SB3387 93RD GENERAL ASSEMBLY

LRB093 22834 AMC 52643 b

93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004
SB3387

Introduced 7/14/2004, by Sen. Kirk W. Dillard - Steven J. Rauschenberger - Christine Radogno

SYNOPSIS AS INTRODUCED:

5 ILCS 120/1.02	from Ch. 102, par. 41.02
5 ILCS 430/5-50
20 ILCS 3960/Act rep.
30 ILCS 5/3-1	from Ch. 15, par. 303-1
30 ILCS 105/5.213 rep.	from Ch. 127, par. 141.213
70 ILCS 910/15	from Ch. 23, par. 1265
210 ILCS 3/20
210 ILCS 3/30
210 ILCS 3/36.5 rep.
210 ILCS 9/10
210 ILCS 9/145
210 ILCS 9/155
210 ILCS 40/2	from Ch. 111 1/2, par. 4160-2
210 ILCS 40/7	from Ch. 111 1/2, par. 4160-7
210 ILCS 45/3-102.2
210 ILCS 45/3-103	from Ch. 111 1/2, par. 4153-103
210 ILCS 50/32.5
210 ILCS 85/4.5
210 ILCS 85/10.8
225 ILCS 7/4 rep.
225 ILCS 47/5
225 ILCS 47/15
225 ILCS 47/20
225 ILCS 47/30
225 ILCS 47/35
225 ILCS 47/40
225 ILCS 510/3	from Ch. 111, par. 953
305 ILCS 5/5-5.01a
305 ILCS 5/5-5.02	from Ch. 23, par. 5-5.02
405 ILCS 25/4.03 rep.	from Ch. 91 1/2, par. 604.03

Repeals the Illinois Health Facilities Planning Act and abolishes the Health Facilities Planning Board. Amends the Health Care Worker Self-Referral Act to transfer the Board's functions under that Act to the Department of Public Health. Amends various other Acts to eliminate references to the Board or the Act. Effective immediately.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning State agencies.

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

4		Section 5. The Open Meetings Act is amended by changing
5		Section 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 of a majority of a quorum of
9		the members of a public body held for the purpose of discussing
10		public business.
11		"Public body" includes all legislative, executive,
12		administrative or advisory bodies of the State, counties,
13		townships, cities, villages, incorporated towns, school
14		districts and all other municipal corporations, boards,
15		bureaus, committees or commissions of this State, and any
16		subsidiary bodies of any of the foregoing including but not
17		limited to committees and subcommittees which are supported in
18		whole or in part by tax revenue, or which expend tax revenue,
19		except the General Assembly and committees or commissions
20		thereof. "Public body" includes tourism boards and convention
21		or civic center boards located in counties that are contiguous
22		to the Mississippi River with populations of more than 250,000
23		but less than 300,000. "Public body" includes the Health
24		Facilities Planning Board. "Public body" does not include a
25		child death review team or the Illinois Child Death Review
26		Teams Executive Council established under the Child Death
27		Review Team Act or an ethics commission acting under the State
28		Officials and Employees Ethics Act.
29		(Source: P.A. 92-468, eff. 8-22-01; 93-617, eff. 12-9-03.)

30		Section 10. The State Officials and Employees Ethics Act is
31		amended by changing Section 5-50 as follows:

1		(5 ILCS 430/5-50)
2		Sec. 5-50. Ex parte communications; special government
3		agents.
4		(a) This Section applies to ex parte communications made to
5		any agency listed in subsection (e).
6		(b) "Ex parte communication" means any written or oral
7		communication by any person that imparts or requests material
8		information or makes a material argument regarding potential
9		action concerning regulatory, quasi-adjudicatory, investment,
10		or licensing matters pending before or under consideration by
11		the agency. "Ex parte communication" does not include the
12		following: (i) statements by a person publicly made in a public
13		forum; (ii) statements regarding matters of procedure and
14		practice, such as format, the number of copies required, the
15		manner of filing, and the status of a matter; and (iii)
16		statements made by a State employee of the agency to the agency
17		head or other employees of that agency.
18		(b-5) An ex parte communication received by an agency,
19		agency head, or other agency employee from an interested party
20		or his or her official representative or attorney shall
21		promptly be memorialized and made a part of the record.
22		(c) An ex parte communication received by any agency,
23		agency head, or other agency employee, other than an ex parte
24		communication described in subsection (b-5), shall immediately
25		be reported to that agency's ethics officer by the recipient of
26		the communication and by any other employee of that agency who
27		responds to the communication. The ethics officer shall require
28		that the ex parte communication be promptly made a part of the
29		record. The ethics officer shall promptly file the ex parte
30		communication with the Executive Ethics Commission, including
31		all written communications, all written responses to the
32		communications, and a memorandum prepared by the ethics officer
33		stating the nature and substance of all oral communications,
34		the identity and job title of the person to whom each
35		communication was made, all responses made, the identity and

1		job title of the person making each response, the identity of
2		each person from whom the written or oral ex parte
3		communication was received, the individual or entity
4		represented by that person, any action the person requested or
5		recommended, and any other pertinent information. The
6		disclosure shall also contain the date of any ex parte
7		communication.
8		(d) "Interested party" means a person or entity whose
9		rights, privileges, or interests are the subject of or are
10		directly affected by a regulatory, quasi-adjudicatory,
11		investment, or licensing matter.
12		(e) This Section applies to the following agencies:
13		Executive Ethics Commission
14		Illinois Commerce Commission
15		Educational Labor Relations Board
16		State Board of Elections
17		Illinois Gaming Board
18		Health Facilities Planning Board
19		Industrial Commission
20		Illinois Labor Relations Board
21		Illinois Liquor Control Commission
22		Pollution Control Board
23		Property Tax Appeal Board
24		Illinois Racing Board
25		Illinois Purchased Care Review Board
26		Department of State Police Merit Board
27		Motor Vehicle Review Board
28		Prisoner Review Board
29		Civil Service Commission
30		Personnel Review Board for the Treasurer
31		Merit Commission for the Secretary of State
32		Merit Commission for the Office of the Comptroller
33		Court of Claims
34		Board of Review of the Department of Employment Security
35		Department of Insurance
36		Department of Professional Regulation and licensing boards

1		under the Department
2		Department of Public Health and licensing boards under the
3		Department
4		Office of Banks and Real Estate and licensing boards under
5		the Office
6		State Employees Retirement System Board of Trustees
7		Judges Retirement System Board of Trustees
8		General Assembly Retirement System Board of Trustees
9		Illinois Board of Investment
10		State Universities Retirement System Board of Trustees
11		Teachers Retirement System Officers Board of Trustees
12		(f) Any person who fails to (i) report an ex parte
13		communication to an ethics officer, (ii) make information part
14		of the record, or (iii) make a filing with the Executive Ethics
15		Commission as required by this Section or as required by
16		Section 5-165 of the Illinois Administrative Procedure Act
17		violates this Act.
18		(Source: P.A. 93-617, eff. 12-9-03.)

19		(20 ILCS 3960/Act rep.)
20		Section 15. The Illinois Health Facilities Planning Act is
21		repealed.

22		Section 20. The Illinois State Auditing Act is amended by
23		changing Section 3-1 as follows:
24		(30 ILCS 5/3-1) (from Ch. 15, par. 303-1)
25		Sec. 3-1. Jurisdiction of Auditor General. The Auditor
26		General has jurisdiction over all State agencies to make post
27		audits and investigations authorized by or under this Act or
28		the Constitution.
29		The Auditor General has jurisdiction over local government
30		agencies and private agencies only:
31		(a) to make such post audits authorized by or under
32		this Act as are necessary and incidental to a post audit of
33		a State agency or of a program administered by a State

1		agency involving public funds of the State, but this
2		jurisdiction does not include any authority to review local
3		governmental agencies in the obligation, receipt,
4		expenditure or use of public funds of the State that are
5		granted without limitation or condition imposed by law,
6		other than the general limitation that such funds be used
7		for public purposes;
8		(b) to make investigations authorized by or under this
9		Act or the Constitution; and
10		(c) to make audits of the records of local government
11		agencies to verify actual costs of state-mandated programs
12		when directed to do so by the Legislative Audit Commission
13		at the request of the State Board of Appeals under the
14		State Mandates Act.
15		In addition to the foregoing, the Auditor General may
16		conduct an audit of the Metropolitan Pier and Exposition
17		Authority, the Regional Transportation Authority, the Suburban
18		Bus Division, the Commuter Rail Division and the Chicago
19		Transit Authority and any other subsidized carrier when
20		authorized by the Legislative Audit Commission. Such audit may
21		be a financial, management or program audit, or any combination
22		thereof.
23		The audit shall determine whether they are operating in
24		accordance with all applicable laws and regulations. Subject to
25		the limitations of this Act, the Legislative Audit Commission
26		may by resolution specify additional determinations to be
27		included in the scope of the audit.
28		In addition to the foregoing, the Auditor General must also
29		conduct a financial audit of the Illinois Sports Facilities
30		Authority's expenditures of public funds in connection with the
31		reconstruction, renovation, remodeling, extension, or
32		improvement of all or substantially all of any existing
33		"facility", as that term is defined in the Illinois Sports
34		Facilities Authority Act.
35		The Auditor General may also conduct an audit, when
36		authorized by the Legislative Audit Commission, of any hospital

1		which receives 10% or more of its gross revenues from payments
2		from the State of Illinois, Department of Public Aid, Medical
3		Assistance Program.
4		The Auditor General is authorized to conduct financial and
5		compliance audits of the Illinois Distance Learning Foundation
6		and the Illinois Conservation Foundation.
7		As soon as practical after the effective date of this
8		amendatory Act of 1995, the Auditor General shall conduct a
9		compliance and management audit of the City of Chicago and any
10		other entity with regard to the operation of Chicago O'Hare
11		International Airport, Chicago Midway Airport and Merrill C.
12		Meigs Field. The audit shall include, but not be limited to, an
13		examination of revenues, expenses, and transfers of funds;
14		purchasing and contracting policies and practices; staffing
15		levels; and hiring practices and procedures. When completed,
16		the audit required by this paragraph shall be distributed in
17		accordance with Section 3-14.
18		The Auditor General shall conduct a financial and
19		compliance and program audit of distributions from the
20		Municipal Economic Development Fund during the immediately
21		preceding calendar year pursuant to Section 8-403.1 of the
22		Public Utilities Act at no cost to the city, village, or
23		incorporated town that received the distributions.
24		The Auditor General must conduct an audit of the Health
25		Facilities Planning Board pursuant to Section 19.5 of the
26		Illinois Health Facilities Planning Act.
27		The Auditor General of the State of Illinois shall annually
28		conduct or cause to be conducted a financial and compliance
29		audit of the books and records of any county water commission
30		organized pursuant to the Water Commission Act of 1985 and
31		shall file a copy of the report of that audit with the Governor
32		and the Legislative Audit Commission. The filed audit shall be
33		open to the public for inspection. The cost of the audit shall
34		be charged to the county water commission in accordance with
35		Section 6z-27 of the State Finance Act. The county water
36		commission shall make available to the Auditor General its

1		books and records and any other documentation, whether in the
2		possession of its trustees or other parties, necessary to
3		conduct the audit required. These audit requirements apply only
4		through July 1, 2007.
5		The Auditor General must conduct audits of the Rend Lake
6		Conservancy District as provided in Section 25.5 of the River
7		Conservancy Districts Act.
8		(Source: P.A. 93-226, eff. 7-22-03; 93-259, eff. 7-22-03;
9		93-275, eff. 7-22-03; revised 8-25-03.)

