Illinois General Assembly - Full Text of HB3155
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Full Text of HB3155  97th General Assembly




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1    AN ACT concerning public health.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Illinois Welfare and Rehabilitation
5Services Planning Act is amended by changing Section 4 as
7    (20 ILCS 10/4)  (from Ch. 127, par. 954)
8    Sec. 4. (a) Plans required by Section 3 shall be prepared
9by and submitted on behalf of the following State agencies, and
10may be prepared and submitted by another State Agency
11designated by the Governor:
12        (1) the Department of Children and Family Services;
13        (2) the Department of Healthcare and Family Services;
14        (3) the Department of Corrections;
15        (4) the Department of Human Services;
16        (5) (blank);
17        (6) the Department on Aging;
18        (7) (blank) the Department of Public Health;
19        (8) the Department of Employment Security.
20    (b) The plans required by Section 3 of this Act shall be
21co-ordinated with the plan adopted by the Department of Human
22Services under Sections 48 through 52 of the Mental Health and
23Developmental Disabilities Administrative Act and any plan



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1adopted, re-adopted or amended by the Department of Human
2Services under those Sections shall be coordinated with plans
3required under Section 3 of this Act.
4(Source: P.A. 95-331, eff. 8-21-07.)
5    Section 10. The Alternative Health Care Delivery Act is
6amended by changing Sections 15, 30, and 35 as follows:
7    (210 ILCS 3/15)
8    Sec. 15. License required. No health care facility or
9program that meets the definition and scope of an alternative
10health care model shall operate as such unless it is a
11participant in a demonstration program under this Act and
12licensed by the Department as an alternative health care model.
13The provisions of this Section as they relate to subacute care
14hospitals shall not apply to hospitals licensed under the
15Illinois Hospital Licensing Act or skilled nursing facilities
16licensed under the Illinois Nursing Home Care Act or the MR/DD
17Community Care Act; provided, however, that the facilities
18shall not hold themselves out to the public as subacute care
19hospitals. The provisions of this Act concerning children's
20respite care centers shall not apply to any facility licensed
21under the Hospital Licensing Act, the Nursing Home Care Act,
22the MR/DD Community Care Act, or the University of Illinois
23Hospital Act that provides respite care services to children.
24(Source: P.A. 95-331, eff. 8-21-07; 96-339, eff. 7-1-10.)



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1    (210 ILCS 3/30)
2    Sec. 30. Demonstration program requirements. The
3requirements set forth in this Section shall apply to
4demonstration programs.
5    (a) (Blank). There shall be no more than:
6        (i) 3 subacute care hospital alternative health care
7    models in the City of Chicago (one of which shall be
8    located on a designated site and shall have been licensed
9    as a hospital under the Illinois Hospital Licensing Act
10    within the 10 years immediately before the application for
11    a license);
12        (ii) 2 subacute care hospital alternative health care
13    models in the demonstration program for each of the
14    following areas:
15            (1) Cook County outside the City of Chicago.
16            (2) DuPage, Kane, Lake, McHenry, and Will
17        Counties.
18            (3) Municipalities with a population greater than
19        50,000 not located in the areas described in item (i)
20        of subsection (a) and paragraphs (1) and (2) of item
21        (ii) of subsection (a); and
22        (iii) 4 subacute care hospital alternative health care
23    models in the demonstration program for rural areas.
24    In selecting among applicants for these licenses in rural
25areas, the Health Facilities and Services Review Board and the



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1Department shall give preference to hospitals that may be
2unable for economic reasons to provide continued service to the
3community in which they are located unless the hospital were to
4receive an alternative health care model license.
5    (a-5) There shall be no more than the total number of
6postsurgical recovery care centers with a certificate of need
7for beds as of January 1, 2008.
8    (a-10) There shall be no more than a total of 9 children's
9respite care center alternative health care models in the
10demonstration program, which shall be located as follows:
11        (1) Two in the City of Chicago.
12        (2) One in Cook County outside the City of Chicago.
13        (3) A total of 2 in the area comprised of DuPage, Kane,
14    Lake, McHenry, and Will counties.
15        (4) A total of 2 in municipalities with a population of
16    50,000 or more and not located in the areas described in
17    paragraphs (1), (2), or (3).
18        (5) A total of 2 in rural areas, as defined by the
19    Health Facilities and Services Review Board.
20    No more than one children's respite care model owned and
21operated by a licensed skilled pediatric facility shall be
22located in each of the areas designated in this subsection
24    (a-15) There shall be 5 authorized community-based
25residential rehabilitation center alternative health care
26models in the demonstration program.



