Good morning, Healthcare Council. After a summer of intense politicking and campaigning, we now have a clearer glimpse into the structure of Illinois government for next year, and it is deep Blue. Veto Session begins next Tuesday, and we've seen a flurry of new bill introductions and committees scheduled. On to the update!

 

Brave New (Blue) World

Tuesday's election in Illinois resulted in significant Democratic gains statewide and in the Illinois General Assembly. Once statewide officials and members of the General Assembly are sworn in next January, Democrats will control all statewide offices and be in the supermajority in both chambers of the legislature.

 

Illinois Governor

Democrat JB Pritzker beat incumbent Republican Gov. Bruce Rauner 54-39. Transition information continues to trickle out, including Gov.-elect Pritzker's transition team leadership and his budget working group. The Chamber has learned that Gov. Rauner's office has already sent transition document templates for agencies to begin filling out.

 

Illinois Attorney General

Democrat State Sen. Kwame Raoul beat Republican Erika Harold 54-43, replacing current Attorney General Lisa Madigan.

 

Other Notable Statewide and Federal Races

Incumbent Democrats also handily won offices for Comptroller (Susana Mendoza), Secretary of State (Jesse White) and Treasurer (Michael Frerichs).

 

West suburban GOP U.S. Reps. Peter Roskam and Randy Hultgren lost to Democrat challengers Sean Casten and Lauren Underwood.

 

General Assembly Recalibration

House and Senate Democrats gained seats yesterday, with House Democrats winning enough seats to go into the supermajority (the Senate Democrats already had a supermajority).

 

The current House composition is 67 Democrats and 51 Republicans. A supermajority is 71. The Democrats picked up the following GOP seats:

 

 

 

 

 

 

The Republicans picked up one seat, Republican Patrick Windhorst over incumbent Democrat Rep. Natalie Phelps Finnie 57-43

 

The following races have a razor-thin margin, and will come down to outstanding vote by mail ballots:

 

 

 

 

The current State Senate composition is 37 Democrats and 22 Republicans. 36 is a supermajority. The Democrats picked up the 27 ^th District (GOP incumbent Sen. Tom Rooney), with two other races not yet finalized (GOP Sens. Mike Connelly and Chris Nybo). 

 

Healthcare Bills in Committee Next Week

The following healthcare-related bills are posted to committees this week.

 

Tuesday, Nov. 13

 

3:00 PM

House Environment
Room 114 Capitol Building - Springfield, IL

Bills Posted:

HB5983 - Durkin -EPA-ETHYLENE OXIDE BAN     

HB5985 - Yingling -EPA-ETHYLENE OXIDE

 

Note: both pieces of legislation are similar in that they would implement a ban on the use of ethylene oxide at different dates in the future, with Rep. Yingling's going even farther by adding a private right of action. Legislative activity follows newspaper reporting over the summer regarding new data from the federal government indicating a higher cancer risk from ethylene oxide than previously thought. Industry disputes these findings and also argues that ethylene oxide is a vital part in the sterilization process for medical equipment. It is likely that one or both of these bills will advance out of committee next Tuesday, with negotiations likely to begin between stakeholders and the bills proponents, the Illinois Environmental Council. If you have direct feedback on either of these bills, please let me know.

 

House Health Care Licenses Committee
Room C-1 Stratton Building - Springfield, IL

Bills Posted:

SJR67 - Moeller - Creates the Home Birth Maternity Care Crisis Study Committee to provide the General Assembly a consumer-focused, evidence-based solution to the Illinois Home Birth Maternity Care Crisis.

 

House Appropriations-Human Services Committee
Room D-1 Stratton Building - Springfield, IL

Bills Posted:

SB938 - Replaces everything after the enacting clause. Amends the Consent by Minors to Medical Procedures Act. Changes the short title to the Consent by Minors to Health Care Services Act. Provides that provisions concerning the giving of consent to the performance of health care services apply to the giving of consent to the performance of health care services by a chiropractic physician or a licensed optometrist. Changes references from "physician licensed to practice medicine and surgery" to "physician licensed to practice medicine in all its branches". Changes references from "medical or surgical procedure" and "medical care" to "health care service". Makes corresponding and other changes.

