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Public Act 100-0518 | ||||
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AN ACT concerning State government.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Health Facilities Planning Act is | ||||
amended by changing Sections 3, 4.2, 5, 5.4, 6, and 12 as | ||||
follows:
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(20 ILCS 3960/3) (from Ch. 111 1/2, par. 1153)
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(Section scheduled to be repealed on December 31, 2019) | ||||
Sec. 3. Definitions. As used in this Act:
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"Health care facilities" means and includes
the following | ||||
facilities, organizations, and related persons:
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(1) An ambulatory surgical treatment center required | ||||
to be licensed
pursuant to the Ambulatory Surgical | ||||
Treatment Center Act.
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(2) An institution, place, building, or agency | ||||
required to be licensed
pursuant to the Hospital Licensing | ||||
Act.
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(3) Skilled and intermediate long term care facilities | ||||
licensed under the
Nursing
Home Care Act. | ||||
(A) If a demonstration project under the Nursing | ||||
Home Care Act applies for a certificate of need to | ||||
convert to a nursing facility, it shall meet the | ||||
licensure and certificate of need requirements in |
effect as of the date of application. | ||
(B) Except as provided in item (A) of this | ||
subsection, this Act does not apply to facilities | ||
granted waivers under Section 3-102.2 of the Nursing | ||
Home Care Act.
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(3.5) Skilled and intermediate care facilities | ||
licensed under the ID/DD Community Care Act or the MC/DD | ||
Act. No permit or exemption is required for a facility | ||
licensed under the ID/DD Community Care Act or the MC/DD | ||
Act prior to the reduction of the number of beds at a | ||
facility. If there is a total reduction of beds at a | ||
facility licensed under the ID/DD Community Care Act or the | ||
MC/DD Act, this is a discontinuation or closure of the | ||
facility. If a facility licensed under the ID/DD Community | ||
Care Act or the MC/DD Act reduces the number of beds or | ||
discontinues the facility, that facility must notify the | ||
Board as provided in Section 14.1 of this Act. | ||
(3.7) Facilities licensed under the Specialized Mental | ||
Health Rehabilitation Act of 2013. | ||
(4) Hospitals, nursing homes, ambulatory surgical | ||
treatment centers, or
kidney disease treatment centers
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maintained by the State or any department or agency | ||
thereof.
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(5) Kidney disease treatment centers, including a | ||
free-standing
hemodialysis unit required to be licensed | ||
under the End Stage Renal Disease Facility Act.
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(A) This Act does not apply to a dialysis facility | ||
that provides only dialysis training, support, and | ||
related services to individuals with end stage renal | ||
disease who have elected to receive home dialysis. | ||
(B) This Act does not apply to a dialysis unit | ||
located in a licensed nursing home that offers or | ||
provides dialysis-related services to residents with | ||
end stage renal disease who have elected to receive | ||
home dialysis within the nursing home. | ||
(C) The Board, however, may require dialysis | ||
facilities and licensed nursing homes under items (A) | ||
and (B) of this subsection to report statistical | ||
information on a quarterly basis to the Board to be | ||
used by the Board to conduct analyses on the need for | ||
proposed kidney disease treatment centers. | ||
(6) An institution, place, building, or room used for | ||
the performance of
outpatient surgical procedures that is | ||
leased, owned, or operated by or on
behalf of an | ||
out-of-state facility.
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(7) An institution, place, building, or room used for | ||
provision of a health care category of service, including, | ||
but not limited to, cardiac catheterization and open heart | ||
surgery. | ||
(8) An institution, place, building, or room housing | ||
major medical equipment used in the direct clinical | ||
diagnosis or treatment of patients, and whose project cost |
is in excess of the capital expenditure minimum. | ||
"Health care facilities" does not include the following | ||
entities or facility transactions: | ||
(1) Federally-owned facilities. | ||
(2) Facilities used solely for healing by prayer or | ||
spiritual means. | ||
(3) An existing facility located on any campus facility | ||
as defined in Section 5-5.8b of the Illinois Public Aid | ||
Code, provided that the campus facility encompasses 30 or | ||
more contiguous acres and that the new or renovated | ||
facility is intended for use by a licensed residential | ||
facility. | ||
(4) Facilities licensed under the Supportive | ||
Residences Licensing Act or the Assisted Living and Shared | ||
Housing Act. | ||
(5) Facilities designated as supportive living | ||
facilities that are in good standing with the program | ||
established under Section 5-5.01a of the Illinois Public | ||
Aid Code. | ||
(6) Facilities established and operating under the | ||
Alternative Health Care Delivery Act as a children's | ||
community-based health care center alternative health care | ||
model demonstration program or as an Alzheimer's Disease | ||
Management Center alternative health care model | ||
demonstration program. | ||
(7) The closure of an entity or a portion of an entity |
licensed under the Nursing Home Care Act, the Specialized | ||
Mental Health Rehabilitation Act of 2013, the ID/DD | ||
Community Care Act, or the MC/DD Act, with the exception of | ||
facilities operated by a county or Illinois Veterans Homes, | ||
that elect to convert, in whole or in part, to an assisted | ||
living or shared housing establishment licensed under the | ||
Assisted Living and Shared Housing Act and with the | ||
exception of a facility licensed under the Specialized | ||
Mental Health Rehabilitation Act of 2013 in connection with | ||
a proposal to close a facility and re-establish the | ||
facility in another location. | ||
(8) Any change of ownership of a health care facility | ||
that is licensed under the Nursing Home Care Act, the | ||
Specialized Mental Health Rehabilitation Act of 2013, the | ||
ID/DD Community Care Act, or the MC/DD Act, with the | ||
exception of facilities operated by a county or Illinois | ||
Veterans Homes. Changes of ownership of facilities | ||
licensed under the Nursing Home Care Act must meet the | ||
requirements set forth in Sections 3-101 through 3-119 of | ||
the Nursing Home Care Act.
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With the exception of those health care facilities | ||
specifically
included in this Section, nothing in this Act | ||
shall be intended to
include facilities operated as a part of | ||
the practice of a physician or
other licensed health care | ||
professional, whether practicing in his
individual capacity or | ||
within the legal structure of any partnership,
medical or |
professional corporation, or unincorporated medical or
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professional group. Further, this Act shall not apply to | ||
physicians or
other licensed health care professional's | ||
practices where such practices
are carried out in a portion of | ||
a health care facility under contract
with such health care | ||
facility by a physician or by other licensed
health care | ||
professionals, whether practicing in his individual capacity
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or within the legal structure of any partnership, medical or
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professional corporation, or unincorporated medical or | ||
professional
groups, unless the entity constructs, modifies, | ||
or establishes a health care facility as specifically defined | ||
in this Section. This Act shall apply to construction or
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modification and to establishment by such health care facility | ||
of such
contracted portion which is subject to facility | ||
licensing requirements,
irrespective of the party responsible | ||
for such action or attendant
financial obligation.
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"Person" means any one or more natural persons, legal | ||
entities,
governmental bodies other than federal, or any | ||
combination thereof.
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"Consumer" means any person other than a person (a) whose | ||
major
occupation currently involves or whose official capacity | ||
within the last
12 months has involved the providing, | ||
administering or financing of any
type of health care facility, | ||
(b) who is engaged in health research or
the teaching of | ||
health, (c) who has a material financial interest in any
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activity which involves the providing, administering or |
financing of any
type of health care facility, or (d) who is or | ||
ever has been a member of
the immediate family of the person | ||
defined by (a), (b), or (c).
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"State Board" or "Board" means the Health Facilities and | ||
Services Review Board.
