Article XII – Administration

(305 ILCS 5/Art. XII heading)

ARTICLE XII.
ADMINISTRATION

 

(305 ILCS 5/12-1) (from Ch. 23, par. 12-1)

Sec. 12-1. Administration of Code; Department of Healthcare and Family Services.

(a) This Code shall be administered by the Department of Human
Services and the Department of Healthcare and Family Services (formerly Illinois Department of Public
Aid)
as provided in the Department of Human Services Act.

(b) The Department of Healthcare and Family Services shall be under the supervision and
direction of the
Director of Healthcare and Family Services, as provided in Section 5-20 of the
Departments of State Government Law (20 ILCS 5/5-20). The Director shall be appointed pursuant
to the
provisions of Section 5-605 and meet the qualifications of Section
5-230 of
that Law.

The Assistant Director of Healthcare and Family Services, created by Section 5-165
of the
Departments of State Government Law (20 ILCS 5/5-165), shall be appointed pursuant to the
provisions
of Section 5-605 of that Law and shall meet the
qualifications
prescribed in
Section 5-230 of that Law.

The salaries of the Director and the Assistant Director shall be those
specified in Section 5-395 of the Departments of State
Government Law (20 ILCS 5/5-395).

The Department of Healthcare and Family Services and the Director of Healthcare and Family Services

shall comply with
other provisions of the Civil Administrative Code of Illinois which are
generally
applicable to the several departments of the State Government created by
that Code.

(Source: P.A. 95-331, eff. 8-21-07.)

 

(305 ILCS 5/12-2) (from Ch. 23, par. 12-2)

Sec. 12-2.
County departments.
The County Departments, under the supervision
and direction of the Illinois
Department and subject to its rules and regulations, shall locally
administer the programs
provided by Articles III, IV, and V of this Code
and shall provide the social services and utilize the rehabilitative
facilities authorized in Articles IX and IXA in respect to
persons served through
Articles III, IV, and V. They shall also
discharge such other duties as may be required by other provisions of
this Code or other laws of this State.

(Source: P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-3) (from Ch. 23, par. 12-3)

Sec. 12-3.
Local governmental units.
As provided in Article VI, local
governmental units shall provide funds for and administer the programs
provided in that Article subject, where so provided, to the supervision of
the Illinois Department. Local governmental units shall also provide the
social services and utilize the rehabilitative facilities authorized in
Article IX for persons served through Article VI, and shall discharge such
other duties as may be required by this Code or other laws of this State.

In counties not under township organization, the county shall provide
funds for and administer such programs.

In counties under township organization (including any such counties
in which the governing authority is a board of commissioners) the
various towns other than those towns lying entirely within the corporate
limits of any city, village or incorporated town having a population of
more than 500,000 inhabitants shall provide funds for and administer
such programs.

Cities, villages, and incorporated towns having a population of more
than 500,000 inhabitants shall provide funds for public aid purposes
under Article VI but the Department of Human Services shall administer the
program for such municipality.
For the fiscal year beginning July 1, 2003, however, the municipality shall
decrease by $5,000,000 the amount of funds it provides for public aid purposes
under Article VI. For each fiscal year thereafter, the municipality shall
decrease the amount of funds it provides for public aid purposes under Article
VI in that fiscal year by an additional amount equal to (i) $5,000,000 or (ii)
the amount provided by the municipality in the preceding fiscal year, whichever
is less, until the municipality does not provide any funds for public aid
purposes under Article VI.

Incorporated towns which have superseded civil townships shall
provide funds for and administer the public aid program provided by
Article VI.

In counties of less than 3 million population having a County
Veterans Assistance Commission in which there has been levied a tax as
authorized by Section 5-2006 of the Counties Code for the purpose of
providing assistance to military veterans and their families, the
County Veterans Assistance Commission shall administer the programs
provided by Article VI for such military veterans and their families
as seek aid through the County Veterans Assistance Commission.

(Source: P.A. 92-111, eff. 1-1-02; 92-597, eff. 6-28-02.)

 

(305 ILCS 5/12-3.1)

Sec. 12-3.1. Discontinuance of a coterminous township. Upon discontinuance of a coterminous township under Articles 27 and 28 of the Township Code, the coterminous municipality shall provide funds for and administer the public aid program provided for under Article VI of this Code.

(Source: P.A. 98-127, eff. 8-2-13; 99-474, eff. 8-27-15.)

 

(305 ILCS 5/12-4) (from Ch. 23, par. 12-4)

Sec. 12-4.
Powers and duties of the Illinois department.
In addition to the powers, duties and functions vested in it by other
provisions of this Code or by other laws of this State, the Illinois
Department shall have the powers enumerated in Sections 12-4.1 to
12-4.30, inclusive, subject to the conditions therein stated.

(Source: P.A. 85-1209.)

 

(305 ILCS 5/12-4.1) (from Ch. 23, par. 12-4.1)

Sec. 12-4.1.
Appointment of administrative staff.

Appoint, in accordance with the “Personnel Code”, approved July 18,
1955, as amended, such administrative staff as may be necessary. The
enactment of this Code shall not impair the merit services status of
persons employed by the Illinois Department on the effective date thereof.

(Source: Laws 1967, p. 122.)

 

(305 ILCS 5/12-4.3) (from Ch. 23, par. 12-4.3)

Sec. 12-4.3.

Child and Spouse Support Unit.)
Establish within the administrative staff a Child and Spouse Support unit, as provided
in Section 10-3.1 of Article X.

(Source: P.A. 79-474.)

 

(305 ILCS 5/12-4.4) (from Ch. 23, par. 12-4.4)

Sec. 12-4.4. Administration of federally-aided programs. Direct
County Departments of Public Aid in the administration of
the federally
funded Supplemental Nutrition Assistance (SNAP) Program, programs to aid refugees and Articles III,
IV, and V of this Code.

The
Illinois Department of Human Services
shall operate a SNAP Employment and Training (SNAP E&T) program in
compliance with federal law. The SNAP E&T program may only be mandatory in counties where the Department can show that there are sufficient program slots for at least the majority of the county’s current non-exempt work registrants as described in Section 11-20 of this Code. Nothing in this Section shall prevent the Department from operating a fully voluntary SNAP E&T program. The SNAP E&T program will have an Earnfare
component. The Earnfare component shall be available in selected geographic
areas based on criteria established by the Illinois Department of Human
Services by rule.
Participants in Earnfare will, to the extent resources allow, earn their
assistance. Participation in the Earnfare program is voluntary, except when
ordered by a court of competent jurisdiction. Eligibility for Earnfare may
be limited to only 6 months out of any 12 consecutive month period. Clients are
not entitled to be placed in an Earnfare slot. Earnfare slots shall be made
available only as resources permit. Earnfare shall be available to persons
receiving SNAP benefits who meet eligibility criteria established by the Illinois
Department of Human Services by rule.
The Illinois Department may, by rule, extend the Earnfare Program to clients
who do not receive SNAP benefits.
Receipt of SNAP benefits is not an
eligibility requirement of
Earnfare when a court of competent jurisdiction orders an individual to
participate in the Earnfare Program. To
the extent resources permit, the Earnfare program will allow participants
to engage in work-related activities to earn monthly financial assistance
payments and to improve participants’ employability in order for them to
succeed in obtaining employment. The Illinois Department of Human Services may enter into
contracts with other public agencies including State agencies, with local
governmental units, and with not-for-profit community based organizations
to carry out the elements of the Program that the Department of Human Services deems appropriate.

The Earnfare Program shall contain the following elements:

• (1) To the extent resources allow and slots exist, the Illinois Department of Human Services shall refer recipients of SNAP benefits who meet eligibility criteria, as established by rule. Receipt of SNAP benefits is not an eligibility requirement of Earnfare when a court of competent jurisdiction orders an individual to participate in the Earnfare Program.
• (2) Persons participating in Earnfare shall engage in employment assigned activities equal to the amount of the SNAP benefits divided by the State or federal minimum wage, whichever is higher, and subsequently shall earn minimum wage assistance for each additional hour of performance in Earnfare activity. Earnfare participants shall be offered the opportunity to earn up to $154. The Department of Human Services may establish a higher amount by rule provided resources permit. If a court of competent jurisdiction orders an individual to participate in the Earnfare program, hours engaged in employment assigned activities shall first be applied for a $50 payment made to the custodial parent as a support obligation. If the individual receives SNAP benefits, the individual shall engage in employment assigned activities equal to the amount of the SNAP benefits divided by the State or federal minimum wage, whichever is higher, and subsequently shall earn State or federal minimum wage assistance, whichever is higher, for each additional hour of performance in Earnfare activity.
• (3) To the extent appropriate slots are available, the Illinois Department of Human Services shall assign Earnfare participants to Earnfare activities based on an assessment of the person’s age, literacy, education, educational achievement, job training, work experience, and recent institutionalization, whenever these factors are known to the Department of Human Services or to the contractor and are relevant to the individual’s success in carrying out the assigned activities and in ultimately obtaining employment.
• (4) The Department of Human Services shall consider the participant’s preferences and personal employment goals in making assignments to the extent administratively possible and to the extent that resources allow.
• (5) The Department of Human Services may enter into cooperative agreements with local governmental units (which may, in turn, enter into agreements with not-for-profit community based organizations): with other public, including State, agencies; directly with not-for-profit community based organizations, and with private employers to create Earnfare activities for program participants.
• (6) To the extent resources permit, the Department of Human Services shall provide the Earnfare participants with the costs of transportation in looking for work and in getting to and from the assigned Earnfare job site and initial expenses of employment.
• (7) All income and asset limitations of the Federal SNAP Program will govern continued Earnfare participation, except that court ordered participants shall participate for 6 months unless the court orders otherwise.
• (8) Earnfare participants shall not displace or substitute for regular, full time or part time employees, regardless of whether or not the employee is currently working, on a leave of absence or in a position or similar position where a layoff has taken place or the employer has terminated the employment of any regular employee or otherwise reduced its workforce with the effect of filling the vacancy so created with a participant subsidized under this program, or is or has been involved in a labor dispute between a labor organization and the sponsor.
• (9) Persons who fail to cooperate with the SNAP E&T program in counties where available program slots exist for at least the majority of that county’s current work registrants shall become ineligible for SNAP benefits according to SNAP regulations, and for Earnfare participation. Failure to participate in Earnfare for all of the hours assigned is not a failure to cooperate unless so established by the employer pursuant to Department of Human Services rules. If a person who is ordered by a court of competent jurisdiction to participate in the Earnfare Program fails to cooperate with the Program, the person shall be referred to the court for failure to comply with the court order.

(Source: P.A. 101-566, eff. 8-23-19.)

 

(305 ILCS 5/12-4.5) (from Ch. 23, par. 12-4.5)

Sec. 12-4.5. Co-operation with Federal Government. Co-operate with the Federal Department of Health and Human Services,
or with any successor agency thereof, or with any other agency of
the Federal Government providing federal funds, commodities, or aid, for
public aid and other purposes, in any reasonable manner not contrary to
this Code, as may be necessary to qualify for federal aid for the several
public aid and welfare service programs established under this Code,
including the costs of administration and personnel training incurred
thereunder, and for such other aid, welfare and related programs for which
federal aid may be available.

The Department of Human Services may supervise the administration of food
and shelter
assistance under this Section for which the Department of Human Services is
authorized to
receive funds from federal, State and private sources. Under such terms as
the Department of Human Services may establish, such monies may be
distributed to units of
local government and non-profit agencies for the purpose of provision of
temporary shelter and food assistance. Temporary shelter means
emergency and transitional living arrangements, including related
ancillary services. Allowable costs shall include remodeling costs but
shall not include other costs not directly related to direct service
provision.

The Department of Human Services may provide low income families and individuals appropriate
supportive services on site to enhance their ability to maintain independent
living arrangements or may contract for the provision of those services on site
with entities that develop or operate housing developments, governmental units,
community based organizations, or not for profit organizations. Those living
arrangements may include transitional housing, single-room occupancy (SRO)
housing developments, or family housing developments. Supportive services may
include any service authorized under this Code including, but not
limited to, services relating to substance abuse, mental health,
transportation, child care, or case management. When appropriate, the
Department of Human Services shall work with other State agencies in order to coordinate services
and to maximize funding. The
Department of Human Services shall give priority for services to residents
of housing
developments
which have been funded by or have a commitment of funds from the Illinois
Housing Development Authority.

The Department of Human Services shall promulgate specific rules
governing the
selection of Distribution Network Agencies under the Federal Surplus
Commodity Program including, but not limited to, policies relative to the
termination of contracts, policies relative to fraud and abuse, appeals
processes, and information relative to application and selection processes.
The Department of Human Services shall also promulgate specific rules that set forth the
information required to be contained in the cost reports to be submitted by
each Distribution Network Agency to the Department of Human Services.

The Department of Human Services shall cooperate with units of local government and
non-profit agencies in the development and implementation of plans to
assure the availability of temporary shelter for persons without a home and/or
food assistance.

The Department of Human Services shall report annually to the House and Senate
Appropriations Committees of the General Assembly regarding the provision
of monies for such assistance as provided in this Section, including the
number of persons served, the level and cost of food provided and the level
and cost of each type of shelter provided and any unmet need as to food and
shelter.

The Illinois Department of Human Services shall make such
reports to the Federal Department or other Federal agencies in such form
and containing such information as may be required, and shall comply with
such provisions as may be necessary to assure the correctness and
verification of such reports if funds are contributed by the Federal
Government. In cooperating with any federal agency providing federal funds,
commodities, or aid for public aid and other purposes, the Department of
Human Services,
with the consent of the Governor, may make necessary expenditures from
moneys appropriated for such purposes for any of the subdivisions of
public aid, for related purposes, or for administration.

(Source: P.A. 97-333, eff. 8-12-11.)

 

(305 ILCS 5/12-4.6) (from Ch. 23, par. 12-4.6)

Sec. 12-4.6.
Receipt and use of federal funds, commodities, or other aid.

Receive, expend and use for all purposes of this Code, and for other
public aid, welfare and related purposes, funds, commodities and other aid
made available by the Federal Government.

(Source: Laws 1967, p. 122.)

 

(305 ILCS 5/12-4.7) (from Ch. 23, par. 12-4.7)

Sec. 12-4.7.
Co-operation with other agencies.
Make use of, aid and
co-operate with State and local governmental agencies, and co-operate with and
assist other governmental and private agencies and organizations engaged in
welfare functions.

(Source: P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-4.7a) (from Ch. 23, par. 12-4.7a)

Sec. 12-4.7a.
(Repealed).

(Source: P.A. 90-372, eff. 7-1-98. Repealed internally, eff. 7-1-98.)

 

(305 ILCS 5/12-4.7b)

Sec. 12-4.7b. Exchanges of information; inmates. The Department shall enter
into intergovernmental agreements
to conduct monthly exchanges of information with
the
Illinois Department of Corrections, the Cook County Department of
Corrections, and the office of the sheriff of every other
county to determine whether any individual included in an assistance unit
receiving public aid
under any Article of this Code is an
inmate in a facility operated by the Illinois Department of Corrections, the
Cook County Department of
Corrections, or a county sheriff. The Illinois Department of Corrections, the Cook County Department of Corrections, and the office of the sheriff of every other county shall honor all intergovernmental agreements with the Department under this Section and shall provide all required information in a timely manner. The Department shall review each month
the entire list of individuals generated by the
monthly exchange and shall verify the eligibility for benefits under this
Code for each individual on the list. The Department shall terminate benefits
under this Code
for any individual determined to be ineligible by this monthly review.
The Department shall use any legal means available to recoup as an overpayment
any assistance
provided to an individual for any period during which he or she was ineligible
to receive the
assistance.

(Source: P.A. 101-115, eff. 7-22-19.)

 

(305 ILCS 5/12-4.7c)

Sec. 12-4.7c. Exchange of information after July 1, 1997.

(a) The Department of Human Services shall exchange with the
Department of Healthcare and Family Services information
that may be necessary for the enforcement of child support orders
entered pursuant to Sections 10-10 and 10-11 of this Code or pursuant to
the Illinois Marriage and Dissolution of Marriage Act, the Non-Support
of Spouse and Children Act, the Non-Support Punishment Act, the Revised
Uniform Reciprocal Enforcement of
Support Act, the Uniform Interstate Family Support Act,
the Illinois Parentage Act of 1984, or the Illinois Parentage Act of 2015.

(b) Notwithstanding any provisions in this Code to the contrary,
the Department of Human Services shall not be liable
to any person for any disclosure of information to the
Department of Healthcare and Family Services (formerly
Illinois Department of Public Aid) under subsection (a)
or for any other
action taken in good faith to comply with the requirements of subsection
(a).

(Source: P.A. 99-85, eff. 1-1-16.)

 

(305 ILCS 5/12-4.7d)

Sec. 12-4.7d.

Interagency agreement regarding investigation of child care
providers. The Department shall enter into a written agreement with the
Department of Children and Family Services which shall provide for interagency
procedures regarding requests by the Department that the Department of Children
and Family Services conduct an investigation of the Central Register, as
defined in the Abused and Neglected Child Reporting Act, to ascertain if a
child care provider who is not required to be licensed
under the Child Care Act of 1969 and who is participating in the child care
assistance program under this Code has been determined to be a perpetrator in
an indicated report of child abuse or neglect.

(Source: P.A. 90-684, eff. 7-31-98.)

 

(305 ILCS 5/12-4.7e)

Sec. 12-4.7e. (Repealed).

(Source: P.A. 96-878, eff. 2-2-10. Repealed internally, eff. 1-1-12.)

 

(305 ILCS 5/12-4.7f)

Sec. 12-4.7f. Death records information. At least once each calendar month, the Department of Human Services shall cross-reference its roster of public aid recipients with the death records information from the Department of Public Health residing on the Electronic Data Warehouse at the Department of Healthcare and Family Services. A public aid recipient who is found to have a death record shall be subject to an immediate cancelation of his or her public aid benefits, including the deactivation of his or her LINK card, in instances where there are no other individuals receiving benefits in that assistance unit and upon
certification that the identity of the public aid recipient matches the identity
of the person named in the death certificate. As used in this Section, “LINK
card” means the electronic benefits transfer card issued by the Department of Human Services for the purpose of enabling a user of the card to obtain Supplemental Nutrition Assistance Program (SNAP) benefits or cash.

(Source: P.A. 99-87, eff. 7-21-15.)

 

(305 ILCS 5/12-4.8) (from Ch. 23, par. 12-4.8)

Sec. 12-4.8.
Supervision of administration of general assistance.
Supervise
the administration of
General Assistance under Article VI by local governmental units
receiving State funds for the purposes of such Article.

(Source: P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-4.8a)

Sec. 12-4.8a.
General assistance record keeping.
The
Illinois Department shall establish procedures
designed to ensure that a person who receives a general assistance grant from
the Illinois Department does not receive a duplicate grant from a township
general assistance program that receives State funds.

(Source: P.A. 88-412.)

 

(305 ILCS 5/12-4.9) (from Ch. 23, par. 12-4.9)

Sec. 12-4.9.
Hearings and investigations.

Conduct hearings and investigations in connection with the
administration of public aid; compel by subpoena, the attendance and
testimony of witnesses and the production of books and papers; and
administer oaths to witnesses. No person shall be compelled to attend an
investigation or hearing at a place outside the county in which he resides.

Subpoenas may be served as provided for in civil actions. The fees of
witnesses for attendance and travel shall be the same as the fees of
witnesses before the Circuit Court and shall be paid as an expense of
administration.

Any qualified officer or employee of the Department designated in
writing by the Director may conduct the hearings and investigations.

(Source: Laws 1967, p. 122.)

 

(305 ILCS 5/12-4.10) (from Ch. 23, par. 12-4.10)

Sec. 12-4.10.
Forms and supplies.

Prescribe the form of and print and supply to the County Departments and
local governmental units official blanks for applications and reports and
such other forms as it deems advisable in relation to the administration of
public aid.

(Source: Laws 1967, p. 122.)

 

(305 ILCS 5/12-4.11) (from Ch. 23, par. 12-4.11)

Sec. 12-4.11. Grant amounts. The Department,
with due regard for and subject to budgetary limitations, shall establish
grant amounts for each of the programs, by regulation. The grant amounts may
vary by program, size of assistance unit and geographic area. Grant amounts under the Temporary Assistance for Needy Families (TANF) program may not vary on the basis of a TANF recipient’s county of residence.

Aid payments shall not be reduced except: (1) for changes in the cost of
items included in the grant amounts, or (2) for changes in the expenses of the
recipient, or (3) for changes in the income or resources available to the
recipient, or (4) for changes in grants resulting from adoption of a
consolidated grant amount.

The maximum benefit levels provided to TANF recipients shall increase as follows: beginning October 1, 2018, the Department of Human Services shall increase TANF grant amounts in effect on September 30, 2018 to at least 30% of the most recent United States Department of Health and Human Services Federal Poverty Guidelines for each family size. Beginning October 1, 2019, and each October 1 thereafter, the maximum benefit levels shall be annually adjusted to remain equal to at least 30% of the most recent poverty guidelines updated periodically in the Federal Register by the U.S. Department
of Health and Human Services under the authority of 42 U.S.C. 9902(2) for each family size.

TANF grants for child-only assistance units shall be at least 75% of TANF grants for assistance units of the same size that consist of a caretaker relative with children.

In fixing standards to govern payments or reimbursements for funeral
and burial expenses, the Department shall establish a minimum allowable
amount of
not less than
$1,000 for Department payment of funeral services and not less than $500 for
Department payment of burial or cremation services. On January 1, 2006, July 1, 2006, and July 1, 2007, the Department shall increase the minimum reimbursement amount for funeral and burial expenses under this Section by a percentage equal to the percentage increase in the Consumer Price Index for All Urban Consumers, if any, during the 12 months immediately preceding that January 1 or July 1. In establishing the minimum
allowable
amount, the Department shall take into account the services
essential to a dignified, low-cost (i) funeral and (ii) burial or
cremation, including reasonable
amounts that may be necessary for
burial space and cemetery charges, and any applicable taxes or other
required governmental fees or charges. If no
person has agreed to pay the total cost of the (i) funeral and
(ii) burial or cremation
charges, the Department shall pay the vendor the actual costs of the (i)
funeral
and
(ii) burial or cremation, or the minimum allowable amount for each service as
established by
the Department, whichever is less, provided that the Department reduces its
payments by
the amount available from the following sources: the decedent’s assets
and
available resources and the anticipated amounts of any death benefits available
to the
decedent’s estate, and amounts paid and arranged to be paid by the
decedent’s legally
responsible relatives. A legally responsible relative is expected to pay
(i) funeral and (ii) burial
or cremation expenses unless financially unable to do so.

Nothing contained in this Section or in any other Section of this
Code shall be construed to prohibit the Illinois Department (1) from
consolidating existing standards on the basis of any standards which are
or were in effect on, or subsequent to July 1, 1969, or (2) from
employing any consolidated standards in determining need for public
aid and the amount of money payment or grant for individual recipients
or recipient families.

(Source: P.A. 100-587, eff. 6-4-18; 101-103, eff. 7-19-19.)

 

(305 ILCS 5/12-4.11-5)

Sec. 12-4.11-5. Murdered Children Funeral and Burial Assistance Program. The Department of Human Services shall by rule administer the Murdered Children Funeral and Burial Assistance Program. Eligibility for the Murdered Children Funeral and Burial Assistance Program shall be limited to those individuals as described in the Murdered Children Funeral and Burial Assistance Act.

Beginning July 1, 2023, the Department of Human Services shall make eligibility determinations for the Murdered Children Funeral and Burial Assistance Program and, subject to appropriation, shall make disbursements for eligible cases to a funeral establishment or cemetery authority as provided under the Murdered Children Funeral and Burial Assistance Act.

(Source: P.A. 102-754, eff. 5-10-22.)

 

(305 ILCS 5/12-4.12) (from Ch. 23, par. 12-4.12)

Sec. 12-4.12.
Insurance Policies in Determination of Need.

To the extent authorized by the rules and regulations of the Illinois
Department, all or a portion of the loan or cash value of insurance
policies may be disregarded in the determination of need under Sections
3-1.2, 4-1.6, 5-4, 6-1.2 and 7-1.2. The Department may also provide, by
rule, (1) for the continuation of life insurance policies at face, cash, or
loan value amounts in excess of funeral and burial expenses, as such
expenses are governed by standards established under Section 12-4.11, and
(2) whether or not provision for continuation is made under (1), for the
taking of assignments of life insurance policies to cover an amount not in
excess of the amount of financial aid which has been, or may be, provided.
In making the determination under (1), the Department shall consider the
physical condition of the insured, the needs of the insured and his
dependents for financial aid, whether those needs will be of a temporary or
continuing nature, and the existence of any unusual circumstances which may
warrant a decision to permit such continuation.

(Source: P.A. 76-1416.)

 

(305 ILCS 5/12-4.13) (from Ch. 23, par. 12-4.13)

Sec. 12-4.13.

Extension of federal commodity and food stamp programs to
non-recipients; Standards of eligibility. The Department of Human
Services shall provide, by rule, for the
extension of Federal surplus foods, food
stamps, or other commodities made available by the Federal Government to
persons who are not recipients of public aid, and establish standards for
determining the eligibility of such persons.

(Source: P.A. 89-507, eff. 7-1-97.)

 

(305 ILCS 5/12-4.13a)

Sec. 12-4.13a. Gross income eligibility standard; SNAP. Subject to federal approval if required, a household that includes an elderly, blind, or disabled person shall be considered categorically eligible for Supplemental Nutrition Assistance Program (SNAP) benefits if the gross income of such household is at or below 200% of the nonfarm income poverty guidelines updated periodically in the Federal Register by the U.S. Department of Health and
Human Services under the authority of 42 U.S.C. 9902(2); and a household that does not include an elderly, blind, or disabled person shall be considered categorically eligible for Supplemental Nutrition Assistance Program (SNAP) benefits if the gross income of such household is at or below 165% of those nonfarm income poverty guidelines.

(Source: P.A. 99-170, eff. 1-1-16.)

 

(305 ILCS 5/12-4.13b)

Sec. 12-4.13b. College student eligibility for supplemental nutrition assistance benefits.

(a) For the purposes of Section 273.5(b)(11)(ii) of Title 7 of the Code of Federal Regulations, a career and technical educational program offered at a community college and approved by the Illinois Community College Board that could be a component of a SNAP Employment and Training (E&T) program, as identified by the Department of Human Services, shall be considered an employment and training program under Section 273.7 of Title 7 of the Code of Federal Regulations, unless prohibited by federal law.

(b) The Department of Human Services, in consultation with representatives of the Illinois Community College Board, the Illinois Student Assistance Commission, the Illinois Workforce Innovation Board, and advocates for students and SNAP recipients, shall establish a protocol to identify and verify all potential exemptions to the eligibility rule described in Section 273.5(a) of Title 7 of the Code of Federal Regulations, and to identify and verify a student’s participation in educational programs, including, but not limited to, self-initiated placements, that would exempt a student from the eligibility rule described in Section 273.5(a) of Title 7 of the Code of Federal Regulations. To the extent possible, this consultation shall take place through existing workgroups convened by the Department of Human Services.

(c) If the United States Department of Agriculture requires federal approval of the exemption designation established pursuant to subsection (a) and the protocol established pursuant to subsection (b), the Department of Human Services shall seek and obtain that approval before publishing the guidance or regulation required by subsection (e).

(d)(1) This Section does not require the Department of Human Services to offer a particular component, support services, or workers’ compensation to a college student found eligible for an exemption pursuant to this Section.

(2) This Section does not restrict or require the use of federal funds for the financing of SNAP E&T programs.

(3) This Section does not require an institution of higher education to verify eligibility for SNAP.

(e) The Department of Human Services shall adopt any rules necessary to implement the provisions of subsections (a), (b), (c), and (d).

(Source: P.A. 100-620, eff. 7-20-18; 101-560, eff. 8-23-19.)

 

(305 ILCS 5/12-4.13c)

Sec. 12-4.13c. SNAP Restaurant Meals Program.

(a) Subject to federal approval of the plan for operating the Program, the Department of Human Services shall establish a Restaurant Meals Program as part of the federal Supplemental Nutrition Assistance Program (SNAP). Under the Restaurant Meals Program, households containing elderly or disabled members, and their spouses, as defined in 7 U.S.C. 2012(j), or homeless individuals, as defined in 7 U.S.C. 2012(l), shall have the option in accordance with 7 U.S.C. 2012(k) to redeem their SNAP benefits at private establishments that contract with the Department to offer meals for eligible individuals at concessional prices subject to 7 U.S.C. 2018(h). The Restaurant Meals Program shall be operational no later than July 1, 2021.

(b) The Department of Human Services shall adopt any rules necessary to implement the provisions of this Section.

(Source: P.A. 101-10, eff. 6-5-19; 101-110, eff. 7-19-19; 102-558, eff. 8-20-21.)

 

(305 ILCS 5/12-4.13d)

Sec. 12-4.13d. SNAP eligibility notification; college students.

(a) To complement student financial assistance programs and to enhance their effectiveness for students with financial need, the Illinois Student Assistance Commission (ISAC) shall annually include information about the Supplemental Nutrition Assistance Program (SNAP) in the language that schools are required to provide to students eligible for the Monetary Award Program grant. The language shall, at a minimum, direct students to information about college student eligibility criteria for SNAP, and it shall direct students to the Department of Human Services and to the Illinois Hunger Coalition’s Hunger Hotline for additional information.

