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92_SB1310
LRB9208129JSpc
1 AN ACT relating to public health.
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 Sections 30 and 35 as follows:
6 (210 ILCS 3/30)
7 Sec. 30. Demonstration program requirements. The
8 requirements set forth in this Section shall apply to
9 demonstration programs.
10 (a) There shall be no more than:
11 (i) 3 subacute care hospital alternative health
12 care models in the City of Chicago (one of which shall be
13 located on a designated site and shall have been licensed
14 as a hospital under the Illinois Hospital Licensing Act
15 within the 10 years immediately before the application
16 for a license);
17 (ii) 2 subacute care hospital alternative health
18 care models in the demonstration program for each of the
19 following areas:
20 (1) Cook County outside the City of Chicago.
21 (2) DuPage, Kane, Lake, McHenry, and Will
22 Counties.
23 (3) Municipalities with a population greater
24 than 50,000 not located in the areas described in
25 item (i) of subsection (a) and paragraphs (1) and
26 (2) of item (ii) of subsection (a); and
27 (iii) 4 subacute care hospital alternative health
28 care models in the demonstration program for rural areas.
29 In selecting among applicants for these licenses in rural
30 areas, the Health Facilities Planning Board and the
31 Department shall give preference to hospitals that may be
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1 unable for economic reasons to provide continued service to
2 the community in which they are located unless the hospital
3 were to receive an alternative health care model license.
4 (a-5) There shall be no more than a total of 12
5 postsurgical recovery care center alternative health care
6 models in the demonstration program, located as follows:
7 (1) Two in the City of Chicago.
8 (2) Two in Cook County outside the City of Chicago.
9 At least one of these shall be owned or operated by a
10 hospital devoted exclusively to caring for children.
11 (3) Two in Kane, Lake, and McHenry Counties.
12 (4) Four in municipalities with a population of
13 50,000 or more not located in the areas described in
14 paragraphs (1), (2), and (3), 3 of which shall be owned
15 or operated by hospitals, at least 2 of which shall be
16 located in counties with a population of less than
17 175,000, according to the most recent decennial census
18 for which data are available, and one of which shall be
19 owned or operated by an ambulatory surgical treatment
20 center.
21 (5) Two in rural areas, both of which shall be
22 owned or operated by hospitals.
23 There shall be no postsurgical recovery care center
24 alternative health care models located in counties with
25 populations greater than 600,000 but less than 1,000,000. A
26 proposed postsurgical recovery care center must be owned or
27 operated by a hospital if it is to be located within, or will
28 primarily serve the residents of, a health service area in
29 which more than 60% of the gross patient revenue of the
30 hospitals within that health service area are derived from
31 Medicaid and Medicare, according to the most recently
32 available calendar year data from the Illinois Health Care
33 Cost Containment Council. Nothing in this paragraph shall
34 preclude a hospital and an ambulatory surgical treatment
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1 center from forming a joint venture or developing a
2 collaborative agreement to own or operate a postsurgical
3 recovery care center.
4 (a-10) There shall be no more than a total of 8
5 children's respite care center alternative health care models
6 in the demonstration program, which shall be located as
7 follows:
8 (1) One in the City of Chicago.
9 (2) One in Cook County outside the City of Chicago.
10 (3) A total of 2 in the area comprised of DuPage,
11 Kane, Lake, McHenry, and Will counties.
12 (4) A total of 2 in municipalities with a
13 population of 50,000 or more and not located in the
14 areas described in paragraphs (1), (2), or (3).
15 (5) A total of 2 in rural areas, as defined by the
16 Health Facilities Planning Board.
17 No more than one children's respite care model owned and
18 operated by a licensed skilled pediatric facility shall be
19 located in each of the areas designated in this subsection
20 (a-10).
21 (a-15) There shall be an authorized community-based
22 residential rehabilitation center alternative health care
23 model in the demonstration program. The community-based
24 residential rehabilitation center shall be located in the
25 area of Illinois south of Interstate Highway 70.
26 (a-20) There shall be an authorized Alzheimer's disease
27 management center alternative health care model in the
28 demonstration program. The Alzheimer's disease management
29 center shall be located in Will County, owned by a
30 not-for-profit entity, and endorsed by a resolution approved
31 by the county board before the effective date of this
32 amendatory Act of the 91st General Assembly.
33 (a-25) There shall be no more than 2 committed persons
34 skilled nursing facility alternative health care models in
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1 the demonstration program, which shall be located as follows:
2 (1) One in Cook County.
