97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB3776

 

Introduced , by Rep. David Harris

 

SYNOPSIS AS INTRODUCED:
 
See Index

    Amends the Illinois Health Facilities Planning Act. Provides that beginning on the effective date of the amendatory Act the Health Facilities and Services Review Board is hereby dissolved and the terms of its members shall cease. Amends various Acts to make corresponding changes. Effective on on July 1, 2012.


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A BILL FOR

 

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1    AN ACT concerning health facilities.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Open Meetings Act is amended by changing
5Section 1.02 as follows:
 
6    (5 ILCS 120/1.02)  (from Ch. 102, par. 41.02)
7    Sec. 1.02. For the purposes of this Act:
8    "Meeting" means any gathering, whether in person or by
9video or audio conference, telephone call, electronic means
10(such as, without limitation, electronic mail, electronic
11chat, and instant messaging), or other means of contemporaneous
12interactive communication, of a majority of a quorum of the
13members of a public body held for the purpose of discussing
14public business or, for a 5-member public body, a quorum of the
15members of a public body held for the purpose of discussing
16public business.
17    Accordingly, for a 5-member public body, 3 members of the
18body constitute a quorum and the affirmative vote of 3 members
19is necessary to adopt any motion, resolution, or ordinance,
20unless a greater number is otherwise required.
21    "Public body" includes all legislative, executive,
22administrative or advisory bodies of the State, counties,
23townships, cities, villages, incorporated towns, school

 

 

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1districts and all other municipal corporations, boards,
2bureaus, committees or commissions of this State, and any
3subsidiary bodies of any of the foregoing including but not
4limited to committees and subcommittees which are supported in
5whole or in part by tax revenue, or which expend tax revenue,
6except the General Assembly and committees or commissions
7thereof. "Public body" includes tourism boards and convention
8or civic center boards located in counties that are contiguous
9to the Mississippi River with populations of more than 250,000
10but less than 300,000. "Public body" includes the Health
11Facilities and Services Review Board. "Public body" does not
12include a child death review team or the Illinois Child Death
13Review Teams Executive Council established under the Child
14Death Review Team Act or an ethics commission acting under the
15State Officials and Employees Ethics Act.
16(Source: P.A. 95-245, eff. 8-17-07; 96-31, eff. 6-30-09.)
 
17    Section 10. The State Officials and Employees Ethics Act is
18amended by changing Section 5-50 as follows:
 
19    (5 ILCS 430/5-50)
20    Sec. 5-50. Ex parte communications; special government
21agents.
22    (a) This Section applies to ex parte communications made to
23any agency listed in subsection (e).
24    (b) "Ex parte communication" means any written or oral

 

 

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1communication by any person that imparts or requests material
2information or makes a material argument regarding potential
3action concerning regulatory, quasi-adjudicatory, investment,
4or licensing matters pending before or under consideration by
5the agency. "Ex parte communication" does not include the
6following: (i) statements by a person publicly made in a public
7forum; (ii) statements regarding matters of procedure and
8practice, such as format, the number of copies required, the
9manner of filing, and the status of a matter; and (iii)
10statements made by a State employee of the agency to the agency
11head or other employees of that agency.
12    (b-5) An ex parte communication received by an agency,
13agency head, or other agency employee from an interested party
14or his or her official representative or attorney shall
15promptly be memorialized and made a part of the record.
16    (c) An ex parte communication received by any agency,
17agency head, or other agency employee, other than an ex parte
18communication described in subsection (b-5), shall immediately
19be reported to that agency's ethics officer by the recipient of
20the communication and by any other employee of that agency who
21responds to the communication. The ethics officer shall require
22that the ex parte communication be promptly made a part of the
23record. The ethics officer shall promptly file the ex parte
24communication with the Executive Ethics Commission, including
25all written communications, all written responses to the
26communications, and a memorandum prepared by the ethics officer

 

 

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1stating the nature and substance of all oral communications,
2the identity and job title of the person to whom each
3communication was made, all responses made, the identity and
4job title of the person making each response, the identity of
5each person from whom the written or oral ex parte
6communication was received, the individual or entity
7represented by that person, any action the person requested or
8recommended, and any other pertinent information. The
9disclosure shall also contain the date of any ex parte
10communication.
11    (d) "Interested party" means a person or entity whose
12rights, privileges, or interests are the subject of or are
13directly affected by a regulatory, quasi-adjudicatory,
14investment, or licensing matter.
15    (e) This Section applies to the following agencies:
16Executive Ethics Commission
17Illinois Commerce Commission
18Educational Labor Relations Board
19State Board of Elections
20Illinois Gaming Board
21Health Facilities and Services Review Board 
22Illinois Workers' Compensation Commission
23Illinois Labor Relations Board
24Illinois Liquor Control Commission
25Pollution Control Board
26Property Tax Appeal Board

 

 

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1Illinois Racing Board
2Illinois Purchased Care Review Board
3Department of State Police Merit Board
4Motor Vehicle Review Board
5Prisoner Review Board
6Civil Service Commission
7Personnel Review Board for the Treasurer
8Merit Commission for the Secretary of State
9Merit Commission for the Office of the Comptroller
10Court of Claims
11Board of Review of the Department of Employment Security
12Department of Insurance
13Department of Professional Regulation and licensing boards
14  under the Department
15Department of Public Health and licensing boards under the
16  Department
17Office of Banks and Real Estate and licensing boards under
18  the Office
19State Employees Retirement System Board of Trustees
20Judges Retirement System Board of Trustees
21General Assembly Retirement System Board of Trustees
22Illinois Board of Investment
23State Universities Retirement System Board of Trustees
24Teachers Retirement System Officers Board of Trustees
25    (f) Any person who fails to (i) report an ex parte
26communication to an ethics officer, (ii) make information part

 

 

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1of the record, or (iii) make a filing with the Executive Ethics
2Commission as required by this Section or as required by
3Section 5-165 of the Illinois Administrative Procedure Act
4violates this Act.
5(Source: P.A. 95-331, eff. 8-21-07; 96-31, eff. 6-30-09.)
 
6    Section 15. The Department of Public Health Powers and
7Duties Law of the Civil Administrative Code of Illinois is
8amended by changing Section 2310-217 as follows:
 
9    (20 ILCS 2310/2310-217)
10    Sec. 2310-217. Center for Comprehensive Health Planning.
11    (a) The Center for Comprehensive Health Planning
12("Center") is hereby created to promote the distribution of
13health care services and improve the healthcare delivery system
14in Illinois by establishing a statewide Comprehensive Health
15Plan and ensuring a predictable, transparent, and efficient
16Certificate of Need process under the Illinois Health
17Facilities Planning Act. The objectives of the Comprehensive
18Health Plan include: to assess existing community resources and
19determine health care needs; to support safety net services for
20uninsured and underinsured residents; to promote adequate
21financing for health care services; and to recognize and
22respond to changes in community health care needs, including
23public health emergencies and natural disasters. The Center
24shall comprehensively assess health and mental health

 

 

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1services; assess health needs with a special focus on the
2identification of health disparities; identify State-level and
3regional needs; and make findings that identify the impact of
4market forces on the access to high quality services for
5uninsured and underinsured residents. The Center shall conduct
6a biennial comprehensive assessment of health resources and
7service needs, including, but not limited to, facilities,
8clinical services, and workforce; conduct needs assessments
9using key indicators of population health status and
10determinations of potential benefits that could occur with
11certain changes in the health care delivery system; collect and
12analyze relevant, objective, and accurate data, including
13health care utilization data; identify issues related to health
14care financing such as revenue streams, federal opportunities,
15better utilization of existing resources, development of
16resources, and incentives for new resource development;
17evaluate findings by the needs assessments; and annually report
18to the General Assembly and the public.
19    The Illinois Department of Public Health shall establish a
20Center for Comprehensive Health Planning to develop a
21long-range Comprehensive Health Plan, which Plan shall guide
22the development of clinical services, facilities, and
23workforce that meet the health and mental health care needs of
24this State.
25    (b) Center for Comprehensive Health Planning.
26        (1) Responsibilities and duties of the Center include:

 

 

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1            (A) (Blank); providing technical assistance to the
2        Health Facilities and Services Review Board to permit
3        that Board to apply relevant components of the
4        Comprehensive Health Plan in its deliberations;
5            (B) attempting to identify unmet health needs and
6        assist in any inter-agency State planning for health
7        resource development;
8            (C) considering health plans and other related
9        publications that have been developed in Illinois and
10        nationally;
11            (D) establishing priorities and recommend methods
12        for meeting identified health service, facilities, and
13        workforce needs. Plan recommendations shall be
14        short-term, mid-term, and long-range;
15            (E) conducting an analysis regarding the
16        availability of long-term care resources throughout
17        the State, using data and plans developed under the
18        Illinois Older Adult Services Act, to adjust existing
19        bed need criteria and standards under the Health
20        Facilities Planning Act for changes in utilization of
21        institutional and non-institutional care options, with
22        special consideration of the availability of the
23        least-restrictive options in accordance with the needs
24        and preferences of persons requiring long-term care;
25        and
26            (F) considering and recognizing health resource

 

 

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1        development projects or information on methods by
2        which a community may receive benefit, that are
3        consistent with health resource needs identified
4        through the comprehensive health planning process.
5        (2) A Comprehensive Health Planner shall be appointed
6    by the Governor, with the advice and consent of the Senate,
7    to supervise the Center and its staff for a paid 3-year
8    term, subject to review and re-approval every 3 years. The
9    Planner shall receive an annual salary of $120,000, or an
10    amount set by the Compensation Review Board, whichever is
11    greater. The Planner shall prepare a budget for review and
12    approval by the Illinois General Assembly, which shall
13    become part of the annual report available on the
14    Department website.
15    (c) Comprehensive Health Plan.
16        (1) The Plan shall be developed with a 5 to 10 year
17    range, and updated every 2 years, or annually, if needed.
18        (2) Components of the Plan shall include:
19            (A) an inventory to map the State for growth,
20        population shifts, and utilization of available
21        healthcare resources, using both State-level and
22        regionally defined areas;
23            (B) an evaluation of health service needs,
24        addressing gaps in service, over-supply, and
25        continuity of care, including an assessment of
26        existing safety net services;

 

 

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1            (C) an inventory of health care facility
2        infrastructure, including regulated facilities and
3        services, and unregulated facilities and services, as
4        determined by the Center;
5            (D) recommendations on ensuring access to care,
6        especially for safety net services, including rural
7        and medically underserved communities; and
8            (E) an integration between health planning for
9        clinical services, facilities and workforce under the
10        Illinois Health Facilities Planning Act and other
11        health planning laws and activities of the State.
12        (3) Components of the Plan may include recommendations
13    that will be integrated into any relevant certificate of
14    need review criteria, standards, and procedures.
15    (d) Within 60 days of receiving the Comprehensive Health
16Plan, the State Board of Health shall review and comment upon
17the Plan and any policy change recommendations. The first Plan
18shall be submitted to the State Board of Health within one year
19after hiring the Comprehensive Health Planner. The Plan shall
20be submitted to the General Assembly by the following March 1.
21The Center and State Board shall hold public hearings on the
22Plan and its updates. The Center shall permit the public to
23request the Plan to be updated more frequently to address
24emerging population and demographic trends.
25    (e) Current comprehensive health planning data and
26information about Center funding shall be available to the

 

 

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1public on the Department website.
2    (f) The Department shall submit to a performance audit of
3the Center by the Auditor General in order to assess whether
4progress is being made to develop a Comprehensive Health Plan
5and whether resources are sufficient to meet the goals of the
6Center for Comprehensive Health Planning.
7(Source: P.A. 96-31, eff. 6-30-09.)
 
