102ND GENERAL ASSEMBLY State of Illinois 2021 and 2022 HB4640

Introduced , by Rep. Deb Conroy

SYNOPSIS AS INTRODUCED: New Act 20 ILCS 2305/2 from Ch. 111 1/2, par. 22 410 ILCS 535/24 from Ch. 111 1/2, par. 73-24 720 ILCS 570/318

Creates the Access to Public Health Data Act. Provides that the Department of Public Health, the Department of Human Services, and the Department of Children and Family Services shall, at the request of a local health department in Illinois, make any and all public health data related to residents of that local health department's jurisdiction available to that local health department for the purposes of preventing or controlling disease, injury, or disability. Provides that the Department of Public Health, the Department of Human Services, and the Department of Children and Family Services may adopt any rules necessary to implement the Act. Contains other provisions. Amends the Department of Public Health Act. Provides that emergency access to medical or health information, records, or data shall include access to electronic health records, provided that the local health authority shall be unable to alter the electronic health records. Provides that a person, facility, institution, or agency providing information under the provisions may withhold a patient's mental or behavioral health history. Amends the Vital Records Act. Provides that no rule adopted by the Department of Public Health shall be construed as restricting access to vital records by any municipality, county, multicounty, public health district, or regional health officer recognized by the Department for the purposes described in specified provisions. Amends the Illinois Controlled Substances Act. Provides that the Department of Public Health may release specified confidential information to a certified local health department engaged in the performance of epidemiological studies, the application of data science methods, or other analytic models that protect and promote public health. Makes other changes. LRB102 22205 CPF 31335 b

A BILL FOR

HB4640LRB102 22205 CPF 31335 b 1 AN ACT concerning health. 2 Be it enacted by the People of the State of Illinois, 3represented in the General Assembly: 4 Section 1. Short title. This Act may be cited as the Access 5to Public Health Data Act. 6 Section 5. Definitions. As used in this Act, "public 7health data" includes, but is not limited to, birth and death 8certificate data, hospital discharge data, adverse pregnancy 9outcomes reporting system (APORS) data, cancer registry data, 10pregnancy risk assessment monitoring system (PRAMS) data, 11syndromic surveillance data, and prescription monitoring 12program (PMP) data. 13 Section 10. Access to public health data; local health 14departments. 15 (a) Notwithstanding any other provision of State law to 16the contrary, the Department of Public Health, the Department 17of Human Services, and the Department of Children and Family 18Services shall, at the request of a local health department in 19this State, make any and all public health data related to 20residents of that local health department's jurisdiction 21available to that local health department for the purposes of 22preventing or controlling disease, injury, or disability. The

HB4640- 2 -LRB102 22205 CPF 31335 b 1commissioner, executive director, chief operating officer, 2chief medical officer, or equivalent executive leader of a 3local health department has express authority to request and 4receive such data.5 (b) The Department of Public Health, the Department of 6Human Services, the Department of Children and Family 7Services, and the requesting local health department shall 8apply appropriate safeguards to ensure the privacy and 9security of the data. 10 Section 15. Date use agreements. The Department of Public 11Health, the Department of Human Services, the Department of 12Children and Family Services, and the requesting local health 13department may enter into data use agreements to ensure 14appropriate, effective, and efficient use of data requested by 15the local health department, though no data use agreement 16shall restrict local health department access to any public 17health data available to the Department of Public Health, the 18Department of Human Services, or the Department of Children 19and Family Services, nor shall it require indemnification as a 20prerequisite to access. 21 Section 20. Standard request data forms. Within 60 days 22after the effective date of this Act, the Department of Public 23Health, the Department of Human Services, and the Department 24of Children and Family Services shall develop a standard data

HB4640- 3 -LRB102 22205 CPF 31335 b 1request form for use by local health departments, the terms of 2which shall be limited to data content, format, method of 3transfer, analytic and statistical methods, scope of use, and 4requirements for safeguarding the data. 5 Section 25. Latest available data. The Department of 6Public Health, the Department of Human Services, and the 7Department of Children and Family Services must provide the 8latest available data for each local health department request 9within 90 business days after receiving the data request form. 10 Section 30. Rules. The Department of Public Health, the 11Department of Human Services, and the Department of Children 12and Family Services may adopt any rules necessary to implement 13this Act. 14 Section 35. The Department of Public Health Act is amended 15by changing Section 2 as follows: 16 (20 ILCS 2305/2) (from Ch. 111 1/2, par. 22) 17 Sec. 2. Powers. 18 (a) The State Department of Public Health has general 19supervision of the interests of the health and lives of the 20people of the State. It has supreme authority in matters of 21quarantine and isolation, and may declare and enforce 22quarantine and isolation when none exists, and may modify or

