Rep. Sara Feigenholtz

Filed: 5/27/2013

 

 


 

 


 
09800SB0026ham004LRB098 05310 KTG 46464 a

1
AMENDMENT TO SENATE BILL 26

2    AMENDMENT NO. ______. Amend Senate Bill 26, AS AMENDED,
3with reference to page and line numbers of House Amendment No.
41 as follows:
 
5on page 4, by inserting immediately below line 8 the following:
6    ""Abuse" means any physical or mental injury or sexual
7assault inflicted on a consumer other than by accidental means
8in a facility."; and
 
9on page 6, line 19, after "triage", by inserting "center"; and
 
10on page 9, immediately below line 13, by inserting the
11following:
12    ""Identified offender" means a person who meets any of the
13following criteria:
14        (1) Has been convicted of, found guilty of, adjudicated
15    delinquent for, found not guilty by reason of insanity for,

 

 

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1    or found unfit to stand trial for, any felony offense
2    listed in Section 25 of the Health Care Worker Background
3    Check Act, except for the following:
4            (i) a felony offense described in Section 10-5 of
5        the Nurse Practice Act;
6            (ii) a felony offense described in Section 4, 5, 6,
7        8, or 17.02 of the Illinois Credit Card and Debit Card
8        Act;
9            (iii) a felony offense described in Section 5, 5.1,
10        5.2, 7, or 9 of the Cannabis Control Act;
11            (iv) a felony offense described in Section 401,
12        401.1, 404, 405, 405.1, 407, or 407.1 of the Illinois
13        Controlled Substances Act; and
14            (v) a felony offense described in the
15        Methamphetamine Control and Community Protection Act.
16        (2) Has been convicted of, adjudicated delinquent for,
17    found not guilty by reason of insanity for, or found unfit
18    to stand trial for, any sex offense as defined in
19    subsection (c) of Section 10 of the Sex Offender Management
20    Board Act."; and
 
21on page 12, immediately below line 9, by inserting the
22following:
 
23    "Section 2-100. Rulemaking. The Department is empowered to
24promulgate any rules necessary to ensure proper implementation

 

 

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1and administration of this Act."; and
 
2on page 15, immediately below line 1, by inserting the
3following:
 
4    "Section 2-104. Screening prior to admission.
5    (a) A facility shall within 24 hours after admission,
6request a criminal history background check pursuant to the
7Uniform Conviction Information Act for all persons age 18 or
8older seeking admission to the facility, unless a background
9check was initiated by a hospital pursuant to subsection (d) of
10Section 6.09 of the Hospital Licensing Act. Background checks
11conducted pursuant to this Section shall be based on the
12consumer's name, date of birth, and other identifiers as
13required by the Department of State Police. If the results of
14the background check are inconclusive, the facility shall
15initiate a fingerprint-based check, unless the fingerprint
16check is waived by the Director of Public Health based on
17verification by the facility that the consumer meets criteria
18related to the consumer's health or lack of potential risk
19which may be established by Departmental rule. A waiver issued
20pursuant to this Section shall be valid only while the consumer
21is immobile or while the criteria supporting the waiver exist.
22The facility shall provide for or arrange for any required
23fingerprint-based checks to be taken on the premises of the
24facility. If a fingerprint-based check is required, the

 

 

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1facility shall arrange for it to be conducted in a manner that
2is respectful of the consumer's dignity and that minimizes any
3emotional or physical hardship to the consumer.
4    (b) If the results of a consumer's criminal history
5background check reveal that the consumer is an identified
6offender as defined in this Act, the facility shall do the
7following:
8        (1) Immediately notify the Department of State Police,
9    in the form and manner required by the Department of State
10    Police, in collaboration with the Department of Public
11    Health, that the consumer is an identified offender.
12        (2) Within 72 hours, arrange for a fingerprint-based
13    criminal history record inquiry to be requested on the
14    identified offender consumer. The inquiry shall be based on
15    the subject's name, sex, race, date of birth, fingerprint
16    images, and other identifiers required by the Department of
17    State Police. The inquiry shall be processed through the
18    files of the Department of State Police and the Federal
19    Bureau of Investigation to locate any criminal history
20    record information that may exist regarding the subject.
21    The Federal Bureau of Investigation shall furnish to the
22    Department of State Police, pursuant to an inquiry under
23    this paragraph (2), any criminal history record
24    information contained in its files.
 
