093_SB1322

 
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 1        AN ACT concerning health.

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

 4        Section  5.   The  Department of Public Health Powers and
 5    Duties Law of the Civil Administrative Code  of  Illinois  is
 6    amended by adding Section 2310-70 as follows:

 7        (20 ILCS 2310/2310-70 new)
 8        Sec.   2310-70.  Establish   areawide   health   planning
 9    organizations.  The  Department  shall assist communities and
10    regions throughout the State  to  establish  areawide  health
11    planning organizations and, in particular, shall assist these
12    organizations to develop health care facilities planning that
13    meets  the criteria for recognition. Areawide health planning
14    organizations may  be  recognized  to  do  health  facilities
15    planning  by  providing  this  component  of  health planning
16    within  the   organization   or   by   contracting   with   a
17    special-purpose  health  planning organization that meets the
18    criteria for health facilities planning.
19        Recognition of these organizations with regard to  health
20    facilities  planning, including establishment of the criteria
21    for recognition, is the responsibility of the Department.
22        The Department is authorized to make grants-in-aid or  to
23    furnish  direct  services to organizations in the development
24    of health facilities planning capability, as a part of  other
25    financial  and  service  assistance  that  the  Department is
26    empowered and  required  to  provide  in  support  of  health
27    planning organizations.

28        Section  10.  The Illinois Health Facilities Planning Act
29    is amended by changing Section 8 as follows:
 
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 1        (20 ILCS 3960/8) (from Ch. 111 1/2, par. 1158)
 2        (Section scheduled to be repealed on July 1, 2003)
 3        Sec. 8.  The Agency shall assist communities and  regions
 4    throughout  the  State  to establish areawide health planning
 5    organizations  and,  in   particular,   shall   assist   such
 6    organizations  to  develop  health  care  facilities planning
 7    which meets the criteria for  recognition  thereof.  Areawide
 8    health  planning organizations may be recognized to do health
 9    facilities planning by providing  this  component  of  health
10    planning  within  the  organization  or by contracting with a
11    special-purpose health planning organization that  meets  the
12    criteria for health facilities planning.
13        Recognition  of these organizations with regard to health
14    facilities planning, including establishment of the  criteria
15    for  such  recognition,  shall  be  the responsibility of the
16    State Board, as provided elsewhere in this Act.
17        The Agency is authorized  to  make  grants-in-aid  or  to
18    furnish  direct  services to organizations in the development
19    of health facilities planning capability, as a part of  other
20    financial   and   service  assistance  which  the  Agency  is
21    empowered and  required  to  provide  in  support  of  health
22    planning organizations.
23        Upon receipt of an application for a permit to establish,
24    construct  or modify a health care facility, the Agency shall
25    notify the applicant in writing within 10 working days either
26    that the application is  complete  or  the  reasons  why  the
27    application is not complete.  If the application is complete,
28    the  Agency shall notify affected persons of the beginning of
29    a review and the review time cycle for the purposes  of  this
30    Act shall begin on the date this notification is mailed.
31        Upon  notifying  affected  persons  of the beginning of a
32    review of an application for a permit,  a  complete  copy  of
33    such  application shall be transmitted to the areawide health
34    planning organization serving the area or community where the
 
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 1    health care facility or major medical equipment  is  proposed
 2    to  be  acquired,  established,  constructed or modified. The
 3    Agency  shall  also  transmit  a  complete   copy   of   such
 4    application  to  any  reasonably  contiguous  areawide health
 5    planning organization.  The Agency shall afford a  reasonable
 6    time as established by the State Board, but not to exceed 120
 7    days  in  length,  for  the  areawide planning organizations'
 8    review of the application.  After reviewing the  application,
 9    each  recognized areawide planning organization shall certify
10    its findings to the State Board as  to  whether  or  not  the
11    application  is  approved  or  disapproved in accordance with
12    standards, criteria or plans of need adopted and approved  by
13    the recognized areawide health planning organization pursuant
14    to  its  recognition  by  the  State  Board  for  health care
15    facilities planning.  The 120-day period shall begin  on  the
16    day the application is found to be substantially complete, as
17    that term is defined by the State Board.  During such 120-day
18    period, the applicant may request an extension.  An applicant
19    may  modify  the  application  at  any  time prior to a final
20    administrative decision on the application.
21        Upon its receipt of an application, the  areawide  health
22    planning  organization or the Agency, as the case may be, may
23    submit a copy of such application to the federally-recognized
24    professional  standards  review  organization,  if  any,  and
25    appropriate  local  health  planning  organization,  if  any,
26    existing in the area where the proposed project is to  occur.
27    Such  organizations  may  review the application for a permit
28    and  submit,  within  30  days  from  the  receipt   of   the
29    application,  a  finding  to  the  agency  or to the areawide
30    health planning organization, as the case may  be.  A  review
31    and  finding by a federally-recognized professional standards
32    review organization must be relevant to  the  activities  for
33    which   such   organization   is  recognized,  and  shall  be
34    considered by the Agency  or  the  areawide  health  planning
 