HB4640- 4 -LRB102 22205 CPF 31335 b 1relax quarantine and isolation when it has been established. 2The Department may adopt, promulgate, repeal and amend rules 3and regulations and make such sanitary investigations and 4inspections as it may from time to time deem necessary for the 5preservation and improvement of the public health, consistent 6with law regulating the following: 7 (1) Transportation of the remains of deceased persons. 8 (2) Sanitary practices relating to drinking water made 9 accessible to the public for human consumption or for 10 lavatory or culinary purposes. 11 (3) Sanitary practices relating to rest room 12 facilities made accessible to the public or to persons 13 handling food served to the public. 14 (4) Sanitary practices relating to disposal of human 15 wastes in or from all buildings and places where people 16 live, work or assemble. 17 The provisions of the Illinois Administrative Procedure 18Act are hereby expressly adopted and shall apply to all 19administrative rules and procedures of the Department of 20Public Health under this Act, except that Section 5-35 of the 21Illinois Administrative Procedure Act relating to procedures 22for rule-making does not apply to the adoption of any rule 23required by federal law in connection with which the 24Department is precluded by law from exercising any discretion. 25 All local boards of health, health authorities and 26officers, police officers, sheriffs and all other officers and

HB4640- 5 -LRB102 22205 CPF 31335 b 1employees of the state or any locality shall enforce the rules 2and regulations so adopted and orders issued by the Department 3pursuant to this Section. 4 The Department of Public Health shall conduct a public 5information campaign to inform Hispanic women of the high 6incidence of breast cancer and the importance of mammograms 7and where to obtain a mammogram. This requirement may be 8satisfied by translation into Spanish and distribution of the 9breast cancer summaries required by Section 2310-345 of the 10Department of Public Health Powers and Duties Law (20 ILCS 112310/2310-345). The information provided by the Department of 12Public Health shall include (i) a statement that mammography 13is the most accurate method for making an early detection of 14breast cancer, however, no diagnostic tool is 100% effective 15and (ii) instructions for performing breast self-examination 16and a statement that it is important to perform a breast 17self-examination monthly. 18 The Department of Public Health shall investigate the 19causes of dangerously contagious or infectious diseases, 20especially when existing in epidemic form, and take means to 21restrict and suppress the same, and whenever such disease 22becomes, or threatens to become epidemic, in any locality and 23the local board of health or local authorities neglect or 24refuse to enforce efficient measures for its restriction or 25suppression or to act with sufficient promptness or 26efficiency, or whenever the local board of health or local

HB4640- 6 -LRB102 22205 CPF 31335 b 1authorities neglect or refuse to promptly enforce efficient 2measures for the restriction or suppression of dangerously 3contagious or infectious diseases, the Department of Public 4Health may enforce such measures as it deems necessary to 5protect the public health, and all necessary expenses so 6incurred shall be paid by the locality for which services are 7rendered. 8 (b) Subject to the provisions of subsection (c), the 9Department may order a person or group of persons to be 10quarantined or isolated or may order a place to be closed and 11made off limits to the public to prevent the probable spread of 12a dangerously contagious or infectious disease, including 13non-compliant tuberculosis patients, until such time as the 14condition can be corrected or the danger to the public health 15eliminated or reduced in such a manner that no substantial 16danger to the public's health any longer exists. Orders for 17isolation of a person or quarantine of a place to prevent the 18probable spread of a sexually transmissible disease shall be 19governed by the provisions of Section 7 of the Illinois 20Sexually Transmissible Disease Control Act and not this 21Section. 22 (c) Except as provided in this Section, no person or a 23group of persons may be ordered to be quarantined or isolated 24and no place may be ordered to be closed and made off limits to 25the public except with the consent of the person or owner of 26the place or upon the prior order of a court of competent

HB4640- 7 -LRB102 22205 CPF 31335 b 1jurisdiction. The Department may, however, order a person or a 2group of persons to be quarantined or isolated or may order a 3place to be closed and made off limits to the public on an 4immediate basis without prior consent or court order if, in 5the reasonable judgment of the Department, immediate action is 6required to protect the public from a dangerously contagious 7or infectious disease. In the event of an immediate order 8issued without prior consent or court order, the Department 9shall, as soon as practical, within 48 hours after issuing the 10order, obtain the consent of the person or owner or file a 11petition requesting a court order authorizing the isolation or 12quarantine or closure. When exigent circumstances exist that 13cause the court system to be unavailable or that make it 14impossible to obtain consent or file a petition within 48 15hours after issuance of an immediate order, the Department 16must obtain consent or file a petition requesting a court 17order as soon as reasonably possible. To obtain a court order, 18the Department, by clear and convincing evidence, must prove 19that the public's health and welfare are significantly 20endangered by a person or group of persons that has, that is 21suspected of having, that has been exposed to, or that is 22reasonably believed to have been exposed to a dangerously 23contagious or infectious disease including non-compliant 24tuberculosis patients or by a place where there is a 25significant amount of activity likely to spread a dangerously 26contagious or infectious disease. The Department must also