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1    (a-20) There shall be an authorized Alzheimer's disease
2management center alternative health care model in the
3demonstration program. The Alzheimer's disease management
4center shall be located in Will County, owned by a
5not-for-profit entity, and endorsed by a resolution approved by
6the county board before the effective date of this amendatory
7Act of the 91st General Assembly.
8    (a-25) There shall be no more than 10 birth center
9alternative health care models in the demonstration program,
10located as follows:
11        (1) Four in the area comprising Cook, DuPage, Kane,
12    Lake, McHenry, and Will counties, one of which shall be
13    owned or operated by a hospital and one of which shall be
14    owned or operated by a federally qualified health center.
15        (2) Three in municipalities with a population of 50,000
16    or more not located in the area described in paragraph (1)
17    of this subsection, one of which shall be owned or operated
18    by a hospital and one of which shall be owned or operated
19    by a federally qualified health center.
20        (3) Three in rural areas, one of which shall be owned
21    or operated by a hospital and one of which shall be owned
22    or operated by a federally qualified health center.
23    The first 3 birth centers authorized to operate by the
24Department shall be located in or predominantly serve the
25residents of a health professional shortage area as determined
26by the United States Department of Health and Human Services.



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1There shall be no more than 2 birth centers authorized to
2operate in any single health planning area for obstetric
3services as determined under the Illinois Health Facilities
4Planning Act. If a birth center is located outside of a health
5professional shortage area, (i) the birth center shall be
6located in a health planning area with a demonstrated need for
7obstetrical service beds, as determined by the Health
8Facilities and Services Review Board or (ii) there must be a
9reduction in the existing number of obstetrical service beds in
10the planning area so that the establishment of the birth center
11does not result in an increase in the total number of
12obstetrical service beds in the health planning area.
13    (b) Alternative health care models, other than a model
14authorized under subsection (a-10) or (a-20), shall obtain a
15certificate of need from the Health Facilities and Services
16Review Board under the Illinois Health Facilities Planning Act
17before receiving a license by the Department. If, after
18obtaining its initial certificate of need, an alternative
19health care delivery model that is a community based
20residential rehabilitation center seeks to increase the bed
21capacity of that center, it must obtain a certificate of need
22from the Health Facilities and Services Review Board before
23increasing the bed capacity. Alternative health care models in
24medically underserved areas shall receive priority in
25obtaining a certificate of need.
26    (c) An alternative health care model license shall be



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1issued for a period of one year and shall be annually renewed
2if the facility or program is in substantial compliance with
3the Department's rules adopted under this Act. A licensed
4alternative health care model that continues to be in
5substantial compliance after the conclusion of the
6demonstration program shall be eligible for annual renewals
7unless and until a different licensure program for that type of
8health care model is established by legislation, except that a
9postsurgical recovery care center meeting the following
10requirements may apply within 3 years after August 25, 2009
11(the effective date of Public Act 96-669) for a Certificate of
12Need permit to operate as a hospital:
13        (1) The postsurgical recovery care center shall apply
14    to the Illinois Health Facilities Planning Board for a
15    Certificate of Need permit to discontinue the postsurgical
16    recovery care center and to establish a hospital.
17        (2) If the postsurgical recovery care center obtains a
18    Certificate of Need permit to operate as a hospital, it
19    shall apply for licensure as a hospital under the Hospital
20    Licensing Act and shall meet all statutory and regulatory
21    requirements of a hospital.
22        (3) After obtaining licensure as a hospital, any
23    license as an ambulatory surgical treatment center and any
24    license as a post-surgical recovery care center shall be
25    null and void.
26        (4) The former postsurgical recovery care center that



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1    receives a hospital license must seek and use its best
2    efforts to maintain certification under Titles XVIII and
3    XIX of the federal Social Security Act.
4    The Department may issue a provisional license to any
5alternative health care model that does not substantially
6comply with the provisions of this Act and the rules adopted
7under this Act if (i) the Department finds that the alternative
8health care model has undertaken changes and corrections which
9upon completion will render the alternative health care model
10in substantial compliance with this Act and rules and (ii) the
11health and safety of the patients of the alternative health
12care model will be protected during the period for which the
13provisional license is issued. The Department shall advise the
14licensee of the conditions under which the provisional license
15is issued, including the manner in which the alternative health
16care model fails to comply with the provisions of this Act and
17rules, and the time within which the changes and corrections
18necessary for the alternative health care model to
19substantially comply with this Act and rules shall be
21    (d) Alternative health care models shall seek
22certification under Titles XVIII and XIX of the federal Social
23Security Act. In addition, alternative health care models shall
24provide charitable care consistent with that provided by
25comparable health care providers in the geographic area.
26    (d-5) (Blank).



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1    (e) Alternative health care models shall, to the extent
2possible, link and integrate their services with nearby health
3care facilities.
4    (f) Each alternative health care model shall implement a
5quality assurance program with measurable benefits and at
6reasonable cost.
7(Source: P.A. 95-331, eff. 8-21-07; 95-445, eff. 1-1-08; 96-31,
8eff. 6-30-09; 96-129, eff. 8-4-09; 96-669, eff. 8-25-09;
996-812, eff. 1-1-10; 96-1000, eff. 7-2-10; 96-1071, eff.
107-16-10; 96-1123, eff. 1-1-11; revised 9-16-10.)
11    (210 ILCS 3/35)
12    Sec. 35. Alternative health care models authorized.
13Notwithstanding any other law to the contrary, alternative
14health care models described in this Section may be established
15on a demonstration basis.
16        (1) (Blank). Alternative health care model; subacute
17    care hospital. A subacute care hospital is a designated
18    site which provides medical specialty care for patients who
19    need a greater intensity or complexity of care than
20    generally provided in a skilled nursing facility but who no
21    longer require acute hospital care. The average length of
22    stay for patients treated in subacute care hospitals shall
23    not be less than 20 days, and for individual patients, the
24    expected length of stay at the time of admission shall not
25    be less than 10 days. Variations from minimum lengths of



