Public Act 095-0584
 
SB1579 Enrolled LRB095 09004 DRJ 31315 b

    AN ACT concerning regulation.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Illinois Health Facilities Planning Act is
amended by changing Section 3 and adding Section 5.1a as
follows:
 
    (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
    (Section scheduled to be repealed on May 31, 2007)
    Sec. 3. Definitions. As used in this Act:
    "Health care facilities" means and includes the following
facilities and organizations:
        1. An ambulatory surgical treatment center required to
    be licensed pursuant to the Ambulatory Surgical Treatment
    Center Act;
        2. An institution, place, building, or agency required
    to be licensed pursuant to the Hospital Licensing Act;
        3. Skilled and intermediate long term care facilities
    licensed under the Nursing Home Care Act;
        3. Skilled and intermediate long term care facilities
    licensed under the Nursing Home Care Act;
        4. Hospitals, nursing homes, ambulatory surgical
    treatment centers, or kidney disease treatment centers
    maintained by the State or any department or agency
    thereof;
        5. Kidney disease treatment centers, including a
    free-standing hemodialysis unit required to be licensed
    under the End Stage Renal Disease Facility Act; and
        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.
    No federally owned facility shall be subject to the
provisions of this Act, nor facilities used solely for healing
by prayer or spiritual means.
    No facility licensed under the Supportive Residences
Licensing Act or the Assisted Living and Shared Housing Act
shall be subject to the provisions of this Act.
    A facility designated as a supportive living facility that
is in good standing with the program established under Section
5-5.01a of the Illinois Public Aid Code shall not be subject to
the provisions of this Act.
    This Act does not apply to facilities granted waivers under
Section 3-102.2 of the Nursing Home Care Act. However, if a
demonstration project under that 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.
    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. 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. The Board, however, may require these dialysis
facilities and licensed nursing homes 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.
    This Act shall not apply to the closure of an entity or a
portion of an entity licensed under the Nursing Home Care Act
that elects to convert, in whole or in part, to an assisted
living or shared housing establishment licensed under the
Assisted Living and Shared Housing Act.
    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
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
or within the legal structure of any partnership, medical or
professional corporation, or unincorporated medical or
professional groups. This Act shall apply to construction or
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.
    "Person" means any one or more natural persons, legal
entities, governmental bodies other than federal, or any
combination thereof.
    "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
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).
    "State Board" means the Health Facilities Planning Board.
    "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
or on behalf of a health care facility which exceeds the
capital expenditure minimum; however, any capital expenditure
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.
    "Establish" means the construction of a health care
facility or the replacement of an existing facility on another
site.
    "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
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.
    "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
equipment for a facility or part; and which exceeds the capital
expenditure minimum.
    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. 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 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.
    "Capital expenditure minimum" means $6,000,000, which
shall be annually adjusted to reflect the increase in
construction costs due to inflation, for major medical
equipment and for all other capital expenditures; provided,
however, that when a capital expenditure is for the
construction or modification of a health and fitness center,
"capital expenditure minimum" means the capital expenditure
minimum for all other capital expenditures in effect on March
1, 2000, which shall be annually adjusted to reflect the
increase in construction costs due to inflation.
    "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;
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
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.
    "Areawide" means a major area of the State delineated on a
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".
    "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".
    "Areawide health planning organization" or "Comprehensive
health planning organization" means the health systems agency
designated by the Secretary, Department of Health and Human
Services or any successor agency.
    "Local health planning organization" means those local
health planning organizations that are designated as such by
the areawide health planning organization of the appropriate
area.
    "Physician" means a person licensed to practice in
accordance with the Medical Practice Act of 1987, as amended.
    "Licensed health care professional" means a person
licensed to practice a health profession under pertinent
licensing statutes of the State of Illinois.
    "Director" means the Director of the Illinois Department of
Public Health.
    "Agency" means the Illinois Department of Public Health.
    "Comprehensive health planning" means health planning
concerned with the total population and all health and
associated problems that affect the well-being of people and
that encompasses health services, health manpower, and health
facilities; and the coordination among these and with those
social, economic, and environmental factors that affect
health.
    "Alternative health care model" means a facility or program
authorized under the Alternative Health Care Delivery Act.
    "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
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
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.
    "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.
    "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.
    "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.
(Source: P.A. 93-41, eff. 6-27-03; 93-766, eff. 7-20-04;
93-935, eff. 1-1-05; 93-1031, eff. 8-27-04; 94-342, eff.
7-26-05; revised 4-3-07.)
 
    (20 ILCS 3960/5.1a new)
    Sec. 5.1a. No person shall construct, modify, or establish
a freestanding emergency center in Illinois, or acquire major
medical equipment or make capital expenditures in relation to
such a facility in excess of the capital expenditure minimum,
as defined by this Act, without first obtaining a permit from
the State Board in accordance with criteria, standards, and
procedures adopted by the State Board for freestanding
emergency centers that ensure the availability of and community
access to essential emergency medical services.
 
