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| [ Engrossed ] | [ Enrolled ] | [ Senate Amendment 001 ] |
91_SB1613
LRB9112970JSpc
1 AN ACT concerning the care of Alzheimer's disease
2 patients.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Alternative Health Care Delivery Act is
6 amended by changing Sections 30 and 35 as follows:
7 (210 ILCS 3/30)
8 Sec. 30. Demonstration program requirements. The
9 requirements set forth in this Section shall apply to
10 demonstration programs.
11 (a) There shall be no more than:
12 (i) 3 subacute care hospital alternative health
13 care models in the City of Chicago (one of which shall be
14 located on a designated site and shall have been licensed
15 as a hospital under the Illinois Hospital Licensing Act
16 within the 10 years immediately before the application
17 for a license);
18 (ii) 2 subacute care hospital alternative health
19 care models in the demonstration program for each of the
20 following areas:
21 (1) Cook County outside the City of Chicago.
22 (2) DuPage, Kane, Lake, McHenry, and Will
23 Counties.
24 (3) Municipalities with a population greater
25 than 50,000 not located in the areas described in
26 item (i) of subsection (a) and paragraphs (1) and
27 (2) of item (ii) of subsection (a); and
28 (iii) 4 subacute care hospital alternative health
29 care models in the demonstration program for rural areas.
30 In selecting among applicants for these licenses in rural
31 areas, the Health Facilities Planning Board and the
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1 Department shall give preference to hospitals that may be
2 unable for economic reasons to provide continued service to
3 the community in which they are located unless the hospital
4 were to receive an alternative health care model license.
5 (a-5) There shall be no more than a total of 12
6 postsurgical recovery care center alternative health care
7 models in the demonstration program, located as follows:
8 (1) Two in the City of Chicago.
9 (2) Two in Cook County outside the City of Chicago.
10 At least one of these shall be owned or operated by a
11 hospital devoted exclusively to caring for children.
12 (3) Two in Kane, Lake, and McHenry Counties.
13 (4) Four in municipalities with a population of
14 50,000 or more not located in the areas described in
15 paragraphs (1), (2), and (3), 3 of which shall be owned
16 or operated by hospitals, at least 2 of which shall be
17 located in counties with a population of less than
18 175,000, according to the most recent decennial census
19 for which data are available, and one of which shall be
20 owned or operated by an ambulatory surgical treatment
21 center.
22 (5) Two in rural areas, both of which shall be
23 owned or operated by hospitals.
24 There shall be no postsurgical recovery care center
25 alternative health care models located in counties with
26 populations greater than 600,000 but less than 1,000,000. A
27 proposed postsurgical recovery care center must be owned or
28 operated by a hospital if it is to be located within, or will
29 primarily serve the residents of, a health service area in
30 which more than 60% of the gross patient revenue of the
31 hospitals within that health service area are derived from
32 Medicaid and Medicare, according to the most recently
33 available calendar year data from the Illinois Health Care
34 Cost Containment Council. Nothing in this paragraph shall
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1 preclude a hospital and an ambulatory surgical treatment
2 center from forming a joint venture or developing a
3 collaborative agreement to own or operate a postsurgical
4 recovery care center.
5 (a-10) There shall be no more than a total of 8
6 children's respite care center alternative health care models
7 in the demonstration program, which shall be located as
8 follows:
9 (1) One in the City of Chicago.
10 (2) One in Cook County outside the City of Chicago.
11 (3) A total of 2 in the area comprised of DuPage,
12 Kane, Lake, McHenry, and Will counties.
13 (4) A total of 2 in municipalities with a
14 population of 50,000 or more and not located in the
15 areas described in paragraphs (1), (2), or (3).
16 (5) A total of 2 in rural areas, as defined by the
17 Health Facilities Planning Board.
18 No more than one children's respite care model owned and
19 operated by a licensed skilled pediatric facility shall be
20 located in each of the areas designated in this subsection
21 (a-10).
22 (a-15) There shall be an authorized community-based
23 residential rehabilitation center alternative health care
24 model in the demonstration program. The community-based
25 residential rehabilitation center shall be located in the
26 area of Illinois south of Interstate Highway 70.
27 (a-20) There shall be an authorized Alzheimer's disease
28 management center alternative health care model in the
29 demonstration program. The Alzheimer's disease management
30 center shall be located in Will County.
