98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
HB4706

 

Introduced , by Rep. Cynthia Soto

 

SYNOPSIS AS INTRODUCED:
 
20 ILCS 3960/3  from Ch. 111 1/2, par. 1153

    Amends the Illinois Health Facilities Planning Act. Adds "managed care entities" to the definition of "health care facilities" under the Act. Effective immediately.


LRB098 18385 OMW 53522 b

 

 

A BILL FOR

 

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1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Health Facilities Planning Act is
5amended by changing Section 3 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7    (Section scheduled to be repealed on December 31, 2019)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, organizations, and related persons:
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
17    licensed under the Nursing Home Care Act;
18        3.5. Skilled and intermediate care facilities licensed
19    under the ID/DD Community Care Act;
20        3.7. Facilities licensed under the Specialized Mental
21    Health Rehabilitation Act;
22        4. Hospitals, nursing homes, ambulatory surgical
23    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;
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        7. An institution, place, building, or room used for
11    provision of a health care category of service, including,
12    but not limited to, cardiac catheterization and open heart
13    surgery; and
14        8. An institution, place, building, or room used for
15    provision of major medical equipment used in the direct
16    clinical diagnosis or treatment of patients, and whose
17    project cost is in excess of the capital expenditure
18    minimum; and .
19        9. Managed care entities.
20    This Act shall not apply to the construction of any new
21facility or the renovation of any existing facility located on
22any campus facility as defined in Section 5-5.8b of the
23Illinois Public Aid Code, provided that the campus facility
24encompasses 30 or more contiguous acres and that the new or
25renovated facility is intended for use by a licensed
26residential facility.

 

 

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1    No federally owned facility shall be subject to the
2provisions of this Act, nor facilities used solely for healing
3by prayer or spiritual means.
4    No facility licensed under the Supportive Residences
5Licensing Act or the Assisted Living and Shared Housing Act
6shall be subject to the provisions of this Act.
7    No facility established and operating under the
8Alternative Health Care Delivery Act as a children's respite
9care center alternative health care model demonstration
10program or as an Alzheimer's Disease Management Center
11alternative health care model demonstration program shall be
12subject to the provisions of this Act.
13    A facility designated as a supportive living facility that
14is in good standing with the program established under Section
155-5.01a of the Illinois Public Aid Code shall not be subject to
16the provisions of this Act.
17    This Act does not apply to facilities granted waivers under
18Section 3-102.2 of the Nursing Home Care Act. However, if a
19demonstration project under that Act applies for a certificate
20of need to convert to a nursing facility, it shall meet the
21licensure and certificate of need requirements in effect as of
22the date of application.
23    This Act does not apply to a dialysis facility that
24provides only dialysis training, support, and related services
25to individuals with end stage renal disease who have elected to
26receive home dialysis. This Act does not apply to a dialysis

 

 

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1unit located in a licensed nursing home that offers or provides
2dialysis-related services to residents with end stage renal
3disease who have elected to receive home dialysis within the
4nursing home. The Board, however, may require these dialysis
5facilities and licensed nursing homes to report statistical
6information on a quarterly basis to the Board to be used by the
7Board to conduct analyses on the need for proposed kidney
8disease treatment centers.
9    This Act shall not apply to the closure of an entity or a
10portion of an entity licensed under the Nursing Home Care Act,
11the Specialized Mental Health Rehabilitation Act, or the ID/DD
12Community Care Act, with the exceptions of facilities operated
13by a county or Illinois Veterans Homes, that elects to convert,
14in whole or in part, to an assisted living or shared housing
15establishment licensed under the Assisted Living and Shared
16Housing Act.
17    This Act does not apply to any change of ownership of a
18healthcare facility that is licensed under the Nursing Home
19Care Act, the Specialized Mental Health Rehabilitation Act, or
20the ID/DD Community Care Act, with the exceptions of facilities
21operated by a county or Illinois Veterans Homes. Changes of
22ownership of facilities licensed under the Nursing Home Care
23Act must meet the requirements set forth in Sections 3-101
24through 3-119 of the Nursing Home Care Act.
25    With the exception of those health care facilities
26specifically included in this Section, nothing in this Act

 

 

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1shall be intended to include facilities operated as a part of
2the practice of a physician or other licensed health care
3professional, whether practicing in his individual capacity or
4within the legal structure of any partnership, medical or
5professional corporation, or unincorporated medical or
6professional group. Further, this Act shall not apply to
7physicians or other licensed health care professional's
8practices where such practices are carried out in a portion of
9a health care facility under contract with such health care
10facility by a physician or by other licensed health care
11professionals, whether practicing in his individual capacity
12or within the legal structure of any partnership, medical or
13professional corporation, or unincorporated medical or
14professional groups, unless the entity constructs, modifies,
15or establishes a health care facility as specifically defined
16in this Section. This Act shall apply to construction or
17modification and to establishment by such health care facility
18of such contracted portion which is subject to facility
19licensing requirements, irrespective of the party responsible
20for such action or attendant financial obligation.
21    No permit or exemption is required for a facility licensed
22under the ID/DD Community Care Act prior to the reduction of
23the number of beds at a facility. If there is a total reduction
24of beds at a facility licensed under the ID/DD Community Care
25Act, this is a discontinuation or closure of the facility.
26However, if a facility licensed under the ID/DD Community Care

 

 

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

 

 

