SB1579 Enrolled LRB095 09004 DRJ 31315 b

1     AN ACT concerning regulation.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4     Section 5. The Illinois Health Facilities Planning Act is
5 amended by changing Section 3 and adding Section 5.1a as
6 follows:
 
7     (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
8     (Section scheduled to be repealed on May 31, 2007)
9     Sec. 3. Definitions. As used in this Act:
10     "Health care facilities" means and includes the following
11 facilities and organizations:
12         1. An ambulatory surgical treatment center required to
13     be licensed pursuant to the Ambulatory Surgical Treatment
14     Center Act;
15         2. An institution, place, building, or agency required
16     to be licensed pursuant to the Hospital Licensing Act;
17         3. Skilled and intermediate long term care facilities
18     licensed under the Nursing Home Care Act;
19         3. Skilled and intermediate long term care facilities
20     licensed under the Nursing Home Care Act;
21         4. Hospitals, nursing homes, ambulatory surgical
22     treatment centers, or kidney disease treatment centers
23     maintained by the State or any department or agency

 

 

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1     thereof;
2         5. Kidney disease treatment centers, including a
3     free-standing hemodialysis unit required to be licensed
4     under the End Stage Renal Disease Facility Act; and
5         6. An institution, place, building, or room used for
6     the performance of outpatient surgical procedures that is
7     leased, owned, or operated by or on behalf of an
8     out-of-state facility.
9     No federally owned facility shall be subject to the
10 provisions of this Act, nor facilities used solely for healing
11 by prayer or spiritual means.
12     No facility licensed under the Supportive Residences
13 Licensing Act or the Assisted Living and Shared Housing Act
14 shall be subject to the provisions of this Act.
15     A facility designated as a supportive living facility that
16 is in good standing with the program established under Section
17 5-5.01a of the Illinois Public Aid Code shall not be subject to
18 the provisions of this Act.
19     This Act does not apply to facilities granted waivers under
20 Section 3-102.2 of the Nursing Home Care Act. However, if a
21 demonstration project under that Act applies for a certificate
22 of need to convert to a nursing facility, it shall meet the
23 licensure and certificate of need requirements in effect as of
24 the date of application.
25     This Act does not apply to a dialysis facility that
26 provides only dialysis training, support, and related services

 

 

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1 to individuals with end stage renal disease who have elected to
2 receive home dialysis. This Act does not apply to a dialysis
3 unit located in a licensed nursing home that offers or provides
4 dialysis-related services to residents with end stage renal
5 disease who have elected to receive home dialysis within the
6 nursing home. The Board, however, may require these dialysis
7 facilities and licensed nursing homes to report statistical
8 information on a quarterly basis to the Board to be used by the
9 Board to conduct analyses on the need for proposed kidney
10 disease treatment centers.
11     This Act shall not apply to the closure of an entity or a
12 portion of an entity licensed under the Nursing Home Care Act
13 that elects to convert, in whole or in part, to an assisted
14 living or shared housing establishment licensed under the
15 Assisted Living and Shared Housing Act.
16     With the exception of those health care facilities
17 specifically included in this Section, nothing in this Act
18 shall be intended to include facilities operated as a part of
19 the practice of a physician or other licensed health care
20 professional, whether practicing in his individual capacity or
21 within the legal structure of any partnership, medical or
22 professional corporation, or unincorporated medical or
23 professional group. Further, this Act shall not apply to
24 physicians or other licensed health care professional's
25 practices where such practices are carried out in a portion of
26 a health care facility under contract with such health care

 

 

