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Public Act 91-0838
SB1613 Enrolled LRB9112970JSpc
AN ACT concerning the care of Alzheimer's disease
patients.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Alternative Health Care Delivery Act is
amended by changing Sections 30 and 35 as follows:
(210 ILCS 3/30)
Sec. 30. Demonstration program requirements. The
requirements set forth in this Section shall apply to
demonstration programs.
(a) There shall be no more than:
(i) 3 subacute care hospital alternative health
care models in the City of Chicago (one of which shall be
located on a designated site and shall have been licensed
as a hospital under the Illinois Hospital Licensing Act
within the 10 years immediately before the application
for a license);
(ii) 2 subacute care hospital alternative health
care models in the demonstration program for each of the
following areas:
(1) Cook County outside the City of Chicago.
(2) DuPage, Kane, Lake, McHenry, and Will
Counties.
(3) Municipalities with a population greater
than 50,000 not located in the areas described in
item (i) of subsection (a) and paragraphs (1) and
(2) of item (ii) of subsection (a); and
(iii) 4 subacute care hospital alternative health
care models in the demonstration program for rural areas.
In selecting among applicants for these licenses in rural
areas, the Health Facilities Planning Board and the
Department shall give preference to hospitals that may be
unable for economic reasons to provide continued service to
the community in which they are located unless the hospital
were to receive an alternative health care model license.
(a-5) There shall be no more than a total of 12
postsurgical recovery care center alternative health care
models in the demonstration program, located as follows:
(1) Two in the City of Chicago.
(2) Two in Cook County outside the City of Chicago.
At least one of these shall be owned or operated by a
hospital devoted exclusively to caring for children.
(3) Two in Kane, Lake, and McHenry Counties.
(4) Four in municipalities with a population of
50,000 or more not located in the areas described in
paragraphs (1), (2), and (3), 3 of which shall be owned
or operated by hospitals, at least 2 of which shall be
located in counties with a population of less than
175,000, according to the most recent decennial census
for which data are available, and one of which shall be
owned or operated by an ambulatory surgical treatment
center.
(5) Two in rural areas, both of which shall be
owned or operated by hospitals.
There shall be no postsurgical recovery care center
alternative health care models located in counties with
populations greater than 600,000 but less than 1,000,000. A
proposed postsurgical recovery care center must be owned or
operated by a hospital if it is to be located within, or will
primarily serve the residents of, a health service area in
which more than 60% of the gross patient revenue of the
hospitals within that health service area are derived from
Medicaid and Medicare, according to the most recently
available calendar year data from the Illinois Health Care
Cost Containment Council. Nothing in this paragraph shall
preclude a hospital and an ambulatory surgical treatment
center from forming a joint venture or developing a
collaborative agreement to own or operate a postsurgical
recovery care center.
(a-10) There shall be no more than a total of 8
children's respite care center alternative health care models
in the demonstration program, which shall be located as
follows:
(1) One 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 Planning Board.
No more than one 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 an authorized community-based
residential rehabilitation center alternative health care
model in the demonstration program. The community-based
residential rehabilitation center shall be located in the
area of Illinois south of Interstate Highway 70.
(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.
(b) Alternative health care models, other than a model
authorized under subsection (a-20), shall obtain a
certificate of need from the Illinois Health Facilities
Planning 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 Illinois Health Facilities Planning 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. 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) The Illinois Department of Public Aid, in
cooperation with the Illinois Department of Public Health,
shall develop and implement a reimbursement methodology for
all facilities participating in the demonstration program.
The Illinois Department of Public Aid shall keep a record of
services provided under the demonstration program to
recipients of medical assistance under the Illinois Public
Aid Code and shall submit an annual report of that
information to the Illinois Department of Public Health.
(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. 91-65, eff. 7-9-99.)
(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) Alternative health care model; subacute care
hospital. A subacute care hospital is a designated site
which provides medical specialty care for patients who
need a greater intensity or complexity of care than
generally provided in a skilled nursing facility but who
no longer require acute hospital care. The average length
of stay for patients treated in subacute care hospitals
shall not be less than 20 days, and for individual
patients, the expected length of stay at the time of
admission shall not be less than 10 days. Variations
from minimum lengths of stay shall be reported to the
Department. There shall be no more than 13 subacute care
hospitals authorized to operate by the Department.
