Public Act 098-0629
 
HB1584 EnrolledLRB098 08118 DRJ 38209 b

    AN ACT concerning regulation.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Illinois Health Facilities Planning Act is
amended by changing Section 3 as follows:
 
    (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
    (Section scheduled to be repealed on December 31, 2019)
    Sec. 3. Definitions. As used in this Act:
    "Health care facilities" means and includes the following
facilities, organizations, and related persons:
        1. An ambulatory surgical treatment center required to
    be licensed pursuant to the Ambulatory Surgical Treatment
    Center Act;
        2. An institution, place, building, or agency required
    to be licensed pursuant to the Hospital Licensing Act;
        3. Skilled and intermediate long term care facilities
    licensed under the Nursing Home Care Act;
        3.5. Skilled and intermediate care facilities licensed
    under the ID/DD Community Care Act;
        3.7. Facilities licensed under the Specialized Mental
    Health Rehabilitation Act;
        4. Hospitals, nursing homes, ambulatory surgical
    treatment centers, or kidney disease treatment centers
    maintained by the State or any department or agency
    thereof;
        5. Kidney disease treatment centers, including a
    free-standing hemodialysis unit required to be licensed
    under the End Stage Renal Disease Facility Act;
        6. An institution, place, building, or room used for
    the performance of outpatient surgical procedures that is
    leased, owned, or operated by or on behalf of an
    out-of-state facility;
        7. An institution, place, building, or room used for
    provision of a health care category of service, including,
    but not limited to, cardiac catheterization and open heart
    surgery; and
        8. An institution, place, building, or room used for
    provision of major medical equipment used in the direct
    clinical diagnosis or treatment of patients, and whose
    project cost is in excess of the capital expenditure
    minimum.
    This Act shall not apply to the construction of any new
facility or the renovation of any existing facility located on
any campus facility as defined in Section 5-5.8b of the
Illinois Public Aid Code, provided that the campus facility
encompasses 30 or more contiguous acres and that the new or
renovated facility is intended for use by a licensed
residential facility.
    No federally owned facility shall be subject to the
provisions of this Act, nor facilities used solely for healing
by prayer or spiritual means.
    No facility licensed under the Supportive Residences
Licensing Act or the Assisted Living and Shared Housing Act
shall be subject to the provisions of this Act.
    No facility established and operating under the
Alternative Health Care Delivery Act as a children's
community-based health care center children's respite care
center alternative health care model demonstration program or
as an Alzheimer's Disease Management Center alternative health
care model demonstration program shall be subject to the
provisions of this Act.
    A facility designated as a supportive living facility that
is in good standing with the program established under Section
5-5.01a of the Illinois Public Aid Code shall not be subject to
the provisions of this Act.
    This Act does not apply to facilities granted waivers under
Section 3-102.2 of the Nursing Home Care Act. However, if a
demonstration project under that Act applies for a certificate
of need to convert to a nursing facility, it shall meet the
licensure and certificate of need requirements in effect as of
the date of application.
    This Act does not apply to a dialysis facility that
provides only dialysis training, support, and related services
to individuals with end stage renal disease who have elected to
receive home dialysis. This Act does not apply to a dialysis
unit located in a licensed nursing home that offers or provides
dialysis-related services to residents with end stage renal
disease who have elected to receive home dialysis within the
nursing home. The Board, however, may require these dialysis
facilities and licensed nursing homes to report statistical
information on a quarterly basis to the Board to be used by the
Board to conduct analyses on the need for proposed kidney
disease treatment centers.
    This Act shall not apply to the closure of an entity or a
portion of an entity licensed under the Nursing Home Care Act,
the Specialized Mental Health Rehabilitation Act, or the ID/DD
Community Care Act, with the exceptions of facilities operated
by a county or Illinois Veterans Homes, that elects to convert,
in whole or in part, to an assisted living or shared housing
establishment licensed under the Assisted Living and Shared
Housing Act.
