Public Act 097-0135
 
HB3155 EnrolledLRB097 02759 RPM 42781 b

    AN ACT concerning public health.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Illinois Welfare and Rehabilitation
Services Planning Act is amended by changing Section 4 as
follows:
 
    (20 ILCS 10/4)  (from Ch. 127, par. 954)
    Sec. 4. (a) Plans required by Section 3 shall be prepared
by and submitted on behalf of the following State agencies, and
may be prepared and submitted by another State Agency
designated by the Governor:
        (1) the Department of Children and Family Services;
        (2) the Department of Healthcare and Family Services;
        (3) the Department of Corrections;
        (4) the Department of Human Services;
        (5) (blank);
        (6) the Department on Aging;
        (7) (blank) the Department of Public Health;
        (8) the Department of Employment Security.
    (b) The plans required by Section 3 of this Act shall be
co-ordinated with the plan adopted by the Department of Human
Services under Sections 48 through 52 of the Mental Health and
Developmental Disabilities Administrative Act and any plan
adopted, re-adopted or amended by the Department of Human
Services under those Sections shall be coordinated with plans
required under Section 3 of this Act.
(Source: P.A. 95-331, eff. 8-21-07.)
 
    Section 10. The Alternative Health Care Delivery Act is
amended by changing Sections 15, 30, and 35 as follows:
 
    (210 ILCS 3/15)
    Sec. 15. License required. No health care facility or
program that meets the definition and scope of an alternative
health care model shall operate as such unless it is a
participant in a demonstration program under this Act and
licensed by the Department as an alternative health care model.
The provisions of this Section as they relate to subacute care
hospitals shall not apply to hospitals licensed under the
Illinois Hospital Licensing Act or skilled nursing facilities
licensed under the Illinois Nursing Home Care Act or the MR/DD
Community Care Act; provided, however, that the facilities
shall not hold themselves out to the public as subacute care
hospitals. The provisions of this Act concerning children's
respite care centers shall not apply to any facility licensed
under the Hospital Licensing Act, the Nursing Home Care Act,
the MR/DD Community Care Act, or the University of Illinois
Hospital Act that provides respite care services to children.
(Source: P.A. 95-331, eff. 8-21-07; 96-339, eff. 7-1-10.)
 
