Rep. Daniel V. Beiser

Filed: 5/21/2009

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 314

2     AMENDMENT NO. ______. Amend Senate Bill 314 by replacing
3 everything after the enacting clause with the following:
 
4     "Section 5. The Illinois Act on the Aging is amended by
5 changing Section 4.04 as follows:
 
6     (20 ILCS 105/4.04)  (from Ch. 23, par. 6104.04)
7     Sec. 4.04. Long Term Care Ombudsman Program.
8     (a) Long Term Care Ombudsman Program. The Department shall
9 establish a Long Term Care Ombudsman Program, through the
10 Office of State Long Term Care Ombudsman ("the Office"), in
11 accordance with the provisions of the Older Americans Act of
12 1965, as now or hereafter amended.
13     (b) Definitions. As used in this Section, unless the
14 context requires otherwise:
15         (1) "Access" has the same meaning as in Section 1-104
16     of the Nursing Home Care Act, as now or hereafter amended;

 

 

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1     that is, it means the right to:
2             (i) Enter any long term care facility or assisted
3         living or shared housing establishment or supportive
4         living facility;
5             (ii) Communicate privately and without restriction
6         with any resident, regardless of age, who consents to
7         the communication;
8             (iii) Seek consent to communicate privately and
9         without restriction with any resident, regardless of
10         age;
11             (iv) Inspect the clinical and other records of a
12         resident, regardless of age, with the express written
13         consent of the resident;
14             (v) Observe all areas of the long term care
15         facility or supportive living facilities, assisted
16         living or shared housing establishment except the
17         living area of any resident who protests the
18         observation.
19         (2) "Long Term Care Facility" means (i) any facility as
20     defined by Section 1-113 of the Nursing Home Care Act, as
21     now or hereafter amended; and (ii) any skilled nursing
22     facility or a nursing facility which meets the requirements
23     of Section 1819(a), (b), (c), and (d) or Section 1919(a),
24     (b), (c), and (d) of the Social Security Act, as now or
25     hereafter amended (42 U.S.C. 1395i-3(a), (b), (c), and (d)
26     and 42 U.S.C. 1396r(a), (b), (c), and (d)).

 

 

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1         (2.5) "Assisted living establishment" and "shared
2     housing establishment" have the meanings given those terms
3     in Section 10 of the Assisted Living and Shared Housing
4     Act.
5         (2.7) "Supportive living facility" means a facility
6     established under Section 5-5.01a of the Illinois Public
7     Aid Code.
8         (3) "State Long Term Care Ombudsman" means any person
9     employed by the Department to fulfill the requirements of
10     the Office of State Long Term Care Ombudsman as required
11     under the Older Americans Act of 1965, as now or hereafter
12     amended, and Departmental policy.
13         (3.1) "Ombudsman" means any designated representative
14     of a regional long term care ombudsman program; provided
15     that the representative, whether he is paid for or
16     volunteers his ombudsman services, shall be qualified and
17     designated by the Office to perform the duties of an
18     ombudsman as specified by the Department in rules and in
19     accordance with the provisions of the Older Americans Act
20     of 1965, as now or hereafter amended.
21     (c) Ombudsman; rules. The Office of State Long Term Care
22 Ombudsman shall be composed of at least one full-time ombudsman
23 and shall include a system of designated regional long term
24 care ombudsman programs. Each regional program shall be
25 designated by the State Long Term Care Ombudsman as a
26 subdivision of the Office and any representative of a regional

 

 

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1 program shall be treated as a representative of the Office.
2     The Department, in consultation with the Office, shall
3 promulgate administrative rules in accordance with the
4 provisions of the Older Americans Act of 1965, as now or
5 hereafter amended, to establish the responsibilities of the
6 Department and the Office of State Long Term Care Ombudsman and
7 the designated regional Ombudsman programs. The administrative
8 rules shall include the responsibility of the Office and
9 designated regional programs to investigate and resolve
10 complaints made by or on behalf of residents of long term care
11 facilities, supportive living facilities, and assisted living
12 and shared housing establishments, including the option to
13 serve residents under the age of 60, relating to actions,
14 inaction, or decisions of providers, or their representatives,
15 of long term care facilities, of supported living facilities,
16 of assisted living and shared housing establishments, of public
17 agencies, or of social services agencies, which may adversely
18 affect the health, safety, welfare, or rights of such
19 residents. The Office and designated regional programs may
20 represent all residents, but are not required by this Act to
21 represent persons under 60 years of age, except to the extent
22 required by federal law. When necessary and appropriate,
23 representatives of the Office shall refer complaints to the
24 appropriate regulatory State agency. The Department, in
25 consultation with the Office, shall cooperate with the
26 Department of Human Services and other State agencies in