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"Construction or modification" means the establishment, | ||
erection,
building, alteration, reconstruction, modernization, | ||
improvement,
extension, discontinuation, change of ownership, | ||
of or by a health care
facility, or the purchase or acquisition | ||
by or through a health care facility
of
equipment or service | ||
for diagnostic or therapeutic purposes or for
facility | ||
administration or operation, or any capital expenditure made by
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or on behalf of a health care facility which
exceeds the | ||
capital expenditure minimum; however, any capital expenditure
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made by or on behalf of a health care facility for (i) the | ||
construction or
modification of a facility licensed under the | ||
Assisted Living and Shared
Housing Act or (ii) a conversion | ||
project undertaken in accordance with Section 30 of the Older | ||
Adult Services Act shall be excluded from any obligations under | ||
this Act.
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"Establish" means the construction of a health care | ||
facility or the
replacement of an existing facility on another | ||
site or the initiation of a category of service.
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"Major medical equipment" means medical equipment which is | ||
used for the
provision of medical and other health services and | ||
which costs in excess
of the capital expenditure minimum, |
except that such term does not include
medical equipment | ||
acquired
by or on behalf of a clinical laboratory to provide | ||
clinical laboratory
services if the clinical laboratory is | ||
independent of a physician's office
and a hospital and it has | ||
been determined under Title XVIII of the Social
Security Act to | ||
meet the requirements of paragraphs (10) and (11) of Section
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1861(s) of such Act. In determining whether medical equipment | ||
has a value
in excess of the capital expenditure minimum, the | ||
value of studies, surveys,
designs, plans, working drawings, | ||
specifications, and other activities
essential to the | ||
acquisition of such equipment shall be included.
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"Capital Expenditure" means an expenditure: (A) made by or | ||
on behalf of
a health care facility (as such a facility is | ||
defined in this Act); and
(B) which under generally accepted | ||
accounting principles is not properly
chargeable as an expense | ||
of operation and maintenance, or is made to obtain
by lease or | ||
comparable arrangement any facility or part thereof or any
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equipment for a facility or part; and which exceeds the capital | ||
expenditure
minimum.
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For the purpose of this paragraph, the cost of any studies, | ||
surveys, designs,
plans, working drawings, specifications, and | ||
other activities essential
to the acquisition, improvement, | ||
expansion, or replacement of any plant
or equipment with | ||
respect to which an expenditure is made shall be included
in | ||
determining if such expenditure exceeds the capital | ||
expenditures minimum.
Unless otherwise interdependent, or |
submitted as one project by the applicant, components of | ||
construction or modification undertaken by means of a single | ||
construction contract or financed through the issuance of a | ||
single debt instrument shall not be grouped together as one | ||
project. Donations of equipment
or facilities to a health care | ||
facility which if acquired directly by such
facility would be | ||
subject to review under this Act shall be considered capital
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expenditures, and a transfer of equipment or facilities for | ||
less than fair
market value shall be considered a capital | ||
expenditure for purposes of this
Act if a transfer of the | ||
equipment or facilities at fair market value would
be subject | ||
to review.
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"Capital expenditure minimum" means $11,500,000 for | ||
projects by hospital applicants, $6,500,000 for applicants for | ||
projects related to skilled and intermediate care long-term | ||
care facilities licensed under the Nursing Home Care Act, and | ||
$3,000,000 for projects by all other applicants, which shall be | ||
annually
adjusted to reflect the increase in construction costs | ||
due to inflation, for major medical equipment and for all other
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capital expenditures.
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"Financial Commitment" means the commitment of at least 33% | ||
of total funds assigned to cover total project cost, which | ||
occurs by the actual expenditure of 33% or more of the total | ||
project cost or the commitment to expend 33% or more of the | ||
total project cost by signed contracts or other legal means. | ||
"Non-clinical service area" means an area (i) for the |
benefit of the
patients, visitors, staff, or employees of a | ||
health care facility and (ii) not
directly related to the | ||
diagnosis, treatment, or rehabilitation of persons
receiving | ||
services from the health care facility. "Non-clinical service | ||
areas"
include, but are not limited to, chapels; gift shops; | ||
news stands; computer
systems; tunnels, walkways, and | ||
elevators; telephone systems; projects to
comply with life | ||
safety codes; educational facilities; student housing;
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patient, employee, staff, and visitor dining areas; | ||
administration and
volunteer offices; modernization of | ||
structural components (such as roof
replacement and masonry | ||
work); boiler repair or replacement; vehicle
maintenance and | ||
storage facilities; parking facilities; mechanical systems for
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heating, ventilation, and air conditioning; loading docks; and | ||
repair or
replacement of carpeting, tile, wall coverings, | ||
window coverings or treatments,
or furniture. Solely for the | ||
purpose of this definition, "non-clinical service
area" does | ||
not include health and fitness centers.
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"Areawide" means a major area of the State delineated on a
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geographic, demographic, and functional basis for health | ||
planning and
for health service and having within it one or | ||
more local areas for
health planning and health service. The | ||
term "region", as contrasted
with the term "subregion", and the | ||
word "area" may be used synonymously
with the term "areawide".
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"Local" means a subarea of a delineated major area that on | ||
a
geographic, demographic, and functional basis may be |
considered to be
part of such major area. The term "subregion" | ||
may be used synonymously
with the term "local".
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"Physician" means a person licensed to practice in | ||
accordance with
the Medical Practice Act of 1987, as amended.
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"Licensed health care professional" means a person | ||
licensed to
practice a health profession under pertinent | ||
licensing statutes of the
State of Illinois.
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"Director" means the Director of the Illinois Department of | ||
Public Health.
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"Agency" or "Department" means the Illinois Department of | ||
Public Health.
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"Alternative health care model" means a facility or program | ||
authorized
under the Alternative Health Care Delivery Act.
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"Out-of-state facility" means a person that is both (i) | ||
licensed as a
hospital or as an ambulatory surgery center under | ||
the laws of another state
or that
qualifies as a hospital or an | ||
ambulatory surgery center under regulations
adopted pursuant | ||
to the Social Security Act and (ii) not licensed under the
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Ambulatory Surgical Treatment Center Act, the Hospital | ||
Licensing Act, or the
Nursing Home Care Act. Affiliates of | ||
out-of-state facilities shall be
considered out-of-state | ||
facilities. Affiliates of Illinois licensed health
care | ||
facilities 100% owned by an Illinois licensed health care | ||
facility, its
parent, or Illinois physicians licensed to | ||
practice medicine in all its
branches shall not be considered | ||
out-of-state facilities. Nothing in
this definition shall be
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construed to include an office or any part of an office of a | ||
physician licensed
to practice medicine in all its branches in | ||
Illinois that is not required to be
licensed under the | ||
Ambulatory Surgical Treatment Center Act.
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"Change of ownership of a health care facility" means a | ||
change in the
person
who has ownership or
control of a health | ||
care facility's physical plant and capital assets. A change
in | ||
ownership is indicated by
the following transactions: sale, | ||
transfer, acquisition, lease, change of
sponsorship, or other | ||
means of
transferring control.
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"Related person" means any person that: (i) is at least 50% | ||
owned, directly
or indirectly, by
either the health care | ||
facility or a person owning, directly or indirectly, at
least | ||
50% of the health
care facility; or (ii) owns, directly or | ||
indirectly, at least 50% of the
health care facility.