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1    stay shall be reported to the Department. There shall be no
2    more than 13 subacute care hospitals authorized to operate
3    by the Department. Subacute care includes physician
4    supervision, registered nursing, and physiological
5    monitoring on a continual basis. A subacute care hospital
6    is either a freestanding building or a distinct physical
7    and operational entity within a hospital or nursing home
8    building. A subacute care hospital shall only consist of
9    beds currently existing in licensed hospitals or skilled
10    nursing facilities, except, in the City of Chicago, on a
11    designated site that was licensed as a hospital under the
12    Illinois Hospital Licensing Act within the 10 years
13    immediately before the application for an alternative
14    health care model license. During the period of operation
15    of the demonstration project, the existing licensed beds
16    shall remain licensed as hospital or skilled nursing
17    facility beds as well as being licensed under this Act. In
18    order to handle cases of complications, emergencies, or
19    exigent circumstances, a subacute care hospital shall
20    maintain a contractual relationship, including a transfer
21    agreement, with a general acute care hospital. If a
22    subacute care model is located in a general acute care
23    hospital, it shall utilize all or a portion of the bed
24    capacity of that existing hospital. In no event shall a
25    subacute care hospital use the word "hospital" in its
26    advertising or marketing activities or represent or hold



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1    itself out to the public as a general acute care hospital.
2        (2) Alternative health care delivery model;
3    postsurgical recovery care center. A postsurgical recovery
4    care center is a designated site which provides
5    postsurgical recovery care for generally healthy patients
6    undergoing surgical procedures that require overnight
7    nursing care, pain control, or observation that would
8    otherwise be provided in an inpatient setting. A
9    postsurgical recovery care center is either freestanding
10    or a defined unit of an ambulatory surgical treatment
11    center or hospital. No facility, or portion of a facility,
12    may participate in a demonstration program as a
13    postsurgical recovery care center unless the facility has
14    been licensed as an ambulatory surgical treatment center or
15    hospital for at least 2 years before August 20, 1993 (the
16    effective date of Public Act 88-441). The maximum length of
17    stay for patients in a postsurgical recovery care center is
18    not to exceed 48 hours unless the treating physician
19    requests an extension of time from the recovery center's
20    medical director on the basis of medical or clinical
21    documentation that an additional care period is required
22    for the recovery of a patient and the medical director
23    approves the extension of time. In no case, however, shall
24    a patient's length of stay in a postsurgical recovery care
25    center be longer than 72 hours. If a patient requires an
26    additional care period after the expiration of the 72-hour



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1    limit, the patient shall be transferred to an appropriate
2    facility. Reports on variances from the 48-hour limit shall
3    be sent to the Department for its evaluation. The reports
4    shall, before submission to the Department, have removed
5    from them all patient and physician identifiers. In order
6    to handle 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 care
11    center shall be no larger than 20 beds. A postsurgical
12    recovery care center shall be located within 15 minutes
13    travel time from the general acute care hospital with which
14    the center maintains a contractual relationship, including
15    a transfer agreement, as required under this paragraph.
16        No postsurgical recovery care center shall
17    discriminate against any patient requiring treatment
18    because of the source of payment for services, including
19    Medicare and Medicaid recipients.
20        The Department shall adopt rules to implement the
21    provisions of Public Act 88-441 concerning postsurgical
22    recovery care centers within 9 months after August 20,
23    1993.
24        (3) Alternative health care delivery model; children's
25    community-based health care center. A children's
26    community-based health care center model is a designated



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1    site that provides nursing care, clinical support
2    services, and therapies for a period of one to 14 days for
3    short-term stays and 120 days to facilitate transitions to
4    home or other appropriate settings for medically fragile
5    children, technology dependent children, and children with
6    special health care needs who are deemed clinically stable
7    by a physician and are younger than 22 years of age. This
8    care is to be provided in a home-like environment that
9    serves no more than 12 children at a time. Children's
10    community-based health care center services must be
11    available through the model to all families, including
12    those whose care is paid for through the Department of
13    Healthcare and Family Services, the Department of Children
14    and Family Services, the Department of Human Services, and
15    insurance companies who cover home health care services or
16    private duty nursing care in the home.
17        Each children's community-based health care center
18    model location shall be physically separate and apart from
19    any other facility licensed by the Department of Public
20    Health under this or any other Act and shall provide the
21    following services: respite care, registered nursing or
22    licensed practical nursing care, transitional care to
23    facilitate home placement or other appropriate settings
24    and reunite families, medical day care, weekend camps, and
25    diagnostic studies typically done in the home setting.
26        Coverage for the services provided by the Department of