 

 

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1 providing information and training to designated regional long
2 term care ombudsman programs about the appropriate assessment
3 and treatment (including information about appropriate
4 supportive services, treatment options, and assessment of
5 rehabilitation potential) of the residents they serve,
6 including children, persons with mental illness (other than
7 Alzheimer's disease and related disorders), and persons with
8 developmental disabilities.
9     The State Long Term Care Ombudsman and all other ombudsmen,
10 as defined in paragraph (3.1) of subsection (b) must submit to
11 background checks under the Health Care Worker Background Check
12 Act and receive training, as prescribed by the Illinois
13 Department on Aging, before visiting facilities. The training
14 must include information specific to assisted living
15 establishments, supportive living facilities, and shared
16 housing establishments and to the rights of residents
17 guaranteed under the corresponding Acts and administrative
18 rules.
19     (c-5) Consumer Choice Information Reports. The Office
20 shall:
21         (1) In collaboration with the Attorney General, create
22     a Consumer Choice Information Report form to be completed
23     by all licensed long term care facilities to aid
24     Illinoisans and their families in making informed choices
25     about long term care. The Office shall create a Consumer
26     Choice Information Report for each type of licensed long

 

 

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1     term care facility.
2         (2) Develop a database of Consumer Choice Information
3     Reports completed by licensed long term care facilities
4     that includes information in the following consumer
5     categories:
6             (A) Medical Care, Services, and Treatment.
7             (B) Special Services and Amenities.
8             (C) Staffing.
9             (D) Facility Statistics and Resident Demographics.
10             (E) Ownership and Administration.
11             (F) Safety and Security.
12             (G) Meals and Nutrition.
13             (H) Rooms, Furnishings, and Equipment.
14             (I) Family, Volunteer, and Visitation Provisions.
15         (3) Make this information accessible to the public,
16     including on the Internet by means of a hyperlink labeled
17     "Resident's Right to Know" on the Office's World Wide Web
18     home page.
19         (4) Have the authority, with the Attorney General, to
20     verify that information provided by a facility is accurate.
21         (5) Request a new report from any licensed facility
22     whenever it deems necessary.
23     (d) Access and visitation rights.
24         (1) In accordance with subparagraphs (A) and (E) of
25     paragraph (3) of subsection (c) of Section 1819 and
26     subparagraphs (A) and (E) of paragraph (3) of subsection

 

 

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1     (c) of Section 1919 of the Social Security Act, as now or
2     hereafter amended (42 U.S.C. 1395i-3 (c)(3)(A) and (E) and
3     42 U.S.C. 1396r (c)(3)(A) and (E)), and Section 712 of the
4     Older Americans Act of 1965, as now or hereafter amended
5     (42 U.S.C. 3058f), a long term care facility, supportive
6     living facility, assisted living establishment, and shared
7     housing establishment must:
8             (i) permit immediate access to any resident,
9         regardless of age, by a designated ombudsman; and
10             (ii) permit representatives of the Office, with
11         the permission of the resident's legal representative
12         or legal guardian, to examine a resident's clinical and
13         other records, regardless of the age of the resident,
14         and if a resident is unable to consent to such review,
15         and has no legal guardian, permit representatives of
16         the Office appropriate access, as defined by the
17         Department, in consultation with the Office, in
18         administrative rules, to the resident's records.
19         (2) Each long term care facility, supportive living
20     facility, assisted living establishment, and shared
21     housing establishment shall display, in multiple,
22     conspicuous public places within the facility accessible
23     to both visitors and residents and in an easily readable
24     format, the address and phone number of the Office of the
25     Long Term Care Ombudsman, in a manner prescribed by the
26     Office.