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1capital expenditure minimum; however, any capital expenditure
2made by or on behalf of a health care facility for (i) the
3construction or modification of a facility licensed under the
4Assisted Living and Shared Housing Act or (ii) a conversion
5project undertaken in accordance with Section 30 of the Older
6Adult Services Act shall be excluded from any obligations under
7this Act.
8    "Establish" means the construction of a health care
9facility or the replacement of an existing facility on another
10site or the initiation of a category of service.
11    "Major medical equipment" means medical equipment which is
12used for the provision of medical and other health services and
13which costs in excess of the capital expenditure minimum,
14except that such term does not include medical equipment
15acquired by or on behalf of a clinical laboratory to provide
16clinical laboratory services if the clinical laboratory is
17independent of a physician's office and a hospital and it has
18been determined under Title XVIII of the Social Security Act to
19meet the requirements of paragraphs (10) and (11) of Section
201861(s) of such Act. In determining whether medical equipment
21has a value in excess of the capital expenditure minimum, the
22value of studies, surveys, designs, plans, working drawings,
23specifications, and other activities essential to the
24acquisition of such equipment shall be included.
25    "Capital Expenditure" means an expenditure: (A) made by or
26on behalf of a health care facility (as such a facility is

 

 

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1defined in this Act); and (B) which under generally accepted
2accounting principles is not properly chargeable as an expense
3of operation and maintenance, or is made to obtain by lease or
4comparable arrangement any facility or part thereof or any
5equipment for a facility or part; and which exceeds the capital
6expenditure minimum.
7    For the purpose of this paragraph, the cost of any studies,
8surveys, designs, plans, working drawings, specifications, and
9other activities essential to the acquisition, improvement,
10expansion, or replacement of any plant or equipment with
11respect to which an expenditure is made shall be included in
12determining if such expenditure exceeds the capital
13expenditures minimum. Unless otherwise interdependent, or
14submitted as one project by the applicant, components of
15construction or modification undertaken by means of a single
16construction contract or financed through the issuance of a
17single debt instrument shall not be grouped together as one
18project. Donations of equipment or facilities to a health care
19facility which if acquired directly by such facility would be
20subject to review under this Act shall be considered capital
21expenditures, and a transfer of equipment or facilities for
22less than fair market value shall be considered a capital
23expenditure for purposes of this Act if a transfer of the
24equipment or facilities at fair market value would be subject
25to review.
26    "Capital expenditure minimum" means $11,500,000 for

 

 

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

 

 

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1    "Areawide" means a major area of the State delineated on a
2geographic, demographic, and functional basis for health
3planning and for health service and having within it one or
4more local areas for health planning and health service. The
5term "region", as contrasted with the term "subregion", and the
6word "area" may be used synonymously with the term "areawide".
7    "Local" means a subarea of a delineated major area that on
8a geographic, demographic, and functional basis may be
9considered to be part of such major area. The term "subregion"
10may be used synonymously with the term "local".
11    "Physician" means a person licensed to practice in
12accordance with the Medical Practice Act of 1987, as amended.
13    "Licensed health care professional" means a person
14licensed to practice a health profession under pertinent
15licensing statutes of the State of Illinois.
16    "Director" means the Director of the Illinois Department of
17Public Health.
18    "Agency" means the Illinois Department of Public Health.
19    "Alternative health care model" means a facility or program
20authorized under the Alternative Health Care Delivery Act.
21    "Out-of-state facility" means a person that is both (i)
22licensed as a hospital or as an ambulatory surgery center under
23the laws of another state or that qualifies as a hospital or an
24ambulatory surgery center under regulations adopted pursuant
25to the Social Security Act and (ii) not licensed under the
26Ambulatory Surgical Treatment Center Act, the Hospital

 

 

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1Licensing Act, or the Nursing Home Care Act. Affiliates of
2out-of-state facilities shall be considered out-of-state
3facilities. Affiliates of Illinois licensed health care
4facilities 100% owned by an Illinois licensed health care
5facility, its parent, or Illinois physicians licensed to
6practice medicine in all its branches shall not be considered
7out-of-state facilities. Nothing in this definition shall be
8construed to include an office or any part of an office of a
9physician licensed to practice medicine in all its branches in
10Illinois that is not required to be licensed under the
11Ambulatory Surgical Treatment Center Act.
12    "Change of ownership of a health care facility" means a
13change in the person who has ownership or control of a health
14care facility's physical plant and capital assets. A change in
15ownership is indicated by the following transactions: sale,
16transfer, acquisition, lease, change of sponsorship, or other
17means of transferring control.
18    "Related person" means any person that: (i) is at least 50%
19owned, directly or indirectly, by either the health care
20facility or a person owning, directly or indirectly, at least
2150% of the health care facility; or (ii) owns, directly or
22indirectly, at least 50% of the health care facility.
23    "Charity care" means care provided by a health care
24facility for which the provider does not expect to receive
25payment from the patient or a third-party payer.
26    "Freestanding emergency center" means a facility subject

 

 

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1to licensure under Section 32.5 of the Emergency Medical
2Services (EMS) Systems Act.
3    "Category of service" means a grouping by generic class of
4various types or levels of support functions, equipment, care,
5or treatment provided to patients or residents, including, but
6not limited to, classes such as medical-surgical, pediatrics,
7or cardiac catheterization. A category of service may include
8subcategories or levels of care that identify a particular
9degree or type of care within the category of service. Nothing
10in this definition shall be construed to include the practice
11of a physician or other licensed health care professional while
12functioning in an office providing for the care, diagnosis, or
13treatment of patients. A category of service that is subject to
14the Board's jurisdiction must be designated in rules adopted by
15the Board.
16(Source: P.A. 97-38, eff. 6-28-11; 97-277, eff. 1-1-12; 97-813,
17eff. 7-13-12; 97-980, eff. 8-17-12; 98-414, eff. 1-1-14.)
 
18    Section 99. Effective date. This Act takes effect upon
19becoming law.