(b) Illinois institutions of higher education that participate in the Monetary Award Program (MAP) shall provide the notice described in subsection (a) to all students who are enrolled, or who are accepted for enrollment and intending to enroll, and who have been identified by ISAC as MAP-eligible at the institution. If possible, the institution may designate a public benefits liaison or single point person to assist students in taking the necessary steps to obtain public benefits if eligible.

(c) ISAC shall adopt any rules necessary to implement the provisions of this Section on or before October 1, 2020.

(Source: P.A. 101-560, eff. 8-23-19; 102-558, eff. 8-20-21.)

 

(305 ILCS 5/12-4.14) (from Ch. 23, par. 12-4.14)

Sec. 12-4.14.
Investigation of resources of applicants, recipients, and responsible
relatives.
Investigate the financial condition of applicants, recipients, and
responsible relatives as defined in Section 2-11 of Article II, in order
to determine whether an applicant or recipient has or can obtain property,
income, resources, or other sources of support sufficient to provide him
with a standard of living compatible with health and well-being.

(Source: Laws 1967, p. 122.)

 

(305 ILCS 5/12-4.15) (from Ch. 23, par. 12-4.15)

Sec. 12-4.15.
(Repealed).

(Source: P.A. 86-651. Repealed by P.A. 90-17, eff. 7-1-97.)

 

(305 ILCS 5/12-4.16) (from Ch. 23, par. 12-4.16)

Sec. 12-4.16.
Economic and social investigations.

Investigate causes of dependency and economic distress, develop plans
and programs for the elimination and prevention of such causes, and
recommend the execution of such programs to appropriate agencies.

(Source: Laws 1967, p. 122.)

 

(305 ILCS 5/12-4.17) (from Ch. 23, par. 12-4.17)

Sec. 12-4.17.
Training personnel for employment in public aid programs.
Establish within the administrative staff a staff development unit to
provide orientation and job-related training for new employees and
continued development and improvement of job skills of all staff of the
Department and County Departments; establish
criteria for and administer and maintain a program for granting employees
educational leave for specialized professional or technical study; and
co-ordinate such training, development, and educational activities with the
training program of the Illinois Department of Central Management Services
and with other
programs for training personnel established under this Section. The
Department may also make grants to public or other non-profit institutions
of higher learning for training personnel employed or preparing for
employment in the public aid programs and conduct special courses of study
or seminars for personnel by experts hired temporarily by the Illinois
Department.

(Source: P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-4.18) (from Ch. 23, par. 12-4.18)

Sec. 12-4.18.
Grants and gifts for public aid and related welfare purposes.
Accept, hold and administer in behalf of the State any grant, gift or legacy
of money, securities, or property to the Illinois
Department or to the State of Illinois for public aid or any related
welfare purpose.

From appropriations from the Assistance to the Homeless Fund, a special
fund in the State treasury, which is hereby created, provide grants to
not-for-profit organizations for the purpose of providing assistance to
homeless persons.

Grants, gifts, and legacies for employment and training programs for public
assistance clients shall be deposited into the Employment and Training Fund.

Grants, gifts, donations, and legacies for functions connected with the
administration of any medical program administered by the Illinois Department
shall be deposited into the Medical Special Purposes Trust
Fund created under Section 12-10.5.

(Source: P.A. 92-37, eff. 7-1-01.)

 

(305 ILCS 5/12-4.19) (from Ch. 23, par. 12-4.19)

Sec. 12-4.19.
Grants for Pilot Studies and Research.

Co-operate with the Federal Government, private foundations, persons,
corporations or other entities making grants of funds or offering the
services of technical assistants for pilot studies and other research
programs relating to effective methods of rehabilitation or the adequacy of
public aid and welfare programs, policies and procedures, and accept, hold
and administer grants made in connection therewith.
Grants for functions connected with the administration of any medical program
administered by the Illinois Department shall be deposited into the
Medical Special Purposes Trust Fund created under Section 12-10.5.

(Source: P.A. 92-37, eff. 7-1-01.)

 

(305 ILCS 5/12-4.20) (from Ch. 23, par. 12-4.20)

Sec. 12-4.20.
Appointment of statewide advisory committees.
Appoint, when and as it may deem necessary, statewide advisory
committees to provide professional or technical consultation in respect to
medical or dental or hospital care, general assistance, home economics, or
other special aspects of public aid and related welfare functions. The
members of the committees shall receive no compensation for their services,
other than expenses actually incurred in the performance of their official
duties. The number of members of each advisory committee shall be
determined by the Illinois Department. The committees shall consult with
and advise the Illinois Department in respect to problems and policies
incident to the administration of the particular Article or Articles of
this Code germane to their respective fields of competence.

The Illinois Department shall include a balanced representation of
recipients, service providers, representatives of community and welfare
advocacy groups, representatives of local governments dealing with public
aid, and representatives of the general public on all statewide advisory
committees appointed by it, except that Professional Advisory Committees created
under Section 5-5 of this Code to provide technical and
professional advice to the Department shall consist entirely of persons
practicing a particular profession.

(Source: P.A. 86-1475.)

 

(305 ILCS 5/12-4.20a) (from Ch. 23, par. 12-4.20a)

Sec. 12-4.20a.
(Repealed).

(Source: P.A. 92-84, eff. 7-1-02. Repealed internally, eff. 7-1-02.)

 

(305 ILCS 5/12-4.20b) (from Ch. 23, par. 12-4.20b)

Sec. 12-4.20b.
(Repealed).

(Source: P.A. 90-372, eff. 7-1-98. Repealed internally, eff. 7-1-98.)

 

(305 ILCS 5/12-4.20c) (from Ch. 23, par. 12-4.20c)

Sec. 12-4.20c.
Appointment of Child Support Advisory Committee.
Appoint
the Child Support Advisory Committee to be composed of members of the
General Assembly, the judiciary, the private bar, and others with expertise
specific to child support establishment and enforcement. Among the tasks of
the Committee shall be the periodic review of the State’s child support
guidelines as required by the federal Family Support Act of 1988. Members
shall be appointed for one year terms commencing on January 1 of each year.
Each newly appointed Committee shall elect a chairperson from among its
members. Members shall serve without compensation, but shall be reimbursed
for expenses incurred in the performance of their duties. The Committee
shall meet at least quarterly and at other times at the call of the
chairperson or at the request of the Director.

(Source: P.A. 86-1347; 86-1432.)

 

(305 ILCS 5/12-4.20d) (from Ch. 23, par. 12-4.20d)

Sec. 12-4.20d.
Appointment of Social Services Advisory Council.
Appoint the Social Services Advisory Council, to be composed of 30
members, which shall include a balanced representation of recipients,
services providers, local governmental units, community and welfare
advocacy groups, academia and the general public. The Council shall advise
the Illinois Department regarding all aspects of assistance
delivered or contracted for under Articles III, IV, VI and IX of this Code
and other areas as deemed appropriate by the Director. In
appointing the first Council, the Director shall name 15 members to 2 year
terms and 15 members to 4 year terms, all of whom shall be appointed within
6 months of the effective date of this amendatory Act of 1991. All members
appointed thereafter shall serve 4 year terms. Members shall serve without
compensation other than reimbursement of expenses actually incurred in the
performance of their official duties. At its first meeting, the Council
shall select a chair from among its members. The Council shall meet at
least quarterly and at other times at the call of the chair.

(Source: P.A. 87-685.)

 

(305 ILCS 5/12-4.21) (from Ch. 23, par. 12-4.21)

Sec. 12-4.21.
Appointment of county welfare services committee.

Appoint, in the manner provided in Section 12-19, the members of the
County Welfare Services Committee in each county of the State.

(Source: Laws 1967, p. 122.)

 

(305 ILCS 5/12-4.22) (from Ch. 23, par. 12-4.22)

Sec. 12-4.22.
Utilization of volunteers.

Adopt, in cooperation with the County Welfare Services Committee of each
county, a plan for the recruitment and full utilization of volunteers to
assist caseworkers and other staff in the performance of their
responsibilities in administering the public aid programs.

(Source: Laws 1967, p. 122.)

 

(305 ILCS 5/12-4.23) (from Ch. 23, par. 12-4.23)

Sec. 12-4.23.
Disposition of obsolete equipment and supplies.

Sell, destroy, or otherwise dispose of office equipment and supplies of
the Illinois Department or the County Departments which have become
worthless by reason of obsolescence or condition of disrepair. If the
Illinois Department orders the sale of all or any portion of such equipment
or supplies, such sale may be either public or private and for cash, and
the proceeds thereof shall be paid into the General Revenue Fund.

(Source: Laws 1967, p. 122.)

 

(305 ILCS 5/12-4.24) (from Ch. 23, par. 12-4.24)

Sec. 12-4.24.
Reports and recommendations.

Recommend to the Governor and General Assembly the enactment of such
legislation as it may deem necessary to improve public aid administration
in this State; submit to the Governor and the General Assembly such reports
as may be requested or as it may deem necessary; and make such other
reports as may be required to supply necessary information concerning
problems and policies relating to the administration of the public aid
programs.

(Source: Laws 1967, p. 122.)

 

(305 ILCS 5/12-4.24a) (from Ch. 23, par. 12-4.24a)

Sec. 12-4.24a. Report and recommendations concerning designated
shortage area. The Illinois Department shall analyze payments made to
providers of medical services under Article V of
this Code to
determine whether any special compensatory standard should be applied to
payments to such providers in designated shortage areas as defined in
Section 3.04 of the Underserved Health Care Provider Workforce Act. The Illinois Department shall, not later than June 30, 1990,
report to the Governor and the General Assembly concerning the results of
its analysis, and may provide by rule for adjustments in its payment rates
to medical service providers in such areas.

(Source: P.A. 101-118, eff. 7-22-19; 102-888, eff. 5-17-22.)

 

(305 ILCS 5/12-4.25) (from Ch. 23, par. 12-4.25)

Sec. 12-4.25. Medical assistance program; vendor participation.

(A) The Illinois Department may deny, suspend, or
terminate the eligibility of any person, firm, corporation, association,
agency, institution or other legal entity to participate as a vendor of
goods or services to recipients under the medical assistance program
under Article V, or may exclude any such
person or entity from participation as such a vendor, and may
deny, suspend, or recover payments, if after reasonable notice and opportunity for a
hearing the Illinois Department finds:

• (a) Such vendor is not complying with the Department’s policy or rules and regulations, or with the terms and conditions prescribed by the Illinois Department in its vendor agreement, which document shall be developed by the Department as a result of negotiations with each vendor category, including physicians, hospitals, long term care facilities, pharmacists, optometrists, podiatric physicians, and dentists setting forth the terms and conditions applicable to the participation of each vendor group in the program; or
• (b) Such vendor has failed to keep or make available for inspection, audit or copying, after receiving a written request from the Illinois Department, such records regarding payments claimed for providing services. This section does not require vendors to make available patient records of patients for whom services are not reimbursed under this Code; or
• (c) Such vendor has failed to furnish any information requested by the Department regarding payments for providing goods or services; or
• (d) Such vendor has knowingly made, or caused to be made, any false statement or representation of a material fact in connection with the administration of the medical assistance program; or
• (e) Such vendor has furnished goods or services to a recipient which are (1) in excess of need, (2) harmful, or (3) of grossly inferior quality, all of such determinations to be based upon competent medical judgment and evaluations; or
• (f) The vendor; a person with management responsibility for a vendor; an officer or person owning, either directly or indirectly, 5% or more of the shares of stock or other evidences of ownership in a corporate vendor; an owner of a sole proprietorship which is a vendor; or a partner in a partnership which is a vendor, either:
• (1) was previously terminated, suspended, or excluded from participation in the Illinois medical assistance program, or was terminated, suspended, or excluded from participation in another state or federal medical assistance or health care program; or
• (2) was a person with management responsibility for a vendor previously terminated, suspended, or excluded from participation in the Illinois medical assistance program, or terminated, suspended, or excluded from participation in another state or federal medical assistance or health care program during the time of conduct which was the basis for that vendor’s termination, suspension, or exclusion; or
• (3) was an officer, or person owning, either directly or indirectly, 5% or more of the shares of stock or other evidences of ownership in a corporate or limited liability company vendor previously terminated, suspended, or excluded from participation in the Illinois medical assistance program, or terminated, suspended, or excluded from participation in a state or federal medical assistance or health care program during the time of conduct which was the basis for that vendor’s termination, suspension, or exclusion; or
• (4) was an owner of a sole proprietorship or partner of a partnership previously terminated, suspended, or excluded from participation in the Illinois medical assistance program, or terminated, suspended, or excluded from participation in a state or federal medical assistance or health care program during the time of conduct which was the basis for that vendor’s termination, suspension, or exclusion; or
• (f-1) Such vendor has a delinquent debt owed to the Illinois Department; or
• (g) The vendor; a person with management responsibility for a vendor; an officer or person owning, either directly or indirectly, 5% or more of the shares of stock or other evidences of ownership in a corporate or limited liability company vendor; an owner of a sole proprietorship which is a vendor; or a partner in a partnership which is a vendor, either:
• (1) has engaged in practices prohibited by applicable federal or State law or regulation; or
• (2) was a person with management responsibility for a vendor at the time that such vendor engaged in practices prohibited by applicable federal or State law or regulation; or
• (3) was an officer, or person owning, either directly or indirectly, 5% or more of the shares of stock or other evidences of ownership in a vendor at the time such vendor engaged in practices prohibited by applicable federal or State law or regulation; or
• (4) was an owner of a sole proprietorship or partner of a partnership which was a vendor at the time such vendor engaged in practices prohibited by applicable federal or State law or regulation; or
• (h) The direct or indirect ownership of the vendor (including the ownership of a vendor that is a sole proprietorship, a partner’s interest in a vendor that is a partnership, or ownership of 5% or more of the shares of stock or other evidences of ownership in a corporate vendor) has been transferred by an individual who is terminated, suspended, or excluded or barred from participating as a vendor to the individual’s spouse, child, brother, sister, parent, grandparent, grandchild, uncle, aunt, niece, nephew, cousin, or relative by marriage.

(A-5) The Illinois Department may deny, suspend, or terminate the
eligibility
of any person, firm, corporation, association, agency, institution, or other
legal entity to participate as a vendor of goods or services to recipients
under the medical assistance program under Article V, or may
exclude any such person or entity from participation as such a
vendor, if, after reasonable
notice and opportunity for a hearing, the Illinois Department finds that the
vendor; a person with management responsibility for a vendor; an officer or
person owning, either directly or indirectly, 5% or more of the shares of stock
or other evidences of ownership in a corporate vendor; an owner of a sole
proprietorship that is a vendor; or a partner in a partnership that is a vendor
has been convicted of an offense based on fraud or willful
misrepresentation related to any of
the following:

• (1) The medical assistance program under Article V of this Code.
• (2) A medical assistance or health care program in another state.
• (3) The Medicare program under Title XVIII of the Social Security Act.
• (4) The provision of health care services.
• (5) A violation of this Code, as provided in Article VIIIA, or another state or federal medical assistance program or health care program.

(A-10) The Illinois Department may deny, suspend, or terminate the eligibility of any person, firm, corporation, association, agency, institution, or other legal entity to participate as a vendor of goods or services to recipients under the medical assistance program under Article V, or may
exclude any such person or entity from participation as such a
vendor, if, after reasonable notice and opportunity for a hearing, the Illinois Department finds that (i) the vendor, (ii) a person with management responsibility for a vendor, (iii) an officer or person owning, either directly or indirectly, 5% or more of the shares of stock or other evidences of ownership in a corporate vendor, (iv) an owner of a sole proprietorship that is a vendor, or (v) a partner in a partnership that is a vendor has been convicted of an offense related to any of the following:

• (1) Murder.
• (2) A Class X felony under the Criminal Code of 1961 or the Criminal Code of 2012.
• (3) Sexual misconduct that may subject recipients to an undue risk of harm.
• (4) A criminal offense that may subject recipients to an undue risk of harm.
• (5) A crime of fraud or dishonesty.
• (6) A crime involving a controlled substance.
• (7) A misdemeanor relating to fraud, theft, embezzlement, breach of fiduciary responsibility, or other financial misconduct related to a health care program.

(A-15) The Illinois Department may deny the eligibility of any person, firm, corporation, association, agency, institution, or other legal entity to participate as a vendor of goods or services to recipients under the medical assistance program under Article V if, after reasonable notice and opportunity for a hearing, the Illinois Department finds:

• (1) The applicant or any person with management responsibility for the applicant; an officer or member of the board of directors of an applicant; an entity owning (directly or indirectly) 5% or more of the shares of stock or other evidences of ownership in a corporate vendor applicant; an owner of a sole proprietorship applicant; a partner in a partnership applicant; or a technical or other advisor to an applicant has a debt owed to the Illinois Department, and no payment arrangements acceptable to the Illinois Department have been made by the applicant.
• (2) The applicant or any person with management responsibility for the applicant; an officer or member of the board of directors of an applicant; an entity owning (directly or indirectly) 5% or more of the shares of stock or other evidences of ownership in a corporate vendor applicant; an owner of a sole proprietorship applicant; a partner in a partnership vendor applicant; or a technical or other advisor to an applicant was (i) a person with management responsibility, (ii) an officer or member of the board of directors of an applicant, (iii) an entity owning (directly or indirectly) 5% or more of the shares of stock or other evidences of ownership in a corporate vendor, (iv) an owner of a sole proprietorship, (v) a partner in a partnership vendor, (vi) a technical or other advisor to a vendor, during a period of time where the conduct of that vendor resulted in a debt owed to the Illinois Department, and no payment arrangements acceptable to the Illinois Department have been made by that vendor.
• (3) There is a credible allegation of the use, transfer, or lease of assets of any kind to an applicant from a current or prior vendor who has a debt owed to the Illinois Department, no payment arrangements acceptable to the Illinois Department have been made by that vendor or the vendor’s alternate payee, and the applicant knows or should have known of such debt.
• (4) There is a credible allegation of a transfer of management responsibilities, or direct or indirect ownership, to an applicant from a current or prior vendor who has a debt owed to the Illinois Department, and no payment arrangements acceptable to the Illinois Department have been made by that vendor or the vendor’s alternate payee, and the applicant knows or should have known of such debt.
• (5) There is a credible allegation of the use, transfer, or lease of assets of any kind to an applicant who is a spouse, child, brother, sister, parent, grandparent, grandchild, uncle, aunt, niece, relative by marriage, nephew, cousin, or relative of a current or prior vendor who has a debt owed to the Illinois Department and no payment arrangements acceptable to the Illinois Department have been made.
• (6) There is a credible allegation that the applicant’s previous affiliations with a provider of medical services that has an uncollected debt, a provider that has been or is subject to a payment suspension under a federal health care program, or a provider that has been previously excluded from participation in the medical assistance program, poses a risk of fraud, waste, or abuse to the Illinois Department.

As used in this subsection, “credible allegation” is defined to include an allegation from any source, including, but not limited to, fraud hotline complaints, claims data mining, patterns identified through provider audits, civil actions filed under the Illinois False Claims Act, and law enforcement investigations. An allegation is considered to be credible when it has indicia of reliability.

(B) The Illinois Department shall deny, suspend or terminate the
eligibility of any person, firm, corporation, association, agency,
institution or other legal entity to participate as a vendor of goods or
services to recipients under the medical assistance program under
Article V, or may
exclude any such person or entity from participation as such a
vendor:

• (1) immediately, if such vendor is not properly licensed, certified, or authorized;
• (2) within 30 days of the date when such vendor’s professional license, certification or other authorization has been refused renewal, restricted, revoked, suspended, or otherwise terminated; or
• (3) if such vendor has been convicted of a violation of this Code, as provided in Article VIIIA.

(C) Upon termination, suspension, or exclusion of a vendor of goods or services from
participation in the medical assistance program authorized by this
Article, a person with management responsibility for such vendor during
the time of any conduct which served as the basis for that vendor’s
termination, suspension, or exclusion is barred from participation in the medical assistance
program.

Upon termination, suspension, or exclusion of a corporate vendor, the officers and persons
owning, directly or indirectly, 5% or more of the shares of stock or
other evidences of ownership in the vendor during the time of any
conduct which served as the basis for that vendor’s termination, suspension, or exclusion are
barred from participation in the medical assistance program. A person who
owns, directly or indirectly, 5% or more of the shares of stock or other
evidences of ownership in a terminated, suspended, or excluded vendor may not transfer his or
her ownership interest in that vendor to his or her spouse, child, brother,
sister, parent, grandparent, grandchild, uncle, aunt, niece, nephew, cousin, or
relative by marriage.

Upon termination, suspension, or exclusion of a sole proprietorship or partnership, the owner
or partners during the time of any conduct which served as the basis for
that vendor’s termination, suspension, or exclusion are barred from participation in the medical
assistance program. The owner of a terminated, suspended, or excluded vendor that is a sole
proprietorship, and a partner in a terminated, suspended, or excluded vendor that is a partnership, may
not transfer his or her ownership or partnership interest in that vendor to his
or her spouse, child, brother, sister, parent, grandparent, grandchild, uncle,
aunt, niece, nephew, cousin, or relative by marriage.

A person who owns, directly or indirectly, 5% or more of the shares of stock or other evidences of ownership in a corporate or limited liability company vendor who owes a debt to the Department, if that vendor has not made payment arrangements acceptable to the Department, shall not transfer his or her ownership interest in that vendor, or vendor assets of any kind, to his or her spouse, child, brother, sister, parent, grandparent, grandchild, uncle, aunt, niece, nephew, cousin, or relative by marriage.

Rules adopted by the Illinois Department to implement these
provisions shall specifically include a definition of the term
“management responsibility” as used in this Section. Such definition
shall include, but not be limited to, typical job titles, and duties and
descriptions which will be considered as within the definition of
individuals with management responsibility for a provider.

A vendor or a prior vendor who has been terminated, excluded, or suspended from the medical assistance program, or from another state or federal medical assistance or health care program, and any individual currently or previously barred from the medical assistance program, or from another state or federal medical assistance or health care program, as a result of being an officer or a person owning, directly or indirectly, 5% or more of the shares of stock or other evidences of ownership in a corporate or limited liability company vendor during the time of any conduct which served as the basis for that vendor’s termination, suspension, or exclusion, may be required to post a surety bond as part of a condition of enrollment or participation in the medical assistance program. The Illinois Department shall establish, by rule, the criteria and requirements for determining when a surety bond must be posted and the value of the bond.

A vendor or a prior vendor who has a debt owed to the Illinois Department and any individual currently or previously barred from the medical assistance program, or from another state or federal medical assistance or health care program, as a result of being an officer or a person owning, directly or indirectly, 5% or more of the shares of stock or other evidences of ownership in that corporate or limited liability company vendor during the time of any conduct which served as the basis for the debt, may be required to post a surety bond as part of a condition of enrollment or participation in the medical assistance program. The Illinois Department shall establish, by rule, the criteria and requirements for determining when a surety bond must be posted and the value of the bond.

(D) If a vendor has been suspended from the medical assistance
program under Article V of the Code, the Director may require that such
vendor correct any deficiencies which served as the basis for the
suspension. The Director shall specify in the suspension order a specific
period of time, which shall not exceed one year from the date of the
order, during which a suspended vendor shall not be eligible to
participate. At the conclusion of the period of suspension the Director
shall reinstate such vendor, unless he finds that such vendor has not
corrected deficiencies upon which the suspension was based.

If a vendor has been terminated, suspended, or excluded from the medical assistance program
under Article V, such vendor shall be barred from participation for at
least one year, except that if a vendor has been terminated, suspended, or excluded based on a
conviction of a
violation of Article VIIIA or a conviction of a felony based on fraud or a
willful misrepresentation related to (i) the medical assistance program under
Article V, (ii) a federal or another state’s medical assistance or health care program, or (iii) the provision of health care services, then
the vendor shall be barred from participation for 5 years or for the length of
the vendor’s sentence for that conviction, whichever is longer. At the end of
one year a vendor who has been terminated, suspended, or excluded
may apply for reinstatement to the program. Upon proper application to
be reinstated such vendor may be deemed eligible by the Director
providing that such vendor meets the requirements for eligibility under
this Code. If such vendor is deemed not eligible for
reinstatement, he
shall be barred from again applying for reinstatement for one year from the
date his application for reinstatement is denied.

A vendor whose termination, suspension, or exclusion from participation in the Illinois medical
assistance program under Article V was based solely on an action by a
governmental entity other than the Illinois Department may, upon reinstatement
by that governmental entity or upon reversal of the termination, suspension, or exclusion, apply for
rescission of the termination, suspension, or exclusion from participation in the Illinois medical
assistance program. Upon proper application for rescission, the vendor may be
deemed eligible by the Director if the vendor meets the requirements for
eligibility under this Code.

If a vendor has been terminated, suspended, or excluded and reinstated to the medical assistance
program under Article V and the vendor is terminated, suspended, or excluded a second or subsequent
time from the medical assistance program, the vendor shall be barred from
participation for at least 2 years, except that if a vendor has been
terminated, suspended, or excluded a second time based on a
conviction of a violation of Article VIIIA or a conviction of a felony based on
fraud or a willful misrepresentation related to (i) the medical assistance
program under Article V, (ii) a federal or another state’s medical assistance or health care program, or (iii) the provision of health care
services, then the vendor shall be barred from participation for life. At
the end of 2 years, a vendor who has
been terminated, suspended, or excluded may apply for reinstatement to the program. Upon application
to be reinstated, the vendor may be deemed eligible if the vendor meets the
requirements for eligibility under this Code. If the vendor is deemed not
eligible for reinstatement, the vendor shall be barred from again applying for
reinstatement for 2 years from the date the vendor’s application for
reinstatement is denied.

(E) The Illinois Department may recover money improperly or
erroneously paid, or overpayments, either by setoff, crediting against
future billings or by requiring direct repayment to the Illinois
Department. The Illinois Department may suspend or deny payment, in whole or in part, if such payment would be improper or erroneous or would otherwise result in overpayment.

• (1) Payments may be suspended, denied, or recovered from a vendor or alternate payee: (i) for services rendered in violation of the Illinois Department’s provider notices, statutes, rules, and regulations; (ii) for services rendered in violation of the terms and conditions prescribed by the Illinois Department in its vendor agreement; (iii) for any vendor who fails to grant the Office of Inspector General timely access to full and complete records, including, but not limited to, records relating to recipients under the medical assistance program for the most recent 6 years, in accordance with Section 140.28 of Title 89 of the Illinois Administrative Code, and other information for the purpose of audits, investigations, or other program integrity functions, after reasonable written request by the Inspector General; this subsection (E) does not require vendors to make available the medical records of patients for whom services are not reimbursed under this Code or to provide access to medical records more than 6 years old; (iv) when the vendor has knowingly made, or caused to be made, any false statement or representation of a material fact in connection with the administration of the medical assistance program; or (v) when the vendor previously rendered services while terminated, suspended, or excluded from participation in the medical assistance program or while terminated or excluded from participation in another state or federal medical assistance or health care program.
• (2) Notwithstanding any other provision of law, if a vendor has the same taxpayer identification number (assigned under Section 6109 of the Internal Revenue Code of 1986) as is assigned to a vendor with past-due financial obligations to the Illinois Department, the Illinois Department may make any necessary adjustments to payments to that vendor in order to satisfy any past-due obligations, regardless of whether the vendor is assigned a different billing number under the medical assistance program.

(E-5) Civil monetary penalties.

