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Public Act 093-1031 |
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AN ACT concerning aging.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 1. Short title. This Act may be cited as the Older | ||||
Adult Services Act. | ||||
Section 5. Purpose. The purpose of this Act is to promote a | ||||
transformation of Illinois' comprehensive system of older | ||||
adult services from funding a primarily facility-based service | ||||
delivery system to primarily a home-based and community-based | ||||
system, taking into account the continuing need for 24-hour | ||||
skilled nursing care and congregate housing with services. Such | ||||
restructuring shall encompass the provision of housing, | ||||
health, financial, and supportive older adult services. It is | ||||
envisioned that this restructuring will promote the | ||||
development, availability, and accessibility of a | ||||
comprehensive, affordable, and sustainable service delivery | ||||
system that places a high priority on home-based and | ||||
community-based services. Such restructuring will encompass | ||||
all aspects of the delivery system regardless of the setting in | ||||
which the service is provided. | ||||
Section 10. Definitions. In this Act: | ||||
"Advisory Committee" means the Older Adult Services | ||||
Advisory Committee. | ||||
"Certified nursing home" means any nursing home licensed | ||||
under the Nursing Home Care Act and certified under Title XIX | ||||
of the Social Security Act to participate as a vendor in the | ||||
medical assistance program under Article V of the Illinois | ||||
Public Aid Code. | ||||
"Comprehensive case management" means the assessment of | ||||
needs and preferences of an older adult at the direction of the | ||||
older adult or the older adult's designated representative and |
the arrangement, coordination, and monitoring of an optimum | ||
package of services to meet the needs of the older adult.
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"Consumer-directed" means decisions made by an informed | ||
older adult from available services and care options, which may | ||
range from independently making all decisions and managing | ||
services directly to limited participation in decision-making, | ||
based upon the functional and cognitive level of the older | ||
adult. | ||
"Coordinated point of entry" means an integrated access | ||
point where consumers receive information and assistance, | ||
assessment of needs, care planning, referral, assistance in | ||
completing applications, authorization of services where | ||
permitted, and follow-up to ensure that referrals and services | ||
are accessed. | ||
"Department" means the Department on Aging, in | ||
collaboration with the departments of Public Health and Public | ||
Aid and other relevant agencies and in consultation with the | ||
Advisory Committee, except as otherwise provided.
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"Departments" means the Department on Aging, the | ||
departments of Public Health and Public Aid, and other relevant | ||
agencies in collaboration with each other and in consultation | ||
with the Advisory Committee, except as otherwise provided.
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"Family caregiver" means an adult family member or another | ||
individual who is an uncompensated provider of home-based or | ||
community-based care to an older adult. | ||
"Health services" means activities that promote, maintain, | ||
improve, or restore mental or physical health or that are | ||
palliative in nature.
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"Older adult" means a person age 60 or older and, if | ||
appropriate, the person's family caregiver. | ||
"Person-centered" means a process that builds upon an older | ||
adult's strengths and capacities to engage in activities that | ||
promote community life and that reflect the older adult's | ||
preferences, choices, and abilities, to the extent | ||
practicable. | ||
"Priority service area" means an area identified by the |
Departments as being less-served with respect to the | ||
availability of and access to older adult services in Illinois. | ||
The Departments shall determine by rule the criteria and | ||
standards used to designate such areas. | ||
"Priority service plan" means the plan developed pursuant | ||
to Section 25 of this Act. | ||
"Provider" means any supplier of services under this Act.
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"Residential setting" means the place where an older adult | ||
lives. | ||
"Restructuring" means the transformation of Illinois' | ||
comprehensive system of older adult services from funding | ||
primarily a facility-based service delivery system to | ||
primarily a home-based and community-based system, taking into | ||
account the continuing need for 24-hour skilled nursing care | ||
and congregate housing with services. | ||
"Services" means the range of housing, health, financial, | ||
and supportive services, other than acute health care services, | ||
that are delivered to an older adult with functional or | ||
cognitive limitations, or socialization needs, who requires | ||
assistance to perform activities of daily living, regardless of | ||
the residential setting in which the services are delivered. | ||
"Supportive services" means non-medical assistance given | ||
over a period of time to an older adult that is needed to | ||
compensate for the older adult's functional or cognitive | ||
limitations, or socialization needs, or those services | ||
designed to restore, improve, or maintain the older adult's | ||
functional or cognitive abilities.
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Section 15. Designation of lead agency; annual report. | ||
(a) The Department on Aging shall be the lead agency for: | ||
the provision of services to older adults and their family | ||
caregivers; restructuring Illinois' service delivery system | ||
for older adults; and implementation of this Act, except where | ||
otherwise provided. The Department on Aging shall collaborate | ||
with the departments of Public Health and Public Aid and any | ||
other relevant agencies, and shall consult with the Advisory |
Committee, in all aspects of these duties, except as otherwise | ||
provided in this Act. | ||
(b) The Departments shall promulgate rules to implement | ||
this Act pursuant to the Illinois Administrative Procedure Act. | ||
(c) On January 1, 2006, and each January 1 thereafter, the | ||
Department shall issue a report to the General Assembly on | ||
progress made in complying with this Act, impediments thereto, | ||
recommendations of the Advisory Committee, and any | ||
recommendations for legislative changes necessary to implement | ||
this Act. To the extent practicable, all reports required by | ||
this Act shall be consolidated into a single report.
