Public Act 094-0342
 
SB1651 Enrolled LRB094 11173 DRJ 41829 b

    AN ACT concerning public aid.
 
    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    (Section scheduled to be repealed on July 1, 2006)
    Sec. 3. Definitions. As used in this Act:
    "Health care facilities" means and includes the following
facilities and organizations:
        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. Skilled and intermediate long term care facilities
    licensed under the Nursing Home Care 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; and
        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.
    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.
    A facility designated as a supportive living facility that
is in good standing with the program demonstration project
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
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.
    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. 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.
    "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" means the Health Facilities Planning 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.
    "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. 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 $6,000,000, 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; provided,
however, that when a capital expenditure is for the
construction or modification of a health and fitness center,
"capital expenditure minimum" means the capital expenditure
minimum for all other capital expenditures in effect on March
1, 2000, which shall be annually adjusted to reflect the
increase in construction costs due to inflation.
    "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".
    "Areawide health planning organization" or "Comprehensive
health planning organization" means the health systems agency
designated by the Secretary, Department of Health and Human
Services or any successor agency.
    "Local health planning organization" means those local
health planning organizations that are designated as such by
the areawide health planning organization of the appropriate
area.
    "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.
    "Comprehensive health planning" means health planning
concerned with the total population and all health and
associated problems that affect the well-being of people and
that encompasses health services, health manpower, and health
facilities; and the coordination among these and with those
social, economic, and environmental factors that affect
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.
(Source: P.A. 93-41, eff. 6-27-03; 93-766, eff. 7-20-04;
93-935, eff. 1-1-05; 93-1031, eff. 8-27-04; revised 10-25-04.)
 
    Section 10. The Nursing Home Care Act is amended by
changing Section 1-113 as follows:
 
    (210 ILCS 45/1-113)  (from Ch. 111 1/2, par. 4151-113)
    Sec. 1-113. "Facility" or "long-term care facility" means a
private home, institution, building, residence, or any other
place, whether operated for profit or not, or a county home for
the infirm and chronically ill operated pursuant to Division
5-21 or 5-22 of the Counties Code, or any similar institution
operated by a political subdivision of the State of Illinois,
which provides, through its ownership or management, personal
care, sheltered care or nursing for 3 or more persons, not
related to the applicant or owner by blood or marriage. It
includes skilled nursing facilities and intermediate care
facilities as those terms are defined in Title XVIII and Title
XIX of the Federal Social Security Act. It also includes homes,
institutions, or other places operated by or under the
authority of the Illinois Department of Veterans' Affairs.
    "Facility" does not include the following:
    (1) A home, institution, or other place operated by the
federal government or agency thereof, or by the State of
Illinois, other than homes, institutions, or other places
operated by or under the authority of the Illinois Department
of Veterans' Affairs;
    (2) A hospital, sanitarium, or other institution whose
principal activity or business is the diagnosis, care, and
treatment of human illness through the maintenance and
operation as organized facilities therefor, which is required
to be licensed under the Hospital Licensing Act;
    (3) Any "facility for child care" as defined in the Child
Care Act of 1969;
    (4) Any "Community Living Facility" as defined in the
Community Living Facilities Licensing Act;
    (5) Any "community residential alternative" as defined in
the Community Residential Alternatives Licensing Act;
    (6) Any nursing home or sanatorium operated solely by and
for persons who rely exclusively upon treatment by spiritual
means through prayer, in accordance with the creed or tenets of
any well-recognized church or religious denomination. However,
such nursing home or sanatorium shall comply with all local
laws and rules relating to sanitation and safety;
    (7) Any facility licensed by the Department of Human
Services as a community-integrated living arrangement as
defined in the Community-Integrated Living Arrangements
Licensure and Certification Act;
    (8) Any "Supportive Residence" licensed under the
Supportive Residences Licensing Act;
    (9) Any "supportive living facility" in good standing with
the program demonstration project established under Section
5-5.01a of the Illinois Public Aid Code;
    (10) Any assisted living or shared housing establishment
licensed under the Assisted Living and Shared Housing Act; or
    (11) An Alzheimer's disease management center alternative
health care model licensed under the Alternative Health Care
Delivery Act.
(Source: P.A. 90-14, eff. 7-1-97; 90-763, eff. 8-14-98; 91-656,
eff. 1-1-01; 91-838, eff. 6-16-00.)
 
