(410 ILCS 225/1)

(from Ch. 111 1/2, par. 7021)

Sec. 1.

Short title.

This Act shall be known and may be cited as the

Prenatal and Newborn Care Act.

(Source: P.A. 86‑860.)

(410 ILCS 225/2)

(from Ch. 111 1/2, par. 7022)

Sec. 2.

Definitions.

As used in this Act, unless the context otherwise requires:

"Advanced practice nurse" or "APN" means an advanced practice nurse licensed under the Nursing and Advanced Practice Nursing Act who has a written collaborative agreement with a collaborating physician that authorizes the provision of prenatal and newborn care.

"Department" means the Illinois Department of Human Services.

"Early and Periodic Screening, Diagnosis and Treatment (EPSDT)" means the provision of preventative health care under 42 C.F.R. 441.50 et seq., including medical and dental services, needed to assess growth and development and detect and treat health problems.

"Hospital" means a hospital as defined under the Hospital Licensing Act.

"Local health authority" means the full‑time official health department or board of health, as recognized by the Illinois Department of Public Health, having jurisdiction over a particular area.

"Nurse" means a nurse licensed under the Nursing and Advanced Practice Nursing Act.

"Physician" means a physician licensed to practice medicine in all of its branches.

"Physician assistant" means a physician assistant licensed under the Physician Assistant Practice Act of 1987 who has been delegated authority to provide prenatal and newborn care.

"Postnatal visit" means a visit occurring after birth, with reference to the newborn.

"Prenatal visit" means a visit occurring before birth.

"Program" means the Prenatal and Newborn Care Program established pursuant to this Act.

(Source: P.A. 93‑962, eff. 8‑20‑04.)

410 ILCS 225/3

(410 ILCS 225/3)

(from Ch. 111 1/2, par. 7023)

Sec. 3.

Prenatal and Newborn Care Program.

The Department shall, subject to appropriations made available for this purpose, establish and operate the Prenatal and Newborn Care Program pursuant to this Act and promulgate any rules which it deems necessary for the implementation of this Act.

(Source: P.A. 89‑507, eff. 7‑1‑97.)

(410 ILCS 225/4)

(from Ch. 111 1/2, par. 7024)

Sec. 4.

Program administration.

The Department may administer this program through grants or contracts to local health authorities or private nonprofit agencies.

(Source: P.A. 86‑860.)

(410 ILCS 225/5)

(from Ch. 111 1/2, par. 7025)

Sec. 5.

Application and eligibility requirements.

(a) Any person requesting program benefits shall be afforded the opportunity to apply for such benefits. The application shall be filed at a place designated by the Department.

(b) Program benefits may be provided to or on behalf of any person: (1) who has been medically diagnosed as pregnant, and who is living in this State voluntarily with the intention of making it her home and not for a temporary purpose; and, (2) who meets the financial eligibility requirements of the Department as set forth in rules promulgated pursuant to this Act. Such rules shall provide that any person will be eligible with a gross income that equals or is less than the nonfarm income official poverty line, as determined by the federal Office of Management and Budget and revised annually in accordance with Section 673(2) of the Omnibus Reconciliation Act of 1981. The Department may establish financial eligibility requirements for income levels above the official federal poverty line. Temporary absence from this State, with an intent to return, shall not render a person ineligible for benefits.

(c) No person receiving aid under Article V of The Illinois Public Aid Code shall be eligible for program benefits.

(d) No person detained in a Federal, State or local correctional facility as a result of being charged with or convicted of a criminal offense shall be eligible for program benefits.

(Source: P.A. 86‑860.)

(410 ILCS 225/6)

(from Ch. 111 1/2, par. 7026)

Sec. 6.

Covered services.

(a) Covered services under the program may include, but are not necessarily limited to, the following:

(1) Laboratory services related to a recipient's

pregnancy, performed or ordered by a physician, advanced practice nurse, or physician assistant.

(2) Screening and treatment for sexually transmitted

disease.

(3) Prenatal visits to a physician in the

physician's office, an advanced practice nurse in the advanced practice nurse's office, a physician assistant in the physician assistant's office, or to a hospital outpatient prenatal clinic, local health department maternity clinic, or community health center.

(4) Radiology services which are directly related to

the pregnancy, are determined to be medically necessary and are ordered by a physician, an advanced practice nurse, or a physician assistant.

(5) Pharmacy services related to the pregnancy.

(6) Other medical consultations related to the

pregnancy.

(7) Physician, advanced practice nurse, physician

assistant, or nurse services associated with delivery.

(8) One postnatal office visit within 60 days after

delivery.

(9) Two EPSDT‑equivalent screenings for the infant

within 90 days after birth.

(10) Social and support services.

(11) Nutrition services.

(12) Case management services.

(b) The following services shall not be covered under the program:

(1) Services determined by the Department not to be

medically necessary.

(2) Services not directly related to the pregnancy,

except for the 2 covered EPSDT‑equivalent screenings.

(3) Hospital inpatient services.

(4) Anesthesiologist and radiologist services during

a period of hospital inpatient care.

(5) Physician, advanced practice nurse, and

physician assistant hospital visits.

(6) Services considered investigational or

experimental.

(Source: P.A. 93‑962, eff. 8‑20‑04.)

410 ILCS 225/7

(410 ILCS 225/7)

(from Ch. 111 1/2, par. 7027)

Sec. 7.

Advisory board consultation.

The Department shall consult with the Maternal and Child Health Advisory Board created under the Illinois Family Case Management Act regarding the implementation of this program. In addition, the Board shall advise the Department on the coordination of services provided under this program with services provided under the Illinois Family Case Management Act and the Problem Pregnancy Health Services and Care Act.

(Source: P.A. 94‑407, eff. 8‑2‑05.)