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Section 20. Priority service areas; service expansion. | ||
(a) The requirements of this Section are subject to the | ||
availability of funding. | ||
(b) The Department shall expand older adult services that | ||
promote independence and permit older adults to remain in their | ||
own homes and communities. Priority shall be given to both the | ||
expansion of services and the development of new services in | ||
priority service areas. | ||
(c) Inventory of services. The Department shall develop and | ||
maintain an inventory and assessment of (i) the types and | ||
quantities of public older adult services and, to the extent | ||
possible, privately provided older adult services, including | ||
the unduplicated count, location, and characteristics of | ||
individuals served by each facility, program, or service and | ||
(ii) the resources supporting those services. | ||
(d) Priority service areas. The Departments shall assess | ||
the current and projected need for older adult services | ||
throughout the State, analyze the results of the inventory, and | ||
identify priority service areas, which shall serve as the basis | ||
for a priority service plan to be filed with the Governor and | ||
the General Assembly no later than July 1, 2006, and every 5 | ||
years thereafter. | ||
(e) Moneys appropriated by the General Assembly for the | ||
purpose of this Section, receipts from donations, grants, fees, |
or taxes that may accrue from any public or private sources to | ||
the Department for the purpose of this Section, and savings | ||
attributable to the nursing home conversion program as | ||
calculated in subsection (h) shall be deposited into the | ||
Department on Aging State Projects Fund. Interest earned by | ||
those moneys in the Fund shall be credited to the Fund. | ||
(f) Moneys described in subsection (e) from the Department | ||
on Aging State Projects Fund shall be used for older adult | ||
services, regardless of where the older adult receives the | ||
service, with priority given to both the expansion of services | ||
and the development of new services in priority service areas. | ||
Fundable services shall include: | ||
(1) Housing, health services, and supportive services: | ||
(A) adult day care; | ||
(B) adult day care for persons with Alzheimer's | ||
disease and related disorders; | ||
(C) activities of daily living; | ||
(D) care-related supplies and equipment; | ||
(E) case management; | ||
(F) community reintegration; | ||
(G) companion; | ||
(H) congregate meals; | ||
(I) counseling and education; | ||
(J) elder abuse prevention and intervention; | ||
(K) emergency response and monitoring; | ||
(L) environmental modifications; | ||
(M) family caregiver support; | ||
(N) financial; | ||
(O) home delivered meals;
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(P) homemaker; | ||
(Q) home health; | ||
(R) hospice; | ||
(S) laundry; | ||
(T) long-term care ombudsman; | ||
(U) medication reminders;
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(V) money management; |
(W) nutrition services;
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(X) personal care; | ||
(Y) respite care; | ||
(Z) residential care; | ||
(AA) senior benefits outreach; | ||
(BB) senior centers; | ||
(CC) services provided under the Assisted Living | ||
and Shared Housing Act, or sheltered care services that | ||
meet the requirements of the Assisted Living and Shared | ||
Housing Act, or services provided under Section | ||
5-5.01a of the Illinois Public Aid Code (the Supportive | ||
Living Facilities Pilot Program); | ||
(DD) telemedicine devices to monitor recipients in | ||
their own homes as an alternative to hospital care, | ||
nursing home care, or home visits; | ||
(EE) training for direct family caregivers; | ||
(FF) transition; | ||
(GG) transportation; | ||
(HH) wellness and fitness programs; and | ||
(II) other programs designed to assist older | ||
adults in Illinois to remain independent and receive | ||
services in the most integrated residential setting | ||
possible for that person. | ||
(2) Older Adult Services Demonstration Grants, | ||
pursuant to subsection (g) of this Section. | ||
(g) Older Adult Services Demonstration Grants. The | ||
Department shall establish a program of demonstration grants to | ||
assist in the restructuring of the delivery system for older | ||
adult services and provide funding for innovative service | ||
delivery models and system change and integration initiatives. | ||
The Department shall prescribe, by rule, the grant application | ||
process. At a minimum, every application must include: | ||
(1) The type of grant sought; | ||
(2) A description of the project; | ||
(3) The objective of the project; | ||
(4) The likelihood of the project meeting identified |
needs; | ||
(5) The plan for financing, administration, and | ||
evaluation of the project; | ||
(6) The timetable for implementation; | ||
(7) The roles and capabilities of responsible | ||
individuals and organizations; | ||
(8) Documentation of collaboration with other service | ||
providers, local community government leaders, and other | ||
stakeholders, other providers, and any other stakeholders | ||
in the community; | ||
(9) Documentation of community support for the | ||
project, including support by other service providers, | ||
local community government leaders, and other | ||
stakeholders;
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(10) The total budget for the project; | ||
(11) The financial condition of the applicant; and | ||
(12) Any other application requirements that may be | ||
established by the Department by rule. | ||
Each project may include provisions for a designated staff | ||
person who is responsible for the development of the project | ||
and recruitment of providers. | ||
Projects may include, but are not limited to: adult family | ||
foster care; family adult day care; assisted living in a | ||
supervised apartment; personal services in a subsidized | ||
housing project; evening and weekend home care coverage; small | ||
incentive grants to attract new providers; money following the | ||
person; cash and counseling; managed long-term care; and at | ||
least one respite care project that establishes a local | ||
coordinated network of volunteer and paid respite workers, | ||
coordinates assignment of respite workers to caregivers and | ||
older adults, ensures the health and safety of the older adult, | ||
provides training for caregivers, and ensures that support | ||
groups are available in the community. | ||
A demonstration project funded in whole or in part by an | ||
Older Adult Services Demonstration Grant is exempt from the | ||
requirements of the Illinois Health Facilities Planning Act. To |
the extent applicable, however, for the purpose of maintaining | ||
the statewide inventory authorized by the Illinois Health | ||
Facilities Planning Act, the Department shall send to the | ||
Health Facilities Planning Board a copy of each grant award | ||
made under this subsection (g). | ||
The Department, in collaboration with the Departments of | ||
Public Health and Public Aid, shall evaluate the effectiveness | ||
of the projects receiving grants under this Section. | ||
(h) No later than July 1 of each year, the Department of | ||
Public Health shall provide information to the Department of | ||
Public Aid to enable the Department of Public Aid to annually | ||
document and verify the savings attributable to the nursing | ||
home conversion program for the previous fiscal year to | ||
estimate an annual amount of such savings that may be | ||
appropriated to the Department on Aging State Projects Fund and | ||
notify the General Assembly, the Department on Aging, the | ||
Department of Human Services, and the Advisory Committee of the | ||
savings no later than October 1 of the same fiscal year.
