Rep. Al Riley

Filed: 3/2/2012

 

 


 

 


 
09700HB4563ham001LRB097 17230 PJG 67052 a

1
AMENDMENT TO HOUSE BILL 4563

2    AMENDMENT NO. ______. Amend House Bill 4563 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Health Facilities Planning Act is
5amended by changing Sections 3, 13, and 14.1 as follows:
 
6    (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
7    (Section scheduled to be repealed on December 31, 2019)
8    Sec. 3. Definitions. As used in this Act:
9    "Health care facilities" means and includes the following
10facilities and organizations:
11        1. An ambulatory surgical treatment center required to
12    be licensed pursuant to the Ambulatory Surgical Treatment
13    Center Act;
14        2. An institution, place, building, or agency required
15    to be licensed pursuant to the Hospital Licensing Act;
16        3. Skilled and intermediate long term care facilities

 

 

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1    licensed under the Nursing Home Care Act;
2        3.5. Skilled and intermediate care facilities licensed
3    under the ID/DD Community Care Act;
4        3.7. Facilities licensed under the Specialized Mental
5    Health Rehabilitation Act;
6        4. Hospitals, nursing homes, ambulatory surgical
7    treatment centers, or kidney disease treatment centers
8    maintained by the State or any department or agency
9    thereof;
10        5. Kidney disease treatment centers, including a
11    free-standing hemodialysis unit required to be licensed
12    under the End Stage Renal Disease Facility Act;
13        6. An institution, place, building, or room used for
14    the performance of outpatient surgical procedures that is
15    leased, owned, or operated by or on behalf of an
16    out-of-state facility;
17        7. An institution, place, building, or room used for
18    provision of a health care category of service as defined
19    by the Board, including, but not limited to, cardiac
20    catheterization and open heart surgery; and
21        8. An institution, place, building, or room used for
22    provision of major medical equipment used in the direct
23    clinical diagnosis or treatment of patients, and whose
24    project cost is in excess of the capital expenditure
25    minimum.
26    This Act shall not apply to the construction of any new

 

 

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1facility or the renovation of any existing facility located on
2any campus facility as defined in Section 5-5.8b of the
3Illinois Public Aid Code, provided that the campus facility
4encompasses 30 or more contiguous acres and that the new or
5renovated facility is intended for use by a licensed
6residential facility.
7    No federally owned facility shall be subject to the
8provisions of this Act, nor facilities used solely for healing
9by prayer or spiritual means.
10    No facility licensed under the Supportive Residences
11Licensing Act or the Assisted Living and Shared Housing Act
12shall be subject to the provisions of this Act.
13    No facility established and operating under the
14Alternative Health Care Delivery Act as a children's respite
15care center alternative health care model demonstration
16program or as an Alzheimer's Disease Management Center
17alternative health care model demonstration program shall be
18subject to the provisions of this Act.
19    A facility designated as a supportive living facility that
20is in good standing with the program established under Section
215-5.01a of the Illinois Public Aid Code shall not be subject to
22the provisions of this Act.
23    This Act does not apply to facilities granted waivers under
24Section 3-102.2 of the Nursing Home Care Act. However, if a
25demonstration project under that Act applies for a certificate
26of need to convert to a nursing facility, it shall meet the

 

 

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

 

 

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1operated by a county or Illinois Veterans Homes. Changes of
2ownership of facilities licensed under the Nursing Home Care
3Act must meet the requirements set forth in Sections 3-101
4through 3-119 of the Nursing Home Care Act.
5    With the exception of those health care facilities
6specifically included in this Section, nothing in this Act
7shall be intended to include facilities operated as a part of
8the practice of a physician or other licensed health care
9professional, whether practicing in his individual capacity or
10within the legal structure of any partnership, medical or
11professional corporation, or unincorporated medical or
12professional group. Further, this Act shall not apply to
13physicians or other licensed health care professional's
14practices where such practices are carried out in a portion of
15a health care facility under contract with such health care
16facility by a physician or by other licensed health care
17professionals, whether practicing in his individual capacity
18or within the legal structure of any partnership, medical or
19professional corporation, or unincorporated medical or
20professional groups. This Act shall apply to construction or
21modification and to establishment by such health care facility
22of such contracted portion which is subject to facility
23licensing requirements, irrespective of the party responsible
24for such action or attendant financial obligation.
25    No permit or exemption is required for a facility licensed
26under the ID/DD Community Care Act prior to the reduction of