• (1) As used in this subsection (E-5):
• (a) “Knowingly” means that a person, with respect to information: (i) has actual knowledge of the information; (ii) acts in deliberate ignorance of the truth or falsity of the information; or (iii) acts in reckless disregard of the truth or falsity of the information. No proof of specific intent to defraud is required.
• (b) “Overpayment” means any funds that a person receives or retains from the medical assistance program to which the person, after applicable reconciliation, is not entitled under this Code.
• (c) “Remuneration” means the offer or transfer of items or services for free or for other than fair market value by a person; however, remuneration does not include items or services of a nominal value of no more than $10 per item or service, or $50 in the aggregate on an annual basis, or any other offer or transfer of items or services as determined by the Department.
• (d) “Should know” means that a person, with respect to information: (i) acts in deliberate ignorance of the truth or falsity of the information; or (ii) acts in reckless disregard of the truth or falsity of the information. No proof of specific intent to defraud is required.
• (2) Any person (including a vendor, provider, organization, agency, or other entity, or an alternate payee thereof, but excluding a recipient) who:
• (a) knowingly presents or causes to be presented to an officer, employee, or agent of the State, a claim that the Department determines:
• (i) is for a medical or other item or service that the person knows or should know was not provided as claimed, including any person who engages in a pattern or practice of presenting or causing to be presented a claim for an item or service that is based on a code that the person knows or should know will result in a greater payment to the person than the code the person knows or should know is applicable to the item or service actually provided;
• (ii) is for a medical or other item or service and the person knows or should know that the claim is false or fraudulent;
• (iii) is presented for a vendor physician’s service, or an item or service incident to a vendor physician’s service, by a person who knows or should know that the individual who furnished, or supervised the furnishing of, the service:
• (AA) was not licensed as a physician;
• (BB) was licensed as a physician but such license had been obtained through a misrepresentation of material fact (including cheating on an examination required for licensing); or
• (CC) represented to the patient at the time the service was furnished that the physician was certified in a medical specialty by a medical specialty board, when the individual was not so certified;
• (iv) is for a medical or other item or service furnished during a period in which the person was excluded from the medical assistance program or a federal or state health care program under which the claim was made pursuant to applicable law; or
• (v) is for a pattern of medical or other items or services that a person knows or should know are not medically necessary;
• (b) knowingly presents or causes to be presented to any person a request for payment which is in violation of the conditions for receipt of vendor payments under the medical assistance program under Section 11-13 of this Code;
• (c) knowingly gives or causes to be given to any person, with respect to medical assistance program coverage of inpatient hospital services, information that he or she knows or should know is false or misleading, and that could reasonably be expected to influence the decision when to discharge such person or other individual from the hospital;
• (d) in the case of a person who is not an organization, agency, or other entity, is excluded from participating in the medical assistance program or a federal or state health care program and who, at the time of a violation of this subsection (E-5):
• (i) retains a direct or indirect ownership or control interest in an entity that is participating in the medical assistance program or a federal or state health care program, and who knows or should know of the action constituting the basis for the exclusion; or
• (ii) is an officer or managing employee of such an entity;
• (e) offers or transfers remuneration to any individual eligible for benefits under the medical assistance program that such person knows or should know is likely to influence such individual to order or receive from a particular vendor, provider, practitioner, or supplier any item or service for which payment may be made, in whole or in part, under the medical assistance program;
• (f) arranges or contracts (by employment or otherwise) with an individual or entity that the person knows or should know is excluded from participation in the medical assistance program or a federal or state health care program, for the provision of items or services for which payment may be made under such a program;
• (g) commits an act described in subsection (b) or (c) of Section 8A-3;
• (h) knowingly makes, uses, or causes to be made or used, a false record or statement material to a false or fraudulent claim for payment for items and services furnished under the medical assistance program;
• (i) fails to grant timely access, upon reasonable request (as defined by the Department by rule), to the Inspector General, for the purpose of audits, investigations, evaluations, or other statutory functions of the Inspector General of the Department;
• (j) orders or prescribes a medical or other item or service during a period in which the person was excluded from the medical assistance program or a federal or state health care program, in the case where the person knows or should know that a claim for such medical or other item or service will be made under such a program;
• (k) knowingly makes or causes to be made any false statement, omission, or misrepresentation of a material fact in any application, bid, or contract to participate or enroll as a vendor or provider of services or a supplier under the medical assistance program;
• (l) knows of an overpayment and does not report and return the overpayment to the Department in accordance with paragraph (6);

shall be subject, in addition to any other penalties that may be prescribed by law, to a civil money penalty of not more than $10,000 for each item or service (or, in cases under subparagraph (c), $15,000 for each individual with respect to whom false or misleading information was given; in cases under subparagraph (d), $10,000 for each day the prohibited relationship occurs; in cases under subparagraph (g), $50,000 for each such act; in cases under subparagraph (h), $50,000 for each false record or statement; in cases under subparagraph (i), $15,000 for each day of the failure described in such subparagraph; or in cases under subparagraph (k), $50,000 for each false statement, omission, or misrepresentation of a material fact). In addition, such a person shall be subject to an assessment of not more than 3 times the amount claimed for each such item or service in lieu of damages sustained by the State because of such claim (or, in cases under subparagraph (g), damages of not more than 3 times the total amount of remuneration offered, paid, solicited, or received, without regard to whether a portion of such remuneration was offered, paid, solicited, or received for a lawful purpose; or in cases under subparagraph (k), an assessment of not more than 3 times the total amount claimed for each item or service for which payment was made based upon the application, bid, or contract containing the false statement, omission, or misrepresentation of a material fact).

• (3) In addition, the Director or his or her designee may make a determination in the same proceeding to exclude, terminate, suspend, or bar the person from participation in the medical assistance program.
• (4) The Illinois Department may seek the civil monetary penalties and exclusion, termination, suspension, or barment identified in this subsection (E-5). Prior to the imposition of any penalties or sanctions, the affected person shall be afforded an opportunity for a hearing after reasonable notice. The Department shall establish hearing procedures by rule.
• (5) Any final order, decision, or other determination made, issued, or executed by the Director under the provisions of this subsection (E-5), whereby a person is aggrieved, shall be subject to review in accordance with the provisions of the Administrative Review Law, and the rules adopted pursuant thereto, which shall apply to and govern all proceedings for the judicial review of final administrative decisions of the Director.
• (6)(a) If a person has received an overpayment, the person shall:
• (i) report and return the overpayment to the Department at the correct address; and
• (ii) notify the Department in writing of the reason for the overpayment.
• (b) An overpayment must be reported and returned under subparagraph (a) by the later of:
• (i) the date which is 60 days after the date on which the overpayment was identified; or
• (ii) the date any corresponding cost report is due, if applicable.

(E-10) A vendor who disputes an overpayment identified as part of a Department audit shall utilize the Department’s self-referral disclosure protocol as set forth under this Code to identify, investigate, and return to the Department any undisputed audit overpayment amount. Unless the disputed overpayment amount is subject to a fraud payment suspension, or involves a termination sanction, the Department shall defer the recovery of the disputed overpayment amount up to one year after the date of the Department’s final audit determination, or earlier, or as required by State or federal law. If the administrative hearing extends beyond one year, and such delay was not caused by the request of the vendor, then the Department shall not recover the disputed overpayment amount until the date of the final administrative decision. If a final administrative decision establishes that the disputed overpayment amount is owed to the Department, then the amount shall be immediately due to the Department. The Department shall be entitled to recover interest from the vendor on the overpayment amount from the date of the overpayment through the date the vendor returns the overpayment to the Department at a rate not to exceed the Wall Street Journal Prime Rate, as published from time to time, but not to exceed 5%. Any interest billed by the Department shall be due immediately upon receipt of the Department’s billing statement.

(F) The Illinois Department may withhold payments to any vendor
or alternate payee prior to or during the pendency of any audit or proceeding under this Section, and through the pendency of any administrative appeal or administrative review by any court proceeding. The Illinois Department shall
state by rule with as much specificity as practicable the conditions
under which payments will not be withheld under this Section. Payments may be denied for bills
submitted with service dates occurring during the pendency of a
proceeding, after a final decision has been rendered, or after the conclusion of any administrative appeal, where the final administrative decision is to terminate, exclude, or suspend
eligibility to participate in the medical assistance program. The
Illinois Department shall state by rule with as much specificity as
practicable the conditions under which payments will not be denied for
such bills.
The Illinois
Department shall state by rule a process and criteria by
which a vendor or alternate payee may request full or partial release of payments withheld under
this subsection. The Department must complete a proceeding under this Section
in a timely manner.

Notwithstanding recovery allowed under subsection (E) or this subsection (F), the Illinois Department may withhold payments to any vendor or alternate payee who is not properly licensed, certified, or in compliance with State or federal agency regulations. Payments may be denied for bills submitted with service dates occurring during the period of time that a vendor is not properly licensed, certified, or in compliance with State or federal regulations. Facilities licensed under
the Nursing Home Care Act shall have payments denied or
withheld pursuant to subsection (I) of this Section.

(F-5) The Illinois Department may temporarily withhold payments to
a vendor or alternate payee if any of the following individuals have been indicted or
otherwise charged under a law of the United States or this or any other state
with an offense that is based on alleged fraud or willful
misrepresentation on the part of the individual related to (i) the medical
assistance program under Article V of this Code, (ii) a federal or another state’s medical assistance
or health care program, or (iii) the provision of health care services:

• (1) If the vendor or alternate payee is a corporation: an officer of the corporation or an individual who owns, either directly or indirectly, 5% or more of the shares of stock or other evidence of ownership of the corporation.
• (2) If the vendor is a sole proprietorship: the owner of the sole proprietorship.
• (3) If the vendor or alternate payee is a partnership: a partner in the partnership.
• (4) If the vendor or alternate payee is any other business entity authorized by law to transact business in this State: an officer of the entity or an individual who owns, either directly or indirectly, 5% or more of the evidences of ownership of the entity.

If the Illinois Department withholds payments to a vendor or alternate payee under this
subsection, the Department shall not release those payments to the vendor
or alternate payee
while any criminal proceeding related to the indictment or charge is pending
unless the Department determines that there is good cause to release the
payments before completion of the proceeding. If the indictment or charge
results in the individual’s conviction, the Illinois Department shall retain
all withheld
payments, which shall be considered forfeited to the Department. If the
indictment or charge does not result in the individual’s conviction, the
Illinois Department
shall release to the vendor or alternate payee all withheld payments.

(F-10) If the Illinois Department establishes that the vendor or alternate payee owes a debt to the Illinois Department, and the vendor or alternate payee subsequently fails to pay or make satisfactory payment arrangements with the Illinois Department for the debt owed, the Illinois Department may seek all remedies available under the law of this State to recover the debt, including, but not limited to, wage garnishment or the filing of claims or liens against the vendor or alternate payee.

(F-15) Enforcement of judgment.

• (1) Any fine, recovery amount, other sanction, or costs imposed, or part of any fine, recovery amount, other sanction, or cost imposed, remaining unpaid after the exhaustion of or the failure to exhaust judicial review procedures under the Illinois Administrative Review Law is a debt due and owing the State and may be collected using all remedies available under the law.
• (2) After expiration of the period in which judicial review under the Illinois Administrative Review Law may be sought for a final administrative decision, unless stayed by a court of competent jurisdiction, the findings, decision, and order of the Director may be enforced in the same manner as a judgment entered by a court of competent jurisdiction.
• (3) In any case in which any person or entity has failed to comply with a judgment ordering or imposing any fine or other sanction, any expenses incurred by the Illinois Department to enforce the judgment, including, but not limited to, attorney’s fees, court costs, and costs related to property demolition or foreclosure, after they are fixed by a court of competent jurisdiction or the Director, shall be a debt due and owing the State and may be collected in accordance with applicable law. Prior to any expenses being fixed by a final administrative decision pursuant to this subsection (F-15), the Illinois Department shall provide notice to the individual or entity that states that the individual or entity shall appear at a hearing before the administrative hearing officer to determine whether the individual or entity has failed to comply with the judgment. The notice shall set the date for such a hearing, which shall not be less than 7 days from the date that notice is served. If notice is served by mail, the 7-day period shall begin to run on the date that the notice was deposited in the mail.
• (4) Upon being recorded in the manner required by Article XII of the Code of Civil Procedure or by the Uniform Commercial Code, a lien shall be imposed on the real estate or personal estate, or both, of the individual or entity in the amount of any debt due and owing the State under this Section. The lien may be enforced in the same manner as a judgment of a court of competent jurisdiction. A lien shall attach to all property and assets of such person, firm, corporation, association, agency, institution, or other legal entity until the judgment is satisfied.
• (5) The Director may set aside any judgment entered by default and set a new hearing date upon a petition filed at any time (i) if the petitioner’s failure to appear at the hearing was for good cause, or (ii) if the petitioner established that the Department did not provide proper service of process. If any judgment is set aside pursuant to this paragraph (5), the hearing officer shall have authority to enter an order extinguishing any lien which has been recorded for any debt due and owing the Illinois Department as a result of the vacated default judgment.

(G) The provisions of the Administrative Review Law, as now or hereafter
amended, and the rules adopted pursuant
thereto, shall apply to and govern all proceedings for the judicial
review of final administrative decisions of the Illinois Department
under this Section. The term “administrative decision” is defined as in
Section 3-101 of the Code of Civil Procedure.

(G-5) Vendors who pose a risk of fraud, waste, abuse, or harm.

• (1) Notwithstanding any other provision in this Section, the Department may terminate, suspend, or exclude vendors who pose a risk of fraud, waste, abuse, or harm from participation in the medical assistance program prior to an evidentiary hearing but after reasonable notice and opportunity to respond as established by the Department by rule.
• (2) Vendors who pose a risk of fraud, waste, abuse, or harm shall submit to a fingerprint-based criminal background check on current and future information available in the State system and current information available through the Federal Bureau of Investigation’s system by submitting all necessary fees and information in the form and manner prescribed by the Illinois State Police. The following individuals shall be subject to the check:
• (A) In the case of a vendor that is a corporation, every shareholder who owns, directly or indirectly, 5% or more of the outstanding shares of the corporation.
• (B) In the case of a vendor that is a partnership, every partner.
• (C) In the case of a vendor that is a sole proprietorship, the sole proprietor.
• (D) Each officer or manager of the vendor.
• Each such vendor shall be responsible for payment of the cost of the criminal background check.
• (3) Vendors who pose a risk of fraud, waste, abuse, or harm may be required to post a surety bond. The Department shall establish, by rule, the criteria and requirements for determining when a surety bond must be posted and the value of the bond.
• (4) The Department, or its agents, may refuse to accept requests for authorization from specific vendors who pose a risk of fraud, waste, abuse, or harm, including prior-approval and post-approval requests, if:
• (A) the Department has initiated a notice of termination, suspension, or exclusion of the vendor from participation in the medical assistance program; or
• (B) the Department has issued notification of its withholding of payments pursuant to subsection (F-5) of this Section; or
• (C) the Department has issued a notification of its withholding of payments due to reliable evidence of fraud or willful misrepresentation pending investigation.
• (5) As used in this subsection, the following terms are defined as follows:
• (A) “Fraud” means an intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or herself or some other person. It includes any act that constitutes fraud under applicable federal or State law.
• (B) “Abuse” means provider practices that are inconsistent with sound fiscal, business, or medical practices and that result in an unnecessary cost to the medical assistance program or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized standards for health care. It also includes recipient practices that result in unnecessary cost to the medical assistance program. Abuse does not include diagnostic or therapeutic measures conducted primarily as a safeguard against possible vendor liability.
• (C) “Waste” means the unintentional misuse of medical assistance resources, resulting in unnecessary cost to the medical assistance program. Waste does not include diagnostic or therapeutic measures conducted primarily as a safeguard against possible vendor liability.
• (D) “Harm” means physical, mental, or monetary damage to recipients or to the medical assistance program.

(G-6) The Illinois Department, upon making a determination based upon information in the possession of the Illinois Department that continuation of participation in the medical assistance program by a vendor would constitute an immediate danger to the public, may immediately suspend such vendor’s participation in the medical assistance program without a hearing. In instances in which the Illinois Department immediately suspends the medical assistance program participation of a vendor under this Section, a hearing upon the vendor’s participation must be convened by the Illinois Department within 15 days after such suspension and completed without appreciable delay. Such hearing shall be held to determine whether to recommend to the Director that the vendor’s medical assistance program participation be denied, terminated, suspended, placed on provisional status, or reinstated. In the hearing, any evidence relevant to the vendor constituting an immediate danger to the public may be introduced against such vendor; provided, however, that the vendor, or his or her counsel, shall have the opportunity to discredit, impeach, and submit evidence rebutting such evidence.

(H) Nothing contained in this Code shall in any way limit or
otherwise impair the authority or power of any State agency responsible
for licensing of vendors.

(I) Based on a finding of noncompliance on the part of a nursing home with
any requirement for certification under Title XVIII or XIX of the Social
Security Act (42 U.S.C. Sec. 1395 et seq. or 42 U.S.C. Sec. 1396 et seq.), the
Illinois Department may impose one or more of the following remedies after
notice to the facility:

• (1) Termination of the provider agreement.
• (2) Temporary management.
• (3) Denial of payment for new admissions.
• (4) Civil money penalties.
• (5) Closure of the facility in emergency situations or transfer of residents, or both.
• (6) State monitoring.
• (7) Denial of all payments when the U.S. Department of Health and Human Services has imposed this sanction.

The Illinois Department shall by rule establish criteria governing continued
payments to a nursing facility subsequent to termination of the facility’s
provider agreement if, in the sole discretion of the Illinois Department,
circumstances affecting the health, safety, and welfare of the facility’s
residents require those continued payments. The Illinois Department may
condition those continued payments on the appointment of temporary management,
sale of the facility to new owners or operators, or other
arrangements that the Illinois Department determines best serve the needs of
the facility’s residents.

Except in the case of a facility that has a right to a hearing on the finding
of noncompliance before an agency of the federal government, a facility may
request a hearing before a State agency on any finding of noncompliance within
60 days after the notice of the intent to impose a remedy. Except in the case
of civil money penalties, a request for a hearing shall not delay imposition of
the penalty. The choice of remedies is not appealable at a hearing. The level
of noncompliance may be challenged only in the case of a civil money penalty.
The Illinois Department shall provide by rule for the State agency that will
conduct the evidentiary hearings.

The Illinois Department may collect interest on unpaid civil money penalties.

The Illinois Department may adopt all rules necessary to implement this
subsection (I).

(J) The Illinois Department, by rule, may permit individual practitioners to designate that Department payments that may be due the practitioner be made to an alternate payee or alternate payees.

• (a) Such alternate payee or alternate payees shall be required to register as an alternate payee in the Medical Assistance Program with the Illinois Department.
• (b) If a practitioner designates an alternate payee, the alternate payee and practitioner shall be jointly and severally liable to the Department for payments made to the alternate payee. Pursuant to subsection (E) of this Section, any Department action to suspend or deny payment or recover money or overpayments from an alternate payee shall be subject to an administrative hearing.
• (c) Registration as an alternate payee or alternate payees in the Illinois Medical Assistance Program shall be conditional. At any time, the Illinois Department may deny or cancel any alternate payee’s registration in the Illinois Medical Assistance Program without cause. Any such denial or cancellation is not subject to an administrative hearing.
• (d) The Illinois Department may seek a revocation of any alternate payee, and all owners, officers, and individuals with management responsibility for such alternate payee shall be permanently prohibited from participating as an owner, an officer, or an individual with management responsibility with an alternate payee in the Illinois Medical Assistance Program, if after reasonable notice and opportunity for a hearing the Illinois Department finds that:
• (1) the alternate payee is not complying with the Department’s policy or rules and regulations, or with the terms and conditions prescribed by the Illinois Department in its alternate payee registration agreement; or
• (2) the alternate payee has failed to keep or make available for inspection, audit, or copying, after receiving a written request from the Illinois Department, such records regarding payments claimed as an alternate payee; or
• (3) the alternate payee has failed to furnish any information requested by the Illinois Department regarding payments claimed as an alternate payee; or
• (4) the alternate payee has knowingly made, or caused to be made, any false statement or representation of a material fact in connection with the administration of the Illinois Medical Assistance Program; or
• (5) the alternate payee, a person with management responsibility for an alternate payee, an officer or person owning, either directly or indirectly, 5% or more of the shares of stock or other evidences of ownership in a corporate alternate payee, or a partner in a partnership which is an alternate payee:
• (a) was previously terminated, suspended, or excluded from participation as a vendor in the Illinois Medical Assistance Program, or was previously revoked as an alternate payee in the Illinois Medical Assistance Program, or was terminated, suspended, or excluded from participation as a vendor in a medical assistance program in another state that is of the same kind as the program of medical assistance provided under Article V of this Code; or
• (b) was a person with management responsibility for a vendor previously terminated, suspended, or excluded from participation as a vendor in the Illinois Medical Assistance Program, or was previously revoked as an alternate payee in the Illinois Medical Assistance Program, or was terminated, suspended, or excluded from participation as a vendor in a medical assistance program in another state that is of the same kind as the program of medical assistance provided under Article V of this Code, during the time of conduct which was the basis for that vendor’s termination, suspension, or exclusion or alternate payee’s revocation; or
• (c) was an officer, or person owning, either directly or indirectly, 5% or more of the shares of stock or other evidences of ownership in a corporate vendor previously terminated, suspended, or excluded from participation as a vendor in the Illinois Medical Assistance Program, or was previously revoked as an alternate payee in the Illinois Medical Assistance Program, or was terminated, suspended, or excluded from participation as a vendor in a medical assistance program in another state that is of the same kind as the program of medical assistance provided under Article V of this Code, during the time of conduct which was the basis for that vendor’s termination, suspension, or exclusion; or
• (d) was an owner of a sole proprietorship or partner in a partnership previously terminated, suspended, or excluded from participation as a vendor in the Illinois Medical Assistance Program, or was previously revoked as an alternate payee in the Illinois Medical Assistance Program, or was terminated, suspended, or excluded from participation as a vendor in a medical assistance program in another state that is of the same kind as the program of medical assistance provided under Article V of this Code, during the time of conduct which was the basis for that vendor’s termination, suspension, or exclusion or alternate payee’s revocation; or
• (6) the alternate payee, a person with management responsibility for an alternate payee, an officer or person owning, either directly or indirectly, 5% or more of the shares of stock or other evidences of ownership in a corporate alternate payee, or a partner in a partnership which is an alternate payee:
• (a) has engaged in conduct prohibited by applicable federal or State law or regulation relating to the Illinois Medical Assistance Program; or
• (b) was a person with management responsibility for a vendor or alternate payee at the time that the vendor or alternate payee engaged in practices prohibited by applicable federal or State law or regulation relating to the Illinois Medical Assistance Program; or
• (c) was an officer, or person owning, either directly or indirectly, 5% or more of the shares of stock or other evidences of ownership in a vendor or alternate payee at the time such vendor or alternate payee engaged in practices prohibited by applicable federal or State law or regulation relating to the Illinois Medical Assistance Program; or
• (d) was an owner of a sole proprietorship or partner in a partnership which was a vendor or alternate payee at the time such vendor or alternate payee engaged in practices prohibited by applicable federal or State law or regulation relating to the Illinois Medical Assistance Program; or
• (7) the direct or indirect ownership of the vendor or alternate payee (including the ownership of a vendor or alternate payee that is a partner’s interest in a vendor or alternate payee, or ownership of 5% or more of the shares of stock or other evidences of ownership in a corporate vendor or alternate payee) has been transferred by an individual who is terminated, suspended, or excluded or barred from participating as a vendor or is prohibited or revoked as an alternate payee to the individual’s spouse, child, brother, sister, parent, grandparent, grandchild, uncle, aunt, niece, nephew, cousin, or relative by marriage.

(K) The Illinois Department of Healthcare and Family Services may withhold payments, in whole or in part, to a provider or alternate payee where there is credible evidence, received from State or federal law enforcement or federal oversight agencies or from the results of a preliminary Department audit, that the circumstances giving rise to the need for a withholding of payments may involve fraud or willful misrepresentation under the Illinois Medical Assistance program. The Department shall by rule define what constitutes “credible” evidence for purposes of this subsection. The Department may withhold payments without first notifying the provider or alternate payee of its intention to withhold such payments. A provider or alternate payee may request a reconsideration of payment withholding, and the Department must grant such a request. The Department shall state by rule a process and criteria by which a provider or alternate payee may request full or partial release of payments withheld under this subsection. This request may be made at any time after the Department first withholds such payments.

• (a) The Illinois Department must send notice of its withholding of program payments within 5 days of taking such action. The notice must set forth the general allegations as to the nature of the withholding action, but need not disclose any specific information concerning its ongoing investigation. The notice must do all of the following:
• (1) State that payments are being withheld in accordance with this subsection.
• (2) State that the withholding is for a temporary period, as stated in paragraph (b) of this subsection, and cite the circumstances under which withholding will be terminated.
• (3) Specify, when appropriate, which type or types of Medicaid claims withholding is effective.
• (4) Inform the provider or alternate payee of the right to submit written evidence for reconsideration of the withholding by the Illinois Department.
• (5) Inform the provider or alternate payee that a written request may be made to the Illinois Department for full or partial release of withheld payments and that such requests may be made at any time after the Department first withholds such payments.
• (b) All withholding-of-payment actions under this subsection shall be temporary and shall not continue after any of the following:
• (1) The Illinois Department or the prosecuting authorities determine that there is insufficient evidence of fraud or willful misrepresentation by the provider or alternate payee.
• (2) Legal proceedings related to the provider’s or alternate payee’s alleged fraud, willful misrepresentation, violations of this Act, or violations of the Illinois Department’s administrative rules are completed.
• (3) The withholding of payments for a period of 3 years.
• (c) The Illinois Department may adopt all rules necessary to implement this subsection (K).

(K-5) The Illinois Department may withhold payments, in whole or in part, to a provider or alternate payee upon initiation of an audit, quality of care review, investigation when there is a credible allegation of fraud, or the provider or alternate payee demonstrating a clear failure to cooperate with the Illinois Department such that the circumstances give rise to the need for a withholding of payments. As used in this subsection, “credible allegation” is defined to include an allegation from any source, including, but not limited to, fraud hotline complaints, claims data mining, patterns identified through provider audits, civil actions filed under the Illinois False Claims Act, and law enforcement investigations. An allegation is considered to be credible when it has indicia of reliability. The Illinois Department may withhold payments without first notifying the provider or alternate payee of its intention to withhold such payments. A provider or alternate payee may request a hearing or a reconsideration of payment withholding, and the Illinois Department must grant such a request. The Illinois Department shall state by rule a process and criteria by which a provider or alternate payee may request a hearing or a reconsideration for the full or partial release of payments withheld under this subsection. This request may be made at any time after the Illinois Department first withholds such payments.

• (a) The Illinois Department must send notice of its withholding of program payments within 5 days of taking such action. The notice must set forth the general allegations as to the nature of the withholding action but need not disclose any specific information concerning its ongoing investigation. The notice must do all of the following:
• (1) State that payments are being withheld in accordance with this subsection.
• (2) State that the withholding is for a temporary period, as stated in paragraph (b) of this subsection, and cite the circumstances under which withholding will be terminated.
• (3) Specify, when appropriate, which type or types of claims are withheld.
• (4) Inform the provider or alternate payee of the right to request a hearing or a reconsideration of the withholding by the Illinois Department, including the ability to submit written evidence.
• (5) Inform the provider or alternate payee that a written request may be made to the Illinois Department for a hearing or a reconsideration for the full or partial release of withheld payments and that such requests may be made at any time after the Illinois Department first withholds such payments.
• (b) All withholding of payment actions under this subsection shall be temporary and shall not continue after any of the following:
• (1) The Illinois Department determines that there is insufficient evidence of fraud, or the provider or alternate payee demonstrates clear cooperation with the Illinois Department, as determined by the Illinois Department, such that the circumstances do not give rise to the need for withholding of payments; or
• (2) The withholding of payments has lasted for a period in excess of 3 years.
• (c) The Illinois Department may adopt all rules necessary to implement this subsection (K-5).

(L) The Illinois Department shall establish a protocol to enable health care providers to disclose an actual or potential violation of this Section pursuant to a self-referral disclosure protocol, referred to in this subsection as “the protocol”. The protocol shall include direction for health care providers on a specific person, official, or office to whom such disclosures shall be made. The Illinois Department shall post information on the protocol on the Illinois Department’s public website. The Illinois Department may adopt rules necessary to implement this subsection (L). In addition to other factors that the Illinois Department finds appropriate, the Illinois Department may consider a health care provider’s timely use or failure to use the protocol in considering the provider’s failure to comply with this Code.

(M) Notwithstanding any other provision of this Code, the Illinois Department, at its discretion, may exempt an entity licensed under the Nursing Home Care Act, the ID/DD Community Care Act, or the MC/DD Act from the provisions of subsections (A-15), (B), and (C) of this Section if the licensed entity is in receivership.

(Source: P.A. 102-538, eff. 8-20-21.)

 

(305 ILCS 5/12-4.25a) (from Ch. 23, par. 12-4.25a)

Sec. 12-4.25a.

Any vendor of physician services who shall be the
subject of a medical quality review by the Illinois Department shall have
the right to consult with another physician or physicians to assist in
understanding the procedures and interpretations of the Illinois
Department and to assist in interpreting, as an experienced or expert
consultant or witness, the quality of care, its relation to a prevailing
standard of care, and standards of documentation of the Illinois
Department. The consulting physician or physicians may be present at the
review meeting where the provider is present. The assistance offered by
the consulting physician or physicians shall respect the
confidentiality of recipient patient relations with the treating physician
in relation to consultation on treatment matters. Nothing in this
subsection shall be deemed to waive the requirements of the Medical Patient
Rights Act as it relates to patient privacy and confidentiality.

(Source: P.A. 87-399.)

 

(305 ILCS 5/12-4.25b) (from Ch. 23, par. 12-4.25b)

Sec. 12-4.25b.

A vendor of physician services who is the subject of
medical quality review by the Illinois Department shall have the right to
record that portion of any Medical Quality Review Committee meeting or
hearing with the Illinois Department, at which the vendor is present and
participates. The recording shall be privileged and confidential
and shall not be disclosed, except however if the Illinois Department
initiates action to deny, suspend or terminate the vendor’s participation
in the Medicaid program, the recording may be disclosed to an attorney or
physician consultant to prepare a defense.

(Source: P.A. 87-399.)

 

(305 ILCS 5/12-4.25c) (from Ch. 23, par. 12-4.25c)

Sec. 12-4.25c.

Where a medical provider’s medical practices are under
review by the Illinois Department and the provider is board certified in a
specialty by a nationally recognized specialty board and practicing in the
specialty, the Illinois Department should attempt to utilize a medical
practitioner with like qualifications to assist in reviewing the medical
practices of the provider under review in the areas of practice within the
specialty.

(Source: P.A. 87-399.)

 

(305 ILCS 5/12-4.26) (from Ch. 23, par. 12-4.26)

Sec. 12-4.26.

Scope of Application.) The Illinois Department may terminate
or suspend a vendor pursuant to the authority and powers conferred in Section
12-4.25, only subsequent to the effective date of this amendatory Act.
However the authority and powers are expressly declared to be retroactive
to the extent that conduct and activities of vendors engaged in prior to
the effective date of this amendatory Act may be relied upon as the basis
for terminating or suspending eligibility to participate in the Medical
Assistance Program, where the vendor had actual or constructive knowledge
of the requirements which applied to his conduct or activities.

(Source: P.A. 80-2nd SS-2.)

 

(305 ILCS 5/12-4.27) (from Ch. 23, par. 12-4.27)

Sec. 12-4.27.

Factual Determinations.) Factual determinations made by
the Department in administrative hearings initiated prior to the effective
date of this amendatory Act and which involve issues of fact relating to
activities which constitute grounds for termination pursuant to this amendatory
Act, shall be reviewed by the Director and may be used as grounds for approval
or denial of applications to participate, for termination of eligibility,
or for recovery of money, without conducting a new administrative proceeding.