HB4640- 8 -LRB102 22205 CPF 31335 b 1prove that all other reasonable means of correcting the 2problem have been exhausted and no less restrictive 3alternative exists. For purposes of this subsection, in 4determining whether no less restrictive alternative exists, 5the court shall consider evidence showing that, under the 6circumstances presented by the case in which an order is 7sought, quarantine or isolation is the measure provided for in 8a rule of the Department or in guidelines issued by the Centers 9for Disease Control and Prevention or the World Health 10Organization. Persons who are or are about to be ordered to be 11isolated or quarantined and owners of places that are or are 12about to be closed and made off limits to the public shall have 13the right to counsel. If a person or owner is indigent, the 14court shall appoint counsel for that person or owner. Persons 15who are ordered to be isolated or quarantined or who are owners 16of places that are ordered to be closed and made off limits to 17the public, shall be given a written notice of such order. The 18written notice shall additionally include the following: (1) 19notice of the right to counsel; (2) notice that if the person 20or owner is indigent, the court will appoint counsel for that 21person or owner; (3) notice of the reason for the order for 22isolation, quarantine, or closure; (4) notice of whether the 23order is an immediate order, and if so, the time frame for the 24Department to seek consent or to file a petition requesting a 25court order as set out in this subsection; and (5) notice of 26the anticipated duration of the isolation, quarantine, or

HB4640- 9 -LRB102 22205 CPF 31335 b 1closure. 2 (d) The Department may order physical examinations and 3tests and collect laboratory specimens as necessary for the 4diagnosis or treatment of individuals in order to prevent the 5probable spread of a dangerously contagious or infectious 6disease. Physical examinations, tests, or collection of 7laboratory specimens must not be such as are reasonably likely 8to lead to serious harm to the affected individual. To prevent 9the spread of a dangerously contagious or infectious disease, 10the Department may, pursuant to the provisions of subsection 11(c) of this Section, isolate or quarantine any person whose 12refusal of physical examination or testing or collection of 13laboratory specimens results in uncertainty regarding whether 14he or she has been exposed to or is infected with a dangerously 15contagious or infectious disease or otherwise poses a danger 16to the public's health. An individual may refuse to consent to 17a physical examination, test, or collection of laboratory 18specimens. An individual shall be given a written notice that 19shall include notice of the following: (i) that the individual 20may refuse to consent to physical examination, test, or 21collection of laboratory specimens; (ii) that if the 22individual consents to physical examination, tests, or 23collection of laboratory specimens, the results of that 24examination, test, or collection of laboratory specimens may 25subject the individual to isolation or quarantine pursuant to 26the provisions of subsection (c) of this Section; (iii) that

HB4640- 10 -LRB102 22205 CPF 31335 b 1if the individual refuses to consent to physical examination, 2tests, or collection of laboratory specimens and that refusal 3results in uncertainty regarding whether he or she has been 4exposed to or is infected with a dangerously contagious or 5infectious disease or otherwise poses a danger to the public's 6health, the individual may be subject to isolation or 7quarantine pursuant to the provisions of subsection (c) of 8this Section; and (iv) that if the individual refuses to 9consent to physical examinations, tests, or collection of 10laboratory specimens and becomes subject to isolation and 11quarantine as provided in this subsection (d), he or she shall 12have the right to counsel pursuant to the provisions of 13subsection (c) of this Section. To the extent feasible without 14endangering the public's health, the Department shall respect 15and accommodate the religious beliefs of individuals in 16implementing this subsection.17 (e) The Department may order the administration of 18vaccines, medications, or other treatments to persons as 19necessary in order to prevent the probable spread of a 20dangerously contagious or infectious disease. A vaccine, 21medication, or other treatment to be administered must not be 22such as is reasonably likely to lead to serious harm to the 23affected individual. To prevent the spread of a dangerously 24contagious or infectious disease, the Department may, pursuant 25to the provisions of subsection (c) of this Section, isolate 26or quarantine persons who are unable or unwilling to receive

HB4640- 11 -LRB102 22205 CPF 31335 b 1vaccines, medications, or other treatments pursuant to this 2Section. An individual may refuse to receive vaccines, 3medications, or other treatments. An individual shall be given 4a written notice that shall include notice of the following: 5(i) that the individual may refuse to consent to vaccines, 6medications, or other treatments; (ii) that if the individual 7refuses to receive vaccines, medications, or other treatments, 8the individual may be subject to isolation or quarantine 9pursuant to the provisions of subsection (c) of this Section; 10and (iii) that if the individual refuses to receive vaccines, 11medications, or other treatments and becomes subject to 12isolation or quarantine as provided in this subsection (e), he 13or she shall have the right to counsel pursuant to the 14provisions of subsection (c) of this Section. To the extent 15feasible without endangering the public's health, the 16Department shall respect and accommodate the religious beliefs 17of individuals in implementing this subsection.18 (f) The Department may order observation and monitoring of 19persons to prevent the probable spread of a dangerously 20contagious or infectious disease. To prevent the spread of a 21dangerously contagious or infectious disease, the Department 22may, pursuant to the provisions of subsection (c) of this 23Section, isolate or quarantine persons whose refusal to 24undergo observation and monitoring results in uncertainty 25regarding whether he or she has been exposed to or is infected 26with a dangerously contagious or infectious disease or

