State of Illinois
91st General Assembly
Legislation

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[ Introduced ][ Enrolled ][ House Amendment 001 ]

91_HB0317eng

 
HB0317 Engrossed                              LRB9100816JSpcA

 1        AN ACT to amend the Alternative Health Care Delivery  Act
 2    by changing Sections 30 and 35.

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

 5        Section 5.  The Alternative Health Care Delivery  Act  is
 6    amended by changing Sections 30 and 35 as follows:

 7        (210 ILCS 3/30)
 8        Sec.   30.    Demonstration  program  requirements.   The
 9    requirements  set  forth  in  this  Section  shall  apply  to
10    demonstration programs.
11        (a)  There shall be no more than:
12             (i)  3 subacute  care  hospital  alternative  health
13        care models in the City of Chicago (one of which shall be
14        located on a designated site and shall have been licensed
15        as  a  hospital under the Illinois Hospital Licensing Act
16        within the 10 years immediately  before  the  application
17        for a license);
18             (ii)  2  subacute  care  hospital alternative health
19        care models in the demonstration program for each of  the
20        following areas:
21                  (1)  Cook County outside the City of Chicago.
22                  (2)  DuPage,  Kane,  Lake,  McHenry,  and  Will
23             Counties.
24                  (3)  Municipalities  with  a population greater
25             than 50,000 not located in the  areas  described  in
26             item  (i)  of  subsection (a) and paragraphs (1) and
27             (2) of item (ii) of subsection (a); and
28             (iii)  4 subacute care hospital  alternative  health
29        care models in the demonstration program for rural areas.
30        In selecting among applicants for these licenses in rural
31    areas,   the   Health   Facilities  Planning  Board  and  the
 
HB0317 Engrossed            -2-               LRB9100816JSpcA
 1    Department shall give preference to  hospitals  that  may  be
 2    unable  for  economic reasons to provide continued service to
 3    the community in which they are located unless  the  hospital
 4    were to receive an alternative health care model license.
 5        (a-5)  There  shall  be  no  more  than  a  total  of  12
 6    postsurgical  recovery  care  center  alternative health care
 7    models in the demonstration program, located as follows:
 8             (1)  Two in the City of Chicago.
 9             (2)  Two in Cook County outside the City of Chicago.
10        At least one of these shall be owned  or  operated  by  a
11        hospital devoted exclusively to caring for children.
12             (3)  Two in Kane, Lake, and McHenry Counties.
13             (4)  Four  in  municipalities  with  a population of
14        50,000 or more not located  in  the  areas  described  in
15        paragraphs  (1),  (2), and (3), 3 of which shall be owned
16        or operated by hospitals, at least 2 of  which  shall  be
17        located  in  counties  with  a  population  of  less than
18        175,000, according to the most  recent  decennial  census
19        for  which  data are available, and one of which shall be
20        owned or operated by  an  ambulatory  surgical  treatment
21        center.
22             (5)  Two  in  rural  areas,  both  of which shall be
23        owned or operated by hospitals.
24        There shall  be  no  postsurgical  recovery  care  center
25    alternative  health  care  models  located  in  counties with
26    populations greater than 600,000 but less than 1,000,000.   A
27    proposed  postsurgical  recovery care center must be owned or
28    operated by a hospital if it is to be located within, or will
29    primarily serve the residents of, a health  service  area  in
30    which  more  than  60%  of  the  gross patient revenue of the
31    hospitals within that health service area  are  derived  from
32    Medicaid   and  Medicare,  according  to  the  most  recently
33    available calendar year data from the  Illinois  Health  Care
34    Cost  Containment  Council.   Nothing in this paragraph shall
 