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1 facility by a physician or by other licensed health care
2 professionals, whether practicing in his individual capacity
3 or within the legal structure of any partnership, medical or
4 professional corporation, or unincorporated medical or
5 professional groups. This Act shall apply to construction or
6 modification and to establishment by such health care facility
7 of such contracted portion which is subject to facility
8 licensing requirements, irrespective of the party responsible
9 for such action or attendant financial obligation.
10     "Person" means any one or more natural persons, legal
11 entities, governmental bodies other than federal, or any
12 combination thereof.
13     "Consumer" means any person other than a person (a) whose
14 major occupation currently involves or whose official capacity
15 within the last 12 months has involved the providing,
16 administering or financing of any type of health care facility,
17 (b) who is engaged in health research or the teaching of
18 health, (c) who has a material financial interest in any
19 activity which involves the providing, administering or
20 financing of any type of health care facility, or (d) who is or
21 ever has been a member of the immediate family of the person
22 defined by (a), (b), or (c).
23     "State Board" means the Health Facilities Planning Board.
24     "Construction or modification" means the establishment,
25 erection, building, alteration, reconstruction, modernization,
26 improvement, extension, discontinuation, change of ownership,

 

 

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1 of or by a health care facility, or the purchase or acquisition
2 by or through a health care facility of equipment or service
3 for diagnostic or therapeutic purposes or for facility
4 administration or operation, or any capital expenditure made by
5 or on behalf of a health care facility which exceeds the
6 capital expenditure minimum; however, any capital expenditure
7 made by or on behalf of a health care facility for (i) the
8 construction or modification of a facility licensed under the
9 Assisted Living and Shared Housing Act or (ii) a conversion
10 project undertaken in accordance with Section 30 of the Older
11 Adult Services Act shall be excluded from any obligations under
12 this Act.
13     "Establish" means the construction of a health care
14 facility or the replacement of an existing facility on another
15 site.
16     "Major medical equipment" means medical equipment which is
17 used for the provision of medical and other health services and
18 which costs in excess of the capital expenditure minimum,
19 except that such term does not include medical equipment
20 acquired by or on behalf of a clinical laboratory to provide
21 clinical laboratory services if the clinical laboratory is
22 independent of a physician's office and a hospital and it has
23 been determined under Title XVIII of the Social Security Act to
24 meet the requirements of paragraphs (10) and (11) of Section
25 1861(s) of such Act. In determining whether medical equipment
26 has a value in excess of the capital expenditure minimum, the

 

 

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1 value of studies, surveys, designs, plans, working drawings,
2 specifications, and other activities essential to the
3 acquisition of such equipment shall be included.
4     "Capital Expenditure" means an expenditure: (A) made by or
5 on behalf of a health care facility (as such a facility is
6 defined in this Act); and (B) which under generally accepted
7 accounting principles is not properly chargeable as an expense
8 of operation and maintenance, or is made to obtain by lease or
9 comparable arrangement any facility or part thereof or any
10 equipment for a facility or part; and which exceeds the capital
11 expenditure minimum.
12     For the purpose of this paragraph, the cost of any studies,
13 surveys, designs, plans, working drawings, specifications, and
14 other activities essential to the acquisition, improvement,
15 expansion, or replacement of any plant or equipment with
16 respect to which an expenditure is made shall be included in
17 determining if such expenditure exceeds the capital
18 expenditures minimum. Donations of equipment or facilities to a
19 health care facility which if acquired directly by such
20 facility would be subject to review under this Act shall be
21 considered capital expenditures, and a transfer of equipment or
22 facilities for less than fair market value shall be considered
23 a capital expenditure for purposes of this Act if a transfer of
24 the equipment or facilities at fair market value would be
25 subject to review.
26     "Capital expenditure minimum" means $6,000,000, which

 

 

