partnership shall
	955	+
	956	+
	957	+
	958	+
	959	+
	960	+	SB0726 Enrolled - 27 - LRB103 03199 CPF 48205 b
	961	+
	962	+
	963	+	SB0726 Enrolled- 28 -LRB103 03199 CPF 48205 b SB0726 Enrolled - 28 - LRB103 03199 CPF 48205 b
	964	+	SB0726 Enrolled - 28 - LRB103 03199 CPF 48205 b
	965	+	1 submit recommendations to the Governor and General Assembly
	966	+	2 that includes recommended updates to the Act to reflect the
	967	+	3 current mental health landscape in this State.
	968	+	4 (Source: P.A. 102-16, eff. 6-17-21; 102-116, eff. 7-23-21;
	969	+	5 102-899, eff. 1-1-23; 102-1034, eff. 1-1-23; 103-154, eff.
	970	+	6 6-30-23.)
	971	+	7 Section 25. The Interagency Children's Behavioral Health
	972	+	8 Services Act is amended by adding Section 6 as follows:
	973	+	9 (405 ILCS 165/6 new)
	974	+	10 Sec. 6. Personal support workers. The Children's
	975	+	11 Behavioral Health Transformation Team in collaboration with
	976	+	12 the Department of Human Services shall develop a program to
	977	+	13 provide one-on-one in-home respite behavioral health aids to
	978	+	14 youth requiring intensive supervision due to behavioral health
	979	+	15 needs.
	980	+
	981	+
	982	+
	983	+
	984	+
	985	+	SB0726 Enrolled - 28 - LRB103 03199 CPF 48205 b