    This Act does not apply to any change of ownership of a
healthcare facility that is licensed under the Nursing Home
Care Act, the Specialized Mental Health Rehabilitation Act, or
the ID/DD Community Care Act, with the exceptions of facilities
operated by a county or Illinois Veterans Homes. Changes of
ownership of facilities licensed under the Nursing Home Care
Act must meet the requirements set forth in Sections 3-101
through 3-119 of the Nursing Home Care Act.
    With the exception of those health care facilities
specifically included in this Section, nothing in this Act
shall be intended to include facilities operated as a part of
the practice of a physician or other licensed health care
professional, whether practicing in his individual capacity or
within the legal structure of any partnership, medical or
professional corporation, or unincorporated medical or
professional group. Further, this Act shall not apply to
physicians or other licensed health care professional's
practices where such practices are carried out in a portion of
a health care facility under contract with such health care
facility by a physician or by other licensed health care
professionals, whether practicing in his individual capacity
or within the legal structure of any partnership, medical or
professional corporation, or unincorporated medical or
professional groups, unless the entity constructs, modifies,
or establishes a health care facility as specifically defined
in this Section. This Act shall apply to construction or
modification and to establishment by such health care facility
of such contracted portion which is subject to facility
licensing requirements, irrespective of the party responsible
for such action or attendant financial obligation.
    No permit or exemption is required for a facility licensed
under the ID/DD Community Care Act prior to the reduction of
the number of beds at a facility. If there is a total reduction
of beds at a facility licensed under the ID/DD Community Care
Act, this is a discontinuation or closure of the facility.
However, if a facility licensed under the ID/DD Community Care
Act reduces the number of beds or discontinues the facility,
that facility must notify the Board as provided in Section 14.1
of this Act.
    "Person" means any one or more natural persons, legal
entities, governmental bodies other than federal, or any
combination thereof.
    "Consumer" means any person other than a person (a) whose
major occupation currently involves or whose official capacity
within the last 12 months has involved the providing,
administering or financing of any type of health care facility,
(b) who is engaged in health research or the teaching of
health, (c) who has a material financial interest in any
activity which involves the providing, administering or
financing of any type of health care facility, or (d) who is or
ever has been a member of the immediate family of the person
defined by (a), (b), or (c).
    "State Board" or "Board" means the Health Facilities and
Services Review Board.
    "Construction or modification" means the establishment,
erection, building, alteration, reconstruction, modernization,
improvement, extension, discontinuation, change of ownership,
of or by a health care facility, or the purchase or acquisition
by or through a health care facility of equipment or service
for diagnostic or therapeutic purposes or for facility
administration or operation, or any capital expenditure made by
or on behalf of a health care facility which exceeds the
capital expenditure minimum; however, any capital expenditure
made by or on behalf of a health care facility for (i) the
construction or modification of a facility licensed under the
Assisted Living and Shared Housing Act or (ii) a conversion
project undertaken in accordance with Section 30 of the Older
Adult Services Act shall be excluded from any obligations under
this Act.
    "Establish" means the construction of a health care
facility or the replacement of an existing facility on another
site or the initiation of a category of service.
    "Major medical equipment" means medical equipment which is
used for the provision of medical and other health services and
which costs in excess of the capital expenditure minimum,
except that such term does not include medical equipment
acquired by or on behalf of a clinical laboratory to provide
clinical laboratory services if the clinical laboratory is
independent of a physician's office and a hospital and it has
been determined under Title XVIII of the Social Security Act to
meet the requirements of paragraphs (10) and (11) of Section
1861(s) of such Act. In determining whether medical equipment
has a value in excess of the capital expenditure minimum, the
value of studies, surveys, designs, plans, working drawings,
specifications, and other activities essential to the
acquisition of such equipment shall be included.
    "Capital Expenditure" means an expenditure: (A) made by or
on behalf of a health care facility (as such a facility is
defined in this Act); and (B) which under generally accepted
accounting principles is not properly chargeable as an expense
of operation and maintenance, or is made to obtain by lease or
comparable arrangement any facility or part thereof or any
equipment for a facility or part; and which exceeds the capital
expenditure minimum.