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1    Healthcare and Family Services under this paragraph (3) is
2    contingent upon federal waiver approval and is provided
3    only to Medicaid eligible clients participating in the home
4    and community based services waiver designated in Section
5    1915(c) of the Social Security Act for medically frail and
6    technologically dependent children or children in
7    Department of Children and Family Services foster care who
8    receive home health benefits.
9        (4) Alternative health care delivery model; community
10    based residential rehabilitation center. A community-based
11    residential rehabilitation center model is a designated
12    site that provides rehabilitation or support, or both, for
13    persons who have experienced severe brain injury, who are
14    medically stable, and who no longer require acute
15    rehabilitative care or intense medical or nursing
16    services. The average length of stay in a community-based
17    residential rehabilitation center shall not exceed 4
18    months. As an integral part of the services provided,
19    individuals are housed in a supervised living setting while
20    having immediate access to the community. The residential
21    rehabilitation center authorized by the Department may
22    have more than one residence included under the license. A
23    residence may be no larger than 12 beds and shall be
24    located as an integral part of the community. Day treatment
25    or individualized outpatient services shall be provided
26    for persons who reside in their own home. Functional



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1    outcome goals shall be established for each individual.
2    Services shall include, but are not limited to, case
3    management, training and assistance with activities of
4    daily living, nursing consultation, traditional therapies
5    (physical, occupational, speech), functional interventions
6    in the residence and community (job placement, shopping,
7    banking, recreation), counseling, self-management
8    strategies, productive activities, and multiple
9    opportunities for skill acquisition and practice
10    throughout the day. The design of individualized program
11    plans shall be consistent with the outcome goals that are
12    established for each resident. The programs provided in
13    this setting shall be accredited by the Commission on
14    Accreditation of Rehabilitation Facilities (CARF). The
15    program shall have been accredited by CARF as a Brain
16    Injury Community-Integrative Program for at least 3 years.
17        (5) Alternative health care delivery model;
18    Alzheimer's disease management center. An Alzheimer's
19    disease management center model is a designated site that
20    provides a safe and secure setting for care of persons
21    diagnosed with Alzheimer's disease. An Alzheimer's disease
22    management center model shall be a facility separate from
23    any other facility licensed by the Department of Public
24    Health under this or any other Act. An Alzheimer's disease
25    management center shall conduct and document an assessment
26    of each resident every 6 months. The assessment shall



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1    include an evaluation of daily functioning, cognitive
2    status, other medical conditions, and behavioral problems.
3    An Alzheimer's disease management center shall develop and
4    implement an ongoing treatment plan for each resident. The
5    treatment plan shall have defined goals. The Alzheimer's
6    disease management center shall treat behavioral problems
7    and mood disorders using nonpharmacologic approaches such
8    as environmental modification, task simplification, and
9    other appropriate activities. All staff must have
10    necessary training to care for all stages of Alzheimer's
11    Disease. An Alzheimer's disease management center shall
12    provide education and support for residents and
13    caregivers. The education and support shall include
14    referrals to support organizations for educational
15    materials on community resources, support groups, legal
16    and financial issues, respite care, and future care needs
17    and options. The education and support shall also include a
18    discussion of the resident's need to make advance
19    directives and to identify surrogates for medical and legal
20    decision-making. The provisions of this paragraph
21    establish the minimum level of services that must be
22    provided by an Alzheimer's disease management center. An
23    Alzheimer's disease management center model shall have no
24    more than 100 residents. Nothing in this paragraph (5)
25    shall be construed as prohibiting a person or facility from
26    providing services and care to persons with Alzheimer's



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1    disease as otherwise authorized under State law.
2        (6) Alternative health care delivery model; birth
3    center. A birth center shall be exclusively dedicated to
4    serving the childbirth-related needs of women and their
5    newborns and shall have no more than 10 beds. A birth
6    center is a designated site that is away from the mother's
7    usual place of residence and in which births are planned to
8    occur following a normal, uncomplicated, and low-risk
9    pregnancy. A birth center shall offer prenatal care and
10    community education services and shall coordinate these
11    services with other health care services available in the
12    community.
13            (A) A birth center shall not be separately licensed
14        if it is one of the following:
15                (1) A part of a hospital; or
16                (2) A freestanding facility that is physically
17            distinct from a hospital but is operated under a
18            license issued to a hospital under the Hospital
19            Licensing Act.
20            (B) A separate birth center license shall be
21        required if the birth center is operated as:
22                (1) A part of the operation of a federally
23            qualified health center as designated by the
24            United States Department of Health and Human
25            Services; or
26                (2) A facility other than one described in