 

 

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1     (e) Immunity. An ombudsman or any representative of the
2 Office participating in the good faith performance of his or
3 her official duties shall have immunity from any liability
4 (civil, criminal or otherwise) in any proceedings (civil,
5 criminal or otherwise) brought as a consequence of the
6 performance of his official duties.
7     (f) Business offenses.
8         (1) No person shall:
9             (i) Intentionally prevent, interfere with, or
10         attempt to impede in any way any representative of the
11         Office in the performance of his official duties under
12         this Act and the Older Americans Act of 1965; or
13             (ii) Intentionally retaliate, discriminate
14         against, or effect reprisals against any long term care
15         facility resident or employee for contacting or
16         providing information to any representative of the
17         Office.
18         (2) A violation of this Section is a business offense,
19     punishable by a fine not to exceed $501.
20         (3) The Director of Aging, in consultation with the
21     Office, shall notify the State's Attorney of the county in
22     which the long term care facility, supportive living
23     facility, or assisted living or shared housing
24     establishment is located, or the Attorney General, of any
25     violations of this Section.
26     (g) Confidentiality of records and identities. The

 

 

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1 Department shall establish procedures for the disclosure by the
2 State Ombudsman or the regional ombudsmen entities of files
3 maintained by the program. The procedures shall provide that
4 the files and records may be disclosed only at the discretion
5 of the State Long Term Care Ombudsman or the person designated
6 by the State Ombudsman to disclose the files and records, and
7 the procedures shall prohibit the disclosure of the identity of
8 any complainant, resident, witness, or employee of a long term
9 care provider unless:
10         (1) the complainant, resident, witness, or employee of
11     a long term care provider or his or her legal
12     representative consents to the disclosure and the consent
13     is in writing;
14         (2) the complainant, resident, witness, or employee of
15     a long term care provider gives consent orally; and the
16     consent is documented contemporaneously in writing in
17     accordance with such requirements as the Department shall
18     establish; or
19         (3) the disclosure is required by court order.
20     (h) Legal representation. The Attorney General shall
21 provide legal representation to any representative of the
22 Office against whom suit or other legal action is brought in
23 connection with the performance of the representative's
24 official duties, in accordance with the State Employee
25 Indemnification Act.
26     (i) Treatment by prayer and spiritual means. Nothing in

 

 

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1 this Act shall be construed to authorize or require the medical
2 supervision, regulation or control of remedial care or
3 treatment of any resident in a long term care facility operated
4 exclusively by and for members or adherents of any church or
5 religious denomination the tenets and practices of which
6 include reliance solely upon spiritual means through prayer for
7 healing.
8     (j) The Long Term Care Ombudsman Fund is created as a
9 special fund in the State treasury to receive moneys for the
10 express purposes of this Section. All interest earned on moneys
11 in the fund shall be credited to the fund. Moneys contained in
12 the fund shall be used to support the purposes of this Section.
13 (Source: P.A. 95-620, eff. 9-17-07; 95-823, eff. 1-1-09;
14 revised 9-5-08.)
 
15     Section 10. The State Finance Act is amended by adding
16 Sections 5.723 and 5.724 as follows:
 
17     (30 ILCS 105/5.723 new)
18     Sec. 5.723. The Long Term Care Ombudsman Fund.
 
19     (30 ILCS 105/5.724 new)
20     Sec. 5.724. The Nursing Home Conversion Fund.
 
21     Section 15. The Nursing Home Care Act is amended by
22 changing Sections 3-103 and 3-308 as follows:
 

 

 