10		(30 ILCS 105/5.213 rep.) (from Ch. 127, par. 141.213)
11		Section 25. The State Finance Act is amended by repealing
12		Section 5.213.

13		Section 30. The Hospital District Law is amended by
14		changing Section 15 as follows:
15		(70 ILCS 910/15) (from Ch. 23, par. 1265)
16		Sec. 15. A Hospital District shall constitute a municipal
17		corporation and body politic separate and apart from any other
18		municipality, the State of Illinois or any other public or
19		governmental agency and shall have and exercise the following
20		governmental powers, and all other powers incidental,
21		necessary, convenient, or desirable to carry out and effectuate
22		such express powers.
23		1. To establish and maintain a hospital and hospital
24		facilities within or outside its corporate limits, and to
25		construct, acquire, develop, expand, extend and improve any
26		such hospital or hospital facility. If a Hospital District
27		utilizes its authority to levy a tax pursuant to Section 20 of
28		this Act for the purpose of establishing and maintaining
29		hospitals or hospital facilities, such District shall be
30		prohibited from establishing and maintaining hospitals or
31		hospital facilities located outside of its district unless so
32		authorized by referendum. To approve the provision of any
33		service and to approve any contract or other arrangement not

1		prohibited by a hospital licensed under the Hospital Licensing
2		Act, incorporated under the General Not-For-Profit Corporation
3		Act, and exempt from taxation under paragraph (3) of subsection
4		(c) of Section 501 of the Internal Revenue Code.
5		2. To acquire land in fee simple, rights in land and
6		easements upon, over or across land and leasehold interests in
7		land and tangible and intangible personal property used or
8		useful for the location, establishment, maintenance,
9		development, expansion, extension or improvement of any such
10		hospital or hospital facility. Such acquisition may be by
11		dedication, purchase, gift, agreement, lease, use or adverse
12		possession or by condemnation.
13		3. To operate, maintain and manage such hospital and
14		hospital facility, and to make and enter into contracts for the
15		use, operation or management of and to provide rules and
16		regulations for the operation, management or use of such
17		hospital or hospital facility.
18		Such contracts may include the lease by the District of all
19		or any portion of its facilities to a not-for-profit
20		corporation organized by the District's board of directors. The
21		rent to be paid pursuant to any such lease shall be in an
22		amount deemed appropriate by the board of directors. Any of the
23		remaining assets which are not the subject of such a lease may
24		be conveyed and transferred to the not-for-profit corporation
25		organized by the District's board of directors provided that
26		the not-for-profit corporation agrees to discharge or assume
27		such debts, liabilities, and obligations of the District as
28		determined to be appropriate by the District's board of
29		directors.
30		4. To fix, charge and collect reasonable fees and
31		compensation for the use or occupancy of such hospital or any
32		part thereof, or any hospital facility, and for nursing care,
33		medicine, attendance, or other services furnished by such
34		hospital or hospital facilities, according to the rules and
35		regulations prescribed by the board from time to time.
36		5. To borrow money and to issue general obligation bonds,

1		revenue bonds, notes, certificates, or other evidences of
2		indebtedness for the purpose of accomplishing any of its
3		corporate purposes, subject to compliance with any conditions
4		or limitations set forth in this Act or the Health Facilities
5		Planning Act or otherwise provided by the constitution of the
6		State of Illinois and to execute, deliver, and perform
7		mortgages and security agreements to secure such borrowing.
8		6. To employ or enter into contracts for the employment of
9		any person, firm, or corporation, and for professional
10		services, necessary or desirable for the accomplishment of the
11		corporate objects of the District or the proper administration,
12		management, protection or control of its property.
13		7. To maintain such hospital for the benefit of the
14		inhabitants of the area comprising the District who are sick,
15		injured, or maimed regardless of race, creed, religion, sex,
16		national origin or color, and to adopt such reasonable rules
17		and regulations as may be necessary to render the use of the
18		hospital of the greatest benefit to the greatest number; to
19		exclude from the use of the hospital all persons who wilfully
20		disregard any of the rules and regulations so established; to
21		extend the privileges and use of the hospital to persons
22		residing outside the area of the District upon such terms and
23		conditions as the board of directors prescribes by its rules
24		and regulations.
25		8. To police its property and to exercise police powers in
26		respect thereto or in respect to the enforcement of any rule or
27		regulation provided by the ordinances of the District and to
28		employ and commission police officers and other qualified
29		persons to enforce the same.
30		The use of any such hospital or hospital facility of a
31		District shall be subject to the reasonable regulation and
32		control of the District and upon such reasonable terms and
33		conditions as shall be established by its board of directors.
34		A regulatory ordinance of a District adopted under any
35		provision of this Section may provide for a suspension or
36		revocation of any rights or privileges within the control of

1		the District for a violation of any such regulatory ordinance.
2		Nothing in this Section or in other provisions of this Act
3		shall be construed to authorize the District or board to
4		establish or enforce any regulation or rule in respect to
5		hospitalization or in the operation or maintenance of such
6		hospital or any hospital facilities within its jurisdiction
7		which is in conflict with any federal or state law or
8		regulation applicable to the same subject matter.
9		9. To provide for the benefit of its employees group life,
10		health, accident, hospital and medical insurance, or any
11		combination of such types of insurance, and to further provide
12		for its employees by the establishment of a pension or
13		retirement plan or system; to effectuate the establishment of
14		any such insurance program or pension or retirement plan or
15		system, a Hospital District may make, enter into or subscribe
16		to agreements, contracts, policies or plans with private
17		insurance companies. Such insurance may include provisions for
18		employees who rely on treatment by spiritual means alone
19		through prayer for healing in accord with the tenets and
20		practice of a well-recognized religious denomination. The
21		board of directors of a Hospital District may provide for
22		payment by the District of a portion of the premium or charge
23		for such insurance or for a pension or retirement plan for
24		employees with the employee paying the balance of such premium
25		or charge. If the board of directors of a Hospital District
26		undertakes a plan pursuant to which the Hospital District pays
27		a portion of such premium or charge, the board shall provide
28		for the withholding and deducting from the compensation of such
29		employees as consent to joining such insurance program or
30		pension or retirement plan or system, the balance of the
31		premium or charge for such insurance or plan or system.
32		If the board of directors of a Hospital District does not
33		provide for a program or plan pursuant to which such District
34		pays a portion of the premium or charge for any group insurance
35		program or pension or retirement plan or system, the board may
36		provide for the withholding and deducting from the compensation

1		of such employees as consent thereto the premium or charge for
2		any group life, health, accident, hospital and medical
3		insurance or for any pension or retirement plan or system.
4		A Hospital District deducting from the compensation of its
5		employees for any group insurance program or pension or
6		retirement plan or system, pursuant to this Section, may agree
7		to receive and may receive reimbursement from the insurance
8		company for the cost of withholding and transferring such
9		amount to the company.
10		10. Except as provided in Section 15.3, to sell at public
11		auction or by sealed bid and convey any real estate held by the
12		District which the board of directors, by ordinance adopted by
13		at least 2/3rds of the members of the board then holding
14		office, has determined to be no longer necessary or useful to,
15		or for the best interests of, the District.
16		An ordinance directing the sale of real estate shall
17		include the legal description of the real estate, its present
18		use, a statement that the property is no longer necessary or
19		useful to, or for the best interests of, the District, the
20		terms and conditions of the sale, whether the sale is to be at
21		public auction or sealed bid, and the date, time, and place the
22		property is to be sold at auction or sealed bids opened.
23		Before making a sale by virtue of the ordinance, the board
24		of directors shall cause notice of the proposal to sell to be
25		published once each week for 3 successive weeks in a newspaper
26		published, or, if none is published, having a general
27		circulation, in the district, the first publication to be not
28		less than 30 days before the day provided in the notice for the
29		public sale or opening of bids for the real estate.
30		The notice of the proposal to sell shall include the same
31		information included in the ordinance directing the sale and
32		shall advertise for bids therefor. A sale of property by public
33		auction shall be held at the property to be sold at a time and
34		date determined by the board of directors. The board of
35		directors may accept the high bid or any other bid determined
36		to be in the best interests of the district by a vote of 2/3rds

1		of the board then holding office, but by a majority vote of
2		those holding office, they may reject any and all bids.
3		The chairman and secretary of the board of directors shall
4		execute all documents necessary for the conveyance of such real
5		property sold pursuant to the foregoing authority.
6		11. To establish and administer a program of loans for
7		postsecondary students pursuing degrees in accredited public
8		health-related educational programs at public institutions of
9		higher education. If a student is awarded a loan, the
10		individual shall agree to accept employment within the hospital
11		district upon graduation from the public institution of higher
12		education. For the purposes of this Act, "public institutions
13		of higher education" means the University of Illinois; Southern
14		Illinois University; Chicago State University; Eastern
15		Illinois University; Governors State University; Illinois
16		State University; Northeastern Illinois University; Northern
17		Illinois University; Western Illinois University; the public
18		community colleges of the State; and any other public colleges,
19		universities or community colleges now or hereafter
20		established or authorized by the General Assembly. The
21		district's board of directors shall by resolution provide for
22		eligibility requirements, award criteria, terms of financing,
23		duration of employment accepted within the district and such
24		other aspects of the loan program as its establishment and
25		administration may necessitate.
26		12. To establish and maintain congregate housing units; to
27		acquire land in fee simple and leasehold interests in land for
28		the location, establishment, maintenance, and development of
29		those housing units; to borrow funds and give debt instruments,
30		real estate mortgages, and security interests in personal
31		property, contract rights, and general intangibles; and to
32		enter into any contract required for participation in any
33		federal or State programs.
34		(Source: P.A. 92-534, eff. 5-14-02; 92-611, eff. 7-3-02.)