    (210 ILCS 3/30)
    Sec. 30. Demonstration program requirements. The
requirements set forth in this Section shall apply to
demonstration programs.
    (a) (Blank). There shall be no more than:
        (i) 3 subacute care hospital alternative health care
    models in the City of Chicago (one of which shall be
    located on a designated site and shall have been licensed
    as a hospital under the Illinois Hospital Licensing Act
    within the 10 years immediately before the application for
    a license);
        (ii) 2 subacute care hospital alternative health care
    models in the demonstration program for each of the
    following areas:
            (1) Cook County outside the City of Chicago.
            (2) DuPage, Kane, Lake, McHenry, and Will
        Counties.
            (3) Municipalities with a population greater than
        50,000 not located in the areas described in item (i)
        of subsection (a) and paragraphs (1) and (2) of item
        (ii) of subsection (a); and
        (iii) 4 subacute care hospital alternative health care
    models in the demonstration program for rural areas.
    In selecting among applicants for these licenses in rural
areas, the Health Facilities and Services Review Board and the
Department shall give preference to hospitals that may be
unable for economic reasons to provide continued service to the
community in which they are located unless the hospital were to
receive an alternative health care model license.
    (a-5) There shall be no more than the total number of
postsurgical recovery care centers with a certificate of need
for beds as of January 1, 2008.
    (a-10) There shall be no more than a total of 9 children's
respite care center alternative health care models in the
demonstration program, which shall be located as follows:
        (1) Two in the City of Chicago.
        (2) One in Cook County outside the City of Chicago.
        (3) A total of 2 in the area comprised of DuPage, Kane,
    Lake, McHenry, and Will counties.
        (4) A total of 2 in municipalities with a population of
    50,000 or more and not located in the areas described in
    paragraphs (1), (2), or (3).
        (5) A total of 2 in rural areas, as defined by the
    Health Facilities and Services Review Board.
    No more than one children's respite care model owned and
operated by a licensed skilled pediatric facility shall be
located in each of the areas designated in this subsection
(a-10).
    (a-15) There shall be 5 authorized community-based
residential rehabilitation center alternative health care
models in the demonstration program.
    (a-20) There shall be an authorized Alzheimer's disease
management center alternative health care model in the
demonstration program. The Alzheimer's disease management
center shall be located in Will County, owned by a
not-for-profit entity, and endorsed by a resolution approved by
the county board before the effective date of this amendatory
Act of the 91st General Assembly.
    (a-25) There shall be no more than 10 birth center
alternative health care models in the demonstration program,
located as follows:
        (1) Four in the area comprising Cook, DuPage, Kane,
    Lake, McHenry, and Will counties, one of which shall be
    owned or operated by a hospital and one of which shall be
    owned or operated by a federally qualified health center.
        (2) Three in municipalities with a population of 50,000
    or more not located in the area described in paragraph (1)
    of this subsection, one of which shall be owned or operated
    by a hospital and one of which shall be owned or operated
    by a federally qualified health center.
        (3) Three in rural areas, one of which shall be owned
    or operated by a hospital and one of which shall be owned
    or operated by a federally qualified health center.
    The first 3 birth centers authorized to operate by the
Department shall be located in or predominantly serve the
residents of a health professional shortage area as determined
by the United States Department of Health and Human Services.
There shall be no more than 2 birth centers authorized to
operate in any single health planning area for obstetric
services as determined under the Illinois Health Facilities
Planning Act. If a birth center is located outside of a health
professional shortage area, (i) the birth center shall be
located in a health planning area with a demonstrated need for
obstetrical service beds, as determined by the Health
Facilities and Services Review Board or (ii) there must be a
reduction in the existing number of obstetrical service beds in
the planning area so that the establishment of the birth center
does not result in an increase in the total number of
obstetrical service beds in the health planning area.
    (b) Alternative health care models, other than a model
authorized under subsection (a-10) or (a-20), shall obtain a
certificate of need from the Health Facilities and Services
Review Board under the Illinois Health Facilities Planning Act
before receiving a license by the Department. If, after
obtaining its initial certificate of need, an alternative
health care delivery model that is a community based
residential rehabilitation center seeks to increase the bed
capacity of that center, it must obtain a certificate of need
from the Health Facilities and Services Review Board before
increasing the bed capacity. Alternative health care models in
medically underserved areas shall receive priority in
obtaining a certificate of need.
    (c) An alternative health care model license shall be
issued for a period of one year and shall be annually renewed
if the facility or program is in substantial compliance with
the Department's rules adopted under this Act. A licensed
alternative health care model that continues to be in
substantial compliance after the conclusion of the
demonstration program shall be eligible for annual renewals
unless and until a different licensure program for that type of
health care model is established by legislation, except that a
postsurgical recovery care center meeting the following
requirements may apply within 3 years after August 25, 2009
(the effective date of Public Act 96-669) for a Certificate of
Need permit to operate as a hospital:
        (1) The postsurgical recovery care center shall apply
    to the Illinois Health Facilities Planning Board for a
    Certificate of Need permit to discontinue the postsurgical
    recovery care center and to establish a hospital.
        (2) If the postsurgical recovery care center obtains a
    Certificate of Need permit to operate as a hospital, it
    shall apply for licensure as a hospital under the Hospital
    Licensing Act and shall meet all statutory and regulatory
    requirements of a hospital.
        (3) After obtaining licensure as a hospital, any
    license as an ambulatory surgical treatment center and any
    license as a post-surgical recovery care center shall be
    null and void.
        (4) The former postsurgical recovery care center that
    receives a hospital license must seek and use its best
    efforts to maintain certification under Titles XVIII and
    XIX of the federal Social Security Act.
    The Department may issue a provisional license to any
alternative health care model that does not substantially
comply with the provisions of this Act and the rules adopted
under this Act if (i) the Department finds that the alternative
health care model has undertaken changes and corrections which
upon completion will render the alternative health care model
in substantial compliance with this Act and rules and (ii) the
health and safety of the patients of the alternative health
care model will be protected during the period for which the
provisional license is issued. The Department shall advise the
licensee of the conditions under which the provisional license
is issued, including the manner in which the alternative health
care model fails to comply with the provisions of this Act and
rules, and the time within which the changes and corrections
necessary for the alternative health care model to
substantially comply with this Act and rules shall be
completed.
    (d) Alternative health care models shall seek
certification under Titles XVIII and XIX of the federal Social
Security Act. In addition, alternative health care models shall
provide charitable care consistent with that provided by
comparable health care providers in the geographic area.
    (d-5) (Blank).
    (e) Alternative health care models shall, to the extent
possible, link and integrate their services with nearby health
care facilities.
    (f) Each alternative health care model shall implement a
quality assurance program with measurable benefits and at
reasonable cost.
(Source: P.A. 95-331, eff. 8-21-07; 95-445, eff. 1-1-08; 96-31,
eff. 6-30-09; 96-129, eff. 8-4-09; 96-669, eff. 8-25-09;
96-812, eff. 1-1-10; 96-1000, eff. 7-2-10; 96-1071, eff.
7-16-10; 96-1123, eff. 1-1-11; revised 9-16-10.)
 