HB0317 Engrossed            -3-               LRB9100816JSpcA
 1    preclude a hospital  and  an  ambulatory  surgical  treatment
 2    center   from   forming  a  joint  venture  or  developing  a
 3    collaborative agreement to  own  or  operate  a  postsurgical
 4    recovery care center.
 5        (a-10)  There  shall  be  no  more  than  a  total  of  8
 6    children's respite care center alternative health care models
 7    in  the  demonstration  program,  which  shall  be located as
 8    follows:
 9             (1)  One in the City of Chicago.
10             (2)  One in Cook County outside the City of Chicago.
11             (3)  A total of 2 in the area comprised  of  DuPage,
12        Kane, Lake, McHenry, and Will counties.
13             (4)  A   total   of   2  in  municipalities  with  a
14        population of 50,000 or more and    not  located  in  the
15        areas described in paragraphs (1), (2), or (3).
16             (5)  A  total of 2 in rural areas, as defined by the
17        Health Facilities Planning Board.
18        No more than one children's respite care model owned  and
19    operated  by  a  licensed skilled pediatric facility shall be
20    located in each of the areas designated  in  this  subsection
21    (a-10).
22        (a-15)  There  shall  be  an  authorized  community-based
23    residential  rehabilitation  center  alternative  health care
24    model in  the  demonstration  program.   The  community-based
25    residential  rehabilitation  center  shall  be located in the
26    area of Illinois south of Interstate Highway 70.
27        (b)  Alternative  health  care  models  shall  obtain   a
28    certificate  of  need  from  the  Illinois  Health Facilities
29    Planning Board under the Illinois Health Facilities  Planning
30    Act  before  receiving a license by the Department. If, after
31    obtaining its initial certificate  of  need,  an  alternative
32    health   care  delivery  model  that  is  a  community  based
33    residential rehabilitation center seeks to increase  the  bed
34    capacity of that center, it must obtain a certificate of need
 
HB0317 Engrossed            -4-               LRB9100816JSpcA
 1    from  the  Illinois  Health  Facilities Planning Board before
 2    increasing the bed capacity.  Alternative  health care models
 3    in medically underserved  areas  shall  receive  priority  in
 4    obtaining a certificate of need.
 5        (c)  An  alternative  health  care model license shall be
 6    issued for a period of one year and shall be annually renewed
 7    if the facility or program is in substantial compliance  with
 8    the  Department's  rules  adopted  under this Act. A licensed
 9    alternative  health  care  model  that  continues  to  be  in
10    substantial  compliance   after   the   conclusion   of   the
11    demonstration  program  shall be eligible for annual renewals
12    unless and until a different licensure program for that  type
13    of  health  care  model  is  established  by legislation. The
14    Department may issue a provisional license to any alternative
15    health care model that does not substantially comply with the
16    provisions of this Act and the rules adopted under  this  Act
17    if  (i) the Department finds that the alternative health care
18    model has  undertaken  changes  and  corrections  which  upon
19    completion  will  render the alternative health care model in
20    substantial compliance with this Act and rules and  (ii)  the
21    health  and  safety of the patients of the alternative health
22    care model will be protected during the period for which  the
23    provisional  license  is issued.  The Department shall advise
24    the licensee of the conditions under  which  the  provisional
25    license   is  issued,  including  the  manner  in  which  the
26    alternative health  care  model  fails  to  comply  with  the
27    provisions  of  this Act and rules, and the time within which
28    the changes and corrections  necessary  for  the  alternative
29    health  care  model to substantially comply with this Act and
30    rules shall be completed.
31        (d)  Alternative   health   care   models   shall    seek
32    certification  under  Titles  XVIII  and  XIX  of the federal
33    Social Security Act.  In addition,  alternative  health  care
34    models  shall  provide  charitable  care consistent with that
 
HB0317 Engrossed            -5-               LRB9100816JSpcA
 1    provided  by  comparable  health  care   providers   in   the
 2    geographic area.
 3        (d-5)  The   Illinois   Department   of  Public  Aid,  in
 4    cooperation with the Illinois Department  of  Public  Health,
 5    shall  develop  and implement a reimbursement methodology for
 6    all facilities participating in  the  demonstration  program.
 7    The  Illinois Department of Public Aid shall keep a record of
 8    services  provided  under  the   demonstration   program   to
 9    recipients  of  medical  assistance under the Illinois Public
10    Aid  Code  and  shall  submit  an  annual  report   of   that
11    information to the Illinois Department of Public Health.
12        (e)  Alternative  health care models shall, to the extent
13    possible, link  and  integrate  their  services  with  nearby
14    health 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. 88-441; 88-490; 88-670, eff.  12-2-94;  89-393,
19    eff. 8-20-95.)