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Section 25. Older adult services restructuring. No later | ||
than January 1, 2005, the Department shall commence the process | ||
of restructuring the older adult services delivery system. | ||
Priority shall be given to both the expansion of services and | ||
the development of new services in priority service areas. | ||
Subject to the availability of funding, the restructuring shall | ||
include, but not be limited to, the following:
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(1) Planning. The Department shall develop a plan to | ||
restructure the State's service delivery system for older | ||
adults. The plan shall include a schedule for the | ||
implementation of the initiatives outlined in this Act and all | ||
other initiatives identified by the participating agencies to | ||
fulfill the purposes of this Act. Financing for older adult | ||
services shall be based on the principle that "money follows | ||
the individual". The plan shall also identify potential | ||
impediments to delivery system restructuring and include any | ||
known regulatory or statutory barriers. |
(2) Comprehensive case management. The Department shall | ||
implement a statewide system of holistic comprehensive case | ||
management. The system shall include the identification and | ||
implementation of a universal, comprehensive assessment tool | ||
to be used statewide to determine the level of functional, | ||
cognitive, socialization, and financial needs of older adults. | ||
This tool shall be supported by an electronic intake, | ||
assessment, and care planning system linked to a central | ||
location. "Comprehensive case management" includes services | ||
and coordination such as (i) comprehensive assessment of the | ||
older adult (including the physical, functional, cognitive, | ||
psycho-social, and social needs of the individual); (ii) | ||
development and implementation of a service plan with the older | ||
adult to mobilize the formal and family resources and services | ||
identified in the assessment to meet the needs of the older | ||
adult, including coordination of the resources and services | ||
with any other plans that exist for various formal services, | ||
such as hospital discharge plans, and with the information and | ||
assistance services; (iii) coordination and monitoring of | ||
formal and family service delivery, including coordination and | ||
monitoring to ensure that services specified in the plan are | ||
being provided; (iv) periodic reassessment and revision of the | ||
status of the older adult with the older adult or, if | ||
necessary, the older adult's designated representative; and | ||
(v) in accordance with the wishes of the older adult, advocacy | ||
on behalf of the older adult for needed services or resources. | ||
(3) Coordinated point of entry. The Department shall | ||
implement and publicize a statewide coordinated point of entry | ||
using a uniform name, identity, logo, and toll-free number. | ||
(4) Public web site. The Department shall develop a public | ||
web site that provides links to available services, resources, | ||
and reference materials concerning caregiving, diseases, and | ||
best practices for use by professionals, older adults, and | ||
family caregivers. | ||
(5) Expansion of older adult services. The Department shall | ||
expand older adult services that promote independence and |
permit older adults to remain in their own homes and | ||
communities. | ||
(6) Consumer-directed home and community-based services. | ||
The Department shall expand the range of service options | ||
available to permit older adults to exercise maximum choice and | ||
control over their care. | ||
(7) Comprehensive delivery system. The Department shall | ||
expand opportunities for older adults to receive services in | ||
systems that integrate acute and chronic care. | ||
(8) Enhanced transition and follow-up services. The | ||
Department shall implement a program of transition from one | ||
residential setting to another and follow-up services, | ||
regardless of residential setting, pursuant to rules with | ||
respect to (i) resident eligibility, (ii) assessment of the | ||
resident's health, cognitive, social, and financial needs, | ||
(iii) development of transition plans, and (iv) the level of | ||
services that must be available before transitioning a resident | ||
from one setting to another. | ||
(9) Family caregiver support. The Department shall develop | ||
strategies for public and private financing of services that | ||
supplement and support family caregivers.
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(10) Quality standards and quality improvement. The | ||
Department shall establish a core set of uniform quality | ||
standards for all providers that focus on outcomes and take | ||
into consideration consumer choice and satisfaction, and the | ||
Department shall require each provider to implement a | ||
continuous quality improvement process to address consumer | ||
issues. The continuous quality improvement process must | ||
benchmark performance, be person-centered and data-driven, and | ||
focus on consumer satisfaction.
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(11) Workforce. The Department shall develop strategies to | ||
attract and retain a qualified and stable worker pool, provide | ||
living wages and benefits, and create a work environment that | ||
is conducive to long-term employment and career development. | ||
Resources such as grants, education, and promotion of career | ||
opportunities may be used. |
(12) Coordination of services. The Department shall | ||
identify methods to better coordinate service networks to | ||
maximize resources and minimize duplication of services and | ||
ease of application. | ||
(13) Barriers to services. The Department shall identify | ||
barriers to the provision, availability, and accessibility of | ||
services and shall implement a plan to address those barriers. | ||
The plan shall: (i) identify barriers, including but not | ||
limited to, statutory and regulatory complexity, reimbursement | ||
issues, payment issues, and labor force issues; (ii) recommend | ||
changes to State or federal laws or administrative rules or | ||
regulations; (iii) recommend application for federal waivers | ||
to improve efficiency and reduce cost and paperwork; (iv) | ||
develop innovative service delivery models; and (v) recommend | ||
application for federal or private service grants. | ||
(14) Reimbursement and funding. The Department shall | ||
investigate and evaluate costs and payments by defining costs | ||
to implement a uniform, audited provider cost reporting system | ||
to be considered by all Departments in establishing payments. | ||
To the extent possible, multiple cost reporting mandates shall | ||
not be imposed. | ||
(15) Medicaid nursing home cost containment and Medicare | ||
utilization. The Department of Public Aid, in collaboration | ||
with the Department on Aging and the Department of Public | ||
Health and in consultation with the Advisory Committee, shall | ||
propose a plan to contain Medicaid nursing home costs and | ||
maximize Medicare utilization. The plan must not impair the | ||
ability of an older adult to choose among available services. | ||
The plan shall include, but not be limited to, (i) techniques | ||
to maximize the use of the most cost-effective services without | ||
sacrificing quality and (ii) methods to identify and serve | ||
older adults in need of minimal services to remain independent, | ||
but who are likely to develop a need for more extensive | ||
services in the absence of those minimal services. | ||
(16) Bed reduction. The Department of Public Health shall | ||
implement a nursing home conversion program to reduce the |
number of Medicaid-certified nursing home beds in areas with | ||
excess beds. The Department of Public Aid shall investigate | ||
changes to the Medicaid nursing facility reimbursement system | ||
in order to reduce beds. Such changes may include, but are not | ||
limited to, incentive payments that will enable facilities to | ||
adjust to the restructuring and expansion of services required | ||
by the Older Adult Services Act, including adjustments for the | ||
voluntary closure or layaway of nursing home beds certified | ||
under Title XIX of the federal Social Security Act. Any savings | ||
shall be reallocated to fund home-based or community-based | ||
older adult services pursuant to Section 20. | ||
(17) Financing. The Department shall investigate and | ||
evaluate financing options for older adult services and shall | ||
make recommendations in the report required by Section 15 | ||
concerning the feasibility of these financing arrangements. | ||
These arrangements shall include, but are not limited to: | ||
(A) private long-term care insurance coverage for | ||
older adult services; | ||
(B) enhancement of federal long-term care financing | ||
initiatives; | ||
(C) employer benefit programs such as medical savings | ||
accounts for long-term care; | ||
(D) individual and family cost-sharing options; | ||
(E) strategies to reduce reliance on government | ||
programs; | ||
(F) fraudulent asset divestiture and financial | ||
planning prevention; and | ||
(G) methods to supplement and support family and | ||
community caregiving. | ||
(18) Older Adult Services Demonstration Grants. The | ||
Department shall implement a program of demonstration grants | ||
that will assist in the restructuring of the older adult | ||
services delivery system, and shall provide funding for | ||
innovative service delivery models and system change and | ||
integration initiatives pursuant to subsection (g) of Section | ||
20. |
(19) Bed need methodology update. For the purposes of | ||
determining areas with excess beds, the Departments shall | ||
provide information and assistance to the Health Facilities | ||
Planning Board to update the Bed Need Methodology for Long-Term | ||
Care to update the assumptions used to establish the | ||
methodology to make them consistent with modern older adult | ||
services.