31 (b) Alternative health care models, other than a model
32 authorized under subsection (a-20), shall obtain a
33 certificate of need from the Illinois Health Facilities
34 Planning Board under the Illinois Health Facilities Planning
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1 Act before receiving a license by the Department. If, after
2 obtaining its initial certificate of need, an alternative
3 health care delivery model that is a community based
4 residential rehabilitation center seeks to increase the bed
5 capacity of that center, it must obtain a certificate of need
6 from the Illinois Health Facilities Planning Board before
7 increasing the bed capacity. Alternative health care models
8 in medically underserved areas shall receive priority in
9 obtaining a certificate of need.
10 (c) An alternative health care model license shall be
11 issued for a period of one year and shall be annually renewed
12 if the facility or program is in substantial compliance with
13 the Department's rules adopted under this Act. A licensed
14 alternative health care model that continues to be in
15 substantial compliance after the conclusion of the
16 demonstration program shall be eligible for annual renewals
17 unless and until a different licensure program for that type
18 of health care model is established by legislation. The
19 Department may issue a provisional license to any alternative
20 health care model that does not substantially comply with the
21 provisions of this Act and the rules adopted under this Act
22 if (i) the Department finds that the alternative health care
23 model has undertaken changes and corrections which upon
24 completion will render the alternative health care model in
25 substantial compliance with this Act and rules and (ii) the
26 health and safety of the patients of the alternative health
27 care model will be protected during the period for which the
28 provisional license is issued. The Department shall advise
29 the licensee of the conditions under which the provisional
30 license is issued, including the manner in which the
31 alternative health care model fails to comply with the
32 provisions of this Act and rules, and the time within which
33 the changes and corrections necessary for the alternative
34 health care model to substantially comply with this Act and
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1 rules shall be completed.
2 (d) Alternative health care models shall seek
3 certification under Titles XVIII and XIX of the federal
4 Social Security Act. In addition, alternative health care
5 models shall provide charitable care consistent with that
6 provided by comparable health care providers in the
7 geographic area.
8 (d-5) The Illinois Department of Public Aid, in
9 cooperation with the Illinois Department of Public Health,
10 shall develop and implement a reimbursement methodology for
11 all facilities participating in the demonstration program.
12 The Illinois Department of Public Aid shall keep a record of
13 services provided under the demonstration program to
14 recipients of medical assistance under the Illinois Public
15 Aid Code and shall submit an annual report of that
16 information to the Illinois Department of Public Health.
17 (e) Alternative health care models shall, to the extent
18 possible, link and integrate their services with nearby
19 health care facilities.
20 (f) Each alternative health care model shall implement a
21 quality assurance program with measurable benefits and at
22 reasonable cost.
23 (Source: P.A. 91-65, eff. 7-9-99.)
24 (210 ILCS 3/35)
25 Sec. 35. Alternative health care models authorized.
26 Notwithstanding any other law to the contrary, alternative
27 health care models described in this Section may be
28 established on a demonstration basis.
29 (1) Alternative health care model; subacute care
30 hospital. A subacute care hospital is a designated site
31 which provides medical specialty care for patients who
32 need a greater intensity or complexity of care than
33 generally provided in a skilled nursing facility but who
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1 no longer require acute hospital care. The average length
2 of stay for patients treated in subacute care hospitals
3 shall not be less than 20 days, and for individual
4 patients, the expected length of stay at the time of
5 admission shall not be less than 10 days. Variations
6 from minimum lengths of stay shall be reported to the
7 Department. There shall be no more than 13 subacute care
8 hospitals authorized to operate by the Department.
9 Subacute care includes physician supervision, registered
10 nursing, and physiological monitoring on a continual
11 basis. A subacute care hospital is either a freestanding
12 building or a distinct physical and operational entity
13 within a hospital or nursing home building. A subacute
14 care hospital shall only consist of beds currently
15 existing in licensed hospitals or skilled nursing
16 facilities, except, in the City of Chicago, on a
17 designated site that was licensed as a hospital under the
18 Illinois Hospital Licensing Act within the 10 years
19 immediately before the application for an alternative
20 health care model license. During the period of operation
21 of the demonstration project, the existing licensed beds
22 shall remain licensed as hospital or skilled nursing
23 facility beds as well as being licensed under this Act.