    Section 10. The Emergency Medical Services (EMS) Systems
Act is amended by changing Sections 3.20 and 32.5 as follows:
 
    (210 ILCS 50/3.20)
    Sec. 3.20. Emergency Medical Services (EMS) Systems.
    (a) "Emergency Medical Services (EMS) System" means an
organization of hospitals, vehicle service providers and
personnel approved by the Department in a specific geographic
area, which coordinates and provides pre-hospital and
inter-hospital emergency care and non-emergency medical
transports at a BLS, ILS and/or ALS level pursuant to a System
program plan submitted to and approved by the Department, and
pursuant to the EMS Region Plan adopted for the EMS Region in
which the System is located.
    (b) One hospital in each System program plan must be
designated as the Resource Hospital. All other hospitals which
are located within the geographic boundaries of a System and
which have standby, basic or comprehensive level emergency
departments must function in that EMS System as either an
Associate Hospital or Participating Hospital and follow all
System policies specified in the System Program Plan, including
but not limited to the replacement of drugs and equipment used
by providers who have delivered patients to their emergency
departments. All hospitals and vehicle service providers
participating in an EMS System must specify their level of
participation in the System Program Plan.
    (c) The Department shall have the authority and
responsibility to:
        (1) Approve BLS, ILS and ALS level EMS Systems which
    meet minimum standards and criteria established in rules
    adopted by the Department pursuant to this Act, including
    the submission of a Program Plan for Department approval.
    Beginning September 1, 1997, the Department shall approve
    the development of a new EMS System only when a local or
    regional need for establishing such System has been
    identified. This shall not be construed as a needs
    assessment for health planning or other purposes outside of
    this Act. Following Department approval, EMS Systems must
    be fully operational within one year from the date of
    approval.
        (2) Monitor EMS Systems, based on minimum standards for
    continuing operation as prescribed in rules adopted by the
    Department pursuant to this Act, which shall include
    requirements for submitting Program Plan amendments to the
    Department for approval.
        (3) Renew EMS System approvals every 4 years, after an
    inspection, based on compliance with the standards for
    continuing operation prescribed in rules adopted by the
    Department pursuant to this Act.
        (4) Suspend, revoke, or refuse to renew approval of any
    EMS System, after providing an opportunity for a hearing,
    when findings show that it does not meet the minimum
    standards for continuing operation as prescribed by the
    Department, or is found to be in violation of its
    previously approved Program Plan.
        (5) Require each EMS System to adopt written protocols
    for the bypassing of or diversion to any hospital, trauma
    center or regional trauma center, which provide that a
    person shall not be transported to a facility other than
    the nearest hospital, regional trauma center or trauma
    center unless the medical benefits to the patient
    reasonably expected from the provision of appropriate
    medical treatment at a more distant facility outweigh the
    increased risks to the patient from transport to the more
    distant facility, or the transport is in accordance with
    the System's protocols for patient choice or refusal.
        (6) Require that the EMS Medical Director of an ILS or
    ALS level EMS System be a physician licensed to practice
    medicine in all of its branches in Illinois, and certified
    by the American Board of Emergency Medicine or the American
    Board of Osteopathic Emergency Medicine, and that the EMS
    Medical Director of a BLS level EMS System be a physician
    licensed to practice medicine in all of its branches in
    Illinois, with regular and frequent involvement in
    pre-hospital emergency medical services. In addition, all
    EMS Medical Directors shall:
            (A) Have experience on an EMS vehicle at the
        highest level available within the System, or make
        provision to gain such experience within 12 months
        prior to the date responsibility for the System is
        assumed or within 90 days after assuming the position;
            (B) Be thoroughly knowledgeable of all skills
        included in the scope of practices of all levels of EMS
        personnel within the System;
            (C) Have or make provision to gain experience
        instructing students at a level similar to that of the
        levels of EMS personnel within the System; and
            (D) For ILS and ALS EMS Medical Directors,
        successfully complete a Department-approved EMS
        Medical Director's Course.
        (7) Prescribe statewide EMS data elements to be
    collected and documented by providers in all EMS Systems
    for all emergency and non-emergency medical services, with
    a one-year phase-in for commencing collection of such data
    elements.
        (8) Define, through rules adopted pursuant to this Act,
    the terms "Resource Hospital", "Associate Hospital",
    "Participating Hospital", "Basic Emergency Department",
    "Standby Emergency Department", "Comprehensive Emergency
    Department", "EMS Medical Director", "EMS Administrative
    Director", and "EMS System Coordinator".
            (A) Upon the effective date of this amendatory Act
        of 1995, all existing Project Medical Directors shall
        be considered EMS Medical Directors, and all persons
        serving in such capacities on the effective date of
        this amendatory Act of 1995 shall be exempt from the
        requirements of paragraph (7) of this subsection;
            (B) Upon the effective date of this amendatory Act
        of 1995, all existing EMS System Project Directors
        shall be considered EMS Administrative Directors.
        (9) Investigate the circumstances that caused a
    hospital in an EMS system to go on bypass status to
    determine whether that hospital's decision to go on bypass
    status was reasonable. The Department may impose
    sanctions, as set forth in Section 3.140 of the Act, upon a
    Department determination that the hospital unreasonably
    went on bypass status in violation of the Act.
        (10) Evaluate the capacity and performance of any
    freestanding emergency center established under Section
    32.5 of this Act in meeting emergency medical service needs
    of the public, including compliance with applicable
    emergency medical standards and assurance of the
    availability of and immediate access to the highest quality
    of medical care possible.
(Source: P.A. 91-357, eff. 7-29-99.)
 
