96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
SB2348

 

Introduced 2/26/2009, by Sen. Susan Garrett

 

SYNOPSIS AS INTRODUCED:
 
See Index

    Amends the Open Meetings Act, the State Officials and Employees Ethics Act, the Illinois Facilities Planning Act, the Hospital Basic Services Preservation Act, the Illinois State Auditing Act, the Alternative Health Care Delivery Act, the Assisted Living and Shared Housing Act, the Emergency Medical Services (EMS) Systems Act, the Health Care Worker Self-Referral Act, the Illinois Public Aid Code, and the Older Adult Services Act. Changes the name of the Health Facilities Planning Board to the "Health Facilities and Services Review Board". Changes the repeal date to July 1, 2010 (now, the repeal date is July 1, 2009).


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB2348 LRB096 10950 JDS 21206 b

1     AN ACT concerning State government.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4     Section 5. The Open Meetings Act is amended by changing
5 Section 1.02 as follows:
 
6     (5 ILCS 120/1.02)  (from Ch. 102, par. 41.02)
7     Sec. 1.02. For the purposes of this Act:
8     "Meeting" means any gathering, whether in person or by
9 video or audio conference, telephone call, electronic means
10 (such as, without limitation, electronic mail, electronic
11 chat, and instant messaging), or other means of contemporaneous
12 interactive communication, of a majority of a quorum of the
13 members of a public body held for the purpose of discussing
14 public business or, for a 5-member public body, a quorum of the
15 members of a public body held for the purpose of discussing
16 public business.
17     Accordingly, for a 5-member public body, 3 members of the
18 body constitute a quorum and the affirmative vote of 3 members
19 is necessary to adopt any motion, resolution, or ordinance,
20 unless a greater number is otherwise required.
21     "Public body" includes all legislative, executive,
22 administrative or advisory bodies of the State, counties,
23 townships, cities, villages, incorporated towns, school

 

 

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1 districts and all other municipal corporations, boards,
2 bureaus, committees or commissions of this State, and any
3 subsidiary bodies of any of the foregoing including but not
4 limited to committees and subcommittees which are supported in
5 whole or in part by tax revenue, or which expend tax revenue,
6 except the General Assembly and committees or commissions
7 thereof. "Public body" includes tourism boards and convention
8 or civic center boards located in counties that are contiguous
9 to the Mississippi River with populations of more than 250,000
10 but less than 300,000. "Public body" includes the Health
11 Facilities and Services Review Board Health Facilities
12 Planning Board. "Public body" does not include a child death
13 review team or the Illinois Child Death Review Teams Executive
14 Council established under the Child Death Review Team Act or an
15 ethics commission acting under the State Officials and
16 Employees Ethics Act.
17 (Source: P.A. 94-1058, eff. 1-1-07; 95-245, eff. 8-17-07.)
 
18     Section 10. The State Officials and Employees Ethics Act is
19 amended by changing Section 5-50 as follows:
 
20     (5 ILCS 430/5-50)
21     Sec. 5-50. Ex parte communications; special government
22 agents.
23     (a) This Section applies to ex parte communications made to
24 any agency listed in subsection (e).

 

 

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1     (b) "Ex parte communication" means any written or oral
2 communication by any person that imparts or requests material
3 information or makes a material argument regarding potential
4 action concerning regulatory, quasi-adjudicatory, investment,
5 or licensing matters pending before or under consideration by
6 the agency. "Ex parte communication" does not include the
7 following: (i) statements by a person publicly made in a public
8 forum; (ii) statements regarding matters of procedure and
9 practice, such as format, the number of copies required, the
10 manner of filing, and the status of a matter; and (iii)
11 statements made by a State employee of the agency to the agency
12 head or other employees of that agency.
13     (b-5) An ex parte communication received by an agency,
14 agency head, or other agency employee from an interested party
15 or his or her official representative or attorney shall
16 promptly be memorialized and made a part of the record.
17     (c) An ex parte communication received by any agency,
18 agency head, or other agency employee, other than an ex parte
19 communication described in subsection (b-5), shall immediately
20 be reported to that agency's ethics officer by the recipient of
21 the communication and by any other employee of that agency who
22 responds to the communication. The ethics officer shall require
23 that the ex parte communication be promptly made a part of the
24 record. The ethics officer shall promptly file the ex parte
25 communication with the Executive Ethics Commission, including
26 all written communications, all written responses to the

 

 

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1 communications, and a memorandum prepared by the ethics officer
2 stating the nature and substance of all oral communications,
3 the identity and job title of the person to whom each
4 communication was made, all responses made, the identity and
5 job title of the person making each response, the identity of
6 each person from whom the written or oral ex parte
7 communication was received, the individual or entity
8 represented by that person, any action the person requested or
9 recommended, and any other pertinent information. The
10 disclosure shall also contain the date of any ex parte
11 communication.
12     (d) "Interested party" means a person or entity whose
13 rights, privileges, or interests are the subject of or are
14 directly affected by a regulatory, quasi-adjudicatory,
15 investment, or licensing matter.
16     (e) This Section applies to the following agencies:
17 Executive Ethics Commission
18 Illinois Commerce Commission
19 Educational Labor Relations Board
20 State Board of Elections
21 Illinois Gaming Board
22 Health Facilities and Services Review Board Health Facilities 
23 Planning Board
24 Illinois Workers' Compensation Commission
25 Illinois Labor Relations Board
26 Illinois Liquor Control Commission

 

 

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1 Pollution Control Board
2 Property Tax Appeal Board
3 Illinois Racing Board
4 Illinois Purchased Care Review Board
5 Department of State Police Merit Board
6 Motor Vehicle Review Board
7 Prisoner Review Board
8 Civil Service Commission
9 Personnel Review Board for the Treasurer
10 Merit Commission for the Secretary of State
11 Merit Commission for the Office of the Comptroller
12 Court of Claims
13 Board of Review of the Department of Employment Security
14 Department of Insurance
15 Department of Professional Regulation and licensing boards
16   under the Department
17 Department of Public Health and licensing boards under the
18   Department
19 Office of Banks and Real Estate and licensing boards under
20   the Office
21 State Employees Retirement System Board of Trustees
22 Judges Retirement System Board of Trustees
23 General Assembly Retirement System Board of Trustees
24 Illinois Board of Investment
25 State Universities Retirement System Board of Trustees
26 Teachers Retirement System Officers Board of Trustees

 

 

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1     (f) Any person who fails to (i) report an ex parte
2 communication to an ethics officer, (ii) make information part
3 of the record, or (iii) make a filing with the Executive Ethics
4 Commission as required by this Section or as required by
5 Section 5-165 of the Illinois Administrative Procedure Act
6 violates this Act.
7 (Source: P.A. 95-331, eff. 8-21-07.)
 
8     Section 15. The Illinois Health Facilities Planning Act is
9 amended by changing Sections 3, 4, 8.5, 15.5, and 19.6 as
10 follows:
 
11     (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
12     (Section scheduled to be repealed on July 1, 2009)
13     Sec. 3. Definitions. As used in this Act:
14     "Health care facilities" means and includes the following
15 facilities and organizations:
16         1. An ambulatory surgical treatment center required to
17     be licensed pursuant to the Ambulatory Surgical Treatment
18     Center Act;
19         2. An institution, place, building, or agency required
20     to be licensed pursuant to the Hospital Licensing Act;
21         3. Skilled and intermediate long term care facilities
22     licensed under the Nursing Home Care Act;
23         4. Hospitals, nursing homes, ambulatory surgical
24     treatment centers, or kidney disease treatment centers

 

 

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1     maintained by the State or any department or agency
2     thereof;
3         5. Kidney disease treatment centers, including a
4     free-standing hemodialysis unit required to be licensed
5     under the End Stage Renal Disease Facility Act; and
6         6. An institution, place, building, or room used for
7     the performance of outpatient surgical procedures that is
8     leased, owned, or operated by or on behalf of an
9     out-of-state facility.
10     This Act shall not apply to the construction of any new
11 facility or the renovation of any existing facility located on
12 any campus facility as defined in Section 5-5.8b of the
13 Illinois Public Aid Code, provided that the campus facility
14 encompasses 30 or more contiguous acres and that the new or
15 renovated facility is intended for use by a licensed
16 residential facility.
17     No federally owned facility shall be subject to the
18 provisions of this Act, nor facilities used solely for healing
19 by prayer or spiritual means.
20     No facility licensed under the Supportive Residences
21 Licensing Act or the Assisted Living and Shared Housing Act
22 shall be subject to the provisions of this Act.
23     A facility designated as a supportive living facility that
24 is in good standing with the program established under Section
25 5-5.01a of the Illinois Public Aid Code shall not be subject to
26 the provisions of this Act.

 

 

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1     This Act does not apply to facilities granted waivers under
2 Section 3-102.2 of the Nursing Home Care Act. However, if a
3 demonstration project under that Act applies for a certificate
4 of need to convert to a nursing facility, it shall meet the
5 licensure and certificate of need requirements in effect as of
6 the date of application.
7     This Act does not apply to a dialysis facility that
8 provides only dialysis training, support, and related services
9 to individuals with end stage renal disease who have elected to
10 receive home dialysis. This Act does not apply to a dialysis
11 unit located in a licensed nursing home that offers or provides
12 dialysis-related services to residents with end stage renal
13 disease who have elected to receive home dialysis within the
14 nursing home. The Board, however, may require these dialysis
15 facilities and licensed nursing homes to report statistical
16 information on a quarterly basis to the Board to be used by the
17 Board to conduct analyses on the need for proposed kidney
18 disease treatment centers.
19     This Act shall not apply to the closure of an entity or a
20 portion of an entity licensed under the Nursing Home Care Act,
21 with the exceptions of facilities operated by a county or
22 Illinois Veterans Homes, that elects to convert, in whole or in
23 part, to an assisted living or shared housing establishment
24 licensed under the Assisted Living and Shared Housing Act.
25     This Act does not apply to any change of ownership of a
26 healthcare facility that is licensed under the Nursing Home

 

 

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1 Care Act, with the exceptions of facilities operated by a
2 county or Illinois Veterans Homes. Changes of ownership of
3 facilities licensed under the Nursing Home Care Act must meet
4 the requirements set forth in Sections 3-101 through 3-119 of
5 the Nursing Home Care Act.
6     With the exception of those health care facilities
7 specifically included in this Section, nothing in this Act
8 shall be intended to include facilities operated as a part of
9 the practice of a physician or other licensed health care
10 professional, whether practicing in his individual capacity or
11 within the legal structure of any partnership, medical or
12 professional corporation, or unincorporated medical or
13 professional group. Further, this Act shall not apply to
14 physicians or other licensed health care professional's
15 practices where such practices are carried out in a portion of
16 a health care facility under contract with such health care
17 facility by a physician or by other licensed health care
18 professionals, whether practicing in his individual capacity
19 or within the legal structure of any partnership, medical or
20 professional corporation, or unincorporated medical or
21 professional groups. This Act shall apply to construction or
22 modification and to establishment by such health care facility
23 of such contracted portion which is subject to facility
24 licensing requirements, irrespective of the party responsible
25 for such action or attendant financial obligation.
26     "Person" means any one or more natural persons, legal

 

 

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1 entities, governmental bodies other than federal, or any
2 combination thereof.
3     "Consumer" means any person other than a person (a) whose
4 major occupation currently involves or whose official capacity
5 within the last 12 months has involved the providing,
6 administering or financing of any type of health care facility,
7 (b) who is engaged in health research or the teaching of
8 health, (c) who has a material financial interest in any
9 activity which involves the providing, administering or
10 financing of any type of health care facility, or (d) who is or
11 ever has been a member of the immediate family of the person
12 defined by (a), (b), or (c).
13     "State Board" or "Board" means the Health Facilities and
14 Services Review Planning Board.
15     "Construction or modification" means the establishment,
16 erection, building, alteration, reconstruction, modernization,
17 improvement, extension, discontinuation, change of ownership,
18 of or by a health care facility, or the purchase or acquisition
19 by or through a health care facility of equipment or service
20 for diagnostic or therapeutic purposes or for facility
21 administration or operation, or any capital expenditure made by
22 or on behalf of a health care facility which exceeds the
23 capital expenditure minimum; however, any capital expenditure
24 made by or on behalf of a health care facility for (i) the
25 construction or modification of a facility licensed under the
26 Assisted Living and Shared Housing Act or (ii) a conversion

 

 