Subacute care includes physician supervision, registered
nursing, and physiological monitoring on a continual
basis. A subacute care hospital is either a freestanding
building or a distinct physical and operational entity
within a hospital or nursing home building. A subacute
care hospital shall only consist of beds currently
existing in licensed hospitals or skilled nursing
facilities, except, in the City of Chicago, on a
designated site that was licensed as a hospital under the
Illinois Hospital Licensing Act within the 10 years
immediately before the application for an alternative
health care model license. During the period of operation
of the demonstration project, the existing licensed beds
shall remain licensed as hospital or skilled nursing
facility beds as well as being licensed under this Act.
In order to handle cases of complications, emergencies,
or exigent circumstances, a subacute care hospital shall
maintain a contractual relationship, including a transfer
agreement, with a general acute care hospital. If a
subacute care model is located in a general acute care
hospital, it shall utilize all or a portion of the bed
capacity of that existing hospital. In no event shall a
subacute care hospital use the word "hospital" in its
advertising or marketing activities or represent or hold
itself out to the public as a general acute care
hospital.
(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 require overnight
nursing care, pain control, or observation that would
otherwise be provided in an inpatient setting. 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 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. 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.
(3) Alternative health care delivery model;
children's respite care center. A children's respite
care center model is a designated site that provides
respite for medically frail, technologically dependent,
clinically stable children, up to age 18, for a period of
one to 14 days. This care is to be provided in a
home-like environment that serves no more than 10
children at a time. Children's respite care center
services must be available through the model to all
families, including those whose care is paid for through
the Illinois Department of Public Aid or the Illinois
Department of Children and Family Services. Each respite
care model location shall be a facility physically
separate and apart from any other facility licensed by
the Department of Public Health under this or any other
Act and shall provide, at a minimum, the following
services: out-of-home respite care; hospital to home
training for families and caregivers; short term
transitional care to facilitate placement and training
for foster care parents; parent and family support
groups.
Coverage for the services provided by the Illinois
Department of Public Aid 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.
(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.
(Source: P.A. 91-65, eff. 7-9-99; 91-357, eff. 7-29-99.)
Section 10. The Alzheimer's Special Care Disclosure Act
is amended by changing Section 10 as follows:
(210 ILCS 4/10)
(Text of Section before amendment by P.A. 91-656)
Sec. 10. Facility defined. As used in this Act,
"facility" means a facility licensed or permitted under the
Nursing Home Care Act, the Life Care Facility Act, or the
Community Living Facilities Licensing Act, or subsection
(a-20) of Section 30 of the Alternative Health Care Delivery
Act.
(Source: P.A. 90-341, eff. 1-1-98.)
(Text of Section after amendment by P.A. 91-656)
Sec. 10. Facility defined. As used in this Act,
"facility" means a facility licensed or permitted under the
Nursing Home Care Act, the Life Care Facility Act, the
Assisted Living and Shared Housing Act, or the Community
Living Facilities Licensing Act, or subsection (a-20) of
Section 30 of the Alternative Health Care Delivery Act.
(Source: P.A. 90-341, eff. 1-1-98; 91-656, eff. 1-1-01.)
Section 15. The Nursing Home Care Act is amended by
changing Section 1-113 as follows:
(210 ILCS 45/1-113) (from Ch. 111 1/2, par. 4151-113)
(Text of Section before amendment by P.A. 91-656)
Sec. 1-113. "Facility" or "long-term care facility"
means a private home, institution, building, residence, or
any other place, whether operated for profit or not, or a
county home for the infirm and chronically ill operated
pursuant to Division 5-21 or 5-22 of the Counties Code, or
any similar institution operated by a political subdivision
of the State of Illinois, which provides, through its
ownership or management, personal care, sheltered care or
nursing for 3 or more persons, not related to the applicant
or owner by blood or marriage. It includes skilled nursing
facilities and intermediate care facilities as those terms
are defined in Title XVIII and Title XIX of the Federal
Social Security Act. It also includes homes, institutions, or
other places operated by or under the authority of the
Illinois Department of Veterans' Affairs.
