Human Services Committee
Filed: 4/15/2008
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1 | AMENDMENT TO HOUSE BILL 5657
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2 | AMENDMENT NO. ______. Amend House Bill 5657 by replacing | ||||||
3 | everything after the enacting clause with the following:
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4 | "Section 5. The Alternative Health Care Delivery Act is | ||||||
5 | amended by changing Sections 25, 30, and 35 as follows:
| ||||||
6 | (210 ILCS 3/25)
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7 | Sec. 25. Department responsibilities. The Department shall | ||||||
8 | have the
responsibilities set forth in this Section.
| ||||||
9 | (a) The Department shall adopt rules for each alternative | ||||||
10 | health care model
authorized under this Act that shall include | ||||||
11 | but not be limited to the
following:
| ||||||
12 | (1) Further definition of the alternative health care | ||||||
13 | models.
| ||||||
14 | (2) The definition and scope of the demonstration | ||||||
15 | program, including the
implementation date and period of | ||||||
16 | operation, not to exceed 5 years.
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1 | (3) License application information required by the | ||||||
2 | Department.
| ||||||
3 | (4) The care of patients in the alternative health care | ||||||
4 | models.
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5 | (5) Rights afforded to patients of the alternative | ||||||
6 | health care models.
| ||||||
7 | (6) Physical plant requirements.
| ||||||
8 | (7) License application and renewal fees, which may | ||||||
9 | cover
the cost of administering the demonstration program.
| ||||||
10 | (8) Information that may be necessary for the Board and | ||||||
11 | the Department to
monitor and evaluate the alternative | ||||||
12 | health care model demonstration program.
| ||||||
13 | (9) Administrative fines that may be assessed by the | ||||||
14 | Department for
violations of this Act or the rules adopted | ||||||
15 | under this Act.
| ||||||
16 | (b) The Department shall issue, renew, deny, suspend, or | ||||||
17 | revoke licenses for
alternative health care models.
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18 | (c) The Department shall perform licensure inspections of | ||||||
19 | alternative health
care models as deemed necessary by the | ||||||
20 | Department to ensure compliance with
this Act or rules.
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21 | (d) The Department shall deposit application fees, renewal | ||||||
22 | fees, and fines
into the Regulatory Evaluation and Basic | ||||||
23 | Enforcement Fund.
| ||||||
24 | (e) The Department shall assist the Board in performing the
| ||||||
25 | Board's
responsibilities under this Act.
| ||||||
26 | (f) (Blank). The Department shall conduct a study to |
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| |||||||
1 | determine the feasibility, the
potential risks and benefits to | ||||||
2 | patients, and the potential effect on the
health care delivery | ||||||
3 | system of authorizing recovery care of nonsurgical
patients in | ||||||
4 | postsurgical recovery center demonstration models. The | ||||||
5 | Department
shall report the findings
of the study
to the | ||||||
6 | General Assembly no later than November 1, 1998.
The Director | ||||||
7 | shall appoint an advisory committee with representation from
| ||||||
8 | the Illinois Hospital and Health Systems Association,
the | ||||||
9 | Illinois State Medical Society, and the Illinois Freestanding | ||||||
10 | Surgery
Center Association,
a physician who is
board certified | ||||||
11 | in internal medicine, a consumer, and other representatives
| ||||||
12 | deemed appropriate by the Director. The advisory committee | ||||||
13 | shall advise the
Department as it carries out the study.
| ||||||
14 | (g) (Blank). Before November 1, 1998 the Department shall | ||||||
15 | initiate a process to
request public comments on how | ||||||
16 | postsurgical recovery centers admitting
nonsurgical patients | ||||||
17 | should be regulated.
| ||||||
18 | (Source: P.A. 90-600, eff. 6-25-98; 90-655, eff. 7-30-98.)
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19 | (210 ILCS 3/30)
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20 | Sec. 30. Demonstration program requirements. The | ||||||
21 | requirements set forth in
this Section shall apply to | ||||||
22 | demonstration programs.
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23 | (a) There shall be no more than:
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24 | (i) 3 subacute care hospital alternative health care | ||||||
25 | models in the City of
Chicago (one of which shall be |
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1 | located on a designated site and shall have been
licensed | ||||||
2 | as a hospital under the Illinois Hospital Licensing Act | ||||||
3 | within the 10
years immediately before the application for | ||||||
4 | a license);
| ||||||
5 | (ii) 2 subacute care hospital alternative health care | ||||||
6 | models in the
demonstration program for each of the | ||||||
7 | following areas:
| ||||||
8 | (1) Cook County outside the City of Chicago.
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9 | (2) DuPage, Kane, Lake, McHenry, and Will | ||||||
10 | Counties.
| ||||||
11 | (3) Municipalities with a population greater than | ||||||
12 | 50,000 not
located in the areas described in item (i) | ||||||
13 | of subsection (a) and paragraphs
(1) and (2) of item | ||||||
14 | (ii) of subsection (a); and
| ||||||
15 | (iii) 4 subacute care hospital alternative health care
| ||||||
16 | models in the demonstration program for rural areas.
| ||||||
17 | In selecting among applicants for these
licenses in rural | ||||||
18 | areas, the Health Facilities Planning Board and the
Department | ||||||
19 | shall give preference to hospitals that may be unable for | ||||||
20 | economic
reasons to provide continued service to the community | ||||||
21 | in which they are located
unless the hospital were to receive | ||||||
22 | an alternative health care model license.
| ||||||
23 | (a-5) There shall be no more than the a total of 12 | ||||||
24 | postsurgical
recovery care centers with certificate of need for | ||||||
25 | beds as of January 1, 2008.
center alternative health care | ||||||
26 | models in the demonstration program, located as
follows:
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1 | (1) Two in the City of Chicago.