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1 project undertaken in accordance with Section 30 of the Older
2 Adult Services Act shall be excluded from any obligations under
3 this Act.
4     "Establish" means the construction of a health care
5 facility or the replacement of an existing facility on another
6 site.
7     "Major medical equipment" means medical equipment which is
8 used for the provision of medical and other health services and
9 which costs in excess of the capital expenditure minimum,
10 except that such term does not include medical equipment
11 acquired by or on behalf of a clinical laboratory to provide
12 clinical laboratory services if the clinical laboratory is
13 independent of a physician's office and a hospital and it has
14 been determined under Title XVIII of the Social Security Act to
15 meet the requirements of paragraphs (10) and (11) of Section
16 1861(s) of such Act. In determining whether medical equipment
17 has a value in excess of the capital expenditure minimum, the
18 value of studies, surveys, designs, plans, working drawings,
19 specifications, and other activities essential to the
20 acquisition of such equipment shall be included.
21     "Capital Expenditure" means an expenditure: (A) made by or
22 on behalf of a health care facility (as such a facility is
23 defined in this Act); and (B) which under generally accepted
24 accounting principles is not properly chargeable as an expense
25 of operation and maintenance, or is made to obtain by lease or
26 comparable arrangement any facility or part thereof or any

 

 

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1 equipment for a facility or part; and which exceeds the capital
2 expenditure minimum.
3     For the purpose of this paragraph, the cost of any studies,
4 surveys, designs, plans, working drawings, specifications, and
5 other activities essential to the acquisition, improvement,
6 expansion, or replacement of any plant or equipment with
7 respect to which an expenditure is made shall be included in
8 determining if such expenditure exceeds the capital
9 expenditures minimum. Donations of equipment or facilities to a
10 health care facility which if acquired directly by such
11 facility would be subject to review under this Act shall be
12 considered capital expenditures, and a transfer of equipment or
13 facilities for less than fair market value shall be considered
14 a capital expenditure for purposes of this Act if a transfer of
15 the equipment or facilities at fair market value would be
16 subject to review.
17     "Capital expenditure minimum" means $6,000,000, which
18 shall be annually adjusted to reflect the increase in
19 construction costs due to inflation, for major medical
20 equipment and for all other capital expenditures; provided,
21 however, that when a capital expenditure is for the
22 construction or modification of a health and fitness center,
23 "capital expenditure minimum" means the capital expenditure
24 minimum for all other capital expenditures in effect on March
25 1, 2000, which shall be annually adjusted to reflect the
26 increase in construction costs due to inflation.

 

 

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1     "Non-clinical service area" means an area (i) for the
2 benefit of the patients, visitors, staff, or employees of a
3 health care facility and (ii) not directly related to the
4 diagnosis, treatment, or rehabilitation of persons receiving
5 services from the health care facility. "Non-clinical service
6 areas" include, but are not limited to, chapels; gift shops;
7 news stands; computer systems; tunnels, walkways, and
8 elevators; telephone systems; projects to comply with life
9 safety codes; educational facilities; student housing;
10 patient, employee, staff, and visitor dining areas;
11 administration and volunteer offices; modernization of
12 structural components (such as roof replacement and masonry
13 work); boiler repair or replacement; vehicle maintenance and
14 storage facilities; parking facilities; mechanical systems for
15 heating, ventilation, and air conditioning; loading docks; and
16 repair or replacement of carpeting, tile, wall coverings,
17 window coverings or treatments, or furniture. Solely for the
18 purpose of this definition, "non-clinical service area" does
19 not include health and fitness centers.
20     "Areawide" means a major area of the State delineated on a
21 geographic, demographic, and functional basis for health
22 planning and for health service and having within it one or
23 more local areas for health planning and health service. The
24 term "region", as contrasted with the term "subregion", and the
25 word "area" may be used synonymously with the term "areawide".
26     "Local" means a subarea of a delineated major area that on

 

 

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1 a geographic, demographic, and functional basis may be
2 considered to be part of such major area. The term "subregion"
3 may be used synonymously with the term "local".
4     "Areawide health planning organization" or "Comprehensive
5 health planning organization" means the health systems agency
6 designated by the Secretary, Department of Health and Human
7 Services or any successor agency.
8     "Local health planning organization" means those local
9 health planning organizations that are designated as such by
10 the areawide health planning organization of the appropriate
11 area.
12     "Physician" means a person licensed to practice in
13 accordance with the Medical Practice Act of 1987, as amended.
14     "Licensed health care professional" means a person
15 licensed to practice a health profession under pertinent
16 licensing statutes of the State of Illinois.
17     "Director" means the Director of the Illinois Department of
18 Public Health.
19     "Agency" means the Illinois Department of Public Health.
20     "Comprehensive health planning" means health planning
21 concerned with the total population and all health and
22 associated problems that affect the well-being of people and
23 that encompasses health services, health manpower, and health
24 facilities; and the coordination among these and with those
25 social, economic, and environmental factors that affect
26 health.

 

 

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1     "Alternative health care model" means a facility or program
2 authorized under the Alternative Health Care Delivery Act.
3     "Out-of-state facility" means a person that is both (i)
4 licensed as a hospital or as an ambulatory surgery center under
5 the laws of another state or that qualifies as a hospital or an
6 ambulatory surgery center under regulations adopted pursuant
7 to the Social Security Act and (ii) not licensed under the
8 Ambulatory Surgical Treatment Center Act, the Hospital
9 Licensing Act, or the Nursing Home Care Act. Affiliates of
10 out-of-state facilities shall be considered out-of-state
11 facilities. Affiliates of Illinois licensed health care
12 facilities 100% owned by an Illinois licensed health care
13 facility, its parent, or Illinois physicians licensed to
14 practice medicine in all its branches shall not be considered
15 out-of-state facilities. Nothing in this definition shall be
16 construed to include an office or any part of an office of a
17 physician licensed to practice medicine in all its branches in
18 Illinois that is not required to be licensed under the
19 Ambulatory Surgical Treatment Center Act.
20     "Change of ownership of a health care facility" means a
21 change in the person who has ownership or control of a health
22 care facility's physical plant and capital assets. A change in
23 ownership is indicated by the following transactions: sale,
24 transfer, acquisition, lease, change of sponsorship, or other
25 means of transferring control.
26     "Related person" means any person that: (i) is at least 50%

 

 

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1 owned, directly or indirectly, by either the health care
2 facility or a person owning, directly or indirectly, at least
3 50% of the health care facility; or (ii) owns, directly or
4 indirectly, at least 50% of the health care facility.
5     "Charity care" means care provided by a health care
6 facility for which the provider does not expect to receive
7 payment from the patient or a third-party payer.
8     "Freestanding emergency center" means a facility subject
9 to licensure under Section 32.5 of the Emergency Medical
10 Services (EMS) Systems Act.
11 (Source: P.A. 94-342, eff. 7-26-05; 95-331, eff. 8-21-07;
12 95-543, eff. 8-28-07; 95-584, eff. 8-31-07; 95-727, eff.
13 6-30-08; 95-876, eff. 8-21-08.)
 
14     (20 ILCS 3960/4)  (from Ch. 111 1/2, par. 1154)
15     (Section scheduled to be repealed on July 1, 2009)
16     Sec. 4. Health Facilities and Services Review Planning
17 Board; membership; appointment; term; compensation; quorum.
18 There is created the Health Facilities and Services Review
19 Planning Board, which shall perform the functions described in
20 this Act.
21     The State Board shall consist of 5 voting members. Each
22 member shall have a reasonable knowledge of health planning,
23 health finance, or health care at the time of his or her
24 appointment. No person shall be appointed or continue to serve
25 as a member of the State Board who is, or whose spouse, parent,

 

 

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1 or child is, a member of the Board of Directors of, has a
2 financial interest in, or has a business relationship with a
3 health care facility.
4     Notwithstanding any provision of this Section to the
5 contrary, the term of office of each member of the State Board
6 is abolished on the effective date of this amendatory Act of
7 the 93rd General Assembly and those members no longer hold
8 office.
9     The State Board shall be appointed by the Governor, with
10 the advice and consent of the Senate. Not more than 3 of the
11 appointments shall be of the same political party at the time
12 of the appointment. No person shall be appointed as a State
13 Board member if that person has served, after the effective
14 date of Public Act 93-41, 2 3-year terms as a State Board
15 member, except for ex officio non-voting members.
16     The Secretary of Human Services, the Director of Healthcare
17 and Family Services, and the Director of Public Health, or
18 their designated representatives, shall serve as ex-officio,
19 non-voting members of the State Board.
20     Of those members initially appointed by the Governor under
21 this amendatory Act of the 93rd General Assembly, 2 shall serve
22 for terms expiring July 1, 2005, 2 shall serve for terms
23 expiring July 1, 2006, and 1 shall serve for a term expiring
24 July 1, 2007. Thereafter, each appointed member shall hold
25 office for a term of 3 years, provided that any member
26 appointed to fill a vacancy occurring prior to the expiration

 

 

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1 of the term for which his or her predecessor was appointed
2 shall be appointed for the remainder of such term and the term
3 of office of each successor shall commence on July 1 of the
4 year in which his predecessor's term expires. Each member
5 appointed after the effective date of this amendatory Act of
6 the 93rd General Assembly shall hold office until his or her
7 successor is appointed and qualified.
8     State Board members, while serving on business of the State
9 Board, shall receive actual and necessary travel and
10 subsistence expenses while so serving away from their places of
11 residence. A member of the State Board who experiences a
12 significant financial hardship due to the loss of income on
13 days of attendance at meetings or while otherwise engaged in
14 the business of the State Board may be paid a hardship
15 allowance, as determined by and subject to the approval of the
16 Governor's Travel Control Board.
17     The Governor shall designate one of the members to serve as
18 Chairman and shall name as full-time Executive Secretary of the
19 State Board, a person qualified in health care facility
20 planning and in administration. The Agency shall provide
21 administrative and staff support for the State Board. The State
22 Board shall advise the Director of its budgetary and staff
23 needs and consult with the Director on annual budget
24 preparation.
25     The State Board shall meet at least once each quarter, or
26 as often as the Chairman of the State Board deems necessary, or

 

 

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1 upon the request of a majority of the members.
2      Three members of the State Board shall constitute a
3 quorum. The affirmative vote of 3 of the members of the State
4 Board shall be necessary for any action requiring a vote to be
5 taken by the State Board. A vacancy in the membership of the
6 State Board shall not impair the right of a quorum to exercise
7 all the rights and perform all the duties of the State Board as
8 provided by this Act.
9     A State Board member shall disqualify himself or herself
10 from the consideration of any application for a permit or
11 exemption in which the State Board member or the State Board
12 member's spouse, parent, or child: (i) has an economic interest
13 in the matter; or (ii) is employed by, serves as a consultant
14 for, or is a member of the governing board of the applicant or
15 a party opposing the application.
16 (Source: P.A. 95-331, eff. 8-21-07.)
 
17     (20 ILCS 3960/8.5)
18     (Section scheduled to be repealed on July 1, 2009)
19     Sec. 8.5. Certificate of exemption for change of ownership
20 of a health care facility; public notice and public hearing.
21     (a) Upon a finding by the Department of Public Health that
22 an application for a change of ownership is complete, the
23 Department of Public Health shall publish a legal notice on 3
24 consecutive days in a newspaper of general circulation in the
25 area or community to be affected and afford the public an

 

 

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1 opportunity to request a hearing. If the application is for a
2 facility located in a Metropolitan Statistical Area, an
3 additional legal notice shall be published in a newspaper of
4 limited circulation, if one exists, in the area in which the
5 facility is located. If the newspaper of limited circulation is
6 published on a daily basis, the additional legal notice shall
7 be published on 3 consecutive days. The legal notice shall also
8 be posted on the Illinois Health Facilities and Services Review
9 Board's Health Facilities Planning Board's web site and sent to
10 the State Representative and State Senator of the district in
11 which the health care facility is located. The Department of
12 Public Health shall not find that an application for change of
13 ownership of a hospital is complete without a signed
14 certification that for a period of 2 years after the change of
15 ownership transaction is effective, the hospital will not adopt
16 a charity care policy that is more restrictive than the policy
17 in effect during the year prior to the transaction.
18     For the purposes of this subsection, "newspaper of limited
19 circulation" means a newspaper intended to serve a particular
20 or defined population of a specific geographic area within a
21 Metropolitan Statistical Area such as a municipality, town,
22 village, township, or community area, but does not include
23 publications of professional and trade associations.
24     (b) If a public hearing is requested, it shall be held at
25 least 15 days but no more than 30 days after the date of
26 publication of the legal notice in the community in which the

 

 

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1 facility is located. The hearing shall be held in a place of
2 reasonable size and accessibility and a full and complete
3 written transcript of the proceedings shall be made. The
4 applicant shall provide a summary of the proposed change of
5 ownership for distribution at the public hearing.
6 (Source: P.A. 93-935, eff. 1-1-05.)
 