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Section 30. Nursing home conversion program. | ||
(a) The Department of Public Health, in collaboration with | ||
the Department on Aging and the Department of Public Aid, shall | ||
establish a nursing home conversion program. Start-up grants, | ||
pursuant to subsections (l) and (m) of this Section, shall be | ||
made available to nursing homes as appropriations permit as an | ||
incentive to reduce certified beds, retrofit, and retool | ||
operations to meet new service delivery expectations and | ||
demands. | ||
(b) Grant moneys shall be made available for capital and | ||
other costs related to: (1) the conversion of all or a part of | ||
a nursing home to an assisted living establishment or a special | ||
program or unit for persons with Alzheimer's disease or related | ||
disorders licensed under the Assisted Living and Shared Housing | ||
Act or a supportive living facility established under Section | ||
5-5.01a of the Illinois Public Aid Code; (2) the conversion of | ||
multi-resident bedrooms in the facility into single-occupancy | ||
rooms; and (3) the development of any of the services | ||
identified in a priority service plan that can be provided by a | ||
nursing home within the confines of a nursing home or | ||
transportation services. Grantees shall be required to provide | ||
a minimum of a 20% match toward the total cost of the project. | ||
(c) Nothing in this Act shall prohibit the co-location of | ||
services or the development of multifunctional centers under | ||
subsection (f) of Section 20, including a nursing home offering | ||
community-based services or a community provider establishing | ||
a residential facility. | ||
(d) A certified nursing home with at least 50% of its |
resident population having their care paid for by the Medicaid | ||
program is eligible to apply for a grant under this Section. | ||
(e) Any nursing home receiving a grant under this Section | ||
shall reduce the number of certified nursing home beds by a | ||
number equal to or greater than the number of beds being | ||
converted for one or more of the permitted uses under item (1) | ||
or (2) of subsection (b). The nursing home shall retain the | ||
Certificate of Need for its nursing and sheltered care beds | ||
that were converted for 15 years. If the beds are reinstated by | ||
the provider or its successor in interest, the provider shall | ||
pay to the fund from which the grant was awarded, on an | ||
amortized basis, the amount of the grant. The Department shall | ||
establish, by rule, the bed reduction methodology for nursing | ||
homes that receive a grant pursuant to item (3) of subsection | ||
(b). | ||
(f) Any nursing home receiving a grant under this Section | ||
shall agree that, for a minimum of 10 years after the date that | ||
the grant is awarded, a minimum of 50% of the nursing home's | ||
resident population shall have their care paid for by the | ||
Medicaid program. If the nursing home provider or its successor | ||
in interest ceases to comply with the requirement set forth in | ||
this subsection, the provider shall pay to the fund from which | ||
the grant was awarded, on an amortized basis, the amount of the | ||
grant. | ||
(g) Before awarding grants, the Department of Public Health | ||
shall seek recommendations from the Department on Aging and the | ||
Department of Public Aid. The Department of Public Health shall | ||
attempt to balance the distribution of grants among geographic | ||
regions, and among small and large nursing homes. The | ||
Department of Public Health shall develop, by rule, the | ||
criteria for the award of grants based upon the following | ||
factors:
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(1) the unique needs of older adults (including those | ||
with moderate and low incomes), caregivers, and providers | ||
in the geographic area of the State the grantee seeks to | ||
serve; |
(2) whether the grantee proposes to provide services in | ||
a priority service area; | ||
(3) the extent to which the conversion or transition | ||
will result in the reduction of certified nursing home beds | ||
in an area with excess beds; | ||
(4) the compliance history of the nursing home; and | ||
(5) any other relevant factors identified by the | ||
Department, including standards of need. | ||
(h) A conversion funded in whole or in part by a grant | ||
under this Section must not: | ||
(1) diminish or reduce the quality of services | ||
available to nursing home residents; | ||
(2) force any nursing home resident to involuntarily | ||
accept home-based or community-based services instead of | ||
nursing home services; | ||
(3) diminish or reduce the supply and distribution of | ||
nursing home services in any community below the level of | ||
need, as defined by the Department by rule; or | ||
(4) cause undue hardship on any person who requires | ||
nursing home care. | ||
(i) The Department shall prescribe, by rule, the grant | ||
application process. At a minimum, every application must | ||
include: | ||
(1) the type of grant sought; | ||
(2) a description of the project; | ||
(3) the objective of the project; | ||
(4) the likelihood of the project meeting identified | ||
needs; | ||
(5) the plan for financing, administration, and | ||
evaluation of the project; | ||
(6) the timetable for implementation;
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(7) the roles and capabilities of responsible | ||
individuals and organizations; | ||
(8) documentation of collaboration with other service | ||
providers, local community government leaders, and other | ||
stakeholders, other providers, and any other stakeholders |
in the community;
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(9) documentation of community support for the | ||
project, including support by other service providers, | ||
local community government leaders, and other | ||
stakeholders; | ||
(10) the total budget for the project;
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(11) the financial condition of the applicant; and | ||
(12) any other application requirements that may be | ||
established by the Department by rule.