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1            subparagraph (A)(1), (A)(2), or (B)(1) of this
2            paragraph (6) whose costs are reimbursable under
3            Title XIX of the federal Social Security Act.
4        In adopting rules for birth centers, the Department
5    shall consider: the American Association of Birth Centers'
6    Standards for Freestanding Birth Centers; the American
7    Academy of Pediatrics/American College of Obstetricians
8    and Gynecologists Guidelines for Perinatal Care; and the
9    Regionalized Perinatal Health Care Code. The Department's
10    rules shall stipulate the eligibility criteria for birth
11    center admission. The Department's rules shall stipulate
12    the necessary equipment for emergency care according to the
13    American Association of Birth Centers' standards and any
14    additional equipment deemed necessary by the Department.
15    The Department's rules shall provide for a time period
16    within which each birth center not part of a hospital must
17    become accredited by either the Commission for the
18    Accreditation of Freestanding Birth Centers or The Joint
19    Commission.
20        A birth center shall be certified to participate in the
21    Medicare and Medicaid programs under Titles XVIII and XIX,
22    respectively, of the federal Social Security Act. To the
23    extent necessary, the Illinois Department of Healthcare
24    and Family Services shall apply for a waiver from the
25    United States Health Care Financing Administration to
26    allow birth centers to be reimbursed under Title XIX of the



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1    federal Social Security Act.
2        A birth center that is not operated under a hospital
3    license shall be located within a ground travel time
4    distance from the general acute care hospital with which
5    the birth center maintains a contractual relationship,
6    including a transfer agreement, as required under this
7    paragraph, that allows for an emergency caesarian delivery
8    to be started within 30 minutes of the decision a caesarian
9    delivery is necessary. A birth center operating under a
10    hospital license shall be located within a ground travel
11    time distance from the licensed hospital that allows for an
12    emergency caesarian delivery to be started within 30
13    minutes of the decision a caesarian delivery is necessary.
14        The services of a medical director physician, licensed
15    to practice medicine in all its branches, who is certified
16    or eligible for certification by the American College of
17    Obstetricians and Gynecologists or the American Board of
18    Osteopathic Obstetricians and Gynecologists or has
19    hospital obstetrical privileges are required in birth
20    centers. The medical director in consultation with the
21    Director of Nursing and Midwifery Services shall
22    coordinate the clinical staff and overall provision of
23    patient care. The medical director or his or her physician
24    designee shall be available on the premises or within a
25    close proximity as defined by rule. The medical director
26    and the Director of Nursing and Midwifery Services shall



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1    jointly develop and approve policies defining the criteria
2    to determine which pregnancies are accepted as normal,
3    uncomplicated, and low-risk, and the anesthesia services
4    available at the center. No general anesthesia may be
5    administered at the center.
6        If a birth center employs certified nurse midwives, a
7    certified nurse midwife shall be the Director of Nursing
8    and Midwifery Services who is responsible for the
9    development of policies and procedures for services as
10    provided by Department rules.
11        An obstetrician, family practitioner, or certified
12    nurse midwife shall attend each woman in labor from the
13    time of admission through birth and throughout the
14    immediate postpartum period. Attendance may be delegated
15    only to another physician or certified nurse midwife.
16    Additionally, a second staff person shall also be present
17    at each birth who is licensed or certified in Illinois in a
18    health-related field and under the supervision of the
19    physician or certified nurse midwife in attendance, has
20    specialized training in labor and delivery techniques and
21    care of newborns, and receives planned and ongoing training
22    as needed to perform assigned duties effectively.
23        The maximum length of stay in a birth center shall be
24    consistent with existing State laws allowing a 48-hour stay
25    or appropriate post-delivery care, if discharged earlier
26    than 48 hours.



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1        A birth center shall participate in the Illinois
2    Perinatal System under the Developmental Disability
3    Prevention Act. At a minimum, this participation shall
4    require a birth center to establish a letter of agreement
5    with a hospital designated under the Perinatal System. A
6    hospital that operates or has a letter of agreement with a
7    birth center shall include the birth center under its
8    maternity service plan under the Hospital Licensing Act and
9    shall include the birth center in the hospital's letter of
10    agreement with its regional perinatal center.
11        A birth center may not discriminate against any patient
12    requiring treatment because of the source of payment for
13    services, including Medicare and Medicaid recipients.
14        No general anesthesia and no surgery may be performed
15    at a birth center. The Department may by rule add birth
16    center patient eligibility criteria or standards as it
17    deems necessary. The Department shall by rule require each
18    birth center to report the information which the Department
19    shall make publicly available, which shall include, but is
20    not limited to, the following:
21            (i) Birth center ownership.
22            (ii) Sources of payment for services.
23            (iii) Utilization data involving patient length of
24        stay.
25            (iv) Admissions and discharges.
26            (v) Complications.