(Source: P.A. 80-2nd SS-2.)

 

(305 ILCS 5/12-4.28) (from Ch. 23, par. 12-4.28)

Sec. 12-4.28.
(Repealed).

(Source: P.A. 83-1362. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-4.29) (from Ch. 23, par. 12-4.29)

Sec. 12-4.29.
Youth employability and career development programs.
The
Illinois Department may establish and administer community-based programs
providing comprehensive, long-term intervention strategies to increase
future employability and career development among high risk youth, as
required by “An Act in relation to the provision of assistance to certain
persons, amending Acts named therein”, certified December 2, 1987.
The Illinois Department may contract with private nonprofit
organizations or units of local government to administer and deliver
services pursuant to the above-named Act.

(Source: P.A. 85-1209.)

 

(305 ILCS 5/12-4.30) (from Ch. 23, par. 12-4.30)

Sec. 12-4.30. Demonstration programs. Establish
demonstration programs, authorized by federal law and pursuant to State
regulations. Such demonstration programs may
include, but shall not be limited to: cashing out welfare benefits such as,
but not limited to, food stamps, energy assistance payments and medical
benefits; providing medical benefits through the purchase of health
insurance; and capping grant amounts at certain levels regardless of the
number of persons in the case. Such demonstration programs may be limited
to particular geographic areas.

(Source: P.A. 93-632, eff. 2-1-04.)

 

(305 ILCS 5/12-4.31)

Sec. 12-4.31.
(Repealed).

(Source: P.A. 90-655, eff. 7-30-98. Repealed by P.A. 90-790, eff.
8-14-98.)

 

(305 ILCS 5/12-4.32)

Sec. 12-4.32.
(Repealed).

(Source: P.A. 90-9, eff. 7-1-97. Repealed by P.A. 90-564, eff. 12-22-97.)

 

(305 ILCS 5/12-4.33)

Sec. 12-4.33. Welfare reform research and accountability.

(a) The Illinois Department shall collect and report
upon all data in connection with federally funded or assisted welfare programs
as federal law may require, including, but not limited to, Section 411 of the
Personal Responsibility and Work Opportunity Reconciliation Act of 1996 and its
implementing regulations and any amendments thereto as may from time to time be
enacted.

(b) In addition to and on the same schedule as the data collection required
by federal law and subsection (a), the Department shall collect and report on
further information with respect to the Temporary Assistance for Needy Families
(“TANF”) program, as follows:

• (1) With respect to denials of applications for benefits, all of the same information about the family required under the federal law, plus the specific reason or reasons for denial of the application.
• (2) With respect to all terminations of benefits, all of the same information as required under the federal law, plus the specific reason or reasons for the termination.

(c) The Department shall collect all of the same data as set forth in
subsections (a) and (b), and report it on the same schedule, with respect to
all cash assistance benefits provided to families that are not funded from the
TANF program
federal block grant or are not otherwise required to be included in the data
collection and reporting in subsections (a) and (b).

(d) Whether or not reports under this Section must be submitted to the
federal government, they shall be considered public and they shall be promptly
made available to
the public at the end of
each fiscal year, free of charge upon request. The data underlying the reports
shall be made available to
academic institutions and public policy organizations
involved in the study of welfare issues or programs
and redacted to conform with applicable privacy
laws. The cost shall be no more than that incurred by the Department in
assembling and delivering the data.

(e) (Blank).

(f) (Blank).

(Source: P.A. 95-322, eff. 1-1-08.)

 

(305 ILCS 5/12-4.34)

Sec. 12-4.34.
Services to noncitizens.

(a) Subject to specific appropriation for this purpose and notwithstanding
Sections 1-11 and 3-1 of this Code, the Department of Human Services is
authorized to provide services to legal immigrants, including but not limited
to naturalization and nutrition services and financial assistance. The nature
of these services, payment levels, and eligibility conditions shall be
determined by rule.

(b) The Illinois Department is authorized to lower the payment levels
established under this subsection or take such other actions during the
fiscal year as are necessary to ensure that payments under this subsection
do not exceed the amounts appropriated for this purpose. These changes
may be accomplished by emergency rule under Section 5-45 of the Illinois
Administrative Procedure Act, except that the limitation on the number of
emergency rules that may be adopted in a 24-month period shall not apply.

(Source: P.A. 91-24, eff. 7-1-99; 91-712, eff. 7-1-00; 92-10, eff.
6-11-01; 92-597, eff. 6-28-02.)

 

(305 ILCS 5/12-4.35)

Sec. 12-4.35. Medical services for certain noncitizens.

(a) Notwithstanding

Section 1-11 of this Code or Section 20(a) of the Children’s Health Insurance
Program Act, the Department of Healthcare and Family Services may provide medical services to
noncitizens who have not yet attained 19 years of age and who are not eligible
for medical assistance under Article V of this Code or under the Children’s
Health Insurance Program created by the Children’s Health Insurance Program Act
due to their not meeting the otherwise applicable provisions of Section 1-11
of this Code or Section 20(a) of the Children’s Health Insurance Program Act.
The medical services available, standards for eligibility, and other conditions
of participation under this Section shall be established by rule by the
Department; however, any such rule shall be at least as restrictive as the
rules for medical assistance under Article V of this Code or the Children’s
Health Insurance Program created by the Children’s Health Insurance Program
Act.

(a-5) Notwithstanding Section 1-11 of this Code, the Department of Healthcare and Family Services may provide medical assistance in accordance with Article V of this Code to noncitizens over the age of 65 years of age who are not eligible for medical assistance under Article V of this Code due to their not meeting the otherwise applicable provisions of Section 1-11 of this Code, whose income is at or below 100% of the federal poverty level after deducting the costs of medical or other remedial care, and who would otherwise meet the eligibility requirements in Section 5-2 of this Code. The medical services available, standards for eligibility, and other conditions of participation under this Section shall be established by rule by the Department; however, any such rule shall be at least as restrictive as the rules for medical assistance under Article V of this Code.

(a-6) By May 30, 2022, notwithstanding Section 1-11 of this Code, the Department of Healthcare and Family Services may provide medical services to noncitizens 55 years of age through 64 years of age who (i) are not eligible for medical assistance under Article V of this Code due to their not meeting the otherwise applicable provisions of Section 1-11 of this Code and (ii) have income at or below 133% of the federal poverty level plus 5% for the applicable family size as determined under applicable federal law and regulations. Persons eligible for medical services under Public Act 102-16 shall receive benefits identical to the benefits provided under the Health Benefits Service Package as that term is defined in subsection (m) of Section 5-1.1 of this Code.

(a-7) By July 1, 2022, notwithstanding Section 1-11 of this Code, the Department of Healthcare and Family Services may provide medical services to noncitizens 42 years of age through 54 years of age who (i) are not eligible for medical assistance under Article V of this Code due to their not meeting the otherwise applicable provisions of Section 1-11 of this Code and (ii) have income at or below 133% of the federal poverty level plus 5% for the applicable family size as determined under applicable federal law and regulations. The medical services available, standards for eligibility, and other conditions of participation under this Section shall be established by rule by the Department; however, any such rule shall be at least as restrictive as the rules for medical assistance under Article V of this Code. In order to provide for the timely and expeditious implementation of this subsection, the Department may adopt rules necessary to establish and implement this subsection through the use of emergency rulemaking in accordance with Section 5-45 of the Illinois Administrative Procedure Act. For purposes of the Illinois Administrative Procedure Act, the General Assembly finds that the adoption of rules to implement this subsection is deemed necessary for the public interest, safety, and welfare.

(a-10) Notwithstanding the provisions of Section 1-11, the Department shall cover immunosuppressive drugs and related services associated with post-kidney transplant management, excluding long-term care costs, for noncitizens who: (i) are not eligible for comprehensive medical benefits; (ii) meet the residency requirements of Section 5-3; and (iii) would meet the financial eligibility requirements of Section 5-2.

(b) The Department is authorized to take any action that would not otherwise be prohibited by applicable law, including, without
limitation, cessation or limitation of enrollment, reduction of available medical services,
and changing standards for eligibility, that is deemed necessary by the
Department during a State fiscal year to assure that payments under this
Section do not exceed available funds.

(c) (Blank).

(d) (Blank).

(Source: P.A. 101-636, eff. 6-10-20; 102-16, eff. 6-17-21; 102-43, Article 25, Section 25-15, eff. 7-6-21; 102-43, Article 45, Section 45-5, eff. 7-6-21; 102-813, eff. 5-13-22; 102-1037, eff. 6-2-22.)

 

(305 ILCS 5/12-4.36)

Sec. 12-4.36. (Repealed).

(Source: P.A. 95-622, eff. 9-17-07. Repealed by P.A. 97-689, eff. 6-14-12.)

 

(305 ILCS 5/12-4.37)

Sec. 12-4.37. Children’s Healthcare Partnership Pilot Program.

(a) The Department of Healthcare and Family Services, in cooperation with the Department of Human Services, shall establish a Children’s Healthcare Partnership Pilot Program in Sangamon County to fund the provision of various health care services by a single provider, or a group of providers that have entered into an agreement for that purpose, at a single location in the county. Services covered under the pilot program shall include, but need not be limited to, family practice, pediatric, nursing (including advanced practice registered nursing), psychiatric, dental, and vision services. The Departments shall fund the provision of all services provided under the pilot program using a rate structure that is cost-based. To be selected by the Departments as the provider of health care services under the pilot program, a provider or group of providers must serve a disproportionate share of low-income or indigent patients, including recipients of medical assistance under Article V of this Code. The Departments shall adopt rules as necessary to implement this Section.

(b) Implementation of this Section is contingent on federal approval. The Department of Healthcare and Family Services shall take appropriate action by January 1, 2010 to seek federal approval.

(c) This Section is inoperative if the provider of health care services under the pilot program receives designation as a Federally Qualified Health Center (FQHC) or FQHC Look-Alike.

(Source: P.A. 100-513, eff. 1-1-18.)

 

(305 ILCS 5/12-4.38)

Sec. 12-4.38. Special FamilyCare provisions. The Department of Healthcare and Family Services may submit to the Comptroller, and the Comptroller is authorized to pay, on behalf of persons enrolled in the FamilyCare Program, claims for services rendered to an enrollee during the period beginning October 1, 2007, and ending on the effective date of any rules adopted to implement the provisions of this amendatory Act of the 96th General Assembly. The authorization for payment of claims applies only to bona fide claims for payment for services rendered. Any claim for payment which is authorized pursuant to the provisions of this amendatory Act of the 96th General Assembly must adhere to all other applicable rules, regulations, and requirements.

(Source: P.A. 96-20, eff. 6-30-09; 97-689, eff. 6-14-12.)

 

(305 ILCS 5/12-4.39)

Sec. 12-4.39. Dental clinic grant program.

(a) Grant program. On and after July 1, 2012, and subject to funding availability, the Department of Healthcare and Family Services may administer a grant program. The purpose of this grant program shall be to build the public infrastructure for dental care and to make grants to local health departments, federally qualified health clinics (FQHCs), and rural health clinics (RHCs) for development of comprehensive dental clinics for dental care services. The primary purpose of these new dental clinics will be to increase dental access for low-income and Department of Healthcare and Family Services clients who have no dental arrangements with a dental provider in a project’s service area. The dental clinic must be willing to accept out-of-area clients who need dental services, including emergency services for adults and Early and Periodic Screening, Diagnosis and Treatment (EPSDT)-referral children. Medically Underserved Areas (MUAs) and Health Professional Shortage Areas (HPSAs) shall receive special priority for grants under this program.

(b) Eligible applicants. The following entities are eligible to apply for grants:

• (1) Local health departments.
• (2) Federally Qualified Health Centers (FQHCs).
• (3) Rural health clinics (RHCs).

(c) Use of grant moneys. Grant moneys must be used to support projects that develop dental services to meet the dental health care needs of Department of Healthcare and Family Services Dental Program clients.
Grant moneys must be used for operating expenses, including, but not limited to: insurance; dental supplies and equipment; dental support services; and renovation expenses.
Grant moneys may not be used to offset existing indebtedness, supplant existing funds, purchase real property, or pay for personnel service salaries for dental employees.

(d) Application process. The Department shall establish procedures for applying for dental clinic grants.

(Source: P.A. 96-67, eff. 7-23-09; 96-1000, eff. 7-2-10; 97-689, eff. 6-14-12.)

 

(305 ILCS 5/12-4.40)

Sec. 12-4.40. Payment Recapture Audits. The Department of Healthcare and Family Services is authorized to contract with third-party entities to conduct Payment Recapture Audits to detect and recapture payments made in error or as a result of fraud or abuse. Payment Recapture Audits under this Section may be performed in conjunction with similar audits performed under federal authorization.

A Payment Recapture Audit shall include the process of identifying improper payments paid to providers or other entities whereby accounting specialists and fraud examination specialists examine payment records and uncover such problems as duplicate payments, payments for services not rendered, overpayments, payments for unauthorized services, and fictitious vendors. This audit may include the use of professional and specialized auditors on a contingency basis, with compensation tied to the identification of misspent funds.

The use of Payment Recapture Audits does not preclude the Office of the Inspector General or any other authorized agency employee from performing activities to identify and prevent improper payments.

(Source: P.A. 96-942, eff. 6-25-10; 97-333, eff. 8-12-11.)

 

(305 ILCS 5/12-4.41)

Sec. 12-4.41. Public Benefits Fraud Protection Task Force.

(a) Purpose. The purpose of the Public Benefits Fraud Protection Task Force is to conduct a thorough review of the nature of public assistance fraud in the State of Illinois; to ascertain the feasibility of implementing a mechanism to determine the pervasiveness and frequency of public assistance fraud; to calculate the detriment of public assistance fraud to the financial status and socio-economic status of public aid recipients specifically and Illinois taxpayers generally; and to determine if more stringent penalties or compassionate procedures are necessary.

(b) Definitions. As used in this Section:

“Task Force” means the Public Benefits Fraud Protection Task Force.

“Public assistance” or “public aid” includes, without limitation, Medicaid, TANF, the Illinois LINK Program, General Assistance, Transitional Assistance, the Supplemental Nutrition Assistance Program, and the Child Care Assistance Program.

(c) The Public Benefits Fraud Protection Task Force. The Public Benefits Fraud Protection Task Force is created. The Task Force shall be composed of 17 members appointed as follows:

• (1) One member of the Illinois Senate appointed by the President of the Senate, who shall be co-chair to the Task Force;
• (2) One member of the Illinois Senate appointed by the Senate Minority Leader;
• (3) One member of the Illinois House of Representatives appointed by the Speaker of the House of Representatives, who shall be co-chair to the Task Force;
• (4) One member of the Illinois House of Representatives appointed by the House Minority Leader;
• (5) The following persons, or their designees: the Director of Public Health, the Director of Healthcare and Family Services, and the Secretary of Human Services;
• (6) The Director of the Illinois Department on Aging, or his or her designee;
• (7) The Executive Inspector General appointed by the Governor, or his or her designee;
• (8) The Inspector General of the Illinois Department of Human Services, or his or her designee;
• (9) A representative from the Illinois State Police Medicaid Fraud Control Unit;
• (10) Three persons, who are not currently employed by a State agency, appointed by the Secretary of Human Services, one of whom shall be a person with professional experience in child care issues, one of whom shall be a person with knowledge and experience in legal aid services, and one of whom shall be a person with knowledge and experience in poverty law;
• (11) The Attorney General, or his or her designee;
• (12) A representative of a union representing front line State employees who administer public benefits programs; and
• (13) A representative of a statewide business association.

(d) Compensation and qualifications. Members shall serve without compensation and shall be adults and residents of Illinois.

(e) Appointments. Appointments shall be made 90 days from the effective date of this amendatory Act of the 96th General Assembly.

(f) Hearings. The Task Force shall solicit comments from stakeholders and hold public hearings before filing any report required by this Section. At the public hearings, the Task Force shall allow interested persons to present their views and comments. The Task Force shall submit all reports required by this Section to the Governor and the General Assembly. In addition to the reports required by this Section, the Task Force may provide, at its discretion, interim reports and recommendations. The Department of Human Services shall provide administrative support to the Task Force.

(g) Task Force duties. The Task Force shall gather information and make recommendations relating to at least the following topics in relation to public assistance fraud:

• (1) Reviews of provider billing of public aid claims.
• (2) Reviews of recipient utilization of public aid.
• (3) Protocols for investigating recipient public aid fraud.
• (4) Protocols for investigating provider public aid fraud.
• (5) Reporting of alleged fraud by private citizens through qui tam actions.
• (6) Examination of current fraud prevention measures which may hinder legitimate aid claims.
• (7) Coordination between relevant agencies in fraud investigation.
• (8) Financial audit of the current costs borne by aid recipients and Illinois government through fraud.
• (9) Examination of enhanced penalties for fraudulent recipients and providers.
• (10) Enhanced whistleblower protections.
• (11) Voluntary assistance from businesses and community groups in efforts to curb fraud.

(h) Task Force recommendations. Any of the findings, recommendations, public postings, and other relevant information regarding the Task Force shall be made available on the Department of Human Services’ website.

(i) Reporting requirements. The Task Force shall submit findings and recommendations to the Governor and the General Assembly by December 31, 2011, including any necessary implementing legislation, and recommendations for changes to policies, rules, or procedures that are not incorporated in the implementing legislation.

(j) Dissolution of Task Force. The Task Force shall be dissolved 90 days after its report has been submitted to the Governor’s Office and the General Assembly.

(Source: P.A. 96-1346, eff. 1-1-11; 97-333, eff. 8-12-11.)

 

(305 ILCS 5/12-4.42)

Sec. 12-4.42. Medicaid Revenue Maximization.

(a) Purpose. The General Assembly finds that there is a need to make changes to the administration of services provided by State and local governments in order to maximize federal financial participation.

(b) Definitions. As used in this Section:

“Community Medicaid mental health services” means all mental health services outlined in Part 132 of Title 59 of the Illinois Administrative Code that are funded through DHS, eligible for federal financial participation, and provided by a community-based provider.

“Community-based provider” means an entity enrolled as a provider pursuant to Sections 140.11 and 140.12 of Title 89 of the Illinois Administrative Code and certified to provide community Medicaid mental health services in accordance with Part 132 of Title 59 of the Illinois Administrative Code.

“DCFS” means the Department of Children and Family Services.

“Department” means the Illinois Department of Healthcare and Family Services.

“Care facility for persons with a developmental disability” means an intermediate care facility for persons with an intellectual disability within the meaning of Title XIX of the Social Security Act, whether public or private and whether organized for profit or not-for-profit, but shall not include any facility operated by the State.

“Care provider for persons with a developmental disability” means a person conducting, operating, or maintaining a care facility for persons with a developmental disability. For purposes of this definition, “person” means any political subdivision of the State, municipal corporation, individual, firm, partnership, corporation, company, limited liability company, association, joint stock association, or trust, or a receiver, executor, trustee, guardian, or other representative appointed by order of any court.

“DHS” means the Illinois Department of Human Services.

“Hospital” means an institution, place, building, or agency located in this State that is licensed as a general acute hospital by the Illinois Department of Public Health under the Hospital Licensing Act, whether public or private and whether organized for profit or not-for-profit.

“Long term care facility” means (i) a skilled nursing or intermediate long term care facility, whether public or private and whether organized for profit or not-for-profit, that is subject to licensure by the Illinois Department of Public Health under the Nursing Home Care Act, including a county nursing home directed and maintained under Section 5-1005 of the Counties Code, and (ii) a part of a hospital in which skilled or intermediate long term care services within the meaning of Title XVIII or XIX of the Social Security Act are provided; except that the term “long term care facility” does not include a facility operated solely as an intermediate care facility for the intellectually disabled within the meaning of Title XIX of the Social Security Act.

“Long term care provider” means (i) a person licensed by the Department of Public Health to operate and maintain a skilled nursing or intermediate long term care facility or (ii) a hospital provider that provides skilled or intermediate long term care services within the meaning of Title XVIII or XIX of the Social Security Act. For purposes of this definition, “person” means any political subdivision of the State, municipal corporation, individual, firm, partnership, corporation, company, limited liability company, association, joint stock association, or trust, or a receiver, executor, trustee, guardian, or other representative appointed by order of any court.

“State-operated facility for persons with a developmental disability” means an intermediate care facility for persons with an intellectual disability within the meaning of Title XIX of the Social Security Act operated by the State.

(c) Administration and deposit of Revenues. The Department shall coordinate the implementation of changes required by Public Act 96-1405 amongst the various State and local government bodies that administer programs referred to in this Section.

Revenues generated by program changes mandated by any provision in this Section, less reasonable administrative costs associated with the implementation of these program changes, which would otherwise be deposited into the General Revenue Fund shall be deposited into the Healthcare Provider Relief Fund.

The Department shall issue a report to the General Assembly detailing the implementation progress of Public Act 96-1405 as a part of the Department’s Medical Programs annual report for fiscal years 2010 and 2011.

(d) Acceleration of payment vouchers. To the extent practicable and permissible under federal law, the Department shall create all vouchers for long term care facilities and facilities for persons with a developmental disability for dates of service in the month in which the enhanced federal medical assistance percentage (FMAP) originally set forth in the American Recovery and Reinvestment Act (ARRA) expires and for dates of service in the month prior to that month and shall, no later than the 15th of the month in which the enhanced FMAP expires, submit these vouchers to the Comptroller for payment.

The Department of Human Services shall create the necessary documentation for State-operated facilities for persons with a developmental disability so that the necessary data for all dates of service before the expiration of the enhanced FMAP originally set forth in the ARRA can be adjudicated by the Department no later than the 15th of the month in which the enhanced FMAP expires.

(e) Billing of DHS community Medicaid mental health services. No later than July 1, 2011, community Medicaid mental health services provided by a community-based provider must be billed directly to the Department.

(f) DCFS Medicaid services. The Department shall work with DCFS to identify existing programs, pending qualifying services, that can be converted in an economically feasible manner to Medicaid in order to secure federal financial revenue.

(g) (Blank).

(h) Public health departments.
The Department shall identify unreimbursed costs for persons covered by Medicaid who are served by the Chicago Department of Public Health.

The Department shall assist the Chicago Department of Public Health in determining total unreimbursed costs associated with the provision of healthcare services to Medicaid enrollees.

The Department shall determine and draw the maximum allowable federal matching dollars associated with the cost of Chicago Department of Public Health services provided to Medicaid enrollees.

(i) Acceleration of hospital-based payments.
The Department shall, by the 10th day of the month in which the enhanced FMAP originally set forth in the ARRA expires, create vouchers for all State fiscal year 2011 hospital payments exempt from the prompt payment requirements of the ARRA. The Department shall submit these vouchers to the Comptroller for payment.

(Source: P.A. 100-201, eff. 8-18-17; 101-209, eff. 8-5-19.)

 

(305 ILCS 5/12-4.44)

Sec. 12-4.44. Report on centralizing administrative functions. The Department of Healthcare and Family Services, with the cooperation of the Department of Human Services, shall provide a report to the General Assembly by January 1, 2012, regarding the feasibility and potential consequences of centralizing administrative functions, to the extent allowable under federal law, for applicants applying only for medical assistance. The report shall include, but need not be limited to, an analysis of centralizing administrative functions in a statewide or regional centers administered by either public or private entities, and an analysis of the impact of removing medical assistance only cases from the caseload assigned to employees in local Department of Human Services field offices that accept and process applications for benefits.

(Source: P.A. 97-172, eff. 7-22-11.)

 

(305 ILCS 5/12-4.45)

Sec. 12-4.45. Third party liability.

(a) To the extent authorized under federal law, the Department of Healthcare and Family Services shall identify individuals receiving services under medical assistance programs funded or partially funded by the State who may be or may have been covered by a third party health insurer, the period of coverage for such individuals, and the nature of coverage. A company, as defined in Section 5.5 of the Illinois Insurance Code and Section 2 of the Comprehensive Health Insurance Plan Act, must provide the Department eligibility information in a federally recommended or mutually agreed-upon format that includes at a minimum:

• (1) The names, addresses, dates, and sex of primary covered persons.
• (2) The policy group numbers of the covered persons.
• (3) The names, dates of birth, and sex of covered dependents, and the relationship of dependents to the primary covered person.
• (4) The effective dates of coverage for each covered person.
• (5) The generally defined covered services information, such as drugs, medical, or any other similar description of services covered.

(b) The Department may impose an administrative penalty on a company that does not comply with the request for information made under Section 5.5 of the Illinois Insurance Code and paragraph (3) of subsection (a) of Section 20 of the Covering ALL KIDS Health Insurance Act. The amount of the penalty shall not exceed $10,000 per day for each day of noncompliance that occurs after the 180th day after the date of the request. The first day of the 180-day period commences on the business day following the date of the correspondence requesting the information sent by the Department to the company. The amount shall be based on:

• (1) The seriousness of the violation, including the nature, circumstances, extent, and gravity of the violation.
• (2) The economic harm caused by the violation.
• (3) The history of previous violations.
• (4) The amount necessary to deter a future violation.
• (5) Efforts to correct the violation.
• (6) Any other matter that justice may require.

(c) The enforcement of the penalty may be stayed during the time the order is under administrative review if the company files an appeal.

(d) The Attorney General may bring suit on behalf of the Department to collect the penalty.

(e) Recoveries made by the Department in connection with the imposition of an administrative penalty as provided under this Section shall be deposited into the Public Aid Recoveries Trust Fund created under Section 12-9.

(Source: P.A. 98-130, eff. 8-2-13; 98-756, eff. 7-16-14.)

 

(305 ILCS 5/12-4.46)

Sec. 12-4.46. Change in legal guardianship; notification. Whenever there is a change in legal guardianship of a minor child who receives benefits under this Code, the appropriate State agency shall immediately inform the Department of Human Services of the change in legal guardianship to ensure such benefits are sent directly to the minor child’s legal guardian.

For purposes of this Section, “legal guardian” means a person appointed guardian, or given custody, of a minor by a circuit court of the State, but does not include a person appointed guardian, or given custody, of a minor under the Juvenile Court Act or the Juvenile Court Act of 1987.

(Source: P.A. 98-256, eff. 8-9-13; 98-756, eff. 7-16-14.)

 

(305 ILCS 5/12-4.47)

Sec. 12-4.47. Continued eligibility for developmental disability services for dependents of military service members.

(a) As used in this Section:

“Dependent” means a spouse, birth child, adopted child, or
stepchild of a military service member.

“Legal resident” means a person who maintains Illinois as his
or her principal establishment, home of record, or permanent home and
to where, whenever absent due to military obligation, he or she intends
to return.

“Military service” means service in the armed forces or armed
forces reserves of the United States, or membership in the Illinois National Guard.

“Military service member” means a person who is currently in military service or who
has separated from military service in the previous 18 months through
either retirement or military separation.

(b) A dependent, who is a legal resident of the State, having
previously been determined to be eligible for developmental disability
services provided by the Department of Human Services, including waiver services provided under the home and community based services programs authorized under Section 1915(c) of the Social Security Act, shall retain eligibility for those developmental disability services as long as he
or she remains a legal resident of the State, regardless of having left the State due to the military service member’s military assignment
outside the State, and as long as he or she is otherwise eligible for such services.

(c) The Department of Human Services shall permit a dependent who resides out-of-state to be placed on the waiting list for developmental disabilities services if the dependent left the State due to the military service member’s military assignment outside the State, is otherwise eligible for those services, and furnishes the following:

• (1) a copy of the military service member’s DD-214 or other equivalent discharge paperwork; and
• (2) proof of the military service member’s legal residence in the State, as prescribed by the Department.

(d) For dependents who received developmental disability services
and who left the State due to the military service member’s military
assignment outside the State, upon the dependent’s return to the State and when a request for services is made, the Department shall:

• (1) determine the dependent’s eligibility for services, which may include a request for waiver services provided under the home and community based services programs authorized under Section 1915(c) of the Social Security Act;
• (2) provide to the dependent notification of the determination of eligibility for services, which includes notification of a denial of services if applicable;
• (3) provide the dependent an opportunity to contest the Department’s determination through the appeals processes established by the Department; and
• (4) resume services if the individual remains eligible.

(e) As a condition of continued eligibility for services under subsection (b) of this Section,
a dependent must inform the Department of his or her
current address and provide updates as requested by the Department.

(f) No payment pursuant to this Section shall be made for developmental disability services authorized under the Illinois Title XIX State Plan and provided outside the State unless those services satisfy the conditions specified in 42 CFR 431.52. No payment pursuant to this Section shall be made for home and community based services provided outside the State of Illinois.

(g) The Department shall request a waiver from the appropriate
federal agency if a waiver is necessary to implement the provisions of this
Section.

(h) The Department may adopt rules necessary to implement the
provisions of this Section.

(Source: P.A. 98-1000, eff. 8-18-14; 99-78, eff. 7-20-15.)

 

(305 ILCS 5/12-4.48)

Sec. 12-4.48. Long-Term Services and Supports Disparities Task Force.

(a) The Department of Healthcare and Family Services shall establish a Long-Term Services and Supports Disparities Task Force.

(b) Members of the Task Force shall be appointed by the Director of the Department of Healthcare and Family Services and shall include representatives of the following agencies, organizations, or groups:

• (1) The Governor’s office.
• (2) The Department of Healthcare and Family Services.
• (3) The Department of Human Services.
• (4) The Department on Aging.
• (5) The Department of Human Rights.
• (6) Area Agencies on Aging.
• (7) The Department of Public Health.
• (8) Managed Care Plans.
• (9) The for-profit urban nursing home or assisted living industry.
• (10) The for-profit rural nursing home or assisted living industry.
• (11) The not-for-profit nursing home or assisted living industry.
• (12) The home care association or home care industry.
• (13) The adult day care association or adult day care industry.
• (14) An association representing workers who provide long-term services and supports.
• (15) A representative of providers that serve the predominantly ethnic minority populations.
• (16) Case Management Organizations.
• (17) Three consumer representatives which may include a consumer of long-term services and supports or an individual who advocates for such consumers. For purposes of this provision, “consumer representative” means a person who is not an elected official and who has no financial interest in a health or long-term care delivery system.