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"Charity care" means care provided by a health care | ||
facility for which the provider does not expect to receive | ||
payment from the patient or a third-party payer. | ||
"Freestanding emergency center" means a facility subject | ||
to licensure under Section 32.5 of the Emergency Medical | ||
Services (EMS) Systems Act. | ||
"Category of service" means a grouping by generic class of | ||
various types or levels of support functions, equipment, care, | ||
or treatment provided to patients or residents, including, but | ||
not limited to, classes such as medical-surgical, pediatrics, | ||
or cardiac catheterization. A category of service may include |
subcategories or levels of care that identify a particular | ||
degree or type of care within the category of service. Nothing | ||
in this definition shall be construed to include the practice | ||
of a physician or other licensed health care professional while | ||
functioning in an office providing for the care, diagnosis, or | ||
treatment of patients. A category of service that is subject to | ||
the Board's jurisdiction must be designated in rules adopted by | ||
the Board. | ||
"State Board Staff Report" means the document that sets | ||
forth the review and findings of the State Board staff, as | ||
prescribed by the State Board, regarding applications subject | ||
to Board jurisdiction. | ||
(Source: P.A. 98-414, eff. 1-1-14; 98-629, eff. 1-1-15; 98-651, | ||
eff. 6-16-14; 98-1086, eff. 8-26-14; 99-78, eff. 7-20-15; | ||
99-180, eff. 7-29-15; 99-527, eff. 1-1-17 .)
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(20 ILCS 3960/4.2)
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(Section scheduled to be repealed on December 31, 2019)
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Sec. 4.2. Ex parte communications.
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(a) Except in the disposition of matters that agencies are | ||
authorized by law
to entertain or dispose of on an ex parte | ||
basis including, but not limited to
rule making, the State | ||
Board, any State Board member, employee, or a hearing
officer | ||
shall not engage in ex parte communication
in connection with | ||
the substance of any formally filed application for
a permit | ||
with any person or party or the representative of any party. |
This subsection (a) applies when the Board, member, employee, | ||
or hearing officer knows, or should know upon reasonable | ||
inquiry, that the application or exemption has been formally | ||
filed with the Board. Nothing in this Section shall prohibit | ||
staff members from providing technical assistance to | ||
applicants. Nothing in this Section shall prohibit staff from | ||
verifying or clarifying an applicant's information as it | ||
prepares the State Board Staff Report staff report . Once an | ||
application or exemption is filed and deemed complete, a | ||
written record of any communication between staff and an | ||
applicant shall be prepared by staff and made part of the | ||
public record, using a prescribed, standardized format, and | ||
shall be included in the application file.
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(b) A State Board member or employee may communicate with | ||
other
members or employees and any State Board member or | ||
hearing
officer may have the aid and advice of one or more | ||
personal assistants.
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(c) An ex parte communication received by the State Board, | ||
any State
Board member, employee, or a hearing officer shall be | ||
made a part of the record
of the
matter, including all written | ||
communications, all written
responses to the communications, | ||
and a memorandum stating the substance of all
oral | ||
communications and all responses made and the identity of each | ||
person from
whom the ex parte communication was received.
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(d) "Ex parte communication" means a communication between | ||
a person who is
not a State Board member or employee and a
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State Board member or
employee
that reflects on the substance | ||
of a pending or impending State Board proceeding and that
takes
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place outside the record of the proceeding. Communications | ||
regarding matters
of procedure and practice, such as the format | ||
of pleading, number of copies
required, manner of service, and | ||
status of proceedings, are not considered ex
parte | ||
communications. Technical assistance with respect to an | ||
application, not
intended to influence any decision on the | ||
application, may be provided by
employees to the applicant. Any | ||
assistance shall be documented in writing by
the applicant and | ||
employees within 10 business days after the assistance is
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provided.
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(e) For purposes of this Section, "employee" means
a person | ||
the State Board or the Agency employs on a full-time, | ||
part-time,
contract, or intern
basis.
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(f) The State Board, State Board member, or hearing | ||
examiner presiding
over the proceeding, in the event of a | ||
violation of this Section, must take
whatever action is | ||
necessary to ensure that the violation does not prejudice
any | ||
party or adversely affect the fairness of the proceedings.
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(g) Nothing in this Section shall be construed to prevent | ||
the State Board or
any member of the State Board from | ||
consulting with the attorney for the State
Board.
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(Source: P.A. 96-31, eff. 6-30-09.)
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(20 ILCS 3960/5) (from Ch. 111 1/2, par. 1155)
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(Section scheduled to be repealed on December 31, 2019)
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Sec. 5. Construction, modification, or establishment of | ||
health care facilities or acquisition of major medical | ||
equipment; permits or exemptions. No person shall construct, | ||
modify or establish a
health care facility or acquire major | ||
medical equipment without first
obtaining a permit or exemption | ||
from the State
Board. The State Board shall not delegate to the | ||
staff of
the State Board or any other person or entity the | ||
authority to grant
permits or exemptions whenever the staff or | ||
other person or
entity would be required to exercise any | ||
discretion affecting the decision
to grant a permit or | ||
exemption. The State Board may, by rule, delegate authority to | ||
the Chairman to grant permits or exemptions when applications | ||
meet all of the State Board's review criteria and are | ||
unopposed.
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A permit or exemption shall be obtained prior to the | ||
acquisition
of major medical equipment or to the construction | ||
or modification of a
health care facility which:
| ||
(a) requires a total capital expenditure in excess of | ||
the capital
expenditure
minimum; or
| ||
(b) substantially changes the scope or changes the | ||
functional operation
of the facility; or
| ||
(c) changes the bed capacity of a health care facility | ||
by increasing the
total number of beds or by distributing | ||
beds among
various categories of service or by relocating | ||
beds from one physical facility
or site to another by more |
than 20 beds or more than 10% of total bed
capacity as | ||
defined by the
State Board, whichever is less, over a 2 | ||
year period.
| ||
A permit shall be valid only for the defined construction | ||
or modifications,
site, amount and person named in the | ||
application for such permit and
shall not be transferable or | ||
assignable. A permit shall be valid until such
time as the | ||
project has been completed,
provided that the project
commences | ||
and proceeds to completion with due diligence by the completion | ||
date or extension date approved by the Board. | ||
A permit holder must do the following: (i) submit the final | ||
completion and cost report for the project within 90 days after | ||
the approved project completion date or extension date and (ii) | ||
submit annual progress reports no earlier than 30 days before | ||
and no later than 30 days after each anniversary date of the | ||
Board's approval of the permit until the project is completed. | ||
To maintain a valid permit and to monitor progress toward | ||
project commencement and completion, routine post-permit | ||
reports shall be limited to annual progress reports and the | ||
final completion and cost report. Annual progress reports shall | ||
include information regarding the committed funds expended | ||
toward the approved project. For projects to be completed in 12 | ||
months or less, the permit holder shall report financial | ||
commitment in the final completion and cost report. For | ||
projects to be completed between 12 to 24 months, the permit | ||
holder shall report financial commitment in the first annual |
report. For projects to be completed in more than 24 months, | ||
the permit holder shall report financial commitment in the | ||
second annual progress report. The If the project is not | ||
completed in one year, then, by the second annual report, the | ||
permit holder shall expend 33% or more of the total project | ||
cost or shall make a commitment to expend 33% or more of the | ||
total project cost by signed contracts or other legal means, | ||
and the report shall contain information regarding financial | ||
commitment those expenditures or commitments. If the project is | ||
to be completed in one year, then the first annual report shall | ||
contain the expenditure commitment information for the total | ||
project cost. The State Board may extend the financial | ||
expenditure commitment period after considering a permit | ||
holder's showing of good cause and request for additional time | ||
to complete the project. | ||
The Certificate of Need process required under this Act is | ||
designed to restrain rising health care costs by preventing | ||
unnecessary construction or modification of health care | ||
facilities. The Board must assure that the establishment, | ||
construction, or modification of a health care facility or the | ||
acquisition of major medical equipment is consistent with the | ||
public interest and that the proposed project is consistent | ||
with the orderly and economic development or acquisition of | ||
those facilities and equipment and is in accord with the | ||
standards, criteria, or plans of need adopted and approved by | ||
the Board. Board decisions regarding the construction of health |
care facilities must consider capacity, quality, value, and | ||
equity. Projects may deviate from the costs, fees, and expenses | ||
provided in their project cost information for the project's | ||
cost components, provided that the final total project cost | ||
does not exceed the approved permit amount. Project alterations | ||
shall not increase the total approved permit amount by more | ||
than the limit set forth under the Board's rules. | ||
Major construction
projects, for the purposes of this Act, | ||
shall include but are not limited
to: projects for the | ||
construction of new buildings; additions to existing
| ||
facilities; modernization projects
whose cost is in excess of | ||
$1,000,000 or 10% of the facilities' operating
revenue, | ||
whichever is less; and such other projects as the State Board | ||
shall
define and prescribe pursuant to this Act.