7     (20 ILCS 3960/15.5)
8     (Section scheduled to be repealed on July 1, 2009)
9     Sec. 15.5. Task Force on Health Planning Reform.
10     (a) The Task Force on Health Planning Reform is created.
11     (b) The Task Force shall consist of 19 voting members, as
12 follows: 6 persons, who are not currently employed by a State
13 agency, appointed by the Director of Public Health, 3 of whom
14 shall be persons with knowledge and experience in the delivery
15 of health care services, including at least one person
16 representing organized health service workers, 2 of whom shall
17 be persons with professional experience in the administration
18 or management of health care facilities, and one of whom shall
19 be a person with experience in health planning; 2 members of
20 the Illinois Senate appointed by the President of the Senate,
21 one of whom shall be a co-chair to the Task Force; 2 members of
22 the Illinois Senate appointed by the Senate Minority Leader; 2
23 members of the Illinois House of Representatives appointed by
24 the Speaker of the House of Representatives, one of whom shall
25 be a co-chair to the Task Force; 2 members of the Illinois

 

 

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1 House of Representatives appointed by the House Minority
2 Leader; the Attorney General, or his or her designee; and 4
3 members of the general public, representing health care
4 consumers, appointed by the Attorney General of Illinois.
5     The following persons, or their designees, shall serve, ex
6 officio, as nonvoting members of the Task Force: the Director
7 of Public Health, the Secretary of the Illinois Health
8 Facilities and Services Review Board Health Facilities
9 Planning Board, the Director of Healthcare and Family Services,
10 the Secretary of Human Services, and the Director of the
11 Governor's Office of Management and Budget.
12     Members shall serve without compensation, but may be
13 reimbursed for their expenses in relation to duties on the Task
14 Force.
15     A vote of 12 members appointed to the Task Force is
16 required with respect to the adoption of recommendations to the
17 Governor and General Assembly and the final report required by
18 this Section.
19     (c) The Task Force shall gather information and make
20 recommendations relating to at least the following topics in
21 relation to the Illinois Health Facilities Planning Act:
22         (1) The impact of health planning on the provision of
23     essential and accessible health care services; prevention
24     of unnecessary duplication of facilities and services;
25     improvement in the efficiency of the health care system;
26     maintenance of an environment in the health care system

 

 

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1     that supports quality care; the most economic use of
2     available resources; and the effect of repealing this Act.
3         (2) Reform of the Illinois Health Facilities and
4     Services Review Board Health Facilities Planning Board to
5     enable it to undertake a more active role in health
6     planning to provide guidance in the development of services
7     to meet the health care needs of Illinois, including
8     identifying and recommending initiatives to meet special
9     needs.
10         (3) Reforms to ensure that health planning under the
11     Illinois Health Facilities Planning Act is coordinated
12     with other health planning laws and activities of the
13     State.
14         (4) Reforms that will enable the Illinois Health
15     Facilities and Services Review Board Health Facilities
16     Planning Board to focus most of its project review efforts
17     on "Certificate-of-Need" applications involving new
18     facilities, discontinuation of services, major expansions,
19     and volume-sensitive services, and to expedite review of
20     other projects to the maximum extent possible.
21         (5) Reforms that will enable the Illinois Health
22     Facilities and Services Review Board Health Facilities
23     Planning Board to determine how criteria, standards, and
24     procedures for evaluating project applications involving
25     specialty providers, ambulatory surgical facilities, and
26     other alternative health care models should be amended to

 

 

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1     give special attention to the impact of those projects on
2     traditional community hospitals to assure the availability
3     and access to essential quality medical care in those
4     communities.
5         (6) Implementation of policies and procedures
6     necessary for the Illinois Health Facilities and Services
7     Review Board Health Facilities Planning Board to give
8     special consideration to the impact of the projects it
9     reviews on access to "safety net" services.
10         (7) Changes in policies and procedures to make the
11     Illinois health facilities planning process predictable,
12     transparent, and as efficient as possible; requiring the
13     State Agency (the Illinois Department of Public Health) and
14     the Illinois Health Facilities and Services Review Board
15     Health Facilities Planning Board to provide timely and
16     appropriate explanations of its decisions and establish
17     more effective procedures to enable public review and
18     comment on facts set forth in State Agency staff analyses
19     of project applications prior to the issuance of final
20     decisions on each project.
21         (8) Reforms to ensure that patient access to new and
22     modernized services will not be delayed during a transition
23     period under any proposed system reform; and that the
24     transition should minimize disruption of the process for
25     current applicants.
26         (9) Identification of the resources necessary to

 

 

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1     support the work of the Agency and the Board.
2     (d) The Task Force shall recommend reforms regarding the
3 following:
4         (1) The size and membership of the current Illinois
5     Health Facilities and Services Review Board Health
6     Facilities Planning Board. Review and make recommendations
7     on the reorganization of the structure and function of the
8     Illinois Health Facilities and Services Review Board
9     Health Facilities Planning Board and the State Agency
10     responsible for health planning (the Illinois Department
11     of Public Health), giving consideration to various options
12     for reassigning the primary responsibility for the review,
13     approval, and denial of project applications between the
14     Board and the State Agency, so that the
15     "Certificate-of-Need" process is administered in the most
16     effective, efficient, and consistent manner possible in
17     accordance with the objectives referenced in subsection
18     (c) of this Section.
19         (2) Changes in policies and procedures that will charge
20     the Illinois Health Facilities and Services Review Board
21     Health Facilities Planning Board with developing a
22     long-range health facilities plan (10 years) to be updated
23     at least every 2 years, so that it is a rolling 10-year
24     plan based upon data no older than 2 years. The plan should
25     incorporate an inventory of the State's health facilities
26     infrastructure including both facilities and services

 

 

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1     regulated under this Act, as well as facilities and
2     services that are not currently regulated under this Act,
3     as determined by the Board. The planning criteria and
4     standards should be adjusted to take into consideration
5     services that are regulated under the Act, but are also
6     offered by non-regulated providers. The Illinois
7     Department of Public Health bed inventory should be updated
8     each year using the most recent utilization data for both
9     hospitals and long-term care facilities including 2003,
10     2004, 2005 and subsequent-year inpatient discharges and
11     days. This revised bed supply should be used as the bed
12     supply input for all Planning Area bed-need calculations.
13     Ten-year population projection data should be incorporated
14     into the plan. Plan updates may include redrawing planning
15     area boundaries to reflect population changes. The Task
16     Force shall consider whether the inventory formula should
17     use migration factors for the medical/surgical,
18     pediatrics, obstetrics, and other categories of service,
19     and if so, what those migration factors should be. The
20     Board should hold public hearings on the plan and its
21     updates. There should be a mechanism for the public to
22     request that the plan be updated more frequently to address
23     emerging population and demographic trends. In developing
24     the plan, the Board should consider health plans and other
25     related publications that have been developed both in
26     Illinois and nationally. In developing the plan, the need

 

 

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1     to ensure access to care, especially for "safety net"
2     services, including rural and medically underserved
3     communities, should be included.
4         (3) Changes in regulations that establish separate
5     criteria, standards, and procedures when necessary to
6     adjust for structural, functional, and operational
7     differences between long-term care facilities and acute
8     care facilities and that allow routine changes of
9     ownership, facility sales, and closure requests to be
10     processed on a timely basis. Consider rules to allow
11     flexibility for facilities to modernize, expand, or
12     convert to alternative uses that are in accord with health
13     planning standards.
14         (4) Changes in policies and procedures so that the
15     Illinois Health Facilities and Services Review Board
16     Health Facilities Planning Board updates the standards and
17     criteria on a regular basis and proposes new standards to
18     keep pace with the evolving health care delivery system.
19     Proton Therapy and Treatment is an example of a new,
20     cutting-edge procedure that may require the Board to
21     immediately develop criteria, standards, and procedures
22     for that type of facility. Temporary advisory committees
23     may be appointed to assist in the development of revisions
24     to the Board's standards and criteria, including experts
25     with professional competence in the subject matter of the
26     proposed standards or criteria that are to be developed.

 

 

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1         (5) Changes in policies and procedures to expedite
2     project approval, particularly for less complex projects,
3     including standards for determining whether a project is in
4     "substantial compliance" with the Board's review
5     standards. The review standards must include a requirement
6     for applicants to include a "Safety Net" Impact Statement.
7     This Statement shall describe the project's impact on
8     safety net services in the community. The State Agency
9     Report shall include an assessment of the Statement.
10         (6) Changes to enforcement processes and compliance
11     standards to ensure they are fair and consistent with the
12     severity of the violation.
13         (7) Revisions in policies and procedures to prevent
14     conflicts of interest by members of the Illinois Health
15     Facilities and Services Review Board Health Facilities
16     Planning Board and State Agency staff, including
17     increasing the penalties for violations.
18         (8) Other changes determined necessary to improve the
19     administration of this Act.
20     (e) The State Agency, at the direction of the Task Force,
21 may hire any necessary staff or consultants, enter into
22 contracts, and make any expenditures necessary for carrying out
23 the duties of the Task Force, all out of moneys appropriated
24 for that purpose. Staff support services shall be provided to
25 the Task Force by the State Agency from such appropriations.
26     (f) The Task Force may establish any advisory committee to

 

 

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1 ensure maximum public participation in the Task Force's
2 planning, organization, and implementation review process. If
3 established, advisory committees shall (i) advise and assist
4 the Task Force in its duties and (ii) help the Task Force to
5 identify issues of public concern.
6     (g) The Task Force may submit findings and recommendations
7 to the Governor and the General Assembly as may be necessary at
8 any time and shall submit a final report by November 3, 2008,
9 including any necessary implementing legislation, and
10 recommendations for changes to policies, rules, or procedures
11 that are not incorporated in the implementing legislation.
12     (h) The Task Force is abolished on December 31, 2008.
13 (Source: P.A. 95-5, eff. 5-31-07; 95-771, eff. 7-31-08.)
 
14     (20 ILCS 3960/19.6)
15     (Section scheduled to be repealed on July 1, 2009)
16     Sec. 19.6. Repeal. This Act is repealed on July 1, 2010
17 2009.
18 (Source: P.A. 94-983, eff. 6-30-06; 95-1, eff. 3-30-07; 95-5,
19 eff. 5-31-07; 95-771, eff. 7-31-08.)
 
20     Section 20. The Hospital Basic Services Preservation Act is
21 amended by changing Section 15 as follows:
 
22     (20 ILCS 4050/15)
23     Sec. 15. Basic services loans.

 

 

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1     (a) Essential community hospitals seeking
2 collateralization of loans under this Act must apply to the
3 Illinois Health Facilities and Services Review Board Health
4 Facilities Planning Board on a form prescribed by the Illinois
5 Health Facilities and Services Review Board Health Facilities
6 Planning Board by rule. The Illinois Health Facilities and
7 Services Review Board Health Facilities Planning Board shall
8 review the application and, if it approves the applicant's
9 plan, shall forward the application and its approval to the
10 Hospital Basic Services Review Board.
11     (b) Upon receipt of the applicant's application and
12 approval from the Illinois Health Facilities and Services
13 Review Board Health Facilities Planning Board, the Hospital
14 Basic Services Review Board shall request from the applicant
15 and the applicant shall submit to the Hospital Basic Services
16 Review Board all of the following information:
17         (1) A copy of the hospital's last audited financial
18     statement.
19         (2) The percentage of the hospital's patients each year
20     who are Medicaid patients.
21         (3) The percentage of the hospital's patients each year
22     who are Medicare patients.
23         (4) The percentage of the hospital's patients each year
24     who are uninsured.
25         (5) The percentage of services provided by the hospital
26     each year for which the hospital expected payment but for

 

 

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1     which no payment was received.
2         (6) Any other information required by the Hospital
3     Basic Services Review Board by rule.
4 The Hospital Basic Services Review Board shall review the
5 applicant's original application, the approval of the Illinois
6 Health Facilities and Services Review Board Health Facilities
7 Planning Board, and the information provided by the applicant
8 to the Hospital Basic Services Review Board under this Section
9 and make a recommendation to the State Treasurer to accept or
10 deny the application.
11     (c) If the Hospital Basic Services Review Board recommends
12 that the application be accepted, the State Treasurer may
13 collateralize the applicant's basic service loan for eligible
14 expenses related to completing, attaining, or upgrading basic
15 services, including, but not limited to, delivery,
16 installation, staff training, and other eligible expenses as
17 defined by the State Treasurer by rule. The total cost for any
18 one project to be undertaken by the applicants shall not exceed
19 $10,000,000 and the amount of each basic services loan
20 collateralized under this Act shall not exceed $5,000,000.
21 Expenditures related to basic service loans shall not exceed
22 the amount available in the Fund necessary to collateralize the
23 loans. The terms of any basic services loan collateralized
24 under this Act must be approved by the State Treasurer in
25 accordance with standards established by the State Treasurer by
26 rule.