25    Section 2-105. Criminal History Report.

 

 

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1    (a) The Department of State Police shall prepare a Criminal
2History Report when it receives information, through the
3criminal history background check required pursuant to
4subsection (d) of Section 6.09 of the Hospital Licensing Act or
5subsection (c) of Section 2-201.5 of the Nursing Home Care Act,
6or through any other means, that a consumer of a facility is an
7identified offender.
8    (b) The Department of State Police shall complete the
9Criminal History Report within 10 business days after receiving
10information under subsection (a) that a consumer is an
11identified offender.
12    (c) The Criminal History Report shall include, but not be
13limited to, the following:
14        (1) Copies of the identified offender's parole,
15    mandatory supervised release, or probation orders.
16        (2) An interview with the identified offender.
17        (3) A detailed summary of the entire criminal history
18    of the offender, including arrests, convictions, and the
19    date of the identified offender's last conviction relative
20    to the date of admission to a long-term care facility.
21        (4) If the identified offender is a convicted or
22    registered sex offender, a review of any and all sex
23    offender evaluations conducted on that offender. If there
24    is no sex offender evaluation available, the Department of
25    State Police shall arrange, through the Department of
26    Public Health, for a sex offender evaluation to be

 

 

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1    conducted on the identified offender. If the convicted or
2    registered sex offender is under supervision by the
3    Illinois Department of Corrections or a county probation
4    department, the sex offender evaluation shall be arranged
5    by and at the expense of the supervising agency. All
6    evaluations conducted on convicted or registered sex
7    offenders under this Act shall be conducted by sex offender
8    evaluators approved by the Sex Offender Management Board.
9    (d) The Department of State Police shall provide the
10Criminal History Report to a licensed forensic psychologist.
11After (i) consideration of the Criminal History Report, (ii)
12consultation with the facility administrator or the facility
13medical director, or both, regarding the mental and physical
14condition of the identified offender, and (iii) reviewing the
15facility's file on the identified offender, including all
16incident reports, all information regarding medication and
17medication compliance, and all information regarding previous
18discharges or transfers from other facilities, the licensed
19forensic psychologist shall prepare an Identified Offender
20Report and Recommendation. The Identified Offender Report and
21Recommendation shall detail whether and to what extent the
22identified offender's criminal history necessitates the
23implementation of security measures within the long-term care
24facility. If the identified offender is a convicted or
25registered sex offender or if the Identified Offender Report
26and Recommendation reveals that the identified offender poses a

 

 

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1significant risk of harm to others within the facility, the
2offender shall be required to have his or her own room within
3the facility.
4    (e) The licensed forensic psychologist shall complete the
5Identified Offender Report and Recommendation within 14
6business days after receiving the Criminal History Report and
7shall promptly provide the Identified Offender Report and
8Recommendation to the Department of State Police, which shall
9provide the Identified Offender Report and Recommendation to
10the following:
11        (1) The facility within which the identified offender
12    resides.
13        (2) The Chief of Police of the municipality in which
14    the facility is located.
15        (3) The State of Illinois Long Term Care Ombudsman.
16        (4) The Department of Public Health.
17    (e-5) The Department of Public Health shall keep a
18continuing record of all consumers determined to be identified
19offenders as defined in Section 1-114.01 of the Nursing Home
20Care Act and shall report the number of identified offender
21consumers annually to the General Assembly.
22    (f) The facility shall incorporate the Identified Offender
23Report and Recommendation into the identified offender's care
24plan created pursuant to 42 CFR 483.20.
25    (g) If, based on the Identified Offender Report and
26Recommendation, a facility determines that it cannot manage the

 

 

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1identified offender consumer safely within the facility, it
2shall commence involuntary transfer or discharge proceedings
3pursuant to Section 3-402.
4    (h) Except for willful and wanton misconduct, any person
5authorized to participate in the development of a Criminal
6History Report or Identified Offender Report and
7Recommendation is immune from criminal or civil liability for
8any acts or omissions as the result of his or her good faith
9effort to comply with this Section."; and
 
10on page 19, line 19, after "authorized", by inserting "under
11Illinois law"; and
 
12on page 20, line 2, by replacing the period with "to the
13Department within 24 hours. Facilities shall comply with
14Sections 3-610 and 3-810 of the Nursing Home Care Act. The
15provisions under Sections 3-610 and 3-810 of the Nursing Home
16Care Act shall apply to employees of facilities licensed under
17this Act."; and
 