35

Section 35. The Alternative Health Care Delivery Act is

1		amended by changing Sections 20, 30, and 36.5 as follows:
2		(210 ILCS 3/20)
3		Sec. 20. Board responsibilities. The State Board of Health
4		shall have the responsibilities set forth in this Section.
5		(a) The Board shall investigate new health care delivery
6		models and recommend to the Governor and the General Assembly,
7		through the Department, those models that should be authorized
8		as alternative health care models for which demonstration
9		programs should be initiated. In its deliberations, the Board
10		shall use the following criteria:
11		(1) The feasibility of operating the model in Illinois,
12		based on a review of the experience in other states
13		including the impact on health professionals of other
14		health care programs or facilities.
15		(2) The potential of the model to meet an unmet need.
16		(3) The potential of the model to reduce health care
17		costs to consumers, costs to third party payors, and
18		aggregate costs to the public.
19		(4) The potential of the model to maintain or improve
20		the standards of health care delivery in some measurable
21		fashion.
22		(5) The potential of the model to provide increased
23		choices or access for patients.
24		(b) The Board shall evaluate and make recommendations to
25		the Governor and the General Assembly, through the Department,
26		regarding alternative health care model demonstration programs
27		established under this Act, at the midpoint and end of the
28		period of operation of the demonstration programs. The report
29		shall include, at a minimum, the following:
30		(1) Whether the alternative health care models
31		improved access to health care for their service
32		populations in the State.
33		(2) The quality of care provided by the alternative
34		health care models as may be evidenced by health outcomes,
35		surveillance reports, and administrative actions taken by

1		the Department.
2		(3) The cost and cost effectiveness to the public,
3		third-party payors, and government of the alternative
4		health care models, including the impact of pilot programs
5		on aggregate health care costs in the area. In addition to
6		any other information collected by the Board under this
7		Section, the Board shall collect from postsurgical
8		recovery care centers uniform billing data substantially
9		the same as specified in Section 4-2(e) of the Illinois
10		Health Finance Reform Act. To facilitate its evaluation of
11		that data, the Board shall forward a copy of the data to
12		the Illinois Health Care Cost Containment Council. All
13		patient identifiers shall be removed from the data before
14		it is submitted to the Board or Council.
15		(4) The impact of the alternative health care models on
16		the health care system in that area, including changing
17		patterns of patient demand and utilization, financial
18		viability, and feasibility of operation of service in
19		inpatient and alternative models in the area.
20		(5) The implementation by alternative health care
21		models of any special commitments made during application
22		review to the Illinois Health Facilities Planning Board.
23		(6) The continuation, expansion, or modification of
24		the alternative health care models.
25		(c) The Board shall advise the Department on the definition
26		and scope of alternative health care models demonstration
27		programs.
28		(d) In carrying out its responsibilities under this
29		Section, the Board shall seek the advice of other Department
30		advisory boards or committees that may be impacted by the
31		alternative health care model or the proposed model of health
32		care delivery. The Board shall also seek input from other
33		interested parties, which may include holding public hearings.
34		(e) The Board shall otherwise advise the Department on the
35		administration of the Act as the Board deems appropriate.
36		(Source: P.A. 87-1188; 88-441.)

1		(210 ILCS 3/30)
2		Sec. 30. Demonstration program requirements. The
3		requirements set forth in this Section shall apply to
4		demonstration programs.
5		(a) There shall be no more than:
6		(i) 3 subacute care hospital alternative health care
7		models in the City of Chicago (one of which shall be
8		located on a designated site and shall have been licensed
9		as a hospital under the Illinois Hospital Licensing Act
10		within the 10 years immediately before the application for
11		a license);
12		(ii) 2 subacute care hospital alternative health care
13		models in the demonstration program for each of the
14		following areas:
15		(1) Cook County outside the City of Chicago.
16		(2) DuPage, Kane, Lake, McHenry, and Will
17		Counties.
18		(3) Municipalities with a population greater than
19		50,000 not located in the areas described in item (i)
20		of subsection (a) and paragraphs (1) and (2) of item
21		(ii) of subsection (a); and
22		(iii) 4 subacute care hospital alternative health care
23		models in the demonstration program for rural areas.
24		In selecting among applicants for these licenses in rural
25		areas, the Health Facilities Planning Board and the Department
26		shall give preference to hospitals that may be unable for
27		economic reasons to provide continued service to the community
28		in which they are located unless the hospital were to receive
29		an alternative health care model license.
30		(a-5) There shall be no more than a total of 12
31		postsurgical recovery care center alternative health care
32		models in the demonstration program, located as follows:
33		(1) Two in the City of Chicago.
34		(2) Two in Cook County outside the City of Chicago. At
35		least one of these shall be owned or operated by a hospital

1		devoted exclusively to caring for children.
2		(3) Two in Kane, Lake, and McHenry Counties.
3		(4) Four in municipalities with a population of 50,000
4		or more not located in the areas described in paragraphs
5		(1), (2), and (3), 3 of which shall be owned or operated by
6		hospitals, at least 2 of which shall be located in counties
7		with a population of less than 175,000, according to the
8		most recent decennial census for which data are available,
9		and one of which shall be owned or operated by an
10		ambulatory surgical treatment center.
11		(5) Two in rural areas, both of which shall be owned or
12		operated by hospitals.
13		There shall be no postsurgical recovery care center
14		alternative health care models located in counties with
15		populations greater than 600,000 but less than 1,000,000. A
16		proposed postsurgical recovery care center must be owned or
17		operated by a hospital if it is to be located within, or will
18		primarily serve the residents of, a health service area in
19		which more than 60% of the gross patient revenue of the
20		hospitals within that health service area are derived from
21		Medicaid and Medicare, according to the most recently available
22		calendar year data from the Illinois Health Care Cost
23		Containment Council. Nothing in this paragraph shall preclude a
24		hospital and an ambulatory surgical treatment center from
25		forming a joint venture or developing a collaborative agreement
26		to own or operate a postsurgical recovery care center.
27		(a-10) There shall be no more than a total of 8 children's
28		respite care center alternative health care models in the
29		demonstration program, which shall be located as follows:
30		(1) One in the City of Chicago.
31		(2) One in Cook County outside the City of Chicago.
32		(3) A total of 2 in the area comprised of DuPage, Kane,
33		Lake, McHenry, and Will counties.
34		(4) A total of 2 in municipalities with a population of
35		50,000 or more and not located in the areas described in
36		paragraphs (1), (2), or (3).

1		(5) A total of 2 in rural areas, as defined by the
2		Health Facilities Planning Board.
3		No more than one children's respite care model owned and
4		operated by a licensed skilled pediatric facility shall be
5		located in each of the areas designated in this subsection
6		(a-10).
7		(a-15) There shall be an authorized community-based
8		residential rehabilitation center alternative health care
9		model in the demonstration program. The community-based
10		residential rehabilitation center shall be located in the area
11		of Illinois south of Interstate Highway 70.
12		(a-20) There shall be an authorized Alzheimer's disease
13		management center alternative health care model in the
14		demonstration program. The Alzheimer's disease management
15		center shall be located in Will County, owned by a
16		not-for-profit entity, and endorsed by a resolution approved by
17		the county board before the effective date of this amendatory
18		Act of the 91st General Assembly.
19		(b) (Blank) Alternative health care models, other than a
20		model authorized under subsection (a-20), shall obtain a
21		certificate of need from the Illinois Health Facilities
22		Planning Board under the Illinois Health Facilities Planning
23		Act before receiving a license by the Department. If, after
24		obtaining its initial certificate of need, an alternative
25		health care delivery model that is a community based
26		residential rehabilitation center seeks to increase the bed
27		capacity of that center, it must obtain a certificate of need
28		from the Illinois Health Facilities Planning Board before
29		increasing the bed capacity. Alternative health care models in
30		medically underserved areas shall receive priority in
31		obtaining a certificate of need.
32		(c) An alternative health care model license shall be
33		issued for a period of one year and shall be annually renewed
34		if the facility or program is in substantial compliance with
35		the Department's rules adopted under this Act. A licensed
36		alternative health care model that continues to be in

1		substantial compliance after the conclusion of the
2		demonstration program shall be eligible for annual renewals
3		unless and until a different licensure program for that type of
4		health care model is established by legislation. The Department
5		may issue a provisional license to any alternative health care
6		model that does not substantially comply with the provisions of
7		this Act and the rules adopted under this Act if (i) the
8		Department finds that the alternative health care model has
9		undertaken changes and corrections which upon completion will
10		render the alternative health care model in substantial
11		compliance with this Act and rules and (ii) the health and
12		safety of the patients of the alternative health care model
13		will be protected during the period for which the provisional
14		license is issued. The Department shall advise the licensee of
15		the conditions under which the provisional license is issued,
16		including the manner in which the alternative health care model
17		fails to comply with the provisions of this Act and rules, and
18		the time within which the changes and corrections necessary for
19		the alternative health care model to substantially comply with
20		this Act and rules shall be completed.
21		(d) Alternative health care models shall seek
22		certification under Titles XVIII and XIX of the federal Social
23		Security Act. In addition, alternative health care models shall
24		provide charitable care consistent with that provided by
25		comparable health care providers in the geographic area.
26		(d-5) The Illinois Department of Public Aid, in cooperation
27		with the Illinois Department of Public Health, shall develop
28		and implement a reimbursement methodology for all facilities
29		participating in the demonstration program. The Illinois
30		Department of Public Aid shall keep a record of services
31		provided under the demonstration program to recipients of
32		medical assistance under the Illinois Public Aid Code and shall
33		submit an annual report of that information to the Illinois
34		Department of Public Health.
35		(e) Alternative health care models shall, to the extent
36		possible, link and integrate their services with nearby health

1		care facilities.
2		(f) Each alternative health care model shall implement a
3		quality assurance program with measurable benefits and at
4		reasonable cost.
5		(Source: P.A. 91-65, eff. 7-9-99; 91-838, eff. 6-16-00.)

6		(210 ILCS 3/36.5 rep.)
7		Section 40. The Alternative Health Care Delivery Act is
8		amended by repealing Section 36.5.

9		Section 45. The Assisted Living and Shared Housing Act is
10		amended by changing Sections 10, 145, and 155 as follows:
11		(210 ILCS 9/10)
12		Sec. 10. Definitions. For purposes of this Act:
13		"Activities of daily living" means eating, dressing,
14		bathing, toileting, transferring, or personal hygiene.
15		"Advisory Board" means the Assisted Living and Shared
16		Housing Advisory Board.
17		"Assisted living establishment" or "establishment" means a
18		home, building, residence, or any other place where sleeping
19		accommodations are provided for at least 3 unrelated adults, at
20		least 80% of whom are 55 years of age or older and where the
21		following are provided consistent with the purposes of this
22		Act:
23		(1) services consistent with a social model that is
24		based on the premise that the resident's unit in assisted
25		living and shared housing is his or her own home;
26		(2) community-based residential care for persons who
27		need assistance with activities of daily living, including
28		personal, supportive, and intermittent health-related
29		services available 24 hours per day, if needed, to meet the
30		scheduled and unscheduled needs of a resident;
31		(3) mandatory services, whether provided directly by
32		the establishment or by another entity arranged for by the
33		establishment, with the consent of the resident or

1		resident's representative; and
2		(4) a physical environment that is a homelike setting
3		that includes the following and such other elements as
4		established by the Department in conjunction with the
5		Assisted Living and Shared Housing Advisory Board:
6		individual living units each of which shall accommodate
7		small kitchen appliances and contain private bathing,
8		washing, and toilet facilities, or private washing and
9		toilet facilities with a common bathing room readily
10		accessible to each resident. Units shall be maintained for
11		single occupancy except in cases in which 2 residents
12		choose to share a unit. Sufficient common space shall exist
13		to permit individual and group activities.
14		"Assisted living establishment" or "establishment" does
15		not mean any of the following:
16		(1) A home, institution, or similar place operated by
17		the federal government or the State of Illinois.
18		(2) A long term care facility licensed under the
19		Nursing Home Care Act. However, a long term care facility
20		may convert distinct parts of the facility to assisted
21		living. If the long term care facility elects to do so, the
22		facility shall retain the Certificate of Need for its
23		nursing and sheltered care beds that were converted.
24		(3) A hospital, sanitarium, or other institution, the
25		principal activity or business of which is the diagnosis,
26		care, and treatment of human illness and that is required
27		to be licensed under the Hospital Licensing Act.
28		(4) A facility for child care as defined in the Child
29		Care Act of 1969.
30		(5) A community living facility as defined in the
31		Community Living Facilities Licensing Act.
32		(6) A nursing home or sanitarium operated solely by and
33		for persons who rely exclusively upon treatment by
34		spiritual means through prayer in accordance with the creed
35		or tenants of a well-recognized church or religious
36		denomination.