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1            (vi) Transfers.
2            (vii) Unusual incidents.
3            (viii) Deaths.
4            (ix) Any other publicly reported data required
5        under the Illinois Consumer Guide.
6            (x) Post-discharge patient status data where
7        patients are followed for 14 days after discharge from
8        the birth center to determine whether the mother or
9        baby developed a complication or infection.
10        Within 9 months after the effective date of this
11    amendatory Act of the 95th General Assembly, the Department
12    shall adopt rules that are developed with consideration of:
13    the American Association of Birth Centers' Standards for
14    Freestanding Birth Centers; the American Academy of
15    Pediatrics/American College of Obstetricians and
16    Gynecologists Guidelines for Perinatal Care; and the
17    Regionalized Perinatal Health Care Code.
18        The Department shall adopt other rules as necessary to
19    implement the provisions of this amendatory Act of the 95th
20    General Assembly within 9 months after the effective date
21    of this amendatory Act of the 95th General Assembly.
22(Source: P.A. 95-331, eff. 8-21-07; 95-445, eff. 1-1-08.)
23    Section 15. The Nursing Home Care Act is amended by
24changing Sections 2-106 and 3-804 as follows:



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1    (210 ILCS 45/2-106)  (from Ch. 111 1/2, par. 4152-106)
2    Sec. 2-106. (a) For purposes of this Act, (i) a physical
3restraint is any manual method or physical or mechanical
4device, material, or equipment attached or adjacent to a
5resident's body that the resident cannot remove easily and
6restricts freedom of movement or normal access to one's body.
7Devices used for positioning, including but not limited to bed
8rails, gait belts, and cushions, shall not be considered to be
9restraints for purposes of this Section; (ii) a chemical
10restraint is any drug used for discipline or convenience and
11not required to treat medical symptoms. The Department shall by
12rule, designate certain devices as restraints, including at
13least all those devices which have been determined to be
14restraints by the United States Department of Health and Human
15Services in interpretive guidelines issued for the purposes of
16administering Titles XVIII and XIX of the Social Security Act.
17    (b) Neither restraints nor confinements shall be employed
18for the purpose of punishment or for the convenience of any
19facility personnel. No restraints or confinements shall be
20employed except as ordered by a physician who documents the
21need for such restraints or confinements in the resident's
22clinical record. Each facility licensed under this Act must
23have a written policy to address the use of restraints and
24seclusion. The Department shall establish by rule the
25provisions that the policy must include, which, to the extent
26practicable, should be consistent with the requirements for



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1participation in the federal Medicare program. Each policy
2shall include periodic review of the use of restraints.
3    (c) A restraint may be used only with the informed consent
4of the resident, the resident's guardian, or other authorized
5representative. A restraint may be used only for specific
6periods, if it is the least restrictive means necessary to
7attain and maintain the resident's highest practicable
8physical, mental or psychosocial well-being, including brief
9periods of time to provide necessary life-saving treatment. A
10restraint may be used only after consultation with appropriate
11health professionals, such as occupational or physical
12therapists, and a trial of less restrictive measures has led to
13the determination that the use of less restrictive measures
14would not attain or maintain the resident's highest practicable
15physical, mental or psychosocial well-being. However, if the
16resident needs emergency care, restraints may be used for brief
17periods to permit medical treatment to proceed unless the
18facility has notice that the resident has previously made a
19valid refusal of the treatment in question.
20    (d) A restraint may be applied only by a person trained in
21the application of the particular type of restraint.
22    (e) Whenever a period of use of a restraint is initiated,
23the resident shall be advised of his or her right to have a
24person or organization of his or her choosing, including the
25Guardianship and Advocacy Commission, notified of the use of
26the restraint. A recipient who is under guardianship may



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1request that a person or organization of his or her choosing be
2notified of the restraint, whether or not the guardian approves
3the notice. If the resident so chooses, the facility shall make
4the notification within 24 hours, including any information
5about the period of time that the restraint is to be used.
6Whenever the Guardianship and Advocacy Commission is notified
7that a resident has been restrained, it shall contact the
8resident to determine the circumstances of the restraint and
9whether further action is warranted.
10    (f) Whenever a restraint is used on a resident whose
11primary mode of communication is sign language, the resident
12shall be permitted to have his or her hands free from restraint
13for brief periods each hour, except when this freedom may
14result in physical harm to the resident or others.
15    (g) The requirements of this Section are intended to
16control in any conflict with the requirements of Sections 1-126
17and 2-108 of the Mental Health and Developmental Disabilities
19(Source: P.A. 95-331, eff. 8-21-07.)
20    (210 ILCS 45/3-804)  (from Ch. 111 1/2, par. 4153-804)
21    Sec. 3-804. The Department shall report to the General
22Assembly by July April 1 of each year upon the performance of
23its inspection, survey and evaluation duties under this Act,
24including the number and needs of the Department personnel
25engaged in such activities. The report shall also describe the



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1Department's actions in enforcement of this Act, including the
2number and needs of personnel so engaged. The report shall also
3include the number of valid and invalid complaints filed with
4the Department within the last calendar year.
5(Source: P.A. 84-1322.)
6    Section 20. The Illinois Migrant Labor Camp Law is amended
7by changing Sections 4 and 6 as follows:
8    (210 ILCS 110/4)  (from Ch. 111 1/2, par. 185.4)
9    Sec. 4. Applications for a license to operate or maintain a
10Migrant Labor Camp or for a renewal thereof shall be made upon
11forms to be furnished by the Department. Such application shall
13    (a) The name and address of the applicant or applicants. If
14the applicant is a partnership, the names and addresses of all
15the partners shall also be given. If the applicant is a
16corporation, the names and addresses of the principal officers
17of the corporation shall be given.
18    (b) The approximate legal description and the address of
19the tract of land upon which the applicant proposes to operate
20and maintain such Migrant Labor Camp.
21    (c) A general plan or sketch of the camp site showing the
22location of the buildings or facilities together with a
23description of the buildings, of the water supply, of the
24toilet, bathing and laundry facilities, and of the fire



