Full Text of HB5657 95th General Assembly
HB5657ham001 95TH GENERAL ASSEMBLY
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Human Services Committee
Filed: 4/15/2008
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09500HB5657ham001 |
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LRB095 17099 DRJ 47904 a |
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| AMENDMENT TO HOUSE BILL 5657
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| AMENDMENT NO. ______. Amend House Bill 5657 by replacing | 3 |
| everything after the enacting clause with the following:
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| "Section 5. The Alternative Health Care Delivery Act is | 5 |
| amended by changing Sections 25, 30, and 35 as follows:
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| (210 ILCS 3/25)
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| Sec. 25. Department responsibilities. The Department shall | 8 |
| have the
responsibilities set forth in this Section.
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| (a) The Department shall adopt rules for each alternative | 10 |
| health care model
authorized under this Act that shall include | 11 |
| but not be limited to the
following:
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| (1) Further definition of the alternative health care | 13 |
| models.
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| (2) The definition and scope of the demonstration | 15 |
| program, including the
implementation date and period of | 16 |
| operation, not to exceed 5 years.
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| (3) License application information required by the | 2 |
| Department.
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| (4) The care of patients in the alternative health care | 4 |
| models.
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| (5) Rights afforded to patients of the alternative | 6 |
| health care models.
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| (6) Physical plant requirements.
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| (7) License application and renewal fees, which may | 9 |
| cover
the cost of administering the demonstration program.
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| (8) Information that may be necessary for the Board and | 11 |
| the Department to
monitor and evaluate the alternative | 12 |
| health care model demonstration program.
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| (9) Administrative fines that may be assessed by the | 14 |
| Department for
violations of this Act or the rules adopted | 15 |
| under this Act.
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| (b) The Department shall issue, renew, deny, suspend, or | 17 |
| revoke licenses for
alternative health care models.
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| (c) The Department shall perform licensure inspections of | 19 |
| alternative health
care models as deemed necessary by the | 20 |
| Department to ensure compliance with
this Act or rules.
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| (d) The Department shall deposit application fees, renewal | 22 |
| fees, and fines
into the Regulatory Evaluation and Basic | 23 |
| Enforcement Fund.
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| (e) The Department shall assist the Board in performing the
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| Board's
responsibilities under this Act.
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| (f) (Blank). The Department shall conduct a study to |
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| determine the feasibility, the
potential risks and benefits to | 2 |
| patients, and the potential effect on the
health care delivery | 3 |
| system of authorizing recovery care of nonsurgical
patients in | 4 |
| postsurgical recovery center demonstration models. The | 5 |
| Department
shall report the findings
of the study
to the | 6 |
| General Assembly no later than November 1, 1998.
The Director | 7 |
| shall appoint an advisory committee with representation from
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| the Illinois Hospital and Health Systems Association,
the | 9 |
| Illinois State Medical Society, and the Illinois Freestanding | 10 |
| Surgery
Center Association,
a physician who is
board certified | 11 |
| in internal medicine, a consumer, and other representatives
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| deemed appropriate by the Director. The advisory committee | 13 |
| shall advise the
Department as it carries out the study.
| 14 |
| (g) (Blank). Before November 1, 1998 the Department shall | 15 |
| initiate a process to
request public comments on how | 16 |
| postsurgical recovery centers admitting
nonsurgical patients | 17 |
| should be regulated.
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| (Source: P.A. 90-600, eff. 6-25-98; 90-655, eff. 7-30-98.)
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| (210 ILCS 3/30)
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| Sec. 30. Demonstration program requirements. The | 21 |
| requirements set forth in
this Section shall apply to | 22 |
| demonstration programs.
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| (a) There shall be no more than:
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| (i) 3 subacute care hospital alternative health care | 25 |
| models in the City of
Chicago (one of which shall be |
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| located on a designated site and shall have been
licensed | 2 |
| as a hospital under the Illinois Hospital Licensing Act | 3 |
| within the 10
years immediately before the application for | 4 |
| a license);
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| (ii) 2 subacute care hospital alternative health care | 6 |
| models in the
demonstration program for each of the | 7 |
| following areas:
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| (1) Cook County outside the City of Chicago.
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| (2) DuPage, Kane, Lake, McHenry, and Will | 10 |
| Counties.
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| (3) Municipalities with a population greater than | 12 |
| 50,000 not
located in the areas described in item (i) | 13 |
| of subsection (a) and paragraphs
(1) and (2) of item | 14 |
| (ii) of subsection (a); and
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| (iii) 4 subacute care hospital alternative health care
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| models in the demonstration program for rural areas.
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| In selecting among applicants for these
licenses in rural | 18 |
| areas, the Health Facilities Planning Board and the
Department | 19 |
| shall give preference to hospitals that may be unable for | 20 |
| economic
reasons to provide continued service to the community | 21 |
| in which they are located
unless the hospital were to receive | 22 |
| an alternative health care model license.
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| (a-5) There shall be no more than the a total of 12 | 24 |
| postsurgical
recovery care centers with certificate of need for | 25 |
| beds as of January 1, 2008.
center alternative health care | 26 |
| models in the demonstration program, located as
follows:
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| (1) Two in the City of Chicago.
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| (2) Two in Cook County outside the City of Chicago. At | 3 |
| least
one of these shall be owned or operated by a hospital | 4 |
| devoted exclusively to
caring for children.
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| (3) Two in Kane, Lake, and McHenry Counties.