    Section 15. The Illinois Public Aid Code is amended by
changing Section 5-5.01a as follows:
 
    (305 ILCS 5/5-5.01a)
    Sec. 5-5.01a. Supportive living facilities program
demonstration project. The For the purpose of studying
alternative settings for long term care, the Department shall
may establish and provide oversight for a program demonstration
project to determine the viability of supportive living
facilities that seek to promote resident independence,
dignity, respect, and well-being in the most cost-effective
manner.
    A supportive living facility is either a free-standing
facility or a distinct physical and operational entity within a
nursing facility. A supportive living facility integrates
housing with health, personal care, and supportive services and
is a designated setting that offers residents their own
separate, private, and distinct living units.
    Sites for the operation of the program Demonstration sites
shall be selected by the Department based upon criteria that
may include the need for services in a geographic area, the
availability of funding, and the site's ability to meet the
standards.
    The Department may adopt rules to implement this Section.
Rules that establish or modify the services, standards, and
conditions for participation in the program demonstration
project shall be adopted by the Department in consultation with
the Department on Aging, the Department of Rehabilitation
Services, and the Department of Mental Health and Developmental
Disabilities (or their successor agencies).
    Facilities or distinct parts of facilities which are
selected as supportive living facilities and are in good
standing with the Department's rules are exempt from the
provisions of the Nursing Home Care Act and the Illinois Health
Facilities Planning Act.
(Source: P.A. 89-499, eff. 6-28-96.)
 
    Section 20. The Older Adult Services Act is amended by
changing Section 20 as follows:
 