18on page 20, line 4, by replacing "or crisis stabilization" with
19"centers"; and
 
20on page 20, line 13, by replacing "knock" with "reasonably
21announce their intent to enter"; and
 

 

 

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1on page 20, immediately below line 15, by inserting the
2following:
3    "Consumers shall be free to leave at any time. If a
4consumer in a triage center expresses a desire to contact a
5third party for any purpose, the facility staff shall contact
6that third party on behalf of the consumer."; and
 
7on page 21, line 6, by replacing "or crisis stabilization" with
8"centers"; and
 
9on page 22, line 12, after the period, by inserting "The
10Department shall by rule establish criteria, hearings, and
11procedures for involuntary discharge."; and
 
12on page 23, by inserting immediately below line 7 the
13following:
 
14    "Section 3-115. Informed consent; restraints. Informed
15consent shall be required for restraints consistent with the
16requirements contained in subsection (c) of Section 2-106 of
17the Nursing Home Care Act.
 
18    Section 3-116. Experimental research. No consumer shall be
19subjected to experimental research or treatment without first
20obtaining his or her informed, written consent. The conduct of
21any experimental research or treatment shall be authorized and

 

 

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1monitored by an institutional review board appointed by the
2executive director. The membership, operating procedures and
3review criteria for the institutional review board shall be
4prescribed under rules and regulations of the Department and
5shall comply with the requirements for institutional review
6boards established by the federal Food and Drug Administration.
7No person who has received compensation in the prior 3 years
8from an entity that manufactures, distributes, or sells
9pharmaceuticals, biologics, or medical devices may serve on the
10institutional review board.
11    No facility shall permit experimental research or
12treatment to be conducted on a consumer, or give access to any
13person or person's records for a retrospective study about the
14safety or efficacy of any care or treatment, without the prior
15written approval of the institutional review board. No
16executive director, or person licensed by the State to provide
17medical care or treatment to any person, may assist or
18participate in any experimental research on or treatment of a
19consumer, including a retrospective study, that does not have
20the prior written approval of the board. Such conduct shall be
21grounds for professional discipline by the Department of
22Financial and Professional Regulation.
23    The institutional review board may exempt from ongoing
24review research or treatment initiated on a consumer before the
25individual's admission to a facility and for which the board
26determines there is adequate ongoing oversight by another

 

 

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1institutional review board. Nothing in this Section shall
2prevent a facility, any facility employee, or any other person
3from assisting or participating in any experimental research on
4or treatment of a consumer, if the research or treatment began
5before the person's admission to a facility, until the board
6has reviewed the research or treatment and decided to grant or
7deny approval or to exempt the research or treatment from
8ongoing review."; and
 
9on page 23, line 15, by replacing "units" with "centers"; and
 
10on page 30, line 12, by replacing "units" with "centers"; and
 
11on page 30, line 24, after "triage", by inserting "centers";
12and
 
13on page 31, line 7, after "checks", by inserting ", consistent
14with Section 1-114.01, subsections (b) and (c) of Section
152-201.5, and Section 2-201.6 of the Nursing Home Care Act"; and
 
16on page 31, line 16, after "check", by inserting ", consistent
17with the Health Care Worker Background Check Act"; and
 
18on page 33, line 14 by inserting after "Act" the following:
19"and the rules promulgated under this Act. The Department shall
20have access to and may reproduce or photocopy any books,

 

 

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1records, and other documents maintained by the facility to the
2extent necessary to carry out this Act and the rules
3promulgated under this Act. The Department shall not divulge or
4disclose the contents of a record under this Section as
5otherwise prohibited by this Act. Any holder of a license or
6applicant for a license shall be deemed to have given consent
7to any authorized officer, employee, or agent of the Department
8to enter and inspect the facility in accordance with this
9Article. Refusal to permit such entry or inspection shall
10constitute grounds for denial, suspension, or revocation of a
11license under this Act"; and
 
12on page 33, line 15, by deleting "scheduled"; and
 
13on page 33, line 16, by deleting "unscheduled"; and
 
14on page 34, by replacing lines 2 and 3 with the following:
15    "(a) The Department may revoke a license for any failure to
16substantially comply with this Act and the rules promulgated
17under this Act, including, but not limited to, the following:";
18and
 