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1 shall be annually adjusted to reflect the increase in
2 construction costs due to inflation, for major medical
3 equipment and for all other capital expenditures; provided,
4 however, that when a capital expenditure is for the
5 construction or modification of a health and fitness center,
6 "capital expenditure minimum" means the capital expenditure
7 minimum for all other capital expenditures in effect on March
8 1, 2000, which shall be annually adjusted to reflect the
9 increase in construction costs due to inflation.
10     "Non-clinical service area" means an area (i) for the
11 benefit of the patients, visitors, staff, or employees of a
12 health care facility and (ii) not directly related to the
13 diagnosis, treatment, or rehabilitation of persons receiving
14 services from the health care facility. "Non-clinical service
15 areas" include, but are not limited to, chapels; gift shops;
16 news stands; computer systems; tunnels, walkways, and
17 elevators; telephone systems; projects to comply with life
18 safety codes; educational facilities; student housing;
19 patient, employee, staff, and visitor dining areas;
20 administration and volunteer offices; modernization of
21 structural components (such as roof replacement and masonry
22 work); boiler repair or replacement; vehicle maintenance and
23 storage facilities; parking facilities; mechanical systems for
24 heating, ventilation, and air conditioning; loading docks; and
25 repair or replacement of carpeting, tile, wall coverings,
26 window coverings or treatments, or furniture. Solely for the

 

 

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1 purpose of this definition, "non-clinical service area" does
2 not include health and fitness centers.
3     "Areawide" means a major area of the State delineated on a
4 geographic, demographic, and functional basis for health
5 planning and for health service and having within it one or
6 more local areas for health planning and health service. The
7 term "region", as contrasted with the term "subregion", and the
8 word "area" may be used synonymously with the term "areawide".
9     "Local" means a subarea of a delineated major area that on
10 a geographic, demographic, and functional basis may be
11 considered to be part of such major area. The term "subregion"
12 may be used synonymously with the term "local".
13     "Areawide health planning organization" or "Comprehensive
14 health planning organization" means the health systems agency
15 designated by the Secretary, Department of Health and Human
16 Services or any successor agency.
17     "Local health planning organization" means those local
18 health planning organizations that are designated as such by
19 the areawide health planning organization of the appropriate
20 area.
21     "Physician" means a person licensed to practice in
22 accordance with the Medical Practice Act of 1987, as amended.
23     "Licensed health care professional" means a person
24 licensed to practice a health profession under pertinent
25 licensing statutes of the State of Illinois.
26     "Director" means the Director of the Illinois Department of

 

 

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1 Public Health.
2     "Agency" means the Illinois Department of Public Health.
3     "Comprehensive health planning" means health planning
4 concerned with the total population and all health and
5 associated problems that affect the well-being of people and
6 that encompasses health services, health manpower, and health
7 facilities; and the coordination among these and with those
8 social, economic, and environmental factors that affect
9 health.
10     "Alternative health care model" means a facility or program
11 authorized under the Alternative Health Care Delivery Act.
12     "Out-of-state facility" means a person that is both (i)
13 licensed as a hospital or as an ambulatory surgery center under
14 the laws of another state or that qualifies as a hospital or an
15 ambulatory surgery center under regulations adopted pursuant
16 to the Social Security Act and (ii) not licensed under the
17 Ambulatory Surgical Treatment Center Act, the Hospital
18 Licensing Act, or the Nursing Home Care Act. Affiliates of
19 out-of-state facilities shall be considered out-of-state
20 facilities. Affiliates of Illinois licensed health care
21 facilities 100% owned by an Illinois licensed health care
22 facility, its parent, or Illinois physicians licensed to
23 practice medicine in all its branches shall not be considered
24 out-of-state facilities. Nothing in this definition shall be
25 construed to include an office or any part of an office of a
26 physician licensed to practice medicine in all its branches in

 

 

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1 Illinois that is not required to be licensed under the
2 Ambulatory Surgical Treatment Center Act.
3     "Change of ownership of a health care facility" means a
4 change in the person who has ownership or control of a health
5 care facility's physical plant and capital assets. A change in
6 ownership is indicated by the following transactions: sale,
7 transfer, acquisition, lease, change of sponsorship, or other
8 means of transferring control.
9     "Related person" means any person that: (i) is at least 50%
10 owned, directly or indirectly, by either the health care
11 facility or a person owning, directly or indirectly, at least
12 50% of the health care facility; or (ii) owns, directly or
13 indirectly, at least 50% of the health care facility.
14     "Charity care" means care provided by a health care
15 facility for which the provider does not expect to receive
16 payment from the patient or a third-party payer.
17     "Freestanding emergency center" means a facility subject
18 to licensure under Section 32.5 of the Emergency Medical
19 Services (EMS) Systems Act.
20 (Source: P.A. 93-41, eff. 6-27-03; 93-766, eff. 7-20-04;
21 93-935, eff. 1-1-05; 93-1031, eff. 8-27-04; 94-342, eff.
22 7-26-05; revised 4-3-07.)
 
