Sen. Christine Radogno

Filed: 10/22/2013

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 1584

2    AMENDMENT NO. ______. Amend House Bill 1584 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Health Facilities Planning Act is
5amended by changing Section 3 as follows:
 
6    (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
7    (Section scheduled to be repealed on December 31, 2019)
8    Sec. 3. Definitions. As used in this Act:
9    "Health care facilities" means and includes the following
10facilities, organizations, and related persons:
11        1. An ambulatory surgical treatment center required to
12    be licensed pursuant to the Ambulatory Surgical Treatment
13    Center Act;
14        2. An institution, place, building, or agency required
15    to be licensed pursuant to the Hospital Licensing Act;
16        3. Skilled and intermediate long term care facilities

 

 

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1    licensed under the Nursing Home Care Act;
2        3.5. Skilled and intermediate care facilities licensed
3    under the ID/DD Community Care Act;
4        3.7. Facilities licensed under the Specialized Mental
5    Health Rehabilitation Act;
6        4. Hospitals, nursing homes, ambulatory surgical
7    treatment centers, or kidney disease treatment centers
8    maintained by the State or any department or agency
9    thereof;
10        5. Kidney disease treatment centers, including a
11    free-standing hemodialysis unit required to be licensed
12    under the End Stage Renal Disease Facility Act;
13        6. An institution, place, building, or room used for
14    the performance of outpatient surgical procedures that is
15    leased, owned, or operated by or on behalf of an
16    out-of-state facility;
17        7. An institution, place, building, or room used for
18    provision of a health care category of service, including,
19    but not limited to, cardiac catheterization and open heart
20    surgery; and
21        8. An institution, place, building, or room used for
22    provision of major medical equipment used in the direct
23    clinical diagnosis or treatment of patients, and whose
24    project cost is in excess of the capital expenditure
25    minimum.
26    This Act shall not apply to the construction of any new

 

 

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1facility or the renovation of any existing facility located on
2any campus facility as defined in Section 5-5.8b of the
3Illinois Public Aid Code, provided that the campus facility
4encompasses 30 or more contiguous acres and that the new or
5renovated facility is intended for use by a licensed
6residential facility.
7    No federally owned facility shall be subject to the
8provisions of this Act, nor facilities used solely for healing
9by prayer or spiritual means.
10    No facility licensed under the Supportive Residences
11Licensing Act or the Assisted Living and Shared Housing Act
12shall be subject to the provisions of this Act.
13    No facility established and operating under the
14Alternative Health Care Delivery Act as a children's
15community-based health care center children's respite care
16center alternative health care model demonstration program or
17as an Alzheimer's Disease Management Center alternative health
18care model demonstration program shall be subject to the
19provisions of this Act.
20    A facility designated as a supportive living facility that
21is in good standing with the program established under Section
225-5.01a of the Illinois Public Aid Code shall not be subject to
23the provisions of this Act.
24    This Act does not apply to facilities granted waivers under
25Section 3-102.2 of the Nursing Home Care Act. However, if a
26demonstration project under that Act applies for a certificate

 

 

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1of need to convert to a nursing facility, it shall meet the
2licensure and certificate of need requirements in effect as of
3the date of application.
4    This Act does not apply to a dialysis facility that
5provides only dialysis training, support, and related services
6to individuals with end stage renal disease who have elected to
7receive home dialysis. This Act does not apply to a dialysis
8unit located in a licensed nursing home that offers or provides
9dialysis-related services to residents with end stage renal
10disease who have elected to receive home dialysis within the
11nursing home. The Board, however, may require these dialysis
12facilities and licensed nursing homes to report statistical
13information on a quarterly basis to the Board to be used by the
14Board to conduct analyses on the need for proposed kidney
15disease treatment centers.
16    This Act shall not apply to the closure of an entity or a
17portion of an entity licensed under the Nursing Home Care Act,
18the Specialized Mental Health Rehabilitation Act, or the ID/DD
19Community Care Act, with the exceptions of facilities operated
20by a county or Illinois Veterans Homes, that elects to convert,
21in whole or in part, to an assisted living or shared housing
22establishment licensed under the Assisted Living and Shared
23Housing Act.
24    This Act does not apply to any change of ownership of a
25healthcare facility that is licensed under the Nursing Home
26Care Act, the Specialized Mental Health Rehabilitation Act, or

 

 