    (320 ILCS 42/20)
    Sec. 20. Priority service areas; service expansion.
    (a) The requirements of this Section are subject to the
availability of funding.
    (b) The Department shall expand older adult services that
promote independence and permit older adults to remain in their
own homes and communities. Priority shall be given to both the
expansion of services and the development of new services in
priority service areas.
    (c) Inventory of services. The Department shall develop and
maintain an inventory and assessment of (i) the types and
quantities of public older adult services and, to the extent
possible, privately provided older adult services, including
the unduplicated count, location, and characteristics of
individuals served by each facility, program, or service and
(ii) the resources supporting those services.
    (d) Priority service areas. The Departments shall assess
the current and projected need for older adult services
throughout the State, analyze the results of the inventory, and
identify priority service areas, which shall serve as the basis
for a priority service plan to be filed with the Governor and
the General Assembly no later than July 1, 2006, and every 5
years thereafter.
    (e) Moneys appropriated by the General Assembly for the
purpose of this Section, receipts from donations, grants, fees,
or taxes that may accrue from any public or private sources to
the Department for the purpose of this Section, and savings
attributable to the nursing home conversion program as
calculated in subsection (h) shall be deposited into the
Department on Aging State Projects Fund. Interest earned by
those moneys in the Fund shall be credited to the Fund.
    (f) Moneys described in subsection (e) from the Department
on Aging State Projects Fund shall be used for older adult
services, regardless of where the older adult receives the
service, with priority given to both the expansion of services
and the development of new services in priority service areas.
Fundable services shall include:
        (1) Housing, health services, and supportive services:
            (A) adult day care;
            (B) adult day care for persons with Alzheimer's
        disease and related disorders;
            (C) activities of daily living;
            (D) care-related supplies and equipment;
            (E) case management;
            (F) community reintegration;
            (G) companion;
            (H) congregate meals;
            (I) counseling and education;
            (J) elder abuse prevention and intervention;
            (K) emergency response and monitoring;
            (L) environmental modifications;
            (M) family caregiver support;
            (N) financial;
            (O) home delivered meals;
            (P) homemaker;
            (Q) home health;
            (R) hospice;
            (S) laundry;
            (T) long-term care ombudsman;
            (U) medication reminders;
            (V) money management;
            (W) nutrition services;
            (X) personal care;
            (Y) respite care;
            (Z) residential care;
            (AA) senior benefits outreach;
            (BB) senior centers;
            (CC) services provided under the Assisted Living
        and Shared Housing Act, or sheltered care services that
        meet the requirements of the Assisted Living and Shared
        Housing Act, or services provided under Section
        5-5.01a of the Illinois Public Aid Code (the Supportive
        Living Facilities Pilot Program);
            (DD) telemedicine devices to monitor recipients in
        their own homes as an alternative to hospital care,
        nursing home care, or home visits;
            (EE) training for direct family caregivers;
            (FF) transition;
            (GG) transportation;
            (HH) wellness and fitness programs; and
            (II) other programs designed to assist older
        adults in Illinois to remain independent and receive
        services in the most integrated residential setting
        possible for that person.
        (2) Older Adult Services Demonstration Grants,
    pursuant to subsection (g) of this Section.
    (g) Older Adult Services Demonstration Grants. The
Department shall establish a program of demonstration grants to
assist in the restructuring of the delivery system for older
adult services and provide funding for innovative service
delivery models and system change and integration initiatives.
The Department shall prescribe, by rule, the grant application
process. At a minimum, every application must include:
        (1) The type of grant sought;
        (2) A description of the project;
        (3) The objective of the project;
        (4) The likelihood of the project meeting identified
    needs;
        (5) The plan for financing, administration, and
    evaluation of the project;
        (6) The timetable for implementation;
        (7) The roles and capabilities of responsible
    individuals and organizations;
        (8) Documentation of collaboration with other service
    providers, local community government leaders, and other
    stakeholders, other providers, and any other stakeholders
    in the community;
        (9) Documentation of community support for the
    project, including support by other service providers,
    local community government leaders, and other
    stakeholders;
        (10) The total budget for the project;
        (11) The financial condition of the applicant; and
        (12) Any other application requirements that may be
    established by the Department by rule.
    Each project may include provisions for a designated staff
person who is responsible for the development of the project
and recruitment of providers.
    Projects may include, but are not limited to: adult family
foster care; family adult day care; assisted living in a
supervised apartment; personal services in a subsidized
housing project; evening and weekend home care coverage; small
incentive grants to attract new providers; money following the
person; cash and counseling; managed long-term care; and at
least one respite care project that establishes a local
coordinated network of volunteer and paid respite workers,
coordinates assignment of respite workers to caregivers and
older adults, ensures the health and safety of the older adult,
provides training for caregivers, and ensures that support
groups are available in the community.
    A demonstration project funded in whole or in part by an
Older Adult Services Demonstration Grant is exempt from the
requirements of the Illinois Health Facilities Planning Act. To
the extent applicable, however, for the purpose of maintaining
the statewide inventory authorized by the Illinois Health
Facilities Planning Act, the Department shall send to the
Health Facilities Planning Board a copy of each grant award
made under this subsection (g).
    The Department, in collaboration with the Departments of
Public Health and Public Aid, shall evaluate the effectiveness
of the projects receiving grants under this Section.
    (h) No later than July 1 of each year, the Department of
Public Health shall provide information to the Department of
Public Aid to enable the Department of Public Aid to annually
document and verify the savings attributable to the nursing
home conversion program for the previous fiscal year to
estimate an annual amount of such savings that may be
appropriated to the Department on Aging State Projects Fund and
notify the General Assembly, the Department on Aging, the
Department of Human Services, and the Advisory Committee of the
savings no later than October 1 of the same fiscal year.
(Source: P.A. 93-1031, eff. 8-27-04.)
 
    Section 99. Effective date. This Act takes effect upon
becoming law.