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| (4) Four in municipalities with a population of 50,000 | 7 |
| or more
not located
in the areas described in paragraphs | 8 |
| (1), (2), and (3), 3 of which
shall be
owned or operated by | 9 |
| hospitals, at least 2 of which shall be located in
counties | 10 |
| with a population of less than 175,000, according to the | 11 |
| most recent
decennial census for which data are available, | 12 |
| and one of
which shall be owned or operated by
an | 13 |
| ambulatory surgical treatment center.
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| (5) Two in rural areas,
both of which shall be owned or | 15 |
| operated by
hospitals.
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| There shall be no postsurgical recovery care center | 17 |
| alternative health care
models located in counties with | 18 |
| populations greater than 600,000 but less
than 1,000,000. A | 19 |
| proposed postsurgical recovery care center must be owned or
| 20 |
| operated by a hospital if it is to be located within, or will | 21 |
| primarily serve
the residents of, a health service area in | 22 |
| which more than 60% of the gross
patient revenue of the | 23 |
| hospitals within that health service area are derived
from | 24 |
| Medicaid and Medicare, according to the most recently available | 25 |
| calendar
year data from the Illinois Health Care Cost | 26 |
| Containment Council. Nothing in
this paragraph shall preclude a |
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| hospital and an ambulatory surgical treatment
center from | 2 |
| forming a joint venture or developing a collaborative agreement | 3 |
| to
own or operate a postsurgical recovery care center.
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| (a-10) There shall be no more than a total of 8 children's | 5 |
| respite care
center alternative health care models in the | 6 |
| demonstration program, which shall
be located as follows:
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| (1) One in the City of Chicago.
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| (2) One in Cook County outside the City of Chicago.
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| (3) A total of 2 in the area comprised of DuPage, Kane, | 10 |
| Lake, McHenry, and
Will counties.
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| (4) A total of 2 in municipalities with a population of | 12 |
| 50,000 or more and
not
located in the areas described in | 13 |
| paragraphs (1), (2), or (3).
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| (5) A total of 2 in rural areas, as defined by the | 15 |
| Health Facilities
Planning Board.
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| No more than one children's respite care model owned and | 17 |
| operated by a
licensed skilled pediatric facility shall be | 18 |
| located in each of the areas
designated in this subsection | 19 |
| (a-10).
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| (a-15) There shall be an authorized community-based | 21 |
| residential
rehabilitation center alternative health care | 22 |
| model in the demonstration
program. The community-based | 23 |
| residential rehabilitation center shall be
located in the area | 24 |
| of Illinois south of Interstate Highway 70.
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| (a-20) There shall be an authorized
Alzheimer's disease | 26 |
| management center alternative health care model in the
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| demonstration program. The Alzheimer's disease management | 2 |
| center shall be
located in Will
County, owned by a
| 3 |
| not-for-profit entity, and endorsed by a resolution approved by | 4 |
| the county
board before the effective date of this amendatory | 5 |
| Act of the 91st General
Assembly.
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| (a-25) There shall be no more than 10 birth center | 7 |
| alternative health care
models in the demonstration program, | 8 |
| located as follows:
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| (1) Four in the area comprising Cook, DuPage, Kane, | 10 |
| Lake, McHenry, and
Will counties, one of
which shall be | 11 |
| owned or operated by a hospital and one of which shall be | 12 |
| owned
or operated by a federally qualified health center.
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| (2) Three in municipalities with a population of 50,000 | 14 |
| or more not
located in the area described in paragraph (1) | 15 |
| of this subsection, one of
which shall be owned or operated | 16 |
| by a hospital and one of which shall be owned
or operated | 17 |
| by a federally qualified health center.
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| (3) Three in rural areas, one of which shall be owned | 19 |
| or operated by a
hospital and one of which shall be owned | 20 |
| or operated by a federally qualified
health center.
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| The first 3 birth centers authorized to operate by the | 22 |
| Department shall be
located in or predominantly serve the | 23 |
| residents of a health professional
shortage area as determined | 24 |
| by the United States Department of Health and Human
Services. | 25 |
| There shall be no more than 2 birth centers authorized to | 26 |
| operate in
any single health planning area for obstetric |
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| services as determined under the
Illinois Health Facilities | 2 |
| Planning Act. If a birth center is located outside
of a
health | 3 |
| professional shortage area, (i) the birth center shall be | 4 |
| located in a
health planning
area with a demonstrated need for | 5 |
| obstetrical service beds, as determined by
the Illinois Health | 6 |
| Facilities Planning Board or (ii) there must be a
reduction in
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| the existing number of obstetrical service beds in the planning | 8 |
| area so that
the establishment of the birth center does not | 9 |
| result in an increase in the
total number of obstetrical | 10 |
| service beds in the health planning area.
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| (b) Alternative health care models, other than a model | 12 |
| authorized under
subsection (a-20), shall obtain a certificate | 13 |
| of
need from the Illinois Health Facilities Planning Board | 14 |
| under the Illinois
Health Facilities Planning Act before | 15 |
| receiving a license by the
Department.
If, after obtaining its | 16 |
| initial certificate of need, an alternative health
care | 17 |
| delivery model that is a community based residential | 18 |
| rehabilitation center
seeks to
increase the bed capacity of | 19 |
| that center, it must obtain a certificate of need
from the | 20 |
| Illinois Health Facilities Planning Board before increasing | 21 |
| the bed
capacity. Alternative
health care models in medically | 22 |
| underserved areas
shall receive priority in obtaining a | 23 |
| certificate of need.