19on page 34, line 5, by replacing "or" with "and"; and
 
20on page 35, line 3, by replacing "the standards of this" with
21"this Act and the rules promulgated under this Act."; and
 

 

 

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1on page 35, by deleting line 4; and
 
2on page 35, line 5, by replacing "the standards" with "this Act
3and the rules promulgated under this Act"; and
 
4on page 35, line 8, by replacing "the standards" with "this Act
5and the rules promulgated under this Act"; and
 
6on page 35, line 11, by replacing "the standards" with "this
7Act and the rules promulgated under this Act"; and
 
8on page 35, lines 15 and 16, by replacing "the standards. The
9agency" with "this Act and the rules promulgated under this
10Act. The facility"; and
 
11on page 36, line 7, by replacing "Part" with "Act or the rules
12promulgated under this Act"; and
 
13on page 36, line 8, by replacing "agency" with "facility"; and
 
14on page 36, line 17, by replacing "Part" with "Act or the rules
15promulgated under this Act"; and
 
16on page 36, line 18, by replacing "standards" with "this Act
17and the rules promulgated under this Act"; and
 

 

 

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1on page 36, line 22, by replacing "agency" with "facility"; and
 
2on page 36, line 23, by replacing "agency" with "facility"; and
 
3on page 37, line 10, by replacing "agency" with "facility"; and
 
4on page 37, line 11, by replacing "agency" with "facility"; and
 
5on page 39, by inserting immediately below line 1 the
6following:
 
7    "Section 4-111. Notwithstanding the existence or pursuit
8of any other remedy, the Director of the Department may, in the
9manner provided by law, upon the advice of the Attorney General
10who shall represent the Director of the Department in the
11proceedings, maintain an action in the name of the State for
12injunction or other process against any person or governmental
13unit to restrain or prevent the establishment of a facility
14without a license issued pursuant to this Act, or to restrain
15or prevent the opening, conduction, operating, or maintaining
16of a facility without a license issued pursuant to this Act. In
17addition, the Director of the Department may, in the manner
18provided by law, in the name of the People of the State and
19through the Attorney General who shall represent the Director
20of the Department in the proceedings, maintain an action for

 

 

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1injunction or other relief or process against any licensee or
2other person to enforce and compel compliance with the
3provisions of this Act and the standards, rules, and
4regulations established by virtue of this Act and any order
5entered for any response action pursuant to this Act and such
6standards, rules, and regulations."; and
 
7by deleting lines 7 through 23 of page 490, all of pages 491
8through 538, and lines 1 through 20 of page 539; and
 
9on page 539, immediately below line 21, by inserting the
10following:
 
11    "Section 11-1. The Illinois Public Aid Code is amended by
12changing Section 14-8 as follows:
 
13    (305 ILCS 5/14-8)  (from Ch. 23, par. 14-8)
14    Sec. 14-8. Disbursements to Hospitals.
15    (a) For inpatient hospital services rendered on and after
16September 1, 1991, the Illinois Department shall reimburse
17hospitals for inpatient services at an inpatient payment rate
18calculated for each hospital based upon the Medicare
19Prospective Payment System as set forth in Sections 1886(b),
20(d), (g), and (h) of the federal Social Security Act, and the
21regulations, policies, and procedures promulgated thereunder,
22except as modified by this Section. Payment rates for inpatient

 

 

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1hospital services rendered on or after September 1, 1991 and on
2or before September 30, 1992 shall be calculated using the
3Medicare Prospective Payment rates in effect on September 1,
41991. Payment rates for inpatient hospital services rendered on
5or after October 1, 1992 and on or before March 31, 1994 shall
6be calculated using the Medicare Prospective Payment rates in
7effect on September 1, 1992. Payment rates for inpatient
8hospital services rendered on or after April 1, 1994 shall be
9calculated using the Medicare Prospective Payment rates
10(including the Medicare grouping methodology and weighting
11factors as adjusted pursuant to paragraph (1) of this
12subsection) in effect 90 days prior to the date of admission.
13For services rendered on or after July 1, 1995, the
14reimbursement methodology implemented under this subsection
15shall not include those costs referred to in Sections
161886(d)(5)(B) and 1886(h) of the Social Security Act. The
17additional payment amounts required under Section
181886(d)(5)(F) of the Social Security Act, for hospitals serving
19a disproportionate share of low-income or indigent patients,
20are not required under this Section. For hospital inpatient
21services rendered on or after July 1, 1995, the Illinois
22Department shall reimburse hospitals using the relative
23weighting factors and the base payment rates calculated for
24each hospital that were in effect on June 30, 1995, less the
25portion of such rates attributed by the Illinois Department to
26the cost of medical education.