| ||
The acquisition by any person of major medical equipment | ||
that will not
be owned by or located in a health care facility | ||
and that will not be used
to provide services to inpatients of | ||
a health care facility shall be exempt
from review provided | ||
that a notice is filed in accordance with exemption
| ||
requirements.
| ||
Notwithstanding any other provision of this Act, no permit | ||
or exemption is
required for the construction or modification | ||
of a non-clinical service area
of a health care facility.
| ||
(Source: P.A. 97-1115, eff. 8-27-12; 98-414, eff. 1-1-14.)
| ||
(20 ILCS 3960/5.4) |
(Section scheduled to be repealed on December 31, 2019) | ||
Sec. 5.4. Safety Net Impact Statement. | ||
(a) General review criteria shall include a requirement | ||
that all health care facilities, with the exception of skilled | ||
and intermediate long-term care facilities licensed under the | ||
Nursing Home Care Act, provide a Safety Net Impact Statement, | ||
which shall be filed with an application for a substantive | ||
project or when the application proposes to discontinue a | ||
category of service. | ||
(b) For the purposes of this Section, "safety net services" | ||
are services provided by health care providers or organizations | ||
that deliver health care services to persons with barriers to | ||
mainstream health care due to lack of insurance, inability to | ||
pay, special needs, ethnic or cultural characteristics, or | ||
geographic isolation. Safety net service providers include, | ||
but are not limited to, hospitals and private practice | ||
physicians that provide charity care, school-based health | ||
centers, migrant health clinics, rural health clinics, | ||
federally qualified health centers, community health centers, | ||
public health departments, and community mental health | ||
centers. | ||
(c) As developed by the applicant, a Safety Net Impact | ||
Statement shall describe all of the following: | ||
(1) The project's material impact, if any, on essential | ||
safety net services in the community, to the extent that it | ||
is feasible for an applicant to have such knowledge. |
(2) The project's impact on the ability of another | ||
provider or health care system to cross-subsidize safety | ||
net services, if reasonably known to the applicant. | ||
(3) How the discontinuation of a facility or service | ||
might impact the remaining safety net providers in a given | ||
community, if reasonably known by the applicant. | ||
(d) Safety Net Impact Statements shall also include all of | ||
the following: | ||
(1) For the 3 fiscal years prior to the application, a | ||
certification describing the amount of charity care | ||
provided by the applicant. The amount calculated by | ||
hospital applicants shall be in accordance with the | ||
reporting requirements for charity care reporting in the | ||
Illinois Community Benefits Act. Non-hospital applicants | ||
shall report charity care, at cost, in accordance with an | ||
appropriate methodology specified by the Board. | ||
(2) For the 3 fiscal years prior to the application, a | ||
certification of the amount of care provided to Medicaid | ||
patients. Hospital and non-hospital applicants shall | ||
provide Medicaid information in a manner consistent with | ||
the information reported each year to the State Board | ||
regarding "Inpatients and Outpatients Served by Payor | ||
Source" and "Inpatient and Outpatient Net Revenue by Payor | ||
Source" as required by the Board under Section 13 of this | ||
Act and published in the Annual Hospital Profile. | ||
(3) Any information the applicant believes is directly |
relevant to safety net services, including information | ||
regarding teaching, research, and any other service. | ||
(e) The Board staff shall publish a notice, that an | ||
application accompanied by a Safety Net Impact Statement has | ||
been filed, in a newspaper having general circulation within | ||
the area affected by the application. If no newspaper has a | ||
general circulation within the county, the Board shall post the | ||
notice in 5 conspicuous places within the proposed area. | ||
(f) Any person, community organization, provider, or | ||
health system or other entity wishing to comment upon or oppose | ||
the application may file a Safety Net Impact Statement Response | ||
with the Board, which shall provide additional information | ||
concerning a project's impact on safety net services in the | ||
community. | ||
(g) Applicants shall be provided an opportunity to submit a | ||
reply to any Safety Net Impact Statement Response. | ||
(h) The State Board Staff Report staff report shall include | ||
a statement as to whether a Safety Net Impact Statement was | ||
filed by the applicant and whether it included information on | ||
charity care, the amount of care provided to Medicaid patients, | ||
and information on teaching, research, or any other service | ||
provided by the applicant directly relevant to safety net | ||
services. The report shall also indicate the names of the | ||
parties submitting responses and the number of responses and | ||
replies, if any, that were filed.
| ||
(Source: P.A. 98-1086, eff. 8-26-14.)
|
(20 ILCS 3960/6) (from Ch. 111 1/2, par. 1156)
| ||
(Section scheduled to be repealed on December 31, 2019)
| ||
Sec. 6. Application for permit or exemption; exemption | ||
regulations.
| ||
(a) An application for a permit or exemption shall be made | ||
to
the State Board upon forms provided by the State Board. This | ||
application
shall contain such information
as the State Board | ||
deems necessary. The State Board shall not require an applicant | ||
to file a Letter of Intent before an application is filed. Such
| ||
application shall include affirmative evidence on which the | ||
State
Board or Chairman may make its decision on the approval | ||
or denial of the permit or
exemption.
| ||
(b) The State Board shall establish by regulation the | ||
procedures and
requirements
regarding issuance of exemptions.
| ||
An exemption shall be approved when information required by the | ||
Board by rule
is submitted. Projects
eligible for an exemption, | ||
rather than a permit, include, but are not limited
to,
change | ||
of ownership of a health care facility, discontinuation of a | ||
category of service, and discontinuation of a health care | ||
facility, other than a health care facility maintained by the | ||
State or any agency or department thereof or a nursing home | ||
maintained by a county. For a change of
ownership of a health | ||
care
facility, the State Board shall provide by rule for an
| ||
expedited
process for obtaining an exemption in accordance with | ||
Section 8.5 of this Act. In connection with a change of |
ownership, the State Board may approve the transfer of an | ||
existing permit without regard to whether the permit to be | ||
transferred has yet been obligated, except for permits | ||
establishing a new facility or a new category of service.
| ||
(c) All applications shall be signed by the applicant and | ||
shall be
verified by any 2 officers thereof.
| ||
(c-5) Any written review or findings of the Board staff or | ||
any other reviewing organization under Section 8 concerning an | ||
application for a permit must be made available to the public | ||
at least 14 calendar days before the meeting of the State Board | ||
at which the review or findings are considered. The applicant | ||
and members of the public may submit, to the State Board, | ||
written responses regarding the facts set forth in the review | ||
or findings of the Board staff or reviewing organization. | ||
Members of the public shall have until 10 days before the | ||
meeting of the State Board to submit any written response | ||
concerning the Board staff's written review or findings. The | ||
Board staff may revise any findings to address corrections of | ||
factual errors cited in the public response. At the meeting, | ||
the State Board may, in its discretion, permit the submission | ||
of other additional written materials.