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| (c) An alternative health care model license shall be | 25 |
| issued for a
period of one year and shall be annually renewed | 26 |
| if the facility or
program is in substantial compliance with |
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| the Department's rules
adopted under this Act. A licensed | 2 |
| alternative health care model that continues
to be in | 3 |
| substantial compliance after the conclusion of the | 4 |
| demonstration
program shall be eligible for annual renewals | 5 |
| unless and until a different
licensure program for that type of | 6 |
| health care model is established by
legislation. The Department | 7 |
| may issue a provisional license to any
alternative health care | 8 |
| model that does not substantially comply with the
provisions of | 9 |
| this Act and the rules adopted under this Act if (i)
the | 10 |
| Department finds that the alternative health care model has | 11 |
| undertaken
changes and corrections which upon completion will | 12 |
| render the alternative
health care model in substantial | 13 |
| compliance with this Act and rules and
(ii) the health and | 14 |
| safety of the patients of the alternative
health care model | 15 |
| will be protected during the period for which the provisional
| 16 |
| license is issued. The Department shall advise the licensee of
| 17 |
| the conditions under which the provisional license is issued, | 18 |
| including
the manner in which the alternative health care model | 19 |
| fails to comply with
the provisions of this Act and rules, and | 20 |
| the time within which the changes
and corrections necessary for | 21 |
| the alternative health care model to
substantially comply with | 22 |
| this Act and rules shall be completed.
| 23 |
| (d) Alternative health care models shall seek | 24 |
| certification under Titles
XVIII and XIX of the federal Social | 25 |
| Security Act. In addition, alternative
health care models shall | 26 |
| provide charitable care consistent with that provided
by |
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| comparable health care providers in the geographic area.
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| (d-5) The Department of Healthcare and Family Services | 3 |
| (formerly Illinois Department of Public Aid), in cooperation | 4 |
| with the
Illinois Department of
Public Health, shall develop | 5 |
| and implement a reimbursement methodology for all
facilities | 6 |
| participating in the demonstration program. The Department of | 7 |
| Healthcare and Family Services shall keep a record of services | 8 |
| provided under the demonstration
program to recipients of | 9 |
| medical assistance under the Illinois Public Aid Code
and shall | 10 |
| submit an annual report of that information to the Illinois
| 11 |
| Department of Public Health.
| 12 |
| (e) Alternative health care models shall, to the extent | 13 |
| possible,
link and integrate their services with nearby health | 14 |
| care facilities.
| 15 |
| (f) Each alternative health care model shall implement a | 16 |
| quality
assurance program with measurable benefits and at | 17 |
| reasonable cost.
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| (Source: P.A. 95-331, eff. 8-21-07; 95-445, eff. 1-1-08.)
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| (210 ILCS 3/35)
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| Sec. 35. Alternative health care models authorized. | 21 |
| Notwithstanding
any other law to the contrary, alternative | 22 |
| health care models
described in this Section may be established | 23 |
| on a demonstration basis.
| 24 |
| (1) Alternative health care model; subacute care | 25 |
| hospital. A subacute
care hospital is a designated site |
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| which provides medical specialty care for
patients who need | 2 |
| a greater intensity or complexity of care than generally
| 3 |
| provided in a skilled nursing facility but who no longer | 4 |
| require acute hospital
care. The average length of stay for | 5 |
| patients treated in subacute care
hospitals shall not be | 6 |
| less than 20 days, and for individual patients, the
| 7 |
| expected length of stay at the time of admission shall not | 8 |
| be less than 10
days. Variations from minimum lengths of | 9 |
| stay shall be reported to the
Department. There shall be no | 10 |
| more than 13 subacute care hospitals
authorized to operate | 11 |
| by the Department. Subacute care includes physician
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| supervision, registered nursing, and physiological | 13 |
| monitoring on a continual
basis. A subacute care hospital | 14 |
| is either a freestanding building or a distinct
physical | 15 |
| and operational entity within a hospital or nursing home | 16 |
| building. A
subacute care hospital shall only consist of | 17 |
| beds currently existing in
licensed hospitals or skilled | 18 |
| nursing facilities, except, in the City of
Chicago, on a | 19 |
| designated site that was licensed as a hospital under the
| 20 |
| Illinois Hospital Licensing Act within the 10 years | 21 |
| immediately before the
application for an alternative | 22 |
| health care model license. During the period of
operation | 23 |
| of the demonstration project, the existing licensed beds | 24 |
| shall remain
licensed as hospital or skilled nursing | 25 |
| facility beds as well as being licensed
under this Act. In | 26 |
| order to handle cases of
complications, emergencies, or |
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| exigent circumstances, a subacute care hospital
shall | 2 |
| maintain a contractual relationship, including a transfer | 3 |
| agreement, with
a general acute care hospital. If a | 4 |
| subacute care model is located in a
general acute care | 5 |
| hospital, it shall utilize all or a portion of the bed
| 6 |
| capacity of that existing hospital. In no event shall a | 7 |
| subacute care hospital
use the word "hospital" in its | 8 |
| advertising or marketing activities or represent
or hold | 9 |
| itself out to the public as a general acute care hospital.
| 10 |
| (2) Alternative health care delivery model; | 11 |
| postsurgical recovery care
center. A postsurgical recovery | 12 |
| care center is a designated site which
provides | 13 |
| postsurgical recovery care for generally healthy patients
| 14 |
| undergoing surgical procedures that require overnight | 15 |
| nursing care, pain
control, or observation that would | 16 |
| otherwise be provided in an inpatient
setting. A | 17 |
| postsurgical recovery care center is either freestanding | 18 |
| or a
defined unit of an ambulatory surgical treatment | 19 |
| center or hospital.
