State of Illinois
92nd General Assembly
Legislation

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[ Engrossed ][ House Amendment 001 ]


92_HB1807

 
                                              LRB9204967DJgcA

 1        AN ACT in relation to health.

 2        Be  it  enacted  by  the People of the State of Illinois,
 3    represented in the General Assembly:

 4        Section 1. Short title. This Act  may  be  cited  as  the
 5    Anti-Obesity and Related Comorbidities Therapy Act.

 6        Section  5.  Public  policy.  It is declared that for the
 7    benefit  of  the  people  of  the  State  of  Illinois,   the
 8    Department  of Public Health, in cooperation with other State
 9    agencies, shall be responsible for supporting programs  aimed
10    at  reducing  the  incidence  and  effects of obesity and its
11    related comorbidities.  The State acknowledges  that  obesity
12    is  the  second-leading  cause  of death in the United States
13    after smoking, resulting in  more  than  300,000  preventable
14    deaths  each  year.   There  is a causal relationship between
15    obesity and other serious  health  complications,  including,
16    but  not  limited to, coronary heart disease, cerebrovascular
17    disease (stroke), type II  diabetes  mellitus,  hypertension,
18    sleep   apnea,  dyslipidemia,  gallbladder  disease,  gastric
19    reflux disease, gout, osteoarthritis of the hips  and  knees,
20    cancer,  infertility,  and  respiratory  difficulties, all of
21    which lead to an increase in  obesity-related  morbidity  and
22    mortality.   In  addition  to  the  health  implications, the
23    economic  consequences  of  the  skyrocketing  incidence   of
24    obesity rates are substantial.  The direct cost of diagnosis,
25    treatment,  and  management  of  obesity  and obesity-related
26    diseases is estimated to be $45.8 billion, or 6.8%  of  total
27    national health care expenditures. The reduction in workplace
28    productivity  due  to  an increase in the number of sick days
29    and physical limitations  is  estimated  to  have  an  annual
30    impact on our economy of $52 billion per year.
31        Obesity  continues  to  dramatically increase both in the
 
                            -2-               LRB9204967DJgcA
 1    United  States  and  in  Illinois.   One-third  of  the  U.S.
 2    population is  considered  to  be  obese.   The  Centers  for
 3    Disease  Control  and  Prevention  reported that 33.5% of the
 4    Illinois population was obese in 1998.  Obesity, while on the
 5    rise in all adult demographic categories, is  more  prevalent
 6    among   African-American  and  Hispanic  populations.   Among
 7    children, there has been a 42% increase in childhood  obesity
 8    rates  since  1980, placing children at an increased risk for
 9    diabetes, hypertension, heart disease, and  stroke  later  in
10    life.
11        It  is clear that obesity has a significant impact on the
12    health of people in  Illinois,  and  the  State  economy,  by
13    reducing   productivity   dramatically  increasing  avoidable
14    medical costs.  Clinical studies demonstrate that weight loss
15    in overweight and obese individuals decreases  the  risk  for
16    developing serious health conditions and leads to improvement
17    in  health  for  many  persons  with  those  conditions.   By
18    investing  in  programs  aimed  at  reducing  obesity and its
19    related comorbidities, the State  can  improve  the  physical
20    health  of a significant portion of its citizenry and control
21    the skyrocketing costs of health care attributed to obesity's
22    comorbidities.   For  example,   research   begun   in   1995
23    demonstrates that intentional weight loss in overweight women
24    with existing obesity-related diseases led to a 20% reduction
25    in  total  mortality,  a  40-50%  reduction in mortality from
26    obesity-related   cancers   and   a   30-40%   reduction   in
27    diabetes-related deaths.
28        In recent years, new scientific breakthroughs have led to
29    new drug therapies  that  are  both  safe  and  effective  in
30    treating  both  obesity and its related comorbidities.  These
31    innovative drug therapies assist obese individuals in  losing
32    weight,  improving  their health, and reducing their need for
33    complex and costly medical services that are paid for by  the
34    State's medical assistance program.  It is the policy of this
 
                            -3-               LRB9204967DJgcA
 1    State  that  where  prophylactic  therapies  actually  reduce
 2    health care costs and improve patient health, those therapies
 3    must  be  supported.   The  legislature  finds  that there is
 4    sufficient scientific and  empirical  evidence  to  establish
 5    that  existing FDA-approved anti-obesity drug therapies, when
 6    properly supervised  by  a  qualified  physician,  fit  these
 7    criteria.