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1protection equipment.
2    (d) The date upon which the occupancy and use of the
3Migrant Labor Camp will commence.
4    The application for the original license or for any renewal
5thereof shall be accompanied by a fee of $100.
6    Application for the original license or any renewal thereof
7shall be filed with the Department in the office of the
8Director at least 60 days prior to the date on which the
9occupancy and use of such camp is to commence. Application for
10a renewal license shall be filed with the Department at least
1160 days prior to the expiration date of the current license.
12The camp shall be ready for inspection at least 30 days prior
13to the date upon which the occupancy and use of such camp is to
15(Source: P.A. 86-595.)
16    (210 ILCS 110/6)  (from Ch. 111 1/2, par. 185.6)
17    Sec. 6. Upon receipt of an application for a license, the
18Department shall inspect the camp site and the facilities
19described in the application approximately 30 days prior to the
20date on which the occupancy and use of such camp is to
21commence. If the Department finds that the Migrant Labor Camp
22described in the application meets and complies with the
23provisions of this Act and the rules and regulations of the
24Department in relation thereto, the Director shall, not less
25than 15 days prior to the date on which the occupancy and use



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1of such camp is to commence, issue a license to the applicant
2for the operation of the camp.
3    If the application is denied, the Department shall notify
4the applicant in writing of such denial not less than 15 days
5prior to the date on which the occupancy and use of such camp
6is to commence, setting forth the reasons therefor. If the
7conditions constituting the basis for such denial are
8remediable, the applicant may correct such conditions and
9notify the Department in writing indicating therein the manner
10in which such conditions have been remedied. Notifications of
11corrections shall be processed in the same manner as the
12original application.
13(Source: Laws 1965, p. 2356.)
14    Section 25. The Poison Control System Act is amended by
15changing Section 15 as follows:
16    (410 ILCS 47/15)
17    Sec. 15. Regional center designation. By January 1, 1993,
18the Director of the Illinois Department of Public Health shall
19designate at least one 2 and no more than 3 human poison
20control centers. The director of the Illinois Department of
21Agriculture shall designate one 1 animal poison control center
22as regional poison control center to provide comprehensive
23poison control center services for animal exposures by January
241, 1993. The services provided by the centers shall adhere to



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1the appropriate national standards promulgated by the American
2Association of Poison Control Centers and the Illinois State
3Veterinary Medical Association; adherence to these standards
4shall occur within 2 years after designation by the respective
5departments, unless the center has been granted an extension by
6the Illinois Department of Public Health or the Illinois
7Department of Agriculture. The 2-year period shall
8automatically be extended for an additional 2 years if funding
9was not secured after a poison control center's initial
10designation. The designated departments shall set standards of
11operation after consulting with current poison control service
12providers. Poison control centers shall cooperate to reduce the
13cost of operations, collect information on poisoning
14exposures, and provide education to the public and health
15professionals. A regional poison control center shall continue
16to operate unless it voluntarily closes or the designating
17departments revoke the designation for failure to comply with
18the standards. Centers designated under this Act shall be
19considered State agencies for purposes of the State Employee
20Indemnification Act.
21(Source: P.A. 87-1145.)
22    Section 30. The Illinois Food, Drug and Cosmetic Act is
23amended by changing Section 21.3 as follows:
24    (410 ILCS 620/21.3)



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1    Sec. 21.3. Certificates of free sale; health certificates;
2shellfish certificates.
3    (a) The Department is authorized, upon request, to issue
4certificates of free sale, health certificates, or an
5equivalent, to Illinois food, dairy, drug, cosmetic, or medical
6device manufacturers, processors, packers, or warehousers. The
7Department shall charge a fee of $10 for issuing a certificate
8of free sale, health certificate, or equivalent.
9    (b) The Department shall issue an Illinois shellfish
10certificate, upon request, to shellfish firms in compliance
11with the National Shellfish Sanitation Program Model Ordinance
12Interstate Shellfish Sanitation Conference.
13    (c) This Section applies on and after January 1, 2003.
14(Source: P.A. 92-769, eff. 1-1-03.)
15    Section 35. The Grade A Pasteurized Milk and Milk Products
16Act is amended by changing Section 3 as follows:
17    (410 ILCS 635/3)  (from Ch. 56 1/2, par. 2203)
18    Sec. 3. Definitions.
19    (a) As used in this Act "Grade A" means that milk and milk
20products are produced and processed in accordance with the
21current Grade A Pasteurized Milk Ordinance as adopted by the
22National Conference on Interstate Milk Shipments and the latest
23United States Public Health Service - Food and Drug
24Administration and all other applicable federal regulations