"Facility" does not include the following:
(1) A home, institution, or other place operated by the
federal government or agency thereof, or by the State of
Illinois, other than homes, institutions, or other places
operated by or under the authority of the Illinois Department
of Veterans' Affairs;
(2) A hospital, sanitarium, or other institution whose
principal activity or business is the diagnosis, care, and
treatment of human illness through the maintenance and
operation as organized facilities therefor, which is required
to be licensed under the Hospital Licensing Act;
(3) Any "facility for child care" as defined in the
Child Care Act of 1969;
(4) Any "Community Living Facility" as defined in the
Community Living Facilities Licensing Act;
(5) Any "community residential alternative" as defined
in the Community Residential Alternatives Licensing Act;
(6) Any nursing home or sanatorium operated solely by
and for persons who rely exclusively upon treatment by
spiritual means through prayer, in accordance with the creed
or tenets of any well-recognized church or religious
denomination. However, such nursing home or sanatorium shall
comply with all local laws and rules relating to sanitation
and safety;
(7) Any facility licensed by the Department of Human
Services as a community-integrated living arrangement as
defined in the Community-Integrated Living Arrangements
Licensure and Certification Act;
(8) Any "Supportive Residence" licensed under the
Supportive Residences Licensing Act; or
(9) Any "supportive living facility" in good standing
with the demonstration project established under Section
5-5.01a of the Illinois Public Aid Code; or.
(11) An Alzheimer's disease management center
alternative health care model licensed under the Alternative
Health Care Delivery Act.
(Source: P.A. 89-499, eff. 6-28-96; 89-507, eff. 7-1-97;
90-14, eff. 7-1-97; 90-763, eff. 8-14-98.)
(Text of Section after amendment by P.A. 91-656)
Sec. 1-113. "Facility" or "long-term care facility"
means a private home, institution, building, residence, or
any other place, whether operated for profit or not, or a
county home for the infirm and chronically ill operated
pursuant to Division 5-21 or 5-22 of the Counties Code, or
any similar institution operated by a political subdivision
of the State of Illinois, which provides, through its
ownership or management, personal care, sheltered care or
nursing for 3 or more persons, not related to the applicant
or owner by blood or marriage. It includes skilled nursing
facilities and intermediate care facilities as those terms
are defined in Title XVIII and Title XIX of the Federal
Social Security Act. It also includes homes, institutions, or
other places operated by or under the authority of the
Illinois Department of Veterans' Affairs.
"Facility" does not include the following:
(1) A home, institution, or other place operated by the
federal government or agency thereof, or by the State of
Illinois, other than homes, institutions, or other places
operated by or under the authority of the Illinois Department
of Veterans' Affairs;
(2) A hospital, sanitarium, or other institution whose
principal activity or business is the diagnosis, care, and
treatment of human illness through the maintenance and
operation as organized facilities therefor, which is required
to be licensed under the Hospital Licensing Act;
(3) Any "facility for child care" as defined in the
Child Care Act of 1969;
(4) Any "Community Living Facility" as defined in the
Community Living Facilities Licensing Act;
(5) Any "community residential alternative" as defined
in the Community Residential Alternatives Licensing Act;
(6) Any nursing home or sanatorium operated solely by
and for persons who rely exclusively upon treatment by
spiritual means through prayer, in accordance with the creed
or tenets of any well-recognized church or religious
denomination. However, such nursing home or sanatorium shall
comply with all local laws and rules relating to sanitation
and safety;
(7) Any facility licensed by the Department of Human
Services as a community-integrated living arrangement as
defined in the Community-Integrated Living Arrangements
Licensure and Certification Act;
(8) Any "Supportive Residence" licensed under the
Supportive Residences Licensing Act;
(9) Any "supportive living facility" in good standing
with the demonstration project established under Section
5-5.01a of the Illinois Public Aid Code; or
(10) Any assisted living or shared housing establishment
licensed under the Assisted Living and Shared Housing Act;
or.
(11) An Alzheimer's disease management center
alternative health care model licensed under the Alternative
Health Care Delivery Act.