 8        Section 10. Definitions. In this Act:
 9        (1)  "At-risk  overweight" means having a body mass index
10    greater than or equal to 27 kilograms per  square  meter  but
11    less  than  30  kilograms  per square meter and having one or
12    more of the following comorbidities:
13             (1) Coronary heart disease.
14             (2) Cerebrovascular disease (stroke).
15             (3) Dyslipidemia.
16             (4) Gallbladder disease.
17             (5) Gastric reflux disease.
18             (6) Gout.
19             (7) Cancer.
20             (8) Hypertension.
21             (9) Infertility.
22             (10) Osteoarthritis of the hips or knees.
23             (11) Sleep apnea.
24             (l2) Type II diabetes mellitus.
25             (13)  Respiratory difficulties.
26        "Body mass index"  is  a  mathematical  formula  used  to
27    determine  a  person's  body  weight in relation to height as
28    measured by dividing a person's weight in kilograms by height
29    in meters squared.
30        "Chronic  treatment"  means  any   daily   drug   therapy
31    indicated  by  labeling approved by the federal Food and Drug
32    Administration for use for more than 60 days.
33        "Medically  indigent  patients"  means  persons  who  are
 
                            -4-               LRB9204967DJgcA
 1    determined  to  be  eligible  for  medical  assistance  under
 2    Article V of the Illinois Public Aid Code.
 3        "Obese" means having a body mass index  greater  than  or
 4    equal to 30 kilograms per square meter.

 5        Section  15.  Anti-obesity  program.  The  Department  of
 6    Public  Health,  in conjunction with the Department of Public
 7    Aid and other appropriate State  agencies,  shall  develop  a
 8    program  to  provide  obese  or  at-risk overweight medically
 9    indigent  patients  with  services  for  the  treatment   and
10    prevention  of  obesity  and  its related comorbidities.  The
11    program shall include education, monitoring,  and  outpatient
12    prescription  drug  coverage  of  anti-obesity drug therapies
13    that  are  approved  by  the  United  States  Food  and  Drug
14    Administration if the patient's treating physician prescribes
15    the therapy as  being  medically  necessary  to  his  or  her
16    healthcare.

17        Section  20.  Rules.  The Department of Public Health may
18    adopt rules to enable it to carry out the provisions of  this
19    Act  and  may  coordinate  its  actions  with  other State or
20    federal agencies to comply with this Act.  The provisions  of
21    the  Illinois  Administrative  Procedure  Act  are  expressly
22    adopted  and apply to all administrative rules and procedures
23    adopted by the Department under this Act, except that Section
24    5-35  of  the Illinois Administrative Procedure Act  relating
25    to  procedures  for rule-making  does   not  apply   to   the
26    adoption  of  any  rule required by federal law in connection
27    with  which  the  Department  is  precluded  by    law   from
28    exercising any discretion.

29        Section  90.   The Illinois Public Aid Code is amended by
30    changing Section 5-5 as follows:
 
                            -5-               LRB9204967DJgcA
 1        (305 ILCS 5/5-5) (from Ch. 23, par. 5-5)
 2        Sec. 5-5.  Medical services. The Illinois Department,  by
 3    rule,  shall  determine  the  quantity and quality of and the
 4    rate of reimbursement for the medical  assistance  for  which
 5    payment  will  be  authorized, and the medical services to be
 6    provided, which may include all or part of the following: (1)
 7    inpatient  hospital   services;   (2)   outpatient   hospital
 8    services;  (3)  other  laboratory  and  X-ray  services;  (4)
 9    skilled  nursing  home  services;  (5)  physicians'  services
10    whether  furnished  in  the  office,  the  patient's  home, a
11    hospital, a skilled nursing home, or elsewhere;  (6)  medical
12    care,  or  any  other  type  of  remedial  care  furnished by
13    licensed practitioners; (7) home health  care  services;  (8)
14    private  duty  nursing  service;  (9)  clinic  services; (10)
15    dental services; (11) physical therapy and related  services;
16    (12)  prescribed drugs, dentures, and prosthetic devices; and
17    eyeglasses prescribed by a physician skilled in the  diseases
18    of  the  eye,  or by an optometrist, whichever the person may
19    select; (13) other  diagnostic,  screening,  preventive,  and
20    rehabilitative  services;  (14) transportation and such other
21    expenses as may  be  necessary;  (15)  medical  treatment  of
22    sexual  assault  survivors,  as  defined in Section 1a of the
23    Sexual  Assault  Survivors  Emergency  Treatment   Act,   for
24    injuries  sustained  as  a  result  of  the  sexual  assault,
25    including  examinations  and  laboratory  tests  to  discover
26    evidence  which  may  be used in criminal proceedings arising
27    from the sexual assault; (16) the diagnosis and treatment  of
28    sickle  cell anemia; and (17) any other medical care, and any
29    other type of remedial care recognized under the laws of this
30    State, but not including abortions, or  induced  miscarriages
31    or  premature  births, unless, in the opinion of a physician,
32    such procedures are necessary for  the  preservation  of  the
33    life  of  the  woman  seeking  such  treatment,  or except an
34    induced premature birth intended to  produce  a  live  viable
 