No facility, or portion of a facility, | 20 |
| may participate in a demonstration
program as a | 21 |
| postsurgical recovery care center unless the facility has | 22 |
| been
licensed as an ambulatory surgical treatment center or | 23 |
| hospital for at least 2
years before August 20, 1993 (the | 24 |
| effective date of Public Act 88-441). The
maximum length of | 25 |
| stay for patients in a
postsurgical recovery care center is | 26 |
| not to exceed 48 hours unless the treating
physician |
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| requests an extension of time from the recovery center's | 2 |
| medical
director on the basis of medical or clinical | 3 |
| documentation that an additional
care period is required | 4 |
| for the recovery of a patient and the medical director
| 5 |
| approves the extension of time. In no case, however, shall | 6 |
| a patient's length
of stay in a postsurgical recovery care | 7 |
| center be longer than 72 hours. If a
patient requires an | 8 |
| additional care period after the expiration of the 72-hour
| 9 |
| limit, the patient shall be transferred to an appropriate | 10 |
| facility. Reports on
variances from the 48-hour limit shall | 11 |
| be sent to the Department for its
evaluation. The reports | 12 |
| shall, before submission to the Department, have
removed | 13 |
| from them all patient and physician identifiers. In order | 14 |
| to handle
cases of complications, emergencies, or exigent | 15 |
| circumstances, every
postsurgical recovery care center as | 16 |
| defined in this paragraph shall maintain a
contractual | 17 |
| relationship, including a transfer agreement, with a | 18 |
| general acute
care hospital. A postsurgical recovery care | 19 |
| center shall be no larger than 20
beds. A postsurgical | 20 |
| recovery care center shall be located within 15 minutes
| 21 |
| travel time from the general acute care hospital with which | 22 |
| the center
maintains a contractual relationship, including | 23 |
| a transfer agreement, as
required under this paragraph.
| 24 |
| No postsurgical recovery care center shall | 25 |
| discriminate against any patient
requiring treatment | 26 |
| because of the source of payment for services, including
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| Medicare and Medicaid recipients.
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| The Department shall adopt rules to implement the | 3 |
| provisions of Public
Act 88-441 concerning postsurgical | 4 |
| recovery care centers within 9 months after
August 20, | 5 |
| 1993.
| 6 |
| (3) Alternative health care delivery model; children's | 7 |
| community-based
health care center. A children's | 8 |
| community-based health care center model is a
designated | 9 |
| site that provides nursing care, clinical support | 10 |
| services, and
therapies for a period of one to 14 days for | 11 |
| short-term stays and 120 days to
facilitate transitions to | 12 |
| home or other appropriate settings for medically
fragile | 13 |
| children, technology
dependent children, and children with | 14 |
| special health care needs who are deemed
clinically stable | 15 |
| by a physician and are younger than 22 years of age. This
| 16 |
| care is to be provided in a home-like environment that | 17 |
| serves no more than 12
children at a time. Children's | 18 |
| community-based health care center
services must be | 19 |
| available through the model to all families, including | 20 |
| those
whose care is paid for through the Department of | 21 |
| Healthcare and Family Services, the Department of
Children | 22 |
| and Family Services, the Department of Human Services, and | 23 |
| insurance
companies who cover home health care services or | 24 |
| private duty nursing care in
the home.
| 25 |
| Each children's community-based health care center | 26 |
| model location shall be
physically separate and
apart from |
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| any other facility licensed by the Department of Public | 2 |
| Health under
this or any other Act and shall provide the | 3 |
| following services: respite care,
registered nursing or | 4 |
| licensed practical nursing care, transitional care to
| 5 |
| facilitate home placement or other appropriate settings | 6 |
| and reunite families,
medical day care, weekend
camps, and | 7 |
| diagnostic studies typically done in the home setting.
| 8 |
| Coverage for the services provided by the
Department of | 9 |
| Healthcare and Family Services
under this paragraph (3) is | 10 |
| contingent upon federal waiver approval and is
provided | 11 |
| only to Medicaid eligible clients participating in the home | 12 |
| and
community based services waiver designated in Section | 13 |
| 1915(c) of the Social
Security Act for medically frail and | 14 |
| technologically dependent children or
children in | 15 |
| Department of Children and Family Services foster care who | 16 |
| receive
home health benefits.
| 17 |
| (4) Alternative health care delivery model; community | 18 |
| based residential
rehabilitation center.
A community-based | 19 |
| residential rehabilitation center model is a designated
| 20 |
| site that provides rehabilitation or support, or both, for | 21 |
| persons who have
experienced severe brain injury, who are | 22 |
| medically stable, and who no longer
require acute | 23 |
| rehabilitative care or intense medical or nursing | 24 |
| services. The
average length of stay in a community-based | 25 |
| residential rehabilitation center
shall not exceed 4 | 26 |
| months. As an integral part of the services provided,
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| individuals are housed in a supervised living setting while | 2 |
| having immediate
access to the community. The residential | 3 |
| rehabilitation center authorized by
the Department may | 4 |
| have more than one residence included under the license.