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 1    organization,  as  the  case  may  be,  in  its review of the
 2    application.
 3        The State Board shall prescribe  and  provide  the  forms
 4    upon  which  the review and finding of the organization shall
 5    be   made.   The   recognized   areawide   health    planning
 6    organizations  shall  submit  their review and finding to the
 7    Agency for its finding on the application and transmittal  to
 8    the State Board for its consideration of denial or approval.
 9        If  there  is no areawide health planning organization in
10    the area where the proposed  establishment,  construction  or
11    modification  of a health care facility is to occur, then the
12    Agency shall be afforded a reasonable time, but not to exceed
13    120 days, for its review  and  finding  thereon.  The  Agency
14    shall  submit  its  review and finding to the State Board for
15    its approval or denial of the permit.
16        When an application for a permit is initially reviewed by
17    a recognized areawide health  planning  organization  or  the
18    Agency,  as  herein provided, the organization or the Agency,
19    as the case may be, shall afford an opportunity for a  public
20    hearing  within  a  reasonable  time  after  receipt  of  the
21    complete  application,  not to exceed 90 days. Notice of such
22    hearing shall be made  promptly  by  certified  mail  to  the
23    applicant  and, within 10 days of the hearing, by publication
24    in  a  newspaper  of  general  circulation  in  the  area  or
25    community to be affected. Such hearing shall be conducted  in
26    the area or community where the proposed project is to occur,
27    and  shall  be  for the purpose of allowing the applicant and
28    any interested person to present public testimony  concerning
29    the  approval,  denial,  renewal or revocation of the permit.
30    All interested persons attending such hearing shall be  given
31    reasonable opportunity to present their views or arguments in
32    writing  or  orally, and a record of all such testimony shall
33    accompany any recommendation of the Agency or the  recognized
34    areawide  health  planning  organization  for  the  issuance,
 
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 1    denial, revocation or renewal of a permit to the State Board.
 2    The   State  Board  shall  promulgate  reasonable  rules  and
 3    regulations governing  the  procedure  and  conduct  of  such
 4    hearings.
 5    (Source: P.A. 88-18.)

 6        (20 ILCS 3960/12.1 rep.)
 7        Section  15.  The Illinois Health Facilities Planning Act
 8    is amended by repealing Section 12.1.

 9        Section 20.  The Health Care Worker Self-Referral Act  is
10    amended by changing Sections 5, 15, and 30 as follows:

11        (225 ILCS 47/5)
12        Sec.   5.   Legislative  intent.   The  General  Assembly
13    recognizes that patient referrals by health care workers  for
14    health  services  to  an entity in which the referring health
15    care  worker  has  an  investment  interest  may  present   a
16    potential  conflict  of interest.  The General Assembly finds
17    that  these  referral  practices  may  limit  or   completely
18    eliminate competitive alternatives in the health care market.
19    In  some  instances,  these referral practices may expand and
20    improve care  or  may  make  services  available  which  were
21    previously  unavailable.   They  may  also provide lower cost
22    options to  patients  or  increase  competition.   Generally,
23    referral   practices   are  positive  occurrences.   However,
24    self-referrals may  result  in  over  utilization  of  health
25    services, increased overall costs of the health care systems,
26    and may affect the quality of health care.
27        It  is  the  intent  of  the  General Assembly to provide
28    guidance to health care workers regarding acceptable  patient
29    referrals,   to   prohibit   patient  referrals  to  entities
30    providing health services in which the referring health  care
31    worker  has  an  investment  interest,  and  to  protect  the
 
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 1    citizens  of Illinois from unnecessary and costly health care
 2    expenditures.
 3        Recognizing the need for flexibility to  quickly  respond
 4    to  changes  in  the  delivery  of  health services, to avoid
 5    results beyond the  limitations  on  self  referral  provided
 6    under  this  Act  and  to  provide  minimal disruption to the
 7    appropriate delivery of health care,  the  Health  Facilities
 8    Planning  Board shall be exclusively and solely authorized to
 9    implement and interpret this Act through adopted rules.
10        The General Assembly recognizes that changes in  delivery
11    of  health  care  has  resulted  in  various methods by which
12    health care workers practice their professions.   It  is  not
13    the  intent  of  the  General  Assembly  to limit appropriate
14    delivery of  care,  nor  force  unnecessary  changes  in  the
15    structures  created by workers for the health and convenience
16    of their patients.
17    (Source: P.A. 87-1207.)

