093_SB0359enr

 
SB359 Enrolled                       LRB093 05213 AMC 05273 b

 1        AN ACT concerning health facilities.

 2        Be  it  enacted  by  the People of the State of Illinois,
 3    represented in the General Assembly:

 4        Section 5.  The Alternative Health Care Delivery  Act  is
 5    amended by changing Section 35 as follows:

 6        (210 ILCS 3/35)
 7        Sec.  35.   Alternative  health  care  models authorized.
 8    Notwithstanding any other law to  the  contrary,  alternative
 9    health   care   models  described  in  this  Section  may  be
10    established on a demonstration basis.
11             (1)  Alternative health care  model;  subacute  care
12        hospital.   A subacute care hospital is a designated site
13        which provides medical specialty care  for  patients  who
14        need  a  greater  intensity  or  complexity  of care than
15        generally provided in a skilled nursing facility but  who
16        no longer require acute hospital care. The average length
17        of  stay  for patients treated in subacute care hospitals
18        shall not be  less  than  20  days,  and  for  individual
19        patients,  the  expected  length  of  stay at the time of
20        admission shall not be less  than  10  days.   Variations
21        from  minimum  lengths  of  stay shall be reported to the
22        Department.  There shall be no more than 13 subacute care
23        hospitals  authorized  to  operate  by  the   Department.
24        Subacute  care includes physician supervision, registered
25        nursing, and  physiological  monitoring  on  a  continual
26        basis.  A subacute care hospital is either a freestanding
27        building or a distinct physical  and  operational  entity
28        within  a  hospital or nursing home building.  A subacute
29        care  hospital  shall  only  consist  of  beds  currently
30        existing  in  licensed  hospitals  or   skilled   nursing
31        facilities,   except,  in  the  City  of  Chicago,  on  a
 
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 1        designated site that was licensed as a hospital under the
 2        Illinois Hospital  Licensing  Act  within  the  10  years
 3        immediately  before  the  application  for an alternative
 4        health care model license. During the period of operation
 5        of the demonstration project, the existing licensed  beds
 6        shall  remain  licensed  as  hospital  or skilled nursing
 7        facility beds as well as being licensed under  this  Act.
 8        In  order  to handle cases of complications, emergencies,
 9        or exigent circumstances, a subacute care hospital  shall
10        maintain a contractual relationship, including a transfer
11        agreement,  with  a  general  acute  care hospital.  If a
12        subacute care model is located in a  general  acute  care
13        hospital,  it  shall  utilize all or a portion of the bed
14        capacity of that existing hospital.  In no event shall  a
15        subacute  care  hospital  use  the word "hospital" in its
16        advertising or marketing activities or represent or  hold
17        itself  out  to  the  public  as  a  general  acute  care
18        hospital.
19             (2)  Alternative   health   care   delivery   model;
20        postsurgical   recovery   care  center.   A  postsurgical
21        recovery care center is a designated site which  provides
22        postsurgical recovery care for generally healthy patients
23        undergoing  surgical  procedures  that  require overnight
24        nursing care, pain control,  or  observation  that  would
25        otherwise   be  provided  in  an  inpatient  setting.   A
26        postsurgical recovery care center is either  freestanding
27        or  a  defined  unit  of an ambulatory surgical treatment
28        center  or  hospital.  No  facility,  or  portion  of   a
29        facility, may participate in a demonstration program as a
30        postsurgical recovery care center unless the facility has
31        been  licensed as an ambulatory surgical treatment center
32        or hospital for at least 2 years before August  20,  1993
33        (the  effective  date of Public Act 88-441).  The maximum
34        length of stay for patients in  a  postsurgical  recovery
 
