410 ILCS 67/5-1
(410 ILCS 67/5-1) Sec. 5-1. Short title. This Article may be cited as the Community Health Worker Certification and Reimbursement Act. References in this Article to "this Act" mean this Article. (Source: P.A. 102-4, eff. 4-27-21.)
410 ILCS 67
410 ILCS 67
in effect410 ILCS 67/5-5 Definition
(410 ILCS 67/5-5) Sec. 5-5. Definition. In this Act, "community health worker" means a frontline public health worker who is a trusted member or has an unusually close understanding of the community served. This trusting relationship enables the community health worker to serve as a liaison, link, and intermediary between health and social services and the community to facilitate access to services and improve the quality and cultural competence of service delivery. A community health worker also builds individual and community capacity by increasing health knowledge and self-sufficiency through a range of activities, including outreach, community education, informal counseling, social support, and advocacy. A community health worker shall have the following core competencies: (1) communication; (2) interpersonal skills and relationship building; (3) service coordination and navigation skills; (4) capacity-building; (5) advocacy; (6) presentation and facilitation skills; (7) organizational skills; cultural competency; (8) public health knowledge; (9) understanding of health systems and basic diseases; (10) behavioral health issues; and (11) field experience. Nothing in this definition shall be construed to authorize a community health worker to provide direct care or treatment to any person or to perform any act or service for which a license issued by a professional licensing board is required. (Source: P.A. 102-4, eff. 4-27-21.)
410 ILCS 67/5-10
(410 ILCS 67/5-10) Sec. 5-10. Community health worker training. (a) Community health workers shall be provided with multi-tiered academic and community-based training opportunities that lead to the mastery of community health worker core competencies. (b) For academic-based training programs, the Department of Public Health shall collaborate with the Illinois State Board of Education, the Illinois Community College Board, and the Illinois Board of Higher Education to adopt a process to certify academic-based training programs that students can attend to obtain individual community health worker certification. Certified training programs shall reflect the approved core competencies and roles for community health workers. (c) For community-based training programs, the Department of Public Health shall collaborate with a statewide association representing community health workers to adopt a process to certify community-based programs that students can attend to obtain individual community health worker certification. (d) Community health workers may need to undergo additional training, including, but not limited to, asthma, diabetes, maternal child health, behavioral health, and social determinants of health training. Multi-tiered training approaches shall provide opportunities that build on each other and prepare community health workers for career pathways both within the community health worker profession and within allied professions. (Source: P.A. 102-4, eff. 4-27-21.)
410 ILCS 67/5-15 (Repealed)
(410 ILCS 67/5-15) Sec. 5-15. (Repealed). (Source: P.A. 102-4, eff. 4-27-21. Repealed by P.A. 102-674, eff. 11-30-21.)
410 ILCS 67/5-17 Community Health Workers Review Board
(410 ILCS 67/5-17) Sec. 5-17. Community Health Workers Review Board. (a) A Community Health Workers Review Board shall be established to advise the Department of Public Health as it seeks to develop an Illinois Community Health Worker Certification Program. The scope includes rules certifying both individuals, including those being grandfathered in, and academic and community-based training programs. The Board shall recommend standards, review proposed regulations, and provide feedback about training programs and reimbursement schedules. The Board shall submit an annual report to the Office of the Governor and the General Assembly about the progress of the Program. The Board shall be co-chaired by a representative of the Department of Public Health and a representative from a statewide association of community health workers. Other members of the Board shall include: (1) The Director of Public Health or his or her designee. (2) The Director of Healthcare and Family Services or his or her designee. (3) The Secretary of Human Services or his or her designee. (4) The Secretary of Financial and Professional Regulation or his or her designee. (5) A member from the Governor's Office appointed by the Governor. (6) Three members appointed by the Senate President. (7) A member appointed by the Senate Minority Leader. (8) Three members appointed by the Speaker of the House of Representatives. (9) A member appointed by the Minority Leader of the House of Representatives. (10) A member from a statewide association of community health workers appointed by the Speaker of the House of Representatives. (11) A member from a statewide association of community health workers appointed by the Senate President. As appointed by the Director of Public Health, in addition to the members specified in this subsection, the Board shall have balanced representation from the community health workers workforce, community health worker employers, community health workers training and educational institutions, and community members who are recipients of services. The Board shall meet quarterly and may do so either in person or remotely. The Department of Public Health shall provide