1		(7) A facility licensed by the Department of Human
2		Services as a community-integrated living arrangement as
3		defined in the Community-Integrated Living Arrangements
4		Licensure and Certification Act.
5		(8) A supportive residence licensed under the
6		Supportive Residences Licensing Act.
7		(9) A life care facility as defined in the Life Care
8		Facilities Act; a life care facility may apply under this
9		Act to convert sections of the community to assisted
10		living.
11		(10) A free-standing hospice facility licensed under
12		the Hospice Program Licensing Act.
13		(11) A shared housing establishment.
14		(12) A supportive living facility as described in
15		Section 5-5.01a of the Illinois Public Aid Code.
16		"Department" means the Department of Public Health.
17		"Director" means the Director of Public Health.
18		"Emergency situation" means imminent danger of death or
19		serious physical harm to a resident of an establishment.
20		"License" means any of the following types of licenses
21		issued to an applicant or licensee by the Department:
22		(1) "Probationary license" means a license issued to an
23		applicant or licensee that has not held a license under
24		this Act prior to its application or pursuant to a license
25		transfer in accordance with Section 50 of this Act.
26		(2) "Regular license" means a license issued by the
27		Department to an applicant or licensee that is in
28		substantial compliance with this Act and any rules
29		promulgated under this Act.
30		"Licensee" means a person, agency, association,
31		corporation, partnership, or organization that has been issued
32		a license to operate an assisted living or shared housing
33		establishment.
34		"Licensed health care professional" means a registered
35		professional nurse, an advanced practice nurse, a physician
36		assistant, and a licensed practical nurse.

1		"Mandatory services" include the following:
2		(1) 3 meals per day available to the residents prepared
3		by the establishment or an outside contractor;
4		(2) housekeeping services including, but not limited
5		to, vacuuming, dusting, and cleaning the resident's unit;
6		(3) personal laundry and linen services available to
7		the residents provided or arranged for by the
8		establishment;
9		(4) security provided 24 hours each day including, but
10		not limited to, locked entrances or building or contract
11		security personnel;
12		(5) an emergency communication response system, which
13		is a procedure in place 24 hours each day by which a
14		resident can notify building management, an emergency
15		response vendor, or others able to respond to his or her
16		need for assistance; and
17		(6) assistance with activities of daily living as
18		required by each resident.
19		"Negotiated risk" is the process by which a resident, or
20		his or her representative, may formally negotiate with
21		providers what risks each are willing and unwilling to assume
22		in service provision and the resident's living environment. The
23		provider assures that the resident and the resident's
24		representative, if any, are informed of the risks of these
25		decisions and of the potential consequences of assuming these
26		risks.
27		"Owner" means the individual, partnership, corporation,
28		association, or other person who owns an assisted living or
29		shared housing establishment. In the event an assisted living
30		or shared housing establishment is operated by a person who
31		leases or manages the physical plant, which is owned by another
32		person, "owner" means the person who operates the assisted
33		living or shared housing establishment, except that if the
34		person who owns the physical plant is an affiliate of the
35		person who operates the assisted living or shared housing
36		establishment and has significant control over the day to day

1		operations of the assisted living or shared housing
2		establishment, the person who owns the physical plant shall
3		incur jointly and severally with the owner all liabilities
4		imposed on an owner under this Act.
5		"Physician" means a person licensed under the Medical
6		Practice Act of 1987 to practice medicine in all of its
7		branches.
8		"Resident" means a person residing in an assisted living or
9		shared housing establishment.
10		"Resident's representative" means a person, other than the
11		owner, agent, or employee of an establishment or of the health
12		care provider unless related to the resident, designated in
13		writing by a resident to be his or her representative. This
14		designation may be accomplished through the Illinois Power of
15		Attorney Act, pursuant to the guardianship process under the
16		Probate Act of 1975, or pursuant to an executed designation of
17		representative form specified by the Department.
18		"Self" means the individual or the individual's designated
19		representative.
20		"Shared housing establishment" or "establishment" means a
21		publicly or privately operated free-standing residence for 12
22		or fewer persons, at least 80% of whom are 55 years of age or
23		older and who are unrelated to the owners and one manager of
24		the residence, where the following are provided:
25		(1) services consistent with a social model that is
26		based on the premise that the resident's unit is his or her
27		own home;
28		(2) community-based residential care for persons who
29		need assistance with activities of daily living, including
30		housing and personal, supportive, and intermittent
31		health-related services available 24 hours per day, if
32		needed, to meet the scheduled and unscheduled needs of a
33		resident; and
34		(3) mandatory services, whether provided directly by
35		the establishment or by another entity arranged for by the
36		establishment, with the consent of the resident or the

1		resident's representative.
2		"Shared housing establishment" or "establishment" does not
3		mean any of the following:
4		(1) A home, institution, or similar place operated by
5		the federal government or the State of Illinois.
6		(2) A long term care facility licensed under the
7		Nursing Home Care Act. A long term care facility may,
8		however, convert sections of the facility to assisted
9		living. If the long term care facility elects to do so, the
10		facility shall retain the Certificate of Need for its
11		nursing beds that were converted.
12		(3) A hospital, sanitarium, or other institution, the
13		principal activity or business of which is the diagnosis,
14		care, and treatment of human illness and that is required
15		to be licensed under the Hospital Licensing Act.
16		(4) A facility for child care as defined in the Child
17		Care Act of 1969.
18		(5) A community living facility as defined in the
19		Community Living Facilities Licensing Act.
20		(6) A nursing home or sanitarium operated solely by and
21		for persons who rely exclusively upon treatment by
22		spiritual means through prayer in accordance with the creed
23		or tenants of a well-recognized church or religious
24		denomination.
25		(7) A facility licensed by the Department of Human
26		Services as a community-integrated community-intergrated
27		living arrangement as defined in the Community-Integrated
28		Living Arrangements Licensure and Certification Act.
29		(8) A supportive residence licensed under the
30		Supportive Residences Licensing Act.
31		(9) A life care facility as defined in the Life Care
32		Facilities Act; a life care facility may apply under this
33		Act to convert sections of the community to assisted
34		living.
35		(10) A free-standing hospice facility licensed under
36		the Hospice Program Licensing Act.

1		(11) An assisted living establishment.
2		(12) A supportive living facility as described in
3		Section 5-5.01a of the Illinois Public Aid Code.
4		"Total assistance" means that staff or another individual
5		performs the entire activity of daily living without
6		participation by the resident.
7		(Source: P.A. 91-656, eff. 1-1-01.)
8		(210 ILCS 9/145)
9		Sec. 145. Conversion of facilities. Entities licensed as
10		facilities under the Nursing Home Care Act may elect to convert
11		to a license under this Act. Any facility that chooses to
12		convert, in whole or in part, shall follow the requirements in
13		the Nursing Home Care Act and rules promulgated under that Act
14		regarding voluntary closure and notice to residents. Any
15		conversion of existing beds licensed under the Nursing Home
16		Care Act to licensure under this Act is exempt from review by
17		the Health Facilities Planning Board.
18		(Source: P.A. 91-656, eff. 1-1-01.)
19		(210 ILCS 9/155)
20		Sec. 155. Application of Act. An establishment licensed
21		under this Act shall obtain and maintain all other licenses,
22		permits, certificates, and other governmental approvals
23		required of it, except that a licensed assisted living or
24		shared housing establishment is exempt from the provisions of
25		the Illinois Health Facilities Planning Act. An establishment
26		licensed under this Act shall comply with the requirements of
27		all local, State, federal, and other applicable laws, rules,
28		and ordinances and the National Fire Protection Association's
29		Life Safety Code.
30		(Source: P.A. 91-656, eff. 1-1-01.)

31		Section 50. The Life Care Facilities Act is amended by
32		changing Sections 2 and 7 as follows:

1		(210 ILCS 40/2) (from Ch. 111 1/2, par. 4160-2)
2		Sec. 2. As used in this Act, unless the context otherwise
3		requires:
4		(a) "Department" means the Department of Public Health.
5		(b) "Director" means the Director of the Department.
6		(c) "Life care contract" means a contract to provide to a
7		person for the duration of such person's life or for a term in
8		excess of one year, nursing services, medical services or
9		personal care services, in addition to maintenance services for
10		such person in a facility, conditioned upon the transfer of an
11		entrance fee to the provider of such services in addition to or
12		in lieu of the payment of regular periodic charges for the care
13		and services involved.
14		(d) "Provider" means a person who provides services
15		pursuant to a life care contract.
16		(e) "Resident" means a person who enters into a life care
17		contract with a provider, or who is designated in a life care
18		contract to be a person provided with maintenance and nursing,
19		medical or personal care services.
20		(f) "Facility" means a place or places in which a provider
21		undertakes to provide a resident with nursing services, medical
22		services or personal care services, in addition to maintenance
23		services for a term in excess of one year or for life pursuant
24		to a life care contract. The term also means a place or places
25		in which a provider undertakes to provide such services to a
26		non-resident.
27		(g) "Living unit" means an apartment, room or other area
28		within a facility set aside for the exclusive use of one or
29		more identified residents.
30		(h) "Entrance fee" means an initial or deferred transfer to
31		a provider of a sum of money or property, made or promised to
32		be made by a person entering into a life care contract, which
33		assures a resident of services pursuant to a life care
34		contract.
35		(i) "Permit" means a written authorization to enter into
36		life care contracts issued by the Department to a provider.

1		(j) "Medical services" means those services pertaining to
2		medical or dental care that are performed in behalf of patients
3		at the direction of a physician licensed under the Medical
4		Practice Act of 1987 or a dentist licensed under the Illinois
5		Dental Practice Act by such physicians or dentists, or by a
6		registered or licensed practical nurse as defined in the
7		Nursing and Advanced Practice Nursing Act or by other
8		professional and technical personnel.
9		(k) "Nursing services" means those services pertaining to
10		the curative, restorative and preventive aspects of nursing
11		care that are performed at the direction of a physician
12		licensed under the Medical Practice Act of 1987 by or under the
13		supervision of a registered or licensed practical nurse as
14		defined in the Nursing and Advanced Practice Nursing Act.
15		(l) "Personal care services" means assistance with meals,
16		dressing, movement, bathing or other personal needs or
17		maintenance, or general supervision and oversight of the
18		physical and mental well-being of an individual, who is
19		incapable of maintaining a private, independent residence or
20		who is incapable of managing his person whether or not a
21		guardian has been appointed for such individual.
22		(m) "Maintenance services" means food, shelter and laundry
23		services.
24		(n) (Blank) "Certificates of Need" means those permits
25		issued pursuant to the Illinois Health Facilities Planning Act
26		as now or hereafter amended.
27		(o) "Non-resident" means a person admitted to a facility
28		who has not entered into a life care contract.
29		(Source: P.A. 90-742, eff. 8-13-98.)
30		(210 ILCS 40/7) (from Ch. 111 1/2, par. 4160-7)
31		Sec. 7. As a condition for the issuance of a permit
32		pursuant to this Act, the provider shall establish and maintain
33		on a current basis, a letter of credit or an escrow account
34		with a bank, trust company, or other financial institution
35		located in the State of Illinois. The letter of credit shall be