HB4640- 12 -LRB102 22205 CPF 31335 b 1otherwise poses a danger to the public's health. An individual 2may refuse to undergo observation and monitoring. An 3individual shall be given written notice that shall include 4notice of the following: (i) that the individual may refuse to 5undergo observation and monitoring; (ii) that if the 6individual consents to observation and monitoring, the results 7of that observation and monitoring may subject the individual 8to isolation or quarantine pursuant to the provisions of 9subsection (c) of this Section; (iii) that if the individual 10refuses to undergo observation and monitoring and that refusal 11results in uncertainty regarding whether he or she has been 12exposed to or is infected with a dangerously contagious or 13infectious disease or otherwise poses a danger to the public's 14health, the individual may be subject to isolation or 15quarantine pursuant to the provisions of subsection (c) of 16this Section; and (iv) that if the individual refuses to 17undergo observation and monitoring and becomes subject to 18isolation or quarantine as provided in this subsection (f), he 19or she shall have the right to counsel pursuant to the 20provisions of subsection (c) of this Section.21 (g) To prevent the spread of a dangerously contagious or 22infectious disease among humans, the Department may examine, 23test, disinfect, seize, or destroy animals or other related 24property believed to be sources of infection. An owner of such 25animal or other related property shall be given written notice 26regarding such examination, testing, disinfection, seizure, or

HB4640- 13 -LRB102 22205 CPF 31335 b 1destruction. When the Department determines that any animal or 2related property is infected with or has been exposed to a 3dangerously contagious or infectious disease, it may agree 4with the owner upon the value of the animal or of any related 5property that it may be found necessary to destroy, and in case 6such an agreement cannot be made, the animals or related 7property shall be appraised by 3 competent and disinterested 8appraisers, one to be selected by the Department, one by the 9claimant, and one by the 2 appraisers thus selected. The 10appraisers shall subscribe to an oath made in writing to 11fairly value the animals or related property in accordance 12with the requirements of this Act. The oath, together with the 13valuation fixed by the appraisers, shall be filed with the 14Department and preserved by it. Upon the appraisal being made, 15the owner or the Department shall immediately destroy the 16animals by "humane euthanasia" as that term is defined in 17Section 2.09 of the Humane Care for Animals Act. Dogs and cats, 18however, shall be euthanized pursuant to the provisions of the 19Humane Euthanasia in Animal Shelters Act. The owner or the 20Department shall additionally, dispose of the carcasses, and 21disinfect, change, or destroy the premises occupied by the 22animals, in accordance with rules prescribed by the Department 23governing such destruction and disinfection. Upon his or her 24failure so to do or to cooperate with the Department, the 25Department shall cause the animals or related property to be 26destroyed and disposed of in the same manner, and thereupon

HB4640- 14 -LRB102 22205 CPF 31335 b 1the owner shall forfeit all right to receive any compensation 2for the destruction of the animals or related property. All 3final administrative decisions of the Department hereunder 4shall be subject to judicial review pursuant to the provisions 5of the Administrative Review Law, and all amendments and 6modifications thereof, and the rules adopted pursuant thereto. 7The term "administrative decision" is defined as in Section 83-101 of the Code of Civil Procedure. 9 (h) To prevent the spread of a dangerously contagious or 10infectious disease, the Department, local boards of health, 11and local public health authorities shall have emergency 12access to medical or health information or records or data 13upon the condition that the Department, local boards of 14health, and local public health authorities shall protect the 15privacy and confidentiality of any medical or health 16information or records or data obtained pursuant to this 17Section in accordance with federal and State law. Emergency 18access to medical or health information, records, or data 19shall include access to electronic health records, provided 20that the local public health authority shall be unable to 21alter the electronic health records. A person, facility, 22institution, or agency providing information under this 23subsection may withhold a patient's mental or behavioral 24health history. Additionally, any such medical or health 25information or records or data shall be exempt from inspection 26and copying under the Freedom of Information Act. Other than a

HB4640- 15 -LRB102 22205 CPF 31335 b 1hearing for the purpose of this Act, any information, records, 2reports, statements, notes, memoranda, or other data in the 3possession of the Department, local boards of health, or local 4public health authorities shall not be admissible as evidence, 5nor discoverable in any action of any kind in any court or 6before any tribunal, board, agency, or person. The access to 7or disclosure of any of this information or data by the 8Department, a local board of health, or a local public 9authority shall not waive or have any effect upon its 10non-discoverability or non-admissibility. Any person, 11facility, institution, or agency that provides emergency 12access to health information and data under this subsection 13shall have immunity from any civil or criminal liability, or 14any other type of liability that might otherwise result by 15reason of these actions except in the event of willful and 16wanton misconduct. The privileged quality of communication 17between any professional person or any facility shall not 18constitute grounds for failure to provide emergency access. 19Nothing in this subsection shall prohibit the sharing of 20information as authorized in Section 2.1 of this Act. The 21disclosure of any of this information, records, reports, 22statements, notes, memoranda, or other data obtained in any 23activity under this Act, except that necessary for the 24purposes of this Act, is unlawful, and any person convicted of 25violating this provision is guilty of a Class A misdemeanor. 26 (i) (A) The Department, in order to prevent and