| ||
(d) Upon receipt of an application for a permit, the State | ||
Board shall
approve and authorize the issuance of a permit if | ||
it finds (1) that the
applicant is fit, willing, and able to | ||
provide a proper standard of
health care service for the | ||
community with particular regard to the
qualification, |
background and character of the applicant, (2) that
economic | ||
feasibility is demonstrated in terms of effect on the existing
| ||
and projected operating budget of the applicant and of the | ||
health care
facility; in terms of the applicant's ability to | ||
establish and operate
such facility in accordance with | ||
licensure regulations promulgated under
pertinent state laws; | ||
and in terms of the projected impact on the total
health care | ||
expenditures in the facility and community, (3) that
safeguards | ||
are provided which assure that the establishment,
construction | ||
or modification of the health care facility or acquisition
of | ||
major medical equipment is consistent
with the public interest, | ||
and (4) that the proposed project is consistent
with the | ||
orderly and economic
development of such facilities and | ||
equipment and is in accord with standards,
criteria, or plans | ||
of need adopted and approved pursuant to the
provisions of | ||
Section 12 of this Act.
| ||
(Source: P.A. 99-154, eff. 7-28-15.)
| ||
(20 ILCS 3960/12) (from Ch. 111 1/2, par. 1162)
| ||
(Section scheduled to be repealed on December 31, 2019) | ||
Sec. 12. Powers and duties of State Board. For purposes of | ||
this Act,
the State Board
shall
exercise the following powers | ||
and duties:
| ||
(1) Prescribe rules,
regulations, standards, criteria, | ||
procedures or reviews which may vary
according to the purpose | ||
for which a particular review is being conducted
or the type of |
project reviewed and which are required to carry out the
| ||
provisions and purposes of this Act. Policies and procedures of | ||
the State Board shall take into consideration the priorities | ||
and needs of medically underserved areas and other health care | ||
services, giving special consideration to the impact of | ||
projects on access to safety net services.
| ||
(2) Adopt procedures for public
notice and hearing on all | ||
proposed rules, regulations, standards,
criteria, and plans | ||
required to carry out the provisions of this Act.
| ||
(3) (Blank).
| ||
(4) Develop criteria and standards for health care | ||
facilities planning,
conduct statewide inventories of health | ||
care facilities, maintain an updated
inventory on the Board's | ||
web site reflecting the
most recent bed and service
changes and | ||
updated need determinations when new census data become | ||
available
or new need formulae
are adopted,
and
develop health | ||
care facility plans which shall be utilized in the review of
| ||
applications for permit under
this Act. Such health facility | ||
plans shall be coordinated by the Board
with pertinent State | ||
Plans. Inventories pursuant to this Section of skilled or | ||
intermediate care facilities licensed under the Nursing Home | ||
Care Act, skilled or intermediate care facilities licensed | ||
under the ID/DD Community Care Act, skilled or intermediate | ||
care facilities licensed under the MC/DD Act, facilities | ||
licensed under the Specialized Mental Health Rehabilitation | ||
Act of 2013, or nursing homes licensed under the Hospital |
Licensing Act shall be conducted on an annual basis no later | ||
than July 1 of each year and shall include among the | ||
information requested a list of all services provided by a | ||
facility to its residents and to the community at large and | ||
differentiate between active and inactive beds.
| ||
In developing health care facility plans, the State Board | ||
shall consider,
but shall not be limited to, the following:
| ||
(a) The size, composition and growth of the population | ||
of the area
to be served;
| ||
(b) The number of existing and planned facilities | ||
offering similar
programs;
| ||
(c) The extent of utilization of existing facilities;
| ||
(d) The availability of facilities which may serve as | ||
alternatives
or substitutes;
| ||
(e) The availability of personnel necessary to the | ||
operation of the
facility;
| ||
(f) Multi-institutional planning and the establishment | ||
of
multi-institutional systems where feasible;
| ||
(g) The financial and economic feasibility of proposed | ||
construction
or modification; and
| ||
(h) In the case of health care facilities established | ||
by a religious
body or denomination, the needs of the | ||
members of such religious body or
denomination may be | ||
considered to be public need.
| ||
The health care facility plans which are developed and | ||
adopted in
accordance with this Section shall form the basis |
for the plan of the State
to deal most effectively with | ||
statewide health needs in regard to health
care facilities.
| ||
(5) Coordinate with other state agencies having | ||
responsibilities
affecting health care facilities, including | ||
those of licensure and cost
reporting.
| ||
(6) Solicit, accept, hold and administer on behalf of the | ||
State
any grants or bequests of money, securities or property | ||
for
use by the State Board in the administration of this Act; | ||
and enter into contracts
consistent with the appropriations for | ||
purposes enumerated in this Act.
| ||
(7) The State Board shall prescribe procedures for review, | ||
standards,
and criteria which shall be utilized
to make | ||
periodic reviews and determinations of the appropriateness
of | ||
any existing health services being rendered by health care | ||
facilities
subject to the Act. The State Board shall consider | ||
recommendations of the
Board in making its
determinations.
| ||
(8) Prescribe rules, regulations,
standards, and criteria | ||
for the conduct of an expeditious review of
applications
for | ||
permits for projects of construction or modification of a | ||
health care
facility, which projects are classified as | ||
emergency, substantive, or non-substantive in nature. | ||
Six months after June 30, 2009 (the effective date of | ||
Public Act 96-31), substantive projects shall include no more | ||
than the following: | ||
(a) Projects to construct (1) a new or replacement | ||
facility located on a new site or
(2) a replacement |
facility located on the same site as the original facility | ||
and the cost of the replacement facility exceeds the | ||
capital expenditure minimum, which shall be reviewed by the | ||
Board within 120 days; | ||
(b) Projects proposing a
(1) new service within an | ||
existing healthcare facility or
(2) discontinuation of a | ||
service within an existing healthcare facility, which | ||
shall be reviewed by the Board within 60 days; or | ||
(c) Projects proposing a change in the bed capacity of | ||
a health care facility by an increase in the total number | ||
of beds or by a redistribution of beds among various | ||
categories of service or by a relocation of beds from one | ||
physical facility or site to another by more than 20 beds | ||
or more than 10% of total bed capacity, as defined by the | ||
State Board, whichever is less, over a 2-year period. | ||
The Chairman may approve applications for exemption that | ||
meet the criteria set forth in rules or refer them to the full | ||
Board. The Chairman may approve any unopposed application that | ||
meets all of the review criteria or refer them to the full | ||
Board. | ||
Such rules shall
not prevent the conduct of a public | ||
hearing upon the timely request
of an interested party. Such | ||
reviews shall not exceed 60 days from the
date the application | ||
is declared to be complete.
| ||
(9) Prescribe rules, regulations,
standards, and criteria | ||
pertaining to the granting of permits for
construction
and |
modifications which are emergent in nature and must be | ||
undertaken
immediately to prevent or correct structural | ||
deficiencies or hazardous
conditions that may harm or injure | ||
persons using the facility, as defined
in the rules and | ||
regulations of the State Board. This procedure is exempt
from | ||
public hearing requirements of this Act.
| ||
(10) Prescribe rules,
regulations, standards and criteria | ||
for the conduct of an expeditious
review, not exceeding 60 | ||
days, of applications for permits for projects to
construct or | ||
modify health care facilities which are needed for the care
and | ||
treatment of persons who have acquired immunodeficiency | ||
syndrome (AIDS)
or related conditions.