                            -6-               LRB9204967DJgcA
 1    child  and  such procedure is necessary for the health of the
 2    mother or her unborn child. The Illinois Department, by rule,
 3    shall  prohibit  any   physician   from   providing   medical
 4    assistance  to anyone eligible therefor under this Code where
 5    such  physician  has  been  found  guilty  of  performing  an
 6    abortion procedure in a wilful and wanton manner upon a woman
 7    who was not pregnant at the time such abortion procedure  was
 8    performed.  The  term "any other type of remedial care" shall
 9    include nursing care and nursing home service for persons who
10    rely on treatment by spiritual means alone through prayer for
11    healing.
12        Notwithstanding any other provision of  this  Section,  a
13    comprehensive  tobacco  use  cessation  program that includes
14    purchasing prescription drugs or prescription medical devices
15    approved by the Food and Drug administration shall be covered
16    under the medical assistance program under this  Article  for
17    persons  who are otherwise eligible for assistance under this
18    Article.
19        Notwithstanding any other provision  of  this  Code,  the
20    Illinois  Department  may  not  require,  as  a  condition of
21    payment  for  any  laboratory  test  authorized  under   this
22    Article,  that  a physician's handwritten signature appear on
23    the laboratory test order form.  The Illinois Department may,
24    however,  impose  other  appropriate  requirements  regarding
25    laboratory test order documentation.
26        The Illinois Department of Public Aid shall  provide  the
27    following  services  to persons eligible for assistance under
28    this Article who are participating in education, training  or
29    employment  programs  operated  by  the  Department  of Human
30    Services as successor to the Department of Public Aid:
31             (1)  dental services, which shall include but not be
32        limited to prosthodontics; and
33             (2)  eyeglasses prescribed by a physician skilled in
34        the diseases of the eye, or by an optometrist,  whichever
 
                            -7-               LRB9204967DJgcA
 1        the person may select.
 2        The  Illinois  Department  shall provide services for the
 3    treatment  and  prevention  of  obesity   and   its   related
 4    comorbidities,    including    education,   monitoring,   and
 5    outpatient prescription drug coverage  of  anti-obesity  drug
 6    therapies  that  are  approved  by the United States Food and
 7    Drug  Administration  if  the  patient's  treating  physician
 8    prescribes the therapy as being medically necessary to his or
 9    her healthcare.  The Illinois Department shall provide  these
10    services   to  recipients  who  participate  in  the  program
11    developed by  the  Department  of  Public  Health  under  the
12    Anti-Obesity and Related Comorbidities Therapy Act.
13        The  Illinois  Department,  by  rule, may distinguish and
14    classify  the  medical  services  to  be  provided  only   in
15    accordance  with the classes of persons designated in Section
16    5-2.
17        The Illinois Department shall authorize the provision of,
18    and  shall  authorize  payment  for,  screening  by  low-dose
19    mammography for the presence  of  occult  breast  cancer  for
20    women  35  years of age or older who are eligible for medical
21    assistance  under  this  Article,  as  follows:   a  baseline
22    mammogram for women 35 to 39  years  of  age  and  an  annual
23    mammogram for women 40 years of age or older.  All screenings
24    shall   include   a  physical  breast  exam,  instruction  on
25    self-examination and information regarding the  frequency  of
26    self-examination  and  its  value as a preventative tool.  As
27    used in this Section, "low-dose mammography" means the  x-ray
28    examination   of   the   breast   using  equipment  dedicated
29    specifically  for  mammography,  including  the  x-ray  tube,
30    filter, compression device, image  receptor,  and  cassettes,
31    with  an average radiation exposure delivery of less than one
32    rad mid-breast, with 2 views for each breast.
33        Any medical or health  care  provider  shall  immediately
34    recommend,  to  any  pregnant  woman  who  is  being provided
 