23     (20 ILCS 3960/5.1a new)
24     Sec. 5.1a. No person shall construct, modify, or establish
25 a freestanding emergency center in Illinois, or acquire major

 

 

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1 medical equipment or make capital expenditures in relation to
2 such a facility in excess of the capital expenditure minimum,
3 as defined by this Act, without first obtaining a permit from
4 the State Board in accordance with criteria, standards, and
5 procedures adopted by the State Board for freestanding
6 emergency centers that ensure the availability of and community
7 access to essential emergency medical services.
 
8     Section 10. The Emergency Medical Services (EMS) Systems
9 Act is amended by changing Sections 3.20 and 32.5 as follows:
 
10     (210 ILCS 50/3.20)
11     Sec. 3.20. Emergency Medical Services (EMS) Systems.
12     (a) "Emergency Medical Services (EMS) System" means an
13 organization of hospitals, vehicle service providers and
14 personnel approved by the Department in a specific geographic
15 area, which coordinates and provides pre-hospital and
16 inter-hospital emergency care and non-emergency medical
17 transports at a BLS, ILS and/or ALS level pursuant to a System
18 program plan submitted to and approved by the Department, and
19 pursuant to the EMS Region Plan adopted for the EMS Region in
20 which the System is located.
21     (b) One hospital in each System program plan must be
22 designated as the Resource Hospital. All other hospitals which
23 are located within the geographic boundaries of a System and
24 which have standby, basic or comprehensive level emergency

 

 

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1 departments must function in that EMS System as either an
2 Associate Hospital or Participating Hospital and follow all
3 System policies specified in the System Program Plan, including
4 but not limited to the replacement of drugs and equipment used
5 by providers who have delivered patients to their emergency
6 departments. All hospitals and vehicle service providers
7 participating in an EMS System must specify their level of
8 participation in the System Program Plan.
9     (c) The Department shall have the authority and
10 responsibility to:
11         (1) Approve BLS, ILS and ALS level EMS Systems which
12     meet minimum standards and criteria established in rules
13     adopted by the Department pursuant to this Act, including
14     the submission of a Program Plan for Department approval.
15     Beginning September 1, 1997, the Department shall approve
16     the development of a new EMS System only when a local or
17     regional need for establishing such System has been
18     identified. This shall not be construed as a needs
19     assessment for health planning or other purposes outside of
20     this Act. Following Department approval, EMS Systems must
21     be fully operational within one year from the date of
22     approval.
23         (2) Monitor EMS Systems, based on minimum standards for
24     continuing operation as prescribed in rules adopted by the
25     Department pursuant to this Act, which shall include
26     requirements for submitting Program Plan amendments to the

 

 

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1     Department for approval.
2         (3) Renew EMS System approvals every 4 years, after an
3     inspection, based on compliance with the standards for
4     continuing operation prescribed in rules adopted by the
5     Department pursuant to this Act.
6         (4) Suspend, revoke, or refuse to renew approval of any
7     EMS System, after providing an opportunity for a hearing,
8     when findings show that it does not meet the minimum
9     standards for continuing operation as prescribed by the
10     Department, or is found to be in violation of its
11     previously approved Program Plan.
12         (5) Require each EMS System to adopt written protocols
13     for the bypassing of or diversion to any hospital, trauma
14     center or regional trauma center, which provide that a
15     person shall not be transported to a facility other than
16     the nearest hospital, regional trauma center or trauma
17     center unless the medical benefits to the patient
18     reasonably expected from the provision of appropriate
19     medical treatment at a more distant facility outweigh the
20     increased risks to the patient from transport to the more
21     distant facility, or the transport is in accordance with
22     the System's protocols for patient choice or refusal.
23         (6) Require that the EMS Medical Director of an ILS or
24     ALS level EMS System be a physician licensed to practice
25     medicine in all of its branches in Illinois, and certified
26     by the American Board of Emergency Medicine or the American