| ||
(10.5) Provide its rationale when voting on an item before | ||
it at a State Board meeting in order to comply with subsection | ||
(b) of Section 3-108 of the Code of Civil Procedure. | ||
(11) Issue written decisions upon request of the applicant | ||
or an adversely affected party to the Board. Requests for a | ||
written decision shall be made within 15 days after the Board | ||
meeting in which a final decision has been made. A "final | ||
decision" for purposes of this Act is the decision to approve | ||
or deny an application, or take other actions permitted under | ||
this Act, at the time and date of the meeting that such action | ||
is scheduled by the Board. The transcript of the State Board | ||
meeting shall be incorporated into the Board's final decision. | ||
The staff of the Board shall prepare a written copy of the | ||
final decision and the Board shall approve a final copy for |
inclusion in the formal record. The Board shall consider, for | ||
approval, the written draft of the final decision no later than | ||
the next scheduled Board meeting. The written decision shall | ||
identify the applicable criteria and factors listed in this Act | ||
and the Board's regulations that were taken into consideration | ||
by the Board when coming to a final decision. If the Board | ||
denies or fails to approve an application for permit or | ||
exemption, the Board shall include in the final decision a | ||
detailed explanation as to why the application was denied and | ||
identify what specific criteria or standards the applicant did | ||
not fulfill. | ||
(12) Require at least one of its members to participate in | ||
any public hearing, after the appointment of a majority of the | ||
members to the Board. | ||
(13) Provide a mechanism for the public to comment on, and | ||
request changes to, draft rules and standards. | ||
(14) Implement public information campaigns to regularly | ||
inform the general public about the opportunity for public | ||
hearings and public hearing procedures. | ||
(15) Establish a separate set of rules and guidelines for | ||
long-term care that recognizes that nursing homes are a | ||
different business line and service model from other regulated | ||
facilities. An open and transparent process shall be developed | ||
that considers the following: how skilled nursing fits in the | ||
continuum of care with other care providers, modernization of | ||
nursing homes, establishment of more private rooms, |
development of alternative services, and current trends in | ||
long-term care services.
The Chairman of the Board shall | ||
appoint a permanent Health Services Review Board Long-term Care | ||
Facility Advisory Subcommittee that shall develop and | ||
recommend to the Board the rules to be established by the Board | ||
under this paragraph (15). The Subcommittee shall also provide | ||
continuous review and commentary on policies and procedures | ||
relative to long-term care and the review of related projects. | ||
The Subcommittee shall make recommendations to the Board no | ||
later than January 1, 2016 and every January thereafter | ||
pursuant to the Subcommittee's responsibility for the | ||
continuous review and commentary on policies and procedures | ||
relative to long-term care. In consultation with other experts | ||
from the health field of long-term care, the Board and the | ||
Subcommittee shall study new approaches to the current bed need | ||
formula and Health Service Area boundaries to encourage | ||
flexibility and innovation in design models reflective of the | ||
changing long-term care marketplace and consumer preferences | ||
and submit its recommendations to the Chairman of the Board no | ||
later than January 1, 2017. The Subcommittee shall evaluate, | ||
and make recommendations to the State Board regarding, the | ||
buying, selling, and exchange of beds between long-term care | ||
facilities within a specified geographic area or drive time. | ||
The Board shall file the proposed related administrative rules | ||
for the separate rules and guidelines for long-term care | ||
required by this paragraph (15) by no later than September 30, |
2011. The Subcommittee shall be provided a reasonable and | ||
timely opportunity to review and comment on any review, | ||
revision, or updating of the criteria, standards, procedures, | ||
and rules used to evaluate project applications as provided | ||
under Section 12.3 of this Act. | ||
The Chairman of the Board shall appoint voting members of | ||
the Subcommittee, who shall serve for a period of 3 years, with | ||
one-third of the terms expiring each January, to be determined | ||
by lot. Appointees shall include, but not be limited to, | ||
recommendations from each of the 3 statewide long-term care | ||
associations, with an equal number to be appointed from each. | ||
Compliance with this provision shall be through the appointment | ||
and reappointment process. All appointees serving as of April | ||
1, 2015 shall serve to the end of their term as determined by | ||
lot or until the appointee voluntarily resigns, whichever is | ||
earlier. | ||
One representative from the Department of Public Health, | ||
the Department of Healthcare and Family Services, the | ||
Department on Aging, and the Department of Human Services may | ||
each serve as an ex-officio non-voting member of the | ||
Subcommittee. The Chairman of the Board shall select a | ||
Subcommittee Chair, who shall serve for a period of 3 years. | ||
(16) Prescribe the format of the State Board Staff Report. | ||
A State Board Staff Report shall pertain to applications that | ||
include, but are not limited to, applications for permit or | ||
exemption, applications for permit renewal, applications for |
extension of the financial commitment obligation period, | ||
applications requesting a declaratory ruling, or applications | ||
under the Health Care Worker Self-Referral Act. State Board | ||
Staff Reports shall compare applications to the relevant review | ||
criteria under the Board's rules. | ||
(17) Establish a separate set of rules and guidelines for | ||
facilities licensed under the Specialized Mental Health | ||
Rehabilitation Act of 2013. An application for the | ||
re-establishment of a facility in connection with the | ||
relocation of the facility shall not be granted unless the | ||
applicant has a contractual relationship with at least one | ||
hospital to provide emergency and inpatient mental health | ||
services required by facility consumers, and at least one | ||
community mental health agency to provide oversight and | ||
assistance to facility consumers while living in the facility, | ||
and appropriate services, including case management, to assist | ||
them to prepare for discharge and reside stably in the | ||
community thereafter. No new facilities licensed under the | ||
Specialized Mental Health Rehabilitation Act of 2013 shall be | ||
established after June 16, 2014 (the effective date of Public | ||
Act 98-651) except in connection with the relocation of an | ||
existing facility to a new location. An application for a new | ||
location shall not be approved unless there are adequate | ||
community services accessible to the consumers within a | ||
reasonable distance, or by use of public transportation, so as | ||
to facilitate the goal of achieving maximum individual |
self-care and independence. At no time shall the total number | ||
of authorized beds under this Act in facilities licensed under | ||
the Specialized Mental Health Rehabilitation Act of 2013 exceed | ||
the number of authorized beds on June 16, 2014 (the effective | ||
date of Public Act 98-651). | ||
(Source: P.A. 98-414, eff. 1-1-14; 98-463, eff. 8-16-13; | ||
98-651, eff. 6-16-14; 98-1086, eff. 8-26-14; 99-78, eff. | ||
7-20-15; 99-114, eff. 7-23-15; 99-180, eff. 7-29-15; 99-277, | ||
eff. 8-5-15; 99-527, eff. 1-1-17; 99-642, eff. 7-28-16 .)
| ||
Section 10. The Alternative Health Care Delivery Act is | ||
amended by changing Section 35 as follows:
| ||
(210 ILCS 3/35)
| ||
Sec. 35. Alternative health care models authorized. | ||
Notwithstanding
any other law to the contrary, alternative | ||
health care models
described in this Section may be established | ||
on a demonstration basis.
| ||
(1) (Blank).
| ||
(2) Alternative health care delivery model; | ||
postsurgical recovery care
center. A postsurgical recovery | ||
care center is a designated site which
provides | ||
postsurgical recovery care for generally healthy patients
| ||
undergoing surgical procedures that potentially require | ||
overnight nursing care, pain
control, or observation that | ||
would otherwise be provided in an inpatient
setting. |
Patients may be discharged from the postsurgical recovery | ||
care center in less than 24 hours if the attending | ||
physician or the facility's medical director believes the | ||
patient has recovered enough to be discharged. A | ||
postsurgical recovery care center is either freestanding | ||
or a
defined unit of an ambulatory surgical treatment | ||
center or hospital.