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(j) A conversion project funded in whole or in part by a | ||
grant under this Section is exempt from the requirements of the | ||
Illinois Health Facilities Planning Act.
The Department of | ||
Public Health, however, shall send to the Health Facilities | ||
Planning Board a copy of each grant award made under this | ||
Section. | ||
(k) Applications for grants are public information, except | ||
that nursing home financial condition and any proprietary data | ||
shall be classified as nonpublic data.
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(l) The Department of Public Health may award grants from | ||
the Long Term Care Civil Money Penalties Fund established under | ||
Section 1919(h)(2)(A)(ii) of the Social Security Act and 42 CFR | ||
488.422(g) if the award meets federal requirements. | ||
Section 35. Older Adult Services Advisory Committee. | ||
(a) The Older Adult Services Advisory Committee is created | ||
to advise the directors of Aging, Public Aid, and Public Health | ||
on all matters related to this Act and the delivery of services | ||
to older adults in general.
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(b) The Advisory Committee shall be comprised of the | ||
following:
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(1) The Director of Aging or his or her designee, who | ||
shall serve as chair and shall be an ex officio and | ||
nonvoting member.
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(2) The Director of Public Aid and the Director of | ||
Public Health or their designees, who shall serve as | ||
vice-chairs and shall be ex officio and nonvoting members.
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(3) One representative each of the Governor's Office, | ||
the Department of Public Aid, the Department of Public | ||
Health, the Department of Veterans' Affairs, the | ||
Department of Human Services, the Department of Insurance, | ||
the Department of Commerce and Economic Opportunity, the | ||
Department on Aging, the Department on Aging's State Long | ||
Term Care Ombudsman, the Illinois Housing Finance | ||
Authority, and the Illinois Housing Development Authority, | ||
each of whom shall be selected by his or her respective | ||
director and shall be an ex officio and nonvoting member.
| ||
(4) Thirty-two members appointed by the Director of | ||
Aging in collaboration with the directors of Public Health | ||
and Public Aid, and selected from the recommendations of | ||
statewide associations and organizations, as follows:
| ||
(A) One member representing the Area Agencies on | ||
Aging;
| ||
(B) Four members representing nursing homes or | ||
licensed assisted living establishments;
| ||
(C) One member representing home health agencies;
| ||
(D) One member representing case management | ||
services;
| ||
(E) One member representing statewide senior | ||
center associations;
| ||
(F) One member representing Community Care Program | ||
homemaker services;
| ||
(G) One member representing Community Care Program | ||
adult day services;
| ||
(H) One member representing nutrition project | ||
directors;
| ||
(I) One member representing hospice programs;
| ||
(J) One member representing individuals with | ||
Alzheimer's disease and related dementias;
| ||
(K) Two members representing statewide trade or | ||
labor unions;
| ||
(L) One advanced practice nurse with experience in | ||
gerontological nursing;
|
(M) One physician specializing in gerontology;
| ||
(N) One member representing regional long-term | ||
care ombudsmen;
| ||
(O) One member representing township officials;
| ||
(P) One member representing municipalities;
| ||
(Q) One member representing county officials;
| ||
(R) One member representing the parish nurse | ||
movement;
| ||
(S) One member representing pharmacists;
| ||
(T) Two members representing statewide | ||
organizations engaging in advocacy or legal | ||
representation on behalf of the senior population;
| ||
(U) Two family caregivers;
| ||
(V) Two citizen members over the age of 60;
| ||
(W) One citizen with knowledge in the area of | ||
gerontology research or health care law;
| ||
(X) One representative of health care facilities | ||
licensed under the Hospital Licensing Act; and
| ||
(Y) One representative of primary care service | ||
providers. | ||
(c) Voting members of the Advisory Committee shall serve | ||
for a term of 3 years or until a replacement is named. All | ||
members shall be appointed no later than January 1, 2005. Of | ||
the initial appointees, as determined by lot, 10 members shall | ||
serve a term of one year; 10 shall serve for a term of 2 years; | ||
and 12 shall serve for a term of 3 years. Any member appointed | ||
to fill a vacancy occurring prior to the expiration of the term | ||
for which his or her predecessor was appointed shall be | ||
appointed for the remainder of that term. The Advisory | ||
Committee shall meet at least quarterly and may meet more | ||
frequently at the call of the Chair. A simple majority of those | ||
appointed shall constitute a quorum. The affirmative vote of a | ||
majority of those present and voting shall be necessary for | ||
Advisory Committee action. Members of the Advisory Committee | ||
shall receive no compensation for their services.
| ||
(d) The Advisory Committee shall have an Executive |
Committee comprised of the Chair, the Vice Chairs, and up to 15 | ||
members of the Advisory Committee appointed by the Chair who | ||
have demonstrated expertise in developing, implementing, or | ||
coordinating the system restructuring initiatives defined in | ||
Section 25. The Executive Committee shall have responsibility | ||
to oversee and structure the operations of the Advisory | ||
Committee and to create and appoint necessary subcommittees and | ||
subcommittee members.
| ||
(e) The Advisory Committee shall study and make | ||
recommendations related to the implementation of this Act, | ||
including but not limited to system restructuring initiatives | ||
as defined in Section 25 or otherwise related to this Act.