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2 | (2) Two in Cook County outside the City of Chicago. At | ||||||
3 | least
one of these shall be owned or operated by a hospital | ||||||
4 | devoted exclusively to
caring for children.
| ||||||
5 | (3) Two in Kane, Lake, and McHenry Counties.
| ||||||
6 | (4) Four in municipalities with a population of 50,000 | ||||||
7 | or more
not located
in the areas described in paragraphs | ||||||
8 | (1), (2), and (3), 3 of which
shall be
owned or operated by | ||||||
9 | hospitals, at least 2 of which shall be located in
counties | ||||||
10 | with a population of less than 175,000, according to the | ||||||
11 | most recent
decennial census for which data are available, | ||||||
12 | and one of
which shall be owned or operated by
an | ||||||
13 | ambulatory surgical treatment center.
| ||||||
14 | (5) Two in rural areas,
both of which shall be owned or | ||||||
15 | operated by
hospitals.
| ||||||
16 | There shall be no postsurgical recovery care center | ||||||
17 | alternative health care
models located in counties with | ||||||
18 | populations greater than 600,000 but less
than 1,000,000. A | ||||||
19 | proposed postsurgical recovery care center must be owned or
| ||||||
20 | operated by a hospital if it is to be located within, or will | ||||||
21 | primarily serve
the residents of, a health service area in | ||||||
22 | which more than 60% of the gross
patient revenue of the | ||||||
23 | hospitals within that health service area are derived
from | ||||||
24 | Medicaid and Medicare, according to the most recently available | ||||||
25 | calendar
year data from the Illinois Health Care Cost | ||||||
26 | Containment Council. Nothing in
this paragraph shall preclude a |
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1 | hospital and an ambulatory surgical treatment
center from | ||||||
2 | forming a joint venture or developing a collaborative agreement | ||||||
3 | to
own or operate a postsurgical recovery care center.
| ||||||
4 | (a-10) There shall be no more than a total of 8 children's | ||||||
5 | respite care
center alternative health care models in the | ||||||
6 | demonstration program, which shall
be located as follows:
| ||||||
7 | (1) One in the City of Chicago.
| ||||||
8 | (2) One in Cook County outside the City of Chicago.
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9 | (3) A total of 2 in the area comprised of DuPage, Kane, | ||||||
10 | Lake, McHenry, and
Will counties.
| ||||||
11 | (4) A total of 2 in municipalities with a population of | ||||||
12 | 50,000 or more and
not
located in the areas described in | ||||||
13 | paragraphs (1), (2), or (3).
| ||||||
14 | (5) A total of 2 in rural areas, as defined by the | ||||||
15 | Health Facilities
Planning Board.
| ||||||
16 | No more than one children's respite care model owned and | ||||||
17 | operated by a
licensed skilled pediatric facility shall be | ||||||
18 | located in each of the areas
designated in this subsection | ||||||
19 | (a-10).
| ||||||
20 | (a-15) There shall be an authorized community-based | ||||||
21 | residential
rehabilitation center alternative health care | ||||||
22 | model in the demonstration
program. The community-based | ||||||
23 | residential rehabilitation center shall be
located in the area | ||||||
24 | of Illinois south of Interstate Highway 70.
| ||||||
25 | (a-20) There shall be an authorized
Alzheimer's disease | ||||||
26 | management center alternative health care model in the
|
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| |||||||
1 | demonstration program. The Alzheimer's disease management | ||||||
2 | center shall be
located in Will
County, owned by a
| ||||||
3 | not-for-profit entity, and endorsed by a resolution approved by | ||||||
4 | the county
board before the effective date of this amendatory | ||||||
5 | Act of the 91st General
Assembly.
| ||||||
6 | (a-25) There shall be no more than 10 birth center | ||||||
7 | alternative health care
models in the demonstration program, | ||||||
8 | located as follows:
| ||||||
9 | (1) Four in the area comprising Cook, DuPage, Kane, | ||||||
10 | Lake, McHenry, and
Will counties, one of
which shall be | ||||||
11 | owned or operated by a hospital and one of which shall be | ||||||
12 | owned
or operated by a federally qualified health center.
| ||||||
13 | (2) Three in municipalities with a population of 50,000 | ||||||
14 | or more not
located in the area described in paragraph (1) | ||||||
15 | of this subsection, one of
which shall be owned or operated | ||||||
16 | by a hospital and one of which shall be owned
or operated | ||||||
17 | by a federally qualified health center.
| ||||||
18 | (3) Three in rural areas, one of which shall be owned | ||||||
19 | or operated by a
hospital and one of which shall be owned | ||||||
20 | or operated by a federally qualified
health center.
| ||||||
21 | The first 3 birth centers authorized to operate by the | ||||||
22 | Department shall be
located in or predominantly serve the | ||||||
23 | residents of a health professional
shortage area as determined | ||||||
24 | by the United States Department of Health and Human
Services. | ||||||
25 | There shall be no more than 2 birth centers authorized to | ||||||
26 | operate in
any single health planning area for obstetric |
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1 | services as determined under the
Illinois Health Facilities | ||||||
2 | Planning Act. If a birth center is located outside
of a
health | ||||||
3 | professional shortage area, (i) the birth center shall be | ||||||
4 | located in a
health planning
area with a demonstrated need for | ||||||
5 | obstetrical service beds, as determined by
the Illinois Health | ||||||
6 | Facilities Planning Board or (ii) there must be a
reduction in
| ||||||
7 | the existing number of obstetrical service beds in the planning | ||||||
8 | area so that
the establishment of the birth center does not | ||||||
9 | result in an increase in the
total number of obstetrical | ||||||
10 | service beds in the health planning area.
| ||||||
11 | (b) Alternative health care models, other than a model | ||||||
12 | authorized under
subsection (a-20), shall obtain a certificate | ||||||
13 | of
need from the Illinois Health Facilities Planning Board | ||||||
14 | under the Illinois
Health Facilities Planning Act before | ||||||
15 | receiving a license by the
Department.