No facility, or portion of a facility, | ||
may participate in a demonstration
program as a | ||
postsurgical recovery care center unless the facility has | ||
been
licensed as an ambulatory surgical treatment center or | ||
hospital for at least 2
years before August 20, 1993 (the | ||
effective date of Public Act 88-441). The
maximum length of | ||
stay for patients in a
postsurgical recovery care center is | ||
not to exceed 48 hours unless the treating
physician | ||
requests an extension of time from the recovery center's | ||
medical
director on the basis of medical or clinical | ||
documentation that an additional
care period is required | ||
for the recovery of a patient and the medical director
| ||
approves the extension of time. In no case, however, shall | ||
a patient's length
of stay in a postsurgical recovery care | ||
center be longer than 72 hours. If a
patient requires an | ||
additional care period after the expiration of the 72-hour
| ||
limit, the patient shall be transferred to an appropriate | ||
facility. Reports on
variances from the 24-hour or 48-hour | ||
limit shall be sent to the Department for its
evaluation. | ||
The reports shall, before submission to the Department, |
have
removed from them all patient and physician | ||
identifiers. Blood products may be administered in the | ||
postsurgical recovery care center model. In order to handle
| ||
cases of complications, emergencies, or exigent | ||
circumstances, every
postsurgical recovery care center as | ||
defined in this paragraph shall maintain a
contractual | ||
relationship, including a transfer agreement, with a | ||
general acute
care hospital. A postsurgical recovery care | ||
center shall be no larger than 20
beds. A postsurgical | ||
recovery care center shall be located within 15 minutes
| ||
travel time from the general acute care hospital with which | ||
the center
maintains a contractual relationship, including | ||
a transfer agreement, as
required under this paragraph.
| ||
No postsurgical recovery care center shall | ||
discriminate against any patient
requiring treatment | ||
because of the source of payment for services, including
| ||
Medicare and Medicaid recipients.
| ||
The Department shall adopt rules to implement the | ||
provisions of Public
Act 88-441 concerning postsurgical | ||
recovery care centers within 9 months after
August 20, | ||
1993. Notwithstanding any other law to the contrary, a | ||
postsurgical recovery care center model may provide sleep | ||
laboratory or similar sleep studies in accordance with | ||
applicable State and federal laws and regulations.
| ||
(3) Alternative health care delivery model; children's | ||
community-based
health care center. A children's |
community-based health care center model is a
designated | ||
site that provides nursing care, clinical support | ||
services, and
therapies for a period of one to 14 days for | ||
short-term stays and 120 days to
facilitate transitions to | ||
home or other appropriate settings for medically
fragile | ||
children, technology
dependent children, and children with | ||
special health care needs who are deemed
clinically stable | ||
by a physician and are younger than 22 years of age. This
| ||
care is to be provided in a home-like environment that | ||
serves no more than 12
children at a time , except that a | ||
children's community-based health care center in existence | ||
on the effective date of this amendatory Act of the 100th | ||
General Assembly that is located in Chicago on grade level | ||
for Life Safety Code purposes may provide care to no more | ||
than 16 children at a time . Children's community-based | ||
health care center
services must be available through the | ||
model to all families, including those
whose care is paid | ||
for through the Department of Healthcare and Family | ||
Services, the Department of
Children and Family Services, | ||
the Department of Human Services, and insurance
companies | ||
who cover home health care services or private duty nursing | ||
care in
the home.
| ||
Each children's community-based health care center | ||
model location shall be
physically separate and
apart from | ||
any other facility licensed by the Department of Public | ||
Health under
this or any other Act and shall provide the |
following services: respite care,
registered nursing or | ||
licensed practical nursing care, transitional care to
| ||
facilitate home placement or other appropriate settings | ||
and reunite families,
medical day care, weekend
camps, and | ||
diagnostic studies typically done in the home setting.
| ||
Coverage for the services provided by the
Department of | ||
Healthcare and Family Services
under this paragraph (3) is | ||
contingent upon federal waiver approval and is
provided | ||
only to Medicaid eligible clients participating in the home | ||
and
community based services waiver designated in Section | ||
1915(c) of the Social
Security Act for medically frail and | ||
technologically dependent children or
children in | ||
Department of Children and Family Services foster care who | ||
receive
home health benefits.
| ||
(4) Alternative health care delivery model; community | ||
based residential
rehabilitation center.
A community-based | ||
residential rehabilitation center model is a designated
| ||
site that provides rehabilitation or support, or both, for | ||
persons who have
experienced severe brain injury, who are | ||
medically stable, and who no longer
require acute | ||
rehabilitative care or intense medical or nursing | ||
services. The
average length of stay in a community-based | ||
residential rehabilitation center
shall not exceed 4 | ||
months. As an integral part of the services provided,
| ||
individuals are housed in a supervised living setting while | ||
having immediate
access to the community. The residential |
rehabilitation center authorized by
the Department may | ||
have more than one residence included under the license.
A | ||
residence may be no larger than 12 beds and shall be | ||
located as an integral
part of the community. Day treatment | ||
or
individualized outpatient services shall be provided | ||
for persons who reside in
their own home. Functional | ||
outcome goals shall be established for each
individual. | ||
Services shall include, but are not limited to, case | ||
management,
training and assistance with activities of | ||
daily living, nursing
consultation, traditional therapies | ||
(physical, occupational, speech),
functional interventions | ||
in the residence and community (job placement,
shopping, | ||
banking, recreation), counseling, self-management | ||
strategies,
productive activities, and multiple | ||
opportunities for skill acquisition and
practice | ||
throughout the day. The design of individualized program | ||
plans shall
be consistent with the outcome goals that are | ||
established for each resident.
The programs provided in | ||
this setting shall be accredited by the
Commission
on | ||
Accreditation of Rehabilitation Facilities (CARF). The | ||
program shall have
been accredited by CARF as a Brain | ||
Injury Community-Integrative Program for at
least 3 years.
| ||
(5) Alternative health care delivery model; | ||
Alzheimer's disease
management center. An Alzheimer's | ||
disease management center model is a
designated site that | ||
provides a safe and secure setting for care of persons
|
diagnosed with Alzheimer's disease. An Alzheimer's disease | ||
management center
model shall be a facility separate from | ||
any other facility licensed by the
Department of Public | ||
Health under this or any other Act. An Alzheimer's
disease | ||
management center shall conduct and document an assessment | ||
of each
resident every 6 months. The assessment shall | ||
include an evaluation of daily
functioning, cognitive | ||
status, other medical conditions, and behavioral
problems. | ||
An Alzheimer's disease management center shall develop and | ||
implement
an ongoing treatment plan for each resident. The | ||
treatment
plan shall have defined goals.
The
Alzheimer's | ||
disease management center shall treat behavioral problems | ||
and mood
disorders using nonpharmacologic approaches such | ||
as environmental modification,
task simplification, and | ||
other appropriate activities.