1		in an amount and form acceptable to the Department, but in no
2		event shall the amount exceed that applicable to the
3		corresponding escrow agreement alternative, as described
4		below. The terms of the escrow agreement shall meet the
5		following provisions:
6		(a) Requirements for new facilities.
7		(1) If the entrance fee applies to a living unit which has
8		not previously been occupied by any resident, all entrance fee
9		payments representing either all or any smaller portion of the
10		total entrance fee shall be paid to the escrow agent by the
11		resident.
12		(2) When the provider has sold at least 1/2 of its living
13		units, obtained a mortgage commitment, if needed, and obtained
14		all necessary zoning permits and Certificates of Need, if
15		required, the escrow agent may release a sum representing 1/5
16		of the resident's total entrance fee to the provider. Upon
17		completion of the foundation of the living unit an additional
18		1/5 of the resident's total entrance fee may be released to the
19		provider. When the living unit is under roof a further and
20		additional 1/5 of the resident's total entrance fee may be
21		released to the provider. All remaining monies, if any, shall
22		remain in escrow until the resident's living unit is
23		substantially completed and ready for occupancy by the
24		resident. When the living unit is ready for occupancy the
25		escrow agent may release the remaining escrow amount to the
26		provider and further entrance fee payments, if any, may be paid
27		by the resident to the provider directly. All monies released
28		from escrow shall be used for the facility and for no other
29		purpose.
30		(b) General requirements for all facilities, including new
31		and existing facilities.
32		(1) At the time of resident occupancy and at all times
33		thereafter, the escrow amount shall be in an amount which
34		equals or exceeds the aggregate principal and interest payments
35		due during the next 6 months on account of any first mortgage
36		or other long-term financing of the facility. Existing

1		facilities shall have 2 years from the date of this Act
2		becoming law to comply with this subsection. Upon application
3		from a facility showing good cause, the Director may extend
4		compliance with this subsection one additional year.
5		(2) Notwithstanding paragraph (1) of this subsection, the
6		escrow monies required under paragraph (1) of this subsection
7		may be released to the provider upon approval by the Director.
8		The Director may attach such conditions on the release of
9		monies as he deems fit including, but not limited to, the
10		performance of an audit which satisfies the Director that the
11		facility is solvent, a plan from the facility to bring the
12		facility back in compliance with paragraph (1) of this
13		subsection, and a repayment schedule.
14		(3) The principal of the escrow account may be invested
15		with the earnings thereon payable to the provider as it
16		accrues.
17		(4) If the facility ceases to operate all monies in the
18		escrow account except the amount representing principal and
19		interest shall be repaid by the escrow agent to the resident.
20		(5) Balloon payments due at conclusion of the mortgage
21		shall not be subject to the escrow requirements of paragraph
22		(1) this subsection.
23		(Source: P.A. 85-1349.)

24		Section 55. The Nursing Home Care Act is amended by
25		changing Sections 3-102.2 and 3-103 as follows:
26		(210 ILCS 45/3-102.2)
27		Sec. 3-102.2. Supported congregate living arrangement
28		demonstration. The Illinois Department may grant no more than 3
29		waivers from the requirements of this Act for facilities
30		participating in the supported congregate living arrangement
31		demonstration. A joint waiver request must be made by an
32		applicant and the Department on Aging. If the Department on
33		Aging does not act upon an application within 60 days, the
34		applicant may submit a written waiver request on its own

1		behalf. The waiver request must include a specific program plan
2		describing the types of residents to be served and the services
3		that will be provided in the facility. The Department shall
4		conduct an on-site review at each facility annually or as often
5		as necessary to ascertain compliance with the program plan. The
6		Department may revoke the waiver if it determines that the
7		facility is not in compliance with the program plan. Nothing in
8		this Section prohibits the Department from conducting
9		complaint investigations.
10		A facility granted a waiver under this Section is not
11		subject to the Illinois Health Facilities Planning Act, unless
12		it subsequently applies for a certificate of need to convert to
13		a nursing facility. A facility applying for conversion shall
14		meet the licensure and certificate of need requirements in
15		effect as of the date of application, and this provision may
16		not be waived.
17		(Source: P.A. 89-530, eff. 7-19-96.)
18		(210 ILCS 45/3-103) (from Ch. 111 1/2, par. 4153-103)
19		Sec. 3-103. The procedure for obtaining a valid license
20		shall be as follows:
21		(1) Application to operate a facility shall be made to the
22		Department on forms furnished by the Department.
23		(2) All license applications shall be accompanied with an
24		application fee. The fee for an annual license shall be based
25		on the licensed capacity of the facility and shall be
26		determined as follows: 0-49 licensed beds, a flat fee of $500;
27		50-99 licensed beds, a flat fee of $750; and for any facility
28		with 100 or more licensed beds, a fee of $1,000 plus $10 per
29		licensed bed. The fee for a 2-year license shall be double the
30		fee for the annual license set forth in the preceding sentence.
31		The first $600,000 of such fees collected each fiscal year
32		shall be deposited with the State Treasurer into the Long Term
33		Care Monitor/Receiver Fund, which has been created as a special
34		fund in the State treasury. Any such fees in excess of $600,000
35		collected in a fiscal year shall be deposited into the General

1		Revenue Fund. This special fund is to be used by the Department
2		for expenses related to the appointment of monitors and
3		receivers as contained in Sections 3-501 through 3-517. At the
4		end of each fiscal year, any funds in excess of $1,000,000 held
5		in the Long Term Care Monitor/Receiver Fund shall be deposited
6		in the State's General Revenue Fund. The application shall be
7		under oath and the submission of false or misleading
8		information shall be a Class A misdemeanor. The application
9		shall contain the following information:
10		(a) The name and address of the applicant if an
11		individual, and if a firm, partnership, or association, of
12		every member thereof, and in the case of a corporation, the
13		name and address thereof and of its officers and its
14		registered agent, and in the case of a unit of local
15		government, the name and address of its chief executive
16		officer;
17		(b) The name and location of the facility for which a
18		license is sought;
19		(c) The name of the person or persons under whose
20		management or supervision the facility will be conducted;
21		(d) The number and type of residents for which
22		maintenance, personal care, or nursing is to be provided;
23		and
24		(e) Such information relating to the number,
25		experience, and training of the employees of the facility,
26		any management agreements for the operation of the
27		facility, and of the moral character of the applicant and
28		employees as the Department may deem necessary.
29		(3) Each initial application shall be accompanied by a
30		financial statement setting forth the financial condition of
31		the applicant and by a statement from the unit of local
32		government having zoning jurisdiction over the facility's
33		location stating that the location of the facility is not in
34		violation of a zoning ordinance. An initial application for a
35		new facility shall be accompanied by a permit as required by
36		the "Illinois Health Facilities Planning Act". After the

1		application is approved, the applicant shall advise the
2		Department every 6 months of any changes in the information
3		originally provided in the application.
4		(4) Other information necessary to determine the identity
5		and qualifications of an applicant to operate a facility in
6		accordance with this Act shall be included in the application
7		as required by the Department in regulations.
8		(Source: P.A. 93-32, eff. 7-1-03.)

9		Section 60. The Emergency Medical Services (EMS) Systems
10		Act is amended by changing Section 32.5 as follows:
11		(210 ILCS 50/32.5)
12		Sec. 32.5. Freestanding Emergency Center.
13		(a) The Department shall issue an annual Freestanding
14		Emergency Center (FEC) license to any facility that:
15		(1) is located: (i)(A) in a municipality with a
16		population of 75,000 or fewer inhabitants; (B) within 15
17		miles of the hospital that owns or controls the FEC; and
18		(C) within 10 miles of the Resource Hospital affiliated
19		with the FEC as part of the EMS System; or (ii) (A) in a
20		municipality that has a hospital that has been providing
21		emergency services but is expected to close by the end of
22		1997 and (B) in a county with a population of more than
23		350,000 but less than 525,000 inhabitants;
24		(2) is wholly owned or controlled by an Associate or
25		Resource Hospital, but is not a part of the hospital's
26		physical plant;
27		(3) meets the standards for licensed FECs, adopted by
28		rule of the Department, including, but not limited to:
29		(A) facility design, specification, operation, and
30		maintenance standards;
31		(B) equipment standards; and
32		(C) the number and qualifications of emergency
33		medical personnel and other staff, which must include
34		at least one board certified emergency physician

1		present at the FEC 24 hours per day.
2		(4) limits its participation in the EMS System strictly
3		to receiving a limited number of BLS runs by emergency
4		medical vehicles according to protocols developed by the
5		Resource Hospital within the FEC's designated EMS System
6		and approved by the Project Medical Director and the
7		Department;
8		(5) provides comprehensive emergency treatment
9		services, as defined in the rules adopted by the Department
10		pursuant to the Hospital Licensing Act, 24 hours per day,
11		on an outpatient basis;
12		(6) provides an ambulance and maintains on site
13		ambulance services staffed with paramedics 24 hours per
14		day;
15		(7) maintains helicopter landing capabilities approved
16		by appropriate State and federal authorities;
17		(8) complies with all State and federal patient rights
18		provisions, including, but not limited to, the Emergency
19		Medical Treatment Act and the federal Emergency Medical
20		Treatment and Active Labor Act;
21		(9) maintains a communications system that is fully
22		integrated with its Resource Hospital within the FEC's
23		designated EMS System;
24		(10) reports to the Department any patient transfers
25		from the FEC to a hospital within 48 hours of the transfer
26		plus any other data determined to be relevant by the
27		Department;
28		(11) submits to the Department, on a quarterly basis,
29		the FEC's morbidity and mortality rates for patients
30		treated at the FEC and other data determined to be relevant
31		by the Department;
32		(12) does not describe itself or hold itself out to the
33		general public as a full service hospital or hospital
34		emergency department in its advertising or marketing
35		activities;
36		(13) complies with any other rules adopted by the

1		Department under this Act that relate to FECs;
2		(14) passes the Department's site inspection for
3		compliance with the FEC requirements of this Act;
4		(15) (blank) submits a copy of a certificate of need or
5		other permit issued by the Illinois Health Facilities
6		Planning Board indicating that the facility that will house
7		the proposed FEC complies with State health planning laws;
8		provided, however, that the Illinois Health Facilities
9		Planning Board shall waive this certificate of need or
10		permit requirement for any proposed FEC that, as of the
11		effective date of this amendatory Act of 1996, meets the
12		criteria for providing comprehensive emergency treatment
13		services, as defined by the rules promulgated under the
14		Hospital Licensing Act, but is not a licensed hospital;
15		(16) submits an application for designation as an FEC
16		in a manner and form prescribed by the Department by rule;
17		(17) pays the annual license fee as determined by the
18		Department by rule; and
19		(18) participated in the demonstration program.
20		(b) The Department shall:
21		(1) annually inspect facilities of initial FEC
22		applicants and licensed FECs, and issue annual licenses to
23		or annually relicense FECs that satisfy the Department's
24		licensure requirements as set forth in subsection (a);
25		(2) suspend, revoke, refuse to issue, or refuse to
26		renew the license of any FEC, after notice and an
27		opportunity for a hearing, when the Department finds that
28		the FEC has failed to comply with the standards and
29		requirements of the Act or rules adopted by the Department
30		under the Act;
31		(3) issue an Emergency Suspension Order for any FEC
32		when the Director or his or her designee has determined
33		that the continued operation of the FEC poses an immediate
34		and serious danger to the public health, safety, and
35		welfare. An opportunity for a hearing shall be promptly
36		initiated after an Emergency Suspension Order has been

1		issued; and
2		(4) adopt rules as needed to implement this Section.
3		(Source: P.A. 93-372, eff. 1-1-04.)