 

 

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1        (1) The weighting factors established under Section
2    1886(d)(4) of the Social Security Act shall not be used in
3    the reimbursement system established under this Section.
4    Rather, the Illinois Department shall establish by rule
5    Medicaid weighting factors to be used in the reimbursement
6    system established under this Section.
7        (2) The Illinois Department shall define by rule those
8    hospitals or distinct parts of hospitals that shall be
9    exempt from the reimbursement system established under
10    this Section. In defining such hospitals, the Illinois
11    Department shall take into consideration those hospitals
12    exempt from the Medicare Prospective Payment System as of
13    September 1, 1991. For hospitals defined as exempt under
14    this subsection, the Illinois Department shall by rule
15    establish a reimbursement system for payment of inpatient
16    hospital services rendered on and after September 1, 1991.
17    For all hospitals that are children's hospitals as defined
18    in Section 5-5.02 of this Code, the reimbursement
19    methodology shall, through June 30, 1992, net of all
20    applicable fees, at least equal each children's hospital
21    1990 ICARE payment rates, indexed to the current year by
22    application of the DRI hospital cost index from 1989 to the
23    year in which payments are made. Excepting county providers
24    as defined in Article XV of this Code, hospitals licensed
25    under the University of Illinois Hospital Act, and
26    facilities operated by the Department of Mental Health and

 

 

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1    Developmental Disabilities (or its successor, the
2    Department of Human Services) for hospital inpatient
3    services rendered on or after July 1, 1995, the Illinois
4    Department shall reimburse children's hospitals, as
5    defined in 89 Illinois Administrative Code Section
6    149.50(c)(3), at the rates in effect on June 30, 1995, and
7    shall reimburse all other hospitals at the rates in effect
8    on June 30, 1995, less the portion of such rates attributed
9    by the Illinois Department to the cost of medical
10    education. For inpatient hospital services provided on or
11    after August 1, 1998, the Illinois Department may establish
12    by rule a means of adjusting the rates of children's
13    hospitals, as defined in 89 Illinois Administrative Code
14    Section 149.50(c)(3), that did not meet that definition
15    before February 28, 2013 on June 30, 1995, in order for the
16    inpatient hospital rates of such hospitals to take into
17    account the average inpatient hospital rates of those
18    children's hospitals that did meet the definition of
19    children's hospitals before February 28, 2013. The
20    Department shall adopt any emergency rules necessary to
21    implement this Section on June 30, 1995.
22        (3) (Blank).
23        (4) Notwithstanding any other provision of this
24    Section, hospitals that on August 31, 1991, have a contract
25    with the Illinois Department under Section 3-4 of the
26    Illinois Health Finance Reform Act may elect to continue to

 

 

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1    be reimbursed at rates stated in such contracts for general
2    and specialty care.
3        (5) In addition to any payments made under this
4    subsection (a), the Illinois Department shall make the
5    adjustment payments required by Section 5-5.02 of this
6    Code; provided, that in the case of any hospital reimbursed
7    under a per case methodology, the Illinois Department shall
8    add an amount equal to the product of the hospital's
9    average length of stay, less one day, multiplied by 20, for
10    inpatient hospital services rendered on or after September
11    1, 1991 and on or before September 30, 1992.
12    (b) (Blank).
13    (b-5) Excepting county providers as defined in Article XV
14of this Code, hospitals licensed under the University of
15Illinois Hospital Act, and facilities operated by the Illinois
16Department of Mental Health and Developmental Disabilities (or
17its successor, the Department of Human Services), for
18outpatient services rendered on or after July 1, 1995 and
19before July 1, 1998 the Illinois Department shall reimburse
20children's hospitals, as defined in the Illinois
21Administrative Code Section 149.50(c)(3), at the rates in
22effect on June 30, 1995, less that portion of such rates
23attributed by the Illinois Department to the outpatient
24indigent volume adjustment and shall reimburse all other
25hospitals at the rates in effect on June 30, 1995, less the
26portions of such rates attributed by the Illinois Department to

 

 