8    Section 20. The Illinois Health Facilities Planning Act is
9amended by changing Sections 2, 3, 8.5, and 19.5 and by adding
10Section 2.5 as follows:
 
11    (20 ILCS 3960/2)  (from Ch. 111 1/2, par. 1152)
12    (Section scheduled to be repealed on December 31, 2019)
13    Sec. 2. Purpose of the Act. This Act shall establish a
14procedure (1) which requires a person establishing,
15constructing or modifying a health care facility, as herein
16defined, to have the qualifications, background, character and
17financial resources to adequately provide a proper service for
18the community; (2) that promotes, through the process of
19comprehensive health planning, the orderly and economic
20development of health care facilities in the State of Illinois
21that avoids unnecessary duplication of such facilities; (3)
22that promotes planning for and development of health care
23facilities needed for comprehensive health care especially in
24areas where the health planning process has identified unmet

 

 

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1needs; and (4) that carries out these purposes in coordination
2with the Center for Comprehensive Health Planning and the
3Comprehensive Health Plan developed by that Center.
4    The changes made to this Act by this amendatory Act of the
596th General Assembly are intended to accomplish the following
6objectives: to improve the financial ability of the public to
7obtain necessary health services; to establish an orderly and
8comprehensive health care delivery system that will guarantee
9the availability of quality health care to the general public;
10to maintain and improve the provision of essential health care
11services and increase the accessibility of those services to
12the medically underserved and indigent; to assure that the
13reduction and closure of health care services or facilities is
14performed in an orderly and timely manner, and that these
15actions are deemed to be in the best interests of the public;
16and to assess the financial burden to patients caused by
17unnecessary health care construction and modification. The
18Health Facilities and Services Review Board must apply the
19findings from the Comprehensive Health Plan to update review
20standards and criteria, as well as better identify needs and
21evaluate applications, and establish mechanisms to support
22adequate financing of the health care delivery system in
23Illinois, for the development and preservation of safety net
24services. The Board must provide written and consistent
25decisions that are based on the findings from the Comprehensive
26Health Plan, as well as other issue or subject specific plans,

 

 

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1recommended by the Center for Comprehensive Health Planning.
2Policies and procedures must include criteria and standards for
3plan variations and deviations that must be updated.
4Evidence-based assessments, projections and decisions will be
5applied regarding capacity, quality, value and equity in the
6delivery of health care services in Illinois. The integrity of
7the Certificate of Need process is ensured through revised
8ethics and communications procedures. Cost containment and
9support for safety net services must continue to be central
10tenets of the Certificate of Need process.
11(Source: P.A. 96-31, eff. 6-30-09.)
 
12    (20 ILCS 3960/2.5 new)
13    Sec. 2.5. Dissolution; Health Facilities and Services
14Review Board. Beginning on the effective date of this
15amendatory Act of the 97th General Assembly the Health
16Facilities and Services Review Board is hereby dissolved and
17the terms of its members shall cease.
 
18    (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
19    (Section scheduled to be repealed on December 31, 2019)
20    Sec. 3. Definitions. As used in this Act:
21    "Health care facilities" means and includes the following
22facilities and organizations:
23        1. An ambulatory surgical treatment center required to
24    be licensed pursuant to the Ambulatory Surgical Treatment

 

 

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1    Center Act;
2        2. An institution, place, building, or agency required
3    to be licensed pursuant to the Hospital Licensing Act;
4        3. Skilled and intermediate long term care facilities
5    licensed under the Nursing Home Care Act;
6        3.5. Skilled and intermediate care facilities licensed
7    under the MR/DD Community Care Act;
8        4. Hospitals, nursing homes, ambulatory surgical
9    treatment centers, or kidney disease treatment centers
10    maintained by the State or any department or agency
11    thereof;
12        5. Kidney disease treatment centers, including a
13    free-standing hemodialysis unit required to be licensed
14    under the End Stage Renal Disease Facility Act;
15        6. An institution, place, building, or room used for
16    the performance of outpatient surgical procedures that is
17    leased, owned, or operated by or on behalf of an
18    out-of-state facility;
19        7. An institution, place, building, or room used for
20    provision of a health care category of service as defined
21    by the Board, including, but not limited to, cardiac
22    catheterization and open heart surgery; and
23        8. An institution, place, building, or room used for
24    provision of major medical equipment used in the direct
25    clinical diagnosis or treatment of patients, and whose
26    project cost is in excess of the capital expenditure

 

 

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1    minimum.
2    This Act shall not apply to the construction of any new
3facility or the renovation of any existing facility located on
4any campus facility as defined in Section 5-5.8b of the
5Illinois Public Aid Code, provided that the campus facility
6encompasses 30 or more contiguous acres and that the new or
7renovated facility is intended for use by a licensed
8residential facility.
9    No federally owned facility shall be subject to the
10provisions of this Act, nor facilities used solely for healing
11by prayer or spiritual means.
12    No facility licensed under the Supportive Residences
13Licensing Act or the Assisted Living and Shared Housing Act
14shall be subject to the provisions of this Act.
15    No facility established and operating under the
16Alternative Health Care Delivery Act as a children's respite
17care center alternative health care model demonstration
18program or as an Alzheimer's Disease Management Center
19alternative health care model demonstration program shall be
20subject to the provisions of this Act.
21    A facility designated as a supportive living facility that
22is in good standing with the program established under Section
235-5.01a of the Illinois Public Aid Code shall not be subject to
24the provisions of this Act.
25    This Act does not apply to facilities granted waivers under
26Section 3-102.2 of the Nursing Home Care Act. However, if a

 

 

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1demonstration project under that Act applies for a certificate
2of need to convert to a nursing facility, it shall meet the
3licensure and certificate of need requirements in effect as of
4the date of application.
5    This Act does not apply to a dialysis facility that
6provides only dialysis training, support, and related services
7to individuals with end stage renal disease who have elected to
8receive home dialysis. This Act does not apply to a dialysis
9unit located in a licensed nursing home that offers or provides
10dialysis-related services to residents with end stage renal
11disease who have elected to receive home dialysis within the
12nursing home. The Board, however, may require these dialysis
13facilities and licensed nursing homes to report statistical
14information on a quarterly basis to the Board to be used by the
15Board to conduct analyses on the need for proposed kidney
16disease treatment centers.
17    This Act shall not apply to the closure of an entity or a
18portion of an entity licensed under the Nursing Home Care Act
19or the MR/DD Community Care Act, with the exceptions of
20facilities operated by a county or Illinois Veterans Homes,
21that elects to convert, in whole or in part, to an assisted
22living or shared housing establishment licensed under the
23Assisted Living and Shared Housing Act.
24    This Act does not apply to any change of ownership of a
25healthcare facility that is licensed under the Nursing Home
26Care Act or the MR/DD Community Care Act, with the exceptions

 

 

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1of facilities operated by a county or Illinois Veterans Homes.
2Changes of ownership of facilities licensed under the Nursing
3Home Care Act must meet the requirements set forth in Sections
43-101 through 3-119 of the Nursing Home Care Act.
5    With the exception of those health care facilities
6specifically included in this Section, nothing in this Act
7shall be intended to include facilities operated as a part of
8the practice of a physician or other licensed health care
9professional, whether practicing in his individual capacity or
10within the legal structure of any partnership, medical or
11professional corporation, or unincorporated medical or
12professional group. Further, this Act shall not apply to
13physicians or other licensed health care professional's
14practices where such practices are carried out in a portion of
15a health care facility under contract with such health care
16facility by a physician or by other licensed health care
17professionals, whether practicing in his individual capacity
18or within the legal structure of any partnership, medical or
19professional corporation, or unincorporated medical or
20professional groups. This Act shall apply to construction or
21modification and to establishment by such health care facility
22of such contracted portion which is subject to facility
23licensing requirements, irrespective of the party responsible
24for such action or attendant financial obligation.
25    "Person" means any one or more natural persons, legal
26entities, governmental bodies other than federal, or any

 

 

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1combination thereof.
2    "Consumer" means any person other than a person (a) whose
3major occupation currently involves or whose official capacity
4within the last 12 months has involved the providing,
5administering or financing of any type of health care facility,
6(b) who is engaged in health research or the teaching of
7health, (c) who has a material financial interest in any
8activity which involves the providing, administering or
9financing of any type of health care facility, or (d) who is or
10ever has been a member of the immediate family of the person
11defined by (a), (b), or (c).
12    "State Board" or "Board" means the Health Facilities and
13Services Review Board.
14    "Construction or modification" means the establishment,
15erection, building, alteration, reconstruction, modernization,
16improvement, extension, discontinuation, change of ownership,
17of or by a health care facility, or the purchase or acquisition
18by or through a health care facility of equipment or service
19for diagnostic or therapeutic purposes or for facility
20administration or operation, or any capital expenditure made by
21or on behalf of a health care facility which exceeds the
22capital expenditure minimum; however, any capital expenditure
23made by or on behalf of a health care facility for (i) the
24construction or modification of a facility licensed under the
25Assisted Living and Shared Housing Act or (ii) a conversion
26project undertaken in accordance with Section 30 of the Older

 

 

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1Adult Services Act shall be excluded from any obligations under
2this Act.
3    "Establish" means the construction of a health care
4facility or the replacement of an existing facility on another
5site or the initiation of a category of service as defined by
6the Board.
7    "Major medical equipment" means medical equipment which is
8used for the provision of medical and other health services and
9which costs in excess of the capital expenditure minimum,
10except that such term does not include medical equipment
11acquired by or on behalf of a clinical laboratory to provide
12clinical laboratory services if the clinical laboratory is
13independent of a physician's office and a hospital and it has
14been determined under Title XVIII of the Social Security Act to
15meet the requirements of paragraphs (10) and (11) of Section
161861(s) of such Act. In determining whether medical equipment
17has a value in excess of the capital expenditure minimum, the
18value of studies, surveys, designs, plans, working drawings,
19specifications, and other activities essential to the
20acquisition of such equipment shall be included.
21    "Capital Expenditure" means an expenditure: (A) made by or
22on behalf of a health care facility (as such a facility is
23defined in this Act); and (B) which under generally accepted
24accounting principles is not properly chargeable as an expense
25of operation and maintenance, or is made to obtain by lease or
26comparable arrangement any facility or part thereof or any

 

 

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1equipment for a facility or part; and which exceeds the capital
2expenditure minimum.
3    For the purpose of this paragraph, the cost of any studies,
4surveys, designs, plans, working drawings, specifications, and
5other activities essential to the acquisition, improvement,
6expansion, or replacement of any plant or equipment with
7respect to which an expenditure is made shall be included in
8determining if such expenditure exceeds the capital
9expenditures minimum. Unless otherwise interdependent, or
10submitted as one project by the applicant, components of
11construction or modification undertaken by means of a single
12construction contract or financed through the issuance of a
13single debt instrument shall not be grouped together as one
14project. Donations of equipment or facilities to a health care
15facility which if acquired directly by such facility would be
16subject to review under this Act shall be considered capital
17expenditures, and a transfer of equipment or facilities for
18less than fair market value shall be considered a capital
19expenditure for purposes of this Act if a transfer of the
20equipment or facilities at fair market value would be subject
21to review.
22    "Capital expenditure minimum" means $11,500,000 for
23projects by hospital applicants, $6,500,000 for applicants for
24projects related to skilled and intermediate care long-term
25care facilities licensed under the Nursing Home Care Act, and
26$3,000,000 for projects by all other applicants, which shall be

 

 

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1annually adjusted to reflect the increase in construction costs
2due to inflation, for major medical equipment and for all other
3capital expenditures.
4    "Non-clinical service area" means an area (i) for the
5benefit of the patients, visitors, staff, or employees of a
6health care facility and (ii) not directly related to the
7diagnosis, treatment, or rehabilitation of persons receiving
8services from the health care facility. "Non-clinical service
9areas" include, but are not limited to, chapels; gift shops;
10news stands; computer systems; tunnels, walkways, and
11elevators; telephone systems; projects to comply with life
12safety codes; educational facilities; student housing;
13patient, employee, staff, and visitor dining areas;
14administration and volunteer offices; modernization of
15structural components (such as roof replacement and masonry
16work); boiler repair or replacement; vehicle maintenance and
17storage facilities; parking facilities; mechanical systems for
18heating, ventilation, and air conditioning; loading docks; and
19repair or replacement of carpeting, tile, wall coverings,
20window coverings or treatments, or furniture. Solely for the
21purpose of this definition, "non-clinical service area" does
22not include health and fitness centers.
23    "Areawide" means a major area of the State delineated on a
24geographic, demographic, and functional basis for health
25planning and for health service and having within it one or
26more local areas for health planning and health service. The

 

 

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1term "region", as contrasted with the term "subregion", and the
2word "area" may be used synonymously with the term "areawide".
3    "Local" means a subarea of a delineated major area that on
4a geographic, demographic, and functional basis may be
5considered to be part of such major area. The term "subregion"
6may be used synonymously with the term "local".
7    "Physician" means a person licensed to practice in
8accordance with the Medical Practice Act of 1987, as amended.
9    "Licensed health care professional" means a person
10licensed to practice a health profession under pertinent
11licensing statutes of the State of Illinois.
12    "Director" means the Director of the Illinois Department of
13Public Health.
14    "Agency" means the Illinois Department of Public Health.
15    "Alternative health care model" means a facility or program
16authorized under the Alternative Health Care Delivery Act.
17    "Out-of-state facility" means a person that is both (i)
18licensed as a hospital or as an ambulatory surgery center under
19the laws of another state or that qualifies as a hospital or an
20ambulatory surgery center under regulations adopted pursuant
21to the Social Security Act and (ii) not licensed under the
22Ambulatory Surgical Treatment Center Act, the Hospital
23Licensing Act, or the Nursing Home Care Act. Affiliates of
24out-of-state facilities shall be considered out-of-state
25facilities. Affiliates of Illinois licensed health care
26facilities 100% owned by an Illinois licensed health care

 

 

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1facility, its parent, or Illinois physicians licensed to
2practice medicine in all its branches shall not be considered
3out-of-state facilities. Nothing in this definition shall be
4construed to include an office or any part of an office of a
5physician licensed to practice medicine in all its branches in
6Illinois that is not required to be licensed under the
7Ambulatory Surgical Treatment Center Act.
8    "Change of ownership of a health care facility" means a
9change in the person who has ownership or control of a health
10care facility's physical plant and capital assets. A change in
11ownership is indicated by the following transactions: sale,
12transfer, acquisition, lease, change of sponsorship, or other
13means of transferring control.
14    "Related person" means any person that: (i) is at least 50%
15owned, directly or indirectly, by either the health care
16facility or a person owning, directly or indirectly, at least
1750% of the health care facility; or (ii) owns, directly or
18indirectly, at least 50% of the health care facility.
19    "Charity care" means care provided by a health care
20facility for which the provider does not expect to receive
21payment from the patient or a third-party payer.
22    "Freestanding emergency center" means a facility subject
23to licensure under Section 32.5 of the Emergency Medical
24Services (EMS) Systems Act.
25(Source: P.A. 95-331, eff. 8-21-07; 95-543, eff. 8-28-07;
2695-584, eff. 8-31-07; 95-727, eff. 6-30-08; 95-876, eff.