 

 

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1the number of beds at a facility. If there is a total reduction
2of beds at a facility licensed under the ID/DD Community Care
3Act, this is a discontinuation or closure of the facility.
4However, if a facility licensed under the ID/DD Community Care
5Act reduces the number of beds or discontinues the facility,
6that facility must notify the Board as provided in Section 14.1
7of this Act.
8    "Person" means any one or more natural persons, legal
9entities, governmental bodies other than federal, or any
10combination thereof.
11    "Consumer" means any person other than a person (a) whose
12major occupation currently involves or whose official capacity
13within the last 12 months has involved the providing,
14administering or financing of any type of health care facility,
15(b) who is engaged in health research or the teaching of
16health, (c) who has a material financial interest in any
17activity which involves the providing, administering or
18financing of any type of health care facility, or (d) who is or
19ever has been a member of the immediate family of the person
20defined by (a), (b), or (c).
21    "State Board" or "Board" means the Health Facilities and
22Services Review Board.
23    "Construction or modification" means the establishment,
24erection, building, alteration, reconstruction, modernization,
25improvement, extension, discontinuation, change of ownership,
26of or by a health care facility, or the purchase or acquisition

 

 

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1by or through a health care facility of equipment or service
2for diagnostic or therapeutic purposes or for facility
3administration or operation, or any capital expenditure made by
4or on behalf of a health care facility which exceeds the
5capital expenditure minimum; however, any capital expenditure
6made by or on behalf of a health care facility for (i) the
7construction or modification of a facility licensed under the
8Assisted Living and Shared Housing Act or (ii) a conversion
9project undertaken in accordance with Section 30 of the Older
10Adult Services Act shall be excluded from any obligations under
11this Act.
12    "Establish" means the construction of a health care
13facility or the replacement of an existing facility on another
14site or the initiation of a category of service as defined by
15the Board.
16    "Major medical equipment" means medical equipment which is
17used for the provision of medical and other health services and
18which costs in excess of the capital expenditure minimum,
19except that such term does not include medical equipment
20acquired by or on behalf of a clinical laboratory to provide
21clinical laboratory services if the clinical laboratory is
22independent of a physician's office and a hospital and it has
23been determined under Title XVIII of the Social Security Act to
24meet the requirements of paragraphs (10) and (11) of Section
251861(s) of such Act. In determining whether medical equipment
26has a value in excess of the capital expenditure minimum, the

 

 

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1value of studies, surveys, designs, plans, working drawings,
2specifications, and other activities essential to the
3acquisition of such equipment shall be included.
4    "Capital Expenditure" means an expenditure: (A) made by or
5on behalf of a health care facility (as such a facility is
6defined in this Act); and (B) which under generally accepted
7accounting principles is not properly chargeable as an expense
8of operation and maintenance, or is made to obtain by lease or
9comparable arrangement any facility or part thereof or any
10equipment for a facility or part; and which exceeds the capital
11expenditure minimum.
12    For the purpose of this paragraph, the cost of any studies,
13surveys, designs, plans, working drawings, specifications, and
14other activities essential to the acquisition, improvement,
15expansion, or replacement of any plant or equipment with
16respect to which an expenditure is made shall be included in
17determining if such expenditure exceeds the capital
18expenditures minimum. Unless otherwise interdependent, or
19submitted as one project by the applicant, components of
20construction or modification undertaken by means of a single
21construction contract or financed through the issuance of a
22single debt instrument shall not be grouped together as one
23project. Donations of equipment or facilities to a health care
24facility which if acquired directly by such facility would be
25subject to review under this Act shall be considered capital
26expenditures, and a transfer of equipment or facilities for

 

 

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1less than fair market value shall be considered a capital
2expenditure for purposes of this Act if a transfer of the
3equipment or facilities at fair market value would be subject
4to review.
5    "Capital expenditure minimum" means $11,500,000 for
6projects by hospital applicants, $6,500,000 for applicants for
7projects related to skilled and intermediate care long-term
8care facilities licensed under the Nursing Home Care Act, and
9$3,000,000 for projects by all other applicants, which shall be
10annually adjusted to reflect the increase in construction costs
11due to inflation, for major medical equipment and for all other
12capital expenditures.
13    "Non-clinical service area" means an area (i) for the
14benefit of the patients, visitors, staff, or employees of a
15health care facility and (ii) not directly related to the
16diagnosis, treatment, or rehabilitation of persons receiving
17services from the health care facility. "Non-clinical service
18areas" include, but are not limited to, chapels; gift shops;
19news stands; computer systems; tunnels, walkways, and
20elevators; telephone systems; projects to comply with life
21safety codes; educational facilities; student housing;
22patient, employee, staff, and visitor dining areas;
23administration and volunteer offices; modernization of
24structural components (such as roof replacement and masonry
25work); boiler repair or replacement; vehicle maintenance and
26storage facilities; parking facilities; mechanical systems for