If, after obtaining its | ||||||
16 | initial certificate of need, an alternative health
care | ||||||
17 | delivery model that is a community based residential | ||||||
18 | rehabilitation center
seeks to
increase the bed capacity of | ||||||
19 | that center, it must obtain a certificate of need
from the | ||||||
20 | Illinois Health Facilities Planning Board before increasing | ||||||
21 | the bed
capacity. Alternative
health care models in medically | ||||||
22 | underserved areas
shall receive priority in obtaining a | ||||||
23 | certificate of need.
| ||||||
24 | (c) An alternative health care model license shall be | ||||||
25 | issued for a
period of one year and shall be annually renewed | ||||||
26 | if the facility or
program is in substantial compliance with |
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| |||||||
1 | the Department's rules
adopted under this Act. A licensed | ||||||
2 | alternative health care model that continues
to be in | ||||||
3 | substantial compliance after the conclusion of the | ||||||
4 | demonstration
program shall be eligible for annual renewals | ||||||
5 | unless and until a different
licensure program for that type of | ||||||
6 | health care model is established by
legislation. The Department | ||||||
7 | may issue a provisional license to any
alternative health care | ||||||
8 | model that does not substantially comply with the
provisions of | ||||||
9 | this Act and the rules adopted under this Act if (i)
the | ||||||
10 | Department finds that the alternative health care model has | ||||||
11 | undertaken
changes and corrections which upon completion will | ||||||
12 | render the alternative
health care model in substantial | ||||||
13 | compliance with this Act and rules and
(ii) the health and | ||||||
14 | safety of the patients of the alternative
health care model | ||||||
15 | will be protected during the period for which the provisional
| ||||||
16 | license is issued. The Department shall advise the licensee of
| ||||||
17 | the conditions under which the provisional license is issued, | ||||||
18 | including
the manner in which the alternative health care model | ||||||
19 | fails to comply with
the provisions of this Act and rules, and | ||||||
20 | the time within which the changes
and corrections necessary for | ||||||
21 | the alternative health care model to
substantially comply with | ||||||
22 | this Act and rules shall be completed.
| ||||||
23 | (d) Alternative health care models shall seek | ||||||
24 | certification under Titles
XVIII and XIX of the federal Social | ||||||
25 | Security Act. In addition, alternative
health care models shall | ||||||
26 | provide charitable care consistent with that provided
by |
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| |||||||
1 | comparable health care providers in the geographic area.
| ||||||
2 | (d-5) The Department of Healthcare and Family Services | ||||||
3 | (formerly Illinois Department of Public Aid), in cooperation | ||||||
4 | with the
Illinois Department of
Public Health, shall develop | ||||||
5 | and implement a reimbursement methodology for all
facilities | ||||||
6 | participating in the demonstration program. The Department of | ||||||
7 | Healthcare and Family Services shall keep a record of services | ||||||
8 | provided under the demonstration
program to recipients of | ||||||
9 | medical assistance under the Illinois Public Aid Code
and shall | ||||||
10 | submit an annual report of that information to the Illinois
| ||||||
11 | Department of Public Health.
| ||||||
12 | (e) Alternative health care models shall, to the extent | ||||||
13 | possible,
link and integrate their services with nearby health | ||||||
14 | care facilities.
| ||||||
15 | (f) Each alternative health care model shall implement a | ||||||
16 | quality
assurance program with measurable benefits and at | ||||||
17 | reasonable cost.
| ||||||
18 | (Source: P.A. 95-331, eff. 8-21-07; 95-445, eff. 1-1-08.)
| ||||||
19 | (210 ILCS 3/35)
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20 | Sec. 35. Alternative health care models authorized. | ||||||
21 | Notwithstanding
any other law to the contrary, alternative | ||||||
22 | health care models
described in this Section may be established | ||||||
23 | on a demonstration basis.
| ||||||
24 | (1) Alternative health care model; subacute care | ||||||
25 | hospital. A subacute
care hospital is a designated site |
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| |||||||
1 | which provides medical specialty care for
patients who need | ||||||
2 | a greater intensity or complexity of care than generally
| ||||||
3 | provided in a skilled nursing facility but who no longer | ||||||
4 | require acute hospital
care. The average length of stay for | ||||||
5 | patients treated in subacute care
hospitals shall not be | ||||||
6 | less than 20 days, and for individual patients, the
| ||||||
7 | expected length of stay at the time of admission shall not | ||||||
8 | be less than 10
days. Variations from minimum lengths of | ||||||
9 | stay shall be reported to the
Department. There shall be no | ||||||
10 | more than 13 subacute care hospitals
authorized to operate | ||||||
11 | by the Department. Subacute care includes physician
| ||||||
12 | supervision, registered nursing, and physiological | ||||||
13 | monitoring on a continual
basis. A subacute care hospital | ||||||
14 | is either a freestanding building or a distinct
physical | ||||||
15 | and operational entity within a hospital or nursing home | ||||||
16 | building. A
subacute care hospital shall only consist of | ||||||
17 | beds currently existing in
licensed hospitals or skilled | ||||||
18 | nursing facilities, except, in the City of
Chicago, on a | ||||||
19 | designated site that was licensed as a hospital under the
| ||||||
20 | Illinois Hospital Licensing Act within the 10 years | ||||||
21 | immediately before the
application for an alternative | ||||||
22 | health care model license. During the period of
operation | ||||||
23 | of the demonstration project, the existing licensed beds | ||||||
24 | shall remain
licensed as hospital or skilled nursing | ||||||
25 | facility beds as well as being licensed
under this Act. In | ||||||
26 | order to handle cases of
complications, emergencies, or |
| |||||||
| |||||||
1 | exigent circumstances, a subacute care hospital
shall | ||||||
2 | maintain a contractual relationship, including a transfer | ||||||
3 | agreement, with
a general acute care hospital. If a | ||||||
4 | subacute care model is located in a
general acute care | ||||||
5 | hospital, it shall utilize all or a portion of the bed
| ||||||
6 | capacity of that existing hospital. In no event shall a | ||||||
7 | subacute care hospital
use the word "hospital" in its | ||||||
8 | advertising or marketing activities or represent
or hold | ||||||
9 | itself out to the public as a general acute care hospital.