 

 

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18-21-08; 96-31, eff. 6-30-09; 96-339, eff. 7-1-10; 96-1000,
2eff. 7-2-10.)
 
3    (20 ILCS 3960/8.5)
4    (Section scheduled to be repealed on December 31, 2019)
5    Sec. 8.5. Certificate of exemption for change of ownership
6of a health care facility; public notice and public hearing.
7    (a) Upon a finding by the Department of Public Health that
8an application for a change of ownership is complete, the
9Department of Public Health shall publish a legal notice on 3
10consecutive days in a newspaper of general circulation in the
11area or community to be affected and afford the public an
12opportunity to request a hearing. If the application is for a
13facility located in a Metropolitan Statistical Area, an
14additional legal notice shall be published in a newspaper of
15limited circulation, if one exists, in the area in which the
16facility is located. If the newspaper of limited circulation is
17published on a daily basis, the additional legal notice shall
18be published on 3 consecutive days. The legal notice shall also
19be posted on the Health Facilities and Services Review Board's
20web site and sent to the State Representative and State Senator
21of the district in which the health care facility is located.
22The Department of Public Health shall not find that an
23application for change of ownership of a hospital is complete
24without a signed certification that for a period of 2 years
25after the change of ownership transaction is effective, the

 

 

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1hospital will not adopt a charity care policy that is more
2restrictive than the policy in effect during the year prior to
3the transaction.
4    For the purposes of this subsection, "newspaper of limited
5circulation" means a newspaper intended to serve a particular
6or defined population of a specific geographic area within a
7Metropolitan Statistical Area such as a municipality, town,
8village, township, or community area, but does not include
9publications of professional and trade associations.
10    (b) If a public hearing is requested, it shall be held at
11least 15 days but no more than 30 days after the date of
12publication of the legal notice in the community in which the
13facility is located. The hearing shall be held in a place of
14reasonable size and accessibility and a full and complete
15written transcript of the proceedings shall be made. The
16applicant shall provide a summary of the proposed change of
17ownership for distribution at the public hearing.
18(Source: P.A. 96-31, eff. 6-30-09.)
 
19    (20 ILCS 3960/19.5)
20    (Section scheduled to be repealed on December 31, 2019 and
21as provided internally)
22    Sec. 19.5. Audit. The Twenty-four months after the last
23member of the 9-member Board is appointed, as required under
24this amendatory Act of the 96th General Assembly, and 36 months
25thereafter, the Auditor General shall commence a performance

 

 

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1audit of the Center for Comprehensive Health Planning, State
2Board, and the Certificate of Need processes to determine:
3        (1) whether progress is being made to develop a
4    Comprehensive Health Plan and whether resources are
5    sufficient to meet the goals of the Center for
6    Comprehensive Health Planning;
7        (2) whether changes to the Certificate of Need
8    processes are being implemented effectively, as well as
9    their impact, if any, on access to safety net services; and
10        (3) whether fines and settlements are fair,
11    consistent, and in proportion to the degree of violations.
12    The Auditor General must report on the results of the audit
13to the General Assembly.
14    This Section is repealed when the Auditor General files his
15or her report with the General Assembly.
16(Source: P.A. 96-31, eff. 6-30-09.)
 
17    Section 25. The Hospital Basic Services Preservation Act is
18amended by changing Section 15 as follows:
 
19    (20 ILCS 4050/15)
20    Sec. 15. Basic services loans.
21    (a) Essential community hospitals seeking
22collateralization of loans under this Act must apply to the
23Health Facilities and Services Review Board on a form
24prescribed by the Health Facilities and Services Review Board

 

 

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1by rule. The Health Facilities and Services Review Board shall
2review the application and, if it approves the applicant's
3plan, shall forward the application and its approval to the
4Hospital Basic Services Review Board on a form prescribed by
5the Hospital Basic Service Review Board.
6    (b) Upon receipt of the applicant's application and
7approval from the Health Facilities and Services Review Board,
8the Hospital Basic Services Review Board shall request from the
9applicant and the applicant shall submit to the Hospital Basic
10Services Review Board all of the following information:
11        (1) A copy of the hospital's last audited financial
12    statement.
13        (2) The percentage of the hospital's patients each year
14    who are Medicaid patients.
15        (3) The percentage of the hospital's patients each year
16    who are Medicare patients.
17        (4) The percentage of the hospital's patients each year
18    who are uninsured.
19        (5) The percentage of services provided by the hospital
20    each year for which the hospital expected payment but for
21    which no payment was received.
22        (6) Any other information required by the Hospital
23    Basic Services Review Board by rule.
24The Hospital Basic Services Review Board shall review the
25applicant's original application, the approval of the Health
26Facilities and Services Review Board, and the information

 

 

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1provided by the applicant to the Hospital Basic Services Review
2Board under this Section and make a recommendation to the State
3Treasurer to accept or deny the application.
4    (c) If the Hospital Basic Services Review Board recommends
5that the application be accepted, the State Treasurer may
6collateralize the applicant's basic service loan for eligible
7expenses related to completing, attaining, or upgrading basic
8services, including, but not limited to, delivery,
9installation, staff training, and other eligible expenses as
10defined by the State Treasurer by rule. The total cost for any
11one project to be undertaken by the applicants shall not exceed
12$10,000,000 and the amount of each basic services loan
13collateralized under this Act shall not exceed $5,000,000.
14Expenditures related to basic service loans shall not exceed
15the amount available in the Fund necessary to collateralize the
16loans. The terms of any basic services loan collateralized
17under this Act must be approved by the State Treasurer in
18accordance with standards established by the State Treasurer by
19rule.
20(Source: P.A. 96-31, eff. 6-30-09.)
 
21    Section 30. The Illinois State Auditing Act is amended by
22changing Section 3-1 as follows:
 
23    (30 ILCS 5/3-1)  (from Ch. 15, par. 303-1)
24    Sec. 3-1. Jurisdiction of Auditor General. The Auditor

 

 

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1General has jurisdiction over all State agencies to make post
2audits and investigations authorized by or under this Act or
3the Constitution.
4    The Auditor General has jurisdiction over local government
5agencies and private agencies only:
6        (a) to make such post audits authorized by or under
7    this Act as are necessary and incidental to a post audit of
8    a State agency or of a program administered by a State
9    agency involving public funds of the State, but this
10    jurisdiction does not include any authority to review local
11    governmental agencies in the obligation, receipt,
12    expenditure or use of public funds of the State that are
13    granted without limitation or condition imposed by law,
14    other than the general limitation that such funds be used
15    for public purposes;
16        (b) to make investigations authorized by or under this
17    Act or the Constitution; and
18        (c) to make audits of the records of local government
19    agencies to verify actual costs of state-mandated programs
20    when directed to do so by the Legislative Audit Commission
21    at the request of the State Board of Appeals under the
22    State Mandates Act.
23    In addition to the foregoing, the Auditor General may
24conduct an audit of the Metropolitan Pier and Exposition
25Authority, the Regional Transportation Authority, the Suburban
26Bus Division, the Commuter Rail Division and the Chicago

 

 

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1Transit Authority and any other subsidized carrier when
2authorized by the Legislative Audit Commission. Such audit may
3be a financial, management or program audit, or any combination
4thereof.
5    The audit shall determine whether they are operating in
6accordance with all applicable laws and regulations. Subject to
7the limitations of this Act, the Legislative Audit Commission
8may by resolution specify additional determinations to be
9included in the scope of the audit.
10    In addition to the foregoing, the Auditor General must also
11conduct a financial audit of the Illinois Sports Facilities
12Authority's expenditures of public funds in connection with the
13reconstruction, renovation, remodeling, extension, or
14improvement of all or substantially all of any existing
15"facility", as that term is defined in the Illinois Sports
16Facilities Authority Act.
17    The Auditor General may also conduct an audit, when
18authorized by the Legislative Audit Commission, of any hospital
19which receives 10% or more of its gross revenues from payments
20from the State of Illinois, Department of Healthcare and Family
21Services (formerly Department of Public Aid), Medical
22Assistance Program.
23    The Auditor General is authorized to conduct financial and
24compliance audits of the Illinois Distance Learning Foundation
25and the Illinois Conservation Foundation.
26    As soon as practical after the effective date of this

 

 

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1amendatory Act of 1995, the Auditor General shall conduct a
2compliance and management audit of the City of Chicago and any
3other entity with regard to the operation of Chicago O'Hare
4International Airport, Chicago Midway Airport and Merrill C.
5Meigs Field. The audit shall include, but not be limited to, an
6examination of revenues, expenses, and transfers of funds;
7purchasing and contracting policies and practices; staffing
8levels; and hiring practices and procedures. When completed,
9the audit required by this paragraph shall be distributed in
10accordance with Section 3-14.
11    The Auditor General shall conduct a financial and
12compliance and program audit of distributions from the
13Municipal Economic Development Fund during the immediately
14preceding calendar year pursuant to Section 8-403.1 of the
15Public Utilities Act at no cost to the city, village, or
16incorporated town that received the distributions.
17    The Auditor General must conduct an audit of the Health
18Facilities and Services Review Board pursuant to Section 19.5
19of the Illinois Health Facilities Planning Act.
20    The Auditor General of the State of Illinois shall annually
21conduct or cause to be conducted a financial and compliance
22audit of the books and records of any county water commission
23organized pursuant to the Water Commission Act of 1985 and
24shall file a copy of the report of that audit with the Governor
25and the Legislative Audit Commission. The filed audit shall be
26open to the public for inspection. The cost of the audit shall

 

 

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1be charged to the county water commission in accordance with
2Section 6z-27 of the State Finance Act. The county water
3commission shall make available to the Auditor General its
4books and records and any other documentation, whether in the
5possession of its trustees or other parties, necessary to
6conduct the audit required. These audit requirements apply only
7through July 1, 2007.
8    The Auditor General must conduct audits of the Rend Lake
9Conservancy District as provided in Section 25.5 of the River
10Conservancy Districts Act.
11    The Auditor General must conduct financial audits of the
12Southeastern Illinois Economic Development Authority as
13provided in Section 70 of the Southeastern Illinois Economic
14Development Authority Act.
15    The Auditor General shall conduct a compliance audit in
16accordance with subsections (d) and (f) of Section 30 of the
17Innovation Development and Economy Act.
18(Source: P.A. 95-331, eff. 8-21-07; 96-31, eff. 6-30-09;
1996-939, eff. 6-24-10.)
 
20    Section 35. The Alternative Health Care Delivery Act is
21amended by changing Sections 20, 30, and 36.5 as follows:
 
22    (210 ILCS 3/20)
23    Sec. 20. Board responsibilities. The State Board of Health
24shall have the responsibilities set forth in this Section.