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1the ID/DD Community Care Act, with the exceptions of facilities
2operated by a county or Illinois Veterans Homes. Changes of
3ownership of facilities licensed under the Nursing Home Care
4Act must meet the requirements set forth in Sections 3-101
5through 3-119 of the Nursing Home Care Act.
6    With the exception of those health care facilities
7specifically included in this Section, nothing in this Act
8shall be intended to include facilities operated as a part of
9the practice of a physician or other licensed health care
10professional, whether practicing in his individual capacity or
11within the legal structure of any partnership, medical or
12professional corporation, or unincorporated medical or
13professional group. Further, this Act shall not apply to
14physicians or other licensed health care professional's
15practices where such practices are carried out in a portion of
16a health care facility under contract with such health care
17facility by a physician or by other licensed health care
18professionals, whether practicing in his individual capacity
19or within the legal structure of any partnership, medical or
20professional corporation, or unincorporated medical or
21professional groups, unless the entity constructs, modifies,
22or establishes a health care facility as specifically defined
23in this Section. This Act shall apply to construction or
24modification and to establishment by such health care facility
25of such contracted portion which is subject to facility
26licensing requirements, irrespective of the party responsible

 

 

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1for such action or attendant financial obligation.
2    No permit or exemption is required for a facility licensed
3under the ID/DD Community Care Act prior to the reduction of
4the number of beds at a facility. If there is a total reduction
5of beds at a facility licensed under the ID/DD Community Care
6Act, this is a discontinuation or closure of the facility.
7However, if a facility licensed under the ID/DD Community Care
8Act reduces the number of beds or discontinues the facility,
9that facility must notify the Board as provided in Section 14.1
10of this Act.
11    "Person" means any one or more natural persons, legal
12entities, governmental bodies other than federal, or any
13combination thereof.
14    "Consumer" means any person other than a person (a) whose
15major occupation currently involves or whose official capacity
16within the last 12 months has involved the providing,
17administering or financing of any type of health care facility,
18(b) who is engaged in health research or the teaching of
19health, (c) who has a material financial interest in any
20activity which involves the providing, administering or
21financing of any type of health care facility, or (d) who is or
22ever has been a member of the immediate family of the person
23defined by (a), (b), or (c).
24    "State Board" or "Board" means the Health Facilities and
25Services Review Board.
26    "Construction or modification" means the establishment,

 

 

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1erection, building, alteration, reconstruction, modernization,
2improvement, extension, discontinuation, change of ownership,
3of or by a health care facility, or the purchase or acquisition
4by or through a health care facility of equipment or service
5for diagnostic or therapeutic purposes or for facility
6administration or operation, or any capital expenditure made by
7or on behalf of a health care facility which exceeds the
8capital expenditure minimum; however, any capital expenditure
9made by or on behalf of a health care facility for (i) the
10construction or modification of a facility licensed under the
11Assisted Living and Shared Housing Act or (ii) a conversion
12project undertaken in accordance with Section 30 of the Older
13Adult Services Act shall be excluded from any obligations under
14this Act.
15    "Establish" means the construction of a health care
16facility or the replacement of an existing facility on another
17site or the initiation of a category of service.
18    "Major medical equipment" means medical equipment which is
19used for the provision of medical and other health services and
20which costs in excess of the capital expenditure minimum,
21except that such term does not include medical equipment
22acquired by or on behalf of a clinical laboratory to provide
23clinical laboratory services if the clinical laboratory is
24independent of a physician's office and a hospital and it has
25been determined under Title XVIII of the Social Security Act to
26meet the requirements of paragraphs (10) and (11) of Section

 

 

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11861(s) of such Act. In determining whether medical equipment
2has a value in excess of the capital expenditure minimum, the
3value of studies, surveys, designs, plans, working drawings,
4specifications, and other activities essential to the
5acquisition of such equipment shall be included.
6    "Capital Expenditure" means an expenditure: (A) made by or
7on behalf of a health care facility (as such a facility is
8defined in this Act); and (B) which under generally accepted
9accounting principles is not properly chargeable as an expense
10of operation and maintenance, or is made to obtain by lease or
11comparable arrangement any facility or part thereof or any
12equipment for a facility or part; and which exceeds the capital
13expenditure minimum.
14    For the purpose of this paragraph, the cost of any studies,
15surveys, designs, plans, working drawings, specifications, and
16other activities essential to the acquisition, improvement,
17expansion, or replacement of any plant or equipment with
18respect to which an expenditure is made shall be included in
19determining if such expenditure exceeds the capital
20expenditures minimum. Unless otherwise interdependent, or
21submitted as one project by the applicant, components of
22construction or modification undertaken by means of a single
23construction contract or financed through the issuance of a
24single debt instrument shall not be grouped together as one
25project. Donations of equipment or facilities to a health care
26facility which if acquired directly by such facility would be