 

 

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1 (Source: P.A. 94-648, eff. 1-1-06.)
 
2     Section 25. The Illinois State Auditing Act is amended by
3 changing Section 3-1 as follows:
 
4     (30 ILCS 5/3-1)  (from Ch. 15, par. 303-1)
5     Sec. 3-1. Jurisdiction of Auditor General. The Auditor
6 General has jurisdiction over all State agencies to make post
7 audits and investigations authorized by or under this Act or
8 the Constitution.
9     The Auditor General has jurisdiction over local government
10 agencies and private agencies only:
11         (a) to make such post audits authorized by or under
12     this Act as are necessary and incidental to a post audit of
13     a State agency or of a program administered by a State
14     agency involving public funds of the State, but this
15     jurisdiction does not include any authority to review local
16     governmental agencies in the obligation, receipt,
17     expenditure or use of public funds of the State that are
18     granted without limitation or condition imposed by law,
19     other than the general limitation that such funds be used
20     for public purposes;
21         (b) to make investigations authorized by or under this
22     Act or the Constitution; and
23         (c) to make audits of the records of local government
24     agencies to verify actual costs of state-mandated programs

 

 

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1     when directed to do so by the Legislative Audit Commission
2     at the request of the State Board of Appeals under the
3     State Mandates Act.
4     In addition to the foregoing, the Auditor General may
5 conduct an audit of the Metropolitan Pier and Exposition
6 Authority, the Regional Transportation Authority, the Suburban
7 Bus Division, the Commuter Rail Division and the Chicago
8 Transit Authority and any other subsidized carrier when
9 authorized by the Legislative Audit Commission. Such audit may
10 be a financial, management or program audit, or any combination
11 thereof.
12     The audit shall determine whether they are operating in
13 accordance with all applicable laws and regulations. Subject to
14 the limitations of this Act, the Legislative Audit Commission
15 may by resolution specify additional determinations to be
16 included in the scope of the audit.
17     In addition to the foregoing, the Auditor General must also
18 conduct a financial audit of the Illinois Sports Facilities
19 Authority's expenditures of public funds in connection with the
20 reconstruction, renovation, remodeling, extension, or
21 improvement of all or substantially all of any existing
22 "facility", as that term is defined in the Illinois Sports
23 Facilities Authority Act.
24     The Auditor General may also conduct an audit, when
25 authorized by the Legislative Audit Commission, of any hospital
26 which receives 10% or more of its gross revenues from payments

 

 

SB2348 - 34 - LRB096 10950 JDS 21206 b

1 from the State of Illinois, Department of Healthcare and Family
2 Services (formerly Department of Public Aid), Medical
3 Assistance Program.
4     The Auditor General is authorized to conduct financial and
5 compliance audits of the Illinois Distance Learning Foundation
6 and the Illinois Conservation Foundation.
7     As soon as practical after the effective date of this
8 amendatory Act of 1995, the Auditor General shall conduct a
9 compliance and management audit of the City of Chicago and any
10 other entity with regard to the operation of Chicago O'Hare
11 International Airport, Chicago Midway Airport and Merrill C.
12 Meigs Field. The audit shall include, but not be limited to, an
13 examination of revenues, expenses, and transfers of funds;
14 purchasing and contracting policies and practices; staffing
15 levels; and hiring practices and procedures. When completed,
16 the audit required by this paragraph shall be distributed in
17 accordance with Section 3-14.
18     The Auditor General shall conduct a financial and
19 compliance and program audit of distributions from the
20 Municipal Economic Development Fund during the immediately
21 preceding calendar year pursuant to Section 8-403.1 of the
22 Public Utilities Act at no cost to the city, village, or
23 incorporated town that received the distributions.
24     The Auditor General must conduct an audit of the Health
25 Facilities and Services Review Board Health Facilities
26 Planning Board pursuant to Section 19.5 of the Illinois Health

 

 

SB2348 - 35 - LRB096 10950 JDS 21206 b

1 Facilities Planning Act.
2     The Auditor General of the State of Illinois shall annually
3 conduct or cause to be conducted a financial and compliance
4 audit of the books and records of any county water commission
5 organized pursuant to the Water Commission Act of 1985 and
6 shall file a copy of the report of that audit with the Governor
7 and the Legislative Audit Commission. The filed audit shall be
8 open to the public for inspection. The cost of the audit shall
9 be charged to the county water commission in accordance with
10 Section 6z-27 of the State Finance Act. The county water
11 commission shall make available to the Auditor General its
12 books and records and any other documentation, whether in the
13 possession of its trustees or other parties, necessary to
14 conduct the audit required. These audit requirements apply only
15 through July 1, 2007.
16     The Auditor General must conduct audits of the Rend Lake
17 Conservancy District as provided in Section 25.5 of the River
18 Conservancy Districts Act.
19     The Auditor General must conduct financial audits of the
20 Southeastern Illinois Economic Development Authority as
21 provided in Section 70 of the Southeastern Illinois Economic
22 Development Authority Act.
23 (Source: P.A. 95-331, eff. 8-21-07.)
 
24     Section 30. The Alternative Health Care Delivery Act is
25 amended by changing Sections 20, 30, and 36.5 as follows:
 

 

 

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1     (210 ILCS 3/20)
2     Sec. 20. Board responsibilities. The State Board of Health
3 shall have the responsibilities set forth in this Section.
4     (a) The Board shall investigate new health care delivery
5 models and recommend to the Governor and the General Assembly,
6 through the Department, those models that should be authorized
7 as alternative health care models for which demonstration
8 programs should be initiated. In its deliberations, the Board
9 shall use the following criteria:
10         (1) The feasibility of operating the model in Illinois,
11     based on a review of the experience in other states
12     including the impact on health professionals of other
13     health care programs or facilities.
14         (2) The potential of the model to meet an unmet need.
15         (3) The potential of the model to reduce health care
16     costs to consumers, costs to third party payors, and
17     aggregate costs to the public.
18         (4) The potential of the model to maintain or improve
19     the standards of health care delivery in some measurable
20     fashion.
21         (5) The potential of the model to provide increased
22     choices or access for patients.
23     (b) The Board shall evaluate and make recommendations to
24 the Governor and the General Assembly, through the Department,
25 regarding alternative health care model demonstration programs

 

 

SB2348 - 37 - LRB096 10950 JDS 21206 b

1 established under this Act, at the midpoint and end of the
2 period of operation of the demonstration programs. The report
3 shall include, at a minimum, the following:
4         (1) Whether the alternative health care models
5     improved access to health care for their service
6     populations in the State.
7         (2) The quality of care provided by the alternative
8     health care models as may be evidenced by health outcomes,
9     surveillance reports, and administrative actions taken by
10     the Department.
11         (3) The cost and cost effectiveness to the public,
12     third-party payors, and government of the alternative
13     health care models, including the impact of pilot programs
14     on aggregate health care costs in the area. In addition to
15     any other information collected by the Board under this
16     Section, the Board shall collect from postsurgical
17     recovery care centers uniform billing data substantially
18     the same as specified in Section 4-2(e) of the Illinois
19     Health Finance Reform Act. To facilitate its evaluation of
20     that data, the Board shall forward a copy of the data to
21     the Illinois Health Care Cost Containment Council. All
22     patient identifiers shall be removed from the data before
23     it is submitted to the Board or Council.
24         (4) The impact of the alternative health care models on
25     the health care system in that area, including changing
26     patterns of patient demand and utilization, financial

 

 

SB2348 - 38 - LRB096 10950 JDS 21206 b

1     viability, and feasibility of operation of service in
2     inpatient and alternative models in the area.
3         (5) The implementation by alternative health care
4     models of any special commitments made during application
5     review to the Illinois Health Facilities and Services
6     Review Board Health Facilities Planning Board.
7         (6) The continuation, expansion, or modification of
8     the alternative health care models.
9     (c) The Board shall advise the Department on the definition
10 and scope of alternative health care models demonstration
11 programs.
12     (d) In carrying out its responsibilities under this
13 Section, the Board shall seek the advice of other Department
14 advisory boards or committees that may be impacted by the
15 alternative health care model or the proposed model of health
16 care delivery. The Board shall also seek input from other
17 interested parties, which may include holding public hearings.
18     (e) The Board shall otherwise advise the Department on the
19 administration of the Act as the Board deems appropriate.
20 (Source: P.A. 87-1188; 88-441.)
 
21     (210 ILCS 3/30)
22     Sec. 30. Demonstration program requirements. The
23 requirements set forth in this Section shall apply to
24 demonstration programs.
25     (a) There shall be no more than:

 

 

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1         (i) 3 subacute care hospital alternative health care
2     models in the City of Chicago (one of which shall be
3     located on a designated site and shall have been licensed
4     as a hospital under the Illinois Hospital Licensing Act
5     within the 10 years immediately before the application for
6     a license);
7         (ii) 2 subacute care hospital alternative health care
8     models in the demonstration program for each of the
9     following areas:
10             (1) Cook County outside the City of Chicago.
11             (2) DuPage, Kane, Lake, McHenry, and Will
12         Counties.
13             (3) Municipalities with a population greater than
14         50,000 not located in the areas described in item (i)
15         of subsection (a) and paragraphs (1) and (2) of item
16         (ii) of subsection (a); and
17         (iii) 4 subacute care hospital alternative health care
18     models in the demonstration program for rural areas.
19     In selecting among applicants for these licenses in rural
20 areas, the Health Facilities and Services Review Board Health
21 Facilities Planning Board and the Department shall give
22 preference to hospitals that may be unable for economic reasons
23 to provide continued service to the community in which they are
24 located unless the hospital were to receive an alternative
25 health care model license.
26     (a-5) There shall be no more than a total of 12

 

 

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1 postsurgical recovery care center alternative health care
2 models in the demonstration program, located as follows:
3         (1) Two in the City of Chicago.
4         (2) Two in Cook County outside the City of Chicago. At
5     least one of these shall be owned or operated by a hospital
6     devoted exclusively to caring for children.
7         (3) Two in Kane, Lake, and McHenry Counties.
8         (4) Four in municipalities with a population of 50,000
9     or more not located in the areas described in paragraphs
10     (1), (2), and (3), 3 of which shall be owned or operated by
11     hospitals, at least 2 of which shall be located in counties
12     with a population of less than 175,000, according to the
13     most recent decennial census for which data are available,
14     and one of which shall be owned or operated by an
15     ambulatory surgical treatment center.
16         (5) Two in rural areas, both of which shall be owned or
17     operated by hospitals.
18     There shall be no postsurgical recovery care center
19 alternative health care models located in counties with
20 populations greater than 600,000 but less than 1,000,000. A
21 proposed postsurgical recovery care center must be owned or
22 operated by a hospital if it is to be located within, or will
23 primarily serve the residents of, a health service area in
24 which more than 60% of the gross patient revenue of the
25 hospitals within that health service area are derived from
26 Medicaid and Medicare, according to the most recently available

 

 

SB2348 - 41 - LRB096 10950 JDS 21206 b

1 calendar year data from the Illinois Health Care Cost
2 Containment Council. Nothing in this paragraph shall preclude a
3 hospital and an ambulatory surgical treatment center from
4 forming a joint venture or developing a collaborative agreement
5 to own or operate a postsurgical recovery care center.
6     (a-10) There shall be no more than a total of 8 children's
7 respite care center alternative health care models in the
8 demonstration program, which shall be located as follows:
9         (1) One in the City of Chicago.
10         (2) One in Cook County outside the City of Chicago.
11         (3) A total of 2 in the area comprised of DuPage, Kane,
12     Lake, McHenry, and Will counties.
13         (4) A total of 2 in municipalities with a population of
14     50,000 or more and not located in the areas described in
15     paragraphs (1), (2), or (3).
16         (5) A total of 2 in rural areas, as defined by the
17     Health Facilities and Services Review Board Health
18     Facilities Planning Board.
19     No more than one children's respite care model owned and
20 operated by a licensed skilled pediatric facility shall be
21 located in each of the areas designated in this subsection
22 (a-10).
23     (a-15) There shall be an authorized community-based
24 residential rehabilitation center alternative health care
25 model in the demonstration program. The community-based
26 residential rehabilitation center shall be located in the area