 

 

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1    (a) The Board shall investigate new health care delivery
2models and recommend to the Governor and the General Assembly,
3through the Department, those models that should be authorized
4as alternative health care models for which demonstration
5programs should be initiated. In its deliberations, the Board
6shall use the following criteria:
7        (1) The feasibility of operating the model in Illinois,
8    based on a review of the experience in other states
9    including the impact on health professionals of other
10    health care programs or facilities.
11        (2) The potential of the model to meet an unmet need.
12        (3) The potential of the model to reduce health care
13    costs to consumers, costs to third party payors, and
14    aggregate costs to the public.
15        (4) The potential of the model to maintain or improve
16    the standards of health care delivery in some measurable
17    fashion.
18        (5) The potential of the model to provide increased
19    choices or access for patients.
20    (b) The Board shall evaluate and make recommendations to
21the Governor and the General Assembly, through the Department,
22regarding alternative health care model demonstration programs
23established under this Act, at the midpoint and end of the
24period of operation of the demonstration programs. The report
25shall include, at a minimum, the following:
26        (1) Whether the alternative health care models

 

 

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1    improved access to health care for their service
2    populations in the State.
3        (2) The quality of care provided by the alternative
4    health care models as may be evidenced by health outcomes,
5    surveillance reports, and administrative actions taken by
6    the Department.
7        (3) The cost and cost effectiveness to the public,
8    third-party payors, and government of the alternative
9    health care models, including the impact of pilot programs
10    on aggregate health care costs in the area. In addition to
11    any other information collected by the Board under this
12    Section, the Board shall collect from postsurgical
13    recovery care centers uniform billing data substantially
14    the same as specified in Section 4-2(e) of the Illinois
15    Health Finance Reform Act. To facilitate its evaluation of
16    that data, the Board shall forward a copy of the data to
17    the Illinois Health Care Cost Containment Council. All
18    patient identifiers shall be removed from the data before
19    it is submitted to the Board or Council.
20        (4) The impact of the alternative health care models on
21    the health care system in that area, including changing
22    patterns of patient demand and utilization, financial
23    viability, and feasibility of operation of service in
24    inpatient and alternative models in the area.
25        (5) (Blank). The implementation by alternative health
26    care models of any special commitments made during

 

 

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1    application review to the Health Facilities and Services
2    Review Board.
3        (6) The continuation, expansion, or modification of
4    the alternative health care models.
5    (c) The Board shall advise the Department on the definition
6and scope of alternative health care models demonstration
7programs.
8    (d) In carrying out its responsibilities under this
9Section, the Board shall seek the advice of other Department
10advisory boards or committees that may be impacted by the
11alternative health care model or the proposed model of health
12care delivery. The Board shall also seek input from other
13interested parties, which may include holding public hearings.
14    (e) The Board shall otherwise advise the Department on the
15administration of the Act as the Board deems appropriate.
16(Source: P.A. 96-31, eff. 6-30-09.)
 
17    (210 ILCS 3/30)
18    Sec. 30. Demonstration program requirements. The
19requirements set forth in this Section shall apply to
20demonstration programs.
21    (a) There shall be no more than:
22        (i) 3 subacute care hospital alternative health care
23    models in the City of Chicago (one of which shall be
24    located on a designated site and shall have been licensed
25    as a hospital under the Illinois Hospital Licensing Act

 

 

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1    within the 10 years immediately before the application for
2    a license);
3        (ii) 2 subacute care hospital alternative health care
4    models in the demonstration program for each of the
5    following areas:
6            (1) Cook County outside the City of Chicago.
7            (2) DuPage, Kane, Lake, McHenry, and Will
8        Counties.
9            (3) Municipalities with a population greater than
10        50,000 not located in the areas described in item (i)
11        of subsection (a) and paragraphs (1) and (2) of item
12        (ii) of subsection (a); and
13        (iii) 4 subacute care hospital alternative health care
14    models in the demonstration program for rural areas.
15    In selecting among applicants for these licenses in rural
16areas, the Health Facilities and Services Review Board and the
17Department shall give preference to hospitals that may be
18unable for economic reasons to provide continued service to the
19community in which they are located unless the hospital were to
20receive an alternative health care model license.
21    (a-5) There shall be no more than the total number of
22postsurgical recovery care centers with a certificate of need
23for beds as of January 1, 2008.
24    (a-10) There shall be no more than a total of 9 children's
25respite care center alternative health care models in the
26demonstration program, which shall be located as follows:

 

 

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1        (1) Two in the City of Chicago.
2        (2) One in Cook County outside the City of Chicago.
3        (3) A total of 2 in the area comprised of DuPage, Kane,
4    Lake, McHenry, and Will counties.
5        (4) A total of 2 in municipalities with a population of
6    50,000 or more and not located in the areas described in
7    paragraphs (1), (2), or (3).
8        (5) A total of 2 in rural areas, as defined by the
9    Health Facilities and Services Review Board.
10    No more than one children's respite care model owned and
11operated by a licensed skilled pediatric facility shall be
12located in each of the areas designated in this subsection
13(a-10).
14    (a-15) There shall be 5 authorized community-based
15residential rehabilitation center alternative health care
16models in the demonstration program.
17    (a-20) There shall be an authorized Alzheimer's disease
18management center alternative health care model in the
19demonstration program. The Alzheimer's disease management
20center shall be located in Will County, owned by a
21not-for-profit entity, and endorsed by a resolution approved by
22the county board before the effective date of this amendatory
23Act of the 91st General Assembly.
24    (a-25) There shall be no more than 10 birth center
25alternative health care models in the demonstration program,
26located as follows:

 

 

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1        (1) Four in the area comprising Cook, DuPage, Kane,
2    Lake, McHenry, and Will counties, one of which shall be
3    owned or operated by a hospital and one of which shall be
4    owned or operated by a federally qualified health center.
5        (2) Three in municipalities with a population of 50,000
6    or more not located in the area described in paragraph (1)
7    of this subsection, one of which shall be owned or operated
8    by a hospital and one of which shall be owned or operated
9    by a federally qualified health center.
10        (3) Three in rural areas, one of which shall be owned
11    or operated by a hospital and one of which shall be owned
12    or operated by a federally qualified health center.
13    The first 3 birth centers authorized to operate by the
14Department shall be located in or predominantly serve the
15residents of a health professional shortage area as determined
16by the United States Department of Health and Human Services.
17There shall be no more than 2 birth centers authorized to
18operate in any single health planning area for obstetric
19services as determined under the Illinois Health Facilities
20Planning Act. If a birth center is located outside of a health
21professional shortage area, (i) the birth center shall be
22located in a health planning area with a demonstrated need for
23obstetrical service beds, as determined by the Health
24Facilities and Services Review Board or (ii) there must be a
25reduction in the existing number of obstetrical service beds in
26the planning area so that the establishment of the birth center

 

 

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1does not result in an increase in the total number of
2obstetrical service beds in the health planning area.
3    (b) (Blank). Alternative health care models, other than a
4model authorized under subsection (a-10) or (a-20), shall
5obtain a certificate of need from the Health Facilities and
6Services Review Board under the Illinois Health Facilities
7Planning Act before receiving a license by the Department. If,
8after obtaining its initial certificate of need, an alternative
9health care delivery model that is a community based
10residential rehabilitation center seeks to increase the bed
11capacity of that center, it must obtain a certificate of need
12from the Health Facilities and Services Review Board before
13increasing the bed capacity. Alternative health care models in
14medically underserved areas shall receive priority in
15obtaining a certificate of need.
16    (c) An alternative health care model license shall be
17issued for a period of one year and shall be annually renewed
18if the facility or program is in substantial compliance with
19the Department's rules adopted under this Act. A licensed
20alternative health care model that continues to be in
21substantial compliance after the conclusion of the
22demonstration program shall be eligible for annual renewals
23unless and until a different licensure program for that type of
24health care model is established by legislation., except that a
25postsurgical recovery care center meeting the following
26requirements may apply within 3 years after August 25, 2009

 

 

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1(the effective date of Public Act 96-669) for a Certificate of
2Need permit to operate as a hospital:
3        (1) (Blank). The postsurgical recovery care center
4    shall apply to the Illinois Health Facilities Planning
5    Board for a Certificate of Need permit to discontinue the
6    postsurgical recovery care center and to establish a
7    hospital.
8        (2) If the postsurgical recovery care center obtains a
9    Certificate of Need permit to operate as a hospital, it
10    shall apply for licensure as a hospital under the Hospital
11    Licensing Act and shall meet all statutory and regulatory
12    requirements of a hospital.
13        (3) After obtaining licensure as a hospital, any
14    license as an ambulatory surgical treatment center and any
15    license as a post-surgical recovery care center shall be
16    null and void.
17        (4) The former postsurgical recovery care center that
18    receives a hospital license must seek and use its best
19    efforts to maintain certification under Titles XVIII and
20    XIX of the federal Social Security Act.
21    The Department may issue a provisional license to any
22alternative health care model that does not substantially
23comply with the provisions of this Act and the rules adopted
24under this Act if (i) the Department finds that the alternative
25health care model has undertaken changes and corrections which
26upon completion will render the alternative health care model

 

 

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1in substantial compliance with this Act and rules and (ii) the
2health and safety of the patients of the alternative health
3care model will be protected during the period for which the
4provisional license is issued. The Department shall advise the
5licensee of the conditions under which the provisional license
6is issued, including the manner in which the alternative health
7care model fails to comply with the provisions of this Act and
8rules, and the time within which the changes and corrections
9necessary for the alternative health care model to
10substantially comply with this Act and rules shall be
11completed.
12    (d) Alternative health care models shall seek
13certification under Titles XVIII and XIX of the federal Social
14Security Act. In addition, alternative health care models shall
15provide charitable care consistent with that provided by
16comparable health care providers in the geographic area.
17    (d-5) (Blank).
18    (e) Alternative health care models shall, to the extent
19possible, link and integrate their services with nearby health
20care facilities.
21    (f) Each alternative health care model shall implement a
22quality assurance program with measurable benefits and at
23reasonable cost.
24(Source: P.A. 95-331, eff. 8-21-07; 95-445, eff. 1-1-08; 96-31,
25eff. 6-30-09; 96-129, eff. 8-4-09; 96-669, eff. 8-25-09;
2696-812, eff. 1-1-10; 96-1000, eff. 7-2-10; 96-1071, eff.

 

 

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17-16-10; 96-1123, eff. 1-1-11; revised 9-16-10.)
 
2    (210 ILCS 3/36.5)
3    Sec. 36.5. Alternative health care models authorized.
4Notwithstanding any other law to the contrary, alternative
5health care models described in part 1 of Section 35 shall be
6licensed without additional consideration by the Health
7Facilities and Services Review Board if:
8        (1) an application for such a model was filed with the
9    Health Facilities and Services Review Board prior to
10    September 1, 1994;
11        (2) (Blank) the application was received by the Health
12    Facilities and Services Review Board and was awarded at
13    least the minimum number of points required for approval by
14    the Board or, if the application was withdrawn prior to
15    Board action, the staff report recommended at least the
16    minimum number of points required for approval by the
17    Board; and
18        (3) the applicant complies with all regulations of the
19    Illinois Department of Public Health to receive a license
20    pursuant to part 1 of Section 35.
21(Source: P.A. 96-31, eff. 6-30-09.)
 
22    Section 40. The Assisted Living and Shared Housing Act is
23amended by changing Section 145 as follows:
 

 

 

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1    (210 ILCS 9/145)
2    Sec. 145. Conversion of facilities. Entities licensed as
3facilities under the Nursing Home Care Act or the MR/DD
4Community Care Act may elect to convert to a license under this
5Act. Any facility that chooses to convert, in whole or in part,
6shall follow the requirements in the Nursing Home Care Act or
7the MR/DD Community Care Act, as applicable, and rules
8promulgated under those Acts regarding voluntary closure and
9notice to residents. Any conversion of existing beds licensed
10under the Nursing Home Care Act or the MR/DD Community Care Act
11to licensure under this Act is exempt from review by the Health
12Facilities and Services Review Board.
13(Source: P.A. 96-31, eff. 6-30-09; 96-339, eff. 7-1-10;
1496-1000, eff. 7-2-10.)
 