HB4640- 16 -LRB102 22205 CPF 31335 b 1 control disease, injury, or disability among citizens of 2 the State of Illinois, may develop and implement, in 3 consultation with local public health authorities, a 4 Statewide system for syndromic data collection through the 5 access to interoperable networks, information exchanges, 6 and databases. The Department may also develop a system 7 for the reporting of comprehensive, integrated data to 8 identify and address unusual occurrences of disease 9 symptoms and other medical complexes affecting the 10 public's health.11 (B) The Department may enter into contracts or 12 agreements with individuals, corporations, hospitals, 13 universities, not-for-profit corporations, governmental 14 entities, or other organizations, whereby those 15 individuals or entities agree to provide assistance in the 16 compilation of the syndromic data collection and reporting 17 system. 18 (C) The Department shall not release any syndromic 19 data or information obtained pursuant to this subsection 20 to any individuals or entities for purposes other than the 21 protection of the public health. All access to data by the 22 Department, reports made to the Department, the identity 23 of or facts that would tend to lead to the identity of the 24 individual who is the subject of the report, and the 25 identity of or facts that would tend to lead to the 26 identity of the author of the report shall be strictly

HB4640- 17 -LRB102 22205 CPF 31335 b 1 confidential, are not subject to inspection or 2 dissemination, and shall be used only for public health 3 purposes by the Department, local public health 4 authorities, or the Centers for Disease Control and 5 Prevention. Entities or individuals submitting reports or 6 providing access to the Department shall not be held 7 liable for the release of information or confidential data 8 to the Department in accordance with this subsection. 9 (D) Nothing in this subsection prohibits the sharing 10 of information as authorized in Section 2.1 of this Act. 11 (j) This Section shall be considered supplemental to the 12existing authority and powers of the Department and shall not 13be construed to restrain or restrict the Department in 14protecting the public health under any other provisions of the 15law. 16 (k) Any person who knowingly or maliciously disseminates 17any false information or report concerning the existence of 18any dangerously contagious or infectious disease in connection 19with the Department's power of quarantine, isolation and 20closure or refuses to comply with a quarantine, isolation or 21closure order is guilty of a Class A misdemeanor. 22 (l) The Department of Public Health may establish and 23maintain a chemical and bacteriologic laboratory for the 24examination of water and wastes, and for the diagnosis of 25diphtheria, typhoid fever, tuberculosis, malarial fever and 26such other diseases as it deems necessary for the protection

HB4640- 18 -LRB102 22205 CPF 31335 b 1of the public health. 2 As used in this Act, "locality" means any governmental 3agency which exercises power pertaining to public health in an 4area less than the State. 5 The terms "sanitary investigations and inspections" and 6"sanitary practices" as used in this Act shall not include or 7apply to "Public Water Supplies" or "Sewage Works" as defined 8in the Environmental Protection Act. The Department may adopt 9rules that are reasonable and necessary to implement and 10effectuate this amendatory Act of the 93rd General Assembly. 11 (m) The public health measures set forth in subsections 12(a) through (h) of this Section may be used by the Department 13to respond to chemical, radiological, or nuclear agents or 14events. The individual provisions of subsections (a) through 15(h) of this Section apply to any order issued by the Department 16under this Section. The provisions of subsection (k) apply to 17chemical, radiological, or nuclear agents or events. Prior to 18the Department issuing an order for public health measures set 19forth in this Act for chemical, radiological, or nuclear 20agents or events as authorized in subsection (m), the 21Department and the Illinois Emergency Management Agency shall 22consult in accordance with the Illinois emergency response 23framework. When responding to chemical, radiological, or 24nuclear agents or events, the Department shall determine the 25health related risks and appropriate public health response 26measures and provide recommendations for response to the

HB4640- 19 -LRB102 22205 CPF 31335 b 1Illinois Emergency Management Agency. Nothing in this Section 2shall supersede the current National Incident Management 3System and the Illinois Emergency Operation Plan or response 4plans and procedures established pursuant to IEMA statutes. 5(Source: P.A. 96-698, eff. 8-25-09.) 6 Section 40. The Vital Records Act is amended by changing 7Section 24 as follows: 8 (410 ILCS 535/24) (from Ch. 111 1/2, par. 73-24) 9 Sec. 24. (1) To protect the integrity of vital records, to 10insure their proper use, and to insure the efficient and 11proper administration of the vital records system, access to 12vital records, and indexes thereof, including vital records in 13the custody of local registrars and county clerks originating 14prior to January 1, 1916, is limited to the custodian and his 15employees, and then only for administrative purposes, except 16that the indexes of those records in the custody of local 17registrars and county clerks, originating prior to January 1, 181916, shall be made available to persons for the purpose of 19genealogical research. Original, photographic or 20microphotographic reproductions of original records of births 21100 years old and older and deaths 50 years old and older, and 22marriage records 75 years old and older on file in the State 23Office of Vital Records and in the custody of the county clerks 24may be made available for inspection in the Illinois State