 

 

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1subject to review under this Act shall be considered capital
2expenditures, and a transfer of equipment or facilities for
3less than fair market value shall be considered a capital
4expenditure for purposes of this Act if a transfer of the
5equipment or facilities at fair market value would be subject
6to review.
7    "Capital expenditure minimum" means $11,500,000 for
8projects by hospital applicants, $6,500,000 for applicants for
9projects related to skilled and intermediate care long-term
10care facilities licensed under the Nursing Home Care Act, and
11$3,000,000 for projects by all other applicants, which shall be
12annually adjusted to reflect the increase in construction costs
13due to inflation, for major medical equipment and for all other
14capital expenditures.
15    "Non-clinical service area" means an area (i) for the
16benefit of the patients, visitors, staff, or employees of a
17health care facility and (ii) not directly related to the
18diagnosis, treatment, or rehabilitation of persons receiving
19services from the health care facility. "Non-clinical service
20areas" include, but are not limited to, chapels; gift shops;
21news stands; computer systems; tunnels, walkways, and
22elevators; telephone systems; projects to comply with life
23safety codes; educational facilities; student housing;
24patient, employee, staff, and visitor dining areas;
25administration and volunteer offices; modernization of
26structural components (such as roof replacement and masonry

 

 

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1work); boiler repair or replacement; vehicle maintenance and
2storage facilities; parking facilities; mechanical systems for
3heating, ventilation, and air conditioning; loading docks; and
4repair or replacement of carpeting, tile, wall coverings,
5window coverings or treatments, or furniture. Solely for the
6purpose of this definition, "non-clinical service area" does
7not include health and fitness centers.
8    "Areawide" means a major area of the State delineated on a
9geographic, demographic, and functional basis for health
10planning and for health service and having within it one or
11more local areas for health planning and health service. The
12term "region", as contrasted with the term "subregion", and the
13word "area" may be used synonymously with the term "areawide".
14    "Local" means a subarea of a delineated major area that on
15a geographic, demographic, and functional basis may be
16considered to be part of such major area. The term "subregion"
17may be used synonymously with the term "local".
18    "Physician" means a person licensed to practice in
19accordance with the Medical Practice Act of 1987, as amended.
20    "Licensed health care professional" means a person
21licensed to practice a health profession under pertinent
22licensing statutes of the State of Illinois.
23    "Director" means the Director of the Illinois Department of
24Public Health.
25    "Agency" means the Illinois Department of Public Health.
26    "Alternative health care model" means a facility or program

 

 

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1authorized under the Alternative Health Care Delivery Act.
2    "Out-of-state facility" means a person that is both (i)
3licensed as a hospital or as an ambulatory surgery center under
4the laws of another state or that qualifies as a hospital or an
5ambulatory surgery center under regulations adopted pursuant
6to the Social Security Act and (ii) not licensed under the
7Ambulatory Surgical Treatment Center Act, the Hospital
8Licensing Act, or the Nursing Home Care Act. Affiliates of
9out-of-state facilities shall be considered out-of-state
10facilities. Affiliates of Illinois licensed health care
11facilities 100% owned by an Illinois licensed health care
12facility, its parent, or Illinois physicians licensed to
13practice medicine in all its branches shall not be considered
14out-of-state facilities. Nothing in this definition shall be
15construed to include an office or any part of an office of a
16physician licensed to practice medicine in all its branches in
17Illinois that is not required to be licensed under the
18Ambulatory Surgical Treatment Center Act.
19    "Change of ownership of a health care facility" means a
20change in the person who has ownership or control of a health
21care facility's physical plant and capital assets. A change in
22ownership is indicated by the following transactions: sale,
23transfer, acquisition, lease, change of sponsorship, or other
24means of transferring control.
25    "Related person" means any person that: (i) is at least 50%
26owned, directly or indirectly, by either the health care

 

 