15    Section 45. The Emergency Medical Services (EMS) Systems
16Act is amended by changing Section 32.5 as follows:
 
17    (210 ILCS 50/32.5)
18    Sec. 32.5. Freestanding Emergency Center.
19    (a) The Department shall issue an annual Freestanding
20Emergency Center (FEC) license to any facility that has
21received a permit from the Health Facilities and Services
22Review Board to establish a Freestanding Emergency Center if
23the application for the permit has been deemed complete by the
24Department of Public Health by March 1, 2009, and:

 

 

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1        (1) is located: (A) in a municipality with a population
2    of 75,000 or fewer inhabitants; (B) within 20 miles of the
3    hospital that owns or controls the FEC; and (C) within 20
4    miles of the Resource Hospital affiliated with the FEC as
5    part of the EMS System;
6        (2) is wholly owned or controlled by an Associate or
7    Resource Hospital, but is not a part of the hospital's
8    physical plant;
9        (3) meets the standards for licensed FECs, adopted by
10    rule of the Department, including, but not limited to:
11            (A) facility design, specification, operation, and
12        maintenance standards;
13            (B) equipment standards; and
14            (C) the number and qualifications of emergency
15        medical personnel and other staff, which must include
16        at least one board certified emergency physician
17        present at the FEC 24 hours per day.
18        (4) limits its participation in the EMS System strictly
19    to receiving a limited number of BLS runs by emergency
20    medical vehicles according to protocols developed by the
21    Resource Hospital within the FEC's designated EMS System
22    and approved by the Project Medical Director and the
23    Department;
24        (5) provides comprehensive emergency treatment
25    services, as defined in the rules adopted by the Department
26    pursuant to the Hospital Licensing Act, 24 hours per day,

 

 

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1    on an outpatient basis;
2        (6) provides an ambulance and maintains on site
3    ambulance services staffed with paramedics 24 hours per
4    day;
5        (7) (blank);
6        (8) complies with all State and federal patient rights
7    provisions, including, but not limited to, the Emergency
8    Medical Treatment Act and the federal Emergency Medical
9    Treatment and Active Labor Act;
10        (9) maintains a communications system that is fully
11    integrated with its Resource Hospital within the FEC's
12    designated EMS System;
13        (10) reports to the Department any patient transfers
14    from the FEC to a hospital within 48 hours of the transfer
15    plus any other data determined to be relevant by the
16    Department;
17        (11) submits to the Department, on a quarterly basis,
18    the FEC's morbidity and mortality rates for patients
19    treated at the FEC and other data determined to be relevant
20    by the Department;
21        (12) does not describe itself or hold itself out to the
22    general public as a full service hospital or hospital
23    emergency department in its advertising or marketing
24    activities;
25        (13) complies with any other rules adopted by the
26    Department under this Act that relate to FECs;

 

 

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1        (14) passes the Department's site inspection for
2    compliance with the FEC requirements of this Act;
3        (15) (blank) submits a copy of the permit issued by the
4    Health Facilities and Services Review Board indicating
5    that the facility has complied with the Illinois Health
6    Facilities Planning Act with respect to the health services
7    to be provided at the facility;
8        (16) submits an application for designation as an FEC
9    in a manner and form prescribed by the Department by rule;
10    and
11        (17) pays the annual license fee as determined by the
12    Department by rule.
13    (a-5) Notwithstanding any other provision of this Section,
14the Department may issue an annual FEC license to a facility
15that is located in a county that does not have a licensed
16general acute care hospital if the facility's application for a
17permit from the Illinois Health Facilities Planning Board has
18been deemed complete by the Department of Public Health by
19March 1, 2009 and if the facility complies with the
20requirements set forth in paragraphs (1) through (17) of
21subsection (a).
22    (a-10) Notwithstanding any other provision of this
23Section, the Department may issue an annual FEC license to a
24facility if the facility has, by March 31, 2009, filed a letter
25of intent to establish an FEC and if the facility complies with
26the requirements set forth in paragraphs (1) through (17) of

 

 

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1subsection (a).
2    (b) The Department shall:
3        (1) annually inspect facilities of initial FEC
4    applicants and licensed FECs, and issue annual licenses to
5    or annually relicense FECs that satisfy the Department's
6    licensure requirements as set forth in subsection (a);
7        (2) suspend, revoke, refuse to issue, or refuse to
8    renew the license of any FEC, after notice and an
9    opportunity for a hearing, when the Department finds that
10    the FEC has failed to comply with the standards and
11    requirements of the Act or rules adopted by the Department
12    under the Act;
13        (3) issue an Emergency Suspension Order for any FEC
14    when the Director or his or her designee has determined
15    that the continued operation of the FEC poses an immediate
16    and serious danger to the public health, safety, and
17    welfare. An opportunity for a hearing shall be promptly
18    initiated after an Emergency Suspension Order has been
19    issued; and
20        (4) adopt rules as needed to implement this Section.
21(Source: P.A. 95-584, eff. 8-31-07; 96-23, eff. 6-30-09; 96-31,
22eff. 6-30-09; 96-883, eff. 3-1-10; 96-1000, eff. 7-2-10;
23revised 9-3-10.)
 
24    Section 50. The Health Care Worker Self-Referral Act is
25amended by changing Sections 5, 15, and 20 as follows:
 

 

 

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1    (225 ILCS 47/5)
2    Sec. 5. Legislative intent. The General Assembly
3recognizes that patient referrals by health care workers for
4health services to an entity in which the referring health care
5worker has an investment interest may present a potential
6conflict of interest. The General Assembly finds that these
7referral practices may limit or completely eliminate
8competitive alternatives in the health care market. In some
9instances, these referral practices may expand and improve care
10or may make services available which were previously
11unavailable. They may also provide lower cost options to
12patients or increase competition. Generally, referral
13practices are positive occurrences. However, self-referrals
14may result in over utilization of health services, increased
15overall costs of the health care systems, and may affect the
16quality of health care.
17    It is the intent of the General Assembly to provide
18guidance to health care workers regarding acceptable patient
19referrals, to prohibit patient referrals to entities providing
20health services in which the referring health care worker has
21an investment interest, and to protect the citizens of Illinois
22from unnecessary and costly health care expenditures.
23    Recognizing the need for flexibility to quickly respond to
24changes in the delivery of health services, to avoid results
25beyond the limitations on self referral provided under this Act

 

 

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1and to provide minimal disruption to the appropriate delivery
2of health care, the Health Facilities and Services Review Board
3shall be exclusively and solely authorized to implement and
4interpret this Act through adopted rules.
5    The General Assembly recognizes that changes in delivery of
6health care has resulted in various methods by which health
7care workers practice their professions. It is not the intent
8of the General Assembly to limit appropriate delivery of care,
9nor force unnecessary changes in the structures created by
10workers for the health and convenience of their patients.
11(Source: P.A. 96-31, eff. 6-30-09.)
 
12    (225 ILCS 47/15)
13    Sec. 15. Definitions. In this Act:
14    (a) (Blank) "Board" means the Health Facilities and
15Services Review Board.
16    (b) "Entity" means any individual, partnership, firm,
17corporation, or other business that provides health services
18but does not include an individual who is a health care worker
19who provides professional services to an individual.
20    (c) "Group practice" means a group of 2 or more health care
21workers legally organized as a partnership, professional
22corporation, not-for-profit corporation, faculty practice plan
23or a similar association in which:
24        (1) each health care worker who is a member or employee
25    or an independent contractor of the group provides

 

 

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1    substantially the full range of services that the health
2    care worker routinely provides, including consultation,
3    diagnosis, or treatment, through the use of office space,
4    facilities, equipment, or personnel of the group;
5        (2) the services of the health care workers are
6    provided through the group, and payments received for
7    health services are treated as receipts of the group; and
8        (3) the overhead expenses and the income from the
9    practice are distributed by methods previously determined
10    by the group.
11    (d) "Health care worker" means any individual licensed
12under the laws of this State to provide health services,
13including but not limited to: dentists licensed under the
14Illinois Dental Practice Act; dental hygienists licensed under
15the Illinois Dental Practice Act; nurses and advanced practice
16nurses licensed under the Nurse Practice Act; occupational
17therapists licensed under the Illinois Occupational Therapy
18Practice Act; optometrists licensed under the Illinois
19Optometric Practice Act of 1987; pharmacists licensed under the
20Pharmacy Practice Act; physical therapists licensed under the
21Illinois Physical Therapy Act; physicians licensed under the
22Medical Practice Act of 1987; physician assistants licensed
23under the Physician Assistant Practice Act of 1987; podiatrists
24licensed under the Podiatric Medical Practice Act of 1987;
25clinical psychologists licensed under the Clinical
26Psychologist Licensing Act; clinical social workers licensed

 

 

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1under the Clinical Social Work and Social Work Practice Act;
2speech-language pathologists and audiologists licensed under
3the Illinois Speech-Language Pathology and Audiology Practice
4Act; or hearing instrument dispensers licensed under the
5Hearing Instrument Consumer Protection Act, or any of their
6successor Acts.
7    (e) "Health services" means health care procedures and
8services provided by or through a health care worker.
9    (f) "Immediate family member" means a health care worker's
10spouse, child, child's spouse, or a parent.
11    (g) "Investment interest" means an equity or debt security
12issued by an entity, including, without limitation, shares of
13stock in a corporation, units or other interests in a
14partnership, bonds, debentures, notes, or other equity
15interests or debt instruments except that investment interest
16for purposes of Section 20 does not include interest in a
17hospital licensed under the laws of the State of Illinois.
18    (h) "Investor" means an individual or entity directly or
19indirectly owning a legal or beneficial ownership or investment
20interest, (such as through an immediate family member, trust,
21or another entity related to the investor).
22    (i) "Office practice" includes the facility or facilities
23at which a health care worker, on an ongoing basis, provides or
24supervises the provision of professional health services to
25individuals.
26    (j) "Referral" means any referral of a patient for health

 

 

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1services, including, without limitation:
2        (1) The forwarding of a patient by one health care
3    worker to another health care worker or to an entity
4    outside the health care worker's office practice or group
5    practice that provides health services.
6        (2) The request or establishment by a health care
7    worker of a plan of care outside the health care worker's
8    office practice or group practice that includes the
9    provision of any health services.
10(Source: P.A. 95-639, eff. 10-5-07; 95-689, eff. 10-29-07;
1195-876, eff. 8-21-08; 96-31, eff. 6-30-09.)
 
12    (225 ILCS 47/20)
13    Sec. 20. Prohibited referrals and claims for payment.
14    (a) A health care worker shall not refer a patient for
15health services to an entity outside the health care worker's
16office or group practice in which the health care worker is an
17investor, unless the health care worker directly provides
18health services within the entity and will be personally
19involved with the provision of care to the referred patient.
20    (b) A Pursuant to Board determination that the following
21exception is applicable, a health care worker may invest in and
22refer to an entity, whether or not the health care worker
23provides direct services within said entity, if there is a
24demonstrated need in the community for the entity and
25alternative financing is not available. For purposes of this

 

 

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1subsection (b), "demonstrated need" in the community for the
2entity may exist if (1) there is no facility of reasonable
3quality that provides medically appropriate service, (2) use of
4existing facilities is onerous or creates too great a hardship
5for patients, or (3) the entity is formed to own or lease
6medical equipment which replaces obsolete or otherwise
7inadequate equipment in or under the control of a hospital
8located in a federally designated health manpower shortage
9area, or (4) such other standards as established, by rule, by
10the Board. "Community" shall be defined as a metropolitan area
11for a city, and a county for a rural area. In addition, the
12following provisions must be met to be exempt under this
13Section:
14        (1) Individuals who are not in a position to refer
15    patients to an entity are given a bona fide opportunity to
16    also invest in the entity on the same terms as those
17    offered a referring health care worker; and
18        (2) No health care worker who invests shall be required
19    or encouraged to make referrals to the entity or otherwise
20    generate business as a condition of becoming or remaining
21    an investor; and
22        (3) The entity shall market or furnish its services to
23    referring health care worker investors and other investors
24    on equal terms; and
25        (4) The entity shall not loan funds or guarantee any
26    loans for health care workers who are in a position to

 

 

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1    refer to an entity; and
2        (5) The income on the health care worker's investment
3    shall be tied to the health care worker's equity in the
4    facility rather than to the volume of referrals made; and
5        (6) Any investment contract between the entity and the
6    health care worker shall not include any covenant or
7    non-competition clause that prevents a health care worker
8    from investing in other entities; and
9        (7) When making a referral, a health care worker must
10    disclose his investment interest in an entity to the
11    patient being referred to such entity. If alternative
12    facilities are reasonably available, the health care
13    worker must provide the patient with a list of alternative
14    facilities. The health care worker shall inform the patient
15    that they have the option to use an alternative facility
16    other than one in which the health care worker has an
17    investment interest and the patient will not be treated
18    differently by the health care worker if the patient
19    chooses to use another entity. This shall be applicable to
20    all health care worker investors, including those who
21    provide direct care or services for their patients in
22    entities outside their office practices; and
23        (8) If a third party payor requests information with
24    regard to a health care worker's investment interest, the
25    same shall be disclosed; and
26        (9) The entity shall establish an internal utilization