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 1        care center is not to exceed 48 hours unless the treating
 2        physician requests an extension of time from the recovery
 3        center's  medical  director  on  the  basis of medical or
 4        clinical documentation that an additional care period  is
 5        required  for  the  recovery of a patient and the medical
 6        director approves the extension of  time.   In  no  case,
 7        however,   shall   a   patient's  length  of  stay  in  a
 8        postsurgical recovery  care  center  be  longer  than  72
 9        hours.  If  a  patient requires an additional care period
10        after the expiration of the 72-hour  limit,  the  patient
11        shall be transferred to an appropriate facility.  Reports
12        on  variances from the 48-hour limit shall be sent to the
13        Department for its evaluation.  The reports shall, before
14        submission to the Department, have removed from them  all
15        patient  and  physician  identifiers.  In order to handle
16        cases   of   complications,   emergencies,   or   exigent
17        circumstances, every postsurgical recovery care center as
18        defined in this paragraph shall  maintain  a  contractual
19        relationship,  including  a  transfer  agreement,  with a
20        general acute care  hospital.   A  postsurgical  recovery
21        care   center   shall  be  no  larger  than  20  beds.  A
22        postsurgical recovery care center shall be located within
23        15 minutes  travel  time  from  the  general  acute  care
24        hospital  with  which  the center maintains a contractual
25        relationship, including a transfer agreement, as required
26        under this paragraph.
27             No   postsurgical   recovery   care   center   shall
28        discriminate  against  any  patient  requiring  treatment
29        because of the source of payment for services,  including
30        Medicare and Medicaid recipients.
31             The  Department  shall  adopt rules to implement the
32        provisions of Public Act 88-441  concerning  postsurgical
33        recovery  care  centers  within 9 months after August 20,
34        1993.
 
SB359 Enrolled              -4-      LRB093 05213 AMC 05273 b
 1             (3)  Alternative   health   care   delivery   model;
 2        children's  community-based  health   care   center.    A
 3        children's  community-based health care center model is a
 4        designated site  that  provides  nursing  care,  clinical
 5        support services, and therapies for a period of one to 14
 6        days  for  short-term  stays  and  120 days to facilitate
 7        transitions to home or  other  appropriate  settings  for
 8        medically    fragile   children,   technology   dependent
 9        children, and children with special health care needs who
10        are deemed clinically  stable  by  a  physician  and  are
11        younger  than  22  years  of  age.   This  care  is to be
12        provided in a home-like environment that serves  no  more
13        than  12  children at a time.  Children's community-based
14        health care center services must be available through the
15        model to all families, including those whose care is paid
16        for through the Department of Public Aid, the  Department
17        of  Children and Family Services, the Department of Human
18        Services, and insurance companies who cover  home  health
19        care services or private duty nursing care in the home.
20             Each  children's  community-based health care center
21        model location shall be  physically  separate  and  apart
22        from  any  other  facility  licensed by the Department of
23        Public Health under this  or  any  other  Act  and  shall
24        provide  the following services: respite care, registered
25        nursing or licensed practical nursing care,  transitional
26        care  to  facilitate  home placement or other appropriate
27        settings and reunite families, medical day care,  weekend
28        camps,  and diagnostic studies typically done in the home
29        setting.  Alternative   health   care   delivery   model;
30        children's  respite  care  center.   A children's respite
31        care center model is  a  designated  site  that  provides
32        respite  for  medically frail, technologically dependent,
33        clinically stable children, up to age 18, for a period of
34        one to 14 days.   This  care  is  to  be  provided  in  a
 
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 1        home-like   environment  that  serves  no  more  than  10
 2        children  at  a  time.  Children's  respite  care  center
 3        services must be available  through  the   model  to  all
 4        families,  including those whose care is paid for through
 5        the Illinois Department of Public  Aid  or  the  Illinois
 6        Department of Children and Family Services.  Each respite
 7        care  model  location  shall  be  a  facility  physically
 8        separate  and  apart  from any other facility licensed by
 9        the Department of Public Health under this or  any  other
10        Act  and  shall  provide,  at  a  minimum,  the following
11        services: out-of-home  respite  care;  hospital  to  home
12        training   for   families   and  caregivers;  short  term
13        transitional care to facilitate  placement  and  training
14        for  foster  care  parents;  parent  and  family  support
15        groups.
16             Coverage  for  the services provided by the Illinois
17        Department of Public Aid  under  this  paragraph  (3)  is
18        contingent  upon  federal waiver approval and is provided
19        only to Medicaid eligible clients  participating  in  the
20        home  and  community  based services waiver designated in
21        Section 1915(c) of the Social Security Act for  medically
22        frail  and technologically dependent children or children
23        in Department of Children and Family Services foster care
24        who receive home health benefits.
25             (4)  Alternative   health   care   delivery   model;
26        community based residential  rehabilitation  center.    A
27        community-based  residential  rehabilitation center model
28        is a designated  site  that  provides  rehabilitation  or
29        support, or both, for persons who have experienced severe
30        brain injury, who are medically stable, and who no longer
31        require  acute  rehabilitative care or intense medical or
32        nursing services.   The  average  length  of  stay  in  a
33        community-based  residential  rehabilitation center shall
34        not exceed 4 months.  As an integral part of the services
 