24 In order to handle cases of complications, emergencies,
25 or exigent circumstances, a subacute care hospital shall
26 maintain a contractual relationship, including a transfer
27 agreement, with a general acute care hospital. If a
28 subacute care model is located in a general acute care
29 hospital, it shall utilize all or a portion of the bed
30 capacity of that existing hospital. In no event shall a
31 subacute care hospital use the word "hospital" in its
32 advertising or marketing activities or represent or hold
33 itself out to the public as a general acute care
34 hospital.
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1 (2) Alternative health care delivery model;
2 postsurgical recovery care center. A postsurgical
3 recovery care center is a designated site which provides
4 postsurgical recovery care for generally healthy patients
5 undergoing surgical procedures that require overnight
6 nursing care, pain control, or observation that would
7 otherwise be provided in an inpatient setting. A
8 postsurgical recovery care center is either freestanding
9 or a defined unit of an ambulatory surgical treatment
10 center or hospital. No facility, or portion of a
11 facility, may participate in a demonstration program as a
12 postsurgical recovery care center unless the facility has
13 been licensed as an ambulatory surgical treatment center
14 or hospital for at least 2 years before August 20, 1993
15 (the effective date of Public Act 88-441). The maximum
16 length of stay for patients in a postsurgical recovery
17 care center is not to exceed 48 hours unless the treating
18 physician requests an extension of time from the recovery
19 center's medical director on the basis of medical or
20 clinical documentation that an additional care period is
21 required for the recovery of a patient and the medical
22 director approves the extension of time. In no case,
23 however, shall a patient's length of stay in a
24 postsurgical recovery care center be longer than 72
25 hours. If a patient requires an additional care period
26 after the expiration of the 72-hour limit, the patient
27 shall be transferred to an appropriate facility. Reports
28 on variances from the 48-hour limit shall be sent to the
29 Department for its evaluation. The reports shall, before
30 submission to the Department, have removed from them all
31 patient and physician identifiers. In order to handle
32 cases of complications, emergencies, or exigent
33 circumstances, every postsurgical recovery care center as
34 defined in this paragraph shall maintain a contractual
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1 relationship, including a transfer agreement, with a
2 general acute care hospital. A postsurgical recovery
3 care center shall be no larger than 20 beds. A
4 postsurgical recovery care center shall be located within
5 15 minutes travel time from the general acute care
6 hospital with which the center maintains a contractual
7 relationship, including a transfer agreement, as required
8 under this paragraph.
9 No postsurgical recovery care center shall
10 discriminate against any patient requiring treatment
11 because of the source of payment for services, including
12 Medicare and Medicaid recipients.
13 The Department shall adopt rules to implement the
14 provisions of Public Act 88-441 concerning postsurgical
15 recovery care centers within 9 months after August 20,
16 1993.
17 (3) Alternative health care delivery model;
18 children's respite care center. A children's respite
19 care center model is a designated site that provides
20 respite for medically frail, technologically dependent,
21 clinically stable children, up to age 18, for a period of
22 one to 14 days. This care is to be provided in a
23 home-like environment that serves no more than 10
24 children at a time. Children's respite care center
25 services must be available through the model to all
26 families, including those whose care is paid for through
27 the Illinois Department of Public Aid or the Illinois
28 Department of Children and Family Services. Each respite
29 care model location shall be a facility physically
30 separate and apart from any other facility licensed by
31 the Department of Public Health under this or any other
32 Act and shall provide, at a minimum, the following
33 services: out-of-home respite care; hospital to home
34 training for families and caregivers; short term
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1 transitional care to facilitate placement and training
2 for foster care parents; parent and family support
3 groups.
4 Coverage for the services provided by the Illinois
5 Department of Public Aid under this paragraph (3) is
6 contingent upon federal waiver approval and is provided
7 only to Medicaid eligible clients participating in the
8 home and community based services waiver designated in
9 Section 1915(c) of the Social Security Act for medically
10 frail and technologically dependent children.
11 (4) Alternative health care delivery model;
12 community based residential rehabilitation center. A
13 community-based residential rehabilitation center model
14 is a designated site that provides rehabilitation or
15 support, or both, for persons who have experienced severe
16 brain injury, who are medically stable, and who no longer
17 require acute rehabilitative care or intense medical or
18 nursing services. The average length of stay in a
19 community-based residential rehabilitation center shall
20 not exceed 4 months. As an integral part of the services
21 provided, individuals are housed in a supervised living
22 setting while having immediate access to the community.