 

 

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1heating, ventilation, and air conditioning; loading docks; and
2repair or replacement of carpeting, tile, wall coverings,
3window coverings or treatments, or furniture. Solely for the
4purpose of this definition, "non-clinical service area" does
5not include health and fitness centers.
6    "Areawide" means a major area of the State delineated on a
7geographic, demographic, and functional basis for health
8planning and for health service and having within it one or
9more local areas for health planning and health service. The
10term "region", as contrasted with the term "subregion", and the
11word "area" may be used synonymously with the term "areawide".
12    "Local" means a subarea of a delineated major area that on
13a geographic, demographic, and functional basis may be
14considered to be part of such major area. The term "subregion"
15may be used synonymously with the term "local".
16    "Physician" means a person licensed to practice in
17accordance with the Medical Practice Act of 1987, as amended.
18    "Licensed health care professional" means a person
19licensed to practice a health profession under pertinent
20licensing statutes of the State of Illinois.
21    "Director" means the Director of the Illinois Department of
22Public Health.
23    "Agency" means the Illinois Department of Public Health.
24    "Alternative health care model" means a facility or program
25authorized under the Alternative Health Care Delivery Act.
26    "Out-of-state facility" means a person that is both (i)

 

 

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1licensed as a hospital or as an ambulatory surgery center under
2the laws of another state or that qualifies as a hospital or an
3ambulatory surgery center under regulations adopted pursuant
4to the Social Security Act and (ii) not licensed under the
5Ambulatory Surgical Treatment Center Act, the Hospital
6Licensing Act, or the Nursing Home Care Act. Affiliates of
7out-of-state facilities shall be considered out-of-state
8facilities. Affiliates of Illinois licensed health care
9facilities 100% owned by an Illinois licensed health care
10facility, its parent, or Illinois physicians licensed to
11practice medicine in all its branches shall not be considered
12out-of-state facilities. Nothing in this definition shall be
13construed to include an office or any part of an office of a
14physician licensed to practice medicine in all its branches in
15Illinois that is not required to be licensed under the
16Ambulatory Surgical Treatment Center Act.
17    "Change of ownership of a health care facility" means a
18change in the person who has ownership or control of a health
19care facility's physical plant and capital assets. A change in
20ownership is indicated by the following transactions: sale,
21transfer, acquisition, lease, change of sponsorship, or other
22means of transferring control.
23    "Related person" means any person that: (i) is at least 50%
24owned, directly or indirectly, by either the health care
25facility or a person owning, directly or indirectly, at least
2650% of the health care facility; or (ii) owns, directly or

 

 

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1indirectly, at least 50% of the health care facility.
2    "Charity care" means care provided by a health care
3facility for which the provider does not expect to receive
4payment from the patient or a third-party payer.
5    "Freestanding emergency center" means a facility subject
6to licensure under Section 32.5 of the Emergency Medical
7Services (EMS) Systems Act.
8(Source: P.A. 96-31, eff. 6-30-09; 96-339, eff. 7-1-10;
996-1000, eff. 7-2-10; 97-38, eff. 6-28-11; 97-277, eff. 1-1-12;
10revised 9-7-11.)
 