A | 5 |
| residence may be no larger than 12 beds and shall be | 6 |
| located as an integral
part of the community. Day treatment | 7 |
| or
individualized outpatient services shall be provided | 8 |
| for persons who reside in
their own home. Functional | 9 |
| outcome goals shall be established for each
individual. | 10 |
| Services shall include, but are not limited to, case | 11 |
| management,
training and assistance with activities of | 12 |
| daily living, nursing
consultation, traditional therapies | 13 |
| (physical, occupational, speech),
functional interventions | 14 |
| in the residence and community (job placement,
shopping, | 15 |
| banking, recreation), counseling, self-management | 16 |
| strategies,
productive activities, and multiple | 17 |
| opportunities for skill acquisition and
practice | 18 |
| throughout the day. The design of individualized program | 19 |
| plans shall
be consistent with the outcome goals that are | 20 |
| established for each resident.
The programs provided in | 21 |
| this setting shall be accredited by the
Commission
on | 22 |
| Accreditation of Rehabilitation Facilities (CARF). The | 23 |
| program shall have
been accredited by CARF as a Brain | 24 |
| Injury Community-Integrative Program for at
least 3 years.
| 25 |
| (5) Alternative health care delivery model; | 26 |
| Alzheimer's disease
management center. An Alzheimer's |
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| disease management center model is a
designated site that | 2 |
| provides a safe and secure setting for care of persons
| 3 |
| diagnosed with Alzheimer's disease. An Alzheimer's disease | 4 |
| management center
model shall be a facility separate from | 5 |
| any other facility licensed by the
Department of Public | 6 |
| Health under this or any other Act. An Alzheimer's
disease | 7 |
| management center shall conduct and document an assessment | 8 |
| of each
resident every 6 months. The assessment shall | 9 |
| include an evaluation of daily
functioning, cognitive | 10 |
| status, other medical conditions, and behavioral
problems. | 11 |
| An Alzheimer's disease management center shall develop and | 12 |
| implement
an ongoing treatment plan for each resident. The | 13 |
| treatment
plan shall have defined goals.
The
Alzheimer's | 14 |
| disease management center shall treat behavioral problems | 15 |
| and mood
disorders using nonpharmacologic approaches such | 16 |
| as environmental modification,
task simplification, and | 17 |
| other appropriate activities.
All staff must have | 18 |
| necessary
training to care for all stages of Alzheimer's | 19 |
| Disease. An
Alzheimer's disease
management center shall | 20 |
| provide education and support for residents and
| 21 |
| caregivers. The
education and support shall include | 22 |
| referrals to support organizations for
educational | 23 |
| materials on community resources, support groups, legal | 24 |
| and
financial issues, respite care, and future care needs | 25 |
| and options. The
education and support shall also include a | 26 |
| discussion of the resident's need to
make advance |
|
|
|
09500HB5657ham001 |
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LRB095 17099 DRJ 47904 a |
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| 1 |
| directives and to identify surrogates for medical and legal
| 2 |
| decision-making. The provisions of this paragraph | 3 |
| establish the minimum level
of services that must be | 4 |
| provided by an Alzheimer's disease management
center. An | 5 |
| Alzheimer's disease management center model shall have no | 6 |
| more
than 100 residents. Nothing in this paragraph (5) | 7 |
| shall be construed as
prohibiting a person or facility from | 8 |
| providing services and care to persons
with Alzheimer's | 9 |
| disease as otherwise authorized under State law.
| 10 |
| (6) Alternative health care delivery model; birth | 11 |
| center. A birth
center shall be exclusively dedicated to | 12 |
| serving the childbirth-related needs of women and their | 13 |
| newborns and shall have no more than 10 beds. A birth | 14 |
| center is a designated site
that is away from the mother's | 15 |
| usual place of residence and in which births are
planned to | 16 |
| occur following a normal, uncomplicated, and low-risk | 17 |
| pregnancy. A
birth center shall offer prenatal care and | 18 |
| community education services and
shall coordinate these | 19 |
| services with other health care services available in
the | 20 |
| community.
| 21 |
| (A) A birth center shall not be separately licensed | 22 |
| if it
is one of the following: | 23 |
| (1) A part of a hospital; or | 24 |
| (2) A freestanding facility that is physically
| 25 |
| distinct from a hospital but is operated under a
| 26 |
| license issued to a hospital under the Hospital
|
|
|
|
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LRB095 17099 DRJ 47904 a |
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| 1 |
| Licensing Act. | 2 |
| (B) A separate birth center license shall be | 3 |
| required if the birth center is operated as: | 4 |
| (1) A part of the operation of a federally
| 5 |
| qualified health center as designated by the | 6 |
| United
States Department of Health and Human | 7 |
| Services; or | 8 |
| (2) A facility other than one described in | 9 |
| subparagraph (A)(1), (A)(2), or (B)(1) of this | 10 |
| paragraph (6) whose costs are
reimbursable under | 11 |
| Title XIX of the federal Social
Security Act. | 12 |
| In adopting rules for birth centers, the Department | 13 |
| shall consider:
the American Association
of Birth Centers' | 14 |
| Standards for Freestanding Birth Centers; the American | 15 |
| Academy of Pediatrics/American College of Obstetricians | 16 |
| and Gynecologists Guidelines for Perinatal Care; and the | 17 |
| Regionalized Perinatal Health Care Code. The Department's | 18 |
| rules shall stipulate the eligibility criteria for birth | 19 |
| center admission. The Department's rules shall
stipulate | 20 |
| the necessary equipment for emergency care
according to the | 21 |
| American Association of Birth Centers'
standards and any | 22 |
| additional equipment deemed necessary by the Department. | 23 |
| The Department's rules shall provide for a time
period | 24 |
| within which each birth center not part of a
hospital must | 25 |
| become accredited by either the Commission for the
| 26 |
| Accreditation of Freestanding Birth Centers or The Joint |
|
|
|
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LRB095 17099 DRJ 47904 a |
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| Commission. | 2 |
| A birth center shall be certified to participate in the | 3 |
| Medicare and Medicaid
programs under Titles XVIII and XIX, | 4 |
| respectively, of the federal Social
Security Act.