 

 

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1     Board of Osteopathic Emergency Medicine, and that the EMS
2     Medical Director of a BLS level EMS System be a physician
3     licensed to practice medicine in all of its branches in
4     Illinois, with regular and frequent involvement in
5     pre-hospital emergency medical services. In addition, all
6     EMS Medical Directors shall:
7             (A) Have experience on an EMS vehicle at the
8         highest level available within the System, or make
9         provision to gain such experience within 12 months
10         prior to the date responsibility for the System is
11         assumed or within 90 days after assuming the position;
12             (B) Be thoroughly knowledgeable of all skills
13         included in the scope of practices of all levels of EMS
14         personnel within the System;
15             (C) Have or make provision to gain experience
16         instructing students at a level similar to that of the
17         levels of EMS personnel within the System; and
18             (D) For ILS and ALS EMS Medical Directors,
19         successfully complete a Department-approved EMS
20         Medical Director's Course.
21         (7) Prescribe statewide EMS data elements to be
22     collected and documented by providers in all EMS Systems
23     for all emergency and non-emergency medical services, with
24     a one-year phase-in for commencing collection of such data
25     elements.
26         (8) Define, through rules adopted pursuant to this Act,

 

 

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1     the terms "Resource Hospital", "Associate Hospital",
2     "Participating Hospital", "Basic Emergency Department",
3     "Standby Emergency Department", "Comprehensive Emergency
4     Department", "EMS Medical Director", "EMS Administrative
5     Director", and "EMS System Coordinator".
6             (A) Upon the effective date of this amendatory Act
7         of 1995, all existing Project Medical Directors shall
8         be considered EMS Medical Directors, and all persons
9         serving in such capacities on the effective date of
10         this amendatory Act of 1995 shall be exempt from the
11         requirements of paragraph (7) of this subsection;
12             (B) Upon the effective date of this amendatory Act
13         of 1995, all existing EMS System Project Directors
14         shall be considered EMS Administrative Directors.
15         (9) Investigate the circumstances that caused a
16     hospital in an EMS system to go on bypass status to
17     determine whether that hospital's decision to go on bypass
18     status was reasonable. The Department may impose
19     sanctions, as set forth in Section 3.140 of the Act, upon a
20     Department determination that the hospital unreasonably
21     went on bypass status in violation of the Act.
22         (10) Evaluate the capacity and performance of any
23     freestanding emergency center established under Section
24     32.5 of this Act in meeting emergency medical service needs
25     of the public, including compliance with applicable
26     emergency medical standards and assurance of the

 

 

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1     availability of and immediate access to the highest quality
2     of medical care possible.
3 (Source: P.A. 91-357, eff. 7-29-99.)
 
4     (210 ILCS 50/32.5)
5     Sec. 32.5. Freestanding Emergency Center.
6     (a) Until June 30, 2009, the The Department shall issue an
7 annual Freestanding Emergency Center (FEC) license to any
8 facility that:
9         (1) is located: (A) (i)(A) in a municipality with a
10     population of 75,000 or fewer inhabitants; (B) within 20 15
11     miles of the hospital that owns or controls the FEC; and
12     (C) within 20 10 miles of the Resource Hospital affiliated
13     with the FEC as part of the EMS System; or (ii) (A) in a
14     municipality that has a hospital that has been providing
15     emergency services but is expected to close by the end of
16     1997 and (B) in a county with a population of more than
17     350,000 but less than 525,000 inhabitants;
18         (2) is wholly owned or controlled by an Associate or
19     Resource Hospital, but is not a part of the hospital's
20     physical plant;
21         (3) meets the standards for licensed FECs, adopted by
22     rule of the Department, including, but not limited to:
23             (A) facility design, specification, operation, and
24         maintenance standards;
25             (B) equipment standards; and