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 1        provided, individuals are housed in a  supervised  living
 2        setting  while  having immediate access to the community.
 3        The residential rehabilitation center authorized  by  the
 4        Department  may  have  more  than  one residence included
 5        under the license.  A residence may be no larger than  12
 6        beds  and  shall  be  located  as an integral part of the
 7        community.  Day treatment  or  individualized  outpatient
 8        services  shall  be  provided  for  persons who reside in
 9        their  own  home.   Functional  outcome  goals  shall  be
10        established for each individual.  Services shall include,
11        but are not limited to,  case  management,  training  and
12        assistance  with  activities  of  daily  living,  nursing
13        consultation,     traditional     therapies    (physical,
14        occupational, speech), functional  interventions  in  the
15        residence   and   community   (job  placement,  shopping,
16        banking,   recreation),    counseling,    self-management
17        strategies,    productive    activities,   and   multiple
18        opportunities  for   skill   acquisition   and   practice
19        throughout the day.  The design of individualized program
20        plans shall be consistent with the outcome goals that are
21        established  for each resident.  The programs provided in
22        this setting shall be accredited  by  the  Commission  on
23        Accreditation  of  Rehabilitation Facilities (CARF).  The
24        program shall have been accredited by  CARF  as  a  Brain
25        Injury  Community-Integrative  Program  for  at  least  3
26        years.
27             (5)  Alternative   health   care   delivery   model;
28        Alzheimer's  disease  management  center.  An Alzheimer's
29        disease management center model is a designated site that
30        provides a safe and secure setting for  care  of  persons
31        diagnosed   with  Alzheimer's  disease.   An  Alzheimer's
32        disease management  center  model  shall  be  a  facility
33        separate   from   any  other  facility  licensed  by  the
34        Department of Public Health under this or any other  Act.
 
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 1        An  Alzheimer's  disease  management center shall conduct
 2        and document an  assessment  of  each  resident  every  6
 3        months.   The  assessment  shall include an evaluation of
 4        daily  functioning,  cognitive  status,   other   medical
 5        conditions,  and  behavioral  problems.   An  Alzheimer's
 6        disease  management center shall develop and implement an
 7        ongoing treatment plan for each resident.  The  treatment
 8        plan  shall  have  defined goals. The Alzheimer's disease
 9        management center shall  treat  behavioral  problems  and
10        mood  disorders using nonpharmacologic approaches such as
11        environmental  modification,  task  simplification,   and
12        other   appropriate   activities.  All  staff  must  have
13        necessary training to care for all stages of  Alzheimer's
14        Disease.   An Alzheimer's disease management center shall
15        provide  education  and   support   for   residents   and
16        caregivers.   The  education  and  support  shall include
17        referrals  to  support  organizations   for   educational
18        materials  on  community resources, support groups, legal
19        and financial issues, respite care, and future care needs
20        and  options.   The  education  and  support  shall  also
21        include a discussion  of  the  resident's  need  to  make
22        advance directives and to identify surrogates for medical
23        and   legal  decision-making.   The  provisions  of  this
24        paragraph establish the minimum level  of  services  that
25        must  be  provided  by  an Alzheimer's disease management
26        center.  An Alzheimer's disease management  center  model
27        shall  have  no more than 100 residents.  Nothing in this
28        paragraph (5) shall be construed as prohibiting a  person
29        or  facility  from providing services and care to persons
30        with Alzheimer's disease as  otherwise  authorized  under
31        State law.
32    (Source:  P.A.  91-65,  eff.  7-9-99;  91-357,  eff. 7-29-99;
33    91-838, eff. 6-16-00.)