| ||||||
10 | (2) Alternative health care delivery model; | ||||||
11 | postsurgical recovery care
center. A postsurgical recovery | ||||||
12 | care center is a designated site which
provides | ||||||
13 | postsurgical recovery care for generally healthy patients
| ||||||
14 | undergoing surgical procedures that require overnight | ||||||
15 | nursing care, pain
control, or observation that would | ||||||
16 | otherwise be provided in an inpatient
setting. A | ||||||
17 | postsurgical recovery care center is either freestanding | ||||||
18 | or a
defined unit of an ambulatory surgical treatment | ||||||
19 | center or hospital.
No facility, or portion of a facility, | ||||||
20 | may participate in a demonstration
program as a | ||||||
21 | postsurgical recovery care center unless the facility has | ||||||
22 | been
licensed as an ambulatory surgical treatment center or | ||||||
23 | hospital for at least 2
years before August 20, 1993 (the | ||||||
24 | effective date of Public Act 88-441). The
maximum length of | ||||||
25 | stay for patients in a
postsurgical recovery care center is | ||||||
26 | not to exceed 48 hours unless the treating
physician |
| |||||||
| |||||||
1 | requests an extension of time from the recovery center's | ||||||
2 | medical
director on the basis of medical or clinical | ||||||
3 | documentation that an additional
care period is required | ||||||
4 | for the recovery of a patient and the medical director
| ||||||
5 | approves the extension of time. In no case, however, shall | ||||||
6 | a patient's length
of stay in a postsurgical recovery care | ||||||
7 | center be longer than 72 hours. If a
patient requires an | ||||||
8 | additional care period after the expiration of the 72-hour
| ||||||
9 | limit, the patient shall be transferred to an appropriate | ||||||
10 | facility. Reports on
variances from the 48-hour limit shall | ||||||
11 | be sent to the Department for its
evaluation. The reports | ||||||
12 | shall, before submission to the Department, have
removed | ||||||
13 | from them all patient and physician identifiers. In order | ||||||
14 | to handle
cases of complications, emergencies, or exigent | ||||||
15 | circumstances, every
postsurgical recovery care center as | ||||||
16 | defined in this paragraph shall maintain a
contractual | ||||||
17 | relationship, including a transfer agreement, with a | ||||||
18 | general acute
care hospital. A postsurgical recovery care | ||||||
19 | center shall be no larger than 20
beds. A postsurgical | ||||||
20 | recovery care center shall be located within 15 minutes
| ||||||
21 | travel time from the general acute care hospital with which | ||||||
22 | the center
maintains a contractual relationship, including | ||||||
23 | a transfer agreement, as
required under this paragraph.
| ||||||
24 | No postsurgical recovery care center shall | ||||||
25 | discriminate against any patient
requiring treatment | ||||||
26 | because of the source of payment for services, including
|
| |||||||
| |||||||
1 | Medicare and Medicaid recipients.
| ||||||
2 | The Department shall adopt rules to implement the | ||||||
3 | provisions of Public
Act 88-441 concerning postsurgical | ||||||
4 | recovery care centers within 9 months after
August 20, | ||||||
5 | 1993.
| ||||||
6 | (3) Alternative health care delivery model; children's | ||||||
7 | community-based
health care center. A children's | ||||||
8 | community-based health care center model is a
designated | ||||||
9 | site that provides nursing care, clinical support | ||||||
10 | services, and
therapies for a period of one to 14 days for | ||||||
11 | short-term stays and 120 days to
facilitate transitions to | ||||||
12 | home or other appropriate settings for medically
fragile | ||||||
13 | children, technology
dependent children, and children with | ||||||
14 | special health care needs who are deemed
clinically stable | ||||||
15 | by a physician and are younger than 22 years of age. This
| ||||||
16 | care is to be provided in a home-like environment that | ||||||
17 | serves no more than 12
children at a time. Children's | ||||||
18 | community-based health care center
services must be | ||||||
19 | available through the model to all families, including | ||||||
20 | those
whose care is paid for through the Department of | ||||||
21 | Healthcare and Family Services, the Department of
Children | ||||||
22 | and Family Services, the Department of Human Services, and | ||||||
23 | insurance
companies who cover home health care services or | ||||||
24 | private duty nursing care in
the home.
| ||||||
25 | Each children's community-based health care center | ||||||
26 | model location shall be
physically separate and
apart from |
| |||||||
| |||||||
1 | any other facility licensed by the Department of Public | ||||||
2 | Health under
this or any other Act and shall provide the | ||||||
3 | following services: respite care,
registered nursing or | ||||||
4 | licensed practical nursing care, transitional care to
| ||||||
5 | facilitate home placement or other appropriate settings | ||||||
6 | and reunite families,
medical day care, weekend
camps, and | ||||||
7 | diagnostic studies typically done in the home setting.
| ||||||
8 | Coverage for the services provided by the
Department of | ||||||
9 | Healthcare and Family Services
under this paragraph (3) is | ||||||
10 | contingent upon federal waiver approval and is
provided | ||||||
11 | only to Medicaid eligible clients participating in the home | ||||||
12 | and
community based services waiver designated in Section | ||||||
13 | 1915(c) of the Social
Security Act for medically frail and | ||||||
14 | technologically dependent children or
children in | ||||||
15 | Department of Children and Family Services foster care who | ||||||
16 | receive
home health benefits.
| ||||||
17 | (4) Alternative health care delivery model; community | ||||||
18 | based residential
rehabilitation center.