| ||
Section 90. The Illinois Act on the Aging is amended by | ||
adding Section 4.12 as follows: | ||
(20 ILCS 105/4.12 new) | ||
Sec. 4.12. Older Adult Services Act. The Department shall | ||
implement the Older Adult Services Act. | ||
Section 91. The Illinois Finance Authority Act is amended | ||
by changing Section 840-5 as follows:
| ||
(20 ILCS 3501/840-5)
| ||
Sec. 840-5. The Authority shall have the following powers:
| ||
(a) To fix and revise from time to time and charge and | ||
collect rates, rents,
fees and charges for the use of and for | ||
the services furnished or to be
furnished by a project or other | ||
health facilities owned, financed or refinanced
by the | ||
Authority or any portion thereof and to contract with any | ||
person,
partnership, association or corporation or other body, | ||
public or private, in
respect thereto; to coordinate its | ||
policies and procedures and cooperate with
recognized health | ||
facility rate setting mechanisms which may now or hereafter
be | ||
established.
| ||
(b) To establish rules and regulations for the use of a |
project or other
health
facilities owned, financed or | ||
refinanced by the Authority or any portion
thereof
and to | ||
designate a participating health institution as its agent to | ||
establish
rules and regulations for the use of a project or | ||
other health facilities owned
by the Authority undertaken for | ||
that participating health institution.
| ||
(c) To establish or contract with others to carry out on | ||
its behalf a health
facility project cost estimating service | ||
and to make this service available on
all projects to provide | ||
expert cost estimates and guidance to the participating
health | ||
institution and to the Authority. In order to implement this | ||
service
and, through it, to contribute to cost containment, the | ||
Authority shall have
the power to require such reasonable | ||
reports and documents from health facility
projects as may be | ||
required for this service and for the development of cost
| ||
reports and guidelines. The Authority may appoint a Technical | ||
Committee on
Health Facility Project Costs and Cost | ||
Containment.
| ||
(d) To make mortgage or other secured or unsecured loans to | ||
or for the
benefit
of any participating health institution for | ||
the cost of a project in accordance
with an agreement between | ||
the Authority and the participating health
institution; | ||
provided that no such loan shall exceed the total cost of the
| ||
project as determined by the participating health institution | ||
and approved by
the Authority; provided further that such loans | ||
may be made to any entity
affiliated with a participating | ||
health institution if the proceeds of such loan
are made | ||
available to or applied for the benefit of such participating | ||
health
institution.
| ||
(e) To make mortgage or other secured or unsecured loans to | ||
or for the
benefit of a participating health institution in | ||
accordance with an agreement
between
the Authority and the | ||
participating health institution to refund outstanding
| ||
obligations, loans, indebtedness or advances issued, made, | ||
given or incurred by
such participating health institution for | ||
the cost of a project; including the
function to issue bonds |
and make loans to or for the benefit of a participating
health | ||
institution to refinance indebtedness incurred by such | ||
participating
health institution in projects undertaken and | ||
completed or for other health
facilities acquired prior to or | ||
after the enactment of this Act when the
Authority finds that | ||
such refinancing is in the public interest, and either
| ||
alleviates a financial hardship of such participating health | ||
institution, or is
in connection with other financing by the | ||
Authority for such participating
health institution or may be | ||
expected to result in a lessened cost of patient
care and a | ||
saving to third parties, including government, and to others | ||
who
must pay for care, or any combination thereof; provided | ||
further that such loans
may
be made to any entity affiliated | ||
with a participating health institution if the
proceeds of such | ||
loan are made available to or applied for the benefit of such
| ||
participating health institution.
| ||
(f) To mortgage all or any portion of a project or other | ||
health facilities
and the property on which any such project or | ||
other health facilities are
located
whether owned or thereafter | ||
acquired, and to assign or pledge mortgages, deeds
of trust, | ||
indentures of mortgage or trust or similar instruments, notes, | ||
and
other securities of participating health institutions to | ||
which or for the
benefit of which the Authority has made loans | ||
or of entities affiliated with
such institutions and the | ||
revenues therefrom, including payments or income from
any | ||
thereof owned or held by the Authority, for the benefit of the | ||
holders of
bonds issued to finance such project or health | ||
facilities or issued to refund
or refinance outstanding | ||
obligations, loans, indebtedness or advances of
participating | ||
health institutions as permitted by this Act.
| ||
(g) To lease to a participating health institution the | ||
project being
financed or refinanced or other health facilities | ||
conveyed to the Authority in
connection with such financing or | ||
refinancing, upon such terms and conditions
as the
Authority | ||
shall deem proper, and to charge and collect rents therefor and | ||
to
terminate any such lease upon the failure of the lessee to |
comply with any of
the obligations thereof; and to include in | ||
any such lease, if desired,
provisions that the lessee thereof | ||
shall have options to renew the lease for
such period or | ||
periods and at such rent as shall be determined by the | ||
Authority
or to purchase any or all of the health facilities or | ||
that upon payment of all
of the indebtedness incurred by the | ||
Authority for the financing of such project
or health | ||
facilities or for refunding outstanding obligations, loans,
| ||
indebtedness or advances of a participating health | ||
institution, then the
Authority may convey any or all of the | ||
project or such other health facilities
to the lessee or | ||
lessees thereof with or without consideration.
| ||
(h) To make studies of needed health facilities that could | ||
not sustain a
loan
were it made under this Act and to recommend | ||
remedial action to the General
Assembly; to do the same with | ||
regard to any laws or regulations that prevent
health | ||
facilities from benefiting from this Act.
| ||
(i) To assist the Department of Commerce and Economic | ||
Opportunity to
establish and implement a program to assist | ||
health facilities to identify and
arrange
financing for energy | ||
conservation projects in buildings and facilities owned or
| ||
leased by health facilities.
| ||
(j) To assist the Department of Human Services in | ||
establishing a low
interest
loan program to help child care | ||
centers and family day care homes serving
children of low | ||
income families under
Section 22.4 of the Children and Family
| ||
Services Act. | ||
(k) To assist the Department of Public Health and nursing | ||
homes in undertaking nursing home conversion projects in | ||
accordance with the Older Adult Services Act.
| ||
(Source: P.A. 93-205, eff. 1-1-04.)