20        (210 ILCS 3/35)
21        Sec.  35.   Alternative  health  care  models authorized.
22    Notwithstanding any other law to  the  contrary,  alternative
23    health   care   models  described  in  this  Section  may  be
24    established on a demonstration basis.
25             (1)  Alternative health care  model;  subacute  care
26        hospital.   A subacute care hospital is a designated site
27        which provides medical specialty care  for  patients  who
28        need  a  greater  intensity  or  complexity  of care than
29        generally provided in a skilled nursing facility but  who
30        no longer require acute hospital care. The average length
31        of  stay  for patients treated in subacute care hospitals
32        shall not be  less  than  20  days,  and  for  individual
33        patients,  the  expected  length  of  stay at the time of
 
HB0317 Engrossed            -6-               LRB9100816JSpcA
 1        admission shall not be less  than  10  days.   Variations
 2        from  minimum  lengths  of  stay shall be reported to the
 3        Department.  There shall be no more than 13 subacute care
 4        hospitals  authorized  to  operate  by  the   Department.
 5        Subacute  care includes physician supervision, registered
 6        nursing, and  physiological  monitoring  on  a  continual
 7        basis.  A subacute care hospital is either a freestanding
 8        building or a distinct physical  and  operational  entity
 9        within  a  hospital or nursing home building.  A subacute
10        care  hospital  shall  only  consist  of  beds  currently
11        existing  in  licensed  hospitals  or   skilled   nursing
12        facilities,   except,  in  the  City  of  Chicago,  on  a
13        designated site that was licensed as a hospital under the
14        Illinois Hospital  Licensing  Act  within  the  10  years
15        immediately  before  the  application  for an alternative
16        health care model license. During the period of operation
17        of the demonstration project, the existing licensed  beds
18        shall  remain  licensed  as  hospital  or skilled nursing
19        facility beds as well as being licensed under  this  Act.
20        In  order  to handle cases of complications, emergencies,
21        or exigent circumstances, a subacute care hospital  shall
22        maintain a contractual relationship, including a transfer
23        agreement,  with  a  general  acute  care hospital.  If a
24        subacute care model is located in a  general  acute  care
25        hospital,  it  shall  utilize all or a portion of the bed
26        capacity of that existing hospital.  In no event shall  a
27        subacute  care  hospital  use  the word "hospital" in its
28        advertising or marketing activities or represent or  hold
29        itself  out  to  the  public  as  a  general  acute  care
30        hospital.
31             (2)  Alternative   health   care   delivery   model;
32        postsurgical   recovery   care  center.   A  postsurgical
33        recovery care center is a designated site which  provides
34        postsurgical recovery care for generally healthy patients
 
HB0317 Engrossed            -7-               LRB9100816JSpcA
 1        undergoing  surgical  procedures  that  require overnight
 2        nursing care, pain control,  or  observation  that  would
 3        otherwise   be  provided  in  an  inpatient  setting.   A
 4        postsurgical recovery care center is either  freestanding
 5        or  a  defined  unit  of an ambulatory surgical treatment
 6        center  or  hospital.  No  facility,  or  portion  of   a
 7        facility, may participate in a demonstration program as a
 8        postsurgical recovery care center unless the facility has
 9        been  licensed as an ambulatory surgical treatment center
10        or hospital for at least 2 years before August  20,  1993
11        (the  effective  date of Public Act 88-441).  The maximum
12        length of stay for patients in  a  postsurgical  recovery
13        care center is not to exceed 48 hours unless the treating
14        physician requests an extension of time from the recovery
15        center's  medical  director  on  the  basis of medical or
16        clinical documentation that an additional care period  is
17        required  for  the  recovery of a patient and the medical
18        director approves the extension of  time.   In  no  case,
19        however,   shall   a   patient's  length  of  stay  in  a
20        postsurgical recovery  care  center  be  longer  than  72
21        hours.  If  a  patient requires an additional care period
22        after the expiration of the 72-hour  limit,  the  patient
23        shall be transferred to an appropriate facility.  Reports
24        on  variances from the 48-hour limit shall be sent to the
25        Department for its evaluation.  The reports shall, before
26        submission to the Department, have removed from them  all
27        patient  and  physician  identifiers.  In order to handle
28        cases   of   complications,   emergencies,   or   exigent
29        circumstances, every postsurgical recovery care center as
30        defined in this paragraph shall  maintain  a  contractual
31        relationship,  including  a  transfer  agreement,  with a
32        general acute care  hospital.   A  postsurgical  recovery
33        care   center   shall  be  no  larger  than  20  beds.  A
34        postsurgical recovery care center shall be located within
 