 

 

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1 of Illinois south of Interstate Highway 70.
2     (a-20) There shall be an authorized Alzheimer's disease
3 management center alternative health care model in the
4 demonstration program. The Alzheimer's disease management
5 center shall be located in Will County, owned by a
6 not-for-profit entity, and endorsed by a resolution approved by
7 the county board before the effective date of this amendatory
8 Act of the 91st General Assembly.
9     (a-25) There shall be no more than 10 birth center
10 alternative health care models in the demonstration program,
11 located as follows:
12         (1) Four in the area comprising Cook, DuPage, Kane,
13     Lake, McHenry, and Will counties, one of which shall be
14     owned or operated by a hospital and one of which shall be
15     owned or operated by a federally qualified health center.
16         (2) Three in municipalities with a population of 50,000
17     or more not located in the area described in paragraph (1)
18     of this subsection, one of which shall be owned or operated
19     by a hospital and one of which shall be owned or operated
20     by a federally qualified health center.
21         (3) Three in rural areas, one of which shall be owned
22     or operated by a hospital and one of which shall be owned
23     or operated by a federally qualified health center.
24     The first 3 birth centers authorized to operate by the
25 Department shall be located in or predominantly serve the
26 residents of a health professional shortage area as determined

 

 

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1 by the United States Department of Health and Human Services.
2 There shall be no more than 2 birth centers authorized to
3 operate in any single health planning area for obstetric
4 services as determined under the Illinois Health Facilities
5 Planning Act. If a birth center is located outside of a health
6 professional shortage area, (i) the birth center shall be
7 located in a health planning area with a demonstrated need for
8 obstetrical service beds, as determined by the Illinois Health
9 Facilities and Services Review Board Health Facilities
10 Planning Board or (ii) there must be a reduction in the
11 existing number of obstetrical service beds in the planning
12 area so that the establishment of the birth center does not
13 result in an increase in the total number of obstetrical
14 service beds in the health planning area.
15     (b) Alternative health care models, other than a model
16 authorized under subsection (a-20), shall obtain a certificate
17 of need from the Illinois Health Facilities and Services Review
18 Board Health Facilities Planning Board under the Illinois
19 Health Facilities Planning Act before receiving a license by
20 the Department. If, after obtaining its initial certificate of
21 need, an alternative health care delivery model that is a
22 community based residential rehabilitation center seeks to
23 increase the bed capacity of that center, it must obtain a
24 certificate of need from the Illinois Health Facilities and
25 Services Review Board Health Facilities Planning Board before
26 increasing the bed capacity. Alternative health care models in

 

 

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1 medically underserved areas shall receive priority in
2 obtaining a certificate of need.
3     (c) An alternative health care model license shall be
4 issued for a period of one year and shall be annually renewed
5 if the facility or program is in substantial compliance with
6 the Department's rules adopted under this Act. A licensed
7 alternative health care model that continues to be in
8 substantial compliance after the conclusion of the
9 demonstration program shall be eligible for annual renewals
10 unless and until a different licensure program for that type of
11 health care model is established by legislation. The Department
12 may issue a provisional license to any alternative health care
13 model that does not substantially comply with the provisions of
14 this Act and the rules adopted under this Act if (i) the
15 Department finds that the alternative health care model has
16 undertaken changes and corrections which upon completion will
17 render the alternative health care model in substantial
18 compliance with this Act and rules and (ii) the health and
19 safety of the patients of the alternative health care model
20 will be protected during the period for which the provisional
21 license is issued. The Department shall advise the licensee of
22 the conditions under which the provisional license is issued,
23 including the manner in which the alternative health care model
24 fails to comply with the provisions of this Act and rules, and
25 the time within which the changes and corrections necessary for
26 the alternative health care model to substantially comply with

 

 

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1 this Act and rules shall be completed.
2     (d) Alternative health care models shall seek
3 certification under Titles XVIII and XIX of the federal Social
4 Security Act. In addition, alternative health care models shall
5 provide charitable care consistent with that provided by
6 comparable health care providers in the geographic area.
7     (d-5) The Department of Healthcare and Family Services
8 (formerly Illinois Department of Public Aid), in cooperation
9 with the Illinois Department of Public Health, shall develop
10 and implement a reimbursement methodology for all facilities
11 participating in the demonstration program. The Department of
12 Healthcare and Family Services shall keep a record of services
13 provided under the demonstration program to recipients of
14 medical assistance under the Illinois Public Aid Code and shall
15 submit an annual report of that information to the Illinois
16 Department of Public Health.
17     (e) Alternative health care models shall, to the extent
18 possible, link and integrate their services with nearby health
19 care facilities.
20     (f) Each alternative health care model shall implement a
21 quality assurance program with measurable benefits and at
22 reasonable cost.
23 (Source: P.A. 95-331, eff. 8-21-07; 95-445, eff. 1-1-08.)
 
24     (210 ILCS 3/36.5)
25     Sec. 36.5. Alternative health care models authorized.

 

 

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1 Notwithstanding any other law to the contrary, alternative
2 health care models described in part 1 of Section 35 shall be
3 licensed without additional consideration by the Illinois
4 Health Facilities and Services Review Board Health Facilities
5 Planning Board if:
6         (1) an application for such a model was filed with the
7     Illinois Health Facilities and Services Review Board
8     Health Facilities Planning Board prior to September 1,
9     1994;
10         (2) the application was received by the Illinois Health
11     Facilities and Services Review Board Health Facilities
12     Planning Board and was awarded at least the minimum number
13     of points required for approval by the Board or, if the
14     application was withdrawn prior to Board action, the staff
15     report recommended at least the minimum number of points
16     required for approval by the Board; and
17         (3) the applicant complies with all regulations of the
18     Illinois Department of Public Health to receive a license
19     pursuant to part 1 of Section 35.
20 (Source: P.A. 89-393, eff. 8-20-95.)
 
21     Section 35. The Assisted Living and Shared Housing Act is
22 amended by changing Section 145 as follows:
 
23     (210 ILCS 9/145)
24     Sec. 145. Conversion of facilities. Entities licensed as

 

 

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1 facilities under the Nursing Home Care Act may elect to convert
2 to a license under this Act. Any facility that chooses to
3 convert, in whole or in part, shall follow the requirements in
4 the Nursing Home Care Act and rules promulgated under that Act
5 regarding voluntary closure and notice to residents. Any
6 conversion of existing beds licensed under the Nursing Home
7 Care Act to licensure under this Act is exempt from review by
8 the Health Facilities and Services Review Board Health
9 Facilities Planning Board.
10 (Source: P.A. 91-656, eff. 1-1-01.)
 
11     Section 40. The Emergency Medical Services (EMS) Systems
12 Act is amended by changing Section 32.5 as follows:
 
13     (210 ILCS 50/32.5)
14     Sec. 32.5. Freestanding Emergency Center.
15     (a) Until June 30, 2009, the Department shall issue an
16 annual Freestanding Emergency Center (FEC) license to any
17 facility that:
18         (1) is located: (A) in a municipality with a population
19     of 75,000 or fewer inhabitants; (B) within 20 miles of the
20     hospital that owns or controls the FEC; and (C) within 20
21     miles of the Resource Hospital affiliated with the FEC as
22     part of the EMS System;
23         (2) is wholly owned or controlled by an Associate or
24     Resource Hospital, but is not a part of the hospital's

 

 

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1     physical plant;
2         (3) meets the standards for licensed FECs, adopted by
3     rule of the Department, including, but not limited to:
4             (A) facility design, specification, operation, and
5         maintenance standards;
6             (B) equipment standards; and
7             (C) the number and qualifications of emergency
8         medical personnel and other staff, which must include
9         at least one board certified emergency physician
10         present at the FEC 24 hours per day.
11         (4) limits its participation in the EMS System strictly
12     to receiving a limited number of BLS runs by emergency
13     medical vehicles according to protocols developed by the
14     Resource Hospital within the FEC's designated EMS System
15     and approved by the Project Medical Director and the
16     Department;
17         (5) provides comprehensive emergency treatment
18     services, as defined in the rules adopted by the Department
19     pursuant to the Hospital Licensing Act, 24 hours per day,
20     on an outpatient basis;
21         (6) provides an ambulance and maintains on site
22     ambulance services staffed with paramedics 24 hours per
23     day;
24         (7) maintains helicopter landing capabilities approved
25     by appropriate State and federal authorities;
26         (8) complies with all State and federal patient rights

 

 

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1     provisions, including, but not limited to, the Emergency
2     Medical Treatment Act and the federal Emergency Medical
3     Treatment and Active Labor Act;
4         (9) maintains a communications system that is fully
5     integrated with its Resource Hospital within the FEC's
6     designated EMS System;
7         (10) reports to the Department any patient transfers
8     from the FEC to a hospital within 48 hours of the transfer
9     plus any other data determined to be relevant by the
10     Department;
11         (11) submits to the Department, on a quarterly basis,
12     the FEC's morbidity and mortality rates for patients
13     treated at the FEC and other data determined to be relevant
14     by the Department;
15         (12) does not describe itself or hold itself out to the
16     general public as a full service hospital or hospital
17     emergency department in its advertising or marketing
18     activities;
19         (13) complies with any other rules adopted by the
20     Department under this Act that relate to FECs;
21         (14) passes the Department's site inspection for
22     compliance with the FEC requirements of this Act;
23         (15) submits a copy of the permit issued by the
24     Illinois Health Facilities and Services Review Board
25     Health Facilities Planning Board indicating that the
26     facility has complied with the Illinois Health Facilities

 

 

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1     Planning Act with respect to the health services to be
2     provided at the facility;
3         (16) submits an application for designation as an FEC
4     in a manner and form prescribed by the Department by rule;
5     and
6         (17) pays the annual license fee as determined by the
7     Department by rule.
8     (b) The Department shall:
9         (1) annually inspect facilities of initial FEC
10     applicants and licensed FECs, and issue annual licenses to
11     or annually relicense FECs that satisfy the Department's
12     licensure requirements as set forth in subsection (a);
13         (2) suspend, revoke, refuse to issue, or refuse to
14     renew the license of any FEC, after notice and an
15     opportunity for a hearing, when the Department finds that
16     the FEC has failed to comply with the standards and
17     requirements of the Act or rules adopted by the Department
18     under the Act;
19         (3) issue an Emergency Suspension Order for any FEC
20     when the Director or his or her designee has determined
21     that the continued operation of the FEC poses an immediate
22     and serious danger to the public health, safety, and
23     welfare. An opportunity for a hearing shall be promptly
24     initiated after an Emergency Suspension Order has been
25     issued; and
26         (4) adopt rules as needed to implement this Section.

 

 

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1 (Source: P.A. 95-584, eff. 8-31-07.)
 
2     Section 45. The Health Care Worker Self-Referral Act is
3 amended by changing Sections 5, 15, and 30 as follows:
 
4     (225 ILCS 47/5)
5     Sec. 5. Legislative intent. The General Assembly
6 recognizes that patient referrals by health care workers for
7 health services to an entity in which the referring health care
8 worker has an investment interest may present a potential
9 conflict of interest. The General Assembly finds that these
10 referral practices may limit or completely eliminate
11 competitive alternatives in the health care market. In some
12 instances, these referral practices may expand and improve care
13 or may make services available which were previously
14 unavailable. They may also provide lower cost options to
15 patients or increase competition. Generally, referral
16 practices are positive occurrences. However, self-referrals
17 may result in over utilization of health services, increased
18 overall costs of the health care systems, and may affect the
19 quality of health care.
20     It is the intent of the General Assembly to provide
21 guidance to health care workers regarding acceptable patient
22 referrals, to prohibit patient referrals to entities providing
23 health services in which the referring health care worker has
24 an investment interest, and to protect the citizens of Illinois

 

 

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1 from unnecessary and costly health care expenditures.
2     Recognizing the need for flexibility to quickly respond to
3 changes in the delivery of health services, to avoid results
4 beyond the limitations on self referral provided under this Act
5 and to provide minimal disruption to the appropriate delivery
6 of health care, the Health Facilities and Services Review Board
7 Health Facilities Planning Board shall be exclusively and
8 solely authorized to implement and interpret this Act through
9 adopted rules.
10     The General Assembly recognizes that changes in delivery of
11 health care has resulted in various methods by which health
12 care workers practice their professions. It is not the intent
13 of the General Assembly to limit appropriate delivery of care,
14 nor force unnecessary changes in the structures created by
15 workers for the health and convenience of their patients.
16 (Source: P.A. 87-1207.)
 