 

Wednesday, Nov. 14

 

9:00 AM               

Senate Environment and Conservation
212 Capitol - Springfield, IL
Subject Matter On: Ethylene Oxide Emissions, SB 3630, SB 3640

 

Note: This hearing will be a subject matter only hearing on ethylene oxide.

 

9:30 AM

House Aging Committee
Room 122B Capitol Building - Springfield, IL

Bills Posted:

HJR129 - Moeller - FALLS PREVENTION AWARENESS DAY

 

House Elections & Campaign Finance Committee
Room D-1 Stratton Building - Springfield, IL

Bills Posted:

SB2275 - Hurley - Creates the Marijuana Legalization Referendum Act. Requires the State Board of Elections to cause a statewide advisory public question to be submitted to the voters at the November 6, 2018 general election asking whether individuals support the legalization of possession and use of marijuana by persons who are at least 21 years of age, subject to regulation and taxation that is similar to the regulation and taxation of tobacco and alcohol. Provides that if a provision of the Act conflicts with any other law, the Act controls. Repeals the Act on January 1, 2019. Effective immediately.

 

10:00 AM

 

House Mental Health Committee
Room D-1 Stratton Building - Springfield, IL

Bills Posted:

SB752 -Moeller - Amends the Deaf and Hard of Hearing Commission Act. Provides that the Deaf and Hard of Hearing Commission shall be composed of 11 Commissioners (currently, members) that are appointed by the Governor and confirmed by the Senate. Requires at least 8 (currently, 6) commissioners of the Commission to be people who are deaf, deafblind, or hard of hearing. Specifies the membership of the Commission. Modifies the qualifications and duties of the Director of the Commission. Provides that the added Director qualifications shall apply to anyone who becomes Director on or after the effective date of this amendatory Act. Establishes the Director as the chief executive officer of the Commission. Modifies a Section concerning the powers and duties of the Commission. Defines "commissioner".

 

House Executive Committee
Room 118 Capitol Building - Springfield, IL

Bills Posted:

SB1226 - Slaughter - Amends the MC/DD Act. Provides that violations cited against a facility as a result of actions involving administration of medication by direct care staff of day programs certified to serve persons with developmental disabilities by the Department of Human Services under the Mental Health and Developmental Disabilities Administrative Act will not result in specified violations, penalties, or fines under the MC/DD Act. Provides that the Department of Public Health shall notify the Division of Developmental Disabilities of the Department of Human Services when it becomes aware of a medication error at a day program or that a resident is injured or is subject to alleged abuse or neglect at a day program. Makes similar changes in the ID/DD Community Care Act.

 

3:30 PM                  

 

Joint Senate Higher Education and Human Services Committee
212 Capitol - Springfield, IL
Subject Matter On: Solutions Regarding The Shortage Of Behavioral Healthcare Workers In Illinois.

New Healthcare Bills Introduced

The following healthcare-related bills and amendments have been introduced since our last update.

 

HB5970 - Ford - Creates the Safe Spaces in Public Places Act. Defines terms. Provides that beginning with the 2019-2020 academic year, each institution of higher learning must install and operate a walk-through metal detector at each public entrance of the institution and during any special event on any campus of the institution if more than 1,000 people are present at the event. Amends the Officers and Employees Article of the Counties Code. Provides that as part of his or her duty to maintain the security of a courthouse, a sheriff shall maintain a walk-through metal detector at each point of entry into the courthouse. Provides that a courthouse shall ensure that all members of the public, other than employees of the county or individuals who display proper credentials, who enter the courthouse at a point of entry are subjected to screening by a walk-through metal detector. Amends the School Code. Provides that beginning with the 2019-2020 school year, a school board shall require each school under its authority to install and operate a walk-through metal detector at all public entrances of the school. Amends the Hospital Licensing Act. Provides that a hospital shall maintain a metal detector at each point of entry into the hospital; defines "point of entry". Provides that a hospital shall ensure that all members of the public, other than the employees of the hospital who display proper credentials, who enter the hospital at a point of entry are subjected to screening by a metal detector. Effective immediately.