HB0317 Engrossed            -8-               LRB9100816JSpcA
 1        15 minutes  travel  time  from  the  general  acute  care
 2        hospital  with  which  the center maintains a contractual
 3        relationship, including a transfer agreement, as required
 4        under this paragraph.
 5             No   postsurgical   recovery   care   center   shall
 6        discriminate  against  any  patient  requiring  treatment
 7        because of the source of payment for services,  including
 8        Medicare and Medicaid recipients.
 9             The  Department  shall  adopt rules to implement the
10        provisions of Public Act 88-441  concerning  postsurgical
11        recovery  care  centers  within 9 months after August 20,
12        1993.
13             (3)  Alternative   health   care   delivery   model;
14        children's respite care center.  A children's  childrens'
15        respite  care  center  model  is  a  designated site that
16        provides respite  for  medically  frail,  technologically
17        dependent,  clinically stable children, up to age 18, for
18        a period of one to 14 days.  This care is to be  provided
19        in  a  home-like  environment that serves no more than 10
20        children  at  a  time.  Children's  respite  care  center
21        services must be available  through  the   model  to  all
22        families,  including those whose care is paid for through
23        the Illinois Department of Public  Aid  or  the  Illinois
24        Department of Children and Family Services.  Each respite
25        care  model  location  shall  be  a  facility  physically
26        separate  and  apart  from any other facility licensed by
27        the Department of Public Health under this or  any  other
28        Act  and  shall  provide,  at  a  minimum,  the following
29        services: out-of-home  respite  care;  hospital  to  home
30        training   for   families   and  caregivers;  short  term
31        transitional care to facilitate  placement  and  training
32        for  foster  care  parents;  parent  and  family  support
33        groups.
34        Coverage  for  the  services  provided  by  the  Illinois
 
HB0317 Engrossed            -9-               LRB9100816JSpcA
 1    Department   of  Public  Aid  under  this  paragraph  (3)  is
 2    contingent upon federal waiver approval and is provided  only
 3    to  Medicaid  eligible  clients participating in the home and
 4    community based services waiver designated in Section 1915(c)
 5    of  the  Social  Security  Act  for   medically   frail   and
 6    technologically dependent children.
 7             (4)  Alternative   health   care   delivery   model;
 8        community  based  residential  rehabilitation  center.  A
 9        community-based  residential  rehabilitation center model
10        is a designated  site  that  provides  rehabilitation  or
11        support, or both, for persons who have experienced severe
12        brain injury, who are medically stable, and who no longer
13        require  acute  rehabilitative care or intense medical or
14        nursing services.   The  average  length  of  stay  in  a
15        community-based  residential  rehabilitation center shall
16        not exceed 4 months.  As an integral part of the services
17        provided, individuals are housed in a  supervised  living
18        setting while having immediate access to the community.
19        The  residential  rehabilitation center authorized by the
20        Department may have  more  than  one  residence  included
21        under  the  license. A residence may be no larger than 12
22        beds and shall be located as  an  integral  part  of  the
23        community.   Day  treatment  or individualized outpatient
24        services shall be provided  for  persons  who  reside  in
25        their  own  home.   Functional  outcome  goals  shall  be
26        established for each individual.  Services shall include,
27        but  are  not  limited  to, case management, training and
28        assistance  with  activities  of  daily  living,  nursing
29        consultation,    traditional     therapies     (physical,
30        occupational,  speech),  functional  interventions in the
31        residence  and  community   (job   placement,   shopping,
32        banking,    recreation),    counseling,   self-management
33        strategies,   productive   activities,    and    multiple
34        opportunities   for   skill   acquisition   and  practice
 
HB0317 Engrossed            -10-              LRB9100816JSpcA
 1        throughout the day.  The design of individualized program
 2        plans shall be consistent with the outcome goals that are
 3        established for each resident.  The programs provided  in
 4        this  setting  shall  be  accredited by the Commission on
 5        Accreditation of Rehabilitation Facilities  (CARF).   The
 6        program  shall  have  been accredited by CARF  as a Brain
 7        Injury  Community-Integrative  Program  for  at  least  3
 8        years.
 9    (Source: P.A. 88-441; 88-490; 88-670, eff.  12-2-94;  89-393,
10    eff. 8-20-95; revised 10-31-98.)

11        Section  99.  Effective date.  This Act takes effect upon
12    becoming law.

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