23 The residential rehabilitation center authorized by the
24 Department may have more than one residence included
25 under the license. A residence may be no larger than 12
26 beds and shall be located as an integral part of the
27 community. Day treatment or individualized outpatient
28 services shall be provided for persons who reside in
29 their own home. Functional outcome goals shall be
30 established for each individual. Services shall include,
31 but are not limited to, case management, training and
32 assistance with activities of daily living, nursing
33 consultation, traditional therapies (physical,
34 occupational, speech), functional interventions in the
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1 residence and community (job placement, shopping,
2 banking, recreation), counseling, self-management
3 strategies, productive activities, and multiple
4 opportunities for skill acquisition and practice
5 throughout the day. The design of individualized program
6 plans shall be consistent with the outcome goals that are
7 established for each resident. The programs provided in
8 this setting shall be accredited by the Commission on
9 Accreditation of Rehabilitation Facilities (CARF). The
10 program shall have been accredited by CARF as a Brain
11 Injury Community-Integrative Program for at least 3
12 years.
13 (5) Alternative health care delivery model;
14 Alzheimer's disease management center. An Alzheimer's
15 disease management center model is a designated site that
16 provides a safe and secure setting for care of persons
17 diagnosed with Alzheimer's disease. An Alzheimer's
18 disease management center model shall be a facility
19 separate from any other facility licensed by the
20 Department of Public Health under this or any other Act.
21 An Alzheimer's disease management center shall conduct
22 and document an assessment of each resident every 6
23 months. The assessment shall include an evaluation of
24 daily functioning, cognitive status, other medical
25 conditions, and behavioral problems. An Alzheimer's
26 disease management center shall develop and implement an
27 ongoing treatment plan for each resident. The treatment
28 plan shall have defined goals and include the use of
29 cholinesterase inhibitors, if clinically indicated, to
30 treat cognitive decline, referral to appropriate
31 structured activities such as exercise, recreation, and
32 adult day care services, and appropriate medical care.
33 The Alzheimer's disease management center shall treat
34 behavioral problems and mood disorders using
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1 nonpharmacologic approaches such as environmental
2 modification, task simplification, and other appropriate
3 activities. An Alzheimer's disease management center
4 shall provide education and support for residents and
5 caregivers. The education and support shall include
6 referrals to support organizations for educational
7 materials on community resources, support groups, legal
8 and financial issues, respite care, and future care needs
9 and options. The education and support shall also
10 include a discussion of the resident's need to make
11 advance directives and to identify surrogates for medical
12 and legal decision-making. The provisions of this
13 paragraph establish the minimum level of services that
14 must be provided by an Alzheimer's disease management
15 center.
16 (Source: P.A. 91-65, eff. 7-9-99; 91-357, eff. 7-29-99.)
17 Section 10. The Alzheimer's Special Care Disclosure Act
18 is amended by changing Section 10 as follows:
19 (210 ILCS 4/10)
20 (Text of Section before amendment by P.A. 91-656)
21 Sec. 10. Facility defined. As used in this Act,
22 "facility" means a facility licensed or permitted under the
23 Nursing Home Care Act, the Life Care Facility Act, or the
24 Community Living Facilities Licensing Act, or subsection
25 (a-20) of Section 30 of the Alternative Health Care Delivery
26 Act.
27 (Source: P.A. 90-341, eff. 1-1-98.)
28 (Text of Section after amendment by P.A. 91-656)
29 Sec. 10. Facility defined. As used in this Act,
30 "facility" means a facility licensed or permitted under the
31 Nursing Home Care Act, the Life Care Facility Act, the
32 Assisted Living and Shared Housing Act, or the Community
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1 Living Facilities Licensing Act, or subsection (a-20) of
2 Section 30 of the Alternative Health Care Delivery Act.
3 (Source: P.A. 90-341, eff. 1-1-98; 91-656, eff. 1-1-01.)
4 Section 95. No acceleration or delay. Where this Act
5 makes changes in a statute that is represented in this Act by
6 text that is not yet or no longer in effect (for example, a
7 Section represented by multiple versions), the use of that
8 text does not accelerate or delay the taking effect of (i)
9 the changes made by this Act or (ii) provisions derived from
10 any other Public Act.
11 Section 99. Effective date. This Act takes effect upon
12 becoming law.