                            -8-               LRB9204967DJgcA
 1    prenatal services and  is  suspected  of  drug  abuse  or  is
 2    addicted  as  defined  in the Alcoholism and Other Drug Abuse
 3    and Dependency Act,  referral  to  a  local  substance  abuse
 4    treatment  provider  licensed  by  the  Department  of  Human
 5    Services  or  to a licensed hospital which provides substance
 6    abuse treatment services.  The Department of Public Aid shall
 7    assure coverage for the cost of treatment of the  drug  abuse
 8    or  addiction  for pregnant recipients in accordance with the
 9    Illinois Medicaid Program in conjunction with the  Department
10    of Human Services.
11        All  medical  providers  providing  medical assistance to
12    pregnant women under this Code shall receive information from
13    the Department on the availability of services under the Drug
14    Free  Families  with  a  Future  or  any  comparable  program
15    providing  case  management  services  for  addicted   women,
16    including  information  on  appropriate  referrals  for other
17    social services that may  be  needed  by  addicted  women  in
18    addition to treatment for addiction.
19        The   Illinois   Department,   in  cooperation  with  the
20    Departments of Human Services (as successor to the Department
21    of Alcoholism and Substance Abuse) and Public Health, through
22    a  public  awareness  campaign,   may   provide   information
23    concerning  treatment  for  alcoholism  and  drug  abuse  and
24    addiction, prenatal health care, and other pertinent programs
25    directed at reducing the number of drug-affected infants born
26    to recipients of medical assistance.
27        Neither  the  Illinois  Department  of Public Aid nor the
28    Department of Human Services  shall  sanction  the  recipient
29    solely on the basis of her substance abuse.
30        The  Illinois Department shall establish such regulations
31    governing  the  dispensing  of  health  services  under  this
32    Article as it shall deem appropriate.  In  formulating  these
33    regulations  the  Illinois  Department shall consult with and
34    give substantial weight to the recommendations offered by the
 
                            -9-               LRB9204967DJgcA
 1    Citizens  Assembly/Council  on  Public  Aid.  The  Department
 2    should  seek  the  advice  of  formal  professional  advisory
 3    committees  appointed  by  the  Director  of   the   Illinois
 4    Department  for  the  purpose  of providing regular advice on
 5    policy and administrative matters, information  dissemination
 6    and  educational  activities  for  medical  and  health  care
 7    providers,  and  consistency  in  procedures  to the Illinois
 8    Department.
 9        The Illinois Department may  develop  and  contract  with
10    Partnerships of medical providers to arrange medical services
11    for   persons  eligible  under  Section  5-2  of  this  Code.
12    Implementation  of  this  Section  may  be  by  demonstration
13    projects in certain geographic areas.  The Partnership  shall
14    be represented by a sponsor organization.  The Department, by
15    rule,   shall   develop   qualifications   for   sponsors  of
16    Partnerships.  Nothing in this Section shall be construed  to
17    require   that   the   sponsor   organization  be  a  medical
18    organization.
19        The sponsor must negotiate formal written contracts  with
20    medical  providers  for  physician  services,  inpatient  and
21    outpatient hospital care, home health services, treatment for
22    alcoholism and substance abuse, and other services determined
23    necessary  by the Illinois Department by rule for delivery by
24    Partnerships.  Physician services must include  prenatal  and
25    obstetrical  care.   The  Illinois Department shall reimburse
26    medical  services  delivered  by  Partnership  providers   to
27    clients  in  target  areas  according  to  provisions of this
28    Article and the Illinois Health Finance  Reform  Act,  except
29    that:
30             (1)  Physicians  participating  in a Partnership and
31        providing certain services, which shall be determined  by
32        the  Illinois  Department, to persons in areas covered by
33        the Partnership may receive an additional  surcharge  for
34        such services.
 