| ||
Section 92. The Illinois Health Facilities Planning Act is | ||
amended by changing Section 3 as follows:
| ||
(20 ILCS 3960/3) (from Ch. 111 1/2, par. 1153)
|
(Section scheduled to be repealed on July 1, 2008)
| ||
Sec. 3. Definitions. As used in this Act:
| ||
"Health care facilities" means and includes
the following | ||
facilities and organizations:
| ||
1. An ambulatory surgical treatment center required to | ||
be licensed
pursuant to the Ambulatory Surgical Treatment | ||
Center Act;
| ||
2. An institution, place, building, or agency required | ||
to be licensed
pursuant to the Hospital Licensing Act;
| ||
3. Skilled and intermediate long term care facilities | ||
licensed under the
Nursing
Home Care Act;
| ||
3. Skilled and intermediate long term care facilities | ||
licensed under the
Nursing
Home Care Act;
| ||
4. Hospitals, nursing homes, ambulatory surgical | ||
treatment centers, or
kidney disease treatment centers
| ||
maintained by the State or any department or agency | ||
thereof;
| ||
5. Kidney disease treatment centers, including a | ||
free-standing
hemodialysis unit; and
| ||
6. An institution, place, building, or room used for | ||
the performance of
outpatient surgical procedures that is | ||
leased, owned, or operated by or on
behalf of an | ||
out-of-state facility.
| ||
No federally owned facility shall be subject to the | ||
provisions of this
Act, nor facilities used solely for healing | ||
by prayer or spiritual means.
| ||
No facility licensed under the Supportive Residences | ||
Licensing Act or the
Assisted Living and Shared Housing Act
| ||
shall be subject to the provisions of this Act.
| ||
A facility designated as a supportive living facility that | ||
is in good
standing with the demonstration project established | ||
under Section 5-5.01a of
the Illinois Public Aid Code shall not | ||
be subject to the provisions of this
Act.
| ||
This Act does not apply to facilities granted waivers under | ||
Section 3-102.2
of the Nursing Home Care Act. However, if a | ||
demonstration project under that
Act applies for a certificate
|
of need to convert to a nursing facility, it shall meet the | ||
licensure and
certificate of need requirements in effect as of | ||
the date of application.
| ||
This Act shall not apply to the closure of an entity or a | ||
portion of an
entity licensed under the Nursing Home Care Act | ||
that elects to convert, in
whole or in part, to an assisted | ||
living or shared housing establishment
licensed under the | ||
Assisted Living and Shared Housing Act.
| ||
With the exception of those health care facilities | ||
specifically
included in this Section, nothing in this Act | ||
shall be intended to
include facilities operated as a part of | ||
the practice of a physician or
other licensed health care | ||
professional, whether practicing in his
individual capacity or | ||
within the legal structure of any partnership,
medical or | ||
professional corporation, or unincorporated medical or
| ||
professional group. Further, this Act shall not apply to | ||
physicians or
other licensed health care professional's | ||
practices where such practices
are carried out in a portion of | ||
a health care facility under contract
with such health care | ||
facility by a physician or by other licensed
health care | ||
professionals, whether practicing in his individual capacity
| ||
or within the legal structure of any partnership, medical or
| ||
professional corporation, or unincorporated medical or | ||
professional
groups. This Act shall apply to construction or
| ||
modification and to establishment by such health care facility | ||
of such
contracted portion which is subject to facility | ||
licensing requirements,
irrespective of the party responsible | ||
for such action or attendant
financial obligation.
| ||
"Person" means any one or more natural persons, legal | ||
entities,
governmental bodies other than federal, or any | ||
combination thereof.
| ||
"Consumer" means any person other than a person (a) whose | ||
major
occupation currently involves or whose official capacity | ||
within the last
12 months has involved the providing, | ||
administering or financing of any
type of health care facility, | ||
(b) who is engaged in health research or
the teaching of |
health, (c) who has a material financial interest in any
| ||
activity which involves the providing, administering or | ||
financing of any
type of health care facility, or (d) who is or | ||
ever has been a member of
the immediate family of the person | ||
defined by (a), (b), or (c).
| ||
"State Board" means the Health Facilities Planning Board.
| ||
"Construction or modification" means the establishment, | ||
erection,
building, alteration, reconstruction, modernization, | ||
improvement,
extension, discontinuation, change of ownership, | ||
of or by a health care
facility, or the purchase or acquisition | ||
by or through a health care facility
of
equipment or service | ||
for diagnostic or therapeutic purposes or for
facility | ||
administration or operation, or any capital expenditure made by
| ||
or on behalf of a health care facility which
exceeds the | ||
capital expenditure minimum; however, any capital expenditure
| ||
made by or on behalf of a health care facility for (i) the | ||
construction or
modification of a facility licensed under the | ||
Assisted Living and Shared
Housing Act or (ii) a conversion | ||
project undertaken in accordance with Section 30 of the Older | ||
Adult Services Act shall be excluded from any obligations under | ||
this Act.
| ||
"Establish" means the construction of a health care | ||
facility or the
replacement of an existing facility on another | ||
site.
| ||
"Major medical equipment" means medical equipment which is | ||
used for the
provision of medical and other health services and | ||
which costs in excess
of the capital expenditure minimum, | ||
except that such term does not include
medical equipment | ||
acquired
by or on behalf of a clinical laboratory to provide | ||
clinical laboratory
services if the clinical laboratory is | ||
independent of a physician's office
and a hospital and it has | ||
been determined under Title XVIII of the Social
Security Act to | ||
meet the requirements of paragraphs (10) and (11) of Section
| ||
1861(s) of such Act. In determining whether medical equipment | ||
has a value
in excess of the capital expenditure minimum, the | ||
value of studies, surveys,
designs, plans, working drawings, |
specifications, and other activities
essential to the | ||
acquisition of such equipment shall be included.
| ||
"Capital Expenditure" means an expenditure: (A) made by or | ||
on behalf of
a health care facility (as such a facility is | ||
defined in this Act); and
(B) which under generally accepted | ||
accounting principles is not properly
chargeable as an expense | ||
of operation and maintenance, or is made to obtain
by lease or | ||
comparable arrangement any facility or part thereof or any
| ||
equipment for a facility or part; and which exceeds the capital | ||
expenditure
minimum.
| ||
For the purpose of this paragraph, the cost of any studies, | ||
surveys, designs,
plans, working drawings, specifications, and | ||
other activities essential
to the acquisition, improvement, | ||
expansion, or replacement of any plant
or equipment with | ||
respect to which an expenditure is made shall be included
in | ||
determining if such expenditure exceeds the capital | ||
expenditures minimum.