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1the cost of medical education and attributed by the Illinois
2Department to the outpatient indigent volume adjustment. For
3outpatient services provided on or after July 1, 1998,
4reimbursement rates shall be established by rule.
5    (c) In addition to any other payments under this Code, the
6Illinois Department shall develop a hospital disproportionate
7share reimbursement methodology that, effective July 1, 1991,
8through September 30, 1992, shall reimburse hospitals
9sufficiently to expend the fee monies described in subsection
10(b) of Section 14-3 of this Code and the federal matching funds
11received by the Illinois Department as a result of expenditures
12made by the Illinois Department as required by this subsection
13(c) and Section 14-2 that are attributable to fee monies
14deposited in the Fund, less amounts applied to adjustment
15payments under Section 5-5.02.
16    (d) Critical Care Access Payments.
17        (1) In addition to any other payments made under this
18    Code, the Illinois Department shall develop a
19    reimbursement methodology that shall reimburse Critical
20    Care Access Hospitals for the specialized services that
21    qualify them as Critical Care Access Hospitals. No
22    adjustment payments shall be made under this subsection on
23    or after July 1, 1995.
24        (2) "Critical Care Access Hospitals" includes, but is
25    not limited to, hospitals that meet at least one of the
26    following criteria:

 

 

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1            (A) Hospitals located outside of a metropolitan
2        statistical area that are designated as Level II
3        Perinatal Centers and that provide a disproportionate
4        share of perinatal services to recipients; or
5            (B) Hospitals that are designated as Level I Trauma
6        Centers (adult or pediatric) and certain Level II
7        Trauma Centers as determined by the Illinois
8        Department; or
9            (C) Hospitals located outside of a metropolitan
10        statistical area and that provide a disproportionate
11        share of obstetrical services to recipients.
12    (e) Inpatient high volume adjustment. For hospital
13inpatient services, effective with rate periods beginning on or
14after October 1, 1993, in addition to rates paid for inpatient
15services by the Illinois Department, the Illinois Department
16shall make adjustment payments for inpatient services
17furnished by Medicaid high volume hospitals. The Illinois
18Department shall establish by rule criteria for qualifying as a
19Medicaid high volume hospital and shall establish by rule a
20reimbursement methodology for calculating these adjustment
21payments to Medicaid high volume hospitals. No adjustment
22payment shall be made under this subsection for services
23rendered on or after July 1, 1995.
24    (f) The Illinois Department shall modify its current rules
25governing adjustment payments for targeted access, critical
26care access, and uncompensated care to classify those

 

 

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1adjustment payments as not being payments to disproportionate
2share hospitals under Title XIX of the federal Social Security
3Act. Rules adopted under this subsection shall not be effective
4with respect to services rendered on or after July 1, 1995. The
5Illinois Department has no obligation to adopt or implement any
6rules or make any payments under this subsection for services
7rendered on or after July 1, 1995.
8    (f-5) The State recognizes that adjustment payments to
9hospitals providing certain services or incurring certain
10costs may be necessary to assure that recipients of medical
11assistance have adequate access to necessary medical services.
12These adjustments include payments for teaching costs and
13uncompensated care, trauma center payments, rehabilitation
14hospital payments, perinatal center payments, obstetrical care
15payments, targeted access payments, Medicaid high volume
16payments, and outpatient indigent volume payments. On or before
17April 1, 1995, the Illinois Department shall issue
18recommendations regarding (i) reimbursement mechanisms or
19adjustment payments to reflect these costs and services,
20including methods by which the payments may be calculated and
21the method by which the payments may be financed, and (ii)
22reimbursement mechanisms or adjustment payments to reflect
23costs and services of federally qualified health centers with
24respect to recipients of medical assistance.
25    (g) If one or more hospitals file suit in any court
26challenging any part of this Article XIV, payments to hospitals

 

 