HB4640- 20 -LRB102 22205 CPF 31335 b 1Archives reference area, Illinois Regional Archives 2Depositories, and other libraries approved by the Illinois 3State Registrar and the Director of the Illinois State 4Archives, provided that the photographic or microphotographic 5copies are made at no cost to the county or to the State of 6Illinois. It is unlawful for any custodian to permit 7inspection of, or to disclose information contained in, vital 8records, or to copy or permit to be copied, all or part of any 9such record except as authorized by this Act or regulations 10adopted pursuant thereto. 11 (2) The State Registrar of Vital Records, or his agent, 12and any municipal, county, multi-county, public health 13district, or regional health officer recognized by the 14Department may examine vital records for the purpose only of 15carrying out the public health programs and responsibilities 16under his jurisdiction. 17 (3) The State Registrar of Vital Records, may disclose, or 18authorize the disclosure of, data contained in the vital 19records when deemed essential for bona fide research purposes 20which are not for private gain. 21 This amendatory Act of 1973 does not apply to any home rule 22unit. 23 (4) The State Registrar shall exchange with the Department 24of Healthcare and Family Services information that may be 25necessary for the establishment of paternity and the 26establishment, modification, and enforcement of child support

HB4640- 21 -LRB102 22205 CPF 31335 b 1orders entered pursuant to the Illinois Public Aid Code, the 2Illinois Marriage and Dissolution of Marriage Act, the 3Non-Support of Spouse and Children Act, the Non-Support 4Punishment Act, the Revised Uniform Reciprocal Enforcement of 5Support Act, the Uniform Interstate Family Support Act, the 6Illinois Parentage Act of 1984, or the Illinois Parentage Act 7of 2015. Notwithstanding any provisions in this Act to the 8contrary, the State Registrar shall not be liable to any 9person for any disclosure of information to the Department of 10Healthcare and Family Services (formerly Illinois Department 11of Public Aid) under this subsection or for any other action 12taken in good faith to comply with the requirements of this 13subsection.14 (5) No rule adopted by the Department shall be construed, 15either explicitly or implicitly, as restricting access to 16vital records by any municipality, county, multicounty, public 17health district, or regional health officer recognized by the 18Department for the purposes described in subsections (2) and 19(3). 20(Source: P.A. 99-85, eff. 1-1-16.) 21 Section 45. The Illinois Controlled Substances Act is 22amended by changing Section 318 as follows: 23 (720 ILCS 570/318) 24 Sec. 318. Confidentiality of information.

HB4640- 22 -LRB102 22205 CPF 31335 b 1 (a) Information received by the central repository under 2Section 316 and former Section 321 is confidential. 3 (a-1) To ensure the federal Health Insurance Portability 4and Accountability Act privacy of an individual's prescription 5data reported to the Prescription Monitoring Program received 6from a retail dispenser under this Act, and in order to execute 7the duties and responsibilities under Section 316 of this Act 8and rules for disclosure under this Section, the Clinical 9Director of the Prescription Monitoring Program or his or her 10designee shall maintain direct access to all Prescription 11Monitoring Program data. Any request for Prescription 12Monitoring Program data from any other department or agency 13must be approved in writing by the Clinical Director of the 14Prescription Monitoring Program or his or her designee unless 15otherwise permitted by law. Prescription Monitoring Program 16data shall only be disclosed as permitted by law. 17 (a-2) As an active step to address the current opioid 18crisis in this State and to prevent and reduce addiction 19resulting from a sports injury or an accident, the 20Prescription Monitoring Program and the Department of Public 21Health shall coordinate a continuous review of the 22Prescription Monitoring Program and the Department of Public 23Health data to determine if a patient may be at risk of opioid 24addiction. Each patient discharged from any medical facility 25with an International Classification of Disease, 10th edition 26code related to a sport or accident injury shall be subject to

HB4640- 23 -LRB102 22205 CPF 31335 b 1the data review. If the discharged patient is dispensed a 2controlled substance, the Prescription Monitoring Program 3shall alert the patient's prescriber as to the addiction risk 4and urge each to follow the Centers for Disease Control and 5Prevention guidelines or his or her respective profession's 6treatment guidelines related to the patient's injury. This 7subsection (a-2), other than this sentence, is inoperative on 8or after January 1, 2024. 9 (b) The Department must carry out a program to protect the 10confidentiality of the information described in subsection 11(a). The Department may disclose the information to another 12person only under subsection (c), (d), or (f) and may charge a 13fee not to exceed the actual cost of furnishing the 14information. 15 (c) The Department may disclose confidential information 16described in subsection (a) to any person who is engaged in 17receiving, processing, or storing the information. 18 (d) The Department may release confidential information 19described in subsection (a) to the following persons: 20 (1) A governing body that licenses practitioners and 21 is engaged in an investigation, an adjudication, or a 22 prosecution of a violation under any State or federal law 23 that involves a controlled substance. 24 (2) An investigator for the Consumer Protection 25 Division of the office of the Attorney General, a 26 prosecuting attorney, the Attorney General, a deputy