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1     (210 ILCS 45/3-103)  (from Ch. 111 1/2, par. 4153-103)
2     Sec. 3-103. The procedure for obtaining a valid license
3 shall be as follows:
4         (1) Application to operate a facility shall be made to
5     the Department on forms furnished by the Department.
6         (2) All license applications shall be accompanied with
7     an application fee. The fee for an annual license shall be
8     $995. Facilities that pay a fee or assessment pursuant to
9     Article V-C of the Illinois Public Aid Code shall be exempt
10     from the license fee imposed under this item (2). The fee
11     for a 2-year license shall be double the fee for the annual
12     license set forth in the preceding sentence. The fees
13     collected shall be deposited with the State Treasurer into
14     the Long Term Care Monitor/Receiver Fund, which has been
15     created as a special fund in the State treasury. This
16     special fund is to be used by the Department for expenses
17     related to the appointment of monitors and receivers as
18     contained in Sections 3-501 through 3-517 of this Act, for
19     the enforcement of this Act, and for implementation of the
20     Abuse Prevention Review Team Act. The Department may reduce
21     or waive a penalty pursuant to Section 3-308 only if that
22     action will not threaten the ability of the Department to
23     meet the expenses required to be met by the Long Term Care
24     Monitor/Receiver Fund. At the end of each fiscal year, any
25     funds in excess of $1,000,000 held in the Long Term Care

 

 

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1     Monitor/Receiver Fund shall be deposited in the State's
2     General Revenue Fund. The application shall be under oath
3     and the submission of false or misleading information shall
4     be a Class A misdemeanor. The application shall contain the
5     following information:
6             (a) The name and address of the applicant if an
7         individual, and if a firm, partnership, or
8         association, of every member thereof, and in the case
9         of a corporation, the name and address thereof and of
10         its officers and its registered agent, and in the case
11         of a unit of local government, the name and address of
12         its chief executive officer;
13             (b) The name and location of the facility for which
14         a license is sought;
15             (c) The name of the person or persons under whose
16         management or supervision the facility will be
17         conducted;
18             (d) The number and type of residents for which
19         maintenance, personal care, or nursing is to be
20         provided; and
21             (e) Such information relating to the number,
22         experience, and training of the employees of the
23         facility, any management agreements for the operation
24         of the facility, and of the moral character of the
25         applicant and employees as the Department may deem
26         necessary.

 

 

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1         (3) Each initial application shall be accompanied by a
2     financial statement setting forth the financial condition
3     of the applicant and by a statement from the unit of local
4     government having zoning jurisdiction over the facility's
5     location stating that the location of the facility is not
6     in violation of a zoning ordinance. An initial application
7     for a new facility shall be accompanied by a permit as
8     required by the "Illinois Health Facilities Planning Act".
9     After the application is approved, the applicant shall
10     advise the Department every 6 months of any changes in the
11     information originally provided in the application.
12         (4) Other information necessary to determine the
13     identity and qualifications of an applicant to operate a
14     facility in accordance with this Act shall be included in
15     the application as required by the Department in
16     regulations.
17 (Source: P.A. 93-32, eff. 7-1-03; 93-841, eff. 7-30-04; 94-931,
18 eff. 6-26-06.)
 
19     (210 ILCS 45/3-308)  (from Ch. 111 1/2, par. 4153-308)
20     Sec. 3-308. In the case of a Type "A" violation, a penalty
21 may be assessed from the date on which the violation is
22 discovered. In the case of a Type "B" or Type "C" violation or
23 an administrative warning issued pursuant to Sections 3-401
24 through 3-413 or the rules promulgated thereunder, the facility
25 shall submit a plan of correction as provided in Section 3-303.

 

 

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1     In the case of a Type "B" violation or an administrative
2 warning issued pursuant to Sections 3-401 through 3-413 or the
3 rules promulgated thereunder, a penalty shall be assessed on
4 the date of notice of the violation, but the Director may
5 reduce the amount or waive such payment for any of the
6 following reasons:
7         (a) The facility submits a true report of correction
8     within 10 days;
9         (b) The facility submits a plan of correction within 10
10     days and subsequently submits a true report of correction
11     within 15 days thereafter;
12         (c) The facility submits a plan of correction within 10
13     days which provides for a correction time that is less than
14     or equal to 30 days and the Department approves such plan;
15     or
16         (d) The facility submits a plan of correction for
17     violations involving substantial capital improvements
18     which provides for correction within the initial 90 day
19     limit provided under Section 3-303.
20     The Director or his or her designee may reallocate the
21 amount of a penalty assessed pursuant to Section 3-305. A
22 facility shall submit to the Director a written request for a
23 penalty reduction, in a form prescribed by the Department,
24 which includes an accounting of all costs for goods and
25 services purchased in correcting the violation. The amount by
26 which a penalty is reduced may not be greater than the amount