To the | 5 |
| extent necessary, the Illinois Department of Healthcare | 6 |
| and Family Services shall apply for
a waiver from the | 7 |
| United States Health Care Financing Administration to | 8 |
| allow
birth centers to be reimbursed under Title XIX of the | 9 |
| federal Social Security
Act. | 10 |
| A birth center that is not operated under a hospital | 11 |
| license shall be located within a ground travel time | 12 |
| distance from the general acute care hospital with which
| 13 |
| the birth center maintains a contractual relationship,
| 14 |
| including a transfer agreement, as required under this
| 15 |
| paragraph, that allows for an emergency caesarian delivery | 16 |
| to be started within 30 minutes of the decision a caesarian | 17 |
| delivery is necessary. A birth center operating under a | 18 |
| hospital license shall be located within a ground travel | 19 |
| time distance from the licensed hospital that allows for an | 20 |
| emergency caesarian delivery to be started within 30 | 21 |
| minutes of the decision a caesarian delivery is necessary. | 22 |
| The services of a
medical director physician, licensed | 23 |
| to practice medicine in all its branches, who is certified | 24 |
| or eligible for certification by the
American College of | 25 |
| Obstetricians and Gynecologists or the
American Board of | 26 |
| Osteopathic Obstetricians and Gynecologists or has |
|
|
|
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LRB095 17099 DRJ 47904 a |
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| hospital
obstetrical privileges are required in birth | 2 |
| centers. The medical director in consultation with the | 3 |
| Director of Nursing and Midwifery Services shall | 4 |
| coordinate the clinical staff and overall provision of | 5 |
| patient care.
The medical director or his or her physician | 6 |
| designee shall be available on the premises or within a | 7 |
| close proximity as defined by rule. The medical director | 8 |
| and the Director of Nursing and Midwifery Services shall | 9 |
| jointly develop and approve policies defining the criteria | 10 |
| to determine which pregnancies are accepted as normal, | 11 |
| uncomplicated, and low-risk, and the anesthesia services | 12 |
| available at the center. No general anesthesia may be | 13 |
| administered at the center. | 14 |
| If a birth center employs
certified nurse midwives, a | 15 |
| certified nurse midwife shall be the Director of
Nursing | 16 |
| and Midwifery
Services who is responsible for the | 17 |
| development of policies and procedures for
services as | 18 |
| provided by Department rules. | 19 |
| An obstetrician, family
practitioner, or certified | 20 |
| nurse midwife shall attend each woman in labor from
the | 21 |
| time of admission through birth and throughout the | 22 |
| immediate postpartum
period. Attendance may be delegated | 23 |
| only to another physician or certified
nurse
midwife. | 24 |
| Additionally, a second staff person shall also be present | 25 |
| at each
birth who is licensed or certified in Illinois in a | 26 |
| health-related field and under the supervision of the |
|
|
|
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LRB095 17099 DRJ 47904 a |
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| physician or certified nurse midwife
in attendance, has | 2 |
| specialized training in labor and delivery techniques and
| 3 |
| care of newborns, and receives planned and ongoing training | 4 |
| as needed to
perform assigned duties effectively. | 5 |
| The maximum length of stay in a birth center shall be
| 6 |
| consistent with existing State laws allowing a 48-hour stay | 7 |
| or appropriate
post-delivery care, if discharged earlier | 8 |
| than 48 hours. | 9 |
| A birth center shall
participate in the Illinois | 10 |
| Perinatal
System under the Developmental Disability | 11 |
| Prevention Act. At a minimum, this
participation shall | 12 |
| require a birth center to establish a letter of agreement
| 13 |
| with a hospital designated under the Perinatal System. A | 14 |
| hospital that
operates or has a letter of agreement with a | 15 |
| birth center shall include the
birth center under its | 16 |
| maternity service plan under the Hospital Licensing Act
and | 17 |
| shall include the birth center in the hospital's letter of | 18 |
| agreement with
its regional perinatal center. | 19 |
| A birth center may not discriminate against any patient | 20 |
| requiring treatment
because of the source of payment for | 21 |
| services, including Medicare and Medicaid
recipients. | 22 |
| No general anesthesia and no surgery may be performed | 23 |
| at a birth center.
The Department may by rule add birth | 24 |
| center patient eligibility criteria or standards as it | 25 |
| deems necessary.