administrative support. The first annual report of the Board shall be submitted to the Governor and the General Assembly one year after the Board's first meeting. A report shall be submitted to the Governor and the General Assembly every year thereafter for each year the Board remains active. (b) There is created within the Department of Public Health the Illinois Community Health Worker Certification Program. The Department shall serve as the Program's regulatory body with the advice and recommendation of the Community Health Workers Review Board. This includes the development and oversight of initial community health worker certification and certification renewals for both individuals and community-based and academic training programs. The Board shall advise on a certification process and may advise on training from community-based organizations, in conjunction with a statewide association of community health workers, and academic institutions, in consultation with the Illinois State Board of Education, the Illinois Community College Board, and the Illinois Board of Higher Education. The Department shall provide administrative support to the Board. (c) The Board shall advise and recommend a certification process for and be authorized to approve training from community-based organizations, in conjunction with a statewide association of community health workers, and academic institutions, in consultation with the Illinois State Board of Education, the Illinois Community College Board, and the Illinois Board of Higher Education. The Program shall base training approval on core competencies, best practices, and affordability. In addition, the Program shall maintain a registry of certification records for individually certified community health workers and a registry of certified training and educational programs. All training programs that are deemed certifiable shall undergo a renewal process, which shall be determined by administrative rule. The Program shall establish criteria to grandfather in any community health workers who were practicing prior to the establishment of the Program. (d) To ensure high-quality service, the Program may examine and consider for adoption best practices from other states that have implemented policies to allow for alternative opportunities to demonstrate competency in core skills and knowledge in addition to certification. (e) The Department of Public Health, with the advice and recommendation of the Board, shall set fees by administrative rule for Illinois Community Health Worker Program certification, community health worker certification, and certification renewals. (f) The Department of Public Health, with the advice and recommendation of the Board, shall have administrative authority to adopt rules and establish administrative procedures for denying, granting, suspending, and revoking any certification issued pursuant to this Act. (g) The Director of Public Health, after notice and opportunity for hearing, may deny, suspend, or revoke a certification or fine a certificate holder or any other person who has violated this Act or the rules adopted under this Act. Notice shall be provided by certified mail, return receipt requested, or by personal service, fixing a date, not less than 15 days from the date of such mailing or service, at which time the person shall be given an opportunity to request a hearing. Failure to request a hearing within that time period constitutes a waiver of the right to a hearing. The hearing shall be conducted by the Director or by an individual designated in writing by the Director as a hearing officer to conduct the hearing. On the basis of any such hearing or upon default of the respondent, the Director shall make a determination specifying his or her findings and conclusions. A copy of the determination shall be sent by certified mail, return receipt requested, or served personally upon the respondent. (h) The procedure governing hearings authorized by this Section shall be in accordance with rules adopted by the Department of Public Health. A full and complete record shall be kept of all proceedings, including the notice of hearing, complaint, and all other documents in the nature of pleadings, written motions filed in the proceedings, and the report and orders of the Director of Public Health and hearing officer. All testimony shall be reported, but need not be transcribed unless the decision is sought to be reviewed under the Administrative Review Law of the Code of Civil Procedure. A copy or copies of the transcript shall be provided to the Board by request, and others interested in a copy or copies of the transcript may be obtained on payment of the cost of preparing the copy or copies. The Director or hearing officer shall, upon his or her own motion or on the written request of any party to the proceeding, issue subpoenas requiring the attendance and the giving of testimony by witnesses and subpoenas duces tecum requiring the production of books, papers, records, or memoranda. All subpoenas and subpoenas duces tecum issued under this Act may be served by any person of legal age. The fees of witnesses for attendance and travel shall be the same as the fees of witnesses before the courts of this State, such fees to be paid when the witness is excused from further attendance. When the witness is subpoenaed at the instance of the Director or hearing officer, the fees shall be paid in the same manner as other expenses of the Department, and when the witness is subpoenaed at the instance of any other party to any such proceeding the Department may require that the cost of service of the subpoena or