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1Grade A Pasteurized Milk Ordinance as may be amended. The term
2Grade A is applicable to "dairy farm", "milk hauler-sampler",
3"milk plant", "milk product", "receiving station", "transfer
4station", "milk tank truck", and "certified pasteurizer
5sealer" whenever used in this Act.
6    (b) Unless the context clearly indicates otherwise, terms
7have the meaning ascribed as follows:
8        (1) "Dairy farm" means any place or premise where one
9    or more cows or goats are kept, and from which a part or
10    all of the milk or milk products are provided, sold, or
11    offered for sale to a milk plant, transfer station, or
12    receiving station.
13        (2) "Milk" means the milk of cows or goats and includes
14    skim milk and cream.
15        (3) "Milk plant" means any place, premise, or
16    establishment where milk or milk products are collected,
17    handled, processed, stored, pasteurized, aseptically
18    processed, bottled, or prepared for distribution.
19        (4) "Milk product" means any product including cream,
20    light cream, light whipping cream, heavy cream, heavy
21    whipping cream, whipped cream, whipped light cream, sour
22    cream, acidified light cream, cultured sour cream,
23    half-and-half, sour half-and-half, acidified sour
24    half-and-half, cultured half-and-half, reconstituted or
25    recombined milk and milk products, concentrated milk,
26    concentrated milk products, skim milk, lowfat milk, frozen



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1    milk concentrate, eggnog, buttermilk, cultured milk,
2    cultured lowfat milk or skim milk, cottage cheese, yogurt,
3    lowfat yogurt, nonfat yogurt, acidified milk, acidified
4    lowfat milk or skim milk, low-sodium milk, low-sodium
5    lowfat milk, low-sodium skim milk, lactose-reduced milk,
6    lactose-reduced lowfat milk, lactose-reduced skim milk,
7    aseptically processed and packaged milk and milk products,
8    and milk, lowfat milk or skim milk with added safe and
9    suitable microbial organisms.
10        (5) "Receiving station" means any place, premise, or
11    establishment where raw milk is received, collected,
12    handled, stored or cooled and prepared for further
13    transporting.
14        (6) "Transfer station" means any place, premise, or
15    establishment where milk or milk products are transferred
16    directly from one milk tank truck to another.
17        (7) "Department" means the Illinois Department of
18    Public Health.
19        (8) "Director" means the Director of the Illinois
20    Department of Public Health.
21        (9) "Embargo or hold for investigation" means a
22    detention or seizure designed to deny the use of milk or
23    milk products which may be unwholesome or to prohibit the
24    use of equipment which may result in contaminated or
25    unwholesome milk or dairy products.
26        (10) "Imminent hazard to the public health" means any



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1    hazard to the public health when the evidence is sufficient
2    to show that a product or practice, posing or contributing
3    to a significant threat of danger to health, creates or may
4    create a public health situation (1) that should be
5    corrected immediately to prevent injury and (2) that should
6    not be permitted to continue while a hearing or other
7    formal proceeding is being held.
8        (11) "Person" means any individual, group of
9    individuals, association, trust, partnership, corporation,
10    person doing business under an assumed name, the State of
11    Illinois, or any political subdivision or department
12    thereof, or any other entity.
13        (12) "Enforcing agency" means the Illinois Department
14    of Public Health or a unit of local government electing to
15    administer and enforce this Act as provided for in this
16    Act.
17        (13) "Permit" means a document awarded to a person for
18    compliance with the provisions of and under conditions set
19    forth in this Act.
20        (14) "Milk hauler-sampler" means a person who is
21    qualified and trained for the grading and sampling of raw
22    milk in accordance with federal and State quality standards
23    and procedures.
24        (15) "Cleaning and sanitizing facility" means any
25    place, premise or establishment where milk tank trucks are
26    cleaned and sanitized.



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1        (16) "Milk tank truck" includes both a bulk pickup tank
2    and a milk transport tank.
3            (A) "Bulk milk pickup tank" means the tank, and
4        those appurtenances necessary for its use, used by a
5        milk hauler-sampler to transport bulk raw milk for
6        pasteurization from a dairy farm to a milk plant,
7        receiving station, or transfer station.
8            (B) "Milk transport tank" means a vehicle,
9        including the truck and tank, used by a milk hauler to
10        transport bulk shipments of milk from a transfer
11        station, receiving station, or milk plant to another
12        transfer station, receiving station, or milk plant.
13        (17) "Certified pasteurizer sealer" means a person who
14    has satisfactorily completed a course of instruction and
15    has demonstrated the ability to satisfactorily conduct all
16    pasteurization control tests, as required by rules adopted
17    by the Department.
18(Source: P.A. 92-216, eff. 1-1-02.)
19    (210 ILCS 3/36.5 rep.)
20    Section 40. The Alternative Health Care Delivery Act is
21amended by repealing Section 36.5.
22    Section 99. Effective date. This Act takes effect upon
23becoming law.