11    (20 ILCS 3960/13)  (from Ch. 111 1/2, par. 1163)
12    (Section scheduled to be repealed on December 31, 2019)
13    Sec. 13. Investigation of applications for permits and
14certificates of recognition. The Agency or the State Board
15shall make or cause to be made such investigations as it or the
16State Board deems necessary in connection with an application
17for a permit or an application for a certificate of
18recognition, or in connection with a determination of whether
19or not construction or modification which has been commenced is
20in accord with the permit issued by the State Board or whether
21construction or modification has been commenced without a
22permit having been obtained. The State Board may issue
23subpoenas duces tecum requiring the production of records and
24may administer oaths to such witnesses.
25    Any circuit court of this State, upon the application of

 

 

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1the State Board or upon the application of any party to such
2proceedings, may, in its discretion, compel the attendance of
3witnesses, the production of books, papers, records, or
4memoranda and the giving of testimony before the State Board,
5by a proceeding as for contempt, or otherwise, in the same
6manner as production of evidence may be compelled before the
7court.
8    The State Board shall require all health facilities
9operating in this State to provide such reasonable reports at
10such times and containing such information as is needed by it
11to carry out the purposes and provisions of this Act. Prior to
12collecting information from health facilities, the State Board
13shall make reasonable efforts through a public process to
14consult with health facilities and associations that represent
15them to determine whether data and information requests will
16result in useful information for health planning, whether
17sufficient information is available from other sources, and
18whether data requested is routinely collected by health
19facilities and is available without retrospective record
20review. Data and information requests shall not impose undue
21paperwork burdens on health care facilities and personnel.
22Health facilities not complying with this requirement shall be
23reported to licensing, accrediting, certifying, or payment
24agencies as being in violation of State law. Health care
25facilities and other parties at interest shall have reasonable
26access, under rules established by the State Board, to all

 

 

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1planning information submitted in accord with this Act
2pertaining to their area.
3    Among the reports to be required by the State Board are
4facility questionnaires for health care facilities licensed
5under the Ambulatory Surgical Treatment Center Act, the
6Hospital Licensing Act, the Nursing Home Care Act, the ID/DD
7Community Care Act, the Specialized Mental Health
8Rehabilitation Act, or the End Stage Renal Disease Facility
9Act. These questionnaires shall be conducted on an annual basis
10and compiled by the Agency. For health care facilities licensed
11under the Nursing Home Care Act or , the Specialized Mental
12Health Rehabilitation Act, or the ID/DD Community Care Act,
13these reports shall include, but not be limited to, the
14identification of specialty services provided by the facility
15to patients, residents, and the community at large. Annual
16reports for facilities licensed under the ID/DD Community Care
17Act shall be different from the annual reports required of
18other health care facilities and shall be specific to those
19facilities licensed under the ID/DD Community Care Act. The
20Health Facilities and Services Review Board shall consult with
21associations representing facilities licensed under the ID/DD
22Community Care Act when developing the information requested in
23these annual reports. For health care facilities that contain
24long term care beds, the reports shall also include the number
25of staffed long term care beds, physical capacity for long term
26care beds at the facility, and long term care beds available

 

 

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1for immediate occupancy. For purposes of this paragraph, "long
2term care beds" means beds (i) licensed under the Nursing Home
3Care Act, (ii) licensed under the ID/DD Community Care Act,
4(iii) licensed under the Hospital Licensing Act, or (iv)
5licensed under the Specialized Mental Health Rehabilitation
6Act and certified as skilled nursing or nursing facility beds
7under Medicaid or Medicare.
8(Source: P.A. 96-339, eff. 7-1-10; 97-38, eff. 6-28-11; 97-227,
9eff. 1-1-12; revised 9-7-11.)
 
10    (20 ILCS 3960/14.1)
11    Sec. 14.1. Denial of permit; other sanctions.
12    (a) The State Board may deny an application for a permit or
13may revoke or take other action as permitted by this Act with
14regard to a permit as the State Board deems appropriate,
15including the imposition of fines as set forth in this Section,
16for any one or a combination of the following:
17        (1) The acquisition of major medical equipment without
18    a permit or in violation of the terms of a permit.
19        (2) The establishment, construction, or modification
20    of a health care facility without a permit or in violation
21    of the terms of a permit.
22        (3) The violation of any provision of this Act or any
23    rule adopted under this Act.
24        (4) The failure, by any person subject to this Act, to
25    provide information requested by the State Board or Agency

 

 