subpoena duces tecum and the fee of the witness be borne by the party at whose instance the witness is summoned. In such case, the Department in its discretion may require a deposit to cover the cost of such service and witness fees. A subpoena or subpoena duces tecum so issued pursuant to this subsection shall be served in the same manner as a subpoena issued by a circuit court. (i) Any circuit court of this State, upon the application of the Director of Public Health or upon the application of any other party to the proceeding, may, in its discretion, compel the attendance of witnesses, the production of books, papers, records, or memoranda, and the giving of testimony before the Director or hearing officer conducting an investigation or holding a hearing authorized by this Act, by an attachment for contempt or otherwise, in the same manner as production of evidence may be compelled before the court. (j) All final administrative decisions of the Department of Public Health under this Act shall be subject to judicial review pursuant to the provisions of the Administrative Review Law of the Code of Civil Procedure and the rules adopted under it. "Administrative decision" has the meaning ascribed to it in Section 3-101 of the Code of Civil Procedure. The Department is not required to certify any record or file any answer or otherwise appear in any proceeding for judicial review unless the party filing the complaint deposits with the clerk of the court the sum of $2 per page representing the costs of the certification. Failure on the part of the plaintiff to make such deposit shall be grounds for dismissal of the action. (k) The State's Attorney of the county in which the violation occurred or the Attorney General shall bring such actions in the name of the people of the State of Illinois and may, in addition to other remedies provided in this Act, bring action for an injunction to restrain such violation, impose civil penalties, and enjoin the operation of any such person or establishment. (l) The State's Attorney of the county in which the violation occurred or the Attorney General shall bring such actions in the name of the people of the State of Illinois and may, in addition to other remedies provided in this Act, bring action for an injunction to restrain such violation, impose civil penalties, and enjoin the operation of any such person or establishment. (m) The provisions of the Illinois Administrative Procedure Act are adopted and shall apply to all administrative rules and procedures of the Department of Public Health under this Act, except that in cases of conflict between the Illinois Administrative Procedure Act and this Act, the provisions of this Act shall control. Section 5-35 of the Illinois Administrative Procedure Act relating to procedures for rulemaking does not apply to the adoption of any rule required by federal law in connection with which the Department is precluded by law from exercising any discretion. (n) Subject to appropriation, the Department of Public Health shall waive or pay for any administrative fees charged to a community health worker certificate holder under this Act. (o) The Board may explore ways to compensate members of the Board. (p) The Department is authorized to adopt rules for the implementation of this Section. (Source: P.A. 102-674, eff. 11-30-21.)
410 ILCS 67/5-20 Reimbursement
(410 ILCS 67/5-20) Sec. 5-20. Reimbursement. Community health worker services shall be covered under the medical assistance program, subject to appropriation, for persons who are otherwise eligible for medical assistance. The Department of Healthcare and Family Services shall develop services, including, but not limited to, care coordination and diagnosis-related patient services, for which community health workers will be eligible for reimbursement and shall request approval from the federal Centers for Medicare and Medicaid Services to reimburse community health worker services under the medical assistance program. For reimbursement under the medical assistance program, a community health worker must work under the supervision of an enrolled medical program provider, as specified by the Department, and certification shall be required for reimbursement. The supervision of enrolled medical program providers and certification are not required for community health workers who receive reimbursement through managed care administrative moneys. Noncertified community health workers are reimbursable at the discretion of managed care entities following availability of community health worker certification. In addition, the Department of Healthcare and Family Services shall amend its contracts with managed care entities to allow managed care entities to employ community health workers or subcontract with community-based organizations that employ community health workers. (Source: P.A. 102-4, eff. 4-27-21.)
410 ILCS 67/5-23 Certification
(410 ILCS 67/5-23) Sec. 5-23. Certification. Certification shall not be required for employment of community health workers. Noncertified community health workers may be employed through funding sources outside of the medical assistance program. (Source: P.A. 102-4, eff. 4-27-21.)
410 ILCS 67/5-25 Rules
(410 ILCS 67/5-25) Sec. 5-25. Rules. The Department of Public Health and the Department of Healthcare and Family Services may adopt rules for the implementation and administration of this Act. (Source: P.A. 102-4, eff. 4-27-21.)
410 ILCS 67/999-99
(410 ILCS 67/999-99) Sec. 999-99. Effective date. This Act takes effect upon becoming law. (Source: P.A. 102-4, eff. 4-27-21.)
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