A community-based | ||||||
19 | residential rehabilitation center model is a designated
| ||||||
20 | site that provides rehabilitation or support, or both, for | ||||||
21 | persons who have
experienced severe brain injury, who are | ||||||
22 | medically stable, and who no longer
require acute | ||||||
23 | rehabilitative care or intense medical or nursing | ||||||
24 | services. The
average length of stay in a community-based | ||||||
25 | residential rehabilitation center
shall not exceed 4 | ||||||
26 | months. As an integral part of the services provided,
|
| |||||||
| |||||||
1 | individuals are housed in a supervised living setting while | ||||||
2 | having immediate
access to the community. The residential | ||||||
3 | rehabilitation center authorized by
the Department may | ||||||
4 | have more than one residence included under the license.
A | ||||||
5 | residence may be no larger than 12 beds and shall be | ||||||
6 | located as an integral
part of the community. Day treatment | ||||||
7 | or
individualized outpatient services shall be provided | ||||||
8 | for persons who reside in
their own home. Functional | ||||||
9 | outcome goals shall be established for each
individual. | ||||||
10 | Services shall include, but are not limited to, case | ||||||
11 | management,
training and assistance with activities of | ||||||
12 | daily living, nursing
consultation, traditional therapies | ||||||
13 | (physical, occupational, speech),
functional interventions | ||||||
14 | in the residence and community (job placement,
shopping, | ||||||
15 | banking, recreation), counseling, self-management | ||||||
16 | strategies,
productive activities, and multiple | ||||||
17 | opportunities for skill acquisition and
practice | ||||||
18 | throughout the day. The design of individualized program | ||||||
19 | plans shall
be consistent with the outcome goals that are | ||||||
20 | established for each resident.
The programs provided in | ||||||
21 | this setting shall be accredited by the
Commission
on | ||||||
22 | Accreditation of Rehabilitation Facilities (CARF). The | ||||||
23 | program shall have
been accredited by CARF as a Brain | ||||||
24 | Injury Community-Integrative Program for at
least 3 years.
| ||||||
25 | (5) Alternative health care delivery model; | ||||||
26 | Alzheimer's disease
management center. An Alzheimer's |
| |||||||
| |||||||
1 | disease management center model is a
designated site that | ||||||
2 | provides a safe and secure setting for care of persons
| ||||||
3 | diagnosed with Alzheimer's disease. An Alzheimer's disease | ||||||
4 | management center
model shall be a facility separate from | ||||||
5 | any other facility licensed by the
Department of Public | ||||||
6 | Health under this or any other Act. An Alzheimer's
disease | ||||||
7 | management center shall conduct and document an assessment | ||||||
8 | of each
resident every 6 months. The assessment shall | ||||||
9 | include an evaluation of daily
functioning, cognitive | ||||||
10 | status, other medical conditions, and behavioral
problems. | ||||||
11 | An Alzheimer's disease management center shall develop and | ||||||
12 | implement
an ongoing treatment plan for each resident. The | ||||||
13 | treatment
plan shall have defined goals.
The
Alzheimer's | ||||||
14 | disease management center shall treat behavioral problems | ||||||
15 | and mood
disorders using nonpharmacologic approaches such | ||||||
16 | as environmental modification,
task simplification, and | ||||||
17 | other appropriate activities.
All staff must have | ||||||
18 | necessary
training to care for all stages of Alzheimer's | ||||||
19 | Disease. An
Alzheimer's disease
management center shall | ||||||
20 | provide education and support for residents and
| ||||||
21 | caregivers. The
education and support shall include | ||||||
22 | referrals to support organizations for
educational | ||||||
23 | materials on community resources, support groups, legal | ||||||
24 | and
financial issues, respite care, and future care needs | ||||||
25 | and options. The
education and support shall also include a | ||||||
26 | discussion of the resident's need to
make advance |
| |||||||
| |||||||
1 | directives and to identify surrogates for medical and legal
| ||||||
2 | decision-making. The provisions of this paragraph | ||||||
3 | establish the minimum level
of services that must be | ||||||
4 | provided by an Alzheimer's disease management
center. An | ||||||
5 | Alzheimer's disease management center model shall have no | ||||||
6 | more
than 100 residents. Nothing in this paragraph (5) | ||||||
7 | shall be construed as
prohibiting a person or facility from | ||||||
8 | providing services and care to persons
with Alzheimer's | ||||||
9 | disease as otherwise authorized under State law.
| ||||||
10 | (6) Alternative health care delivery model; birth | ||||||
11 | center. A birth
center shall be exclusively dedicated to | ||||||
12 | serving the childbirth-related needs of women and their | ||||||
13 | newborns and shall have no more than 10 beds. A birth | ||||||
14 | center is a designated site
that is away from the mother's | ||||||
15 | usual place of residence and in which births are
planned to | ||||||
16 | occur following a normal, uncomplicated, and low-risk | ||||||
17 | pregnancy. A
birth center shall offer prenatal care and | ||||||
18 | community education services and
shall coordinate these | ||||||
19 | services with other health care services available in
the | ||||||
20 | community.