 

 

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1             (C) the number and qualifications of emergency
2         medical personnel and other staff, which must include
3         at least one board certified emergency physician
4         present at the FEC 24 hours per day.
5         (4) limits its participation in the EMS System strictly
6     to receiving a limited number of BLS runs by emergency
7     medical vehicles according to protocols developed by the
8     Resource Hospital within the FEC's designated EMS System
9     and approved by the Project Medical Director and the
10     Department;
11         (5) provides comprehensive emergency treatment
12     services, as defined in the rules adopted by the Department
13     pursuant to the Hospital Licensing Act, 24 hours per day,
14     on an outpatient basis;
15         (6) provides an ambulance and maintains on site
16     ambulance services staffed with paramedics 24 hours per
17     day;
18         (7) maintains helicopter landing capabilities approved
19     by appropriate State and federal authorities;
20         (8) complies with all State and federal patient rights
21     provisions, including, but not limited to, the Emergency
22     Medical Treatment Act and the federal Emergency Medical
23     Treatment and Active Labor Act;
24         (9) maintains a communications system that is fully
25     integrated with its Resource Hospital within the FEC's
26     designated EMS System;

 

 

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1         (10) reports to the Department any patient transfers
2     from the FEC to a hospital within 48 hours of the transfer
3     plus any other data determined to be relevant by the
4     Department;
5         (11) submits to the Department, on a quarterly basis,
6     the FEC's morbidity and mortality rates for patients
7     treated at the FEC and other data determined to be relevant
8     by the Department;
9         (12) does not describe itself or hold itself out to the
10     general public as a full service hospital or hospital
11     emergency department in its advertising or marketing
12     activities;
13         (13) complies with any other rules adopted by the
14     Department under this Act that relate to FECs;
15         (14) passes the Department's site inspection for
16     compliance with the FEC requirements of this Act;
17         (15) submits a copy of the a certificate of need or
18     other permit issued by the Illinois Health Facilities
19     Planning Board indicating that the facility has complied
20     with the Illinois Health Facilities Planning Act with
21     respect to the health services to be provided at the
22     facility that will house the proposed FEC complies with
23     State health planning laws; provided, however, that the
24     Illinois Health Facilities Planning Board shall waive this
25     certificate of need or permit requirement for any proposed
26     FEC that, as of the effective date of this amendatory Act

 

 

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1     of 1996, meets the criteria for providing comprehensive
2     emergency treatment services, as defined by the rules
3     promulgated under the Hospital Licensing Act, but is not a
4     licensed hospital;
5         (16) submits an application for designation as an FEC
6     in a manner and form prescribed by the Department by rule;
7     and
8         (17) pays the annual license fee as determined by the
9     Department by rule. ; and
10         (18) participated in the demonstration program.
11     (b) The Department shall:
12         (1) annually inspect facilities of initial FEC
13     applicants and licensed FECs, and issue annual licenses to
14     or annually relicense FECs that satisfy the Department's
15     licensure requirements as set forth in subsection (a);
16         (2) suspend, revoke, refuse to issue, or refuse to
17     renew the license of any FEC, after notice and an
18     opportunity for a hearing, when the Department finds that
19     the FEC has failed to comply with the standards and
20     requirements of the Act or rules adopted by the Department
21     under the Act;
22         (3) issue an Emergency Suspension Order for any FEC
23     when the Director or his or her designee has determined
24     that the continued operation of the FEC poses an immediate
25     and serious danger to the public health, safety, and
26     welfare. An opportunity for a hearing shall be promptly

 

 

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1     initiated after an Emergency Suspension Order has been
2     issued; and
3         (4) adopt rules as needed to implement this Section.
4 (Source: P.A. 93-372, eff. 1-1-04.)
 
5     Section 99. Effective date. This Act takes effect upon
6 becoming law.