(c) The Task Force shall not meet unless all consumer representative positions are filled. The Task Force shall reflect diversity in race, ethnicity, and gender.

(d) The Chair of the Task Force shall be appointed by the Director of the Department of Healthcare and Family Services.

(e) The Director of the Department of Healthcare and Family Services shall assign appropriate staff and resources to support the efforts of the Task Force. The Task Force shall meet as often as necessary but not less than 4 times per calendar year.

(f) The Task Force shall promote and facilitate communication, coordination, and collaboration among relevant State agencies and communities of color, limited English-speaking communities, and the private and public entities providing services to those communities.

(g) The Task Force shall do all of the following:

• (1) Document the number and types of Long-Term Services and Supports (LTSS) providers in the State and the number of clients served in each setting.
• (2) Document the number and racial profiles of residents using LTSS, including, but not limited to, residential nursing facilities, assisted living facilities, adult day care, home health services, and other home and community based long-term care services.
• (3) Document the number and profiles of family or informal caregivers who provide care for minority elders.
• (4) Compare data over multiple years to identify trends in the delivery of LTSS for each racial or ethnic category including: Alaskan Native or American Indian, Asian or Pacific Islander, black or African American, Hispanic, or white.
• (5) Identify any racial disparities in the provision of care in various LTSS settings and determine factors that might influence the disparities found.
• (6) Identify any disparities uniquely experienced in metropolitan or rural areas and make recommendations to address these areas.
• (7) Assess whether the LTSS industry, including managed care plans and independent providers, is equipped to offer culturally sensitive, competent, and linguistically appropriate care to meet the needs of a diverse aging population and their informal and formal caregivers.
• (8) Consider whether to recommend that the State require all home and community based services as a condition of licensure to report data similar to that gathered under the Minimum Data Set and required when a new resident is admitted to a nursing home.
• (9) Identify and prioritize recommendations for actions to be taken by the State to address disparity issues identified in the course of these studies.
• (10) Monitor the progress of the State in eliminating racial disparities in the delivery of LTSS.

(h) The Task Force shall conduct public hearings, inquiries, studies, and other forms of information gathering to identify how the actions of State government contribute to or reduce racial disparities in long-term care settings.

(i) The Task Force shall report its findings and recommendations to the Governor and the General Assembly no later than one year after the effective date of this amendatory Act of the 98th General Assembly. Annual reports shall be issued every year thereafter and shall include documentation of progress made to eliminate disparities in long-term care service settings.

(Source: P.A. 98-825, eff. 8-1-14; 99-78, eff. 7-20-15.)

 

(305 ILCS 5/12-4.49)

Sec. 12-4.49. Breast cancer imaging and diagnostic equipment grant program.

(a) On and after January 1, 2016 and subject to funding availability, the Department of Healthcare and Family Services shall administer a grant program the purpose of which shall be to build the public infrastructure for breast cancer imaging and diagnostic services across the State, in particular in rural, medically underserved areas and in areas with high breast cancer mortality.

(b) In order to be eligible for the program, an applicant must be a:

• (1) disproportionate share hospital with high MIUR (as set by the Department by rule);
• (2) mammography facility in a rural area;
• (3) federally qualified health center; or
• (4) rural health clinic.

(c) The grants may be used to purchase new equipment for breast imaging, image-guided biopsies, or other equipment to enhance the detection and diagnosis of breast cancer.

(d) The primary purpose of these grants is to increase access for low-income and Department of Healthcare and Family Services clients to high quality breast cancer screening and diagnostics. Medically Underserved Areas (MUAs), areas with high breast cancer mortality rates, and Health Professional Shortage Areas (HPSAs) shall receive special priority for grants under this program.

(e) The Department shall establish procedures for applying for grant funds under this Section.

(Source: P.A. 99-433, eff. 8-21-15.)

 

(305 ILCS 5/12-4.50)

Sec. 12-4.50. Healthy Local Food Incentives Program.

(a) Legislative findings. Diet and other lifestyle choices contribute to more than half of all deaths in Illinois. Health risk factors include smoking, obesity, stress, nutrition, high blood pressure, and alcohol and drug use. Illinois residents should be encouraged to adopt diets and lifestyles that lead to wellness. The State can help provide that encouragement by funding wellness programs that enhance the health of Illinois residents. Healthy local food incentives encourage wellness among some of the most vulnerable residents of Illinois (those whose incomes are below the poverty line and who often have limited access to fresh, healthy, and affordable foods) by doubling the purchasing power of LINK cardholders at farmers markets across the State. The benefits of such a program include: an increase in population health, Medicaid health care cost savings, decreased incidence of preventable diseases, increased revenue for Illinois small farmers, and economic stimulus for the region.

(b) Definitions. As used in this Section:

“FINI eligible fruits and vegetables” means any variety of fresh, canned, dried, or frozen whole or cut fruits and vegetables without added sugars, fats, or oils, and salt (i.e. sodium), as defined by the Food Insecurity Nutrition Incentive Grant Program administered by the United States Department of Agriculture.

“LINK card” means an electronic benefits transfer card issued by the Department of Human Services for the purpose of enabling a user of the card to obtain SNAP benefits or cash.

“SNAP” means the federal Supplemental Nutrition Assistance Program.

(c) The Department of Human Services shall establish a Healthy Local Food Incentives Program to double the purchasing power of Illinois residents with limited access to fresh fruits and vegetables. The Healthy Local Food Incentives Fund is created as a special fund in the State treasury for the purpose of implementing the Healthy Local Food Incentives Program. All moneys received pursuant to this Section shall be deposited into the Healthy Local Food Incentives Fund.

(d) Subject to appropriation, the Department of Human Services shall make an annual grant of $500,000 from the Fund to a qualified Illinois non-profit organization or agency, which shall be distributed to participating Illinois farmers markets for the purpose of providing matching dollar incentives (up to a specified amount) for the dollar value of SNAP benefits spent on FINI eligible fruits and vegetables at participating Illinois farmers markets and direct producer-to-consumer venues.

(e) The designated qualified non-profit organization or agency shall have a demonstrated track record of:

• (1) building a statewide network;
• (2) designing and implementing successful healthy food incentive programs that connect SNAP recipients with local producers;
• (3) implementing funds distribution and reporting processes;
• (4) providing training and technical assistance to farmers markets;
• (5) conducting community outreach and data collection; and
• (6) providing full accounting and administration of funds distributed to farmers markets.

(f) 100% of the moneys deposited into the Fund shall be distributed to participating Illinois farmers markets for healthy local food incentives.

(g) Within 90 days after the end of a grant cycle, the designated qualified non-profit organization or agency shall submit a progress report to the Department of Human Services. The progress report shall include the following information:

• (1) the names and locations of Illinois farmers markets and direct producer-to-consumer venues that received funds distributed under the Program;
• (2) the dollar amount of funds awarded to each participating Illinois farmers market and direct producer-to-consumer venue;
• (3) the dollar amount of SNAP benefits, and funds provided under the Program, that were spent at Illinois farmers markets participating in the Program, as well as the dollar amount of any unspent funds available under the Program;
• (4) the number of SNAP transactions carried out annually at participating Illinois farmers markets;
• (5) the impact of the Program on increasing the quantity of fresh fruits and vegetables consumed by SNAP families, as determined by customer surveys.

(h) No later than December 31, 2017, the Department of Human Services shall adopt rules to implement the provisions of this Section.

(i) (Blank).

(Source: P.A. 99-928, eff. 1-20-17; 100-636, eff. 1-1-19.)

 

(305 ILCS 5/12-4.51)

Sec. 12-4.51. Workforce training and healthy families demonstration project.

(a) Subject to the availability of funds provided for this purpose by the federal government, local philanthropic or charitable sources, or other private sources, there is created a 5-year demonstration project within the Department of Human Services to provide an intensive workforce training program for entry-level workers and a multi-generational healthy family initiative. No general revenue funds may be used to fund the demonstration project created under this Section. The demonstration project shall be implemented no later than 6 months after January 1, 2019 (the effective date of Public Act 100-806) and shall terminate 5 years after the initial date of implementation. The demonstration project shall be operated and maintained by a non-profit, community-based entity that shall provide the majority of the wages earned by participants enrolled in the workforce training program as well as support services to families, including new and expectant parents, enrolled in the multi-generational healthy family initiative. The total number of participants in the 5-year demonstration project at any one time shall not exceed 500. Participants enrolled in the workforce training program or the multi-generational healthy family initiative shall qualify to have whatever financial assistance they receive from their participation excluded from consideration for purposes of determining eligibility for or the amount of assistance under this Code as provided in subsection (d) of Section 1-7. The selected entity must immediately notify the Department of Human Services or the Department of Healthcare and Family Services whenever a participant enrolled in the workforce training program or the multi-generational healthy family initiative leaves the demonstration project and ceases to participate in any of the programs under the demonstration making the participant ineligible to receive an exemption as provided in subsection (d) of Section 1-7.

(b) The entity selected to operate and maintain the demonstration project shall be a non-profit, community-based entity in good standing with the State that is located in a county with a population of less than 3,000,000. The selected entity must comply with all applicable State and federal requirements and must develop and implement a research component to determine the effectiveness of the demonstration project in promoting and instilling self-sufficiency through its intensive workforce training program and multi-generational healthy family initiative. The State shall not fund the research component outlined in the Section or any program under the demonstration project.

(c) Beginning one year after the initial implementation date of the demonstration project, and each year thereafter for the duration of the demonstration, the selected entity shall submit a report to the Department of Human Services, the Department of Healthcare and Family Services, and the General Assembly that details the progress and effectiveness of the demonstration project and the demonstration’s impact on instilling the value of self-sufficiency in participants. The 4th annual report shall also provide policy recommendations on best practices for and continued research on facilitating bridges to self-sufficiency. The 4th annual report may also include a recommendation on making the demonstration project permanent upon completion of the demonstration project period.

The reports to the General Assembly shall be filed with the Clerk of the House of Representatives and the Secretary of the Senate in electronic form only, in the manner that the Clerk and the Secretary shall direct.

(Source: P.A. 100-806, eff. 1-1-19; 101-81, eff. 7-12-19.)

 

(305 ILCS 5/12-4.52)

Sec. 12-4.52. Prescriber education.

(a) The Department of Healthcare and Family Services shall develop, in collaboration with a public university that has a Doctor of Pharmacy Professional Program and is located in a county with a population of more than 3,000,000, a program designed to provide
prescribing physicians under the medical assistance program with an evidence-based, non-commercial source of the latest
objective information about pharmaceuticals. Information shall be
presented to prescribing physicians by specially trained pharmacists, nurses, or
other health professionals to assist prescribing physicians in making
appropriate therapeutic recommendations.

(b) The prescriber education program shall consist of 2 components: a web-based curriculum and an academic educator outreach. The program shall contract with clinical pharmacists to provide scheduled visits with prescribing physicians to update them on the latest research concerning medication usage and new updates on disease states in an unbiased manner.

(c) Education provided under the prescriber education program shall include, but not be limited to, disease-based educational modules on the treatment of chronic non-cancer pain, diabetes, hypertension, hyperlipidemia, respiratory syncytial virus, and nicotine dependence. New modules may be created periodically as needed and existing module content shall be reviewed and updated on an annual or as-needed basis. Educational modules provided under the program shall provide prescribing physicians with continuing medical education credit.

(d) Additional resources provided under the prescriber education program shall include, but not be limited to, the following:

• (1) a drug information response center available to prescribing physicians that provides thorough and timely in-depth answers to any questions a prescribing physician may have within 48 hours after a question is received; and
• (2) information on drug utilization trends within individual and group practices.

(Source: P.A. 101-278, eff. 1-1-20.)

 

(305 ILCS 5/12-4.53)

Sec. 12-4.53. Prospective Payment System (PPS) rates. Effective January 1, 2021, and subsequent years, based on specific appropriation, the Prospective Payment System (PPS) rates for FQHCs shall be increased based on the cost principles found at 45 Code of Federal Regulations Part 75 or its successor. Such rates shall be increased by using any of the following methods: reducing the current minimum productivity and efficiency standards no lower than 3500 encounters per FTE physician; increasing the statewide median cost cap from 105% to 120%, a one-time re-basing of rates utilizing 2018 FQHC cost reports, or another alternative payment method acceptable to the Centers for Medicare and Medicaid Services and the FQHCs, including an across the board percentage increase to existing rates.

(Source: P.A. 101-636, eff. 6-10-20; 101-655, eff. 3-12-21.)

 

(305 ILCS 5/12-4.54)

Sec. 12-4.54. SNAP, WIC; diapers, menstrual hygiene products. If the United States Department of Agriculture’s Food and Nutrition Service creates and makes available to the states a waiver permitting recipients of benefits provided under the Supplemental Nutrition Assistance Program or the Special Supplemental Nutrition Program for Women, Infants, and Children to use their benefits to purchase diapers or menstrual hygiene products such as tampons, sanitary napkins, and feminine wipes, then the Department of Human Services shall apply for the waiver. If the United States Department of Agriculture approves the Department of Human Services’ waiver application, then the Department of Human Services shall adopt rules and make other changes as necessary to implement the approved waiver.

(Source: P.A. 102-248, eff. 1-1-22; 102-813, eff. 5-13-22.)

 

(305 ILCS 5/12-4.55)

Sec. 12-4.55. Community-based long-term services; application for federal funding. The Department of Healthcare and Family Services shall apply for all available federal funding to promote community inclusion and integration for persons with disabilities, regardless of age, and older adults so that those persons have the option to transition out of institutions and receive long-term care services and supports in the settings of their choice.

(Source: P.A. 102-536, eff. 8-20-21; 102-813, eff. 5-13-22.)

 

(305 ILCS 5/12-4.56)

Sec. 12-4.56. Managed Primary Care Demonstration Project. The Department shall establish and implement a Managed Primary Care Demonstration Project to provide primary care services that are focused on preventive rather than curative care to persons who reside in underserved communities that lack accessible health and medical services. The demonstration project shall operate for a 5-year period and provide supplemental services to medical assistance recipients. The Department shall contract with a health care organization through a competitive process that is capable of providing patient-centered, prevention-focused services, that may include, but are not limited to, the following:

• (1) Patient navigators to manage patient care.
• (2) Patient-tailored preventive health care plans.
• (3) Administrative personal health care consultants for home health maintenance between medical office visits.
• (4) Clinical personal health care consultants for telehealth (health information and advice) and wellness initiatives.
• (5) A patient portal.
• (6) An online virtual health hub that provides patients with access to wellness, self-guided education, health seminars, a video library, and additional health and wellness resources.
• (7) Community health and human services centers to engage, educate, and empower patients to get involved in their own self-care.
• (8) Mobile preventive health stations and kiosks to bring services to underserved communities that are health or medical deserts.
• (9) Call centers to interact with medical homes and facilitate service offerings.

A request for proposals for the demonstration project shall be issued by December 31, 2022.

(Source: P.A. 102-699, eff. 4-19-22.)

 

(305 ILCS 5/12-4.101)

Sec. 12-4.101.
(Repealed).

(Source: P.A. 90-655, eff. 7-30-98. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-4.102)

Sec. 12-4.102.
(Repealed).

(Source: P.A. 88-412. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-4.103)

Sec. 12-4.103.
Individual Development Accounts.
Subject to funding availability, the Illinois Department shall
establish a program that allows eligible low-income
individuals to open and maintain Individual Development Accounts for the
purpose of enabling the individual to accumulate funds for a qualified purpose.
A qualified purpose for establishing an Individual Development Account shall
be one or more of the following:

(1) to pay for postsecondary education expenses if the expenses are paid
directly to an eligible educational institution;

(2) to acquire a principal residence if the individual is buying a home for
the first time and if the funds are paid directly to the person to whom the
amounts required for the purchase are due; or

(3) to finance business capitalization expenses if the funds are paid
directly into a business capitalization account at a federally insured
financial institution and are restricted to use solely for qualified business
capitalization expenses.

An individual may make contributions to his or her
Individual Development Account only from earned income as
defined in Section 911(d)(2) of the Internal Revenue Code of 1986.

An Individual Development Account program shall be established in
accordance with subsection (h) of Section 404 of the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996. State funds made available
for this program and federal funds, to the extent they may be used for this
purpose, shall be used (i) to match, dollar for dollar, contributions made by
individuals participating in an Individual Development Account program approved
by the Illinois Department, (ii) to fund or supplement other funds available
for the costs of the administration of an Individual Development Account
program by a not-for-profit organization, and (iii) for a grant or grants to
not-for-profit organizations to provide technical assistance and training to
other not-for-profit organizations in the State that wish to establish an
Individual Development Account program consistent with this Section. No
Individual Development Account program shall qualify for State funds under this
Section unless the administering not-for-profit organization verifies that it
has secured at least a dollar for dollar match from
other sources for contributions made by participating individuals.

The Illinois Department shall by rule establish qualifications for a
not-for-profit organization to administer an Individual Development Account
program.
The Illinois Department shall establish eligibility criteria for individuals
seeking to participate in an Individual Development Account program. The
Illinois Department shall promulgate rules regarding the administration of
Individual Development Account programs by approved not-for-profit
organizations administering the programs.

Notwithstanding any other provision of State law, funds in an Individual
Development Account, including accrued interest and matching deposits, shall be
disregarded for the purpose of determining the eligibility and benefit levels
under this Code of the individual establishing the Individual Development
Account with respect to any period during which such individual maintains or
makes contributions into such an account.
Nothing in this Section shall prohibit a not-for-profit organization which does
not
receive State matching funds from administering an approved Individual
Development Account under this Section.

(Source: P.A. 90-783, eff. 8-14-98.)

 

(305 ILCS 5/12-4.103a)

Sec. 12-4.103a. Assets for Independence Program.

(a) Program established. Subject to available funding and receipt of a federal Assets for Independence grant award, the Department of Human Services shall establish and administer an Assets for Independence Program (Program). The Program shall be established in accordance with the terms of the Assets for Independence Act (AFIA) as now and hereafter amended (Title IV Community Opportunities, Accountability, and Training and Educational Services Act as amended, Public Law 105-285, 42 U.S.C. 604 note).

(b) Assets for Independence Fund. The Assets for Independence Fund is established. The Fund shall be held by the Secretary or his or her designee as ex-officio custodian thereof separate and apart from all other State funds. The Assets for Independence Fund is authorized to receive grants under AFIA, State moneys appropriated for the Program, and moneys from voluntary donations from individuals, foundations, corporations, and other sources. Moneys in the Assets for Independence Fund shall not be commingled with other State funds, but they shall be deposited as required by law and maintained in a separate account on the books of a savings and loan association, bank, or other qualified financial institution. All interest earnings on amounts within the Assets for Independence Fund shall accrue to the Assets for Independence Fund and shall be used in accordance with the terms of the AFIA. Administrative expenses related to the Program, including the provision of financial education to Program participants, shall be paid from the Assets for Independence Fund in accordance with the terms of AFIA Section 707(c)(3).

(c) Program purpose. The purpose of the Program is to allow eligible low-income Illinois citizens, subject to the availability of State and federal funds and authorization from the Department, to open and maintain an Individual Development Account (IDA) at a federally insured financial institution. Deposits into an IDA that are used for subsequent qualified purchases shall be matched dollar-for-dollar by moneys from the Assets for Independence Fund. Not more than $2,000 of moneys from the Assets for Independence Fund shall be provided to any one individual. Not more than $4,000 of moneys from the Assets for Independence Fund shall be provided to any one household. Assets for Independence Fund moneys not being used to administer the Program shall be used only for qualified purchases, shall be distributed only directly to the vendor of a qualified purchase, and shall require the authorization by signature of the Department’s chief financial officer.

(d) Contributions to IDA and use of moneys. An individual may make contributions to his or her IDA only from earned income as defined in Section 911(d)(2) of the Internal Revenue Code of 1986. The moneys deposited into an IDA shall not be commingled with any Assets for Independence Fund moneys. An IDA holder shall have a 36-month period, beginning on the date the Department authorizes the holder to open the IDA, within which to make a qualified purchase. If a qualified purchase is not made within that 36-month period, Assets for Independence Fund moneys earmarked for that individual shall be released, and the Department shall authorize another eligible person to open an IDA. Under no circumstances, and at no time, shall an IDA holder lose the ability to withdraw moneys from his or her IDA.

(e) Qualified purchases. A qualified asset purchase using moneys from an IDA shall be defined in accordance with AFIA Section 404(8) and shall be one or more of the following:

• (1) Payment of post-secondary education expenses, if the expenses are paid directly to an eligible educational institution.
• (2) Acquisition of a principal residence, if the individual is buying a home for the first time and if the funds are paid directly to the person to whom the amounts required for the purchase are due.
• (3) Financing of business capitalization expenses, if the funds are paid directly into a business capitalization account at a federally insured financial institution and are restricted to use solely for qualified business capitalization expenses.

(f) Program eligibility. Program eligibility shall be established by the Department in accordance with AFIA Section 408. Persons eligible to open an IDA and to receive Assets for Independence Fund moneys are Illinois citizens currently residing in Illinois who are (i) able to demonstrate that they are currently eligible for assistance under the State’s Temporary Assistance for Needy Families program or (ii) able to demonstrate that the adjusted gross income of their household in the calendar year preceding the determination of eligibility was equal to or less than 200% of the poverty line, as determined by the Federal Office of Management and Budget. An individual must further demonstrate that the net worth of his or her household, as of the end of the calendar year preceding the determination of eligibility, does not exceed $10,000, as determined by AFIA Section 408(2)(B). Notwithstanding any other provision of State law, moneys in an Individual Development Account, including accrued interest and matching deposits, shall be disregarded for the purpose of determining the eligibility and benefit levels under this Code in the case of the individual establishing the IDA with respect to any period during which the individual maintains or makes contributions into the IDA. The Department shall approve an individual to open an IDA at a federally insured financial institution upon determining, based on the individual’s application, that all eligibility criteria are met and subject to the availability of $2,000 in Assets for Independence Fund moneys.

(Source: P.A. 94-1043, eff. 7-24-06.)

 

(305 ILCS 5/12-4.104)

Sec. 12-4.104.
Family and Community Development Grant Program.

(a) Subject to funding availability, a family and community development
grant
program shall be administered by the Department
of
Human Services. The program shall be designed to make services
available to families who are at risk of long-term economic
dependency and to work with communities to provide economic opportunities. The
purpose of the program is to fund, evaluate, and provide
recommendations on not less than 8 nor more than 10 projects to
move 100 families at risk of
long-term economic dependency to self-sufficiency through the family and
community development program.

(b) As used in this Section only:

“Applicant” means a public or private organization that makes application
for a grant through the request for proposals process.

“Council” means the Social Services Advisory Council.

“Department” means the Department of Human Services.

“Grant” means an award to fund a project approved by the
Department with the advice of the Council.

“Grantee” means the recipient of a grant approved by the Department.

(c) The Social Services Advisory Council as established within
the Department of Human Services shall,
with
respect to the family and community development
grants
administered by the Department,
involve a representative of the Human Resource
Investment Council in considering proposed projects and monitoring approved
projects.

(d) The Council shall:

• (1) Identify the factors and conditions that place Illinois families at risk of long-term dependency upon the AFDC program or its successor program. The Council shall seek to use relevant research findings and national and Illinois-specific data on TANF (formerly AFDC).
• (2) Identify the factors and conditions that place Illinois families at risk of family instability, long-term economic dependency, and foster care placement.
• (3) Report those findings to the Secretary of Human Services for his or her evaluation.
• (4) Recommend grants to public or private organizations to provide family and community development services to families at risk of long-term economic dependency.
• (5) In cooperation with the Illinois Community Action Association, use family and community development outcome measures to independently evaluate the effectiveness of demonstration projects.
• (6) Seek the support of an Illinois accredited university to continue research and evaluation responsibilities.
• (7) Seek additional support for the funding of family and community development grants.
• (8) Make recommendations to the Governor, the General Assembly, and the Secretary of Human Services on the effectiveness of family and community development intervention programs in Illinois.
• (9) Evaluate and make recommendations regarding the cost and benefits to the expansion of the services provided under TANF (formerly AFDC) to include tuition for parenting skills programs, family support and counseling services, child development services, job readiness and job skill training, and transportation and child care expenses associated with the programs and services.

(e) In cooperation with the Illinois Community Action Association,
the grantees shall identify families that
receive TANF (formerly AFDC)
payments that may place families at
risk of long-term economic
dependency.

(f) The Department shall adopt rules for the operation of this program.

(Source: P.A. 90-783, eff. 8-14-98.)

 

(305 ILCS 5/12-4.105)

Sec. 12-4.105. Human poison control center; payment program. Subject to funding availability resulting from transfers made from the Hospital Provider Fund to the Healthcare Provider Relief Fund as authorized under this Code, for State fiscal year 2017 and State fiscal year 2018, and for each State fiscal year thereafter in which the assessment under Section 5A-2 is imposed, the Department of Healthcare and Family Services shall pay to the human poison control center designated under the Poison Control System Act an amount of not less than $3,000,000 for each of State fiscal years 2017 through 2020, and for State fiscal years 2021 through 2026 an amount of not less than $3,750,000 and for the period July 1, 2026 through December 31, 2026 an amount
of not less than $1,875,000, if the human poison control center is in operation.

(Source: P.A. 101-650, eff. 7-7-20; 102-886, eff. 5-17-22.)

 

(305 ILCS 5/12-4.201)

Sec. 12-4.201. Data warehouse concerning medical and related
services.

(a) The Department of Healthcare and Family Services may purchase services and
materials associated with the costs of developing and implementing a data
warehouse comprised of management and decision making information in
regard to the liability associated with, and utilization of, medical and
related services, out of moneys available for that purpose.

(b) The Department of Healthcare and Family Services shall perform all necessary administrative functions to expand its linearly-scalable data warehouse to encompass other healthcare data sources at both the Department of Human Services and the Department of Public Health. The Department of Healthcare and Family Services shall leverage the inherent capabilities of the data warehouse to accomplish this expansion with marginal additional technical administration. The purpose of
this expansion is to allow for programmatic review and analysis including the interrelatedness among the various healthcare programs in order to ascertain effectiveness toward, and ultimate impact on, clients. Beginning
July 1, 2005, the Department of Healthcare and Family Services (formerly Department of Public Aid) shall supply quarterly reports to the Commission on Government Forecasting and Accountability detailing progress toward this mandate.

(c) The Department of Healthcare and Family Services (HFS), the Illinois Department of Public Health, the Illinois Department of Human Services, and the Division of Specialized Care for Children, University of Illinois at Chicago, with necessary support from the Department of Central Management Services, shall integrate into the medical data warehouse individual record level data owned by one of these agencies that pertains to maternal and child health, including the following data sets:

• (1) Vital Records as they relate to births, birth outcomes, and deaths.
• (2) Adverse Pregnancy Outcomes Reporting System (APORS).
• (3) Genetics/Newborn Screenings/SIDS.
• (4) Cornerstone (WIC, FCM, Teen Parents, Immunization).
• (5) HFS medical claims data.
• (6) I-CARE.
• (7) Children with Special Healthcare Needs Data.

By September 1, 2009, the departments of Healthcare and Family Services, Public Health, and Human Services and the Division of Specialized Care for Children shall jointly prepare a work plan for fully integrating these data sets into the medical data warehouse. The work plan shall provide an overall project design, including defining a mutually acceptable transfer format for each discrete data set, the data update frequency, and a single method of data transfer for each data set. By October 1, 2009, the Department of Public Health shall grant to the Department of Healthcare and Family Services complete access to all vital records data. The Department of Public Health shall prepare a report detailing that this task has been accomplished and submit this report to the Commission on Government Forecasting and Accountability by October 15, 2009. By March 1, 2010, the data sets shall be completely loaded into the medical data warehouse. By July 1, 2010, data from the various sources shall be processed so as to be compatible with other data in the medical data warehouse and available for analysis in an integrated manner.

With the cooperation of the other agencies, HFS shall submit status reports on the progress of these efforts to the Governor and the General Assembly no later than October 1, 2009 and April 1, 2010, with a final report due no later than November 1, 2010.

On an ongoing basis, the 4 agencies shall review the feasibility of adding data from additional sources to the warehouse. Such review may take into account the cost effectiveness of adding the data, the utility of adding data that is not available as identifiable individual record level data, the requirements related to adding data owned by another entity or not available in electronic form, whether sharing of the data is otherwise prohibited by law and the resources required and available for effecting the addition.

The departments shall use analysis of the data in the medical data warehouse to improve maternal and child health outcomes, and in particular improve birth outcomes, and to reduce racial health disparities in this area.

All access and use of the data shall be in compliance with all applicable federal and State laws, regulations, and mandates.

Notwithstanding anything in this Section, data incorporated into the data warehouse shall remain subject to the same provisions of law regarding confidentiality and use restrictions as they are subject to in the control of the contributing agency. The Department of Healthcare and Family Services shall develop measures to ensure that the interplay of the several data sets contributed to the data warehouse does not lead to the use or release of data from the data warehouse that would not otherwise be subject to use or release under State or federal law.

(Source: P.A. 95-331, eff. 8-21-07; 96-799, eff. 10-28-09; 96-1000, eff. 7-2-10.)