09800SB0026ham004- 23 -LRB098 05310 KTG 46464 a

1under this Article XIV shall be made only to the extent that
2sufficient monies are available in the Fund and only to the
3extent that any monies in the Fund are not prohibited from
4disbursement under any order of the court.
5    (h) Payments under the disbursement methodology described
6in this Section are subject to approval by the federal
7government in an appropriate State plan amendment.
8    (i) The Illinois Department may by rule establish criteria
9for and develop methodologies for adjustment payments to
10hospitals participating under this Article.
11    (j) Hospital Residing Long Term Care Services. In addition
12to any other payments made under this Code, the Illinois
13Department may by rule establish criteria and develop
14methodologies for payments to hospitals for Hospital Residing
15Long Term Care Services.
16    (k) Critical Access Hospital outpatient payments. In
17addition to any other payments authorized under this Code, the
18Illinois Department shall reimburse critical access hospitals,
19as designated by the Illinois Department of Public Health in
20accordance with 42 CFR 485, Subpart F, for outpatient services
21at an amount that is no less than the cost of providing such
22services, based on Medicare cost principles. Payments under
23this subsection shall be subject to appropriation.
24    (l) On and after July 1, 2012, the Department shall reduce
25any rate of reimbursement for services or other payments or
26alter any methodologies authorized by this Code to reduce any

 

 

09800SB0026ham004- 24 -LRB098 05310 KTG 46464 a

1rate of reimbursement for services or other payments in
2accordance with Section 5-5e.
3(Source: P.A. 96-1382, eff. 1-1-11; 97-689, eff. 6-14-12;
4revised 8-3-12.)"; and
 
5on page 544, line 26, after "research", by inserting "and
6education"; and
 
7on page 545, line 17, after "research", by inserting "and
8education"; and
 
9on page 548, by deleting lines 8 and 9; and
 
10on page 561, by replacing lines 15 through 16 with "a
11municipality prior to September 30, 1998 or (ii) the hospital
12has been designated by the State"; and
 
13on page 578, line 24 by replacing "resident" with "residents";
14and
 
15on page 582, line 12 by inserting before "Transition" the
16following:
17"For dates of services beginning January 1, 2014, the RUG-IV
18nursing component per diem for a nursing home shall be the
19product of the statewide RUG-IV nursing base per diem rate, the
20facility average case mix index, and the regional wage

 

 

09800SB0026ham004- 25 -LRB098 05310 KTG 46464 a

1adjustor."; and
 
2on page 582, line 15 by replacing "subsection (d-1)" with "this
3subsection (e-2)"; and
 
4on page 582, line 25 by replacing "subsection (d-1)" with "this
5subsection (e-2)"; and
 
6on page 584, line 21, after "triage" by inserting "center"; and
 
7on page 585, by inserting immediately below line 13 the
8following:
 
9    "Section 11-45. The Illinois Public Aid Code is amended by
10adding Section 5-5.4h as follows:
 
11    (305 ILCS 5/5-5.4h new)
12    Sec. 5-5.4h. Medicaid reimbursement for pediatric skilled
13nursing facilities.
14    (a) Facilities uniquely licensed as pediatric skilled
15nursing facilities that serve severely and chronically ill
16pediatric patients shall have a specific reimbursement system
17designed to recognize the characteristics and needs of the
18patients they serve.
19    (b) For dates of services starting July 1, 2013 and until a
20new reimbursement system is designed, pediatric skilled

 

 

09800SB0026ham004- 26 -LRB098 05310 KTG 46464 a

1nursing facilities that meet the following criteria:
2        (1) serve exceptional care patients; and
3        (2) have 30% or more of their patients receiving
4    ventilator care;
5shall receive Medicaid reimbursement on a 30-day expedited
6schedule."; and
 
7on page 596, line 11, by replacing "60" with "75"; and
 
8on page 597, by replacing lines 1 through 3 with the following:
 
9    "the portions of the health and life safety survey
10    associated with federal certification and State licensure
11    surveys must be started within 7 working days of each
12    other. Nothing in this paragraph (1) of subsection (f) of
13    this Section applies to a complaint investigation."; and
 
14on page 597, line 4, after "complaint", by inserting "and
15incident report"; and
 
16on page 597, by replacing lines 5 and 6 with the following:
17"shall permit the facility to challenge the amount of the fine
18due to the excessive length of"; and
 
19on page 597, immediately below line 15, by inserting the
20following:
 

 

 

09800SB0026ham004- 27 -LRB098 05310 KTG 46464 a

1        "This paragraph (2) does not apply to complaint
2    investigations exited within 14 working days or a situation
3    that triggers an extended survey."; and
 
4on page 624, line 8, after "occurred,", by inserting "and the
5facility in which the applicant resides is notified,"; and
 
6on page 625, line 5, by replacing "2014" with "2013"; and
 
7on page 625, line 6, by replacing "2015" with "2014".