17     (225 ILCS 47/15)
18     Sec. 15. Definitions. In this Act:
19     (a) "Board" means the Health Facilities and Services Review
20 Board Health Facilities Planning Board.
21     (b) "Entity" means any individual, partnership, firm,
22 corporation, or other business that provides health services
23 but does not include an individual who is a health care worker
24 who provides professional services to an individual.
25     (c) "Group practice" means a group of 2 or more health care

 

 

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1 workers legally organized as a partnership, professional
2 corporation, not-for-profit corporation, faculty practice plan
3 or a similar association in which:
4         (1) each health care worker who is a member or employee
5     or an independent contractor of the group provides
6     substantially the full range of services that the health
7     care worker routinely provides, including consultation,
8     diagnosis, or treatment, through the use of office space,
9     facilities, equipment, or personnel of the group;
10         (2) the services of the health care workers are
11     provided through the group, and payments received for
12     health services are treated as receipts of the group; and
13         (3) the overhead expenses and the income from the
14     practice are distributed by methods previously determined
15     by the group.
16     (d) "Health care worker" means any individual licensed
17 under the laws of this State to provide health services,
18 including but not limited to: dentists licensed under the
19 Illinois Dental Practice Act; dental hygienists licensed under
20 the Illinois Dental Practice Act; nurses and advanced practice
21 nurses licensed under the Nurse Practice Act; occupational
22 therapists licensed under the Illinois Occupational Therapy
23 Practice Act; optometrists licensed under the Illinois
24 Optometric Practice Act of 1987; pharmacists licensed under the
25 Pharmacy Practice Act; physical therapists licensed under the
26 Illinois Physical Therapy Act; physicians licensed under the

 

 

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1 Medical Practice Act of 1987; physician assistants licensed
2 under the Physician Assistant Practice Act of 1987; podiatrists
3 licensed under the Podiatric Medical Practice Act of 1987;
4 clinical psychologists licensed under the Clinical
5 Psychologist Licensing Act; clinical social workers licensed
6 under the Clinical Social Work and Social Work Practice Act;
7 speech-language pathologists and audiologists licensed under
8 the Illinois Speech-Language Pathology and Audiology Practice
9 Act; or hearing instrument dispensers licensed under the
10 Hearing Instrument Consumer Protection Act, or any of their
11 successor Acts.
12     (e) "Health services" means health care procedures and
13 services provided by or through a health care worker.
14     (f) "Immediate family member" means a health care worker's
15 spouse, child, child's spouse, or a parent.
16     (g) "Investment interest" means an equity or debt security
17 issued by an entity, including, without limitation, shares of
18 stock in a corporation, units or other interests in a
19 partnership, bonds, debentures, notes, or other equity
20 interests or debt instruments except that investment interest
21 for purposes of Section 20 does not include interest in a
22 hospital licensed under the laws of the State of Illinois.
23     (h) "Investor" means an individual or entity directly or
24 indirectly owning a legal or beneficial ownership or investment
25 interest, (such as through an immediate family member, trust,
26 or another entity related to the investor).

 

 

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1     (i) "Office practice" includes the facility or facilities
2 at which a health care worker, on an ongoing basis, provides or
3 supervises the provision of professional health services to
4 individuals.
5     (j) "Referral" means any referral of a patient for health
6 services, including, without limitation:
7         (1) The forwarding of a patient by one health care
8     worker to another health care worker or to an entity
9     outside the health care worker's office practice or group
10     practice that provides health services.
11         (2) The request or establishment by a health care
12     worker of a plan of care outside the health care worker's
13     office practice or group practice that includes the
14     provision of any health services.
15 (Source: P.A. 95-639, eff. 10-5-07; 95-689, eff. 10-29-07;
16 95-876, eff. 8-21-08.)
 
17     (225 ILCS 47/30)
18     Sec. 30. Rulemaking. The Health Facilities and Services
19 Review Board Health Facilities Planning Board shall
20 exclusively and solely implement the provisions of this Act
21 pursuant to rules adopted in accordance with the Illinois
22 Administrative Procedure Act concerning, but not limited to:
23     (a) Standards and procedures for the administration of this
24 Act.
25     (b) Procedures and criteria for exceptions from the

 

 

SB2348 - 56 - LRB096 10950 JDS 21206 b

1 prohibitions set forth in Section 20.
2     (c) Procedures and criteria for determining practical
3 compliance with the needs and alternative investor criteria in
4 Section 20.
5     (d) Procedures and criteria for determining when a written
6 request for an opinion set forth in Section 20 is complete.
7     (e) Procedures and criteria for advising health care
8 workers of the applicability of this Act to practices pursuant
9 to written requests.
10 (Source: P.A. 87-1207.)
 
11     Section 50. The Illinois Public Aid Code is amended by
12 changing Section 5-5.02 as follows:
 
13     (305 ILCS 5/5-5.02)  (from Ch. 23, par. 5-5.02)
14     Sec. 5-5.02. Hospital reimbursements.
15     (a) Reimbursement to Hospitals; July 1, 1992 through
16 September 30, 1992. Notwithstanding any other provisions of
17 this Code or the Illinois Department's Rules promulgated under
18 the Illinois Administrative Procedure Act, reimbursement to
19 hospitals for services provided during the period July 1, 1992
20 through September 30, 1992, shall be as follows:
21         (1) For inpatient hospital services rendered, or if
22     applicable, for inpatient hospital discharges occurring,
23     on or after July 1, 1992 and on or before September 30,
24     1992, the Illinois Department shall reimburse hospitals

 

 

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1     for inpatient services under the reimbursement
2     methodologies in effect for each hospital, and at the
3     inpatient payment rate calculated for each hospital, as of
4     June 30, 1992. For purposes of this paragraph,
5     "reimbursement methodologies" means all reimbursement
6     methodologies that pertain to the provision of inpatient
7     hospital services, including, but not limited to, any
8     adjustments for disproportionate share, targeted access,
9     critical care access and uncompensated care, as defined by
10     the Illinois Department on June 30, 1992.
11         (2) For the purpose of calculating the inpatient
12     payment rate for each hospital eligible to receive
13     quarterly adjustment payments for targeted access and
14     critical care, as defined by the Illinois Department on
15     June 30, 1992, the adjustment payment for the period July
16     1, 1992 through September 30, 1992, shall be 25% of the
17     annual adjustment payments calculated for each eligible
18     hospital, as of June 30, 1992. The Illinois Department
19     shall determine by rule the adjustment payments for
20     targeted access and critical care beginning October 1,
21     1992.
22         (3) For the purpose of calculating the inpatient
23     payment rate for each hospital eligible to receive
24     quarterly adjustment payments for uncompensated care, as
25     defined by the Illinois Department on June 30, 1992, the
26     adjustment payment for the period August 1, 1992 through

 

 

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1     September 30, 1992, shall be one-sixth of the total
2     uncompensated care adjustment payments calculated for each
3     eligible hospital for the uncompensated care rate year, as
4     defined by the Illinois Department, ending on July 31,
5     1992. The Illinois Department shall determine by rule the
6     adjustment payments for uncompensated care beginning
7     October 1, 1992.
8     (b) Inpatient payments. For inpatient services provided on
9 or after October 1, 1993, in addition to rates paid for
10 hospital inpatient services pursuant to the Illinois Health
11 Finance Reform Act, as now or hereafter amended, or the
12 Illinois Department's prospective reimbursement methodology,
13 or any other methodology used by the Illinois Department for
14 inpatient services, the Illinois Department shall make
15 adjustment payments, in an amount calculated pursuant to the
16 methodology described in paragraph (c) of this Section, to
17 hospitals that the Illinois Department determines satisfy any
18 one of the following requirements:
19         (1) Hospitals that are described in Section 1923 of the
20     federal Social Security Act, as now or hereafter amended;
21     or
22         (2) Illinois hospitals that have a Medicaid inpatient
23     utilization rate which is at least one-half a standard
24     deviation above the mean Medicaid inpatient utilization
25     rate for all hospitals in Illinois receiving Medicaid
26     payments from the Illinois Department; or

 

 

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1         (3) Illinois hospitals that on July 1, 1991 had a
2     Medicaid inpatient utilization rate, as defined in
3     paragraph (h) of this Section, that was at least the mean
4     Medicaid inpatient utilization rate for all hospitals in
5     Illinois receiving Medicaid payments from the Illinois
6     Department and which were located in a planning area with
7     one-third or fewer excess beds as determined by the
8     Illinois Health Facilities and Services Review Board
9     Health Facilities Planning Board, and that, as of June 30,
10     1992, were located in a federally designated Health
11     Manpower Shortage Area; or
12         (4) Illinois hospitals that:
13             (A) have a Medicaid inpatient utilization rate
14         that is at least equal to the mean Medicaid inpatient
15         utilization rate for all hospitals in Illinois
16         receiving Medicaid payments from the Department; and
17             (B) also have a Medicaid obstetrical inpatient
18         utilization rate that is at least one standard
19         deviation above the mean Medicaid obstetrical
20         inpatient utilization rate for all hospitals in
21         Illinois receiving Medicaid payments from the
22         Department for obstetrical services; or
23         (5) Any children's hospital, which means a hospital
24     devoted exclusively to caring for children. A hospital
25     which includes a facility devoted exclusively to caring for
26     children shall be considered a children's hospital to the

 

 

SB2348 - 60 - LRB096 10950 JDS 21206 b

1     degree that the hospital's Medicaid care is provided to
2     children if either (i) the facility devoted exclusively to
3     caring for children is separately licensed as a hospital by
4     a municipality prior to September 30, 1998 or (ii) the
5     hospital has been designated by the State as a Level III
6     perinatal care facility, has a Medicaid Inpatient
7     Utilization rate greater than 55% for the rate year 2003
8     disproportionate share determination, and has more than
9     10,000 qualified children days as defined by the Department
10     in rulemaking.
11     (c) Inpatient adjustment payments. The adjustment payments
12 required by paragraph (b) shall be calculated based upon the
13 hospital's Medicaid inpatient utilization rate as follows:
14         (1) hospitals with a Medicaid inpatient utilization
15     rate below the mean shall receive a per day adjustment
16     payment equal to $25;
17         (2) hospitals with a Medicaid inpatient utilization
18     rate that is equal to or greater than the mean Medicaid
19     inpatient utilization rate but less than one standard
20     deviation above the mean Medicaid inpatient utilization
21     rate shall receive a per day adjustment payment equal to
22     the sum of $25 plus $1 for each one percent that the
23     hospital's Medicaid inpatient utilization rate exceeds the
24     mean Medicaid inpatient utilization rate;
25         (3) hospitals with a Medicaid inpatient utilization
26     rate that is equal to or greater than one standard

 

 

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1     deviation above the mean Medicaid inpatient utilization
2     rate but less than 1.5 standard deviations above the mean
3     Medicaid inpatient utilization rate shall receive a per day
4     adjustment payment equal to the sum of $40 plus $7 for each
5     one percent that the hospital's Medicaid inpatient
6     utilization rate exceeds one standard deviation above the
7     mean Medicaid inpatient utilization rate; and
8         (4) hospitals with a Medicaid inpatient utilization
9     rate that is equal to or greater than 1.5 standard
10     deviations above the mean Medicaid inpatient utilization
11     rate shall receive a per day adjustment payment equal to
12     the sum of $90 plus $2 for each one percent that the
13     hospital's Medicaid inpatient utilization rate exceeds 1.5
14     standard deviations above the mean Medicaid inpatient
15     utilization rate.
16     (d) Supplemental adjustment payments. In addition to the
17 adjustment payments described in paragraph (c), hospitals as
18 defined in clauses (1) through (5) of paragraph (b), excluding
19 county hospitals (as defined in subsection (c) of Section 15-1
20 of this Code) and a hospital organized under the University of
21 Illinois Hospital Act, shall be paid supplemental inpatient
22 adjustment payments of $60 per day. For purposes of Title XIX
23 of the federal Social Security Act, these supplemental
24 adjustment payments shall not be classified as adjustment
25 payments to disproportionate share hospitals.
26     (e) The inpatient adjustment payments described in

 

 

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1 paragraphs (c) and (d) shall be increased on October 1, 1993
2 and annually thereafter by a percentage equal to the lesser of
3 (i) the increase in the DRI hospital cost index for the most
4 recent 12 month period for which data are available, or (ii)
5 the percentage increase in the statewide average hospital
6 payment rate over the previous year's statewide average
7 hospital payment rate. The sum of the inpatient adjustment
8 payments under paragraphs (c) and (d) to a hospital, other than
9 a county hospital (as defined in subsection (c) of Section 15-1
10 of this Code) or a hospital organized under the University of
11 Illinois Hospital Act, however, shall not exceed $275 per day;
12 that limit shall be increased on October 1, 1993 and annually
13 thereafter by a percentage equal to the lesser of (i) the
14 increase in the DRI hospital cost index for the most recent
15 12-month period for which data are available or (ii) the
16 percentage increase in the statewide average hospital payment
17 rate over the previous year's statewide average hospital
18 payment rate.
19     (f) Children's hospital inpatient adjustment payments. For
20 children's hospitals, as defined in clause (5) of paragraph
21 (b), the adjustment payments required pursuant to paragraphs
22 (c) and (d) shall be multiplied by 2.0.
23     (g) County hospital inpatient adjustment payments. For
24 county hospitals, as defined in subsection (c) of Section 15-1
25 of this Code, there shall be an adjustment payment as
26 determined by rules issued by the Illinois Department.