 

The Chamber opposed similar legislation earlier this session.

 

HB5983 - Durkin - Amends the Environmental Protection Act. Provides that ethylene oxide shall only be used to sterilize medical products, and only if the Environmental Protection Agency determines that there is no substitute sterilization technology available for sterilizing a particular medical product. Requires the Agency to prohibit all uses of ethylene oxide by January 1, 2022. Provides that the Agency shall not renew an air pollution operating permit if the Agency finds that the facility is emitting ethylene oxide at a level that violates any federal or State standards pertaining to ethylene oxide. Provides circumstances under which the Agency shall reopen and modify permits issued to facilities emitting ethylene oxide under the Clean Air Act Permit Program. Effective immediately.

 

HB5985 - Yingling - Amends the Environmental Protection Act. Provides that ethylene oxide may only be used for the sterilization of medical products. Prohibits the use of ethylene oxide on and after January 1, 2021. Provides that the Environmental Protection Agency shall reevaluate emissions standards and regulations for ethylene oxide and promulgate new emissions standards and regulations. Provides reporting requirements. Provides that the Agency shall conduct an evaluation of ethylene oxide emissions by facilities with a Clean Air Act Permit Program permit and evaluate and modify any such permit as needed. Provides that the Agency shall revoke a facility's CAAPP permit if a significant public health hazard is determined to exist due to ethylene oxide emissions. Provides that a facility permitted to emit ethylene oxide shall halt emissions of ethylene oxide for a specific amount of time. Provides that it is a violation to emit ethylene oxide at a level that violates any federal or State emissions standards or regulations and the Agency shall not renew the permit of any facility in violation. Provides a right of action for any person exposed to ethylene oxide. Provides notice requirements regarding ethylene oxide. Effective immediately.

 

SB3630 - Curran - Amends the Environmental Protection Act. Provides that the Illinois Environmental Protection Agency shall reevaluate the current air pollution operating permit of any facility emitting ethylene oxide and conduct a 90-day public hearing process on such permits. Provides that no air pollution operating permit shall be renewed if the facility is in violation of any federal or State standards or current studies pertaining to ethylene oxide. In the event of an ethylene oxide leak, a facility shall issue a notice to all affected property owners and local government within 2,500 feet of the leak site. Provides that a facility emitting ethylene oxide at levels higher than federal or State standards shall immediately cease operations until the level of emissions are reduced below both federal and State standards. Effective immediately.

 

SB3640 - Curran - Amends the Environmental Protection Act. Provides that ethylene oxide shall only be used to sterilize medical products, and only if the Environmental Protection Agency determines that there is no substitute sterilization technology available for sterilizing a particular medical product. Requires the Agency to prohibit all uses of ethylene oxide by January 1, 2022. Provides that the Agency shall not renew an air pollution operating permit if the Agency finds that the facility is emitting ethylene oxide at a level that violates any federal or State standards pertaining to ethylene oxide. Provides circumstances under which the Agency shall reopen and modify permits issued to facilities emitting ethylene oxide under the Clean Air Act Permit Program. Effective immediately.

 

SB3642 - McCann - Amends the Illinois Insurance Code. Provides that the Third Party Prescription Program Act does not apply to pharmacy benefits managers. Creates the Pharmacy Benefits Managers Article in the Code. Requires all pharmacy benefits managers doing business in the State to register with the Director of Insurance. Includes provisions on applications for registration, discipline of registered pharmacy benefits managers, examinations, fines, multi-source generic lists, reimbursements, restricted pharmacy fees, audits, and review by the Director.