The Department shall by rule require each | 26 |
| birth center to report the information which the Department |
|
|
|
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LRB095 17099 DRJ 47904 a |
|
| 1 |
| shall make publicly available, which shall include, but is | 2 |
| not limited to, the following: | 3 |
| (i) Birth center ownership. | 4 |
| (ii) Sources of payment for services. | 5 |
| (iii) Utilization data involving patient length of | 6 |
| stay. | 7 |
| (iv) Admissions and discharges. | 8 |
| (v) Complications. | 9 |
| (vi) Transfers. | 10 |
| (vii) Unusual incidents. | 11 |
| (viii) Deaths. | 12 |
| (ix) Any other publicly reported data required | 13 |
| under the Illinois Consumer Guide. | 14 |
| (x) Post-discharge patient status data where | 15 |
| patients are followed for 14 days after discharge from | 16 |
| the birth center to determine whether the mother or | 17 |
| baby developed a complication or infection. | 18 |
| Within 9 months after the effective date of this | 19 |
| amendatory Act of the 95th
General Assembly, the Department | 20 |
| shall adopt rules that are developed with consideration of: | 21 |
| the American Association of Birth Centers' Standards for | 22 |
| Freestanding Birth Centers; the American Academy of | 23 |
| Pediatrics/American College of Obstetricians and | 24 |
| Gynecologists Guidelines for Perinatal Care; and the | 25 |
| Regionalized Perinatal Health Care Code. | 26 |
| The Department shall adopt other rules as necessary to |
|
|
|
09500HB5657ham001 |
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LRB095 17099 DRJ 47904 a |
|
| 1 |
| implement the provisions of this
amendatory Act of the 95th | 2 |
| General Assembly within 9 months after the
effective date | 3 |
| of this amendatory Act of the 95th General Assembly. | 4 |
| (Source: P.A. 95-331, eff. 8-21-07; 95-445, eff. 1-1-08.)
| 5 |
| (210 ILCS 3/35.1 rep.)
| 6 |
| Section 6. The Alternative Health Care Delivery Act is | 7 |
| amended by repealing Section 35.1. | 8 |
| Section 10. The Hospital Licensing Act is amended by | 9 |
| changing Sections 3 and 4.6 as follows:
| 10 |
| (210 ILCS 85/3) (from Ch. 111 1/2, par. 144)
| 11 |
| Sec. 3. As used in this Act:
| 12 |
| (A) "Hospital" means any institution, place, building, or | 13 |
| agency, public
or private, whether organized for profit or not, | 14 |
| devoted primarily to the
maintenance and operation of | 15 |
| facilities for the diagnosis and treatment or
care of 2 or more | 16 |
| unrelated persons admitted for overnight stay or longer
in | 17 |
| order to obtain medical, including obstetric, psychiatric and | 18 |
| nursing,
care of illness, disease, injury, infirmity, or | 19 |
| deformity.
| 20 |
| The term "hospital", without regard to length of stay, | 21 |
| shall also
include:
| 22 |
| (a) any facility which is devoted primarily to | 23 |
| providing psychiatric and
related services and programs |
|
|
|
09500HB5657ham001 |
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LRB095 17099 DRJ 47904 a |
|
| 1 |
| for the diagnosis and treatment or care of
2 or more | 2 |
| unrelated persons suffering from emotional or nervous | 3 |
| diseases;
| 4 |
| (b) all places where pregnant females are received, | 5 |
| cared for, or
treated during delivery irrespective of the | 6 |
| number of patients received.
| 7 |
| The term "hospital" includes general and specialized | 8 |
| hospitals, postsurgical recovery care hospitals,
tuberculosis | 9 |
| sanitaria, mental or psychiatric hospitals and sanitaria, and
| 10 |
| includes maternity homes, lying-in homes, and homes for unwed | 11 |
| mothers in
which care is given during delivery.
| 12 |
| The term "hospital" does not include:
| 13 |
| (1) any person or institution
required to be licensed | 14 |
| pursuant to the Nursing Home Care Act, as amended;
| 15 |
| (2) hospitalization or care facilities maintained by | 16 |
| the State or any
department or agency thereof, where such | 17 |
| department or agency has authority
under law to establish | 18 |
| and enforce standards for the hospitalization or
care | 19 |
| facilities under its management and control;
| 20 |
| (3) hospitalization or care facilities maintained by | 21 |
| the federal
government or agencies thereof;
| 22 |
| (4) hospitalization or care facilities maintained by | 23 |
| any university or
college established under the laws of | 24 |
| this State and supported principally
by public funds raised | 25 |
| by taxation;
| 26 |
| (5) any person or facility required to be licensed |
|
|
|
09500HB5657ham001 |
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LRB095 17099 DRJ 47904 a |
|
| 1 |
| pursuant to the
Alcoholism and Other Drug Abuse and | 2 |
| Dependency Act;
| 3 |
| (6) any facility operated solely by and for persons who | 4 |
| rely
exclusively upon treatment by spiritual means through | 5 |
| prayer, in accordance
with the creed or tenets of any | 6 |
| well-recognized church or religious
denomination; or
| 7 |
| (7) An Alzheimer's disease management center | 8 |
| alternative health care
model licensed under the | 9 |
| Alternative Health Care Delivery Act.
| 10 |
| (B) "Person" means the State, and any political subdivision | 11 |
| or municipal
corporation, individual, firm, partnership, | 12 |
| corporation, company,
association, or joint stock association, | 13 |
| or the legal successor thereof.
| 14 |
| (C) "Department" means the Department of Public Health of | 15 |
| the State of
Illinois.
| 16 |
| (D) "Director" means the Director of Public Health of
the | 17 |
| State of Illinois.
| 18 |
| (E) "Perinatal" means the period of time
between the | 19 |
| conception of an
infant and the end of the first month after | 20 |
| birth.