 

 

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1     (h) For the purposes of this Section the following terms
2 shall be defined as follows:
3         (1) "Medicaid inpatient utilization rate" means a
4     fraction, the numerator of which is the number of a
5     hospital's inpatient days provided in a given 12-month
6     period to patients who, for such days, were eligible for
7     Medicaid under Title XIX of the federal Social Security
8     Act, and the denominator of which is the total number of
9     the hospital's inpatient days in that same period.
10         (2) "Mean Medicaid inpatient utilization rate" means
11     the total number of Medicaid inpatient days provided by all
12     Illinois Medicaid-participating hospitals divided by the
13     total number of inpatient days provided by those same
14     hospitals.
15         (3) "Medicaid obstetrical inpatient utilization rate"
16     means the ratio of Medicaid obstetrical inpatient days to
17     total Medicaid inpatient days for all Illinois hospitals
18     receiving Medicaid payments from the Illinois Department.
19     (i) Inpatient adjustment payment limit. In order to meet
20 the limits of Public Law 102-234 and Public Law 103-66, the
21 Illinois Department shall by rule adjust disproportionate
22 share adjustment payments.
23     (j) University of Illinois Hospital inpatient adjustment
24 payments. For hospitals organized under the University of
25 Illinois Hospital Act, there shall be an adjustment payment as
26 determined by rules adopted by the Illinois Department.

 

 

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1     (k) The Illinois Department may by rule establish criteria
2 for and develop methodologies for adjustment payments to
3 hospitals participating under this Article.
4 (Source: P.A. 93-40, eff. 6-27-03.)
 
5     Section 55. The Older Adult Services Act is amended by
6 changing Sections 20, 25, and 30 as follows:
 
7     (320 ILCS 42/20)
8     Sec. 20. Priority service areas; service expansion.
9     (a) The requirements of this Section are subject to the
10 availability of funding.
11     (b) The Department shall expand older adult services that
12 promote independence and permit older adults to remain in their
13 own homes and communities. Priority shall be given to both the
14 expansion of services and the development of new services in
15 priority service areas.
16     (c) Inventory of services. The Department shall develop and
17 maintain an inventory and assessment of (i) the types and
18 quantities of public older adult services and, to the extent
19 possible, privately provided older adult services, including
20 the unduplicated count, location, and characteristics of
21 individuals served by each facility, program, or service and
22 (ii) the resources supporting those services.
23     (d) Priority service areas. The Departments shall assess
24 the current and projected need for older adult services

 

 

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1 throughout the State, analyze the results of the inventory, and
2 identify priority service areas, which shall serve as the basis
3 for a priority service plan to be filed with the Governor and
4 the General Assembly no later than July 1, 2006, and every 5
5 years thereafter.
6     (e) Moneys appropriated by the General Assembly for the
7 purpose of this Section, receipts from donations, grants, fees,
8 or taxes that may accrue from any public or private sources to
9 the Department for the purpose of this Section, and savings
10 attributable to the nursing home conversion program as
11 calculated in subsection (h) shall be deposited into the
12 Department on Aging State Projects Fund. Interest earned by
13 those moneys in the Fund shall be credited to the Fund.
14     (f) Moneys described in subsection (e) from the Department
15 on Aging State Projects Fund shall be used for older adult
16 services, regardless of where the older adult receives the
17 service, with priority given to both the expansion of services
18 and the development of new services in priority service areas.
19 Fundable services shall include:
20         (1) Housing, health services, and supportive services:
21             (A) adult day care;
22             (B) adult day care for persons with Alzheimer's
23         disease and related disorders;
24             (C) activities of daily living;
25             (D) care-related supplies and equipment;
26             (E) case management;

 

 

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1             (F) community reintegration;
2             (G) companion;
3             (H) congregate meals;
4             (I) counseling and education;
5             (J) elder abuse prevention and intervention;
6             (K) emergency response and monitoring;
7             (L) environmental modifications;
8             (M) family caregiver support;
9             (N) financial;
10             (O) home delivered meals;
11             (P) homemaker;
12             (Q) home health;
13             (R) hospice;
14             (S) laundry;
15             (T) long-term care ombudsman;
16             (U) medication reminders;
17             (V) money management;
18             (W) nutrition services;
19             (X) personal care;
20             (Y) respite care;
21             (Z) residential care;
22             (AA) senior benefits outreach;
23             (BB) senior centers;
24             (CC) services provided under the Assisted Living
25         and Shared Housing Act, or sheltered care services that
26         meet the requirements of the Assisted Living and Shared

 

 

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1         Housing Act, or services provided under Section
2         5-5.01a of the Illinois Public Aid Code (the Supportive
3         Living Facilities Program);
4             (DD) telemedicine devices to monitor recipients in
5         their own homes as an alternative to hospital care,
6         nursing home care, or home visits;
7             (EE) training for direct family caregivers;
8             (FF) transition;
9             (GG) transportation;
10             (HH) wellness and fitness programs; and
11             (II) other programs designed to assist older
12         adults in Illinois to remain independent and receive
13         services in the most integrated residential setting
14         possible for that person.
15         (2) Older Adult Services Demonstration Grants,
16     pursuant to subsection (g) of this Section.
17     (g) Older Adult Services Demonstration Grants. The
18 Department shall establish a program of demonstration grants to
19 assist in the restructuring of the delivery system for older
20 adult services and provide funding for innovative service
21 delivery models and system change and integration initiatives.
22 The Department shall prescribe, by rule, the grant application
23 process. At a minimum, every application must include:
24         (1) The type of grant sought;
25         (2) A description of the project;
26         (3) The objective of the project;

 

 

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1         (4) The likelihood of the project meeting identified
2     needs;
3         (5) The plan for financing, administration, and
4     evaluation of the project;
5         (6) The timetable for implementation;
6         (7) The roles and capabilities of responsible
7     individuals and organizations;
8         (8) Documentation of collaboration with other service
9     providers, local community government leaders, and other
10     stakeholders, other providers, and any other stakeholders
11     in the community;
12         (9) Documentation of community support for the
13     project, including support by other service providers,
14     local community government leaders, and other
15     stakeholders;
16         (10) The total budget for the project;
17         (11) The financial condition of the applicant; and
18         (12) Any other application requirements that may be
19     established by the Department by rule.
20     Each project may include provisions for a designated staff
21 person who is responsible for the development of the project
22 and recruitment of providers.
23     Projects may include, but are not limited to: adult family
24 foster care; family adult day care; assisted living in a
25 supervised apartment; personal services in a subsidized
26 housing project; evening and weekend home care coverage; small

 

 

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1 incentive grants to attract new providers; money following the
2 person; cash and counseling; managed long-term care; and at
3 least one respite care project that establishes a local
4 coordinated network of volunteer and paid respite workers,
5 coordinates assignment of respite workers to caregivers and
6 older adults, ensures the health and safety of the older adult,
7 provides training for caregivers, and ensures that support
8 groups are available in the community.
9     A demonstration project funded in whole or in part by an
10 Older Adult Services Demonstration Grant is exempt from the
11 requirements of the Illinois Health Facilities Planning Act. To
12 the extent applicable, however, for the purpose of maintaining
13 the statewide inventory authorized by the Illinois Health
14 Facilities Planning Act, the Department shall send to the
15 Health Facilities and Services Review Board Health Facilities
16 Planning Board a copy of each grant award made under this
17 subsection (g).
18     The Department, in collaboration with the Departments of
19 Public Health and Healthcare and Family Services, shall
20 evaluate the effectiveness of the projects receiving grants
21 under this Section.
22     (h) No later than July 1 of each year, the Department of
23 Public Health shall provide information to the Department of
24 Healthcare and Family Services to enable the Department of
25 Healthcare and Family Services to annually document and verify
26 the savings attributable to the nursing home conversion program

 

 

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1 for the previous fiscal year to estimate an annual amount of
2 such savings that may be appropriated to the Department on
3 Aging State Projects Fund and notify the General Assembly, the
4 Department on Aging, the Department of Human Services, and the
5 Advisory Committee of the savings no later than October 1 of
6 the same fiscal year.
7 (Source: P.A. 94-342, eff. 7-26-05; 95-331, eff. 8-21-07.)
 
8     (320 ILCS 42/25)
9     Sec. 25. Older adult services restructuring. No later than
10 January 1, 2005, the Department shall commence the process of
11 restructuring the older adult services delivery system.
12 Priority shall be given to both the expansion of services and
13 the development of new services in priority service areas.
14 Subject to the availability of funding, the restructuring shall
15 include, but not be limited to, the following:
16     (1) Planning. The Department shall develop a plan to
17 restructure the State's service delivery system for older
18 adults. The plan shall include a schedule for the
19 implementation of the initiatives outlined in this Act and all
20 other initiatives identified by the participating agencies to
21 fulfill the purposes of this Act. Financing for older adult
22 services shall be based on the principle that "money follows
23 the individual". The plan shall also identify potential
24 impediments to delivery system restructuring and include any
25 known regulatory or statutory barriers.

 

 

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1     (2) Comprehensive case management. The Department shall
2 implement a statewide system of holistic comprehensive case
3 management. The system shall include the identification and
4 implementation of a universal, comprehensive assessment tool
5 to be used statewide to determine the level of functional,
6 cognitive, socialization, and financial needs of older adults.
7 This tool shall be supported by an electronic intake,
8 assessment, and care planning system linked to a central
9 location. "Comprehensive case management" includes services
10 and coordination such as (i) comprehensive assessment of the
11 older adult (including the physical, functional, cognitive,
12 psycho-social, and social needs of the individual); (ii)
13 development and implementation of a service plan with the older
14 adult to mobilize the formal and family resources and services
15 identified in the assessment to meet the needs of the older
16 adult, including coordination of the resources and services
17 with any other plans that exist for various formal services,
18 such as hospital discharge plans, and with the information and
19 assistance services; (iii) coordination and monitoring of
20 formal and family service delivery, including coordination and
21 monitoring to ensure that services specified in the plan are
22 being provided; (iv) periodic reassessment and revision of the
23 status of the older adult with the older adult or, if
24 necessary, the older adult's designated representative; and
25 (v) in accordance with the wishes of the older adult, advocacy
26 on behalf of the older adult for needed services or resources.