 

SB 0458 (SFA 0002) - Telehealth insurance coverage - Replaces everything after the enacting clause. Amends the Illinois Insurance Code. In provisions concerning coverage for telehealth services, provides that certain health benefit policies or plans shall provide coverage for the cost of health care services provided through telehealth on the same basis and at the same rate that the health insurer is responsible for coverage for providing the same service through in-person treatment or consultation (rather than certain policies must meet specified criteria if they provide coverage for telehealth services). Defines "telehealth" (rather than "telehealth services") and provides that it includes telepsychiatry. Provides the requirements of coverage for telehealth services. Provides that the provisions do not preclude a health benefit policy or plan from undertaking utilization review to determine the appropriateness of telehealth as a means of delivering a health care service, provided that the determination is made in the same manner as those regarding the same service when it is delivered in person. Provides that the provisions do not authorize a health benefit policy or plan to require the use of telehealth. Provides that a health care provider is not required to use telehealth, and a patient is not required to use telehealth if the patient chooses in-person care. Amends the Illinois Public Aid Code. Provides payment, reimbursement, and service requirements for telehealth services provided under the State's fee-for-service or managed care medical assistance programs. Provides that "telehealth" includes telepsychiatry. Provides that the Department of Healthcare and Family Services shall implement the new provisions 60 days after the effective date of the amendatory Act. Repeals a provision requiring the Department to reimburse psychiatrists and federally qualified health centers for mental health services provided by psychiatrists to medical assistance recipients through telepsychiatry.

 

JCAR Update

Below are new proposed rules since our last update.

 

DPH proposed a new Part titled Alzheimer's Disease and Related Dementias Services Code (77 IAC 973; 42 Ill Reg 19510) implementing two Public Acts that created the Alzheimer's Disease and Related Dementias Services Act [410 ILCS 406]. The Act and the new Part govern all facilities and services, including home health, assisted living, intermediate or skilled nursing, and hospice services, that serve persons with Alzheimer's Disease or related dementias. Services must be implemented in accordance with nationally recognized standards of care (e.g., Alzheimer's Association, National Institutes of Health). The new Part also lists qualifications and continuing education requirements for an Alzheimer's services director and training requirements for staff with direct access to clients or patients. An entity that knowingly offers Alzheimer's/dementia services not in compliance with this Part and is licensed, certified or regulated by the State will be deemed in violation of its licensing/certification statutes and any contract or agreement it has with the State; non-licensed entities will be guilty of a business offense punishable by a fine of at least $1,001. Those affected by this rulemaking include nursing homes, assisted living facilities, home care and hospice services, and other entities that care for persons with dementia.

 

DOI proposed a new Part titled Unclaimed Life Insurance Benefits (50 IAC 920; 42 Ill Reg 19362) implementing provisions of the Unclaimed Life Insurance Benefits Act [215 ILCS 185] that require DOI to establish a Lost Policy Finder Service. All Illinois insurers must register for the service within 30 days after the new Part takes effect or within 30 days after they are authorized to sell life insurance products in Illinois.

 

DOI also proposed amendments to Improper Claims Practice (50 IAC 919; 42 Ill Reg 19331) updating the Part to add definitions; clarify the Part's applicability to all claims activity on or after 6/17/74; list criteria for frequency of examinations and maintenance of claims data; and clarify current practices regarding filing of fire and extended coverage claims, storage and towing of vehicles, unreasonable delays in resolving claims, and other issues.

 

DFPR proposed an amendment to the Part titled Illinois Dental Practice Act (68 IAC 1220; 42 Ill Reg 19144) establishing educational requirements for public health dental hygenists employed or contracted by State or local agencies or school-based programs. In addition to other requirements for licensure, public health dental hygenists must complete 42 hours of advanced courses. At least 29 hours must include didactic (in person) instruction covering emergency procedures for medically compromised patients, geriatric and pediatric dentistry, pharmacology, pathology, and medical recordkeeping procedures. The remaining 13 hours, which may be taken in person or online, must address special needs patients, teledentristy, cultural competency, communication with low oral health literacy patients, nutrition, and professional ethics. Courses must be provided by a Statewide dental or dental hygiene association or by an institution accredited by the Commission on Dental Accreditation. Once these educational courses are completed, a public health dental hygienist may enter a written supervision agreement with a licensed dentist that will enable the hygienist to work independently in a public health setting. Dentists, dental hygenists, local health departments, schools and dental hygiene education providers are affected by this rulemaking.

2019 Planning

Working on legislation for next year?  Let us know so we can be of service.