 

(305 ILCS 5/12-4.202)

Sec. 12-4.202. (Repealed).

(P.A. 94-267, eff. 7-19-05. Repealed internally, eff. 1-1-06.)

 

(305 ILCS 5/12-5) (from Ch. 23, par. 12-5)

Sec. 12-5. Appropriations; uses; federal grants; report to
General Assembly. From the sums appropriated by the General Assembly,
the Illinois Department shall order for payment by warrant from the State
Treasury grants for public aid under Articles III, IV, and V,
including
grants for funeral and burial expenses, and all costs of administration of
the Illinois Department and the County Departments relating thereto. Moneys
appropriated to the Illinois Department for public aid under Article VI may
be used, with the consent of the Governor, to co-operate
with federal, State, and local agencies in the development of work
projects designed to provide suitable employment for persons receiving
public aid under Article VI. The Illinois Department, with the consent
of the Governor, may be the agent of the State for the receipt and
disbursement of federal funds or commodities for public aid purposes
under Article VI and for related purposes in which the
co-operation of the Illinois Department is sought by the federal
government, and, in connection therewith, may make necessary
expenditures from moneys appropriated for public aid under any Article
of this Code and for administration. The Illinois Department may make necessary expenditures from monies
appropriated to it for operations, administration, and grants, including
payment to the Health Insurance Reserve Fund for group insurance costs at
the rate certified by the Department of Central Management Services.

All grants received by the Illinois Department for programs funded by the
Federal Social Services Block Grant shall be deposited in the Social Services
Block Grant Fund. All funds received into the Social Services Block Grant Fund
as reimbursement for expenditures from the General Revenue Fund shall be
transferred to the General Revenue Fund. All funds received into the Social
Services Block Grant fund for reimbursement for expenditure out of the Local
Initiative Fund shall be transferred into the Local Initiative Fund. Any other
federal funds received into the Social Services Block Grant Fund shall be
transferred to the DHS Special Purposes Trust Fund. All federal funds received by
the Illinois Department as reimbursement for Employment and Training Programs
for expenditures made by the Illinois Department from grants, gifts, or
legacies as provided in Section 12-4.18 or made by an entity other than the
Illinois Department and all federal funds received from the Emergency Contingency Fund for State Temporary Assistance for Needy Families Programs established by the American Recovery and Reinvestment Act of 2009 shall be deposited into the Employment and Training Fund.

During each State fiscal year, an amount not exceeding a total of $68,800,000 of the federal funds received by the
Illinois Department under the provisions of Title IV-A of the federal Social Security Act shall be deposited
into the DCFS Children’s Services
Fund.

All federal funds, except those covered by the foregoing 3
paragraphs, received as reimbursement for expenditures from the General Revenue
Fund shall be deposited in the General Revenue Fund for administrative and
distributive expenditures properly chargeable by federal law or regulation to
aid programs established under Articles III through XII and Titles IV, XVI, XIX
and XX of the Federal Social Security Act. Any other federal funds received by
the Illinois Department under Sections 12-4.6, 12-4.18 and
12-4.19 that are required by Section 12-10 of this Code to be paid into the
DHS Special Purposes Trust Fund shall be deposited into the DHS Special Purposes Trust
Fund. Any other federal funds received by the Illinois Department pursuant to
the Child Support Enforcement Program established by Title IV-D of the Social
Security Act shall be deposited in the Child Support Enforcement Trust Fund
as required under Section 12-10.2 or in the Child Support Administrative Fund as required under Section 12-10.2a of this Code. Any other federal funds received by the Illinois Department for
expenditures made under Title XIX of the Social Security Act and Articles
V and VI of this Code that are required by Section 15-2 of this Code
to be paid into the County Provider Trust Fund shall be deposited
into the County Provider Trust Fund. Any other federal funds received
by the Illinois Department for hospital
inpatient, hospital ambulatory care, and disproportionate share hospital
expenditures made under Title XIX of the Social Security Act and Article V of
this Code that are required by Section 5A-8 of this Code to be paid into the
Hospital Provider Fund shall be deposited into the Hospital Provider Fund. Any
other federal funds received by the Illinois Department for medical
assistance program expenditures made under Title XIX of the Social Security
Act and Article V of this Code that are required by Section 5B-8 of this
Code to be paid into the Long-Term Care Provider Fund shall be deposited
into the Long-Term Care Provider Fund. Any other federal funds received by
the Illinois Department for medical assistance program expenditures made
under Title XIX of the Social Security Act and Article V of this Code that
are required by Section 5C-7 of this Code to be paid into the
Care Provider Fund for Persons with a Developmental Disability shall be deposited into the
Care Provider Fund for Persons with a Developmental Disability. Any other federal funds received
by the Illinois Department for trauma center
adjustment payments that are required by Section 5-5.03 of this Code and made
under Title XIX of the Social Security Act and Article V of this Code shall be
deposited into the Trauma Center Fund. Any other federal funds received by
the Illinois Department as reimbursement for expenses for early intervention
services paid from the Early Intervention Services Revolving Fund shall be
deposited into that Fund.

The Illinois Department shall report to the General Assembly at the
end of each fiscal quarter the amount of all funds received and paid into
the Social Services Block Grant Fund and the Local Initiative Fund and the
expenditures and transfers of such funds for services, programs and other
purposes authorized by law. Such report shall be filed with the Speaker,
Minority Leader and Clerk of the House, with the President, Minority Leader
and Secretary of the Senate, with the Chairmen of the House and Senate
Appropriations Committees, the House Human Resources Committee and the
Senate Public Health, Welfare and Corrections Committee, or the successor
standing Committees of each as provided by the rules of the House and
Senate, respectively, with the Commission on Government Forecasting and Accountability and with the State
Government Report Distribution Center for the General Assembly as is
required under paragraph (t) of Section 7 of the State Library Act
shall be deemed sufficient to comply with this Section.

(Source: P.A. 100-587, eff. 6-4-18; 100-863, eff. 8-14-18; 100-1148, eff. 12-10-18; 101-275, eff. 8-9-19.)

 

(305 ILCS 5/12-6) (from Ch. 23, par. 12-6)

Sec. 12-6.
(Repealed).

(Source: P.A. 90-372, eff. 7-1-98. Repealed internally, eff. 7-1-98.)

 

(305 ILCS 5/12-8) (from Ch. 23, par. 12-8)

Sec. 12-8. Public Assistance Emergency Revolving Fund – Uses. The
Public Assistance Emergency Revolving Fund, established by Act approved
July 8, 1955 shall be held by the Illinois Department and shall be used
for the following purposes:

• 1. To provide immediate financial aid to applicants in acute need who have been determined eligible for aid under Articles III, IV, or V.
• 2. To provide emergency aid to recipients under said Articles who have failed to receive their grants because of mail box or other thefts, or who are victims of a burnout, eviction, or other circumstances causing privation, in which cases the delays incident to the issuance of grants from appropriations would cause hardship and suffering.
• 3. To provide emergency aid for transportation, meals and lodging to applicants who are referred to cities other than where they reside for physical examinations to establish blindness or disability, or to determine the incapacity of the parent of a dependent child.
• 4. To provide emergency transportation expense allowances to recipients engaged in vocational training and rehabilitation projects.
• 5. To assist public aid applicants in obtaining copies of birth certificates, death certificates, marriage licenses or other similar legal documents which may facilitate the verification of eligibility for public aid under this Code.
• 6. To provide immediate payments to current or former recipients of child support enforcement services, or refunds to responsible relatives, for child support made to the Illinois Department under Title IV-D of the Social Security Act when such recipients of services or responsible relatives are legally entitled to all or part of such child support payments under applicable State or federal law.
• 7. To provide payments to individuals or providers of transportation to and from medical care for the benefit of recipients under Articles III, IV, V, and VI.
• 8. To provide immediate payment of fees, as follows:
• (A) To sheriffs and other public officials authorized by law to serve process in judicial and administrative child support actions in the State of Illinois and other states.
• (B) To county clerks, recorders of deeds, and other public officials and keepers of real property records in order to perfect and release real property liens.
• (C) To State and local officials in connection with the processing of Qualified Illinois Domestic Relations Orders.

Disbursements from the Public Assistance Emergency Revolving Fund
shall be made by the Illinois Department.

Expenditures from the Public Assistance Emergency Revolving Fund
shall be for purposes which are properly chargeable to appropriations
made to the Illinois Department, or, in the case of payments under subparagraphs 6 and 8, to the Child Support Enforcement Trust Fund or the Child Support Administrative Fund, except that no expenditure, other than payment of the fees provided for under subparagraph 8 of this Section,
shall be made for purposes which are properly chargeable to appropriations
for the following objects: personal services; extra help; state contributions
to retirement system; state contributions to Social Security; state
contributions for employee group insurance; contractual services; travel;
commodities; printing; equipment; electronic data processing; operation of
auto equipment; telecommunications services; library books; and refunds.
The Illinois Department shall reimburse the Public Assistance Emergency
Revolving Fund by warrants drawn by the State Comptroller on the
appropriation or appropriations which are so chargeable, or, in the case of
payments under subparagraphs 6 and 8, by warrants drawn on the Child Support
Enforcement Trust Fund or the Child Support Administrative Fund, payable to the Revolving Fund.

(Source: P.A. 97-735, eff. 7-3-12.)

 

(305 ILCS 5/12-8.1)

Sec. 12-8.1.
State Disbursement Unit Revolving Fund.

(a) There is created a revolving fund to be known as the State Disbursement
Unit Revolving Fund, to be held by the Director of the Illinois Department,
outside the State treasury,
for the following purposes:

• (1) the deposit of all support payments received by the Illinois Department’s State Disbursement Unit;
• (2) the deposit of other funds including, but not limited to, transfers of funds from other accounts attributable to support payments received by the Illinois Department’s State Disbursement Unit;
• (3) the deposit of any interest accrued by the revolving fund, which interest shall be available for payment of (i) any amounts considered to be Title IV-D program income that must be paid to the U.S. Department of Health and Human Services and (ii) any balance remaining after payments made under item (i) of this subsection (3) to the General Revenue Fund; however, the disbursements under this subdivision (3) may not exceed the amount of the interest accrued by the revolving fund;
• (4) the disbursement of such payments to obligees or to the assignees of the obligees in accordance with the provisions of Title IV-D of the Social Security Act and rules promulgated by the Department, provided that such disbursement is based upon a payment by a payor or obligor deposited into the revolving fund established by this Section; and
• (5) the disbursement of funds to payors or obligors to correct erroneous payments to the Illinois Department’s State Disbursement Unit, in an amount not to exceed the erroneous payments.

(b) (Blank).

(Source: P.A. 92-44, eff. 7-1-01; 93-20, eff. 6-20-03.)

 

(305 ILCS 5/12-8.2)

Sec. 12-8.2. Medical Assistance Dental Reimbursement Revolving Fund. There is created a revolving fund to be known as the Medical Assistance Dental Reimbursement Revolving Fund, to be held by the Director of the Department of Healthcare and Family Services, outside of the State treasury, for the following purposes:

• (1) The deposit of all funds to pay for dental services provided by enrolled dental service providers for services to participants in the medical programs administered by the Department.
• (2) The deposit of any interest accrued by the revolving fund, which interest shall be available to pay for dental services provided by enrolled dental service providers for services to participants in the medical programs administered by the Department.
• (3) The payment of amounts to enrolled dental service providers for dental services provided to participants in the medical programs administered by the Department.

(Source: P.A. 96-1123, eff. 1-1-11.)

 

(305 ILCS 5/12-9) (from Ch. 23, par. 12-9)

Sec. 12-9. Public Aid Recoveries Trust Fund; uses. The Public Aid Recoveries Trust Fund shall consist of (1)
recoveries by the Department of Healthcare and Family Services (formerly Illinois Department of Public Aid) authorized by this Code
in respect to applicants or recipients under Articles III, IV, V, and VI,
including recoveries made by the Department of Healthcare and Family Services (formerly Illinois Department of Public
Aid) from the estates of deceased recipients, (2) recoveries made by the
Department of Healthcare and Family Services (formerly Illinois Department of Public Aid) in respect to applicants and recipients under
the Children’s Health Insurance Program Act, and the Covering ALL KIDS Health Insurance Act, (2.5) recoveries made by the Department of Healthcare and Family Services in connection with the imposition of an administrative penalty as provided under Section 12-4.45, (3) federal funds received on
behalf of and earned by State universities and local governmental entities
for services provided to
applicants or recipients covered under this Code, the Children’s Health Insurance Program Act, and the Covering ALL KIDS Health Insurance Act, (3.5) federal financial participation revenue related to eligible disbursements made by the Department of Healthcare and Family Services from appropriations required by this Section, and (4) all other moneys received to the Fund, including interest thereon. The Fund shall be held
as a special fund in the State Treasury.

Disbursements from this Fund shall be only (1) for the reimbursement of
claims collected by the Department of Healthcare and Family Services (formerly Illinois Department of Public Aid) through error
or mistake, (2) for payment to persons or agencies designated as payees or
co-payees on any instrument, whether or not negotiable, delivered to the
Department of Healthcare and Family Services (formerly
Illinois Department of Public Aid) as a recovery under this Section, such
payment to be in proportion to the respective interests of the payees in the
amount so collected, (3) for payments to the Department of Human Services
for collections made by the Department of Healthcare and Family Services (formerly Illinois Department of Public Aid) on behalf of
the Department of Human Services under this Code, the Children’s Health Insurance Program Act, and the Covering ALL KIDS Health Insurance Act, (4) for payment of
administrative expenses incurred in performing the
activities authorized under this Code, the Children’s Health Insurance Program Act, and the Covering ALL KIDS Health Insurance Act, (5)
for payment of fees to persons or agencies in the performance of activities
pursuant to the collection of monies owed the State that are collected
under this Code, the Children’s Health Insurance Program Act, and the Covering ALL KIDS Health Insurance Act, (6) for payments of any amounts which are
reimbursable to the federal government which are required to be paid by State
warrant by either the State or federal government, and (7) for payments
to State universities and local governmental entities of federal funds for
services provided to
applicants or recipients covered under this Code, the Children’s Health Insurance Program Act, and the Covering ALL KIDS Health Insurance Act. Disbursements
from this Fund for purposes of items (4) and (5) of this
paragraph shall be subject to appropriations from the Fund to the Department of Healthcare and Family Services (formerly Illinois
Department of Public Aid).

The balance in this Fund after
payment therefrom of any amounts reimbursable to the federal government, and
minus the amount reasonably anticipated to be needed to make the disbursements
authorized by this Section during the current and following 3 calendar months, shall be certified by the
Director of Healthcare and Family Services and transferred by the
State Comptroller to the Drug Rebate Fund or the Healthcare Provider Relief Fund in
the State Treasury, as appropriate, on at least an annual basis by June 30th of each fiscal year. The Director of Healthcare and Family Services may certify and the State Comptroller shall transfer to the Drug Rebate Fund or the Healthcare Provider Relief Fund amounts on a more frequent basis.

On July 1, 1999, the State Comptroller shall transfer the sum of $5,000,000
from the Public Aid Recoveries Trust Fund (formerly the Public Assistance
Recoveries Trust Fund) into the DHS Recoveries Trust Fund.

(Source: P.A. 97-647, eff. 1-1-12; 97-689, eff. 6-14-12; 98-130, eff. 8-2-13; 98-651, eff. 6-16-14.)

 

(305 ILCS 5/12-9.1)

Sec. 12-9.1. DHS Recoveries Trust Fund; uses. The DHS Recoveries Trust
Fund shall consist of (1) recoveries authorized by this Code in respect to
applicants or recipients under Articles III, IV, and VI, including recoveries
from the estates of deceased recipients, (2) payments received by the Illinois
Department of Human Services under Sections 10-3.1, 10-8, 10-10, 10-16, 10-19,
and 12-9 that are required by those Sections to be paid into the DHS Recoveries
Trust Fund, (3) federal financial participation revenue related to eligible disbursements made by the Illinois Department of Human Services from appropriations required by this Section, and (4) amounts received by the Illinois Department of Human Services directly from federal or State grants and intended to be used to pay a portion of the Department’s administrative expenses associated with those grants. This Fund shall be held as a special fund in the State Treasury.

Disbursements from the Fund shall be only (1) for the reimbursement of
claims collected by the Illinois Department of Human Services through error
or mistake, (2) for payment to persons or agencies designated as payees or
co-payees on any instrument, whether or not negotiable, delivered to the
Illinois Department of Human Services as a recovery under this Section, such
payment to be in proportion to the respective interests of the payees in the
amount so collected, (3) for payments to non-recipients, or to former
recipients of financial aid of the collections which are made in their behalf
under Article X, (4) for payment to local governmental units of support
payments collected by the Illinois Department of Human Services pursuant to
an agreement under Section 10-3.1, (5) for payment of administrative expenses
incurred in performing the activities authorized by Article X, (6) for payment of administrative expenses associated with the administration of federal or State grants, (7) for payment
of fees to person or agencies in the performance of activities pursuant to the
collection of moneys owed the State, (8) for payments of any amounts which are
reimbursable to the federal government which are required to be paid by State
warrant by either the State or federal government, and (9) for disbursements to
attorneys or advocates for legal representation in an appeal of any claim for
federal Supplemental Security Income benefits before an administrative law
judge as provided for in Section 3-13 of this Code. Disbursements from the
Fund for purposes of items (5), (6), (7), and (9) of this paragraph shall be subject
to appropriations from the Fund to the Illinois Department of Human Services.

Any transfers from the Fund that were required to be made prior to June 19, 2013 (the effective date of Public Act 98-24) shall not be made.

(Source: P.A. 100-59, eff. 1-1-18.)

 

(305 ILCS 5/12-10) (from Ch. 23, par. 12-10)

Sec. 12-10. DHS Special Purposes Trust Fund; uses. The DHS Special
Purposes Trust Fund, to be held outside the State Treasury by the State
Treasurer as ex-officio custodian, shall consist of (1) any federal grants
received under Section 12-4.6 that are not required by Section 12-5 to be paid
into the General Revenue Fund or transferred into the Local Initiative Fund
under Section 12-10.1 or deposited in the Employment and Training Fund under
Section 12-10.3 or in the special account established and maintained in that
Fund as provided
in that Section; (2) grants, gifts or legacies of moneys or securities
received under Section 12-4.18; (3) grants received under Section 12-4.19; and
(4) funds for child care and development services. Disbursements from this
Fund shall be only for the purposes authorized by the aforementioned Sections.

Disbursements from this Fund shall be by warrants drawn by the State
Comptroller on receipt of vouchers duly executed and certified by the Illinois
Department of Human Services, including payment to the Health Insurance
Reserve Fund for group insurance costs at the rate certified by the Department
of Central Management Services.

In addition to any other transfers that may be provided for by law, the State Comptroller shall direct and the State Treasurer shall transfer from the DHS Special Purposes Trust Fund into the Governor’s Grant Fund such amounts as may be directed in writing by the Secretary of Human Services.

In addition to any other transfers that may be provided for by law, the State Comptroller shall direct and the State Treasurer shall transfer from the DHS Special Purposes Trust Fund into the Employment and Training fund such amounts as may be directed in writing by the Secretary of Human Services.

(Source: P.A. 101-10, eff. 6-5-19; 102-16, eff. 6-17-21.)

 

(305 ILCS 5/12-10.1) (from Ch. 23, par. 12-10.1)

Sec. 12-10.1.
Local Initiative Fund – Uses.
There is hereby created the Local Initiative Fund in the
State Treasury. The Local Initiative Fund is created for the purpose of
receiving and disbursing monies in accordance with the provisions of the
Social Services Block Grant of the federal Social Security Act and related
rules and regulations,
as now or hereafter amended, governing the use of such monies.

Expenditures from the Local Initiative Fund shall be made for services
contained in the Projected Expenditure Report required of the State
under the Social Services Block Grant of the federal
Social Security Act. The Local Initiative
Fund shall be administered by the Illinois Department, which
shall expend monies appropriated from such fund by the Illinois General
Assembly for the purchase and provision of social services. The Illinois
Department shall execute a written contract for the purchase
of social services from persons qualified to provide such
services. Such contract
shall be filed with the Illinois Department and the State
Comptroller.

There shall be paid into the Local Initiative Fund the following monies:

1. Federal funds paid to the State as reimbursement for expenditures
from the Local Initiative Fund made according to the provisions of the
federal Social Services Block Grant.

2. Payments by the Illinois Department for the purpose of
reimbursing the Local Initiative Fund for expenditures for services not
approved for federal reimbursement under the Social Security Block Grant of
the federal Social Security Act either by the Illinois Department or by the
federal Department of Health and Human Services. Such
payments shall be made by the Illinois Department in the
amount that the Director of the Illinois Department has
determined was not caused by the failure of a provider of services to comply
with the provisions of a service contract or the provisions of the Social
Services Block Grant of the federal Social Security Act and related rules
and regulations as now or hereafter amended. Any such expenditures for
services not approved for federal reimbursement which are subsequently paid
into the Social Services Block Grant Fund shall be transferred into
the General Revenue Fund.

(Source: P.A. 89-507, eff. 7-1-97.)

 

(305 ILCS 5/12-10.2) (from Ch. 23, par. 12-10.2)

Sec. 12-10.2.
The Child Support Enforcement Trust Fund.

(a) The Child Support Enforcement Trust Fund, to be held by
the State Treasurer as ex-officio custodian outside the State Treasury,
pursuant to the Child Support Enforcement Program established by Title
IV-D of the Social Security Act, shall consist of the following, through June
30, 2002:

• (1) all support payments assigned to the Illinois Department under Article X of this Code and rules promulgated by the Illinois Department that are disbursed to the Illinois Department by the State Disbursement Unit established under Section 10-26,
• (2) all support payments received by the Illinois Department as a result of the Child Support Enforcement Program established by Title IV-D of the Social Security Act that are not required or directed to be paid to the State Disbursement Unit established under Section 10-26,
• (3) all federal grants received by the Illinois Department funded by Title IV-D of the Social Security Act, except those federal funds received under the Title IV-D program as reimbursement for expenditures from the General Revenue Fund,
• (4) incentive payments received by the Illinois Department from other states or political subdivisions of other states for the enforcement and collection by the Department of an assigned child support obligation in behalf of such other states or their political subdivisions pursuant to the provisions of Title IV-D of the Social Security Act,
• (5) incentive payments retained by the Illinois Department from the amounts which otherwise would be paid to the federal government to reimburse the federal government’s share of the support collection for the Department’s enforcement and collection of an assigned support obligation on behalf of the State of Illinois pursuant to the provisions of Title IV-D of the Social Security Act,
• (6) all fees charged by the Department for child support enforcement services, as authorized under Title IV-D of the Social Security Act and Section 10-1 of this Code, and any other fees, costs, fines, recoveries, or penalties provided for by State or federal law and received by the Department under the Child Support Enforcement Program established by Title IV-D of the Social Security Act,
• (7) all amounts appropriated by the General Assembly for deposit into the Fund, and
• (8) any gifts, grants, donations, or awards from individuals, private businesses, nonprofit associations, and governmental entities.

(a-5) On and after July 1, 2002, the Child Support Enforcement Trust Fund
shall
consist of the following:

• (1) all support payments assigned to the Illinois Department under Article X of this Code and rules adopted by the Illinois Department that are disbursed to the Illinois Department by the State Disbursement Unit established under Section 10-26, regardless of the fiscal year in which the payments were receipted;
• (2) all support payments received by the Illinois Department as a result of the Child Support Enforcement Program established by Title IV-D of the Social Security Act that are not required or directed to be paid to the State Disbursement Unit established under Section 10-26, regardless of the fiscal year in which the payments were receipted;
• (3) all federal grants received by the Illinois Department funded by Title IV-D of the Social Security Act, except those federal funds received under the Title IV-D program as reimbursement for expenditures from the General Revenue Fund, and receipted on or before June 30, 2002;
• (4) incentive payments received by the Illinois Department from other states or political subdivisions of other states for the enforcement and collection by the Department of an assigned child support obligation in behalf of those other states or their political subdivisions pursuant to the provisions of Title IV-D of the Social Security Act, and receipted on or before June 30, 2002;
• (5) incentive payments retained by the Illinois Department from the amounts that otherwise would be paid to the federal government to reimburse the federal government’s share of the support collection for the Department’s enforcement and collection of an assigned support obligation on behalf of the State of Illinois pursuant to the provisions of Title IV-D of the Social Security Act, and receipted on or before June 30, 2002;
• (6) all fees charged by the Department for child support enforcement services, as authorized under Title IV-D of the Social Security Act and Section 10-1 of this Code, and any other fees, costs, fines, recoveries, or penalties provided for by State or federal law and received by the Department under the Child Support Enforcement Program established by Title IV-D of the Social Security Act, and receipted on or before June 30, 2002;
• (7) all amounts appropriated by the General Assembly for deposit into the Child Support Enforcement Trust Fund; and
• (8) any gifts, grants, donations, or awards from individuals, private businesses, nonprofit associations, and governmental entities, receipted on or before June 30, 2002.

(b) Disbursements from this Fund shall be only for the following
purposes:

• (1) for the reimbursement of funds received by the Illinois Department through error or mistake,
• (2) for payments to non-recipients, current recipients, and former recipients of financial aid of support payments received on their behalf under Article X of this Code that are not required to be disbursed by the State Disbursement Unit established under Section 10.26,
• (3) for any other payments required by law to be paid by the Illinois Department to non-recipients, current recipients, and former recipients,
• (4) for payment of any administrative expenses incurred through fiscal year 2002 and for payment of any administrative expenses by transfer to the Child Support Administrative Fund under Section 12-10.2a, including payment to the Health Insurance Reserve Fund for group insurance costs at the rate certified by the Department of Central Management Services, except those required to be paid from the General Revenue Fund, including personal and contractual services, incurred in performing the Title IV-D activities authorized by Article X of this Code,
• (5) for the reimbursement of the Public Assistance Emergency Revolving Fund for expenditures made from that Fund for payments to former recipients of public aid for child support made to the Illinois Department when the former public aid recipient is legally entitled to all or part of the child support payments, pursuant to the provisions of Title IV-D of the Social Security Act,
• (6) for the payment of incentive amounts owed to other states or political subdivisions of other states that enforce and collect an assigned support obligation on behalf of the State of Illinois pursuant to the provisions of Title IV-D of the Social Security Act,
• (7) for the payment of incentive amounts owed to political subdivisions of the State of Illinois that enforce and collect an assigned support obligation on behalf of the State pursuant to the provisions of Title IV-D of the Social Security Act, and
• (8) for payments of any amounts which are reimbursable to the Federal government which are required to be paid by State warrant by either the State or Federal government.

Disbursements from this Fund shall be by warrants drawn by the State
Comptroller on receipt of vouchers duly executed and certified by the Illinois
Department or any other State agency that receives an appropriation from the
Fund.

(c) The Illinois Department’s child support administrative expenses, as
defined in Section 12-10.2a, that are incurred after fiscal year 2002 shall be
paid only as provided in that Section.

(Source: P.A. 91-212, eff. 7-20-99; 91-400, eff. 7-30-99; 91-712, eff.
7-1-00; 92-44, eff. 7-1-01; 92-570, eff. 6-26-02; 92-651, eff. 7-11-02.)

 

(305 ILCS 5/12-10.2a)

Sec. 12-10.2a. Child Support Administrative Fund.

(a) Beginning July 1, 2002, the Child Support Administrative Fund is created
as a special fund in
the State treasury. Moneys in the Fund may be used, subject to appropriation,
only for the Department of Healthcare and Family Services’ (formerly Department of Public Aid’s) child support administrative expenses,
as defined in this Section.

(a-5) Moneys in the Child Support Administrative Fund shall consist of the
following:

• (1) all federal grants received by the Illinois Department funded by Title IV-D of the Social Security Act, except those federal funds received under the Title IV-D program as reimbursement for expenditures from the General Revenue Fund;
• (2) incentive payments received by the Illinois Department from other states or political subdivisions of other states for the enforcement and collection by the Department of an assigned child support obligation in behalf of those other states or their political subdivisions pursuant to the provisions of Title IV-D of the Social Security Act;
• (3) incentive payments retained by the Illinois Department from the amounts that otherwise would be paid to the federal government to reimburse the federal government’s share of the support collection for the Department’s enforcement and collection of an assigned support obligation on behalf of the State of Illinois pursuant to the provisions of Title IV-D of the Social Security Act;
• (4) all fees charged by the Department for child support enforcement services, as authorized under Title IV-D of the Social Security Act and Section 10-1 of this Code, and any other fees, costs, fines, recoveries, or penalties provided for by State or federal law and received by the Department under the Child Support Enforcement Program established by Title IV-D of the Social Security Act;
• (5) all amounts appropriated by the General Assembly for deposit into the Child Support Administrative Fund; and
• (6) any gifts, grants, donations, or awards from individuals, private businesses, nonprofit associations, and governmental entities.

(a-10) The moneys identified in subsection (a-5) of this Section shall
include
moneys receipted on or after July 1, 2002, regardless of the fiscal year in
which the
moneys were earned.

(b) As used in this Section, “child support administrative expenses” means
administrative expenses, including payment to the Health Insurance Reserve Fund
for group insurance costs at the rate certified by the Department of Central
Management Services, except those required to be paid from the General Revenue
Fund, including personal and contractual services, incurred by the Department of Healthcare and Family Services (formerly Department
of Public Aid), either directly or under its contracts with SDU contractors as
defined in Section 10-26.2, in performing activities authorized
by Article X of this Code, and including appropriations to other State
agencies or offices. The term includes expenses incurred by the
Department of Healthcare and Family Services (formerly
Department of Public Aid) in administering the Child Support Enforcement Trust
Fund and the State Disbursement Unit Revolving Fund.