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1    within 30 days after a formal written request for the
2    information.
3        (5) The failure to pay any fine imposed under this
4    Section within 30 days of its imposition.
5    (a-5) For facilities licensed under the ID/DD Community
6Care Act, no permit shall be denied on the basis of prior
7operator history, other than for actions specified under item
8(2), (4), or (5) of Section 3-117 of the ID/DD Community Care
9Act. For facilities licensed under the Specialized Mental
10Health Rehabilitation Act, no permit shall be denied on the
11basis of prior operator history, other than for actions
12specified under item (2), (4), or (5) of Section 3-117 of the
13Specialized Mental Health Rehabilitation Act. For facilities
14licensed under the Nursing Home Care Act, no permit shall be
15denied on the basis of prior operator history, other than for:
16(i) actions specified under item (2), (3), (4), (5), or (6) of
17Section 3-117 of the Nursing Home Care Act; (ii) actions
18specified under item (a)(6) of Section 3-119 of the Nursing
19Home Care Act; or (iii) actions within the preceding 5 years
20constituting a substantial and repeated failure to comply with
21the Nursing Home Care Act or the rules and regulations adopted
22by the Department under that Act. The State Board shall not
23deny a permit on account of any action described in this
24subsection (a-5) without also considering all such actions in
25the light of all relevant information available to the State
26Board, including whether the permit is sought to substantially

 

 

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1comply with a mandatory or voluntary plan of correction
2associated with any action described in this subsection (a-5).
3    (b) Persons shall be subject to fines as follows:
4        (1) A permit holder who fails to comply with the
5    requirements of maintaining a valid permit shall be fined
6    an amount not to exceed 1% of the approved permit amount
7    plus an additional 1% of the approved permit amount for
8    each 30-day period, or fraction thereof, that the violation
9    continues.
10        (2) A permit holder who alters the scope of an approved
11    project or whose project costs exceed the allowable permit
12    amount without first obtaining approval from the State
13    Board shall be fined an amount not to exceed the sum of (i)
14    the lesser of $25,000 or 2% of the approved permit amount
15    and (ii) in those cases where the approved permit amount is
16    exceeded by more than $1,000,000, an additional $20,000 for
17    each $1,000,000, or fraction thereof, in excess of the
18    approved permit amount.
19        (3) A person who acquires major medical equipment or
20    who establishes a category of service without first
21    obtaining a permit or exemption, as the case may be, shall
22    be fined an amount not to exceed $10,000 for each such
23    acquisition or category of service established plus an
24    additional $10,000 for each 30-day period, or fraction
25    thereof, that the violation continues.
26        (4) A person who constructs, modifies, or establishes a

 

 

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1    health care facility without first obtaining a permit shall
2    be fined an amount not to exceed $25,000 plus an additional
3    $25,000 for each 30-day period, or fraction thereof, that
4    the violation continues.
5        (5) A person who discontinues a health care facility or
6    a category of service without first obtaining a permit
7    shall be fined an amount not to exceed $10,000 plus an
8    additional $10,000 for each 30-day period, or fraction
9    thereof, that the violation continues. For purposes of this
10    subparagraph (5), facilities licensed under the Nursing
11    Home Care Act or the ID/DD Community Care Act, with the
12    exceptions of facilities operated by a county or Illinois
13    Veterans Homes, are exempt from this permit requirement.
14    However, facilities licensed under the Nursing Home Care
15    Act or the ID/DD Community Care Act must comply with
16    Section 3-423 of the Nursing Home Care Act or Section 3-423
17    of the ID/DD Community Care Act and must provide the Board
18    and the Department of Human Services with 30 days' 30-days'
19    written notice of its intent to close. Facilities licensed
20    under the ID/DD Community Care Act also must provide the
21    Board and the Department of Human Services with 30 days'
22    written notice of its intent to reduce the number of beds
23    for a facility.
24        (6) A person subject to this Act who fails to provide
25    information requested by the State Board or Agency within
26    30 days of a formal written request shall be fined an

 

 

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1    amount not to exceed $1,000 plus an additional $1,000 for
2    each 30-day period, or fraction thereof, that the
3    information is not received by the State Board or Agency.
4    (c) Before imposing any fine authorized under this Section,
5the State Board shall afford the person or permit holder, as
6the case may be, an appearance before the State Board and an
7opportunity for a hearing before a hearing officer appointed by
8the State Board. The hearing shall be conducted in accordance
9with Section 10.
10    (d) All fines collected under this Act shall be transmitted
11to the State Treasurer, who shall deposit them into the
12Illinois Health Facilities Planning Fund.
13(Source: P.A. 96-339, eff. 7-1-10; 96-1372, eff. 7-29-10;
1497-38, eff. 6-28-11; 97-227, eff. 1-1-12; revised 9-7-11.)
 
15    Section 99. Effective date. This Act takes effect upon
16becoming law.".