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1facility or a person owning, directly or indirectly, at least
250% of the health care facility; or (ii) owns, directly or
3indirectly, at least 50% of the health care facility.
4    "Charity care" means care provided by a health care
5facility for which the provider does not expect to receive
6payment from the patient or a third-party payer.
7    "Freestanding emergency center" means a facility subject
8to licensure under Section 32.5 of the Emergency Medical
9Services (EMS) Systems Act.
10    "Category of service" means a grouping by generic class of
11various types or levels of support functions, equipment, care,
12or treatment provided to patients or residents, including, but
13not limited to, classes such as medical-surgical, pediatrics,
14or cardiac catheterization. A category of service may include
15subcategories or levels of care that identify a particular
16degree or type of care within the category of service. Nothing
17in this definition shall be construed to include the practice
18of a physician or other licensed health care professional while
19functioning in an office providing for the care, diagnosis, or
20treatment of patients. A category of service that is subject to
21the Board's jurisdiction must be designated in rules adopted by
22the Board.
23(Source: P.A. 97-38, eff. 6-28-11; 97-277, eff. 1-1-12; 97-813,
24eff. 7-13-12; 97-980, eff. 8-17-12; 98-414, eff. 1-1-14.)
 
25    Section 10. The Alternative Health Care Delivery Act is

 

 

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1amended by changing Sections 15, 30, and 35 as follows:
 
2    (210 ILCS 3/15)
3    Sec. 15. License required. No health care facility or
4program that meets the definition and scope of an alternative
5health care model shall operate as such unless it is a
6participant in a demonstration program under this Act and
7licensed by the Department as an alternative health care model.
8The provisions of this Act concerning children's
9community-based health care centers children's respite care
10centers shall not apply to any facility licensed under the
11Hospital Licensing Act, the Nursing Home Care Act, the
12Specialized Mental Health Rehabilitation Act, the ID/DD
13Community Care Act, or the University of Illinois Hospital Act
14that provides respite care services to children.
15(Source: P.A. 96-339, eff. 7-1-10; 97-38, eff. 6-28-11; 97-135,
16eff. 7-14-11; 97-227, eff. 1-1-12; 97-813, eff. 7-13-12.)
 
17    (210 ILCS 3/30)
18    Sec. 30. Demonstration program requirements. The
19requirements set forth in this Section shall apply to
20demonstration programs.
21    (a) (Blank).
22    (a-5) There shall be no more than the total number of
23postsurgical recovery care centers with a certificate of need
24for beds as of January 1, 2008.

 

 

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1    (a-10) There shall be no more than a total of 9 children's
2community-based health care center children's respite care
3center alternative health care models in the demonstration
4program, which shall be located as follows:
5        (1) Two in the City of Chicago.
6        (2) One in Cook County outside the City of Chicago.
7        (3) A total of 2 in the area comprised of DuPage, Kane,
8    Lake, McHenry, and Will counties.
9        (4) A total of 2 in municipalities with a population of
10    50,000 or more and not located in the areas described in
11    paragraphs (1), (2), or (3).
12        (5) A total of 2 in rural areas, as defined by the
13    Health Facilities and Services Review Board.
14    No more than one children's community-based health care
15center children's respite care model owned and operated by a
16licensed skilled pediatric facility shall be located in each of
17the areas designated in this subsection (a-10).
18    (a-15) There shall be 5 authorized community-based
19residential rehabilitation center alternative health care
20models in the demonstration program.
21    (a-20) There shall be an authorized Alzheimer's disease
22management center alternative health care model in the
23demonstration program. The Alzheimer's disease management
24center shall be located in Will County, owned by a
25not-for-profit entity, and endorsed by a resolution approved by
26the county board before the effective date of this amendatory

 

 

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1Act of the 91st General Assembly.
2    (a-25) There shall be no more than 10 birth center
3alternative health care models in the demonstration program,
4located as follows:
5        (1) Four in the area comprising Cook, DuPage, Kane,
6    Lake, McHenry, and Will counties, one of which shall be
7    owned or operated by a hospital and one of which shall be
8    owned or operated by a federally qualified health center.
9        (2) Three in municipalities with a population of 50,000
10    or more not located in the area described in paragraph (1)
11    of this subsection, one of which shall be owned or operated
12    by a hospital and one of which shall be owned or operated
13    by a federally qualified health center.
14        (3) Three in rural areas, one of which shall be owned
15    or operated by a hospital and one of which shall be owned
16    or operated by a federally qualified health center.
17    The first 3 birth centers authorized to operate by the
18Department shall be located in or predominantly serve the
19residents of a health professional shortage area as determined
20by the United States Department of Health and Human Services.
21There shall be no more than 2 birth centers authorized to
22operate in any single health planning area for obstetric
23services as determined under the Illinois Health Facilities
24Planning Act. If a birth center is located outside of a health
25professional shortage area, (i) the birth center shall be
26located in a health planning area with a demonstrated need for

