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Public Act 098-0629
Public Act 0629 98TH GENERAL ASSEMBLY
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Public Act 098-0629
| | HB1584 Enrolled | LRB098 08118 DRJ 38209 b |
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| 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 as follows:
| (20 ILCS 3960/3) (from Ch. 111 1/2, par. 1153)
| (Section scheduled to be repealed on December 31, 2019) | Sec. 3. Definitions. As used in this Act:
| "Health care facilities" means and includes
the following | facilities, organizations, and related persons:
| 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;
| 3.5. Skilled and intermediate care facilities licensed | under the ID/DD Community Care Act; | 3.7. Facilities licensed under the Specialized Mental | Health Rehabilitation Act;
| 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;
| 5. Kidney disease treatment centers, including a | free-standing
hemodialysis unit required to be licensed | under the End Stage Renal Disease Facility Act;
| 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;
| 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; and | 8. An institution, place, building, or room used for | provision of 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. | This Act shall not apply to the construction of any new | facility or the renovation of any 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. | 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.
| No facility established and operating under the | Alternative Health Care Delivery Act as a children's | community-based health care center children's respite care | center alternative health care model demonstration program or | as an Alzheimer's Disease Management Center alternative health | care model demonstration program 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, | the Specialized Mental Health Rehabilitation Act, or the ID/DD | Community Care Act, with the exceptions of facilities operated | by a county or Illinois Veterans Homes, 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.
| This Act does not apply to any change of ownership of a | healthcare facility that is licensed under the Nursing Home | Care Act, the Specialized Mental Health Rehabilitation Act, or | the ID/DD Community Care Act, with the exceptions 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.
| 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, unless the entity constructs, modifies, | or establishes a health care facility as specifically defined | in this Section. 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. | No permit or exemption is required for a facility licensed | under the ID/DD Community Care 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, this is a discontinuation or closure of the facility. | However, if a facility licensed under the ID/DD Community Care |
| 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.
| "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" or "Board" means the Health Facilities and | Services Review 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 or the initiation of a category of service.
| "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.
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
| 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 $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
| capital expenditures.
| "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".
| "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.
| "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. | "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. | (Source: P.A. 97-38, eff. 6-28-11; 97-277, eff. 1-1-12; 97-813, | eff. 7-13-12; 97-980, eff. 8-17-12; 98-414, eff. 1-1-14.)
| Section 10. The Alternative Health Care Delivery Act is | amended by changing Sections 15 and 30 as follows:
| (210 ILCS 3/15)
| Sec. 15. License required. No health care facility or | program that
meets the definition and scope of an alternative | health care model shall
operate as such unless it is a | participant in a demonstration program under
this Act and |
| licensed by the Department as an alternative health care model.
| The provisions of this Act concerning children's | community-based health care centers children's respite care | centers
shall not apply to any facility licensed under the | Hospital Licensing Act, the
Nursing Home Care Act, the | Specialized Mental Health Rehabilitation Act, the ID/DD | Community Care Act, or the University of Illinois Hospital Act | that provides
respite care services to children.
| (Source: P.A. 96-339, eff. 7-1-10; 97-38, eff. 6-28-11; 97-135, | eff. 7-14-11; 97-227, eff. 1-1-12; 97-813, eff. 7-13-12.)
| (210 ILCS 3/30)
| Sec. 30. Demonstration program requirements. The | requirements set forth in
this Section shall apply to | demonstration programs.
| (a) (Blank).
| (a-5) There shall be no more than the total number of | postsurgical
recovery care centers with a certificate of need | for beds as of January 1, 2008.
| (a-10) There shall be no more than a total of 9 children's | community-based health care center children's respite care
| center alternative health care models in the demonstration | program, which shall
be located as follows:
| (1) Two in the City of Chicago.
| (2) One in Cook County outside the City of Chicago.
| (3) A total of 2 in the area comprised of DuPage, Kane, |
| Lake, McHenry, and
Will counties.
| (4) A total of 2 in municipalities with a population of | 50,000 or more and
not
located in the areas described in | paragraphs (1), (2), or (3).
| (5) A total of 2 in rural areas, as defined by the | Health Facilities
and Services Review Board.
| No more than one children's community-based health care | center children's respite care model owned and operated by a
| licensed skilled pediatric facility shall be located in each of | the areas
designated in this subsection (a-10).
| (a-15) There shall be 5 authorized community-based | residential
rehabilitation center alternative health care | models in the demonstration
program.
| (a-20) There shall be an authorized
Alzheimer's disease | management center alternative health care model in the
| demonstration program. The Alzheimer's disease management | center shall be
located in Will
County, owned by a
| not-for-profit entity, and endorsed by a resolution approved by | the county
board before the effective date of this amendatory | Act of the 91st General
Assembly.