 

 

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1    review program to ensure that investing health care workers
2    provided appropriate or necessary utilization; and
3        (10) If a health care worker's financial interest in an
4    entity is incompatible with a referred patient's interest,
5    the health care worker shall make alternative arrangements
6    for the patient's care.
7    The Board shall make such a determination for a health care
8worker within 90 days of a completed written request. Failure
9to make such a determination within the 90 day time frame shall
10mean that no alternative is practical based upon the facts set
11forth in the completed written request.
12    (c) It shall not be a violation of this Act for a health
13care worker to refer a patient for health services to a
14publicly traded entity in which he or she has an investment
15interest provided that:
16        (1) the entity is listed for trading on the New York
17    Stock Exchange or on the American Stock Exchange, or is a
18    national market system security traded under an automated
19    inter-dealer quotation system operated by the National
20    Association of Securities Dealers; and
21        (2) the entity had, at the end of the corporation's
22    most recent fiscal year, total net assets of at least
23    $30,000,000 related to the furnishing of health services;
24    and
25        (3) any investment interest obtained after the
26    effective date of this Act is traded on the exchanges

 

 

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1    listed in paragraph 1 of subsection (c) of this Section
2    after the entity became a publicly traded corporation; and
3        (4) the entity markets or furnishes its services to
4    referring health care worker investors and other health
5    care workers on equal terms; and
6        (5) all stock held in such publicly traded companies,
7    including stock held in the predecessor privately held
8    company, shall be of one class without preferential
9    treatment as to status or remuneration; and
10        (6) the entity does not loan funds or guarantee any
11    loans for health care workers who are in a position to be
12    referred to an entity; and
13        (7) the income on the health care worker's investment
14    is tied to the health care worker's equity in the entity
15    rather than to the volume of referrals made; and
16        (8) the investment interest does not exceed 1/2 of 1%
17    of the entity's total equity.
18    (d) Any hospital licensed under the Hospital Licensing Act
19shall not discriminate against or otherwise penalize a health
20care worker for compliance with this Act.
21    (e) Any health care worker or other entity shall not enter
22into an arrangement or scheme seeking to make referrals to
23another health care worker or entity based upon the condition
24that the health care worker or entity will make referrals with
25an intent to evade the prohibitions of this Act by inducing
26patient referrals which would be prohibited by this Section if

 

 

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1the health care worker or entity made the referral directly.
2    (f) If compliance with the need and alternative investor
3criteria is not practical, the health care worker shall
4identify to the patient reasonably available alternative
5facilities. The Board shall, by rule, designate when compliance
6is "not practical".
7    (g) (Blank). Health care workers may request from the Board
8that it render an advisory opinion that a referral to an
9existing or proposed entity under specified circumstances does
10or does not violate the provisions of this Act. The Board's
11opinion shall be presumptively correct. Failure to render such
12an advisory opinion within 90 days of a completed written
13request pursuant to this Section shall create a rebuttable
14presumption that a referral described in the completed written
15request is not or will not be a violation of this Act.
16    (h) Notwithstanding any provision of this Act to the
17contrary, a health care worker may refer a patient, who is a
18member of a health maintenance organization "HMO" licensed in
19this State, for health services to an entity, outside the
20health care worker's office or group practice, in which the
21health care worker is an investor, provided that any such
22referral is made pursuant to a contract with the HMO.
23Furthermore, notwithstanding any provision of this Act to the
24contrary, a health care worker may refer an enrollee of a
25"managed care community network", as defined in subsection (b)
26of Section 5-11 of the Illinois Public Aid Code, for health

 

 

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1services to an entity, outside the health care worker's office
2or group practice, in which the health care worker is an
3investor, provided that any such referral is made pursuant to a
4contract with the managed care community network.
5(Source: P.A. 92-370, eff. 8-15-01.)
 
6    (225 ILCS 47/30 rep.)
7    (225 ILCS 47/35 rep.)
8    (225 ILCS 47/40 rep.)
9    Section 52. The Health Care Worker Self-Referral Act is
10amended by repealing Sections 30, 35, and 40.
 
11    Section 55. The Illinois Public Aid Code is amended by
12changing Section 5-5.02 as follows:
 
13    (305 ILCS 5/5-5.02)  (from Ch. 23, par. 5-5.02)
14    Sec. 5-5.02. Hospital reimbursements.
15    (a) Reimbursement to Hospitals; July 1, 1992 through
16September 30, 1992. Notwithstanding any other provisions of
17this Code or the Illinois Department's Rules promulgated under
18the Illinois Administrative Procedure Act, reimbursement to
19hospitals for services provided during the period July 1, 1992
20through September 30, 1992, shall be as follows:
21        (1) For inpatient hospital services rendered, or if
22    applicable, for inpatient hospital discharges occurring,
23    on or after July 1, 1992 and on or before September 30,

 

 

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1    1992, the Illinois Department shall reimburse hospitals
2    for inpatient services under the reimbursement
3    methodologies in effect for each hospital, and at the
4    inpatient payment rate calculated for each hospital, as of
5    June 30, 1992. For purposes of this paragraph,
6    "reimbursement methodologies" means all reimbursement
7    methodologies that pertain to the provision of inpatient
8    hospital services, including, but not limited to, any
9    adjustments for disproportionate share, targeted access,
10    critical care access and uncompensated care, as defined by
11    the Illinois Department on June 30, 1992.
12        (2) For the purpose of calculating the inpatient
13    payment rate for each hospital eligible to receive
14    quarterly adjustment payments for targeted access and
15    critical care, as defined by the Illinois Department on
16    June 30, 1992, the adjustment payment for the period July
17    1, 1992 through September 30, 1992, shall be 25% of the
18    annual adjustment payments calculated for each eligible
19    hospital, as of June 30, 1992. The Illinois Department
20    shall determine by rule the adjustment payments for
21    targeted access and critical care beginning October 1,
22    1992.
23        (3) For the purpose of calculating the inpatient
24    payment rate for each hospital eligible to receive
25    quarterly adjustment payments for uncompensated care, as
26    defined by the Illinois Department on June 30, 1992, the

 

 

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1    adjustment payment for the period August 1, 1992 through
2    September 30, 1992, shall be one-sixth of the total
3    uncompensated care adjustment payments calculated for each
4    eligible hospital for the uncompensated care rate year, as
5    defined by the Illinois Department, ending on July 31,
6    1992. The Illinois Department shall determine by rule the
7    adjustment payments for uncompensated care beginning
8    October 1, 1992.
9    (b) Inpatient payments. For inpatient services provided on
10or after October 1, 1993, in addition to rates paid for
11hospital inpatient services pursuant to the Illinois Health
12Finance Reform Act, as now or hereafter amended, or the
13Illinois Department's prospective reimbursement methodology,
14or any other methodology used by the Illinois Department for
15inpatient services, the Illinois Department shall make
16adjustment payments, in an amount calculated pursuant to the
17methodology described in paragraph (c) of this Section, to
18hospitals that the Illinois Department determines satisfy any
19one of the following requirements:
20        (1) Hospitals that are described in Section 1923 of the
21    federal Social Security Act, as now or hereafter amended;
22    or
23        (2) Illinois hospitals that have a Medicaid inpatient
24    utilization rate which is at least one-half a standard
25    deviation above the mean Medicaid inpatient utilization
26    rate for all hospitals in Illinois receiving Medicaid

 

 

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1    payments from the Illinois Department; or
2        (3) Illinois hospitals that on July 1, 1991 had a
3    Medicaid inpatient utilization rate, as defined in
4    paragraph (h) of this Section, that was at least the mean
5    Medicaid inpatient utilization rate for all hospitals in
6    Illinois receiving Medicaid payments from the Illinois
7    Department and which were located in a planning area with
8    one-third or fewer excess beds as determined by the Health
9    Facilities and Services Review Board, and that, as of June
10    30, 1992, were located in a federally designated Health
11    Manpower Shortage Area; or
12        (4) Illinois hospitals that:
13            (A) have a Medicaid inpatient utilization rate
14        that is at least equal to the mean Medicaid inpatient
15        utilization rate for all hospitals in Illinois
16        receiving Medicaid payments from the Department; and
17            (B) also have a Medicaid obstetrical inpatient
18        utilization rate that is at least one standard
19        deviation above the mean Medicaid obstetrical
20        inpatient utilization rate for all hospitals in
21        Illinois receiving Medicaid payments from the
22        Department for obstetrical services; or
23        (5) Any children's hospital, which means a hospital
24    devoted exclusively to caring for children. A hospital
25    which includes a facility devoted exclusively to caring for
26    children shall be considered a children's hospital to the

 

 

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1    degree that the hospital's Medicaid care is provided to
2    children if either (i) the facility devoted exclusively to
3    caring for children is separately licensed as a hospital by
4    a municipality prior to September 30, 1998 or (ii) the
5    hospital has been designated by the State as a Level III
6    perinatal care facility, has a Medicaid Inpatient
7    Utilization rate greater than 55% for the rate year 2003
8    disproportionate share determination, and has more than
9    10,000 qualified children days as defined by the Department
10    in rulemaking.
11    (c) Inpatient adjustment payments. The adjustment payments
12required by paragraph (b) shall be calculated based upon the
13hospital's Medicaid inpatient utilization rate as follows:
14        (1) hospitals with a Medicaid inpatient utilization
15    rate below the mean shall receive a per day adjustment
16    payment equal to $25;
17        (2) hospitals with a Medicaid inpatient utilization
18    rate that is equal to or greater than the mean Medicaid
19    inpatient utilization rate but less than one standard
20    deviation above the mean Medicaid inpatient utilization
21    rate shall receive a per day adjustment payment equal to
22    the sum of $25 plus $1 for each one percent that the
23    hospital's Medicaid inpatient utilization rate exceeds the
24    mean Medicaid inpatient utilization rate;
25        (3) hospitals with a Medicaid inpatient utilization
26    rate that is equal to or greater than one standard

 

 

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1    deviation above the mean Medicaid inpatient utilization
2    rate but less than 1.5 standard deviations above the mean
3    Medicaid inpatient utilization rate shall receive a per day
4    adjustment payment equal to the sum of $40 plus $7 for each
5    one percent that the hospital's Medicaid inpatient
6    utilization rate exceeds one standard deviation above the
7    mean Medicaid inpatient utilization rate; and
8        (4) hospitals with a Medicaid inpatient utilization
9    rate that is equal to or greater than 1.5 standard
10    deviations above the mean Medicaid inpatient utilization
11    rate shall receive a per day adjustment payment equal to
12    the sum of $90 plus $2 for each one percent that the
13    hospital's Medicaid inpatient utilization rate exceeds 1.5
14    standard deviations above the mean Medicaid inpatient
15    utilization rate.
16    (d) Supplemental adjustment payments. In addition to the
17adjustment payments described in paragraph (c), hospitals as
18defined in clauses (1) through (5) of paragraph (b), excluding
19county hospitals (as defined in subsection (c) of Section 15-1
20of this Code) and a hospital organized under the University of
21Illinois Hospital Act, shall be paid supplemental inpatient
22adjustment payments of $60 per day. For purposes of Title XIX
23of the federal Social Security Act, these supplemental
24adjustment payments shall not be classified as adjustment
25payments to disproportionate share hospitals.
26    (e) The inpatient adjustment payments described in

 

 

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1paragraphs (c) and (d) shall be increased on October 1, 1993
2and annually thereafter by a percentage equal to the lesser of
3(i) the increase in the DRI hospital cost index for the most
4recent 12 month period for which data are available, or (ii)
5the percentage increase in the statewide average hospital
6payment rate over the previous year's statewide average
7hospital payment rate. The sum of the inpatient adjustment
8payments under paragraphs (c) and (d) to a hospital, other than
9a county hospital (as defined in subsection (c) of Section 15-1
10of this Code) or a hospital organized under the University of
11Illinois Hospital Act, however, shall not exceed $275 per day;
12that limit shall be increased on October 1, 1993 and annually
13thereafter by a percentage equal to the lesser of (i) the
14increase in the DRI hospital cost index for the most recent
1512-month period for which data are available or (ii) the
16percentage increase in the statewide average hospital payment
17rate over the previous year's statewide average hospital
18payment rate.
19    (f) Children's hospital inpatient adjustment payments. For
20children's hospitals, as defined in clause (5) of paragraph
21(b), the adjustment payments required pursuant to paragraphs
22(c) and (d) shall be multiplied by 2.0.
23    (g) County hospital inpatient adjustment payments. For
24county hospitals, as defined in subsection (c) of Section 15-1
25of this Code, there shall be an adjustment payment as
26determined by rules issued by the Illinois Department.