4		Section 65. The Hospital Licensing Act is amended by
5		changing Sections 4.5 and 10.8 as follows:
6		(210 ILCS 85/4.5)
7		Sec. 4.5. Hospital with multiple locations; single
8		license.
9		(a) A hospital located in a county with fewer than
10		3,000,000 inhabitants may apply to the Department for approval
11		to conduct its operations from more than one location within
12		the county under a single license.
13		(b) The facilities or buildings at those locations must be
14		owned or operated together by a single corporation or other
15		legal entity serving as the licensee and must share:
16		(1) a single board of directors with responsibility for
17		governance, including financial oversight and the
18		authority to designate or remove the chief executive
19		officer;
20		(2) a single medical staff accountable to the board of
21		directors and governed by a single set of medical staff
22		bylaws, rules, and regulations with responsibility for the
23		quality of the medical services; and
24		(3) a single chief executive officer, accountable to
25		the board of directors, with management responsibility.
26		(c) Each hospital building or facility that is located on a
27		site geographically separate from the campus or premises of
28		another hospital building or facility operated by the licensee
29		must, at a minimum, individually comply with the Department's
30		hospital licensing requirements for emergency services.
31		(d) The hospital shall submit to the Department a
32		comprehensive plan in relation to the waiver or waivers
33		requested describing the services and operations of each
34		facility or building and how common services or operations will

1		be coordinated between the various locations. With the
2		exception of items required by subsection (c), the Department
3		is authorized to waive compliance with the hospital licensing
4		requirements for specific buildings or facilities, provided
5		that the hospital has documented which other building or
6		facility under its single license provides that service or
7		operation, and that doing so would not endanger the public's
8		health, safety, or welfare. Nothing in this Section relieves a
9		hospital from the requirements of the Health Facilities
10		Planning Act.
11		(Source: P.A. 89-171, eff. 7-19-95.)
12		(210 ILCS 85/10.8)
13		Sec. 10.8. Requirements for employment of physicians.
14		(a) Physician employment by hospitals and hospital
15		affiliates. Employing entities may employ physicians to
16		practice medicine in all of its branches provided that the
17		following requirements are met:
18		(1) The employed physician is a member of the medical
19		staff of either the hospital or hospital affiliate. If a
20		hospital affiliate decides to have a medical staff, its
21		medical staff shall be organized in accordance with written
22		bylaws where the affiliate medical staff is responsible for
23		making recommendations to the governing body of the
24		affiliate regarding all quality assurance activities and
25		safeguarding professional autonomy. The affiliate medical
26		staff bylaws may not be unilaterally changed by the
27		governing body of the affiliate. Nothing in this Section
28		requires hospital affiliates to have a medical staff.
29		(2) Independent physicians, who are not employed by an
30		employing entity, periodically review the quality of the
31		medical services provided by the employed physician to
32		continuously improve patient care.
33		(3) The employing entity and the employed physician
34		sign a statement acknowledging that the employer shall not
35		unreasonably exercise control, direct, or interfere with

1		the employed physician's exercise and execution of his or
2		her professional judgment in a manner that adversely
3		affects the employed physician's ability to provide
4		quality care to patients. This signed statement shall take
5		the form of a provision in the physician's employment
6		contract or a separate signed document from the employing
7		entity to the employed physician. This statement shall
8		state: "As the employer of a physician, (employer's name)
9		shall not unreasonably exercise control, direct, or
10		interfere with the employed physician's exercise and
11		execution of his or her professional judgment in a manner
12		that adversely affects the employed physician's ability to
13		provide quality care to patients."
14		(4) The employing entity shall establish a mutually
15		agreed upon independent review process with criteria under
16		which an employed physician may seek review of the alleged
17		violation of this Section by physicians who are not
18		employed by the employing entity. The affiliate may arrange
19		with the hospital medical staff to conduct these reviews.
20		The independent physicians shall make findings and
21		recommendations to the employing entity and the employed
22		physician within 30 days of the conclusion of the gathering
23		of the relevant information.
24		(b) Definitions. For the purpose of this Section:
25		"Employing entity" means a hospital licensed under the
26		Hospital Licensing Act or a hospital affiliate.
27		"Employed physician" means a physician who receives an IRS
28		W-2 form, or any successor federal income tax form, from an
29		employing entity.
30		"Hospital" means a hospital licensed under the Hospital
31		Licensing Act, except county hospitals as defined in subsection
32		(c) of Section 15-1 of the Public Aid Code.
33		"Hospital affiliate" means a corporation, partnership,
34		joint venture, limited liability company, or similar
35		organization, other than a hospital, that is devoted primarily
36		to the provision, management, or support of health care

1		services and that directly or indirectly controls, is
2		controlled by, or is under common control of the hospital.
3		"Control" means having at least an equal or a majority
4		ownership or membership interest. A hospital affiliate shall be
5		100% owned or controlled by any combination of hospitals, their
6		parent corporations, or physicians licensed to practice
7		medicine in all its branches in Illinois. "Hospital affiliate"
8		does not include a health maintenance organization regulated
9		under the Health Maintenance Organization Act.
10		"Physician" means an individual licensed to practice
11		medicine in all its branches in Illinois.
12		"Professional judgment" means the exercise of a
13		physician's independent clinical judgment in providing
14		medically appropriate diagnoses, care, and treatment to a
15		particular patient at a particular time. Situations in which an
16		employing entity does not interfere with an employed
17		physician's professional judgment include, without limitation,
18		the following:
19		(1) practice restrictions based upon peer review of the
20		physician's clinical practice to assess quality of care and
21		utilization of resources in accordance with applicable
22		bylaws;
23		(2) supervision of physicians by appropriately
24		licensed medical directors, medical school faculty,
25		department chairpersons or directors, or supervising
26		physicians;
27		(3) written statements of ethical or religious
28		directives; and
29		(4) reasonable referral restrictions that do not, in
30		the reasonable professional judgment of the physician,
31		adversely affect the health or welfare of the patient.
32		(c) Private enforcement. An employed physician aggrieved
33		by a violation of this Act may seek to obtain an injunction or
34		reinstatement of employment with the employing entity as the
35		court may deem appropriate. Nothing in this Section limits or
36		abrogates any common law cause of action. Nothing in this

1		Section shall be deemed to alter the law of negligence.
2		(d) Department enforcement. The Department may enforce the
3		provisions of this Section, but nothing in this Section shall
4		require or permit the Department to license, certify, or
5		otherwise investigate the activities of a hospital affiliate
6		not otherwise required to be licensed by the Department.
7		(e) Retaliation prohibited. No employing entity shall
8		retaliate against any employed physician for requesting a
9		hearing or review under this Section. No action may be taken
10		that affects the ability of a physician to practice during this
11		review, except in circumstances where the medical staff bylaws
12		authorize summary suspension.
13		(f) Physician collaboration. No employing entity shall
14		adopt or enforce, either formally or informally, any policy,
15		rule, regulation, or practice inconsistent with the provision
16		of adequate collaboration, including medical direction of
17		licensed advanced practice nurses or supervision of licensed
18		physician assistants and delegation to other personnel under
19		Section 54.5 of the Medical Practice Act of 1987.
20		(g) Physician disciplinary actions. Nothing in this
21		Section shall be construed to limit or prohibit the governing
22		body of an employing entity or its medical staff, if any, from
23		taking disciplinary actions against a physician as permitted by
24		law.
25		(h) Physician review. Nothing in this Section shall be
26		construed to prohibit a hospital or hospital affiliate from
27		making a determination not to pay for a particular health care
28		service or to prohibit a medical group, independent practice
29		association, hospital medical staff, or hospital governing
30		body from enforcing reasonable peer review or utilization
31		review protocols or determining whether the employed physician
32		complied with those protocols.
33		(i) (Blank) Review. Nothing in this Section may be used or
34		construed to establish that any activity of a hospital or
35		hospital affiliate is subject to review under the Illinois
36		Health Facilities Planning Act.

1		(j) Rules. The Department shall adopt any rules necessary
2		to implement this Section.
3		(Source: P.A. 92-455, eff. 9-30-01.)

4		(225 ILCS 7/4 rep.)
5		Section 70. The Board and Care Home Registration Act is
6		amended by repealing Section 4.

7		Section 75. The Health Care Worker Self-Referral Act is
8		amended by changing Sections 5, 15, 20, 30, 35, and 40 as
9		follows:
10		(225 ILCS 47/5)
11		Sec. 5. Legislative intent. The General Assembly
12		recognizes that patient referrals by health care workers for
13		health services to an entity in which the referring health care
14		worker has an investment interest may present a potential
15		conflict of interest. The General Assembly finds that these
16		referral practices may limit or completely eliminate
17		competitive alternatives in the health care market. In some
18		instances, these referral practices may expand and improve care
19		or may make services available which were previously
20		unavailable. They may also provide lower cost options to
21		patients or increase competition. Generally, referral
22		practices are positive occurrences. However, self-referrals
23		may result in over utilization of health services, increased
24		overall costs of the health care systems, and may affect the
25		quality of health care.
26		It is the intent of the General Assembly to provide
27		guidance to health care workers regarding acceptable patient
28		referrals, to prohibit patient referrals to entities providing
29		health services in which the referring health care worker has
30		an investment interest, and to protect the citizens of Illinois
31		from unnecessary and costly health care expenditures.
32		Recognizing the need for flexibility to quickly respond to
33		changes in the delivery of health services, to avoid results

1		beyond the limitations on self referral provided under this Act
2		and to provide minimal disruption to the appropriate delivery
3		of health care, the Department of Public Health may adopt rules
4		Health Facilities Planning Board shall be exclusively and
5		solely authorized to implement and interpret this Act through
6		adopted rules.
7		The General Assembly recognizes that changes in delivery of
8		health care has resulted in various methods by which health
9		care workers practice their professions. It is not the intent
10		of the General Assembly to limit appropriate delivery of care,
11		nor force unnecessary changes in the structures created by
12		workers for the health and convenience of their patients.
13		(Source: P.A. 87-1207.)
14		(225 ILCS 47/15)
15		Sec. 15. Definitions. In this Act:
16		(a) "Department" means the Department of Public Health.
17		"Board" means the Health Facilities Planning Board.
18		(b) "Entity" means any individual, partnership, firm,
19		corporation, or other business that provides health services
20		but does not include an individual who is a health care worker
21		who provides professional services to an individual.
22		(c) "Group practice" means a group of 2 or more health care
23		workers legally organized as a partnership, professional
24		corporation, not-for-profit corporation, faculty practice plan
25		or a similar association in which:
26		(1) each health care worker who is a member or employee
27		or an independent contractor of the group provides
28		substantially the full range of services that the health
29		care worker routinely provides, including consultation,
30		diagnosis, or treatment, through the use of office space,
31		facilities, equipment, or personnel of the group;
32		(2) the services of the health care workers are
33		provided through the group, and payments received for
34		health services are treated as receipts of the group; and
35		(3) the overhead expenses and the income from the