(c) Child support administrative expenses incurred in fiscal year 2003 or
thereafter shall be paid only from moneys appropriated
from
the Child Support Administrative Fund.

(d) Before April 1, 2003 and before April 1 of each year thereafter, the
Department of Healthcare and Family Services (formerly Department of Public Aid) shall provide notification to the General Assembly of
the
amount of
the Department’s child support administrative expenses expected to be incurred
during the fiscal year beginning on the next July 1, including the estimated
amount required for the operation of the State
Disbursement Unit, which shall be separately identified in the annual
administrative appropriation.

(e) For the fiscal year beginning July 1, 2002 and for each fiscal year
thereafter, the State Comptroller and the State Treasurer shall transfer from
the Child Support Enforcement Trust Fund to the Child Support Administrative
Fund amounts as determined by the Department necessary to enable the Department
to meet its child support
administrative expenses for the then-current fiscal year. For any fiscal year,
the State Comptroller and the State Treasurer may not transfer more than the
total amount appropriated for the Department’s child support
administrative expenses for that fiscal year.

(f) By December 1, 2001, the Illinois Department shall provide a corrective
action plan to the General Assembly regarding the establishment of accurate
accounts in the Child Support Enforcement Trust Fund. The plan shall include
those tasks that may be required to establish accurate accounts, the estimated
time for completion of each of those tasks and the plan, and the estimated cost
for completion of each of the tasks and the plan.

(Source: P.A. 95-331, eff. 8-21-07.)

 

(305 ILCS 5/12-10.3) (from Ch. 23, par. 12-10.3)

Sec. 12-10.3. Employment and Training Fund; uses.

(a) The Employment and Training Fund is hereby created in the State
Treasury for the purpose of receiving and disbursing moneys in accordance
with the provisions of Title IV-A of the federal Social Security Act; the Food Stamp
Act, Title 7 of the United States Code; and related rules and regulations
governing the use of those moneys for the purposes of providing employment
and training services, supportive services, cash assistance payments, short-term non-recurrent payments, and other related social services. Beginning in fiscal year 2022, the Employment and Training Fund may receive revenues from State, federal, and private sources related to child care services and programs.

(b) All federal funds received by the Illinois Department as
reimbursement for expenditures for employment and training programs made by
the Illinois Department from grants, gifts, or legacies as provided in
Section 12-4.18 or by an entity other than the Department, and all federal funds received from the Emergency Contingency Fund for State Temporary Assistance for Needy Families Programs established by the American Recovery and Reinvestment Act of 2009,
shall be deposited into the Employment and Training Fund.

(c) Except as provided in subsection (d) of this Section, the
Employment and Training Fund shall be administered by the Illinois
Department, and the Illinois Department may make payments from the
Employment and Training Fund to clients or to public and private entities on behalf of clients for employment and training services, supportive services, cash assistance payments, short-term non-recurrent payments, child care services and child care related programs, and other related social services consistent with the purposes authorized under this Code.

(d) (Blank).

(e) The Illinois Department shall execute a written grant agreement when
purchasing employment and training services from entities qualified to
provide services under
the programs.

(Source: P.A. 102-16, eff. 6-17-21.)

 

(305 ILCS 5/12-10.4)

Sec. 12-10.4. Juvenile Rehabilitation Services Medicaid Matching Fund.
There is created in the State Treasury the Juvenile Rehabilitation Services
Medicaid Matching Fund. Deposits to this Fund shall consist of all moneys
received from the federal government for behavioral health services secured by
counties pursuant to an agreement with the Department of Healthcare and Family Services with respect to Title XIX of the
Social Security Act or under the Children’s Health Insurance Program pursuant
to the Children’s Health Insurance Program Act and Title XXI of the Social
Security Act for minors who are committed to mental health facilities by the
Illinois court system and for residential placements secured by the
Department of Juvenile Justice for minors as a condition of their aftercare release.

Disbursements from the Fund shall be made, subject to appropriation, by the
Department of Healthcare and Family Services for grants to the Department of Juvenile Justice

and those counties which secure behavioral health services ordered by the
courts and which have an interagency agreement with the Department and submit
detailed bills according to standards determined by the Department.

(Source: P.A. 98-558, eff. 1-1-14.)

 

(305 ILCS 5/12-10.5)

Sec. 12-10.5. Medical Special Purposes Trust Fund.

(a) The Medical Special Purposes Trust Fund (“the Fund”) is created.
Any grant, gift, donation, or legacy of money or securities that the
Department of Healthcare and Family Services is authorized to receive under Section 12-4.18 or
Section 12-4.19 or any monies from any other source, and that are dedicated for functions connected with the
administration of any medical program administered by the Department, shall
be deposited into the Fund. All federal moneys received by the Department as
reimbursement for disbursements authorized to be made from the Fund shall also
be deposited into the Fund. In addition, federal moneys received on account
of State expenditures made in connection with obtaining compliance with the
federal Health Insurance Portability and Accountability Act (HIPAA) shall be
deposited into the Fund.

(b) No moneys received from a service provider or a governmental or private
entity that is enrolled with the Department as a provider of medical services
shall be deposited into the Fund.

(c) Disbursements may be made from the Fund for the purposes connected with
the grants, gifts, donations, legacies, or other monies deposited into the Fund, including,
but not limited to, medical quality assessment projects, eligibility population
studies, medical information systems evaluations, and other administrative
functions that assist the Department in fulfilling its health care mission
under any medical program administered by the Department.

(Source: P.A. 97-48, eff. 6-28-11; 97-689, eff. 6-14-12.)

 

(305 ILCS 5/12-10.6)

Sec. 12-10.6.
Medicaid Buy-In Program Revolving Fund.

(a) The Medicaid Buy-In Program Revolving Fund is created as a special fund
in the State treasury. The Fund shall consist of cost-sharing payments made by
individuals pursuant to the Medicaid Buy-In Program established under paragraph
11 of Section 5-2 of this Code. All earnings on moneys in the Fund shall be
credited to the Fund.

(b) Moneys in the Fund shall be appropriated to the Department to pay the
costs of administering the Medicaid Buy-In Program, including payments for
medical assistance benefits provided to Program participants. The Department
shall adopt rules specifying the particular purposes for which the moneys in
the Fund may be spent.

(Source: P.A. 92-163, eff. 7-25-01; 92-651, eff. 7-11-02.)

 

(305 ILCS 5/12-10.6a)

Sec. 12-10.6a. The Electronic Health Record Incentive Fund.

(a) The Electronic Health Record Incentive Fund is a special fund created in the State treasury. All federal moneys received by the Department of Healthcare and Family Services for payments to qualifying health care providers to encourage the adoption and use of certified electronic health records technology pursuant to paragraph 1903(t)(1) of the Social Security Act, shall be deposited into the Fund.

(b) Disbursements from the Fund shall be made at the direction of the Director of Healthcare and Family Services to qualifying health care providers, in amounts established under applicable federal regulation (42 CFR 495 et seq.), in order to encourage the adoption and use of certified electronic health records technology.

(Source: P.A. 97-169, eff. 7-22-11.)

 

(305 ILCS 5/12-10.7)

Sec. 12-10.7. The Health and Human Services Medicaid Trust Fund. The Health and Human Services Medicaid Trust Fund shall consist of (i) moneys appropriated or transferred into the Fund, pursuant to statute, (ii) federal financial participation moneys received pursuant to expenditures from the Fund, and (iii) the interest earned on moneys in the Fund. Subject to appropriation, the moneys in the Fund shall be used by a State agency for such purposes as that agency may, by the appropriation language, be directed.

(Source: P.A. 102-1071, eff. 6-10-22.)

 

(305 ILCS 5/12-10.7a)

Sec. 12-10.7a. The Money Follows the Person Budget Transfer Fund is hereby created as a special fund in the State treasury.

(a) Notwithstanding any State law to the contrary, the following moneys shall be deposited into the Fund:

• (1) enhanced federal financial participation funds related to any spending under a Money Follows the Person demonstration project as approved by the federal Centers for Medicare and Medicaid Services on May 14, 2007, and as codified at 20 ILCS 2407/51 et seq., regardless of whether such spending occurred from the Money Follows the Person Budget Transfer Fund;
• (2) federal financial participation funds related to any spending under a Money Follows the Person demonstration project as approved by the federal Centers for Medicare and Medicaid Services on May 14, 2007, and as codified at 20 ILCS 2407/51 et seq., that occurred from the Money Follows the Person Budget Transfer Fund;
• (3) deposits made via the voucher-warrant process from institutional long-term care appropriations to the Department of Healthcare and Family Services and institutional developmentally disabled long-term care appropriations to the Department of Human Services;
• (4) deposits made via the voucher-warrant process from appropriation lines used to fund community-based services for individuals eligible for nursing facility level of care to the Department of Human Services, the Department on Aging, or the Department of Healthcare and Family Services;
• (5) interest earned on moneys in the Fund; and
• (6) all other moneys received by the Fund from any source.

(b) Subject to appropriation, moneys in the Fund may be used by the Department of Healthcare and Family Services for reimbursement or payment for:

• (1) expenses related to rebalancing long-term care services between institutional and community-based settings as authorized under a Money Follows the Person demonstration project as approved by the federal Centers for Medicare and Medicaid Services on May 14, 2007, and as codified at 20 ILCS 2407/51 et seq.;
• (2) expenses for community-based services for individuals eligible for nursing facility level of care in the Department of Human Services, the Department on Aging, or the Department of Healthcare and Family Services to the extent the expenses reimbursed or paid are in excess of the amounts budgeted to those Departments each fiscal year for persons transitioning out of institutional long-term care settings under a Money Follows the Person demonstration project as approved by the federal Centers for Medicare and Medicaid Services on May 14, 2007, and as codified at 20 ILCS 2407/51 et seq.;
• (3) expenses for institutional long-term care services at the Department of Healthcare and Family Services to the extent that the expenses reimbursed or paid are for services in excess of the amount budgeted to the Department each fiscal year for persons who had or otherwise were expected to transition out of institutional long-term care settings under a Money Follows the Person demonstration project as approved by the federal Centers for Medicare and Medicaid Services on May 14, 2007, and as codified at 20 ILCS 2407/51 et seq.; and
• (4) expenses, including operational, administrative, and refund expenses, necessary to implement and operate a Money Follows the Person demonstration project as approved by the federal Centers for Medicare and Medicaid Services on May 14, 2007, and as codified at 20 ILCS 2407/51 et seq.

Expenses reimbursed or paid on behalf of other agencies by the Department of Healthcare and Family Services under this subsection shall be pursuant to an interagency agreement and allowable under a Money Follows the Person demonstration project as approved by the federal Centers for Medicare and Medicaid Services on May 14, 2007, and as codified at 20 ILCS 2407/51 et seq.

(Source: P.A. 95-744, eff. 7-18-08.)

 

(305 ILCS 5/12-10.8)

Sec. 12-10.8. (Repealed).

(Source: P.A. 95-707, eff. 1-11-08. Repealed by P.A. 97-820, eff. 7-17-12.)

 

(305 ILCS 5/12-10.9)

Sec. 12-10.9. (Repealed).

(Source: P.A. 95-744, eff. 7-18-08. Repealed by P.A. 97-820, eff. 7-17-12.)

 

(305 ILCS 5/12-10.10)

Sec. 12-10.10. DHS Technology Initiative Fund.

(a) The DHS Technology Initiative Fund is hereby created as a trust fund within the State treasury with the State Treasurer as the ex-officio custodian of the Fund.

(b) The Department of Human Services may accept and receive grants, awards, gifts, and bequests from any source, public or private, in support of information technology initiatives. Moneys received in support of information technology initiatives, and any interest earned thereon, shall be deposited into the DHS Technology Initiative Fund.

(c) Moneys in the Fund may be used by the Department of Human Services for the purpose of making grants associated with the development and implementation of information technology projects or paying for operational expenses of the Department of Human Services related to such projects.

(d) The Department of Human Services, in consultation with the Department of Innovation and Technology, shall use the funds deposited in the DHS Technology Initiative Fund to pay for information technology solutions either provided by Department of Innovation and Technology or arranged or coordinated by the Department of Innovation and Technology.

(Source: P.A. 100-611, eff. 7-20-18; 101-275, eff. 8-9-19.)

 

(305 ILCS 5/12-11) (from Ch. 23, par. 12-11)

Sec. 12-11. Deposits by State Treasurer. The State Treasurer shall
deposit moneys received by him as ex-officio custodian of the Child
Support Enforcement Trust Fund and the DHS Special Purposes Trust Fund in
banks or savings and loan associations which have been approved by him
as State Depositaries under the Deposit of State Moneys Act, and
with respect to such moneys shall be entitled to the
same rights and privileges as are provided by such Act with
respect to moneys in the treasury of the State of Illinois.

(Source: P.A. 99-933, eff. 1-27-17.)

 

(305 ILCS 5/12-12) (from Ch. 23, par. 12-12)

Sec. 12-12.
Collection of claims; enforcement of penalty provisions.
The Illinois Department shall pursue the legal procedure necessary to
collect the claims and enforce the penalty provisions provided in any
Section or Article of this Code relative to applicants and recipients of
public aid. The Attorney General, at the request of the Illinois
Department, shall take the necessary proceedings and represent the
Illinois Department in any matter arising in connection with such claims
or enforcement of penalty provisions.

(Source: P.A. 81-1085.)

 

(305 ILCS 5/12-12.1)

Sec. 12-12.1.
Deadbeats most wanted list.

(a) The Director may disclose a “deadbeats most wanted list” of
individuals who are in arrears in their child support obligations under an
Illinois court order or administrative order. The list shall include only
those persons who are in arrears in an amount greater than $5,000 (or such
greater amount as established by the Department by rule). The list shall
not exceed 200 individuals at any point. The list shall include the
individual’s name and address, the amount of any child support arrearage,
and any other information deemed appropriate by the Department.

(b) At least 90 days before the disclosure under subsection (a) of the
name of an individual who is in arrears in his or her child support
obligations, the Director shall mail a written notice to the individual by
certified mail addressed to the individual’s last known address. The notice
shall detail the amount of the arrearage and the Department’s intent to
disclose the arrearage. If the arrearage is not paid 60 days after the notice
was delivered to the individual or the Department has been notified that
delivery was refused, and the individual has not, since the mailing of the
notice, entered into a written agreement with the Department for payment
of the arrearage, the Director may disclose the individual’s arrearage under
subsection (a).

(c) An individual in arrears in his or her child support obligations
under an Illinois court order or administrative order is not subject to
disclosure under subsection (a) if (1) a written agreement for payment
exists between the individual and the Department or (2) the arrearage is
the subject of an administrative hearing, administrative review, or judicial
review.

(d) The list shall be available for public inspection at the Department
or by other means of publication, including the Internet.

(e) A disclosure made by the Director in a good faith effort to
comply with this Section may not be considered a violation of any
confidentiality laws.

(Source: P.A. 92-373, eff. 7-1-02.)

 

(305 ILCS 5/12-13) (from Ch. 23, par. 12-13)

Sec. 12-13. Rules and regulations. The Department shall make all rules and
regulations and take such action as may be necessary or desirable for carrying
out the provisions of this Code, to the end that its spirit and purpose may be
achieved and the public aid programs administered efficiently throughout the
State. However, the rules and regulations shall not provide that payment for
services rendered to a specific recipient by (i) a person licensed under
the
Medical Practice Act of 1987, whether under a general or limited license,
(ii) a
person licensed or registered under other laws of this State to provide dental,
optometric, or pediatric care,
or (iii) a licensed clinical social worker
may be authorized only when services are
recommended for that recipient by a person licensed to practice medicine in all
its branches.

Whenever a rule of the Department requires that an applicant or
recipient verify information submitted to the Department, the rule, in
order to make the public fully aware of what information is required for
verification, shall specify the acceptable means of verification or shall
list examples of acceptable means of verification.

The provisions of the Illinois Administrative Procedure Act are hereby
expressly adopted and incorporated herein, and shall apply to all
administrative rules and procedures of the Illinois Department under this Act,
except that Section 5-35 of the Illinois Administrative Procedure Act relating
to procedures for rule-making does not apply to the adoption of any rule
required by federal law in connection with which the Illinois Department is
precluded by law from exercising any discretion, and the requirements of the
Administrative Procedure Act with respect to contested cases are not applicable
to (1) hearings involving eligibility of applicants or recipients of public
aid or (2) support hearings involving responsible relatives.

(Source: P.A. 95-518, eff. 8-28-07.)

 

(305 ILCS 5/12-13.05)

Sec. 12-13.05. Rules for Temporary Assistance for Needy Families.
All rules regulating the Temporary Assistance for Needy Families program and
all other rules regulating the amendatory changes to this Code made by this
amendatory Act of 1997 shall be promulgated pursuant to this Section.

(Source: P.A. 94-416, eff. 1-1-06.)

 

(305 ILCS 5/12-13.1)

Sec. 12-13.1. Inspector General.

(a) The Governor shall appoint, and the Senate shall confirm, an Inspector
General who shall function within the Illinois Department of Public Aid (now Healthcare and Family Services) and
report to the Governor. The term of the Inspector General shall expire on the
third Monday of January, 1997 and every 4 years thereafter.

(b) In order to prevent, detect, and eliminate fraud, waste, abuse,
mismanagement, and misconduct, the Inspector General shall oversee the
Department of Healthcare and Family Services’ and the Department on Aging’s integrity
functions, which include, but are not limited to, the following:

• (1) Investigation of misconduct by employees, vendors, contractors and medical providers, except for allegations of violations of the State Officials and Employees Ethics Act which shall be referred to the Office of the Governor’s Executive Inspector General for investigation.
• (2) Prepayment and post-payment audits of medical providers related to ensuring that appropriate payments are made for services rendered and to the prevention and recovery of overpayments.
• (3) Monitoring of quality assurance programs administered by the Department of Healthcare and Family Services and the Community Care Program administered by the Department on Aging.
• (4) Quality control measurements of the programs administered by the Department of Healthcare and Family Services and the Community Care Program administered by the Department on Aging.
• (5) Investigations of fraud or intentional program violations committed by clients of the Department of Healthcare and Family Services and the Community Care Program administered by the Department on Aging.
• (6) Actions initiated against contractors, vendors, or medical providers for any of the following reasons:
• (A) Violations of the medical assistance program and the Community Care Program administered by the Department on Aging.
• (B) Sanctions against providers brought in conjunction with the Department of Public Health or the Department of Human Services (as successor to the Department of Mental Health and Developmental Disabilities).
• (C) Recoveries of assessments against hospitals and long-term care facilities.
• (D) Sanctions mandated by the United States Department of Health and Human Services against medical providers.
• (E) Violations of contracts related to any programs administered by the Department of Healthcare and Family Services and the Community Care Program administered by the Department on Aging.
• (7) Representation of the Department of Healthcare and Family Services at hearings with the Illinois Department of Financial and Professional Regulation in actions taken against professional licenses held by persons who are in violation of orders for child support payments.

(b-5) At the request of the Secretary of Human Services, the Inspector
General shall, in relation to any function performed by the Department of Human
Services as successor to the Department of Public Aid, exercise one or more
of the powers provided under this Section as if those powers related to the
Department of Human Services; in such matters, the Inspector General shall
report his or her findings to the Secretary of Human Services.

(c) Notwithstanding, and in addition to, any other
provision of law, the Inspector General shall have access to all information, personnel
and facilities of the
Department of Healthcare and Family Services and the Department of
Human Services (as successor to the Department of Public Aid), their employees, vendors, contractors and medical providers and any federal,
State or local governmental agency that are necessary to perform the duties of
the Office as directly related to public assistance programs administered by
those departments. No medical provider shall
be compelled, however, to provide individual medical records of patients who
are not clients of the programs administered by the Department of Healthcare and
Family Services. State and local
governmental agencies are authorized and directed to provide the requested
information, assistance or cooperation.

For purposes of enhanced program integrity functions and
oversight, and to the extent consistent with applicable
information and privacy, security, and disclosure laws, State
agencies and departments shall provide the Office of Inspector General access to confidential and other information and data, and the Inspector General is authorized to enter into agreements with appropriate federal agencies and departments to secure similar data. This includes, but is not limited to, information pertaining to: licensure; certification; earnings; immigration status; citizenship; wage reporting; unearned and earned income; pension income;
employment; supplemental security income; social security
numbers; National Provider Identifier (NPI) numbers; the
National Practitioner Data Bank (NPDB); program and agency
exclusions; taxpayer identification numbers; tax delinquency;
corporate information; and death records.

The Inspector General shall enter into agreements with State agencies and departments, and is authorized to enter into agreements with federal agencies and departments, under which such agencies and departments shall share data necessary for medical assistance program integrity functions and oversight. The Inspector General shall enter into agreements with State agencies and departments, and is authorized to enter into agreements with federal agencies and departments, under which such agencies shall share data necessary for recipient and vendor screening, review, and investigation, including but not limited to vendor payment and recipient eligibility verification. The Inspector General shall develop, in cooperation with other State and federal agencies and departments, and in compliance with applicable federal laws and regulations, appropriate and effective
methods to share such data. The Inspector General shall enter into agreements with State agencies and departments, and is authorized to enter into agreements with federal agencies and departments, including, but not limited to: the Secretary of State; the
Department of Revenue; the Department of Public Health; the
Department of Human Services; and the Department of Financial and Professional Regulation.

The Inspector General shall have the authority to deny payment, prevent overpayments, and recover overpayments.

The Inspector General shall have the authority to deny or
suspend payment to, and deny, terminate, or suspend the
eligibility of, any vendor who fails to grant the Inspector
General timely access to full and complete records, including records of recipients under the medical assistance program for the most recent 6 years, in accordance with Section 140.28 of Title 89 of the Illinois Administrative Code, and other information for the purpose of audits, investigations, or other program integrity functions, after reasonable written request by the Inspector General.

(d) The Inspector General shall serve as the
Department of Healthcare and Family Services’

primary liaison with law enforcement,
investigatory and prosecutorial agencies, including but not limited to the
following:

• (1) The Department of State Police.
• (2) The Federal Bureau of Investigation and other federal law enforcement agencies.
• (3) The various Inspectors General of federal agencies overseeing the programs administered by the Department of Healthcare and Family Services.
• (4) The various Inspectors General of any other State agencies with responsibilities for portions of programs primarily administered by the Department of Healthcare and Family Services.
• (5) The Offices of the several United States Attorneys in Illinois.
• (6) The several State’s Attorneys.
• (7) The offices of the Centers for Medicare and Medicaid Services that administer the Medicare and Medicaid integrity programs.

The Inspector General shall meet on a regular basis with these entities to
share information regarding possible misconduct by any persons or entities
involved with the public aid programs administered by the Department
of Healthcare and Family Services.

(e) All investigations conducted by the Inspector General shall be conducted
in a manner that ensures the preservation of evidence for use in criminal
prosecutions. If the Inspector General determines that a possible criminal act
relating to fraud in the provision or administration of the medical assistance
program has been committed, the Inspector General shall immediately notify the
Medicaid Fraud Control Unit. If the Inspector General determines that a
possible criminal act has been committed within the jurisdiction of the Office,
the Inspector General may request the special expertise of the Department of
State Police. The Inspector General may present for prosecution the findings
of any criminal investigation to the Office of the Attorney General, the
Offices of the several United States Attorneys in Illinois or the several
State’s Attorneys.

(f) To carry out his or her duties as described in this Section, the
Inspector General and his or her designees shall have the power to compel
by subpoena the attendance and testimony of witnesses and the production
of books, electronic records and papers as directly related to public
assistance programs administered by the Department of Healthcare and Family Services or
the Department of Human Services (as successor to the Department of Public
Aid). No medical provider shall be compelled, however, to provide individual
medical records of patients who are not clients of the Medical Assistance
Program.

(g) The Inspector General shall report all convictions, terminations, and
suspensions taken against vendors, contractors and medical providers to the
Department of Healthcare and Family Services and to any agency responsible for
licensing or regulating those persons or entities.

(h) The Inspector General shall make annual
reports, findings, and recommendations regarding the Office’s investigations
into reports of fraud, waste, abuse, mismanagement, or misconduct relating to
any programs administered by the Department
of Healthcare and Family Services or the Department of Human Services (as successor to the
Department of Public Aid) to the General Assembly and the Governor. These
reports shall include, but not be limited to, the following information:

• (1) Aggregate provider billing and payment information, including the number of providers at various Medicaid earning levels.
• (2) The number of audits of the medical assistance program and the dollar savings resulting from those audits.
• (3) The number of prescriptions rejected annually under the Department of Healthcare and Family Services’ Refill Too Soon program and the dollar savings resulting from that program.
• (4) Provider sanctions, in the aggregate, including terminations and suspensions.
• (5) A detailed summary of the investigations undertaken in the previous fiscal year. These summaries shall comply with all laws and rules regarding maintaining confidentiality in the public aid programs.

(i) Nothing in this Section shall limit investigations by the
Department of Healthcare and Family Services or the Department of Human Services that may
otherwise be required by law or that may be necessary in their capacity as the
central administrative authorities responsible for administration of their agency’s
programs in this
State.

(j) The Inspector General may issue shields or other distinctive identification to his or her employees not exercising the powers of a peace officer if the Inspector General determines that a shield or distinctive identification is needed by an employee to carry out his or her responsibilities.

(Source: P.A. 97-689, eff. 6-14-12; 98-8, eff. 5-3-13.)

 

(305 ILCS 5/12-13.2)

Sec. 12-13.2.
Two-year financial plans.

(a) On or before September 30, 1994, the Illinois Department shall submit to
the
General Assembly an initial 2-year financial plan with respect to the Illinois
Department’s administration and financing of the State’s Medicaid program for
fiscal years 1995 and 1996. The Illinois Department shall submit subsequent
2-year financial plans in accordance with this Section. Beginning with
fiscal year 1997, and every second fiscal year thereafter, the Illinois
Department shall submit a financial plan covering a period of 2 fiscal years
not
later than March 1 before the commencement of the first fiscal year to which
the financial plan relates. Each financial plan shall be submitted in
accordance with the procedures set forth in this Section.

(b) Each financial plan for each fiscal year to which it relates shall
contain a description of revenues, liabilities, expenditures, appropriations,
and cash resources and uses.

(c) The Illinois Department shall regularly reexamine the revenue and
expenditure estimates on which each financial plan was based and revise them
as
necessary. The Illinois Department shall promptly notify the General Assembly
of any material change in the revenue or expenditure estimates in the financial
plan. The Illinois Department shall submit to the General Assembly modified
financial plans based on revised revenue or expenditure estimates or for any
other good reason.

(Source: P.A. 88-554, eff. 7-26-94.)

 

(305 ILCS 5/12-13.3)

Sec. 12-13.3.
Transitional jobs; pilot program.
Subject to appropriations
or other funding, the Department of Human
Services may establish a pilot program to place hard-to-employ persons,
including
persons who have been released from a county jail or a facility under the
jurisdiction of
the Department of Corrections, in jobs. By rule, the Department shall determine
the
location in which the pilot program is to be implemented and the services to be
provided.
In determining locations for the pilot program, however, the Department shall
give priority to areas of the State in which the concentration of released
offenders is the highest.
The Department may consult with the Department of Corrections in establishing
the pilot
program.

(Source: P.A. 93-208, eff. 7-18-03.)

 

(305 ILCS 5/12-13.4)

Sec. 12-13.4. Materials on nutritional health. The Department of Human Services, in cooperation with the Department of Public Health, shall develop materials and resources on nutritional health for distribution to new enrollees in the TANF program under Article IV and the Food Stamp program. The Department of Public Health shall develop a video presentation on nutritional health to be shown to new enrollees in the TANF program under Article IV and the Food Stamp program. The Department of Human Services shall develop the materials and resources within 6 months after the effective date of this amendatory Act of the 94th General Assembly and shall provide those materials and resources to all persons who enroll in the TANF program and the Food Stamp program after the materials and resources are developed.

(Source: P.A. 94-433, eff. 1-1-06.)

 

(305 ILCS 5/12-14.1) (from Ch. 23, par. 12-14.1)

Sec. 12-14.1.
Audit by Auditor General.
The Auditor General shall conduct
a post audit to determine if the Department has complied with the requirements
of Section 5-5.9 of this Code. The audit required by this Section shall
be in accordance with and subject to the Illinois State Auditing Act as
now and hereafter amended. The Legislative Audit Commission, by resolution,
may make additions or clarifications to the scope or coverage of the audit
required by this Section.

(Source: P.A. 82-664.)

 

(305 ILCS 5/12-15) (from Ch. 23, par. 12-15)

Sec. 12-15.
Civil Recoveries.
Any person, firm, corporation, association, agency, institution or other
legal entity who, without intent to violate this Code, obtains benefits
or payments under this Code to which he or it is not entitled, or in a greater
amount than that to which he or it is entitled shall be liable for any excess
benefits or payments received.

The Attorney General, or the State’s Attorney in actions involving a local
governmental unit, may initiate court proceedings to recover benefits or
payments obtained under this Code to which a person or entity is not entitled.

(Source: P.A. 82-440.)

 

(305 ILCS 5/12-16) (from Ch. 23, par. 12-16)

Sec. 12-16. Public Aid Claims Enforcement Division of Office of Attorney
General. The Public Aid Claims Enforcement Division in the Office of the
Attorney General, established pursuant to the 1949 Code, shall institute in
behalf of the State all court actions referred to it by the Department of Healthcare and Family Services (formerly Illinois Department
of Public Aid) or the Department of Human Services (as successor to the
Illinois Department of Public Aid) under this Code and other laws for the
recovery of financial aid provided under the public aid programs, the
enforcement of obligations of support, and the enforcement of other claims,
penalties and obligations.