HB4640- 24 -LRB102 22205 CPF 31335 b 1 Attorney General, or an investigator from the office of 2 the Attorney General, who is engaged in any of the 3 following activities involving controlled substances: 4 (A) an investigation; 5 (B) an adjudication; or 6 (C) a prosecution of a violation under any State 7 or federal law that involves a controlled substance. 8 (3) A law enforcement officer who is: 9 (A) authorized by the Illinois State Police or the 10 office of a county sheriff or State's Attorney or 11 municipal police department of Illinois to receive 12 information of the type requested for the purpose of 13 investigations involving controlled substances; or 14 (B) approved by the Department to receive 15 information of the type requested for the purpose of 16 investigations involving controlled substances; and 17 (C) engaged in the investigation or prosecution of 18 a violation under any State or federal law that 19 involves a controlled substance. 20 (4) Select representatives of the Department of 21 Children and Family Services through the indirect online 22 request process. Access shall be established by an 23 intergovernmental agreement between the Department of 24 Children and Family Services and the Department of Human 25 Services. 26 (5) A certified local health department engaged in the

HB4640- 25 -LRB102 22205 CPF 31335 b 1 performance of epidemiological studies, the application of 2 data science methods, or other analytic models that 3 protect and promote public health. 4 (e) Except in the case of release under paragraph (5) of 5subsection (d) of confidential information to a certified 6local health department for the purpose of the performance of 7epidemiological studies, the application of data science 8methods, or other analytic models that protect and promote 9public health, before Before the Department releases 10confidential information under subsection (d), the applicant 11must demonstrate in writing to the Department that: 12 (1) the applicant has reason to believe that a 13 violation under any State or federal law that involves a 14 controlled substance has occurred; and 15 (2) the requested information is reasonably related to 16 the investigation, adjudication, or prosecution of the 17 violation described in subdivision (1). 18 (f) The Department may receive and release prescription 19record information under Section 316 and former Section 321 20to: 21 (1) a governing body that licenses practitioners; 22 (2) an investigator for the Consumer Protection 23 Division of the office of the Attorney General, a 24 prosecuting attorney, the Attorney General, a deputy 25 Attorney General, or an investigator from the office of 26 the Attorney General;

HB4640- 26 -LRB102 22205 CPF 31335 b 1 (3) any Illinois law enforcement officer who is: 2 (A) authorized to receive the type of information 3 released; and 4 (B) approved by the Department to receive the type 5 of information released; or 6 (4) prescription monitoring entities in other states 7 per the provisions outlined in subsection (g) and (h) 8 below; 9confidential prescription record information collected under 10Sections 316 and 321 (now repealed) that identifies vendors or 11practitioners, or both, who are prescribing or dispensing 12large quantities of Schedule II, III, IV, or V controlled 13substances outside the scope of their practice, pharmacy, or 14business, as determined by the Advisory Committee created by 15Section 320. 16 (g) The information described in subsection (f) may not be 17released until it has been reviewed by an employee of the 18Department who is licensed as a prescriber or a dispenser and 19until that employee has certified that further investigation 20is warranted. However, failure to comply with this subsection 21(g) does not invalidate the use of any evidence that is 22otherwise admissible in a proceeding described in subsection 23(h). 24 (h) An investigator or a law enforcement officer receiving 25confidential information under subsection (c), (d), or (f) may 26disclose the information to a law enforcement officer or an

HB4640- 27 -LRB102 22205 CPF 31335 b 1attorney for the office of the Attorney General for use as 2evidence in the following: 3 (1) A proceeding under any State or federal law that 4 involves a controlled substance. 5 (2) A criminal proceeding or a proceeding in juvenile 6 court that involves a controlled substance. 7 (i) The Department may compile statistical reports from 8the information described in subsection (a). The reports must 9not include information that identifies, by name, license or 10address, any practitioner, dispenser, ultimate user, or other 11person administering a controlled substance. 12 (j) Based upon federal, initial and maintenance funding, a 13prescriber and dispenser inquiry system shall be developed to 14assist the health care community in its goal of effective 15clinical practice and to prevent patients from diverting or 16abusing medications. 17 (1) An inquirer shall have read-only access to a 18 stand-alone database which shall contain records for the 19 previous 12 months.20 (2) Dispensers may, upon positive and secure 21 identification, make an inquiry on a patient or customer 22 solely for a medical purpose as delineated within the 23 federal HIPAA law.24 (3) The Department shall provide a one-to-one secure 25 link and encrypted software necessary to establish the 26 link between an inquirer and the Department. Technical

HB4640- 28 -LRB102 22205 CPF 31335 b 1 assistance shall also be provided.2 (4) Written inquiries are acceptable but must include 3 the fee and the requestor's Drug Enforcement 4 Administration license number and submitted upon the 5 requestor's business stationery.6 (5) As directed by the Prescription Monitoring Program 7 Advisory Committee and the Clinical Director for the 8 Prescription Monitoring Program, aggregate data that does 9 not indicate any prescriber, practitioner, dispenser, or 10 patient may be used for clinical studies.11 (6) Tracking analysis shall be established and used 12 per administrative rule.13 (7) Nothing in this Act or Illinois law shall be 14 construed to require a prescriber or dispenser to make use 15 of this inquiry system. 16 (8) If there is an adverse outcome because of a 17 prescriber or dispenser making an inquiry, which is 18 initiated in good faith, the prescriber or dispenser shall 19 be held harmless from any civil liability. 20 (k) The Department shall establish, by rule, the process 21by which to evaluate possible erroneous association of 22prescriptions to any licensed prescriber or end user of the 23Illinois Prescription Information Library (PIL).24 (l) The Prescription Monitoring Program Advisory Committee 25is authorized to evaluate the need for and method of 26establishing a patient specific identifier.