    (210 ILCS 50/32.5)
    Sec. 32.5. Freestanding Emergency Center.
    (a) Until June 30, 2009, the The Department shall issue an
annual Freestanding Emergency Center (FEC) license to any
facility that:
        (1) is located: (A) (i)(A) in a municipality with a
    population of 75,000 or fewer inhabitants; (B) within 20 15
    miles of the hospital that owns or controls the FEC; and
    (C) within 20 10 miles of the Resource Hospital affiliated
    with the FEC as part of the EMS System; or (ii) (A) in a
    municipality that has a hospital that has been providing
    emergency services but is expected to close by the end of
    1997 and (B) in a county with a population of more than
    350,000 but less than 525,000 inhabitants;
        (2) is wholly owned or controlled by an Associate or
    Resource Hospital, but is not a part of the hospital's
    physical plant;
        (3) meets the standards for licensed FECs, adopted by
    rule of the Department, including, but not limited to:
            (A) facility design, specification, operation, and
        maintenance standards;
            (B) equipment standards; and
            (C) the number and qualifications of emergency
        medical personnel and other staff, which must include
        at least one board certified emergency physician
        present at the FEC 24 hours per day.
        (4) limits its participation in the EMS System strictly
    to receiving a limited number of BLS runs by emergency
    medical vehicles according to protocols developed by the
    Resource Hospital within the FEC's designated EMS System
    and approved by the Project Medical Director and the
    Department;
        (5) provides comprehensive emergency treatment
    services, as defined in the rules adopted by the Department
    pursuant to the Hospital Licensing Act, 24 hours per day,
    on an outpatient basis;
        (6) provides an ambulance and maintains on site
    ambulance services staffed with paramedics 24 hours per
    day;
        (7) maintains helicopter landing capabilities approved
    by appropriate State and federal authorities;
        (8) complies with all State and federal patient rights
    provisions, including, but not limited to, the Emergency
    Medical Treatment Act and the federal Emergency Medical
    Treatment and Active Labor Act;
        (9) maintains a communications system that is fully
    integrated with its Resource Hospital within the FEC's
    designated EMS System;
        (10) reports to the Department any patient transfers
    from the FEC to a hospital within 48 hours of the transfer
    plus any other data determined to be relevant by the
    Department;
        (11) submits to the Department, on a quarterly basis,
    the FEC's morbidity and mortality rates for patients
    treated at the FEC and other data determined to be relevant
    by the Department;
        (12) does not describe itself or hold itself out to the
    general public as a full service hospital or hospital
    emergency department in its advertising or marketing
    activities;
        (13) complies with any other rules adopted by the
    Department under this Act that relate to FECs;
        (14) passes the Department's site inspection for
    compliance with the FEC requirements of this Act;
        (15) submits a copy of the a certificate of need or
    other permit issued by the Illinois Health Facilities
    Planning Board indicating that the facility has complied
    with the Illinois Health Facilities Planning Act with
    respect to the health services to be provided at the
    facility that will house the proposed FEC complies with
    State health planning laws; provided, however, that the
    Illinois Health Facilities Planning Board shall waive this
    certificate of need or permit requirement for any proposed
    FEC that, as of the effective date of this amendatory Act
    of 1996, meets the criteria for providing comprehensive
    emergency treatment services, as defined by the rules
    promulgated under the Hospital Licensing Act, but is not a
    licensed hospital;
        (16) submits an application for designation as an FEC
    in a manner and form prescribed by the Department by rule;
    and
        (17) pays the annual license fee as determined by the
    Department by rule. ; and
        (18) participated in the demonstration program.
    (b) The Department shall:
        (1) annually inspect facilities of initial FEC
    applicants and licensed FECs, and issue annual licenses to
    or annually relicense FECs that satisfy the Department's
    licensure requirements as set forth in subsection (a);
        (2) suspend, revoke, refuse to issue, or refuse to
    renew the license of any FEC, after notice and an
    opportunity for a hearing, when the Department finds that
    the FEC has failed to comply with the standards and
    requirements of the Act or rules adopted by the Department
    under the Act;
        (3) issue an Emergency Suspension Order for any FEC
    when the Director or his or her designee has determined
    that the continued operation of the FEC poses an immediate
    and serious danger to the public health, safety, and
    welfare. An opportunity for a hearing shall be promptly
    initiated after an Emergency Suspension Order has been
    issued; and
        (4) adopt rules as needed to implement this Section.
(Source: P.A. 93-372, eff. 1-1-04.)
 
    Section 99. Effective date. This Act takes effect upon
becoming law.