    For the purpose of this paragraph, the cost of any studies,
surveys, designs, plans, working drawings, specifications, and
other activities essential to the acquisition, improvement,
expansion, or replacement of any plant or equipment with
respect to which an expenditure is made shall be included in
determining if such expenditure exceeds the capital
expenditures minimum. Unless otherwise interdependent, or
submitted as one project by the applicant, components of
construction or modification undertaken by means of a single
construction contract or financed through the issuance of a
single debt instrument shall not be grouped together as one
project. Donations of equipment or facilities to a health care
facility which if acquired directly by such facility would be
subject to review under this Act shall be considered capital
expenditures, and a transfer of equipment or facilities for
less than fair market value shall be considered a capital
expenditure for purposes of this Act if a transfer of the
equipment or facilities at fair market value would be subject
to review.
    "Capital expenditure minimum" means $11,500,000 for
projects by hospital applicants, $6,500,000 for applicants for
projects related to skilled and intermediate care long-term
care facilities licensed under the Nursing Home Care Act, and
$3,000,000 for projects by all other applicants, which shall be
annually adjusted to reflect the increase in construction costs
due to inflation, for major medical equipment and for all other
capital expenditures.
    "Non-clinical service area" means an area (i) for the
benefit of the patients, visitors, staff, or employees of a
health care facility and (ii) not directly related to the
diagnosis, treatment, or rehabilitation of persons receiving
services from the health care facility. "Non-clinical service
areas" include, but are not limited to, chapels; gift shops;
news stands; computer systems; tunnels, walkways, and
elevators; telephone systems; projects to comply with life
safety codes; educational facilities; student housing;
patient, employee, staff, and visitor dining areas;
administration and volunteer offices; modernization of
structural components (such as roof replacement and masonry
work); boiler repair or replacement; vehicle maintenance and
storage facilities; parking facilities; mechanical systems for
heating, ventilation, and air conditioning; loading docks; and
repair or replacement of carpeting, tile, wall coverings,
window coverings or treatments, or furniture. Solely for the
purpose of this definition, "non-clinical service area" does
not include health and fitness centers.
    "Areawide" means a major area of the State delineated on a
geographic, demographic, and functional basis for health
planning and for health service and having within it one or
more local areas for health planning and health service. The
term "region", as contrasted with the term "subregion", and the
word "area" may be used synonymously with the term "areawide".
    "Local" means a subarea of a delineated major area that on
a geographic, demographic, and functional basis may be
considered to be part of such major area. The term "subregion"
may be used synonymously with the term "local".
    "Physician" means a person licensed to practice in
accordance with the Medical Practice Act of 1987, as amended.
    "Licensed health care professional" means a person
licensed to practice a health profession under pertinent
licensing statutes of the State of Illinois.
    "Director" means the Director of the Illinois Department of
Public Health.
    "Agency" means the Illinois Department of Public Health.
    "Alternative health care model" means a facility or program
authorized under the Alternative Health Care Delivery Act.
    "Out-of-state facility" means a person that is both (i)
licensed as a hospital or as an ambulatory surgery center under
the laws of another state or that qualifies as a hospital or an
ambulatory surgery center under regulations adopted pursuant
to the Social Security Act and (ii) not licensed under the
Ambulatory Surgical Treatment Center Act, the Hospital
Licensing Act, or the Nursing Home Care Act. Affiliates of
out-of-state facilities shall be considered out-of-state
facilities. Affiliates of Illinois licensed health care
facilities 100% owned by an Illinois licensed health care
facility, its parent, or Illinois physicians licensed to
practice medicine in all its branches shall not be considered
out-of-state facilities. Nothing in this definition shall be
construed to include an office or any part of an office of a
physician licensed to practice medicine in all its branches in
Illinois that is not required to be licensed under the
Ambulatory Surgical Treatment Center Act.
    "Change of ownership of a health care facility" means a
change in the person who has ownership or control of a health
care facility's physical plant and capital assets. A change in
ownership is indicated by the following transactions: sale,
transfer, acquisition, lease, change of sponsorship, or other
means of transferring control.
    "Related person" means any person that: (i) is at least 50%
owned, directly or indirectly, by either the health care
facility or a person owning, directly or indirectly, at least
50% of the health care facility; or (ii) owns, directly or
indirectly, at least 50% of the health care facility.