HB4640- 29 -LRB102 22205 CPF 31335 b 1 (m) Patients who identify prescriptions attributed to them 2that were not obtained by them shall be given access to their 3personal prescription history pursuant to the validation 4process as set forth by administrative rule.5 (n) The Prescription Monitoring Program is authorized to 6develop operational push reports to entities with compatible 7electronic medical records. The process shall be covered 8within administrative rule established by the Department.9 (o) Hospital emergency departments and freestanding 10healthcare facilities providing healthcare to walk-in patients 11may obtain, for the purpose of improving patient care, a 12unique identifier for each shift to utilize the PIL system. 13 (p) The Prescription Monitoring Program shall 14automatically create a log-in to the inquiry system when a 15prescriber or dispenser obtains or renews his or her 16controlled substance license. The Department of Financial and 17Professional Regulation must provide the Prescription 18Monitoring Program with electronic access to the license 19information of a prescriber or dispenser to facilitate the 20creation of this profile. The Prescription Monitoring Program 21shall send the prescriber or dispenser information regarding 22the inquiry system, including instructions on how to log into 23the system, instructions on how to use the system to promote 24effective clinical practice, and opportunities for continuing 25education for the prescribing of controlled substances. The 26Prescription Monitoring Program shall also send to all

HB4640- 30 -LRB102 22205 CPF 31335 b 1enrolled prescribers, dispensers, and designees information 2regarding the unsolicited reports produced pursuant to Section 3314.5 of this Act. 4 (q) A prescriber or dispenser may authorize a designee to 5consult the inquiry system established by the Department under 6this subsection on his or her behalf, provided that all the 7following conditions are met: 8 (1) the designee so authorized is employed by the same 9 hospital or health care system; is employed by the same 10 professional practice; or is under contract with such 11 practice, hospital, or health care system; 12 (2) the prescriber or dispenser takes reasonable steps 13 to ensure that such designee is sufficiently competent in 14 the use of the inquiry system; 15 (3) the prescriber or dispenser remains responsible 16 for ensuring that access to the inquiry system by the 17 designee is limited to authorized purposes and occurs in a 18 manner that protects the confidentiality of the 19 information obtained from the inquiry system, and remains 20 responsible for any breach of confidentiality; and 21 (4) the ultimate decision as to whether or not to 22 prescribe or dispense a controlled substance remains with 23 the prescriber or dispenser.24 The Prescription Monitoring Program shall send to 25registered designees information regarding the inquiry system, 26including instructions on how to log onto the system.

HB4640- 31 -LRB102 22205 CPF 31335 b 1 (r) The Prescription Monitoring Program shall maintain an 2Internet website in conjunction with its prescriber and 3dispenser inquiry system. This website shall include, at a 4minimum, the following information: 5 (1) current clinical guidelines developed by health 6 care professional organizations on the prescribing of 7 opioids or other controlled substances as determined by 8 the Advisory Committee;9 (2) accredited continuing education programs related 10 to prescribing of controlled substances; 11 (3) programs or information developed by health care 12 professionals that may be used to assess patients or help 13 ensure compliance with prescriptions;14 (4) updates from the Food and Drug Administration, the 15 Centers for Disease Control and Prevention, and other 16 public and private organizations which are relevant to 17 prescribing;18 (5) relevant medical studies related to prescribing;19 (6) other information regarding the prescription of 20 controlled substances; and21 (7) information regarding prescription drug disposal 22 events, including take-back programs or other disposal 23 options or events. 24 The content of the Internet website shall be periodically 25reviewed by the Prescription Monitoring Program Advisory 26Committee as set forth in Section 320 and updated in

HB4640- 32 -LRB102 22205 CPF 31335 b 1accordance with the recommendation of the advisory committee. 2 (s) The Prescription Monitoring Program shall regularly 3send electronic updates to the registered users of the 4Program. The Prescription Monitoring Program Advisory 5Committee shall review any communications sent to registered 6users and also make recommendations for communications as set 7forth in Section 320. These updates shall include the 8following information: 9 (1) opportunities for accredited continuing education 10 programs related to prescribing of controlled substances;11 (2) current clinical guidelines developed by health 12 care professional organizations on the prescribing of 13 opioids or other drugs as determined by the Advisory 14 Committee;15 (3) programs or information developed by health care 16 professionals that may be used to assess patients or help 17 ensure compliance with prescriptions;18 (4) updates from the Food and Drug Administration, the 19 Centers for Disease Control and Prevention, and other 20 public and private organizations which are relevant to 21 prescribing;22 (5) relevant medical studies related to prescribing;23 (6) other information regarding prescribing of 24 controlled substances;25 (7) information regarding prescription drug disposal 26 events, including take-back programs or other disposal

HB4640- 33 -LRB102 22205 CPF 31335 b 1 options or events; and2 (8) reminders that the Prescription Monitoring Program 3 is a useful clinical tool. 4(Source: P.A. 99-480, eff. 9-9-15; 100-125, eff. 1-1-18; 5100-1093, eff. 8-26-18.)