The Division shall be staffed with attorneys appointed by the Attorney
General as Special Assistant Attorneys’ General whose special duty it shall be
to execute the aforesaid duties. The Assistant Attorneys’ General shall be
assigned exclusively to such duties. They may engage only in such political
activities as are not prohibited by the Hatch Political Activity Act, Title 5,
U.S.C.A., Sections 118i et seq.

The Attorney General may request the appropriate State’s Attorney of a county
or staff of the Child and Spouse Support Unit established under Section 10-3.1
of this Code to institute any such action in behalf of the State or to assist
the Attorney General in the prosecution of actions instituted by his Office.

(Source: P.A. 95-331, eff. 8-21-07.)

 

(305 ILCS 5/12-17) (from Ch. 23, par. 12-17)

Sec. 12-17.
(Repealed).

(Source: Laws 1967, p. 122. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-17.1) (from Ch. 23, par. 12-17.1)

Sec. 12-17.1.
(Repealed).

(Source: P.A. 88-412. Repealed by P.A. 92-111, eff.
1-1-02.)

 

(305 ILCS 5/12-17.2) (from Ch. 23, par. 12-17.2)

Sec. 12-17.2.
(Repealed).

(Source: Repealed by P.A. 88-412.)

 

(305 ILCS 5/12-17.3) (from Ch. 23, par. 12-17.3)

Sec. 12-17.3.
(Repealed).

(Source: Laws 1967, p. 122. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-17.4) (from Ch. 23, par. 12-17.4)

Sec. 12-17.4.
(Repealed).

(Source: P.A. 90-655, eff. 7-30-98. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-17.5) (from Ch. 23, par. 12-17.5)

Sec. 12-17.5.
(Repealed).

(Source: Laws 1967, p. 122. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-18) (from Ch. 23, par. 12-18)

Sec. 12-18.
(Repealed).

(Source: Laws 1967, p. 122. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-18.1) (from Ch. 23, par. 12-18.1)

Sec. 12-18.1.
(Repealed).

(Source: P.A. 88-412. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-18.1a) (from Ch. 23, par. 12-18.1a)

Sec. 12-18.1a.
(Repealed).

(Source: P.A. 77-352. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-18.2) (from Ch. 23, par. 12-18.2)

Sec. 12-18.2.
(Repealed).

(Source: P.A. 81-1085. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-18.3) (from Ch. 23, par. 12-18.3)

Sec. 12-18.3.
(Repealed).

(Source: Laws 1967, p. 122. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-18.4) (from Ch. 23, par. 12-18.4)

Sec. 12-18.4.
(Repealed).

(Source: P.A. 81-1509. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-18.5) (from Ch. 23, par. 12-18.5)

Sec. 12-18.5.
(Repealed).

(Source: P.A. 78-363. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-18.6) (from Ch. 23, par. 12-18.6)

Sec. 12-18.6.
(Repealed).

(Source: P.A. 81-230. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-18.8) (from Ch. 23, par. 12-18.8)

Sec. 12-18.8.
(Repealed).

(Source: P.A. 78-363. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-18.9) (from Ch. 23, par. 12-18.9)

Sec. 12-18.9.
(Repealed).

(Source: P.A. 78-363. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-19) (from Ch. 23, par. 12-19)

Sec. 12-19.

County
welfare services committees; membership.
If a county welfare services committee is formed in a county of less than 3,000,000 population, the committee may consist of not more than 10 members appointed by the Illinois
Department and the following members, ex-officio: the state’s attorney
and
the chairman of the county board. The terms of the state’s
attorney and the chairman of the county board shall be co-extensive with
their terms of office. The terms of the Illinois Department appointees
shall be as specified in this Section.

In counties of 3,000,000 or more population, if a county
welfare services
committee is formed, it may consist of not more than 33
members appointed by the Illinois Department
and the president of the county board of commissioners, ex-officio. The
term of the president of the county board of commissioners shall be
co-extensive with his term of office. The terms of the Illinois Department
appointees shall be as specified in this Section.

The Illinois Department shall make its appointments from a list of
nominees submitted with the advice and consent of the county board by the
presiding officer of the county board of each county. If the county board
fails or refuses to submit a list of nominees, the Illinois Department may
make appointments from among the residents of the county.

The Illinois Department and the county boards shall include a balanced
representation of recipients, service providers, representatives of community
and welfare advocacy groups, representatives of local governments dealing
with public aid, and representatives of the general public on all county
welfare services committees appointed by the Illinois Department or on lists
of nominees submitted by the presiding officers of the county boards.

(Source: P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-19.1) (from Ch. 23, par. 12-19.1)

Sec. 12-19.1.
Appointments-Terms-Vacancy.

In counties of less than 3 million population, the Illinois Department
shall appoint 3 members of the County Welfare Services Committee on July 1,
1967; 4 members on July 1, 1968; and 3 members on July 1, 1969, as
successors respectively to the members whose terms expire on such dates. In
counties of 3 million or more population, the Illinois Department shall
appoint 4 members of the Committee on July 1, 1967; 4 on July 1, 1968; and
4 on July 1, 1969, as successors respectively to the members whose terms
expire on such dates, and shall on July 1, 1971, appoint 25 members, 7 of
whom shall serve for a term of 1 year, 7 of whom shall serve for 2 years,
and 11 of whom shall serve for 3 years as designated by the Illinois
Department at the time of appointment. Thereafter, upon the expiration of
any term, successors shall be appointed in like manner as the original
appointees, for a term of 3 years and until their successors are appointed.
Vacancies in office shall be filled in like manner as original appointments
but appointment shall be only for the remainder of the term of the vacancy.

(Source: P.A. 77-522.)

 

(305 ILCS 5/12-19.2) (from Ch. 23, par. 12-19.2)

Sec. 12-19.2.
Organization of committee.
The county welfare services committee, at its first meeting in each
calendar year, shall organize by electing from its membership a chairman and
vice chairman. These officers shall serve a
term of one year and until their successors are elected but neither may
serve more than 3 consecutive terms. The Department of Human Services local
office administrator shall act as the executive secretary of the committee and assist it in
fulfilling its responsibilities in the manner the committee
designates. The committee may request the assistance of other members of the
staff of the County Department to perform duties the committee
designates. The committee shall provide rules for transacting its business
and keeping records thereof. It shall hold as many meetings during each
calendar year as may be necessary to fulfill committee responsibilities. In
counties of less than 3,000,000 population, meetings may be
called by the
chairman or any 3 members. In counties of 3,000,000 or more
population,
meetings may be called by the chairman or any 11 members. The members of
the committee shall receive no compensation for their services but shall be
reimbursed for actual and necessary traveling and other expenses incurred
in the performance of their duties.

(Source: P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-19.3) (from Ch. 23, par. 12-19.3)

Sec. 12-19.3.
Information to committee.
The County Department shall furnish each member of the County Welfare
Services Committee, upon such member’s request, a copy of the existing
regulations and of all changes of regulations pertaining to any of the
public aid programs, and of rulings handed down by the Illinois Department
or the courts on review, affecting or interpreting such regulations.

(Source: P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-19.4) (from Ch. 23, par. 12-19.4)

Sec. 12-19.4.
(Repealed).

(Source: P.A. 82-783. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-19.5) (from Ch. 23, par. 12-19.5)

Sec. 12-19.5.
Advisory functions; reports.
The County Welfare Services
Committee shall advise the County Department in relation to the
administration of its functions and duties. The Committee shall also advise
the Illinois Department on all matters pertaining to public aid in the
county, recommend the development of community welfare programs it may deem
necessary and stimulate community interest in these programs and their
proper organization, survey economic and social welfare conditions and
employment opportunities, and perform any other duties as the Illinois
Department may prescribe.

The Committee shall submit to the Illinois Department periodic reports
of its activities, findings, and recommendations at the times
and in the manner as the Department may direct.

The Committee shall review the quality of services provided to
recipients of and applicants for assistance and other social services and
the quality of relations between recipients and applicants and employees of
the Illinois Department and County Departments. The Committee shall report
annually to the Illinois Department its findings in these matters and its
recommendations for improvement.

(Source: P.A. 87-528.)

 

(305 ILCS 5/12-20) (from Ch. 23, par. 12-20)

Sec. 12-20.
(Repealed).

(Source: Laws 1967, p. 122. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-21) (from Ch. 23, par. 12-21)

Sec. 12-21.
Administration in local Governmental Units.
Administration of the public aid programs for which responsibility is
vested in local governmental units under Article VI shall be in
accordance with the provisions of Sections 12-21.1 to 12-21.20,
inclusive.

However, all public aid programs which provide medical services or assistance
to non-residents of the State of Illinois which, but for the aspect of residency,
would be a township responsibility, shall be administered by the Illinois
Department pursuant to Sections 12-4 to 12-12, inclusive, of this Article,
and pursuant to the Department’s authorized rules and regulations.

(Source: P.A. 81-1509.)

 

(305 ILCS 5/12-21.1) (from Ch. 23, par. 12-21.1)

Sec. 12-21.1.

Supervisors of general assistance in counties not under
township organization – Other staffing. In counties not under township organization,
the presiding officer of
the county board, with the advice and consent of the County Board, shall
designate a Supervisor of General Assistance for the county and appoint
such other employees as may be necessary to provide public aid under
Article VI. The County Board shall prescribe the compensation
and duties of the Supervisor and other employees.

(Source: P.A. 81-1085.)

 

(305 ILCS 5/12-21.2) (from Ch. 23, par. 12-21.2)

Sec. 12-21.2.

Supervisors of general assistance in counties under
township organization – Other staffing. In counties under township organization,
the supervisors of the
respective towns therein shall be ex officio Supervisors of General
Assistance of their towns. The Supervisor of General Assistance shall
appoint such other employees as may be necessary to provide public aid
under Article VI and prescribe their compensation and duties.

(Source: P.A. 81-1085.)

 

(305 ILCS 5/12-21.3) (from Ch. 23, par. 12-21.3)

Sec. 12-21.3.
(Repealed).

(Source: P.A. 83-333. Repealed by P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-21.4) (from Ch. 23, par. 12-21.4)

Sec. 12-21.4.

Supervisor of general assistance in incorporated town which has superseded
a civil township-Other staff.

In an incorporated town which has superseded a civil township, the
supervisor of such incorporated town shall be ex officio Supervisor of
General Assistance. The governing body of the incorporated town may by
ordinance provide for the appointment of other employees as may be
necessary to provide public aid under Article VI, and fix their
compensation.

(Source: Laws 1967, p. 122.)

 

(305 ILCS 5/12-21.5) (from Ch. 23, par. 12-21.5)

Sec. 12-21.5.
Veterans Assistance Commission as local governmental unit.

In counties having less than 3 million inhabitants in which there is
created a County Veterans Assistance Commission, the Superintendent of
Veterans Assistance shall be selected and other employees appointed as provided
in Section 10 of the Military Veterans Assistance Act and the compensation
of the Superintendent and other employees shall be as therein provided.

(Source: P.A. 87-796.)

 

(305 ILCS 5/12-21.6) (from Ch. 23, par. 12-21.6)

Sec. 12-21.6.

Compensation and standards of employees of local
governmental units receiving state funds. In any local governmental unit
receiving State funds for public aid
purposes under Article VI, the number and compensation rates
and standards of competence, performance, and tenure of all employees or
other persons paid from public aid funds, including the compensation
rates of the persons serving as or designated as Supervisor of General
Assistance if such person is paid in whole or in part from public aid
funds, shall be subject to review and approval of the Illinois
Department.

(Source: P.A. 81-1085.)

 

(305 ILCS 5/12-21.7) (from Ch. 23, par. 12-21.7)

Sec. 12-21.7.
Limitations on political activities.

In any local governmental unit receiving State funds, each employee
whose duties pertain to determination of eligibility for or the amount
of public aid is prohibited from engaging in at any time, whether during
or outside of regular working hours, any of the following activities:

1. Using or threatening to use the influence or authority of his
position to coerce or to persuade any person to follow any course of
political action.

2. Soliciting money from any person for any political purpose.

3. Selling or distributing tickets for political meetings.

4. Assisting at the polls in behalf of any party or party-designated
candidate on any election day.

5. Initiating or circulating petitions on behalf of a candidate.

6. Distributing campaign literature or material in behalf of any
candidate.

Any employee who engages in the foregoing proscribed political
activities shall be subject to immediate discharge in accordance with
the procedures controlling his position. If an employee engages in such
activities at the request or direction of any officer or officers of the
local governmental unit, or if the governmental unit fails to initiate
procedures for the dismissal of an employee who persists in such
activities, the Illinois Department may withhold the payment of any
further State funds to the local governmental unit until the
governmental unit has established that its actions are in full accord
with the objectives of this Section.

(Source: Laws 1967, p. 122.)

 

(305 ILCS 5/12-21.8) (from Ch. 23, par. 12-21.8)

Sec. 12-21.8.
Duties of supervisors of general assistance.
Except for
the Supervisor of General Assistance who is the Director of the County
Department of Public Aid, the Supervisor of General Assistance shall
receive and pay out moneys raised by taxes or allocated by the State for
public aid purposes and shall provide public aid to all persons eligible
therefor under Article VI of this Code. State and municipal funds for
General Assistance purposes in a city, village or incorporated town of
more than 500,000 population shall be received and disbursed as provided
in Section 12-10.

The Supervisor of General Assistance shall keep such records and
submit annually and at such other times as their respective county
boards, city councils, board of trustees, or board of town trustees may
require, reports relating to the administration of such public aid
programs as are the responsibility of the local governmental unit under
this Code, prepared in such form as may be directed by such agencies.

On or before the 15th day of each calendar month, Supervisors of
General Assistance shall submit to the Illinois Department full itemized
reports of all receipts and expenditures of moneys for public aid and
the costs of administration under Article VI of this Code during the
prior calendar month, together with such other reports as the Illinois
Department may require. The Illinois Department may audit the books and
records dealing with such public aid programs at such times as it deems
necessary.

(Source: P.A. 82-783.)

 

(305 ILCS 5/12-21.9) (from Ch. 23, par. 12-21.9)

Sec. 12-21.9.
Limitations on indebtedness.
No indebtedness shall be incurred by any Supervisor of General
Assistance in excess of taxes levied for public aid purposes and
uncollected, or for the payment of which funds are not currently available,
without the consent of the city council or board of trustees, board of town
trustees, or county board, as the case may be.

(Source: P.A. 82-783.)

 

(305 ILCS 5/12-21.10) (from Ch. 23, par. 12-21.10)

Sec. 12-21.10.

Default and misappropriation of funds; Removal of
supervisor; Conditions requiring appointment of interim supervisor.
If the Supervisor of General Assistance is a defaulter and in arrears
with the governmental unit, or has misused, misappropriated, or
converted to his own use or the use of any other person any of the funds
of the unit, or is guilty of any other misconduct in office, the
governing body of the governmental unit, and in the case of a township,
the board of town trustees, may remove him as Supervisor of General
Assistance and appoint a suitable person to be the supervisor therein;
provided, that for a township containing 4,000 inhabitants or more, upon
written request of the township supervisors, the board of town trustees
may appoint a Supervisor of General Assistance who is a resident of such
township, and fix his compensation and term of office, which shall not
exceed the term of the board.

If, as provided in Section 12-21.18, the Illinois Department has
ordered the withholding of State funds for failure of the governmental
unit to comply with the Department’s rules and regulations, the
governing body of the governmental unit, and in the case of a township,
the board of town trustees, upon written order of the Illinois
Department shall appoint an Interim Supervisor of General Assistance,
acceptable to the Illinois Department, to serve as Supervisor of General
Assistance for the governmental unit until such time as the policies and
procedures of the unit are determined by the Department to be in
compliance with its rules. If, after a reasonable time as determined by
the Illinois Department, the governmental unit or agency to which such
order is directed fails to make an appointment, or appoints a person who
is not acceptable to the Illinois Department, the Public Aid Committee,
established under Section 11-8, of the county in which the governmental
unit is located, upon written order of the Illinois Department, shall
appoint an Interim Supervisor, which appointment shall be subject to the
approval of the Illinois Department.

The appointing authority shall fix the compensation of the Interim
Supervisor of General Assistance, subject to approval of the Illinois
Department, which shall be payable from the general assistance fund of
the local governmental unit.

An Interim Supervisor of General Assistance may be removed and
another person appointed in his place in the same manner and for the
same reasons as in the case of an initial appointment of an Interim
Supervisor.

The Illinois Department shall not order the appointment of an Interim
Supervisor of General Assistance if the local governmental unit takes
such action as the Department considers to have established satisfactory
compliance with its rules, and a reasonable time, to be determined by
the Department, shall be allowed the governmental unit to establish such
compliance.

If an Interim Supervisor of General Assistance has been appointed, he
shall exercise all the powers of that office in respect to the
administration of general assistance, and shall have the sole authority
to disburse State and local funds available for this purpose. If the
governmental unit thereafter takes such action to assure the Department
that it will comply with the Department’s rules, the service of the
Interim Supervisor shall be terminated.

(Source: P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-21.11) (from Ch. 23, par. 12-21.11)

Sec. 12-21.11.
Bonds.
Every Supervisor of General Assistance, including an Interim Supervisor
of General Assistance appointed as provided in Section 12-21.10, shall
execute to the governmental unit which he serves an official bond in a
penal sum and with sureties to be fixed and approved by the governing body
thereof, and, in the case of a township, as fixed and approved by the board
of town trustees, conditioned for the faithful discharge of his duties and
the due application of all funds and property which shall come to his hands
as such Supervisor. If the local governmental unit receives State funds in
accordance with the provisions of this Code, the amount and surety of the
bond shall be subject to the further approval of the Illinois Department.

(Source: P.A. 82-783.)

 

(305 ILCS 5/12-21.12) (from Ch. 23, par. 12-21.12)

Sec. 12-21.12.

Actions against local governmental units – Intervention
of Attorney General. In any action against a local governmental unit to recover
expenditures alleged to be the responsibility of the governmental unit
under Article VI of this Code, the Supervisor of General
Assistance of such governmental unit shall notify the Illinois
Department of the filing of the action. If the governmental unit was a
recipient of State funds for public aid purposes during all or part of
the period of the expenditures for which the action is brought, or if,
as a result of the action, the governmental unit may qualify for and
request State funds, the Attorney General shall be permitted to
intervene and participate in the action in order to protect the State’s
interest therein.

(Source: P.A. 81-1085.)

 

(305 ILCS 5/12-21.13) (from Ch. 23, par. 12-21.13)

Sec. 12-21.13.
Local funds required to qualify for state aid.
To qualify
for State funds to supplement local funds for public aid purposes, a local
governmental unit shall, except as hereinafter provided, levy within the
time that such levy is authorized to be made a tax of an amount which, when
added to the unobligated balance available for such purposes at the close
of the fiscal year preceding the fiscal year for which the tax is levied
will equal .10% of the last known total equalized value of all taxable
property in the governmental unit.

In a county of less than 3 million population in which there is
created a County Veterans Assistance Commission, the county shall levy
for assistance to military veterans and their families, within the
time that such levy is authorized to be made, a tax of an amount which,
when added to the unobligated balance available for such purpose at the
close of the preceding fiscal year will equal .02% of the last known
assessed value of the taxable property in the county, or which will
equal .03% of such assessed value if such higher amount is authorized by
the electors of the county, as provided in Section 5-2006 of the Counties
Code.

If, however, at the latest date in the year on which the aforesaid
taxes are authorized to be levied there is in the unobligated balance of
the local governmental unit an amount equal to .10%, or .02% in the case
of Veterans’ Assistance, of the last known total equalized value of all
taxable property in the governmental unit, then no tax need be levied in
that year in order for the local governmental unit to qualify for State
funds.

In determining the amount of the unobligated balance which is to be
applied in producing the required levy for receipt of State funds, or
which is to be applied in determining whether a tax levy is required,
there shall be deducted from the gross unobligated balance of funds
available at the close of the preceding fiscal year the total amount of
State funds allocated to the governmental unit during that year and the
total amount of any monies transferred to a township’s general town fund
under Section 235-20 of the Township Code
during that year, and
only the remainder shall be considered in determining the amount of the
deficiency needed to produce an amount equal to the qualifying levy for
the current year.

(Source: P.A. 87-796; 88-670, eff. 12-2-94.)

 

(305 ILCS 5/12-21.14) (from Ch. 23, par. 12-21.14)

Sec. 12-21.14.
Requirements; review by Illinois
Department; allocations. The County Board of each county or a duly
appointed committee thereof, or any other county agency designated by
the County Board, shall by the last day of each month submit to
the Illinois Department an itemized statement showing, for all local
governmental units therein except a city, village or incorporated town
of more than 500,000 population, assistance
furnished in the county under Article VI of this Code during the previous
month and the expenses for the administration thereof, and the actual
revenues available through taxation by the
local governmental
units. If the Illinois
Department has reason to believe that the amounts submitted by any
county are excessive, it may require appropriate officials of the county
to appear before it and substantiate the amounts to the satisfaction
of the Department.

The Illinois Department shall review these amounts and shall
determine and allocate to the several counties the amounts necessary to
supplement local funds actually available for public aid purposes. There
shall be a yearly reconciliation of amounts allocated to the local
governmental units by the Illinois Department to supplement local
funds.

If, because of circumstances beyond the local governmental unit’s
control, such as a sudden caseload increase or an unexpected increase in
the administrative expenses, a local governmental unit has insufficient
local funds actually available to furnish assistance or pay administrative
expenses, the Illinois Department shall provide a special allocation of
funds to the local governmental unit to meet the need. In calculating the
need for a special allocation, the Illinois Department shall take into
consideration the amount of funds legally available from the taxes levied
by the local governmental unit for public aid purposes and any available
unobligated balances.

If a local governmental unit has not received State funds for public
aid purposes for at least 84 consecutive months immediately prior to its
request for State funds, the Illinois Department shall not consider as a
legally available resource of the governmental unit public aid funds, or
the proceeds of public aid taxes and tax anticipation warrants which may
have been transferred or expended during such period for other purposes.

Except as hereinafter provided, State allocations shall be paid to
the County Treasurer for disbursement to local governmental units as
certified by the Illinois Department. Until January 1, 1974, moneys
allocated by the Illinois Department for General Assistance purposes in
a city, village or incorporated town of more than 500,000 population and
moneys received from the Treasurer of the municipality from taxes levied
for General Assistance purposes in the municipality and other moneys and
funds designated in Section 11-43-2 of the Illinois Municipal Code shall
be paid into the special fund established by the County Treasurer of the
county in which the municipality is located and retained for
disbursement by the Director of the County Department of Public Aid
serving as Supervisor of General Assistance for the municipality.

On January 1, 1974, or as soon thereafter as is feasible but not
later than January 1, 1975, the County Treasurer shall transfer to the
Special Purposes Trust Fund (now known as the DHS Special Purposes Trust Fund) established by Section 12-10 of this Code
all State and municipal moneys remaining in or due to the special fund
of the County Treasury. After December 31, 1973, but not later than June
30, 1979, State allocations and municipal funds for General Assistance
purposes in such a municipality, and other moneys and funds designated
by Section 11-43-2 of the Illinois Municipal Code, shall be paid into
the Special Purposes Trust Fund (now known as the DHS Special Purposes Trust Fund) and disbursed as provided in Section
12-10. State and municipal moneys paid into the Special Purposes Trust
Fund (now known as the DHS Special Purposes Trust Fund) under the foregoing provision shall be used exclusively for (1)
furnishing General Assistance within the municipality; (2) the payment
of administrative costs; and (3) the payment of warrants issued against
and in anticipation of taxes levied by the municipality for General
Assistance purposes, and the accrued interest thereon. After June 30,
1979, moneys and funds designated by Section 11-43-2 of the Illinois
Municipal Code, shall be paid into the General Revenue Fund as
reimbursement for appropriated funds disbursed.

(Source: P.A. 99-933, eff. 1-27-17.)

 

(305 ILCS 5/12-21.16) (from Ch. 23, par. 12-21.16)

Sec. 12-21.16.
Administrative costs.
In any local governmental unit receiving State funds, moneys expended
for costs of administration, exclusive of any compensation paid to the
Supervisor of General Assistance from funds other than public aid funds,
shall not exceed amounts which have been submitted to and approved by the
Illinois Department.

If a local governmental unit is a participating municipality in the
Illinois Municipal Retirement Fund created by Article 7 of the “Illinois
Pension Code”, its estimate of administrative expenses may include amounts
required as contributions by the governmental unit in behalf of its
employees engaged in the administration of public aid for retirement
annuity purposes for current service rendered by such employees on and
after July 1, 1953, provided the governmental unit has levied a tax at a
rate not less than one-half the maximum rate authorized under Section 7-171
of the aforesaid Article.

Contributions for retirement annuity purposes of
employees of the County Department engaged in administration of General
Assistance for such a municipality shall be met from funds appropriated for
the State contribution to the State Employees Retirement System under
Article 14 of the “Illinois Pension Code”.

The contributions of a governmental unit for retirement annuity purposes
which are authorized to be included in estimates of administrative expenses
shall include Social Security contributions for which the unit is obligated
under the Illinois Municipal Retirement Fund created by Article 7 of the
Illinois Pension Code, or if the governmental unit is not a participating
municipality in that Fund, the Social Security contributions for which it
is obligated pursuant to an agreement executed under Article 21 of the
Illinois Pension Code. In like manner, if the retirement fund established
under Article 9 of the Illinois Pension Code becomes obligated for Social
Security employer contributions, the estimated expenses of the County
Department may include the Social Security contributions together with the
regular contributions for which the county is obligated.

A local governmental unit receiving State funds may include in its
estimate of administrative expenses obligations assumed by it for insurance
premiums or charges for group life or health insurance, or both, for
employees of the local governmental unit, for any such employees who retire
or who had retired on or after January 1, 1966, and for dependents
receiving an annuity as survivors of such employees or retired employees if
the governmental unit has so acted under Section 3 of “An Act defining the
powers and duties of local governmental agencies to pay premiums and costs
or portions thereof, and to withhold parts of employee and elected or
appointed official compensation to provide insurance or retirement benefits
for employees and appointed or elected officials”, approved August 16,
1963, as amended, or has so acted in exercise of its powers as a home rule
unit. The amount included for this purpose in the estimate of
administrative expenses shall not exceed the comparable insurance premiums
or charges per employee, retiree, or survivor currently paid by the State
of Illinois for State employees under the “State Employees Group Insurance
Act of 1971”.

(Source: P.A. 78-1297.)

 

(305 ILCS 5/12-21.17) (from Ch. 23, par. 12-21.17)

Sec. 12-21.17.
Supervision by Illinois Department.
If a local governmental
unit receives State funds for public aid
purposes under Article VI its administration, including the use of local
resources, shall be subject to the supervision and the rules and
regulations of the Illinois Department. The Department shall also
supervise the setting of the local uniform budget standard and its
enforcement.

Such units and the officers thereof shall deliver to the Illinois
Department for examination and inspection all books, records, accounts,
and other documents which the Department requires.

(Source: P.A. 81-1085.)

 

(305 ILCS 5/12-21.18) (from Ch. 23, par. 12-21.18)

Sec. 12-21.18.
Non-compliance with rules of the Illinois Department.
If a local governmental unit subject to the supervision of the Illinois
Department is, in the determination of the Department, refusing or failing
to comply with the Department’s rules and regulations, the Illinois
Department shall give notice promptly by United States registered or
certified mail to the Supervisor of General Assistance or other proper
officer of such unit of the rules which are not being observed and give the
governmental unit or its designated representative an opportunity to appear
before it and substantiate its position in respect to the rule or rules at
issue.

If within 5 days after such notice, the local governmental unit
continues to refuse or fails to comply with the Department’s rules, or
fails to avail itself of the opportunity offered for a hearing before the
Department, the Department shall instruct the County Treasurer of the
County in which the governmental unit is located to withhold the payment of
any further State funds until he receives notice from the Department to
release the funds.

The Illinois Department may suspend an order for the withholding of
funds (1) if the governmental unit takes such action as the Department
considers to have established satisfactory compliance with its rules or (2)
upon appointment of an Interim Supervisor of General Assistance, as
directed by the provisions of Section 12-21.10.

The provisions of the Administrative Review Law,
as amended, and the rules adopted pursuant thereto, shall apply to and
govern proceedings for the judicial review of final administrative
decisions of the Illinois Department under this Section. The term
“administrative decision” is defined as in Section 3-101 of the Code of Civil Procedure.

(Source: P.A. 82-783.)

 

(305 ILCS 5/12-21.20) (from Ch. 23, par. 12-21.20)

Sec. 12-21.20.
Destruction of Obsolete Records.
Obsolete records, documents,
papers, and memoranda pertaining to
public aid under Article VI may be destroyed or otherwise
disposed of by local governmental units at any time subsequent to the
expiration of 5 years after the matters to which they relate have been
concluded.

(Source: P.A. 92-111, eff. 1-1-02.)

 

(305 ILCS 5/12-21.21)

Sec. 12-21.21. Federal waiver or State Plan amendment. The Department of Healthcare and Family Services and the Department of Human Services shall jointly submit the necessary application to the federal Centers for Medicare and Medicaid Services for a waiver or State Plan amendment to allow remote monitoring and support services as a waiver-reimbursable service for persons with intellectual and developmental disabilities. The application shall be submitted no later than January 1, 2021.

No later than July 1, 2021, the Department of Human Services shall adopt rules to allow remote monitoring and support services at community-integrated living arrangements.

(Source: P.A. 101-649, eff. 7-7-20.)