 

 

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1 of the costs reported by the facility. A facility that accepts
2 a penalty reallocation under this Section waives its right to
3 dispute a notice of violation and any remaining fine or penalty
4 in an administrative hearing. The Director shall consider the
5 following factors in determinations to reduce or waive such
6 penalties:
7         (1) The violation has not caused actual harm to a
8     resident. ;
9         (2) The facility has made a diligent effort to correct
10     the violation and to prevent its recurrence. ;
11         (3) The facility has no record of a pervasive pattern
12     of the same or similar violations. ; and
13         (4) The facility did not benefit financially from
14     committing or continuing the violation. The facility has a
15     record of substantial compliance with this Act and the
16     regulations promulgated hereunder.
17     At least annually, and upon request, the Department shall
18 provide a list of all reallocations and the reasons for those
19 reallocations.
20     If a plan of correction is approved and carried out for a
21 Type "C" violation, the fine provided under Section 3-305 shall
22 be suspended for the time period specified in the approved plan
23 of correction. If a plan of correction is approved and carried
24 out for a Type "B" violation or an administrative warning
25 issued pursuant to Sections 3-401 through 3-413 or the rules
26 promulgated thereunder, with respect to a violation that

 

 

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1 continues after the date of notice of violation, the fine
2 provided under Section 3-305 shall be suspended for the time
3 period specified in the approved plan of correction.
4     If a good faith plan of correction is not received within
5 the time provided by Section 3-303, a penalty may be assessed
6 from the date of the notice of the Type "B" or "C" violation or
7 an administrative warning issued pursuant to Sections 3-401
8 through 3-413 or the rules promulgated thereunder served under
9 Section 3-301 until the date of the receipt of a good faith
10 plan of correction, or until the date the violation is
11 corrected, whichever is earlier. If a violation is not
12 corrected within the time specified by an approved plan of
13 correction or any lawful extension thereof, a penalty may be
14 assessed from the date of notice of the violation, until the
15 date the violation is corrected.
16 (Source: P.A. 87-549.)
 
17     Section 20. The Older Adult Services Act is amended by
18 changing Section 30 as follows:
 
19     (320 ILCS 42/30)
20     Sec. 30. Nursing home conversion program.
21     (a) The Department of Public Health, in collaboration with
22 the Department on Aging and the Department of Healthcare and
23 Family Services, shall establish a nursing home conversion
24 program. Start-up grants, pursuant to subsections (l) and (m)

 

 

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1 of this Section, shall be made available to nursing homes as
2 appropriations permit as an incentive to reduce certified beds,
3 retrofit, and retool operations to meet new service delivery
4 expectations and demands.
5     (b) Grant moneys shall be made available for capital and
6 other costs related to: (1) the conversion of all or a part of
7 a nursing home to an assisted living establishment or a special
8 program or unit for persons with Alzheimer's disease or related
9 disorders licensed under the Assisted Living and Shared Housing
10 Act or a supportive living facility established under Section
11 5-5.01a of the Illinois Public Aid Code; (2) the conversion of
12 multi-resident bedrooms in the facility into single-occupancy
13 rooms; and (3) the development of any of the services
14 identified in a priority service plan that can be provided by a
15 nursing home within the confines of a nursing home or
16 transportation services. Grantees shall be required to provide
17 a minimum of a 20% match toward the total cost of the project.
18     (c) Nothing in this Act shall prohibit the co-location of
19 services or the development of multifunctional centers under
20 subsection (f) of Section 20, including a nursing home offering
21 community-based services or a community provider establishing
22 a residential facility.
23     (d) A certified nursing home with at least 50% of its
24 resident population having their care paid for by the Medicaid
25 program is eligible to apply for a grant under this Section.
26     (e) Any nursing home receiving a grant under this Section

 

 