18        (225 ILCS 47/15)
19        Sec. 15.  Definitions.  In this Act:
20        (a)  "Board" means, before the  effective  date  of  this
21    amendatory  Act  of  the  93rd  General  Assembly, the Health
22    Facilities Planning Board. On and after the effective date of
23    this amendatory Act of the  93rd  General  Assembly,  "Board"
24    means the Illinois Department of Public Health.
25        (b)  "Entity"  means  any  individual, partnership, firm,
26    corporation, or other business that provides health  services
27    but  does  not  include  an  individual  who is a health care
28    worker who provides professional services to an individual.
29        (c)  "Group practice" means a group of 2 or  more  health
30    care workers legally organized as a partnership, professional
31    corporation,  not-for-profit  corporation,  faculty  practice
32    plan or a similar association in which:
33             (1)  each  health  care  worker  who  is a member or
 
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 1        employee  or  an  independent  contractor  of  the  group
 2        provides substantially the full range  of  services  that
 3        the  health  care  worker  routinely  provides, including
 4        consultation, diagnosis, or treatment, through the use of
 5        office space, facilities, equipment, or personnel of  the
 6        group;
 7             (2)  the  services  of  the  health care workers are
 8        provided through the group,  and  payments  received  for
 9        health services are treated as receipts of the group; and
10             (3)  the  overhead  expenses and the income from the
11        practice are distributed by methods previously determined
12        by the group.
13        (d)  "Health care worker" means any  individual  licensed
14    under  the  laws  of  this  State to provide health services,
15    including but not limited to:  dentists  licensed  under  the
16    Illinois  Dental  Practice  Act;  dental  hygienists licensed
17    under the Illinois Dental Practice Act; nurses  and  advanced
18    practice  nurses  licensed  under  the  Nursing  and Advanced
19    Practice Nursing Act; occupational therapists licensed  under
20    the  Illinois Occupational Therapy Practice Act; optometrists
21    licensed under the Illinois Optometric Practice Act of  1987;
22    pharmacists licensed under the Pharmacy Practice Act of 1987;
23    physical  therapists  licensed  under  the  Illinois Physical
24    Therapy Act; physicians licensed under the  Medical  Practice
25    Act   of   1987;  physician  assistants  licensed  under  the
26    Physician  Assistant  Practice  Act  of   1987;   podiatrists
27    licensed  under  the  Podiatric Medical Practice Act of 1987;
28    clinical   psychologists   licensed   under   the    Clinical
29    Psychologist  Licensing Act; clinical social workers licensed
30    under the Clinical Social Work and Social Work Practice  Act;
31    speech-language  pathologists and audiologists licensed under
32    the Illinois Speech-Language Pathology and Audiology Practice
33    Act; or hearing  instrument  dispensers  licensed  under  the
34    Hearing  Instrument  Consumer Protection Act, or any of their
 
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 1    successor Acts.
 2        (e)  "Health services" means health care  procedures  and
 3    services provided by or through a health care worker.
 4        (f)  "Immediate   family  member"  means  a  health  care
 5    worker's spouse, child, child's spouse, or a parent.
 6        (g)  "Investment  interest"  means  an  equity  or   debt
 7    security  issued by an entity, including, without limitation,
 8    shares of stock in a corporation, units or other interests in
 9    a partnership, bonds,  debentures,  notes,  or  other  equity
10    interests or debt instruments except that investment interest
11    for  purposes  of  Section  20 does not include interest in a
12    hospital licensed under the laws of the State of Illinois.
13        (h)  "Investor" means an individual or entity directly or
14    indirectly  owning  a  legal  or  beneficial   ownership   or
15    investment  interest,  (such  as  through an immediate family
16    member, trust, or another entity related to the investor).
17        (i)  "Office   practice"   includes   the   facility   or
18    facilities at which a  health  care  worker,  on  an  ongoing
19    basis,  provides  or supervises the provision of professional
20    health services to individuals.
21        (j)  "Referral" means  any  referral  of  a  patient  for
22    health services, including, without limitation:
23             (1)  The  forwarding of a patient by one health care
24        worker to another health care  worker  or  to  an  entity
25        outside the health care worker's office practice or group
26        practice that provides health services.
27             (2)  The  request  or establishment by a health care
28        worker of a plan of care outside the health care worker's
29        office practice  or  group  practice  that  includes  the
30        provision of any health services.
31    (Source: P.A. 89-72, eff. 12-31-95; 90-742, eff. 8-13-98.)

32        (225 ILCS 47/30)
33        Sec.  30.  Rulemaking.   The  Health  Facilities Planning
 
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 1    Board shall exclusively and solely implement  the  provisions
 2    of  this Act pursuant to rules adopted in accordance with the
 3    Illinois Administrative Procedure  Act  concerning,  but  not
 4    limited to:
 5        (a)  Standards  and  procedures for the administration of
 6    this Act.
 7        (b)  Procedures and  criteria  for  exceptions  from  the
 8    prohibitions set forth in Section 20.
 9        (c)  Procedures  and  criteria  for determining practical
10    compliance with the needs and alternative  investor  criteria
11    in Section 20.
12        (d)  Procedures  and  criteria  for  determining  when  a
13    written  request  for  an  opinion set forth in Section 20 is
14    complete.
15        (e)  Procedures and criteria  for  advising  health  care
16    workers  of  the  applicability  of  this  Act  to  practices
17    pursuant to written requests.
18    (Source: P.A. 87-1207.)

19        Section  99.  Effective date.  This Act takes effect upon
20    becoming law.