1		practice are distributed by methods previously determined
2		by the group.
3		(d) "Health care worker" means any individual licensed
4		under the laws of this State to provide health services,
5		including but not limited to: dentists licensed under the
6		Illinois Dental Practice Act; dental hygienists licensed under
7		the Illinois Dental Practice Act; nurses and advanced practice
8		nurses licensed under the Nursing and Advanced Practice Nursing
9		Act; occupational therapists licensed under the Illinois
10		Occupational Therapy Practice Act; optometrists licensed under
11		the Illinois Optometric Practice Act of 1987; pharmacists
12		licensed under the Pharmacy Practice Act of 1987; physical
13		therapists licensed under the Illinois Physical Therapy Act;
14		physicians licensed under the Medical Practice Act of 1987;
15		physician assistants licensed under the Physician Assistant
16		Practice Act of 1987; podiatrists licensed under the Podiatric
17		Medical Practice Act of 1987; clinical psychologists licensed
18		under the Clinical Psychologist Licensing Act; clinical social
19		workers licensed under the Clinical Social Work and Social Work
20		Practice Act; speech-language pathologists and audiologists
21		licensed under the Illinois Speech-Language Pathology and
22		Audiology Practice Act; or hearing instrument dispensers
23		licensed under the Hearing Instrument Consumer Protection Act,
24		or any of their successor Acts.
25		(e) "Health services" means health care procedures and
26		services provided by or through a health care worker.
27		(f) "Immediate family member" means a health care worker's
28		spouse, child, child's spouse, or a parent.
29		(g) "Investment interest" means an equity or debt security
30		issued by an entity, including, without limitation, shares of
31		stock in a corporation, units or other interests in a
32		partnership, bonds, debentures, notes, or other equity
33		interests or debt instruments except that investment interest
34		for purposes of Section 20 does not include interest in a
35		hospital licensed under the laws of the State of Illinois.
36		(h) "Investor" means an individual or entity directly or

1		indirectly owning a legal or beneficial ownership or investment
2		interest, (such as through an immediate family member, trust,
3		or another entity related to the investor).
4		(i) "Office practice" includes the facility or facilities
5		at which a health care worker, on an ongoing basis, provides or
6		supervises the provision of professional health services to
7		individuals.
8		(j) "Referral" means any referral of a patient for health
9		services, including, without limitation:
10		(1) The forwarding of a patient by one health care
11		worker to another health care worker or to an entity
12		outside the health care worker's office practice or group
13		practice that provides health services.
14		(2) The request or establishment by a health care
15		worker of a plan of care outside the health care worker's
16		office practice or group practice that includes the
17		provision of any health services.
18		(Source: P.A. 89-72, eff. 12-31-95; 90-742, eff. 8-13-98.)
19		(225 ILCS 47/20)
20		Sec. 20. Prohibited referrals and claims for payment.
21		(a) A health care worker shall not refer a patient for
22		health services to an entity outside the health care worker's
23		office or group practice in which the health care worker is an
24		investor, unless the health care worker directly provides
25		health services within the entity and will be personally
26		involved with the provision of care to the referred patient.
27		(b) Pursuant to Department Board determination that the
28		following exception is applicable, a health care worker may
29		invest in and refer to an entity, whether or not the health
30		care worker provides direct services within said entity, if
31		there is a demonstrated need in the community for the entity
32		and alternative financing is not available. For purposes of
33		this subsection (b), "demonstrated need" in the community for
34		the entity may exist if (1) there is no facility of reasonable
35		quality that provides medically appropriate service, (2) use of

1		existing facilities is onerous or creates too great a hardship
2		for patients, (3) the entity is formed to own or lease medical
3		equipment which replaces obsolete or otherwise inadequate
4		equipment in or under the control of a hospital located in a
5		federally designated health manpower shortage area, or (4) such
6		other standards as established, by rule, by the Department
7		Board. "Community" shall be defined as a metropolitan area for
8		a city, and a county for a rural area. In addition, the
9		following provisions must be met to be exempt under this
10		Section:
11		(1) Individuals who are not in a position to refer
12		patients to an entity are given a bona fide opportunity to
13		also invest in the entity on the same terms as those
14		offered a referring health care worker; and
15		(2) No health care worker who invests shall be required
16		or encouraged to make referrals to the entity or otherwise
17		generate business as a condition of becoming or remaining
18		an investor; and
19		(3) The entity shall market or furnish its services to
20		referring health care worker investors and other investors
21		on equal terms; and
22		(4) The entity shall not loan funds or guarantee any
23		loans for health care workers who are in a position to
24		refer to an entity; and
25		(5) The income on the health care worker's investment
26		shall be tied to the health care worker's equity in the
27		facility rather than to the volume of referrals made; and
28		(6) Any investment contract between the entity and the
29		health care worker shall not include any covenant or
30		non-competition clause that prevents a health care worker
31		from investing in other entities; and
32		(7) When making a referral, a health care worker must
33		disclose his investment interest in an entity to the
34		patient being referred to such entity. If alternative
35		facilities are reasonably available, the health care
36		worker must provide the patient with a list of alternative

1		facilities. The health care worker shall inform the patient
2		that they have the option to use an alternative facility
3		other than one in which the health care worker has an
4		investment interest and the patient will not be treated
5		differently by the health care worker if the patient
6		chooses to use another entity. This shall be applicable to
7		all health care worker investors, including those who
8		provide direct care or services for their patients in
9		entities outside their office practices; and
10		(8) If a third party payor requests information with
11		regard to a health care worker's investment interest, the
12		same shall be disclosed; and
13		(9) The entity shall establish an internal utilization
14		review program to ensure that investing health care workers
15		provided appropriate or necessary utilization; and
16		(10) If a health care worker's financial interest in an
17		entity is incompatible with a referred patient's interest,
18		the health care worker shall make alternative arrangements
19		for the patient's care.
20		The Department Board shall make such a determination for a
21		health care worker within 90 days of a completed written
22		request. Failure to make such a determination within the 90 day
23		time frame shall mean that no alternative is practical based
24		upon the facts set forth in the completed written request.
25		(c) It shall not be a violation of this Act for a health
26		care worker to refer a patient for health services to a
27		publicly traded entity in which he or she has an investment
28		interest provided that:
29		(1) the entity is listed for trading on the New York
30		Stock Exchange or on the American Stock Exchange, or is a
31		national market system security traded under an automated
32		inter-dealer quotation system operated by the National
33		Association of Securities Dealers; and
34		(2) the entity had, at the end of the corporation's
35		most recent fiscal year, total net assets of at least
36		$30,000,000 related to the furnishing of health services;

1		and
2		(3) any investment interest obtained after the
3		effective date of this Act is traded on the exchanges
4		listed in paragraph 1 of subsection (c) of this Section
5		after the entity became a publicly traded corporation; and
6		(4) the entity markets or furnishes its services to
7		referring health care worker investors and other health
8		care workers on equal terms; and
9		(5) all stock held in such publicly traded companies,
10		including stock held in the predecessor privately held
11		company, shall be of one class without preferential
12		treatment as to status or remuneration; and
13		(6) the entity does not loan funds or guarantee any
14		loans for health care workers who are in a position to be
15		referred to an entity; and
16		(7) the income on the health care worker's investment
17		is tied to the health care worker's equity in the entity
18		rather than to the volume of referrals made; and
19		(8) the investment interest does not exceed 1/2 of 1%
20		of the entity's total equity.
21		(d) Any hospital licensed under the Hospital Licensing Act
22		shall not discriminate against or otherwise penalize a health
23		care worker for compliance with this Act.
24		(e) Any health care worker or other entity shall not enter
25		into an arrangement or scheme seeking to make referrals to
26		another health care worker or entity based upon the condition
27		that the health care worker or entity will make referrals with
28		an intent to evade the prohibitions of this Act by inducing
29		patient referrals which would be prohibited by this Section if
30		the health care worker or entity made the referral directly.
31		(f) If compliance with the need and alternative investor
32		criteria is not practical, the health care worker shall
33		identify to the patient reasonably available alternative
34		facilities. The Department Board shall, by rule, designate when
35		compliance is "not practical".
36		(g) Health care workers may request from the Department

1		Board that it render an advisory opinion that a referral to an
2		existing or proposed entity under specified circumstances does
3		or does not violate the provisions of this Act. The
4		Department's Board's opinion shall be presumptively correct.
5		Failure to render such an advisory opinion within 90 days of a
6		completed written request pursuant to this Section shall create
7		a rebuttable presumption that a referral described in the
8		completed written request is not or will not be a violation of
9		this Act.
10		(h) Notwithstanding any provision of this Act to the
11		contrary, a health care worker may refer a patient, who is a
12		member of a health maintenance organization "HMO" licensed in
13		this State, for health services to an entity, outside the
14		health care worker's office or group practice, in which the
15		health care worker is an investor, provided that any such
16		referral is made pursuant to a contract with the HMO.
17		Furthermore, notwithstanding any provision of this Act to the
18		contrary, a health care worker may refer an enrollee of a
19		"managed care community network", as defined in subsection (b)
20		of Section 5-11 of the Illinois Public Aid Code, for health
21		services to an entity, outside the health care worker's office
22		or group practice, in which the health care worker is an
23		investor, provided that any such referral is made pursuant to a
24		contract with the managed care community network.
25		(Source: P.A. 92-370, eff. 8-15-01.)
26		(225 ILCS 47/30)
27		Sec. 30. Rulemaking. The Department Health Facilities
28		Planning Board shall exclusively and solely implement the
29		provisions of this Act pursuant to rules adopted in accordance
30		with the Illinois Administrative Procedure Act concerning, but
31		not limited to:
32		(a) Standards and procedures for the administration of this
33		Act.
34		(b) Procedures and criteria for exceptions from the
35		prohibitions set forth in Section 20.

1		(c) Procedures and criteria for determining practical
2		compliance with the needs and alternative investor criteria in
3		Section 20.
4		(d) Procedures and criteria for determining when a written
5		request for an opinion set forth in Section 20 is complete.
6		(e) Procedures and criteria for advising health care
7		workers of the applicability of this Act to practices pursuant
8		to written requests.
9		Rules adopted under this Act by the Health Facilities
10		Planning Board shall remain in effect until amended or repealed
11		by the Department.
12		(Source: P.A. 87-1207.)
13		(225 ILCS 47/35)
14		Sec. 35. Administrative Procedure Act; application. The
15		Illinois Administrative Procedure Act is hereby expressly
16		adopted and incorporated herein and shall apply to the
17		Department Board as if all of the provisions of such Act were
18		included in this Act; except that in case of a conflict between
19		the Illinois Administrative Procedure Act and this Act the
20		provisions of this Act shall control.
21		(Source: P.A. 87-1207.)
22		(225 ILCS 47/40)
23		Sec. 40. Review under Administrative Review Law. Any person
24		who is adversely affected by a final decision of the Department
25		Board may have such decision judicially reviewed. The
26		provisions of the Administrative Review Law and the rules
27		adopted pursuant thereto shall apply to and govern all
28		proceedings for the judicial review of final administrative
29		decisions of the Department Board. The term "administrative
30		decisions" is as defined in Section 3-101 of the Code of Civil
31		Procedure.
32		(Source: P.A. 87-1207.)