 

 

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1obstetrical service beds, as determined by the Health
2Facilities and Services Review Board or (ii) there must be a
3reduction in the existing number of obstetrical service beds in
4the planning area so that the establishment of the birth center
5does not result in an increase in the total number of
6obstetrical service beds in the health planning area.
7    (b) Alternative health care models, other than a model
8authorized under subsection (a-10) or (a-20), shall obtain a
9certificate of need from the Health Facilities and Services
10Review Board under the Illinois Health Facilities Planning Act
11before receiving a license by the Department. If, after
12obtaining its initial certificate of need, an alternative
13health care delivery model that is a community based
14residential rehabilitation center seeks to increase the bed
15capacity of that center, it must obtain a certificate of need
16from the Health Facilities and Services Review Board before
17increasing the bed capacity. Alternative health care models in
18medically underserved areas shall receive priority in
19obtaining a certificate of need.
20    (c) An alternative health care model license shall be
21issued for a period of one year and shall be annually renewed
22if the facility or program is in substantial compliance with
23the Department's rules adopted under this Act. A licensed
24alternative health care model that continues to be in
25substantial compliance after the conclusion of the
26demonstration program shall be eligible for annual renewals

 

 

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1unless and until a different licensure program for that type of
2health care model is established by legislation, except that a
3postsurgical recovery care center meeting the following
4requirements may apply within 3 years after August 25, 2009
5(the effective date of Public Act 96-669) for a Certificate of
6Need permit to operate as a hospital:
7        (1) The postsurgical recovery care center shall apply
8    to the Health Facilities and Services Review Board for a
9    Certificate of Need permit to discontinue the postsurgical
10    recovery care center and to establish a hospital.
11        (2) If the postsurgical recovery care center obtains a
12    Certificate of Need permit to operate as a hospital, it
13    shall apply for licensure as a hospital under the Hospital
14    Licensing Act and shall meet all statutory and regulatory
15    requirements of a hospital.
16        (3) After obtaining licensure as a hospital, any
17    license as an ambulatory surgical treatment center and any
18    license as a post-surgical recovery care center shall be
19    null and void.
20        (4) The former postsurgical recovery care center that
21    receives a hospital license must seek and use its best
22    efforts to maintain certification under Titles XVIII and
23    XIX of the federal Social Security Act.
24    The Department may issue a provisional license to any
25alternative health care model that does not substantially
26comply with the provisions of this Act and the rules adopted

 

 

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1under this Act if (i) the Department finds that the alternative
2health care model has undertaken changes and corrections which
3upon completion will render the alternative health care model
4in substantial compliance with this Act and rules and (ii) the
5health and safety of the patients of the alternative health
6care model will be protected during the period for which the
7provisional license is issued. The Department shall advise the
8licensee of the conditions under which the provisional license
9is issued, including the manner in which the alternative health
10care model fails to comply with the provisions of this Act and
11rules, and the time within which the changes and corrections
12necessary for the alternative health care model to
13substantially comply with this Act and rules shall be
14completed.
15    (d) Alternative health care models shall seek
16certification under Titles XVIII and XIX of the federal Social
17Security Act. In addition, alternative health care models shall
18provide charitable care consistent with that provided by
19comparable health care providers in the geographic area.
20    (d-5) (Blank).
21    (e) Alternative health care models shall, to the extent
22possible, link and integrate their services with nearby health
23care facilities.
24    (f) Each alternative health care model shall implement a
25quality assurance program with measurable benefits and at
26reasonable cost.

 

 

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1(Source: P.A. 96-31, eff. 6-30-09; 96-129, eff. 8-4-09; 96-669,
2eff. 8-25-09; 96-812, eff. 1-1-10; 96-1000, eff. 7-2-10;
396-1071, eff. 7-16-10; 96-1123, eff. 1-1-11; 97-135, eff.
47-14-11; 97-333, eff. 8-12-11; 97-813, eff. 7-13-12.)".