Donations of equipment
or facilities to a | ||
health care facility which if acquired directly by such
| ||
facility would be subject to review under this Act shall be | ||
considered capital
expenditures, and a transfer of equipment or | ||
facilities for less than fair
market value shall be considered | ||
a capital expenditure for purposes of this
Act if a transfer of | ||
the equipment or facilities at fair market value would
be | ||
subject to review.
| ||
"Capital expenditure minimum" means $6,000,000, which | ||
shall be annually
adjusted to reflect the increase in | ||
construction costs due to inflation, for major medical | ||
equipment and for all other
capital expenditures; provided, | ||
however, that when a capital expenditure is
for the | ||
construction or modification of a health and fitness center, | ||
"capital
expenditure minimum" means the capital expenditure | ||
minimum for all other
capital expenditures in effect on March | ||
1, 2000, which shall be annually
adjusted to reflect the | ||
increase in construction costs due to inflation.
| ||
"Non-clinical service area" means an area (i) for the | ||
benefit of the
patients, visitors, staff, or employees of a |
health care facility and (ii) not
directly related to the | ||
diagnosis, treatment, or rehabilitation of persons
receiving | ||
services from the health care facility. "Non-clinical service | ||
areas"
include, but are not limited to, chapels; gift shops; | ||
news stands; computer
systems; tunnels, walkways, and | ||
elevators; telephone systems; projects to
comply with life | ||
safety codes; educational facilities; student housing;
| ||
patient, employee, staff, and visitor dining areas; | ||
administration and
volunteer offices; modernization of | ||
structural components (such as roof
replacement and masonry | ||
work); boiler repair or replacement; vehicle
maintenance and | ||
storage facilities; parking facilities; mechanical systems for
| ||
heating, ventilation, and air conditioning; loading docks; and | ||
repair or
replacement of carpeting, tile, wall coverings, | ||
window coverings or treatments,
or furniture. Solely for the | ||
purpose of this definition, "non-clinical service
area" does | ||
not include health and fitness centers.
| ||
"Areawide" means a major area of the State delineated on a
| ||
geographic, demographic, and functional basis for health | ||
planning and
for health service and having within it one or | ||
more local areas for
health planning and health service. The | ||
term "region", as contrasted
with the term "subregion", and the | ||
word "area" may be used synonymously
with the term "areawide".
| ||
"Local" means a subarea of a delineated major area that on | ||
a
geographic, demographic, and functional basis may be | ||
considered to be
part of such major area. The term "subregion" | ||
may be used synonymously
with the term "local".
| ||
"Areawide health planning organization" or "Comprehensive | ||
health
planning organization" means the health systems agency | ||
designated by the
Secretary, Department of Health and Human | ||
Services or any successor agency.
| ||
"Local health planning organization" means those local | ||
health
planning organizations that are designated as such by | ||
the areawide
health planning organization of the appropriate | ||
area.
| ||
"Physician" means a person licensed to practice in |
accordance with
the Medical Practice Act of 1987, as amended.
| ||
"Licensed health care professional" means a person | ||
licensed to
practice a health profession under pertinent | ||
licensing statutes of the
State of Illinois.
| ||
"Director" means the Director of the Illinois Department of | ||
Public Health.
| ||
"Agency" means the Illinois Department of Public Health.
| ||
"Comprehensive health planning" means health planning | ||
concerned with
the total population and all health and | ||
associated problems that affect
the well-being of people and | ||
that encompasses health services, health
manpower, and health | ||
facilities; and the coordination among these and
with those | ||
social, economic, and environmental factors that affect | ||
health.
| ||
"Alternative health care model" means a facility or program | ||
authorized
under the Alternative Health Care Delivery Act.
| ||
"Out-of-state facility" means a person that is both (i) | ||
licensed as a
hospital or as an ambulatory surgery center under | ||
the laws of another state
or that
qualifies as a hospital or an | ||
ambulatory surgery center under regulations
adopted pursuant | ||
to the Social Security Act and (ii) not licensed under the
| ||
Ambulatory Surgical Treatment Center Act, the Hospital | ||
Licensing Act, or the
Nursing Home Care Act. Affiliates of | ||
out-of-state facilities shall be
considered out-of-state | ||
facilities. Affiliates of Illinois licensed health
care | ||
facilities 100% owned by an Illinois licensed health care | ||
facility, its
parent, or Illinois physicians licensed to | ||
practice medicine in all its
branches shall not be considered | ||
out-of-state facilities. Nothing in
this definition shall be
| ||
construed to include an office or any part of an office of a | ||
physician licensed
to practice medicine in all its branches in | ||
Illinois that is not required to be
licensed under the | ||
Ambulatory Surgical Treatment Center Act.
| ||
"Change of ownership of a health care facility" means a | ||
change in the
person
who has ownership or
control of a health | ||
care facility's physical plant and capital assets. A change
in |
ownership is indicated by
the following transactions: sale, | ||
transfer, acquisition, lease, change of
sponsorship, or other | ||
means of
transferring control.
| ||
"Related person" means any person that: (i) is at least 50% | ||
owned, directly
or indirectly, by
either the health care | ||
facility or a person owning, directly or indirectly, at
least | ||
50% of the health
care facility; or (ii) owns, directly or | ||
indirectly, at least 50% of the
health care facility.
| ||
(Source: P.A. 93-41, eff. 6-27-03.)
| ||
Section 96. The Illinois Public Aid Code is amended by | ||
adding Section 5-5d as follows: | ||
(305 ILCS 5/5-5d new)
| ||
Sec. 5-5d. Enhanced transition and follow-up services. The | ||
Department of Public Aid shall apply for any necessary waivers | ||
pursuant to Section 1915(c) of the Social Security Act to | ||
facilitate the transition from one residential setting to | ||
another and follow-up services. Nothing in this Section shall | ||
be considered as limiting current similar programs by the | ||
Department of Human Services or the Department on Aging.
| ||
Section 99. Effective date. This Act takes effect upon | ||
becoming law.
|