3 (2) One located outside Cook, DuPage, Kane, Lake,
4 McHenry, and Will Counties.
5 (b) Alternative health care models, other than a model
6 authorized under subsection (a-20), shall obtain a
7 certificate of need from the Illinois Health Facilities
8 Planning Board under the Illinois Health Facilities Planning
9 Act before receiving a license by the Department. If, after
10 obtaining its initial certificate of need, an alternative
11 health care delivery model that is a community based
12 residential rehabilitation center seeks to increase the bed
13 capacity of that center, it must obtain a certificate of need
14 from the Illinois Health Facilities Planning Board before
15 increasing the bed capacity. Alternative health care models
16 in medically underserved areas shall receive priority in
17 obtaining a certificate of need.
18 (c) An alternative health care model license shall be
19 issued for a period of one year and shall be annually renewed
20 if the facility or program is in substantial compliance with
21 the Department's rules adopted under this Act. A licensed
22 alternative health care model that continues to be in
23 substantial compliance after the conclusion of the
24 demonstration program shall be eligible for annual renewals
25 unless and until a different licensure program for that type
26 of health care model is established by legislation. The
27 Department may issue a provisional license to any alternative
28 health care model that does not substantially comply with the
29 provisions of this Act and the rules adopted under this Act
30 if (i) the Department finds that the alternative health care
31 model has undertaken changes and corrections which upon
32 completion will render the alternative health care model in
33 substantial compliance with this Act and rules and (ii) the
34 health and safety of the patients of the alternative health
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1 care model will be protected during the period for which the
2 provisional license is issued. The Department shall advise
3 the licensee of the conditions under which the provisional
4 license is issued, including the manner in which the
5 alternative health care model fails to comply with the
6 provisions of this Act and rules, and the time within which
7 the changes and corrections necessary for the alternative
8 health care model to substantially comply with this Act and
9 rules shall be completed.
10 (d) Alternative health care models shall seek
11 certification under Titles XVIII and XIX of the federal
12 Social Security Act. In addition, alternative health care
13 models shall provide charitable care consistent with that
14 provided by comparable health care providers in the
15 geographic area.
16 (d-5) The Illinois Department of Public Aid, in
17 cooperation with the Illinois Department of Public Health,
18 shall develop and implement a reimbursement methodology for
19 all facilities participating in the demonstration program.
20 The Illinois Department of Public Aid shall keep a record of
21 services provided under the demonstration program to
22 recipients of medical assistance under the Illinois Public
23 Aid Code and shall submit an annual report of that
24 information to the Illinois Department of Public Health.
25 (e) Alternative health care models shall, to the extent
26 possible, link and integrate their services with nearby
27 health care facilities.
28 (f) Each alternative health care model shall implement a
29 quality assurance program with measurable benefits and at
30 reasonable cost.
31 (Source: P.A. 91-65, eff. 7-9-99; 91-838, eff. 6-16-00.)
32 (210 ILCS 3/35)
33 Sec. 35. Alternative health care models authorized.
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1 Notwithstanding any other law to the contrary, alternative
2 health care models described in this Section may be
3 established on a demonstration basis.
4 (1) Alternative health care model; subacute care
5 hospital. A subacute care hospital is a designated site
6 which provides medical specialty care for patients who
7 need a greater intensity or complexity of care than
8 generally provided in a skilled nursing facility but who
9 no longer require acute hospital care. The average length
10 of stay for patients treated in subacute care hospitals
11 shall not be less than 20 days, and for individual
12 patients, the expected length of stay at the time of
13 admission shall not be less than 10 days. Variations
14 from minimum lengths of stay shall be reported to the
15 Department. There shall be no more than 13 subacute care
16 hospitals authorized to operate by the Department.
17 Subacute care includes physician supervision, registered
18 nursing, and physiological monitoring on a continual
19 basis. A subacute care hospital is either a freestanding
20 building or a distinct physical and operational entity
21 within a hospital or nursing home building. A subacute
22 care hospital shall only consist of beds currently
23 existing in licensed hospitals or skilled nursing
24 facilities, except, in the City of Chicago, on a
25 designated site that was licensed as a hospital under the
26 Illinois Hospital Licensing Act within the 10 years
27 immediately before the application for an alternative
28 health care model license. During the period of operation
29 of the demonstration project, the existing licensed beds
30 shall remain licensed as hospital or skilled nursing
31 facility beds as well as being licensed under this Act.