 

 

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1    (h) For the purposes of this Section the following terms
2shall be defined as follows:
3        (1) "Medicaid inpatient utilization rate" means a
4    fraction, the numerator of which is the number of a
5    hospital's inpatient days provided in a given 12-month
6    period to patients who, for such days, were eligible for
7    Medicaid under Title XIX of the federal Social Security
8    Act, and the denominator of which is the total number of
9    the hospital's inpatient days in that same period.
10        (2) "Mean Medicaid inpatient utilization rate" means
11    the total number of Medicaid inpatient days provided by all
12    Illinois Medicaid-participating hospitals divided by the
13    total number of inpatient days provided by those same
14    hospitals.
15        (3) "Medicaid obstetrical inpatient utilization rate"
16    means the ratio of Medicaid obstetrical inpatient days to
17    total Medicaid inpatient days for all Illinois hospitals
18    receiving Medicaid payments from the Illinois Department.
19    (i) Inpatient adjustment payment limit. In order to meet
20the limits of Public Law 102-234 and Public Law 103-66, the
21Illinois Department shall by rule adjust disproportionate
22share adjustment payments.
23    (j) University of Illinois Hospital inpatient adjustment
24payments. For hospitals organized under the University of
25Illinois Hospital Act, there shall be an adjustment payment as
26determined by rules adopted by the Illinois Department.

 

 

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1    (k) The Illinois Department may by rule establish criteria
2for and develop methodologies for adjustment payments to
3hospitals participating under this Article.
4(Source: P.A. 96-31, eff. 6-30-09.)
 
5    Section 60. The Older Adult Services Act is amended by
6changing Sections 20, 25, and 30 as follows:
 
7    (320 ILCS 42/20)
8    Sec. 20. Priority service areas; service expansion.
9    (a) The requirements of this Section are subject to the
10availability of funding.
11    (b) The Department shall expand older adult services that
12promote independence and permit older adults to remain in their
13own homes and communities. Priority shall be given to both the
14expansion of services and the development of new services in
15priority service areas.
16    (c) Inventory of services. The Department shall develop and
17maintain an inventory and assessment of (i) the types and
18quantities of public older adult services and, to the extent
19possible, privately provided older adult services, including
20the unduplicated count, location, and characteristics of
21individuals served by each facility, program, or service and
22(ii) the resources supporting those services.
23    (d) Priority service areas. The Departments shall assess
24the current and projected need for older adult services

 

 

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1throughout the State, analyze the results of the inventory, and
2identify priority service areas, which shall serve as the basis
3for a priority service plan to be filed with the Governor and
4the General Assembly no later than July 1, 2006, and every 5
5years thereafter.
6    (e) Moneys appropriated by the General Assembly for the
7purpose of this Section, receipts from donations, grants, fees,
8or taxes that may accrue from any public or private sources to
9the Department for the purpose of this Section, and savings
10attributable to the nursing home conversion program as
11calculated in subsection (h) shall be deposited into the
12Department on Aging State Projects Fund. Interest earned by
13those moneys in the Fund shall be credited to the Fund.
14    (f) Moneys described in subsection (e) from the Department
15on Aging State Projects Fund shall be used for older adult
16services, regardless of where the older adult receives the
17service, with priority given to both the expansion of services
18and the development of new services in priority service areas.
19Fundable services shall include:
20        (1) Housing, health services, and supportive services:
21            (A) adult day care;
22            (B) adult day care for persons with Alzheimer's
23        disease and related disorders;
24            (C) activities of daily living;
25            (D) care-related supplies and equipment;
26            (E) case management;

 

 

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1            (F) community reintegration;
2            (G) companion;
3            (H) congregate meals;
4            (I) counseling and education;
5            (J) elder abuse prevention and intervention;
6            (K) emergency response and monitoring;
7            (L) environmental modifications;
8            (M) family caregiver support;
9            (N) financial;
10            (O) home delivered meals;
11            (P) homemaker;
12            (Q) home health;
13            (R) hospice;
14            (S) laundry;
15            (T) long-term care ombudsman;
16            (U) medication reminders;
17            (V) money management;
18            (W) nutrition services;
19            (X) personal care;
20            (Y) respite care;
21            (Z) residential care;
22            (AA) senior benefits outreach;
23            (BB) senior centers;
24            (CC) services provided under the Assisted Living
25        and Shared Housing Act, or sheltered care services that
26        meet the requirements of the Assisted Living and Shared

 

 

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1        Housing Act, or services provided under Section
2        5-5.01a of the Illinois Public Aid Code (the Supportive
3        Living Facilities Program);
4            (DD) telemedicine devices to monitor recipients in
5        their own homes as an alternative to hospital care,
6        nursing home care, or home visits;
7            (EE) training for direct family caregivers;
8            (FF) transition;
9            (GG) transportation;
10            (HH) wellness and fitness programs; and
11            (II) other programs designed to assist older
12        adults in Illinois to remain independent and receive
13        services in the most integrated residential setting
14        possible for that person.
15        (2) Older Adult Services Demonstration Grants,
16    pursuant to subsection (g) of this Section.
17    (g) Older Adult Services Demonstration Grants. The
18Department shall establish a program of demonstration grants to
19assist in the restructuring of the delivery system for older
20adult services and provide funding for innovative service
21delivery models and system change and integration initiatives.
22The Department shall prescribe, by rule, the grant application
23process. At a minimum, every application must include:
24        (1) The type of grant sought;
25        (2) A description of the project;
26        (3) The objective of the project;

 

 

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1        (4) The likelihood of the project meeting identified
2    needs;
3        (5) The plan for financing, administration, and
4    evaluation of the project;
5        (6) The timetable for implementation;
6        (7) The roles and capabilities of responsible
7    individuals and organizations;
8        (8) Documentation of collaboration with other service
9    providers, local community government leaders, and other
10    stakeholders, other providers, and any other stakeholders
11    in the community;
12        (9) Documentation of community support for the
13    project, including support by other service providers,
14    local community government leaders, and other
15    stakeholders;
16        (10) The total budget for the project;
17        (11) The financial condition of the applicant; and
18        (12) Any other application requirements that may be
19    established by the Department by rule.
20    Each project may include provisions for a designated staff
21person who is responsible for the development of the project
22and recruitment of providers.
23    Projects may include, but are not limited to: adult family
24foster care; family adult day care; assisted living in a
25supervised apartment; personal services in a subsidized
26housing project; evening and weekend home care coverage; small

 

 

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1incentive grants to attract new providers; money following the
2person; cash and counseling; managed long-term care; and at
3least one respite care project that establishes a local
4coordinated network of volunteer and paid respite workers,
5coordinates assignment of respite workers to caregivers and
6older adults, ensures the health and safety of the older adult,
7provides training for caregivers, and ensures that support
8groups are available in the community.
9    A demonstration project funded in whole or in part by an
10Older Adult Services Demonstration Grant is exempt from the
11requirements of the Illinois Health Facilities Planning Act. To
12the extent applicable, however, for the purpose of maintaining
13the statewide inventory authorized by the Illinois Health
14Facilities Planning Act, the Department shall send to the
15Health Facilities and Services Review Board a copy of each
16grant award made under this subsection (g).
17    The Department, in collaboration with the Departments of
18Public Health and Healthcare and Family Services, shall
19evaluate the effectiveness of the projects receiving grants
20under this Section.
21    (h) No later than July 1 of each year, the Department of
22Public Health shall provide information to the Department of
23Healthcare and Family Services to enable the Department of
24Healthcare and Family Services to annually document and verify
25the savings attributable to the nursing home conversion program
26for the previous fiscal year to estimate an annual amount of

 

 

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1such savings that may be appropriated to the Department on
2Aging State Projects Fund and notify the General Assembly, the
3Department on Aging, the Department of Human Services, and the
4Advisory Committee of the savings no later than October 1 of
5the same fiscal year.
6(Source: P.A. 95-331, eff. 8-21-07; 96-31, eff. 6-30-09.)
 
7    (320 ILCS 42/25)
8    Sec. 25. Older adult services restructuring. No later than
9January 1, 2005, the Department shall commence the process of
10restructuring the older adult services delivery system.
11Priority shall be given to both the expansion of services and
12the development of new services in priority service areas.
13Subject to the availability of funding, the restructuring shall
14include, but not be limited to, the following:
15    (1) Planning. The Department on Aging and the Departments
16of Public Health and Healthcare and Family Services shall
17develop a plan to restructure the State's service delivery
18system for older adults pursuant to this Act no later than
19September 30, 2010. The plan shall include a schedule for the
20implementation of the initiatives outlined in this Act and all
21other initiatives identified by the participating agencies to
22fulfill the purposes of this Act and shall protect the rights
23of all older Illinoisans to services based on their health
24circumstances and functioning level, regardless of whether
25they receive their care in their homes, in a community setting,

 

 

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1or in a residential facility. Financing for older adult
2services shall be based on the principle that "money follows
3the individual" taking into account individual preference, but
4shall not jeopardize the health, safety, or level of care of
5nursing home residents. The plan shall also identify potential
6impediments to delivery system restructuring and include any
7known regulatory or statutory barriers.
8    (2) Comprehensive case management. The Department shall
9implement a statewide system of holistic comprehensive case
10management. The system shall include the identification and
11implementation of a universal, comprehensive assessment tool
12to be used statewide to determine the level of functional,
13cognitive, socialization, and financial needs of older adults.
14This tool shall be supported by an electronic intake,
15assessment, and care planning system linked to a central
16location. "Comprehensive case management" includes services
17and coordination such as (i) comprehensive assessment of the
18older adult (including the physical, functional, cognitive,
19psycho-social, and social needs of the individual); (ii)
20development and implementation of a service plan with the older
21adult to mobilize the formal and family resources and services
22identified in the assessment to meet the needs of the older
23adult, including coordination of the resources and services
24with any other plans that exist for various formal services,
25such as hospital discharge plans, and with the information and
26assistance services; (iii) coordination and monitoring of

 

 

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1formal and family service delivery, including coordination and
2monitoring to ensure that services specified in the plan are
3being provided; (iv) periodic reassessment and revision of the
4status of the older adult with the older adult or, if
5necessary, the older adult's designated representative; and
6(v) in accordance with the wishes of the older adult, advocacy
7on behalf of the older adult for needed services or resources.
8    (3) Coordinated point of entry. The Department shall
9implement and publicize a statewide coordinated point of entry
10using a uniform name, identity, logo, and toll-free number.
11    (4) Public web site. The Department shall develop a public
12web site that provides links to available services, resources,
13and reference materials concerning caregiving, diseases, and
14best practices for use by professionals, older adults, and
15family caregivers.
16    (5) Expansion of older adult services. The Department shall
17expand older adult services that promote independence and
18permit older adults to remain in their own homes and
19communities.
20    (6) Consumer-directed home and community-based services.
21The Department shall expand the range of service options
22available to permit older adults to exercise maximum choice and
23control over their care.
24    (7) Comprehensive delivery system. The Department shall
25expand opportunities for older adults to receive services in
26systems that integrate acute and chronic care.