(Source: P.A. 90-14, eff. 7-1-97; 90-763, eff. 8-14-98;
91-656, eff. 1-1-01.)
Section 20. The Hospital Licensing Act is amended by
changing Section 3 as follows:
(210 ILCS 85/3) (from Ch. 111 1/2, par. 144)
Sec. 3. As used in this Act:
(A) "Hospital" means any institution, place, building,
or agency, public or private, whether organized for profit or
not, devoted primarily to the maintenance and operation of
facilities for the diagnosis and treatment or care of 2 or
more unrelated persons admitted for overnight stay or longer
in order to obtain medical, including obstetric, psychiatric
and nursing, care of illness, disease, injury, infirmity, or
deformity.
The term "hospital", without regard to length of stay,
shall also include:
(a) any facility which is devoted primarily to
providing psychiatric and related services and programs
for the diagnosis and treatment or care of 2 or more
unrelated persons suffering from emotional or nervous
diseases;
(b) all places where pregnant females are received,
cared for, or treated during delivery irrespective of the
number of patients received.
The term "hospital" includes general and specialized
hospitals, tuberculosis sanitaria, mental or psychiatric
hospitals and sanitaria, and includes maternity homes,
lying-in homes, and homes for unwed mothers in which care is
given during delivery.
The term "hospital" does not include:
(1) any person or institution required to be
licensed pursuant to the Nursing Home Care Act, as
amended;
(2) hospitalization or care facilities maintained
by the State or any department or agency thereof, where
such department or agency has authority under law to
establish and enforce standards for the hospitalization
or care facilities under its management and control;
(3) hospitalization or care facilities maintained
by the federal government or agencies thereof;
(4) hospitalization or care facilities maintained
by any university or college established under the laws
of this State and supported principally by public funds
raised by taxation;
(5) any person or facility required to be licensed
pursuant to the Alcoholism and Other Drug Abuse and
Dependency Act; or
(6) any facility operated solely by and for persons
who rely exclusively upon treatment by spiritual means
through prayer, in accordance with the creed or tenets of
any well-recognized church or religious denomination; or.
(7) An Alzheimer's disease management center
alternative health care model licensed under the
Alternative Health Care Delivery Act.
(B) "Person" means the State, and any political
subdivision or municipal corporation, individual, firm,
partnership, corporation, company, association, or joint
stock association, or the legal successor thereof.
(C) "Department" means the Department of Public Health
of the State of Illinois.
(D) "Director" means the Director of Public Health of
the State of Illinois.
(E) "Perinatal" means the period of time between the
conception of an infant and the end of the first month after
birth.
(F) "Federally designated organ procurement agency"
means the organ procurement agency designated by the
Secretary of the U.S. Department of Health and Human Services
for the service area in which a hospital is located; except
that in the case of a hospital located in a county adjacent
to Wisconsin which currently contracts with an organ
procurement agency located in Wisconsin that is not the organ
procurement agency designated by the U.S. Secretary of Health
and Human Services for the service area in which the hospital
is located, if the hospital applies for a waiver pursuant to
42 USC 1320b-8(a), it may designate an organ procurement
agency located in Wisconsin to be thereafter deemed its
federally designated organ procurement agency for the
purposes of this Act.
(G) "Tissue bank" means any facility or program
operating in Illinois that is certified by the American
Association of Tissue Banks or the Eye Bank Association of
America and is involved in procuring, furnishing, donating,
or distributing corneas, bones, or other human tissue for the
purpose of injecting, transfusing, or transplanting any of
them into the human body. "Tissue bank" does not include a
licensed blood bank. For the purposes of this Act, "tissue"
does not include organs.
(Source: P.A. 88-670, eff. 12-2-94; 89-393, eff. 8-20-95.)
Section 95. No acceleration or delay. Where this Act
makes changes in a statute that is represented in this Act by
text that is not yet or no longer in effect (for example, a
Section represented by multiple versions), the use of that
text does not accelerate or delay the taking effect of (i)
the changes made by this Act or (ii) provisions derived from
any other Public Act.
Section 99. Effective date. This Act takes effect upon
becoming law.
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