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1 shall reduce the number of certified nursing home beds by a
2 number equal to or greater than the number of beds being
3 converted for one or more of the permitted uses under item (1)
4 or (2) of subsection (b). The nursing home shall retain the
5 Certificate of Need for its nursing and sheltered care beds
6 that were converted for 15 years. If the beds are reinstated by
7 the provider or its successor in interest, the provider shall
8 pay to the fund from which the grant was awarded, on an
9 amortized basis, the amount of the grant. The Department shall
10 establish, by rule, the bed reduction methodology for nursing
11 homes that receive a grant pursuant to item (3) of subsection
12 (b).
13     (f) Any nursing home receiving a grant under this Section
14 shall agree that, for a minimum of 10 years after the date that
15 the grant is awarded, a minimum of 50% of the nursing home's
16 resident population shall have their care paid for by the
17 Medicaid program. If the nursing home provider or its successor
18 in interest ceases to comply with the requirement set forth in
19 this subsection, the provider shall pay to the fund from which
20 the grant was awarded, on an amortized basis, the amount of the
21 grant.
22     (g) Before awarding grants, the Department of Public Health
23 shall seek recommendations from the Department on Aging and the
24 Department of Healthcare and Family Services. The Department of
25 Public Health shall attempt to balance the distribution of
26 grants among geographic regions, and among small and large

 

 

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1 nursing homes. The Department of Public Health shall develop,
2 by rule, the criteria for the award of grants based upon the
3 following factors:
4         (1) the unique needs of older adults (including those
5     with moderate and low incomes), caregivers, and providers
6     in the geographic area of the State the grantee seeks to
7     serve;
8         (2) whether the grantee proposes to provide services in
9     a priority service area;
10         (3) the extent to which the conversion or transition
11     will result in the reduction of certified nursing home beds
12     in an area with excess beds;
13         (4) the compliance history of the nursing home; and
14         (5) any other relevant factors identified by the
15     Department, including standards of need.
16     (h) A conversion funded in whole or in part by a grant
17 under this Section must not:
18         (1) diminish or reduce the quality of services
19     available to nursing home residents;
20         (2) force any nursing home resident to involuntarily
21     accept home-based or community-based services instead of
22     nursing home services;
23         (3) diminish or reduce the supply and distribution of
24     nursing home services in any community below the level of
25     need, as defined by the Department by rule; or
26         (4) cause undue hardship on any person who requires

 

 

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1     nursing home care.
2     (i) The Department shall prescribe, by rule, the grant
3 application process. At a minimum, every application must
4 include:
5         (1) the type of grant sought;
6         (2) a description of the project;
7         (3) the objective of the project;
8         (4) the likelihood of the project meeting identified
9     needs;
10         (5) the plan for financing, administration, and
11     evaluation of the project;
12         (6) the timetable for implementation;
13         (7) the roles and capabilities of responsible
14     individuals and organizations;
15         (8) documentation of collaboration with other service
16     providers, local community government leaders, and other
17     stakeholders, other providers, and any other stakeholders
18     in the community;
19         (9) documentation of community support for the
20     project, including support by other service providers,
21     local community government leaders, and other
22     stakeholders;
23         (10) the total budget for the project;
24         (11) the financial condition of the applicant; and
25         (12) any other application requirements that may be
26     established by the Department by rule.

 

 

09600SB0314ham003 - 21 - LRB096 03651 DRJ 27284 a

1     (j) A conversion project funded in whole or in part by a
2 grant under this Section is exempt from the requirements of the
3 Illinois Health Facilities Planning Act. The Department of
4 Public Health, however, shall send to the Health Facilities
5 Planning Board a copy of each grant award made under this
6 Section.
7     (k) Applications for grants are public information, except
8 that nursing home financial condition and any proprietary data
9 shall be classified as nonpublic data.
10     (l) The Department of Public Health may award grants from
11 the Long Term Care Civil Money Penalties Fund established under
12 Section 1919(h)(2)(A)(ii) of the Social Security Act and 42 CFR
13 488.422(g) if the award meets federal requirements.
14     (m) The Nursing Home Conversion Fund is created as a
15 special fund in the State treasury. Moneys appropriated by the
16 General Assembly or transferred from other sources for the
17 purposes of this Section shall be deposited into the Fund. All
18 interest earned on moneys in the fund shall be credited to the
19 fund. Moneys contained in the fund shall be used to support the
20 purposes of this Section.
21 (Source: P.A. 95-331, eff. 8-21-07.)
 
22     Section 99. Effective date. This Act takes effect upon
23 becoming law.".