| ||||||
21 | (A) A birth center shall not be separately licensed | ||||||
22 | if it
is one of the following: | ||||||
23 | (1) A part of a hospital; or | ||||||
24 | (2) A freestanding facility that is physically
| ||||||
25 | distinct from a hospital but is operated under a
| ||||||
26 | license issued to a hospital under the Hospital
|
| |||||||
| |||||||
1 | Licensing Act. | ||||||
2 | (B) A separate birth center license shall be | ||||||
3 | required if the birth center is operated as: | ||||||
4 | (1) A part of the operation of a federally
| ||||||
5 | qualified health center as designated by the | ||||||
6 | United
States Department of Health and Human | ||||||
7 | Services; or | ||||||
8 | (2) A facility other than one described in | ||||||
9 | subparagraph (A)(1), (A)(2), or (B)(1) of this | ||||||
10 | paragraph (6) whose costs are
reimbursable under | ||||||
11 | Title XIX of the federal Social
Security Act. | ||||||
12 | In adopting rules for birth centers, the Department | ||||||
13 | shall consider:
the American Association
of Birth Centers' | ||||||
14 | Standards for Freestanding Birth Centers; the American | ||||||
15 | Academy of Pediatrics/American College of Obstetricians | ||||||
16 | and Gynecologists Guidelines for Perinatal Care; and the | ||||||
17 | Regionalized Perinatal Health Care Code. The Department's | ||||||
18 | rules shall stipulate the eligibility criteria for birth | ||||||
19 | center admission. The Department's rules shall
stipulate | ||||||
20 | the necessary equipment for emergency care
according to the | ||||||
21 | American Association of Birth Centers'
standards and any | ||||||
22 | additional equipment deemed necessary by the Department. | ||||||
23 | The Department's rules shall provide for a time
period | ||||||
24 | within which each birth center not part of a
hospital must | ||||||
25 | become accredited by either the Commission for the
| ||||||
26 | Accreditation of Freestanding Birth Centers or The Joint |
| |||||||
| |||||||
1 | Commission. | ||||||
2 | A birth center shall be certified to participate in the | ||||||
3 | Medicare and Medicaid
programs under Titles XVIII and XIX, | ||||||
4 | respectively, of the federal Social
Security Act.
To the | ||||||
5 | extent necessary, the Illinois Department of Healthcare | ||||||
6 | and Family Services shall apply for
a waiver from the | ||||||
7 | United States Health Care Financing Administration to | ||||||
8 | allow
birth centers to be reimbursed under Title XIX of the | ||||||
9 | federal Social Security
Act. | ||||||
10 | A birth center that is not operated under a hospital | ||||||
11 | license shall be located within a ground travel time | ||||||
12 | distance from the general acute care hospital with which
| ||||||
13 | the birth center maintains a contractual relationship,
| ||||||
14 | including a transfer agreement, as required under this
| ||||||
15 | paragraph, that allows for an emergency caesarian delivery | ||||||
16 | to be started within 30 minutes of the decision a caesarian | ||||||
17 | delivery is necessary. A birth center operating under a | ||||||
18 | hospital license shall be located within a ground travel | ||||||
19 | time distance from the licensed hospital that allows for an | ||||||
20 | emergency caesarian delivery to be started within 30 | ||||||
21 | minutes of the decision a caesarian delivery is necessary. | ||||||
22 | The services of a
medical director physician, licensed | ||||||
23 | to practice medicine in all its branches, who is certified | ||||||
24 | or eligible for certification by the
American College of | ||||||
25 | Obstetricians and Gynecologists or the
American Board of | ||||||
26 | Osteopathic Obstetricians and Gynecologists or has |
| |||||||
| |||||||
1 | hospital
obstetrical privileges are required in birth | ||||||
2 | centers. The medical director in consultation with the | ||||||
3 | Director of Nursing and Midwifery Services shall | ||||||
4 | coordinate the clinical staff and overall provision of | ||||||
5 | patient care.
The medical director or his or her physician | ||||||
6 | designee shall be available on the premises or within a | ||||||
7 | close proximity as defined by rule. The medical director | ||||||
8 | and the Director of Nursing and Midwifery Services shall | ||||||
9 | jointly develop and approve policies defining the criteria | ||||||
10 | to determine which pregnancies are accepted as normal, | ||||||
11 | uncomplicated, and low-risk, and the anesthesia services | ||||||
12 | available at the center. No general anesthesia may be | ||||||
13 | administered at the center. | ||||||
14 | If a birth center employs
certified nurse midwives, a | ||||||
15 | certified nurse midwife shall be the Director of
Nursing | ||||||
16 | and Midwifery
Services who is responsible for the | ||||||
17 | development of policies and procedures for
services as | ||||||
18 | provided by Department rules. | ||||||
19 | An obstetrician, family
practitioner, or certified | ||||||
20 | nurse midwife shall attend each woman in labor from
the | ||||||
21 | time of admission through birth and throughout the | ||||||
22 | immediate postpartum
period. Attendance may be delegated | ||||||
23 | only to another physician or certified
nurse
midwife. | ||||||
24 | Additionally, a second staff person shall also be present | ||||||
25 | at each
birth who is licensed or certified in Illinois in a | ||||||
26 | health-related field and under the supervision of the |
| |||||||
| |||||||
1 | physician or certified nurse midwife
in attendance, has | ||||||
2 | specialized training in labor and delivery techniques and
| ||||||
3 | care of newborns, and receives planned and ongoing training | ||||||
4 | as needed to
perform assigned duties effectively. | ||||||
5 | The maximum length of stay in a birth center shall be
| ||||||
6 | consistent with existing State laws allowing a 48-hour stay | ||||||
7 | or appropriate
post-delivery care, if discharged earlier | ||||||
8 | than 48 hours. | ||||||
9 | A birth center shall
participate in the Illinois | ||||||
10 | Perinatal
System under the Developmental Disability | ||||||
11 | Prevention Act. At a minimum, this
participation shall | ||||||
12 | require a birth center to establish a letter of agreement
| ||||||
13 | with a hospital designated under the Perinatal System. A | ||||||
14 | hospital that
operates or has a letter of agreement with a | ||||||
15 | birth center shall include the
birth center under its | ||||||
16 | maternity service plan under the Hospital Licensing Act
and | ||||||
17 | shall include the birth center in the hospital's letter of | ||||||
18 | agreement with
its regional perinatal center. | ||||||
19 | A birth center may not discriminate against any patient | ||||||
20 | requiring treatment
because of the source of payment for | ||||||
21 | services, including Medicare and Medicaid
recipients. | ||||||
22 | No general anesthesia and no surgery may be performed | ||||||
23 | at a birth center.
The Department may by rule add birth | ||||||
24 | center patient eligibility criteria or standards as it | ||||||
25 | deems necessary.