    "Charity care" means care provided by a health care
facility for which the provider does not expect to receive
payment from the patient or a third-party payer.
    "Freestanding emergency center" means a facility subject
to licensure under Section 32.5 of the Emergency Medical
Services (EMS) Systems Act.
    "Category of service" means a grouping by generic class of
various types or levels of support functions, equipment, care,
or treatment provided to patients or residents, including, but
not limited to, classes such as medical-surgical, pediatrics,
or cardiac catheterization. A category of service may include
subcategories or levels of care that identify a particular
degree or type of care within the category of service. Nothing
in this definition shall be construed to include the practice
of a physician or other licensed health care professional while
functioning in an office providing for the care, diagnosis, or
treatment of patients. A category of service that is subject to
the Board's jurisdiction must be designated in rules adopted by
the Board.
(Source: P.A. 97-38, eff. 6-28-11; 97-277, eff. 1-1-12; 97-813,
eff. 7-13-12; 97-980, eff. 8-17-12; 98-414, eff. 1-1-14.)
 
    Section 10. The Alternative Health Care Delivery Act is
amended by changing Sections 15 and 30 as follows:
 
    (210 ILCS 3/15)
    Sec. 15. License required. No health care facility or
program that meets the definition and scope of an alternative
health care model shall operate as such unless it is a
participant in a demonstration program under this Act and
licensed by the Department as an alternative health care model.
The provisions of this Act concerning children's
community-based health care centers children's respite care
centers shall not apply to any facility licensed under the
Hospital Licensing Act, the Nursing Home Care Act, the
Specialized Mental Health Rehabilitation Act, the ID/DD
Community Care Act, or the University of Illinois Hospital Act
that provides respite care services to children.
(Source: P.A. 96-339, eff. 7-1-10; 97-38, eff. 6-28-11; 97-135,
eff. 7-14-11; 97-227, eff. 1-1-12; 97-813, eff. 7-13-12.)
 
    (210 ILCS 3/30)
    Sec. 30. Demonstration program requirements. The
requirements set forth in this Section shall apply to
demonstration programs.
    (a) (Blank).
    (a-5) There shall be no more than the total number of
postsurgical recovery care centers with a certificate of need
for beds as of January 1, 2008.
    (a-10) There shall be no more than a total of 9 children's
community-based health care center children's respite care
center alternative health care models in the demonstration
program, which shall be located as follows:
        (1) Two in the City of Chicago.
        (2) One in Cook County outside the City of Chicago.
        (3) A total of 2 in the area comprised of DuPage, Kane,
    Lake, McHenry, and Will counties.
        (4) A total of 2 in municipalities with a population of
    50,000 or more and not located in the areas described in
    paragraphs (1), (2), or (3).
        (5) A total of 2 in rural areas, as defined by the
    Health Facilities and Services Review Board.
    No more than one children's community-based health care
center children's respite care model owned and operated by a
licensed skilled pediatric facility shall be located in each of
the areas designated in this subsection (a-10).
    (a-15) There shall be 5 authorized community-based
residential rehabilitation center alternative health care
models in the demonstration program.
    (a-20) There shall be an authorized Alzheimer's disease
management center alternative health care model in the
demonstration program. The Alzheimer's disease management
center shall be located in Will County, owned by a
not-for-profit entity, and endorsed by a resolution approved by
the county board before the effective date of this amendatory
Act of the 91st General Assembly.
    (a-25) There shall be no more than 10 birth center
alternative health care models in the demonstration program,
located as follows:
        (1) Four in the area comprising Cook, DuPage, Kane,
    Lake, McHenry, and Will counties, one of which shall be
    owned or operated by a hospital and one of which shall be
    owned or operated by a federally qualified health center.
        (2) Three in municipalities with a population of 50,000
    or more not located in the area described in paragraph (1)
    of this subsection, one of which shall be owned or operated
    by a hospital and one of which shall be owned or operated
    by a federally qualified health center.
        (3) Three in rural areas, one of which shall be owned
    or operated by a hospital and one of which shall be owned
    or operated by a federally qualified health center.