 

 

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1    (8) Enhanced transition and follow-up services. The
2Department shall implement a program of transition from one
3residential setting to another and follow-up services,
4regardless of residential setting, pursuant to rules with
5respect to (i) resident eligibility, (ii) assessment of the
6resident's health, cognitive, social, and financial needs,
7(iii) development of transition plans, and (iv) the level of
8services that must be available before transitioning a resident
9from one setting to another.
10    (9) Family caregiver support. The Department shall develop
11strategies for public and private financing of services that
12supplement and support family caregivers.
13    (10) Quality standards and quality improvement. The
14Department shall establish a core set of uniform quality
15standards for all providers that focus on outcomes and take
16into consideration consumer choice and satisfaction, and the
17Department shall require each provider to implement a
18continuous quality improvement process to address consumer
19issues. The continuous quality improvement process must
20benchmark performance, be person-centered and data-driven, and
21focus on consumer satisfaction.
22    (11) Workforce. The Department shall develop strategies to
23attract and retain a qualified and stable worker pool, provide
24living wages and benefits, and create a work environment that
25is conducive to long-term employment and career development.
26Resources such as grants, education, and promotion of career

 

 

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1opportunities may be used.
2    (12) Coordination of services. The Department shall
3identify methods to better coordinate service networks to
4maximize resources and minimize duplication of services and
5ease of application.
6    (13) Barriers to services. The Department shall identify
7barriers to the provision, availability, and accessibility of
8services and shall implement a plan to address those barriers.
9The plan shall: (i) identify barriers, including but not
10limited to, statutory and regulatory complexity, reimbursement
11issues, payment issues, and labor force issues; (ii) recommend
12changes to State or federal laws or administrative rules or
13regulations; (iii) recommend application for federal waivers
14to improve efficiency and reduce cost and paperwork; (iv)
15develop innovative service delivery models; and (v) recommend
16application for federal or private service grants.
17    (14) Reimbursement and funding. The Department shall
18investigate and evaluate costs and payments by defining costs
19to implement a uniform, audited provider cost reporting system
20to be considered by all Departments in establishing payments.
21To the extent possible, multiple cost reporting mandates shall
22not be imposed.
23    (15) Medicaid nursing home cost containment and Medicare
24utilization. The Department of Healthcare and Family Services
25(formerly Department of Public Aid), in collaboration with the
26Department on Aging and the Department of Public Health and in

 

 

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1consultation with the Advisory Committee, shall propose a plan
2to contain Medicaid nursing home costs and maximize Medicare
3utilization. The plan must not impair the ability of an older
4adult to choose among available services. The plan shall
5include, but not be limited to, (i) techniques to maximize the
6use of the most cost-effective services without sacrificing
7quality and (ii) methods to identify and serve older adults in
8need of minimal services to remain independent, but who are
9likely to develop a need for more extensive services in the
10absence of those minimal services.
11    (16) Bed reduction. The Department of Public Health shall
12implement a nursing home conversion program to reduce the
13number of Medicaid-certified nursing home beds in areas with
14excess beds. The Department of Healthcare and Family Services
15shall investigate changes to the Medicaid nursing facility
16reimbursement system in order to reduce beds. Such changes may
17include, but are not limited to, incentive payments that will
18enable facilities to adjust to the restructuring and expansion
19of services required by the Older Adult Services Act, including
20adjustments for the voluntary closure or layaway of nursing
21home beds certified under Title XIX of the federal Social
22Security Act. Any savings shall be reallocated to fund
23home-based or community-based older adult services pursuant to
24Section 20.
25    (17) Financing. The Department shall investigate and
26evaluate financing options for older adult services and shall

 

 

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1make recommendations in the report required by Section 15
2concerning the feasibility of these financing arrangements.
3These arrangements shall include, but are not limited to:
4        (A) private long-term care insurance coverage for
5    older adult services;
6        (B) enhancement of federal long-term care financing
7    initiatives;
8        (C) employer benefit programs such as medical savings
9    accounts for long-term care;
10        (D) individual and family cost-sharing options;
11        (E) strategies to reduce reliance on government
12    programs;
13        (F) fraudulent asset divestiture and financial
14    planning prevention; and
15        (G) methods to supplement and support family and
16    community caregiving.
17    (18) Older Adult Services Demonstration Grants. The
18Department shall implement a program of demonstration grants
19that will assist in the restructuring of the older adult
20services delivery system, and shall provide funding for
21innovative service delivery models and system change and
22integration initiatives pursuant to subsection (g) of Section
2320.
24    (19) (Blank). Bed need methodology update. For the purposes
25of determining areas with excess beds, the Departments shall
26provide information and assistance to the Health Facilities and

 

 

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1Services Review Board to update the Bed Need Methodology for
2Long-Term Care to update the assumptions used to establish the
3methodology to make them consistent with modern older adult
4services.
5    (20) Affordable housing. The Departments shall utilize the
6recommendations of Illinois' Annual Comprehensive Housing
7Plan, as developed by the Affordable Housing Task Force through
8the Governor's Executive Order 2003-18, in their efforts to
9address the affordable housing needs of older adults.
10    The Older Adult Services Advisory Committee shall
11investigate innovative and promising practices operating as
12demonstration or pilot projects in Illinois and in other
13states. The Department on Aging shall provide the Older Adult
14Services Advisory Committee with a list of all demonstration or
15pilot projects funded by the Department on Aging, including
16those specified by rule, law, policy memorandum, or funding
17arrangement. The Committee shall work with the Department on
18Aging to evaluate the viability of expanding these programs
19into other areas of the State.
20(Source: P.A. 96-31, eff. 6-30-09; 96-248, eff. 8-11-09;
2196-1000, eff. 7-2-10.)
 
22    (320 ILCS 42/30)
23    Sec. 30. Nursing home conversion program.
24    (a) The Department of Public Health, in collaboration with
25the Department on Aging and the Department of Healthcare and

 

 

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1Family Services, shall establish a nursing home conversion
2program. Start-up grants, pursuant to subsections (l) and (m)
3of this Section, shall be made available to nursing homes as
4appropriations permit as an incentive to reduce certified beds,
5retrofit, and retool operations to meet new service delivery
6expectations and demands.
7    (b) Grant moneys shall be made available for capital and
8other costs related to: (1) the conversion of all or a part of
9a nursing home to an assisted living establishment or a special
10program or unit for persons with Alzheimer's disease or related
11disorders licensed under the Assisted Living and Shared Housing
12Act or a supportive living facility established under Section
135-5.01a of the Illinois Public Aid Code; (2) the conversion of
14multi-resident bedrooms in the facility into single-occupancy
15rooms; and (3) the development of any of the services
16identified in a priority service plan that can be provided by a
17nursing home within the confines of a nursing home or
18transportation services. Grantees shall be required to provide
19a minimum of a 20% match toward the total cost of the project.
20    (c) Nothing in this Act shall prohibit the co-location of
21services or the development of multifunctional centers under
22subsection (f) of Section 20, including a nursing home offering
23community-based services or a community provider establishing
24a residential facility.
25    (d) A certified nursing home with at least 50% of its
26resident population having their care paid for by the Medicaid

 

 

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1program is eligible to apply for a grant under this Section.
2    (e) Any nursing home receiving a grant under this Section
3shall reduce the number of certified nursing home beds by a
4number equal to or greater than the number of beds being
5converted for one or more of the permitted uses under item (1)
6or (2) of subsection (b). The nursing home shall retain the
7Certificate of Need for its nursing and sheltered care beds
8that were converted for 15 years. If the beds are reinstated by
9the provider or its successor in interest, the provider shall
10pay to the fund from which the grant was awarded, on an
11amortized basis, the amount of the grant. The Department shall
12establish, by rule, the bed reduction methodology for nursing
13homes that receive a grant pursuant to item (3) of subsection
14(b).
15    (f) Any nursing home receiving a grant under this Section
16shall agree that, for a minimum of 10 years after the date that
17the grant is awarded, a minimum of 50% of the nursing home's
18resident population shall have their care paid for by the
19Medicaid program. If the nursing home provider or its successor
20in interest ceases to comply with the requirement set forth in
21this subsection, the provider shall pay to the fund from which
22the grant was awarded, on an amortized basis, the amount of the
23grant.
24    (g) Before awarding grants, the Department of Public Health
25shall seek recommendations from the Department on Aging and the
26Department of Healthcare and Family Services. The Department of

 

 

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1Public Health shall attempt to balance the distribution of
2grants among geographic regions, and among small and large
3nursing homes. The Department of Public Health shall develop,
4by rule, the criteria for the award of grants based upon the
5following factors:
6        (1) the unique needs of older adults (including those
7    with moderate and low incomes), caregivers, and providers
8    in the geographic area of the State the grantee seeks to
9    serve;
10        (2) whether the grantee proposes to provide services in
11    a priority service area;
12        (3) the extent to which the conversion or transition
13    will result in the reduction of certified nursing home beds
14    in an area with excess beds;
15        (4) the compliance history of the nursing home; and
16        (5) any other relevant factors identified by the
17    Department, including standards of need.
18    (h) A conversion funded in whole or in part by a grant
19under this Section must not:
20        (1) diminish or reduce the quality of services
21    available to nursing home residents;
22        (2) force any nursing home resident to involuntarily
23    accept home-based or community-based services instead of
24    nursing home services;
25        (3) diminish or reduce the supply and distribution of
26    nursing home services in any community below the level of

 

 

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1    need, as defined by the Department by rule; or
2        (4) cause undue hardship on any person who requires
3    nursing home care.
4    (i) The Department shall prescribe, by rule, the grant
5application process. At a minimum, every application must
6include:
7        (1) the type of grant sought;
8        (2) a description of the project;
9        (3) the objective of the project;
10        (4) the likelihood of the project meeting identified
11    needs;
12        (5) the plan for financing, administration, and
13    evaluation of the project;
14        (6) the timetable for implementation;
15        (7) the roles and capabilities of responsible
16    individuals and organizations;
17        (8) documentation of collaboration with other service
18    providers, local community government leaders, and other
19    stakeholders, other providers, and any other stakeholders
20    in the community;
21        (9) documentation of community support for the
22    project, including support by other service providers,
23    local community government leaders, and other
24    stakeholders;
25        (10) the total budget for the project;
26        (11) the financial condition of the applicant; and

 

 

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1        (12) any other application requirements that may be
2    established by the Department by rule.
3    (j) A conversion project funded in whole or in part by a
4grant under this Section is exempt from the requirements of the
5Illinois Health Facilities Planning Act. The Department of
6Public Health, however, shall send to the Health Facilities and
7Services Review Board a copy of each grant award made under
8this Section.
9    (k) Applications for grants are public information, except
10that nursing home financial condition and any proprietary data
11shall be classified as nonpublic data.
12    (l) The Department of Public Health may award grants from
13the Long Term Care Civil Money Penalties Fund established under
14Section 1919(h)(2)(A)(ii) of the Social Security Act and 42 CFR
15488.422(g) if the award meets federal requirements.
16    (m) The Nursing Home Conversion Fund is created as a
17special fund in the State treasury. Moneys appropriated by the
18General Assembly or transferred from other sources for the
19purposes of this Section shall be deposited into the Fund. All
20interest earned on moneys in the fund shall be credited to the
21fund. Moneys contained in the fund shall be used to support the
22purposes of this Section.
23(Source: P.A. 95-331, eff. 8-21-07; 96-31, eff. 6-30-09;
2496-758, eff. 8-25-09; 96-1000, eff. 7-2-10.)
 
25    (20 ILCS 3960/4 rep.)

 

 

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1    (20 ILCS 3960/4.2 rep.)
2    (20 ILCS 3960/5 rep.)
3    (20 ILCS 3960/5.4 rep.)
4    (20 ILCS 3960/6 rep.)
5    (20 ILCS 3960/12 rep.)
6    (20 ILCS 3960/12.2 rep.)
7    (20 ILCS 3960/12.3 rep.)
8    (20 ILCS 3960/15.1 rep.)
9    Section 90. The Illinois Health Facilities Planning Act is
10amended by repealing Sections 4, 4.2, 5, 5.4, 6, 12, 12.2,
1112.3, and 15.1.
 
12    Section 99. Effective date. This Act takes effect on July
131, 2012.

 

 

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1 INDEX
2 Statutes amended in order of appearance
3    5 ILCS 120/1.02from Ch. 102, par. 41.02
4    5 ILCS 430/5-50
5    20 ILCS 2310/2310-217
6    20 ILCS 3960/2from Ch. 111 1/2, par. 1152
7    20 ILCS 3960/2.5 new
8    20 ILCS 3960/3from Ch. 111 1/2, par. 1153
9    20 ILCS 3960/8.5
10    20 ILCS 3960/19.5
11    20 ILCS 4050/15
12    30 ILCS 5/3-1from Ch. 15, par. 303-1
13    210 ILCS 3/20
14    210 ILCS 3/30
15    210 ILCS 3/36.5
16    210 ILCS 9/145
17    210 ILCS 50/32.5
18    225 ILCS 47/5
19    225 ILCS 47/15
20    225 ILCS 47/20
21    225 ILCS 47/30 rep.
22    225 ILCS 47/35 rep.
23    225 ILCS 47/40 rep.
24    305 ILCS 5/5-5.02from Ch. 23, par. 5-5.02
25    320 ILCS 42/20

 

 

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1    320 ILCS 42/25
2    320 ILCS 42/30
3    20 ILCS 3960/4 rep.
4    20 ILCS 3960/4.2 rep.
5    20 ILCS 3960/5 rep.
6    20 ILCS 3960/5.4 rep.
7    20 ILCS 3960/6 rep.
8    20 ILCS 3960/12 rep.
9    20 ILCS 3960/12.2 rep.
10    20 ILCS 3960/12.3 rep.
11    20 ILCS 3960/15.1 rep.