The Department shall by rule require each | ||||||
26 | birth center to report the information which the Department |
| |||||||
| |||||||
1 | shall make publicly available, which shall include, but is | ||||||
2 | not limited to, the following: | ||||||
3 | (i) Birth center ownership. | ||||||
4 | (ii) Sources of payment for services. | ||||||
5 | (iii) Utilization data involving patient length of | ||||||
6 | stay. | ||||||
7 | (iv) Admissions and discharges. | ||||||
8 | (v) Complications. | ||||||
9 | (vi) Transfers. | ||||||
10 | (vii) Unusual incidents. | ||||||
11 | (viii) Deaths. | ||||||
12 | (ix) Any other publicly reported data required | ||||||
13 | under the Illinois Consumer Guide. | ||||||
14 | (x) Post-discharge patient status data where | ||||||
15 | patients are followed for 14 days after discharge from | ||||||
16 | the birth center to determine whether the mother or | ||||||
17 | baby developed a complication or infection. | ||||||
18 | Within 9 months after the effective date of this | ||||||
19 | amendatory Act of the 95th
General Assembly, the Department | ||||||
20 | shall adopt rules that are developed with consideration of: | ||||||
21 | the American Association of Birth Centers' Standards for | ||||||
22 | Freestanding Birth Centers; the American Academy of | ||||||
23 | Pediatrics/American College of Obstetricians and | ||||||
24 | Gynecologists Guidelines for Perinatal Care; and the | ||||||
25 | Regionalized Perinatal Health Care Code. | ||||||
26 | The Department shall adopt other rules as necessary to |
| |||||||
| |||||||
1 | implement the provisions of this
amendatory Act of the 95th | ||||||
2 | General Assembly within 9 months after the
effective date | ||||||
3 | of this amendatory Act of the 95th General Assembly. | ||||||
4 | (Source: P.A. 95-331, eff. 8-21-07; 95-445, eff. 1-1-08.)
| ||||||
5 | (210 ILCS 3/35.1 rep.)
| ||||||
6 | Section 6. The Alternative Health Care Delivery Act is | ||||||
7 | amended by repealing Section 35.1. | ||||||
8 | Section 10. The Hospital Licensing Act is amended by | ||||||
9 | changing Sections 3 and 4.6 as follows:
| ||||||
10 | (210 ILCS 85/3) (from Ch. 111 1/2, par. 144)
| ||||||
11 | Sec. 3. As used in this Act:
| ||||||
12 | (A) "Hospital" means any institution, place, building, or | ||||||
13 | agency, public
or private, whether organized for profit or not, | ||||||
14 | devoted primarily to the
maintenance and operation of | ||||||
15 | facilities for the diagnosis and treatment or
care of 2 or more | ||||||
16 | unrelated persons admitted for overnight stay or longer
in | ||||||
17 | order to obtain medical, including obstetric, psychiatric and | ||||||
18 | nursing,
care of illness, disease, injury, infirmity, or | ||||||
19 | deformity.
| ||||||
20 | The term "hospital", without regard to length of stay, | ||||||
21 | shall also
include:
| ||||||
22 | (a) any facility which is devoted primarily to | ||||||
23 | providing psychiatric and
related services and programs |
| |||||||
| |||||||
1 | for the diagnosis and treatment or care of
2 or more | ||||||
2 | unrelated persons suffering from emotional or nervous | ||||||
3 | diseases;
| ||||||
4 | (b) all places where pregnant females are received, | ||||||
5 | cared for, or
treated during delivery irrespective of the | ||||||
6 | number of patients received.
| ||||||
7 | The term "hospital" includes general and specialized | ||||||
8 | hospitals, postsurgical recovery care hospitals,
tuberculosis | ||||||
9 | sanitaria, mental or psychiatric hospitals and sanitaria, and
| ||||||
10 | includes maternity homes, lying-in homes, and homes for unwed | ||||||
11 | mothers in
which care is given during delivery.
| ||||||
12 | The term "hospital" does not include:
| ||||||
13 | (1) any person or institution
required to be licensed | ||||||
14 | pursuant to the Nursing Home Care Act, as amended;
| ||||||
15 | (2) hospitalization or care facilities maintained by | ||||||
16 | the State or any
department or agency thereof, where such | ||||||
17 | department or agency has authority
under law to establish | ||||||
18 | and enforce standards for the hospitalization or
care | ||||||
19 | facilities under its management and control;
| ||||||
20 | (3) hospitalization or care facilities maintained by | ||||||
21 | the federal
government or agencies thereof;
| ||||||
22 | (4) hospitalization or care facilities maintained by | ||||||
23 | any university or
college established under the laws of | ||||||
24 | this State and supported principally
by public funds raised | ||||||
25 | by taxation;
| ||||||
26 | (5) any person or facility required to be licensed |
| |||||||
| |||||||
1 | pursuant to the
Alcoholism and Other Drug Abuse and | ||||||
2 | Dependency Act;
| ||||||
3 | (6) any facility operated solely by and for persons who | ||||||
4 | rely
exclusively upon treatment by spiritual means through | ||||||
5 | prayer, in accordance
with the creed or tenets of any | ||||||
6 | well-recognized church or religious
denomination; or
| ||||||
7 | (7) An Alzheimer's disease management center | ||||||
8 | alternative health care
model licensed under the | ||||||
9 | Alternative Health Care Delivery Act.
| ||||||
10 | (B) "Person" means the State, and any political subdivision | ||||||
11 | or municipal
corporation, individual, firm, partnership, | ||||||
12 | corporation, company,
association, or joint stock association, | ||||||
13 | or the legal successor thereof.
| ||||||
14 | (C) "Department" means the Department of Public Health of | ||||||
15 | the State of
Illinois.
| ||||||
16 | (D) "Director" means the Director of Public Health of
the | ||||||
17 | State of Illinois.