    The first 3 birth centers authorized to operate by the
Department shall be located in or predominantly serve the
residents of a health professional shortage area as determined
by the United States Department of Health and Human Services.
There shall be no more than 2 birth centers authorized to
operate in any single health planning area for obstetric
services as determined under the Illinois Health Facilities
Planning Act. If a birth center is located outside of a health
professional shortage area, (i) the birth center shall be
located in a health planning area with a demonstrated need for
obstetrical service beds, as determined by the Health
Facilities and Services Review Board or (ii) there must be a
reduction in the existing number of obstetrical service beds in
the planning area so that the establishment of the birth center
does not result in an increase in the total number of
obstetrical service beds in the health planning area.
    (b) Alternative health care models, other than a model
authorized under subsection (a-10) or (a-20), shall obtain a
certificate of need from the Health Facilities and Services
Review Board under the Illinois Health Facilities Planning Act
before receiving a license by the Department. If, after
obtaining its initial certificate of need, an alternative
health care delivery model that is a community based
residential rehabilitation center seeks to increase the bed
capacity of that center, it must obtain a certificate of need
from the Health Facilities and Services Review Board before
increasing the bed capacity. Alternative health care models in
medically underserved areas shall receive priority in
obtaining a certificate of need.
    (c) An alternative health care model license shall be
issued for a period of one year and shall be annually renewed
if the facility or program is in substantial compliance with
the Department's rules adopted under this Act. A licensed
alternative health care model that continues to be in
substantial compliance after the conclusion of the
demonstration program shall be eligible for annual renewals
unless and until a different licensure program for that type of
health care model is established by legislation, except that a
postsurgical recovery care center meeting the following
requirements may apply within 3 years after August 25, 2009
(the effective date of Public Act 96-669) for a Certificate of
Need permit to operate as a hospital:
        (1) The postsurgical recovery care center shall apply
    to the Health Facilities and Services Review Board for a
    Certificate of Need permit to discontinue the postsurgical
    recovery care center and to establish a hospital.
        (2) If the postsurgical recovery care center obtains a
    Certificate of Need permit to operate as a hospital, it
    shall apply for licensure as a hospital under the Hospital
    Licensing Act and shall meet all statutory and regulatory
    requirements of a hospital.
        (3) After obtaining licensure as a hospital, any
    license as an ambulatory surgical treatment center and any
    license as a post-surgical recovery care center shall be
    null and void.
        (4) The former postsurgical recovery care center that
    receives a hospital license must seek and use its best
    efforts to maintain certification under Titles XVIII and
    XIX of the federal Social Security Act.
    The Department may issue a provisional license to any
alternative health care model that does not substantially
comply with the provisions of this Act and the rules adopted
under this Act if (i) the Department finds that the alternative
health care model has undertaken changes and corrections which
upon completion will render the alternative health care model
in substantial compliance with this Act and rules and (ii) the
health and safety of the patients of the alternative health
care model will be protected during the period for which the
provisional license is issued. The Department shall advise the
licensee of the conditions under which the provisional license
is issued, including the manner in which the alternative health
care model fails to comply with the provisions of this Act and
rules, and the time within which the changes and corrections
necessary for the alternative health care model to
substantially comply with this Act and rules shall be
completed.
    (d) Alternative health care models shall seek
certification under Titles XVIII and XIX of the federal Social
Security Act. In addition, alternative health care models shall
provide charitable care consistent with that provided by
comparable health care providers in the geographic area.
    (d-5) (Blank).
    (e) Alternative health care models shall, to the extent
possible, link and integrate their services with nearby health
care facilities.
    (f) Each alternative health care model shall implement a
quality assurance program with measurable benefits and at
reasonable cost.
(Source: P.A. 96-31, eff. 6-30-09; 96-129, eff. 8-4-09; 96-669,
eff. 8-25-09; 96-812, eff. 1-1-10; 96-1000, eff. 7-2-10;
96-1071, eff. 7-16-10; 96-1123, eff. 1-1-11; 97-135, eff.
7-14-11; 97-333, eff. 8-12-11; 97-813, eff. 7-13-12.)

Effective Date: 1/1/2015