                            -10-              LRB9204967DJgcA
 1             (2)  The   Department  may  elect  to  consider  and
 2        negotiate   financial   incentives   to   encourage   the
 3        development of Partnerships and the efficient delivery of
 4        medical care.
 5             (3)  Persons  receiving  medical  services   through
 6        Partnerships  may  receive  medical  and  case management
 7        services above the  level  usually  offered  through  the
 8        medical assistance program.
 9        Medical  providers  shall  be  required  to  meet certain
10    qualifications to participate in Partnerships to  ensure  the
11    delivery   of   high   quality   medical   services.    These
12    qualifications  shall  be  determined by rule of the Illinois
13    Department  and  may  be  higher  than   qualifications   for
14    participation in the medical assistance program.  Partnership
15    sponsors  may  prescribe reasonable additional qualifications
16    for participation by medical providers, only with  the  prior
17    written approval of the Illinois Department.
18        Nothing  in  this  Section shall limit the free choice of
19    practitioners, hospitals,  and  other  providers  of  medical
20    services  by  clients.  In order to ensure patient freedom of
21    choice, the Illinois Department shall immediately  promulgate
22    all  rules  and  take  all  other  necessary  actions so that
23    provided  services  may  be  accessed  from   therapeutically
24    certified  optometrists  to  the  full extent of the Illinois
25    Optometric  Practice  Act  of  1987  without   discriminating
26    between service providers.
27        The  Department  shall apply for a waiver from the United
28    States Health Care Financing Administration to allow for  the
29    implementation of Partnerships under this Section.
30        The   Illinois   Department  shall  require  health  care
31    providers to maintain records that document the medical  care
32    and  services  provided  to  recipients of Medical Assistance
33    under this Article.  The Illinois  Department  shall  require
34    health  care  providers to make available, when authorized by
 
                            -11-              LRB9204967DJgcA
 1    the patient, in writing, the  medical  records  in  a  timely
 2    fashion  to  other  health care providers who are treating or
 3    serving persons eligible for Medical  Assistance  under  this
 4    Article.    All  dispensers  of  medical  services  shall  be
 5    required to maintain and  retain  business  and  professional
 6    records  sufficient  to  fully  and  accurately  document the
 7    nature,  scope,  details  and  receipt  of  the  health  care
 8    provided to persons eligible  for  medical  assistance  under
 9    this  Code, in accordance with regulations promulgated by the
10    Illinois Department. The rules and regulations shall  require
11    that  proof  of  the receipt of prescription drugs, dentures,
12    prosthetic devices and eyeglasses by eligible  persons  under
13    this Section accompany each claim for reimbursement submitted
14    by the dispenser of such medical services. No such claims for
15    reimbursement  shall  be approved for payment by the Illinois
16    Department without such proof of receipt, unless the Illinois
17    Department shall have put into effect and shall be  operating
18    a  system  of post-payment audit and review which shall, on a
19    sampling basis, be deemed adequate by the Illinois Department
20    to assure that such drugs, dentures, prosthetic  devices  and
21    eyeglasses for which payment is being made are actually being
22    received  by  eligible  recipients.  Within 90 days after the
23    effective date of this amendatory Act of 1984,  the  Illinois
24    Department  shall  establish  a  current  list of acquisition
25    costs  for  all  prosthetic  devices  and  any  other   items
26    recognized  as  medical  equipment  and supplies reimbursable
27    under this Article and shall update such list on a  quarterly
28    basis,  except that the acquisition costs of all prescription
29    drugs shall be updated no less frequently than every 30  days
30    as required by Section 5-5.12.
31        The  rules  and  regulations  of  the Illinois Department
32    shall require that a written statement including the required
33    opinion  of  a  physician  shall  accompany  any  claim   for
34    reimbursement  for  abortions,  or  induced  miscarriages  or
 