| ||||||
18 | (E) "Perinatal" means the period of time
between the | ||||||
19 | conception of an
infant and the end of the first month after | ||||||
20 | birth.
| ||||||
21 | (F) "Federally designated organ procurement agency" means | ||||||
22 | the organ
procurement agency designated by the Secretary of the | ||||||
23 | U.S. Department of Health
and Human Services for the service | ||||||
24 | area in which a hospital is located; except
that in the case of | ||||||
25 | a hospital located in a county adjacent to Wisconsin
which | ||||||
26 | currently contracts with an organ procurement agency located in |
| |||||||
| |||||||
1 | Wisconsin
that is not the organ procurement agency designated | ||||||
2 | by the U.S. Secretary of
Health and Human Services for the | ||||||
3 | service area in which the hospital is
located, if the hospital | ||||||
4 | applies for a waiver pursuant to 42 USC
1320b-8(a), it may | ||||||
5 | designate an organ procurement agency
located in Wisconsin to | ||||||
6 | be thereafter deemed its federally designated organ
| ||||||
7 | procurement agency for the purposes of this Act.
| ||||||
8 | (G) "Tissue bank" means any facility or program operating | ||||||
9 | in Illinois
that is certified by the American Association of | ||||||
10 | Tissue Banks or the Eye Bank
Association of America and is | ||||||
11 | involved in procuring, furnishing, donating,
or distributing | ||||||
12 | corneas, bones, or other human tissue for the purpose of
| ||||||
13 | injecting, transfusing, or transplanting any of them into the | ||||||
14 | human body.
"Tissue bank" does not include a licensed blood | ||||||
15 | bank. For the purposes of this
Act, "tissue" does not include | ||||||
16 | organs.
| ||||||
17 | (Source: P.A. 91-838, eff. 6-16-00.)
| ||||||
18 | (210 ILCS 85/4.6)
| ||||||
19 | Sec. 4.6. Additional licensing requirements.
| ||||||
20 | (a) Notwithstanding any other law or rule to the contrary, | ||||||
21 | without the issuance of a Certificate of Need Permit or | ||||||
22 | Certificate of Exemption from Illinois Health Facilities | ||||||
23 | Planning Board, the Department
may license as a hospital a | ||||||
24 | building
that meets either of the following criteria: | ||||||
25 | (1) It (i) is owned or operated by a hospital licensed
|
| |||||||
| |||||||
1 | under
this Act, (ii) is located in a municipality with a | ||||||
2 | population of less than
60,000, and
(iii) includes a | ||||||
3 | postsurgical recovery care center licensed under the
| ||||||
4 | Alternative
Health Care Delivery Act for a period of not | ||||||
5 | less than 2 years, an ambulatory
surgical treatment center | ||||||
6 | licensed under the Ambulatory Surgical Treatment
Center | ||||||
7 | Act, and a
Freestanding
Emergency Center licensed under the | ||||||
8 | Emergency Medical Services (EMS)
Systems Act. Only the | ||||||
9 | components of the building which are currently licensed
| ||||||
10 | shall be eligible under the provisions of this Section. | ||||||
11 | (2) It is a postsurgical recovery care center under the | ||||||
12 | Alternative Health Care Delivery Act, is affiliated with or | ||||||
13 | connected to a licensed hospital or ambulatory surgical | ||||||
14 | treatment center, that previously received a Certificate | ||||||
15 | of Need from the Illinois Health Facilities Planning Board | ||||||
16 | and maintains an organized medical staff of physicians, | ||||||
17 | permanent facilities that include inpatient beds, medical | ||||||
18 | services, including physician services, and continuous | ||||||
19 | registered professional nursing services for not less than | ||||||
20 | 24 hours every day. These licenses will be for postsurgical | ||||||
21 | recovery care hospitals.
| ||||||
22 | (b) Prior to issuing a license, the Department shall | ||||||
23 | inspect the facility
and
require the facility to meet such of | ||||||
24 | the Department's rules relating to
the
establishment of | ||||||
25 | hospitals as the Department determines are appropriate to such
| ||||||
26 | facility. The Department's licensure of the facility as a |
| |||||||
| |||||||
1 | postsurgical recovery care hospital shall be the only approval | ||||||
2 | required for the facility to make improvements and operate as a | ||||||
3 | postsurgical recovery care hospital. Once the Department | ||||||
4 | approves the facility and issues a hospital
license, all other | ||||||
5 | licenses as listed in subsection (a) above shall be null and
| ||||||
6 | void. Upon receiving licensure as a postsurgical recovery care | ||||||
7 | hospital, any facility licensed under subdivision (a)(2) of | ||||||
8 | this Section shall be subject to the following limitations: | ||||||
9 | (1) The facility shall not have a number of beds that | ||||||
10 | is greater than the number of authorized postsurgical | ||||||
11 | recovery care beds. | ||||||
12 | (2) The facility shall continue to be subject to the | ||||||
13 | length-of-stay limitations set forth in Section 35 of the | ||||||
14 | Alternative Health Care Delivery Act. | ||||||
15 | (3) The facility shall seek certification under | ||||||
16 | Section 1861(e) of the federal Social Security Act.
| ||||||
17 | (c) A license as a postsurgical recovery care hospital Only | ||||||
18 | one license may be issued under the authority of subdivision | ||||||
19 | (a)(2) of this Section only to a postsurgical recovery care | ||||||
20 | center established under the Alternative Health Care Delivery | ||||||
21 | Act .
No license may be issued after 18 months after the | ||||||
22 | effective date of this
amendatory Act of the 91st General | ||||||
23 | Assembly. No license may be issued after 36 months after the | ||||||
24 | effective date of this
amendatory Act of the 95th General | ||||||
25 | Assembly.
| ||||||
26 | (Source: P.A. 91-736, eff. 6-2-00.)
|
| |||||||
| |||||||
1 | Section 99. Effective date. This Act takes effect July 1, | ||||||
2 | 2008.".
|