All staff must have | ||
necessary
training to care for all stages of Alzheimer's | ||
Disease. An
Alzheimer's disease
management center shall | ||
provide education and support for residents and
| ||
caregivers. The
education and support shall include | ||
referrals to support organizations for
educational | ||
materials on community resources, support groups, legal | ||
and
financial issues, respite care, and future care needs | ||
and options. The
education and support shall also include a | ||
discussion of the resident's need to
make advance | ||
directives and to identify surrogates for medical and legal
| ||
decision-making. The provisions of this paragraph |
establish the minimum level
of services that must be | ||
provided by an Alzheimer's disease management
center. An | ||
Alzheimer's disease management center model shall have no | ||
more
than 100 residents. Nothing in this paragraph (5) | ||
shall be construed as
prohibiting a person or facility from | ||
providing services and care to persons
with Alzheimer's | ||
disease as otherwise authorized under State law.
| ||
(6) Alternative health care delivery model; birth | ||
center. A birth
center shall be exclusively dedicated to | ||
serving the childbirth-related needs of women and their | ||
newborns and shall have no more than 10 beds. A birth | ||
center is a designated site
that is away from the mother's | ||
usual place of residence and in which births are
planned to | ||
occur following a normal, uncomplicated, and low-risk | ||
pregnancy. A
birth center shall offer prenatal care and | ||
community education services and
shall coordinate these | ||
services with other health care services available in
the | ||
community.
| ||
(A) A birth center shall not be separately licensed | ||
if it
is one of the following: | ||
(1) A part of a hospital; or | ||
(2) A freestanding facility that is physically
| ||
distinct from a hospital but is operated under a
| ||
license issued to a hospital under the Hospital
| ||
Licensing Act. | ||
(B) A separate birth center license shall be |
required if the birth center is operated as: | ||
(1) A part of the operation of a federally
| ||
qualified health center as designated by the | ||
United
States Department of Health and Human | ||
Services; or | ||
(2) A facility other than one described in | ||
subparagraph (A)(1), (A)(2), or (B)(1) of this | ||
paragraph (6) whose costs are
reimbursable under | ||
Title XIX of the federal Social
Security Act. | ||
In adopting rules for birth centers, the Department | ||
shall consider:
the American Association
of Birth Centers' | ||
Standards for Freestanding Birth Centers; the American | ||
Academy of Pediatrics/American College of Obstetricians | ||
and Gynecologists Guidelines for Perinatal Care; and the | ||
Regionalized Perinatal Health Care Code. The Department's | ||
rules shall stipulate the eligibility criteria for birth | ||
center admission. The Department's rules shall
stipulate | ||
the necessary equipment for emergency care
according to the | ||
American Association of Birth Centers'
standards and any | ||
additional equipment deemed necessary by the Department. | ||
The Department's rules shall provide for a time
period | ||
within which each birth center not part of a
hospital must | ||
become accredited by either the Commission for the
| ||
Accreditation of Freestanding Birth Centers or The Joint | ||
Commission. | ||
A birth center shall be certified to participate in the |
Medicare and Medicaid
programs under Titles XVIII and XIX, | ||
respectively, of the federal Social
Security Act.
To the | ||
extent necessary, the Illinois Department of Healthcare | ||
and Family Services shall apply for
a waiver from the | ||
United States Health Care Financing Administration to | ||
allow
birth centers to be reimbursed under Title XIX of the | ||
federal Social Security
Act. | ||
A birth center that is not operated under a hospital | ||
license shall be located within a ground travel time | ||
distance from the general acute care hospital with which
| ||
the birth center maintains a contractual relationship,
| ||
including a transfer agreement, as required under this
| ||
paragraph, that allows for an emergency caesarian delivery | ||
to be started within 30 minutes of the decision a caesarian | ||
delivery is necessary. A birth center operating under a | ||
hospital license shall be located within a ground travel | ||
time distance from the licensed hospital that allows for an | ||
emergency caesarian delivery to be started within 30 | ||
minutes of the decision a caesarian delivery is necessary. | ||
The services of a
medical director physician, licensed | ||
to practice medicine in all its branches, who is certified | ||
or eligible for certification by the
American College of | ||
Obstetricians and Gynecologists or the
American Board of | ||
Osteopathic Obstetricians and Gynecologists or has | ||
hospital
obstetrical privileges are required in birth | ||
centers. The medical director in consultation with the |
Director of Nursing and Midwifery Services shall | ||
coordinate the clinical staff and overall provision of | ||
patient care.
The medical director or his or her physician | ||
designee shall be available on the premises or within a | ||
close proximity as defined by rule. The medical director | ||
and the Director of Nursing and Midwifery Services shall | ||
jointly develop and approve policies defining the criteria | ||
to determine which pregnancies are accepted as normal, | ||
uncomplicated, and low-risk, and the anesthesia services | ||
available at the center. No general anesthesia may be | ||
administered at the center. | ||
If a birth center employs
certified nurse midwives, a | ||
certified nurse midwife shall be the Director of
Nursing | ||
and Midwifery
Services who is responsible for the | ||
development of policies and procedures for
services as | ||
provided by Department rules. | ||
An obstetrician, family
practitioner, or certified | ||
nurse midwife shall attend each woman in labor from
the | ||
time of admission through birth and throughout the | ||
immediate postpartum
period. Attendance may be delegated | ||
only to another physician or certified
nurse
midwife. | ||
Additionally, a second staff person shall also be present | ||
at each
birth who is licensed or certified in Illinois in a | ||
health-related field and under the supervision of the | ||
physician or certified nurse midwife
in attendance, has | ||
specialized training in labor and delivery techniques and
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care of newborns, and receives planned and ongoing training | ||
as needed to
perform assigned duties effectively. | ||
The maximum length of stay in a birth center shall be
| ||
consistent with existing State laws allowing a 48-hour stay | ||
or appropriate
post-delivery care, if discharged earlier | ||
than 48 hours. | ||
A birth center shall
participate in the Illinois | ||
Perinatal
System under the Developmental Disability | ||
Prevention Act. At a minimum, this
participation shall | ||
require a birth center to establish a letter of agreement
| ||
with a hospital designated under the Perinatal System. A | ||
hospital that
operates or has a letter of agreement with a | ||
birth center shall include the
birth center under its | ||
maternity service plan under the Hospital Licensing Act
and | ||
shall include the birth center in the hospital's letter of | ||
agreement with
its regional perinatal center. | ||
A birth center may not discriminate against any patient | ||
requiring treatment
because of the source of payment for | ||
services, including Medicare and Medicaid
recipients. | ||
No general anesthesia and no surgery may be performed | ||
at a birth center.
The Department may by rule add birth | ||
center patient eligibility criteria or standards as it | ||
deems necessary.
The Department shall by rule require each | ||
birth center to report the information which the Department | ||
shall make publicly available, which shall include, but is | ||
not limited to, the following: |
(i) Birth center ownership. | ||
(ii) Sources of payment for services. | ||
(iii) Utilization data involving patient length of | ||
stay. | ||
(iv) Admissions and discharges. | ||
(v) Complications. | ||
(vi) Transfers. | ||
(vii) Unusual incidents. | ||
(viii) Deaths. | ||
(ix) Any other publicly reported data required | ||
under the Illinois Consumer Guide. | ||
(x) Post-discharge patient status data where | ||
patients are followed for 14 days after discharge from | ||
the birth center to determine whether the mother or | ||
baby developed a complication or infection. | ||
Within 9 months after the effective date of this | ||
amendatory Act of the 95th
General Assembly, the Department | ||
shall adopt rules that are developed with consideration of: | ||
the American Association of Birth Centers' Standards for | ||
Freestanding Birth Centers; the American Academy of | ||
Pediatrics/American College of Obstetricians and | ||
Gynecologists Guidelines for Perinatal Care; and the | ||
Regionalized Perinatal Health Care Code. | ||
The Department shall adopt other rules as necessary to | ||
implement the provisions of this
amendatory Act of the 95th | ||
General Assembly within 9 months after the
effective date |
of this amendatory Act of the 95th General Assembly. | ||
(Source: P.A. 97-135, eff. 7-14-11; 97-987, eff. 1-1-13.)
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