33

Section 80. The Nurse Agency Licensing Act is amended by

1		changing Section 3 as follows:
2		(225 ILCS 510/3) (from Ch. 111, par. 953)
3		Sec. 3. Definitions. As used in this Act:
4		(a) "Certified nurse aide" means an individual certified as
5		defined in Section 3-206 of the Nursing Home Care Act, as now
6		or hereafter amended.
7		(b) "Department" means the Department of Labor.
8		(c) "Director" means the Director of Labor.
9		(d) "Health care facility" means and includes the following
10		facilities and organizations:
11		(1) an ambulatory surgical treatment center required
12		to be licensed pursuant to the Ambulatory Surgical
13		Treatment Center Act;
14		(2) an institution, place, building, or agency
15		required to be licensed pursuant to the Hospital Licensing
16		Act;
17		(3) skilled and intermediate long term care facilities
18		licensed under the Nursing Home Care Act;
19		(4) hospitals, nursing homes, ambulatory surgical
20		treatment centers, or kidney disease treatment centers
21		maintained by the State or any department or agency
22		thereof;
23		(5) kidney disease treatment centers, including a
24		free-standing hemodialysis unit; and
25		(6) an institution, place, building, or room used for
26		the performance of outpatient surgical procedures that is
27		leased, owned, or operated by or on behalf of an
28		out-of-state facility.
29		is defined as in Section 3 of the Illinois Health Facilities
30		Planning Act, as now or hereafter amended.
31		(e) "Licensee" means any nursing agency which is properly
32		licensed under this Act.
33		(f) "Nurse" means a registered nurse or a licensed
34		practical nurse as defined in the Nursing and Advanced Practice
35		Nursing Act.

1		(g) "Nurse agency" means any individual, firm,
2		corporation, partnership or other legal entity that employs,
3		assigns or refers nurses or certified nurse aides to a health
4		care facility for a fee. The term "nurse agency" includes
5		nurses registries. The term "nurse agency" does not include
6		services provided by home health agencies licensed and operated
7		under the Home Health Agency Licensing Act or a licensed or
8		certified individual who provides his or her own services as a
9		regular employee of a health care facility, nor does it apply
10		to a health care facility's organizing nonsalaried employees to
11		provide services only in that facility.
12		(Source: P.A. 90-742, eff. 8-13-98.)

13		Section 85. The Illinois Public Aid Code is amended by
14		changing Sections 5-5.01a and 5-5.02 as follows:
15		(305 ILCS 5/5-5.01a)
16		Sec. 5-5.01a. Supportive living facilities demonstration
17		project. For the purpose of studying alternative settings for
18		long term care, the Department may establish and provide
19		oversight for a demonstration project to determine the
20		viability of supportive living facilities that seek to promote
21		resident independence, dignity, respect, and well-being in the
22		most cost-effective manner.
23		A supportive living facility is either a free-standing
24		facility or a distinct physical and operational entity within a
25		nursing facility. A supportive living facility integrates
26		housing with health, personal care, and supportive services and
27		is a designated setting that offers residents their own
28		separate, private, and distinct living units.
29		Demonstration sites shall be selected by the Department
30		based upon criteria that may include the need for services in a
31		geographic area, the availability of funding, and the site's
32		ability to meet the standards.
33		The Department may adopt rules to implement this Section.
34		Rules that establish or modify the services, standards, and

1		conditions for participation in the demonstration project
2		shall be adopted by the Department in consultation with the
3		Department on Aging, the Department of Rehabilitation
4		Services, and the Department of Mental Health and Developmental
5		Disabilities (or their successor agencies).
6		Facilities or distinct parts of facilities which are
7		selected as supportive living facilities and are in good
8		standing with the Department's rules are exempt from the
9		provisions of the Nursing Home Care Act and the Illinois Health
10		Facilities Planning Act.
11		(Source: P.A. 89-499, eff. 6-28-96.)
12		(305 ILCS 5/5-5.02) (from Ch. 23, par. 5-5.02)
13		Sec. 5-5.02. Hospital reimbursements.
14		(a) Reimbursement to Hospitals; July 1, 1992 through
15		September 30, 1992. Notwithstanding any other provisions of
16		this Code or the Illinois Department's Rules promulgated under
17		the Illinois Administrative Procedure Act, reimbursement to
18		hospitals for services provided during the period July 1, 1992
19		through September 30, 1992, shall be as follows:
20		(1) For inpatient hospital services rendered, or if
21		applicable, for inpatient hospital discharges occurring,
22		on or after July 1, 1992 and on or before September 30,
23		1992, the Illinois Department shall reimburse hospitals
24		for inpatient services under the reimbursement
25		methodologies in effect for each hospital, and at the
26		inpatient payment rate calculated for each hospital, as of
27		June 30, 1992. For purposes of this paragraph,
28		"reimbursement methodologies" means all reimbursement
29		methodologies that pertain to the provision of inpatient
30		hospital services, including, but not limited to, any
31		adjustments for disproportionate share, targeted access,
32		critical care access and uncompensated care, as defined by
33		the Illinois Department on June 30, 1992.
34		(2) For the purpose of calculating the inpatient
35		payment rate for each hospital eligible to receive

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

1		utilization rate which is at least one-half a standard
2		deviation above the mean Medicaid inpatient utilization
3		rate for all hospitals in Illinois receiving Medicaid
4		payments from the Illinois Department; or
5		(3) Illinois hospitals that on July 1, 1991 had a
6		Medicaid inpatient utilization rate, as defined in
7		paragraph (h) of this Section, that was at least the mean
8		Medicaid inpatient utilization rate for all hospitals in
9		Illinois receiving Medicaid payments from the Illinois
10		Department and which were located in a planning area with
11		one-third or fewer excess beds as determined by the
12		Illinois Health Facilities Planning Board, and that, as of
13		June 30, 1992, were located in a federally designated
14		Health Manpower Shortage Area; or
15		(4) Illinois hospitals that:
16		(A) have a Medicaid inpatient utilization rate
17		that is at least equal to the mean Medicaid inpatient
18		utilization rate for all hospitals in Illinois
19		receiving Medicaid payments from the Department; and
20		(B) also have a Medicaid obstetrical inpatient
21		utilization rate that is at least one standard
22		deviation above the mean Medicaid obstetrical
23		inpatient utilization rate for all hospitals in
24		Illinois receiving Medicaid payments from the
25		Department for obstetrical services; or
26		(5) Any children's hospital, which means a hospital
27		devoted exclusively to caring for children. A hospital
28		which includes a facility devoted exclusively to caring for
29		children shall be considered a children's hospital to the
30		degree that the hospital's Medicaid care is provided to
31		children if either (i) the facility devoted exclusively to
32		caring for children is separately licensed as a hospital by
33		a municipality prior to September 30, 1998 or (ii) the
34		hospital has been designated by the State as a Level III
35		perinatal care facility, has a Medicaid Inpatient
36		Utilization rate greater than 55% for the rate year 2003

1		disproportionate share determination, and has more than
2		10,000 qualified children days as defined by the Department
3		in rulemaking.
4		(c) Inpatient adjustment payments. The adjustment payments
5		required by paragraph (b) shall be calculated based upon the
6		hospital's Medicaid inpatient utilization rate as follows:
7		(1) hospitals with a Medicaid inpatient utilization
8		rate below the mean shall receive a per day adjustment
9		payment equal to $25;
10		(2) hospitals with a Medicaid inpatient utilization
11		rate that is equal to or greater than the mean Medicaid
12		inpatient utilization rate but less than one standard
13		deviation above the mean Medicaid inpatient utilization
14		rate shall receive a per day adjustment payment equal to
15		the sum of $25 plus $1 for each one percent that the
16		hospital's Medicaid inpatient utilization rate exceeds the
17		mean Medicaid inpatient utilization rate;
18		(3) hospitals with a Medicaid inpatient utilization
19		rate that is equal to or greater than one standard
20		deviation above the mean Medicaid inpatient utilization
21		rate but less than 1.5 standard deviations above the mean
22		Medicaid inpatient utilization rate shall receive a per day
23		adjustment payment equal to the sum of $40 plus $7 for each
24		one percent that the hospital's Medicaid inpatient
25		utilization rate exceeds one standard deviation above the
26		mean Medicaid inpatient utilization rate; and
27		(4) hospitals with a Medicaid inpatient utilization
28		rate that is equal to or greater than 1.5 standard
29		deviations above the mean Medicaid inpatient utilization
30		rate shall receive a per day adjustment payment equal to
31		the sum of $90 plus $2 for each one percent that the
32		hospital's Medicaid inpatient utilization rate exceeds 1.5
33		standard deviations above the mean Medicaid inpatient
34		utilization rate.
35
36		(d) Supplemental adjustment payments. In addition to the

1		adjustment payments described in paragraph (c), hospitals as
2		defined in clauses (1) through (5) of paragraph (b), excluding
3		county hospitals (as defined in subsection (c) of Section 15-1
4		of this Code) and a hospital organized under the University of
5		Illinois Hospital Act, shall be paid supplemental inpatient
6		adjustment payments of $60 per day. For purposes of Title XIX
7		of the federal Social Security Act, these supplemental
8		adjustment payments shall not be classified as adjustment
9		payments to disproportionate share hospitals.
10		(e) The inpatient adjustment payments described in
11		paragraphs (c) and (d) shall be increased on October 1, 1993
12		and annually thereafter by a percentage equal to the lesser of
13		(i) the increase in the DRI hospital cost index for the most
14		recent 12 month period for which data are available, or (ii)
15		the percentage increase in the statewide average hospital
16		payment rate over the previous year's statewide average
17		hospital payment rate. The sum of the inpatient adjustment
18		payments under paragraphs (c) and (d) to a hospital, other than
19		a county hospital (as defined in subsection (c) of Section 15-1
20		of this Code) or a hospital organized under the University of
21		Illinois Hospital Act, however, shall not exceed $275 per day;
22		that limit shall be increased on October 1, 1993 and annually
23		thereafter by a percentage equal to the lesser of (i) the
24		increase in the DRI hospital cost index for the most recent
25		12-month period for which data are available or (ii) the
26		percentage increase in the statewide average hospital payment
27		rate over the previous year's statewide average hospital
28		payment rate.
29		(f) Children's hospital inpatient adjustment payments. For
30		children's hospitals, as defined in clause (5) of paragraph
31		(b), the adjustment payments required pursuant to paragraphs
32		(c) and (d) shall be multiplied by 2.0.
33		(g) County hospital inpatient adjustment payments. For
34		county hospitals, as defined in subsection (c) of Section 15-1
35		of this Code, there shall be an adjustment payment as
36		determined by rules issued by the Illinois Department.

1		(h) For the purposes of this Section the following terms
2		shall 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
20		the limits of Public Law 102-234 and Public Law 103-66, the
21		Illinois Department shall by rule adjust disproportionate
22		share adjustment payments.
23		(j) University of Illinois Hospital inpatient adjustment
24		payments. For hospitals organized under the University of
25		Illinois Hospital Act, there shall be an adjustment payment as
26		determined by rules adopted by the Illinois Department.
27		(k) The Illinois Department may by rule establish criteria
28		for and develop methodologies for adjustment payments to
29		hospitals participating under this Article.
30		(Source: P.A. 93-40, eff. 6-27-03.)

31		(405 ILCS 25/4.03 rep.) (from Ch. 91 1/2, par. 604.03)
32		Section 90. The Specialized Living Centers Act is amended
33		by repealing Section 4.03.

Section 999. Effective date. This Act takes effect upon becoming law.