 

 

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1     (3) Coordinated point of entry. The Department shall
2 implement and publicize a statewide coordinated point of entry
3 using a uniform name, identity, logo, and toll-free number.
4     (4) Public web site. The Department shall develop a public
5 web site that provides links to available services, resources,
6 and reference materials concerning caregiving, diseases, and
7 best practices for use by professionals, older adults, and
8 family caregivers.
9     (5) Expansion of older adult services. The Department shall
10 expand older adult services that promote independence and
11 permit older adults to remain in their own homes and
12 communities.
13     (6) Consumer-directed home and community-based services.
14 The Department shall expand the range of service options
15 available to permit older adults to exercise maximum choice and
16 control over their care.
17     (7) Comprehensive delivery system. The Department shall
18 expand opportunities for older adults to receive services in
19 systems that integrate acute and chronic care.
20     (8) Enhanced transition and follow-up services. The
21 Department shall implement a program of transition from one
22 residential setting to another and follow-up services,
23 regardless of residential setting, pursuant to rules with
24 respect to (i) resident eligibility, (ii) assessment of the
25 resident's health, cognitive, social, and financial needs,
26 (iii) development of transition plans, and (iv) the level of

 

 

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1 services that must be available before transitioning a resident
2 from one setting to another.
3     (9) Family caregiver support. The Department shall develop
4 strategies for public and private financing of services that
5 supplement and support family caregivers.
6     (10) Quality standards and quality improvement. The
7 Department shall establish a core set of uniform quality
8 standards for all providers that focus on outcomes and take
9 into consideration consumer choice and satisfaction, and the
10 Department shall require each provider to implement a
11 continuous quality improvement process to address consumer
12 issues. The continuous quality improvement process must
13 benchmark performance, be person-centered and data-driven, and
14 focus on consumer satisfaction.
15     (11) Workforce. The Department shall develop strategies to
16 attract and retain a qualified and stable worker pool, provide
17 living wages and benefits, and create a work environment that
18 is conducive to long-term employment and career development.
19 Resources such as grants, education, and promotion of career
20 opportunities may be used.
21     (12) Coordination of services. The Department shall
22 identify methods to better coordinate service networks to
23 maximize resources and minimize duplication of services and
24 ease of application.
25     (13) Barriers to services. The Department shall identify
26 barriers to the provision, availability, and accessibility of

 

 

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1 services and shall implement a plan to address those barriers.
2 The plan shall: (i) identify barriers, including but not
3 limited to, statutory and regulatory complexity, reimbursement
4 issues, payment issues, and labor force issues; (ii) recommend
5 changes to State or federal laws or administrative rules or
6 regulations; (iii) recommend application for federal waivers
7 to improve efficiency and reduce cost and paperwork; (iv)
8 develop innovative service delivery models; and (v) recommend
9 application for federal or private service grants.
10     (14) Reimbursement and funding. The Department shall
11 investigate and evaluate costs and payments by defining costs
12 to implement a uniform, audited provider cost reporting system
13 to be considered by all Departments in establishing payments.
14 To the extent possible, multiple cost reporting mandates shall
15 not be imposed.
16     (15) Medicaid nursing home cost containment and Medicare
17 utilization. The Department of Healthcare and Family Services
18 (formerly Department of Public Aid), in collaboration with the
19 Department on Aging and the Department of Public Health and in
20 consultation with the Advisory Committee, shall propose a plan
21 to contain Medicaid nursing home costs and maximize Medicare
22 utilization. The plan must not impair the ability of an older
23 adult to choose among available services. The plan shall
24 include, but not be limited to, (i) techniques to maximize the
25 use of the most cost-effective services without sacrificing
26 quality and (ii) methods to identify and serve older adults in

 

 

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1 need of minimal services to remain independent, but who are
2 likely to develop a need for more extensive services in the
3 absence of those minimal services.
4     (16) Bed reduction. The Department of Public Health shall
5 implement a nursing home conversion program to reduce the
6 number of Medicaid-certified nursing home beds in areas with
7 excess beds. The Department of Healthcare and Family Services
8 shall investigate changes to the Medicaid nursing facility
9 reimbursement system in order to reduce beds. Such changes may
10 include, but are not limited to, incentive payments that will
11 enable facilities to adjust to the restructuring and expansion
12 of services required by the Older Adult Services Act, including
13 adjustments for the voluntary closure or layaway of nursing
14 home beds certified under Title XIX of the federal Social
15 Security Act. Any savings shall be reallocated to fund
16 home-based or community-based older adult services pursuant to
17 Section 20.
18     (17) Financing. The Department shall investigate and
19 evaluate financing options for older adult services and shall
20 make recommendations in the report required by Section 15
21 concerning the feasibility of these financing arrangements.
22 These arrangements shall include, but are not limited to:
23         (A) private long-term care insurance coverage for
24     older adult services;
25         (B) enhancement of federal long-term care financing
26     initiatives;

 

 

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1         (C) employer benefit programs such as medical savings
2     accounts for long-term care;
3         (D) individual and family cost-sharing options;
4         (E) strategies to reduce reliance on government
5     programs;
6         (F) fraudulent asset divestiture and financial
7     planning prevention; and
8         (G) methods to supplement and support family and
9     community caregiving.
10     (18) Older Adult Services Demonstration Grants. The
11 Department shall implement a program of demonstration grants
12 that will assist in the restructuring of the older adult
13 services delivery system, and shall provide funding for
14 innovative service delivery models and system change and
15 integration initiatives pursuant to subsection (g) of Section
16 20.
17     (19) Bed need methodology update. For the purposes of
18 determining areas with excess beds, the Departments shall
19 provide information and assistance to the Health Facilities and
20 Services Review Board Health Facilities Planning Board to
21 update the Bed Need Methodology for Long-Term Care to update
22 the assumptions used to establish the methodology to make them
23 consistent with modern older adult services.
24     (20) Affordable housing. The Departments shall utilize the
25 recommendations of Illinois' Annual Comprehensive Housing
26 Plan, as developed by the Affordable Housing Task Force through

 

 

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1 the Governor's Executive Order 2003-18, in their efforts to
2 address the affordable housing needs of older adults.
3     The Older Adult Services Advisory Committee shall
4 investigate innovative and promising practices operating as
5 demonstration or pilot projects in Illinois and in other
6 states. The Department on Aging shall provide the Older Adult
7 Services Advisory Committee with a list of all demonstration or
8 pilot projects funded by the Department on Aging, including
9 those specified by rule, law, policy memorandum, or funding
10 arrangement. The Committee shall work with the Department on
11 Aging to evaluate the viability of expanding these programs
12 into other areas of the State.
13 (Source: P.A. 93-1031, eff. 8-27-04; 94-236, eff. 7-14-05;
14 94-766, eff. 1-1-07.)
 
15     (320 ILCS 42/30)
16     Sec. 30. Nursing home conversion program.
17     (a) The Department of Public Health, in collaboration with
18 the Department on Aging and the Department of Healthcare and
19 Family Services, shall establish a nursing home conversion
20 program. Start-up grants, pursuant to subsections (l) and (m)
21 of this Section, shall be made available to nursing homes as
22 appropriations permit as an incentive to reduce certified beds,
23 retrofit, and retool operations to meet new service delivery
24 expectations and demands.
25     (b) Grant moneys shall be made available for capital and

 

 

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1 other costs related to: (1) the conversion of all or a part of
2 a nursing home to an assisted living establishment or a special
3 program or unit for persons with Alzheimer's disease or related
4 disorders licensed under the Assisted Living and Shared Housing
5 Act or a supportive living facility established under Section
6 5-5.01a of the Illinois Public Aid Code; (2) the conversion of
7 multi-resident bedrooms in the facility into single-occupancy
8 rooms; and (3) the development of any of the services
9 identified in a priority service plan that can be provided by a
10 nursing home within the confines of a nursing home or
11 transportation services. Grantees shall be required to provide
12 a minimum of a 20% match toward the total cost of the project.
13     (c) Nothing in this Act shall prohibit the co-location of
14 services or the development of multifunctional centers under
15 subsection (f) of Section 20, including a nursing home offering
16 community-based services or a community provider establishing
17 a residential facility.
18     (d) A certified nursing home with at least 50% of its
19 resident population having their care paid for by the Medicaid
20 program is eligible to apply for a grant under this Section.
21     (e) Any nursing home receiving a grant under this Section
22 shall reduce the number of certified nursing home beds by a
23 number equal to or greater than the number of beds being
24 converted for one or more of the permitted uses under item (1)
25 or (2) of subsection (b). The nursing home shall retain the
26 Certificate of Need for its nursing and sheltered care beds

 

 

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1 that were converted for 15 years. If the beds are reinstated by
2 the provider or its successor in interest, the provider shall
3 pay to the fund from which the grant was awarded, on an
4 amortized basis, the amount of the grant. The Department shall
5 establish, by rule, the bed reduction methodology for nursing
6 homes that receive a grant pursuant to item (3) of subsection
7 (b).
8     (f) Any nursing home receiving a grant under this Section
9 shall agree that, for a minimum of 10 years after the date that
10 the grant is awarded, a minimum of 50% of the nursing home's
11 resident population shall have their care paid for by the
12 Medicaid program. If the nursing home provider or its successor
13 in interest ceases to comply with the requirement set forth in
14 this subsection, the provider shall pay to the fund from which
15 the grant was awarded, on an amortized basis, the amount of the
16 grant.
17     (g) Before awarding grants, the Department of Public Health
18 shall seek recommendations from the Department on Aging and the
19 Department of Healthcare and Family Services. The Department of
20 Public Health shall attempt to balance the distribution of
21 grants among geographic regions, and among small and large
22 nursing homes. The Department of Public Health shall develop,
23 by rule, the criteria for the award of grants based upon the
24 following factors:
25         (1) the unique needs of older adults (including those
26     with moderate and low incomes), caregivers, and providers

 

 

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1     in the geographic area of the State the grantee seeks to
2     serve;
3         (2) whether the grantee proposes to provide services in
4     a priority service area;
5         (3) the extent to which the conversion or transition
6     will result in the reduction of certified nursing home beds
7     in an area with excess beds;
8         (4) the compliance history of the nursing home; and
9         (5) any other relevant factors identified by the
10     Department, including standards of need.
11     (h) A conversion funded in whole or in part by a grant
12 under this Section must not:
13         (1) diminish or reduce the quality of services
14     available to nursing home residents;
15         (2) force any nursing home resident to involuntarily
16     accept home-based or community-based services instead of
17     nursing home services;
18         (3) diminish or reduce the supply and distribution of
19     nursing home services in any community below the level of
20     need, as defined by the Department by rule; or
21         (4) cause undue hardship on any person who requires
22     nursing home care.
23     (i) The Department shall prescribe, by rule, the grant
24 application process. At a minimum, every application must
25 include:
26         (1) the type of grant sought;

 

 

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1         (2) a description of the project;
2         (3) the objective of the project;
3         (4) the likelihood of the project meeting identified
4     needs;
5         (5) the plan for financing, administration, and
6     evaluation of the project;
7         (6) the timetable for implementation;
8         (7) the roles and capabilities of responsible
9     individuals and organizations;
10         (8) documentation of collaboration with other service
11     providers, local community government leaders, and other
12     stakeholders, other providers, and any other stakeholders
13     in the community;
14         (9) documentation of community support for the
15     project, including support by other service providers,
16     local community government leaders, and other
17     stakeholders;
18         (10) the total budget for the project;
19         (11) the financial condition of the applicant; and
20         (12) any other application requirements that may be
21     established by the Department by rule.
22     (j) A conversion project funded in whole or in part by a
23 grant under this Section is exempt from the requirements of the
24 Illinois Health Facilities Planning Act. The Department of
25 Public Health, however, shall send to the Health Facilities and
26 Services Review Board Health Facilities Planning Board a copy

 

 

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1 of each grant award made under this Section.
2     (k) Applications for grants are public information, except
3 that nursing home financial condition and any proprietary data
4 shall be classified as nonpublic data.
5     (l) The Department of Public Health may award grants from
6 the Long Term Care Civil Money Penalties Fund established under
7 Section 1919(h)(2)(A)(ii) of the Social Security Act and 42 CFR
8 488.422(g) if the award meets federal requirements.
9 (Source: P.A. 95-331, eff. 8-21-07.)

 

 

SB2348 - 83 - LRB096 10950 JDS 21206 b

1 INDEX
2 Statutes amended in order of appearance
3     5 ILCS 120/1.02 from Ch. 102, par. 41.02
4     5 ILCS 430/5-50
5     20 ILCS 3960/3 from Ch. 111 1/2, par. 1153
6     20 ILCS 3960/4 from Ch. 111 1/2, par. 1154
7     20 ILCS 3960/8.5
8     20 ILCS 3960/15.5
9     20 ILCS 3960/19.6
10     20 ILCS 4050/15
11     30 ILCS 5/3-1 from Ch. 15, par. 303-1
12     210 ILCS 3/20
13     210 ILCS 3/30
14     210 ILCS 3/36.5
15     210 ILCS 9/145
16     210 ILCS 50/32.5
17     225 ILCS 47/5
18     225 ILCS 47/15
19     225 ILCS 47/30
20     305 ILCS 5/5-5.02 from Ch. 23, par. 5-5.02
21     320 ILCS 42/20
22     320 ILCS 42/25
23     320 ILCS 42/30