| (a-25) There shall be no more than 10 birth center | alternative health care
models in the demonstration program, | located as follows:
| (1) Four in the area comprising Cook, DuPage, Kane, | Lake, McHenry, and
Will counties, one of
which shall be | owned or operated by a hospital and one of which shall be |
| owned
or operated by a federally qualified health center.
| (2) Three in municipalities with a population of 50,000 | or more not
located in the area described in paragraph (1) | of this subsection, one of
which shall be owned or operated | by a hospital and one of which shall be owned
or operated | by a federally qualified health center.
| (3) Three in rural areas, one of which shall be owned | or operated by a
hospital and one of which shall be owned | or operated by a federally qualified
health center.
| The first 3 birth centers authorized to operate by the | Department shall be
located in or predominantly serve the | residents of a health professional
shortage area as determined | by the United States Department of Health and Human
Services. | There shall be no more than 2 birth centers authorized to | operate in
any single health planning area for obstetric | services as determined under the
Illinois Health Facilities | Planning Act. If a birth center is located outside
of a
health | professional shortage area, (i) the birth center shall be | located in a
health planning
area with a demonstrated need for | obstetrical service beds, as determined by
the Health | Facilities and Services Review Board or (ii) there must be a
| reduction in
the existing number of obstetrical service beds in | the planning area so that
the establishment of the birth center | does not result in an increase in the
total number of | obstetrical service beds in the health planning area.
| (b) Alternative health care models, other than a model |
| authorized under subsection (a-10) or
(a-20), shall obtain a | certificate of
need from the Health Facilities and Services | Review Board under the Illinois
Health Facilities Planning Act | before receiving a license by the
Department.
If, after | obtaining its initial certificate of need, an alternative | health
care delivery model that is a community based | residential rehabilitation center
seeks to
increase the bed | capacity of that center, it must obtain a certificate of need
| from the Health Facilities and Services Review Board before | increasing the bed
capacity. Alternative
health care models in | medically underserved areas
shall receive priority in | obtaining a certificate of need.
| (c) An alternative health care model license shall be | issued for a
period of one year and shall be annually renewed | if the facility or
program is in substantial compliance with | the Department's rules
adopted under this Act. A licensed | alternative health care model that continues
to be in | substantial compliance after the conclusion of the | demonstration
program shall be eligible for annual renewals | unless and until a different
licensure program for that type of | health care model is established by
legislation, except that a | postsurgical recovery care center meeting the following | requirements may apply within 3 years after August 25, 2009 | (the effective date of Public Act 96-669) for a Certificate of | Need permit to operate as a hospital: | (1) The postsurgical recovery care center shall apply |
| to the Health Facilities and Services Review Board for a | Certificate of Need permit to discontinue the postsurgical | recovery care center and to establish a hospital. | (2) If the postsurgical recovery care center obtains a | Certificate of Need permit to operate as a hospital, it | shall apply for licensure as a hospital under the Hospital | Licensing Act and shall meet all statutory and regulatory | requirements of a hospital. | (3) After obtaining licensure as a hospital, any | license as an ambulatory surgical treatment center and any | license as a post-surgical recovery care center shall be | null and void. | (4) The former postsurgical recovery care center that | receives a hospital license must seek and use its best | efforts to maintain certification under Titles XVIII and | XIX of the federal Social Security Act. | The Department may issue a provisional license to any
| alternative health care model that does not substantially | comply with the
provisions of this Act and the rules adopted | under this Act if (i)
the Department finds that the alternative | health care model has undertaken
changes and corrections which | upon completion will render the alternative
health care model | in substantial compliance with this Act and rules and
(ii) the | health and safety of the patients of the alternative
health | care model will be protected during the period for which the | provisional
license is issued. The Department shall advise the |
| licensee of
the conditions under which the provisional license | is issued, including
the manner in which the alternative health | care model fails to comply with
the provisions of this Act and | rules, and the time within which the changes
and corrections | necessary for the alternative health care model to
| substantially comply with this Act and rules shall be | completed.
| (d) Alternative health care models shall seek | certification under Titles
XVIII and XIX of the federal Social | Security Act. In addition, alternative
health care models shall | provide charitable care consistent with that provided
by | comparable health care providers in the geographic area.
| (d-5) (Blank).
| (e) Alternative health care models shall, to the extent | possible,
link and integrate their services with nearby health | care facilities.
| (f) Each alternative health care model shall implement a | quality
assurance program with measurable benefits and at | reasonable cost.
| (Source: P.A. 96-31, eff. 6-30-09; 96-129, eff. 8-4-09; 96-669, | eff. 8-25-09; 96-812, eff. 1-1-10; 96-1000, eff. 7-2-10; | 96-1071, eff. 7-16-10; 96-1123, eff. 1-1-11; 97-135, eff. | 7-14-11; 97-333, eff. 8-12-11; 97-813, eff. 7-13-12.)
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Effective Date: 1/1/2015
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