SB2437: MEDICAID-MATERNAL HLTH-DOULAS

Legislative Summary

Amends the Medical Assistance Article of the Illinois Public Aid Code by adding provisions concerning doula policies for hospitals and birthing centers; medical assistance coverage for persons who are foreign-born victims of human trafficking, torture, or other serious crimes, and their derivative family members; the development of tardive dyskinesia screening guidelines for providers serving patients prescribed antipsychotic medications under the medical assistance program in State-operated residential facilities and community-based settings; quarterly reporting requirements for the Department and managed care organizations concerning their compliance with specified statutory prohibitions on prior authorization mandates and utilization controls for FDA-approved prescription drugs that treat mental illness; a rate evaluation to study the soundness of the rate paid for private duty nursing services for medically fragile and technology dependent children; reimbursement rates for long-term ambulatory electrocardiogram monitoring services; medical assistance coverage for over-the-counter choline dietary supplements for pregnant persons; language clarifying that a redetermination for medical assistance eligibility is not an initial application; reimbursement rates for the support component of the nursing facility rate for skilled or intermediate care facilities and for facilities licensed under the Specialized Mental Health Rehabilitation Act of 2013; and other matters. Creates the Certified Family Health Aide Program for Children and Adults Act. Permits the Department of Public Health, in partnership with the Department of Healthcare and Family Services to create a certification pathway for a legally responsible caregiver, or a person who has been designated by a legally responsible caregiver, who is seeking certification as a certified family health aide, including the adoption of any necessary rules for the certification process. Amends the Alternative Health Care Delivery Act, the Home Health, Home Services, and Home Nursing Agency Licensing Act, and the Hospital Licensing Act to require children's community-based health care centers, home nursing agencies, and hospitals to provide training for, and retain records regarding, certified family health aides. Amends the Nurse Practice Act. Provides that the Act does not prohibit the practice of relevant nursing care by a legally responsible caregiver or a person designated by a legally responsible caregiver who has been certified as a certified family health aide for the specified services. Amends the Medical Assistance Article of the Illinois Public Aid Code. Adds provisions permitting the Department of Healthcare and Family Services to apply for a Home and Community-Based Services State Plan amendment and federal waiver amendment to provide reimbursement for a certified family health aide program for children and adults; and other matters. Amends the Hospital Licensing Act. Provides that a hospital located in a county with fewer than 325,000 inhabitants may apply to the Department of Public Health for approval to conduct its operations from more than one location within contiguous counties provided that the facility located in the contiguous county is separately licensed under the Act and was acquired out of bankruptcy proceedings prior to the effective date of the amendatory Act. Amends the Nursing Home Care Act. Makes changes to provisions concerning staffing ratios computations. Provides that monetary penalties for facilities not in compliance with minimum staffing standards may not be waived except where there is no more than a 10% deviation from the staffing requirements, in which case a facility shall not receive a violation or penalty. Requires a facility that receives a violation notice to post for 60 consecutive days on its website and at all publicly used exterior entryways into the facility a notice that states the applicable quarter during which the facility was not in compliance. Effective immediately, except that some provisions take effect January 1, 2026.