32 In order to handle cases of complications, emergencies,
33 or exigent circumstances, a subacute care hospital shall
34 maintain a contractual relationship, including a transfer
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1 agreement, with a general acute care hospital. If a
2 subacute care model is located in a general acute care
3 hospital, it shall utilize all or a portion of the bed
4 capacity of that existing hospital. In no event shall a
5 subacute care hospital use the word "hospital" in its
6 advertising or marketing activities or represent or hold
7 itself out to the public as a general acute care
8 hospital.
9 (2) Alternative health care delivery model;
10 postsurgical recovery care center. A postsurgical
11 recovery care center is a designated site which provides
12 postsurgical recovery care for generally healthy patients
13 undergoing surgical procedures that require overnight
14 nursing care, pain control, or observation that would
15 otherwise be provided in an inpatient setting. A
16 postsurgical recovery care center is either freestanding
17 or a defined unit of an ambulatory surgical treatment
18 center or hospital. No facility, or portion of a
19 facility, may participate in a demonstration program as a
20 postsurgical recovery care center unless the facility has
21 been licensed as an ambulatory surgical treatment center
22 or hospital for at least 2 years before August 20, 1993
23 (the effective date of Public Act 88-441). The maximum
24 length of stay for patients in a postsurgical recovery
25 care center is not to exceed 48 hours unless the treating
26 physician requests an extension of time from the recovery
27 center's medical director on the basis of medical or
28 clinical documentation that an additional care period is
29 required for the recovery of a patient and the medical
30 director approves the extension of time. In no case,
31 however, shall a patient's length of stay in a
32 postsurgical recovery care center be longer than 72
33 hours. If a patient requires an additional care period
34 after the expiration of the 72-hour limit, the patient
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1 shall be transferred to an appropriate facility. Reports
2 on variances from the 48-hour limit shall be sent to the
3 Department for its evaluation. The reports shall, before
4 submission to the Department, have removed from them all
5 patient and physician identifiers. In order to handle
6 cases of complications, emergencies, or exigent
7 circumstances, every postsurgical recovery care center as
8 defined in this paragraph shall maintain a contractual
9 relationship, including a transfer agreement, with a
10 general acute care hospital. A postsurgical recovery
11 care center shall be no larger than 20 beds. A
12 postsurgical recovery care center shall be located within
13 15 minutes travel time from the general acute care
14 hospital with which the center maintains a contractual
15 relationship, including a transfer agreement, as required
16 under this paragraph.
17 No postsurgical recovery care center shall
18 discriminate against any patient requiring treatment
19 because of the source of payment for services, including
20 Medicare and Medicaid recipients.
21 The Department shall adopt rules to implement the
22 provisions of Public Act 88-441 concerning postsurgical
23 recovery care centers within 9 months after August 20,
24 1993.
25 (3) Alternative health care delivery model;
26 children's respite care center. A children's respite
27 care center model is a designated site that provides
28 respite for medically frail, technologically dependent,
29 clinically stable children, up to age 18, for a period of
30 one to 14 days. This care is to be provided in a
31 home-like environment that serves no more than 10
32 children at a time. Children's respite care center
33 services must be available through the model to all
34 families, including those whose care is paid for through
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1 the Illinois Department of Public Aid or the Illinois
2 Department of Children and Family Services. Each respite
3 care model location shall be a facility physically
4 separate and apart from any other facility licensed by
5 the Department of Public Health under this or any other
6 Act and shall provide, at a minimum, the following
7 services: out-of-home respite care; hospital to home
8 training for families and caregivers; short term
9 transitional care to facilitate placement and training
10 for foster care parents; parent and family support
11 groups.
12 Coverage for the services provided by the Illinois
13 Department of Public Aid under this paragraph (3) is
14 contingent upon federal waiver approval and is provided
15 only to Medicaid eligible clients participating in the
16 home and community based services waiver designated in
17 Section 1915(c) of the Social Security Act for medically
18 frail and technologically dependent children.
19 (4) Alternative health care delivery model;
20 community based residential rehabilitation center. A
21 community-based residential rehabilitation center model
22 is a designated site that provides rehabilitation or
23 support, or both, for persons who have experienced severe
24 brain injury, who are medically stable, and who no longer
25 require acute rehabilitative care or intense medical or
26 nursing services. The average length of stay in a
27 community-based residential rehabilitation center shall
28 not exceed 4 months. As an integral part of the services
29 provided, individuals are housed in a supervised living
30 setting while having immediate access to the community.