                            -12-              LRB9204967DJgcA
 1    premature   births.    This  statement  shall  indicate  what
 2    procedures were used in providing such medical services.
 3        The Illinois Department shall require that all dispensers
 4    of medical services, other than an individual practitioner or
 5    group  of  practitioners,  desiring  to  participate  in  the
 6    Medical Assistance program established under this Article  to
 7    disclose all financial, beneficial, ownership, equity, surety
 8    or  other  interests  in  any  and  all  firms, corporations,
 9    partnerships,  associations,  business   enterprises,   joint
10    ventures,  agencies,  institutions  or  other  legal entities
11    providing any form of health  care  services  in  this  State
12    under this Article.
13        The  Illinois  Department may require that all dispensers
14    of medical services desiring to participate  in  the  medical
15    assistance  program  established under this Article disclose,
16    under such terms and conditions as  the  Illinois  Department
17    may  by  rule  establish,  all  inquiries  from  clients  and
18    attorneys  regarding  medical  bills  paid  by  the  Illinois
19    Department,   which   inquiries   could   indicate  potential
20    existence of claims or liens for the Illinois Department.
21        The  Illinois  Department   shall   establish   policies,
22    procedures,   standards   and   criteria   by  rule  for  the
23    acquisition,  repair  and   replacement   of   orthotic   and
24    prosthetic devices and durable medical equipment.  Such rules
25    shall provide, but not be limited to, the following services:
26    (1)  immediate  repair  or  replacement  of  such  devices by
27    recipients without medical  authorization;  and  (2)  rental,
28    lease,   purchase   or   lease-purchase  of  durable  medical
29    equipment   in   a   cost-effective   manner,   taking   into
30    consideration the recipient's medical prognosis,  the  extent
31    of  the recipient's needs, and the requirements and costs for
32    maintaining  such  equipment.   Such  rules  shall  enable  a
33    recipient to  temporarily  acquire  and  use  alternative  or
34    substitute   devices   or   equipment   pending   repairs  or
 
                            -13-              LRB9204967DJgcA
 1    replacements of any device or equipment previously authorized
 2    for such recipient by the Department. Rules under clause  (2)
 3    above  shall  not  provide  for purchase or lease-purchase of
 4    durable medical equipment or supplies used for the purpose of
 5    oxygen delivery and respiratory care.
 6        The Department shall execute,  relative  to  the  nursing
 7    home  prescreening  project,  written inter-agency agreements
 8    with the Department of Human Services and the  Department  on
 9    Aging,  to  effect  the  following: (i) intake procedures and
10    common  eligibility  criteria  for  those  persons  who   are
11    receiving    non-institutional   services;   and   (ii)   the
12    establishment and development of  non-institutional  services
13    in  areas of the State where they are not currently available
14    or are undeveloped.
15        The Illinois Department shall  develop  and  operate,  in
16    cooperation  with other State Departments and agencies and in
17    compliance with  applicable  federal  laws  and  regulations,
18    appropriate  and  effective systems of health care evaluation
19    and programs for monitoring of  utilization  of  health  care
20    services  and  facilities, as it affects persons eligible for
21    medical assistance under this Code. The  Illinois  Department
22    shall  report  regularly the results of the operation of such
23    systems and programs  to  the  Citizens  Assembly/Council  on
24    Public  Aid  to  enable the Committee to ensure, from time to
25    time, that these programs are effective and meaningful.
26        The Illinois Department  shall  report  annually  to  the
27    General Assembly, no later than the second Friday in April of
28    1979 and each year thereafter, in regard to:
29             (a)  actual  statistics and trends in utilization of
30        medical services by public aid recipients;
31             (b)  actual statistics and trends in  the  provision
32        of the various medical services by medical vendors;
33             (c)  current rate structures and proposed changes in
34        those  rate  structures  for the various medical vendors;
 
                            -14-              LRB9204967DJgcA
 1        and
 2             (d)  efforts at utilization review  and  control  by
 3        the Illinois Department.
 4        The  period  covered  by each report shall be the 3 years
 5    ending on the June 30 prior to the report.  The report  shall
 6    include   suggested  legislation  for  consideration  by  the
 7    General Assembly.  The filing of one copy of the report  with
 8    the  Speaker,  one copy with the Minority Leader and one copy
 9    with the Clerk of the House of Representatives, one copy with
10    the President, one copy with the Minority Leader and one copy
11    with  the  Secretary  of  the  Senate,  one  copy  with   the
12    Legislative  Research  Unit,  such additional copies with the
13    State Government Report Distribution Center for  the  General
14    Assembly  as  is required under paragraph (t) of Section 7 of
15    the  State  Library  Act  and  one  copy  with  the  Citizens
16    Assembly/Council on Public Aid  or  its  successor  shall  be
17    deemed sufficient to comply with this Section.
18    (Source: P.A. 90-7, eff. 6-10-97; 90-14, eff. 7-1-97; 91-344,
19    eff.  1-1-00;  91-462,  eff.  8-6-99;  91-666, eff. 12-22-99;
20    revised 1-6-00.) 4967

21        Section 99.  Effective date.  This Act takes effect  upon
22    becoming law.

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