| 21 |
| (F) "Federally designated organ procurement agency" means | 22 |
| the organ
procurement agency designated by the Secretary of the | 23 |
| U.S. Department of Health
and Human Services for the service | 24 |
| area in which a hospital is located; except
that in the case of | 25 |
| a hospital located in a county adjacent to Wisconsin
which | 26 |
| currently contracts with an organ procurement agency located in |
|
|
|
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LRB095 17099 DRJ 47904 a |
|
| 1 |
| Wisconsin
that is not the organ procurement agency designated | 2 |
| by the U.S. Secretary of
Health and Human Services for the | 3 |
| service area in which the hospital is
located, if the hospital | 4 |
| applies for a waiver pursuant to 42 USC
1320b-8(a), it may | 5 |
| designate an organ procurement agency
located in Wisconsin to | 6 |
| be thereafter deemed its federally designated organ
| 7 |
| procurement agency for the purposes of this Act.
| 8 |
| (G) "Tissue bank" means any facility or program operating | 9 |
| in Illinois
that is certified by the American Association of | 10 |
| Tissue Banks or the Eye Bank
Association of America and is | 11 |
| involved in procuring, furnishing, donating,
or distributing | 12 |
| corneas, bones, or other human tissue for the purpose of
| 13 |
| injecting, transfusing, or transplanting any of them into the | 14 |
| human body.
"Tissue bank" does not include a licensed blood | 15 |
| bank. For the purposes of this
Act, "tissue" does not include | 16 |
| organs.
| 17 |
| (Source: P.A. 91-838, eff. 6-16-00.)
| 18 |
| (210 ILCS 85/4.6)
| 19 |
| Sec. 4.6. Additional licensing requirements.
| 20 |
| (a) Notwithstanding any other law or rule to the contrary, | 21 |
| without the issuance of a Certificate of Need Permit or | 22 |
| Certificate of Exemption from Illinois Health Facilities | 23 |
| Planning Board, the Department
may license as a hospital a | 24 |
| building
that meets either of the following criteria: | 25 |
| (1) It (i) is owned or operated by a hospital licensed
|
|
|
|
09500HB5657ham001 |
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LRB095 17099 DRJ 47904 a |
|
| 1 |
| under
this Act, (ii) is located in a municipality with a | 2 |
| population of less than
60,000, and
(iii) includes a | 3 |
| postsurgical recovery care center licensed under the
| 4 |
| Alternative
Health Care Delivery Act for a period of not | 5 |
| less than 2 years, an ambulatory
surgical treatment center | 6 |
| licensed under the Ambulatory Surgical Treatment
Center | 7 |
| Act, and a
Freestanding
Emergency Center licensed under the | 8 |
| Emergency Medical Services (EMS)
Systems Act. Only the | 9 |
| components of the building which are currently licensed
| 10 |
| shall be eligible under the provisions of this Section. | 11 |
| (2) It is a postsurgical recovery care center under the | 12 |
| Alternative Health Care Delivery Act, is affiliated with or | 13 |
| connected to a licensed hospital or ambulatory surgical | 14 |
| treatment center, that previously received a Certificate | 15 |
| of Need from the Illinois Health Facilities Planning Board | 16 |
| and maintains an organized medical staff of physicians, | 17 |
| permanent facilities that include inpatient beds, medical | 18 |
| services, including physician services, and continuous | 19 |
| registered professional nursing services for not less than | 20 |
| 24 hours every day. These licenses will be for postsurgical | 21 |
| recovery care hospitals.
| 22 |
| (b) Prior to issuing a license, the Department shall | 23 |
| inspect the facility
and
require the facility to meet such of | 24 |
| the Department's rules relating to
the
establishment of | 25 |
| hospitals as the Department determines are appropriate to such
| 26 |
| facility. The Department's licensure of the facility as a |
|
|
|
09500HB5657ham001 |
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LRB095 17099 DRJ 47904 a |
|
| 1 |
| postsurgical recovery care hospital shall be the only approval | 2 |
| required for the facility to make improvements and operate as a | 3 |
| postsurgical recovery care hospital. Once the Department | 4 |
| approves the facility and issues a hospital
license, all other | 5 |
| licenses as listed in subsection (a) above shall be null and
| 6 |
| void. Upon receiving licensure as a postsurgical recovery care | 7 |
| hospital, any facility licensed under subdivision (a)(2) of | 8 |
| this Section shall be subject to the following limitations: | 9 |
| (1) The facility shall not have a number of beds that | 10 |
| is greater than the number of authorized postsurgical | 11 |
| recovery care beds. | 12 |
| (2) The facility shall continue to be subject to the | 13 |
| length-of-stay limitations set forth in Section 35 of the | 14 |
| Alternative Health Care Delivery Act. | 15 |
| (3) The facility shall seek certification under | 16 |
| Section 1861(e) of the federal Social Security Act.
| 17 |
| (c) A license as a postsurgical recovery care hospital Only | 18 |
| one license may be issued under the authority of subdivision | 19 |
| (a)(2) of this Section only to a postsurgical recovery care | 20 |
| center established under the Alternative Health Care Delivery | 21 |
| Act .
No license may be issued after 18 months after the | 22 |
| effective date of this
amendatory Act of the 91st General | 23 |
| Assembly. No license may be issued after 36 months after the | 24 |
| effective date of this
amendatory Act of the 95th General | 25 |
| Assembly.
| 26 |
| (Source: P.A. 91-736, eff. 6-2-00.)
|
|
|
|
09500HB5657ham001 |
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LRB095 17099 DRJ 47904 a |
|
| 1 |
| Section 99. Effective date. This Act takes effect July 1, | 2 |
| 2008.".
|
|