31 The residential rehabilitation center authorized by the
32 Department may have more than one residence included
33 under the license. A residence may be no larger than 12
34 beds and shall be located as an integral part of the
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1 community. Day treatment or individualized outpatient
2 services shall be provided for persons who reside in
3 their own home. Functional outcome goals shall be
4 established for each individual. Services shall include,
5 but are not limited to, case management, training and
6 assistance with activities of daily living, nursing
7 consultation, traditional therapies (physical,
8 occupational, speech), functional interventions in the
9 residence and community (job placement, shopping,
10 banking, recreation), counseling, self-management
11 strategies, productive activities, and multiple
12 opportunities for skill acquisition and practice
13 throughout the day. The design of individualized program
14 plans shall be consistent with the outcome goals that are
15 established for each resident. The programs provided in
16 this setting shall be accredited by the Commission on
17 Accreditation of Rehabilitation Facilities (CARF). The
18 program shall have been accredited by CARF as a Brain
19 Injury Community-Integrative Program for at least 3
20 years.
21 (5) Alternative health care delivery model;
22 Alzheimer's disease management center. An Alzheimer's
23 disease management center model is a designated site that
24 provides a safe and secure setting for care of persons
25 diagnosed with Alzheimer's disease. An Alzheimer's
26 disease management center model shall be a facility
27 separate from any other facility licensed by the
28 Department of Public Health under this or any other Act.
29 An Alzheimer's disease management center shall conduct
30 and document an assessment of each resident every 6
31 months. The assessment shall include an evaluation of
32 daily functioning, cognitive status, other medical
33 conditions, and behavioral problems. An Alzheimer's
34 disease management center shall develop and implement an
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1 ongoing treatment plan for each resident. The treatment
2 plan shall have defined goals. The Alzheimer's disease
3 management center shall treat behavioral problems and
4 mood disorders using nonpharmacologic approaches such as
5 environmental modification, task simplification, and
6 other appropriate activities. All staff must have
7 necessary training to care for all stages of Alzheimer's
8 Disease. An Alzheimer's disease management center shall
9 provide education and support for residents and
10 caregivers. The education and support shall include
11 referrals to support organizations for educational
12 materials on community resources, support groups, legal
13 and financial issues, respite care, and future care needs
14 and options. The education and support shall also
15 include a discussion of the resident's need to make
16 advance directives and to identify surrogates for medical
17 and legal decision-making. The provisions of this
18 paragraph establish the minimum level of services that
19 must be provided by an Alzheimer's disease management
20 center. An Alzheimer's disease management center model
21 shall have no more than 100 residents. Nothing in this
22 paragraph (5) shall be construed as prohibiting a person
23 or facility from providing services and care to persons
24 with Alzheimer's disease as otherwise authorized under
25 State law.
26 (6) Alternative health care delivery model;
27 committed persons skilled nursing facility. A committed
28 persons skilled nursing facility model is a designated
29 site that provides skilled nursing care for medically
30 compromised or disabled committed persons in need of
31 long-term nursing care. This care is to be provided in a
32 skilled nursing home that meets the requirements of the
33 Nursing Home Care Act, except that the provisions of
34 Article II of the Nursing Home Care Act shall not apply
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1 to committed persons, as defined in Section 3-1-2 of the
2 Unified Code of Corrections, who reside in committed
3 person skilled nursing facility model licensed under this
4 Act. Committed persons are entitled to all rights and
5 protections as provided under the Unified Code of
6 Corrections and the Americans With Disabilities Act of
7 1990 and the regulations promulgated pursuant thereto. A
8 committed persons skilled nursing facility model shall be
9 built as a nursing facility in accordance with applicable
10 provisions of the National Fire Protection Association's
11 Life Safety Code and shall provide, at a minimum, the
12 following services: intermediate nursing and personal
13 care, skilled nursing care, and assistance with daily
14 living for its residents. The Department shall establish
15 the standards for compliance and licensing of these
16 facilities. Coverage for the services provided by the
17 Department of Public Aid under this paragraph (6) is
18 provided only to Medicaid eligible clients pursuant to
19 Section 1905(a)(A) of the Social Security Act for
20 otherwise Medicaid eligible committed persons transferred
21 hereunder.
22 (Source: P.A. 91-65, eff. 7-9-99; 91-357, eff. 7-29-99;
23 91-838, eff. 6-16-00.)
24 (730 ILCS 135/Act rep.)
25 Section 90. The Illinois Prison Inspection Act is
26 repealed.
27 Section 99. Effective date. This Act takes effect upon
28 becoming law.