    (210 ILCS 3/35)
    Sec. 35. Alternative health care models authorized.
Notwithstanding any other law to the contrary, alternative
health care models described in this Section may be established
on a demonstration basis.
        (1) (Blank). Alternative health care model; subacute
    care hospital. A subacute care hospital is a designated
    site which provides medical specialty care for patients who
    need a greater intensity or complexity of care than
    generally provided in a skilled nursing facility but who no
    longer require acute hospital care. The average length of
    stay for patients treated in subacute care hospitals shall
    not be less than 20 days, and for individual patients, the
    expected length of stay at the time of admission shall not
    be less than 10 days. Variations from minimum lengths of
    stay shall be reported to the Department. There shall be no
    more than 13 subacute care hospitals authorized to operate
    by the Department. Subacute care includes physician
    supervision, registered nursing, and physiological
    monitoring on a continual basis. A subacute care hospital
    is either a freestanding building or a distinct physical
    and operational entity within a hospital or nursing home
    building. A subacute care hospital shall only consist of
    beds currently existing in licensed hospitals or skilled
    nursing facilities, except, in the City of Chicago, on a
    designated site that was licensed as a hospital under the
    Illinois Hospital Licensing Act within the 10 years
    immediately before the application for an alternative
    health care model license. During the period of operation
    of the demonstration project, the existing licensed beds
    shall remain licensed as hospital or skilled nursing
    facility beds as well as being licensed under this Act. In
    order to handle cases of complications, emergencies, or
    exigent circumstances, a subacute care hospital shall
    maintain a contractual relationship, including a transfer
    agreement, with a general acute care hospital. If a
    subacute care model is located in a general acute care
    hospital, it shall utilize all or a portion of the bed
    capacity of that existing hospital. In no event shall a
    subacute care hospital use the word "hospital" in its
    advertising or marketing activities or represent or hold
    itself out to the public as a general acute care hospital.
        (2) Alternative health care delivery model;
    postsurgical recovery care center. A postsurgical recovery
    care center is a designated site which provides
    postsurgical recovery care for generally healthy patients
    undergoing surgical procedures that require overnight
    nursing care, pain control, or observation that would
    otherwise be provided in an inpatient setting. A
    postsurgical recovery care center is either freestanding
    or a defined unit of an ambulatory surgical treatment
    center or hospital. No facility, or portion of a facility,
    may participate in a demonstration program as a
    postsurgical recovery care center unless the facility has
    been licensed as an ambulatory surgical treatment center or
    hospital for at least 2 years before August 20, 1993 (the
    effective date of Public Act 88-441). The maximum length of
    stay for patients in a postsurgical recovery care center is
    not to exceed 48 hours unless the treating physician
    requests an extension of time from the recovery center's
    medical director on the basis of medical or clinical
    documentation that an additional care period is required
    for the recovery of a patient and the medical director
    approves the extension of time. In no case, however, shall
    a patient's length of stay in a postsurgical recovery care
    center be longer than 72 hours. If a patient requires an
    additional care period after the expiration of the 72-hour
    limit, the patient shall be transferred to an appropriate
    facility. Reports on variances from the 48-hour limit shall
    be sent to the Department for its evaluation. The reports
    shall, before submission to the Department, have removed
    from them all patient and physician identifiers. In order
    to handle cases of complications, emergencies, or exigent
    circumstances, every postsurgical recovery care center as
    defined in this paragraph shall maintain a contractual
    relationship, including a transfer agreement, with a
    general acute care hospital. A postsurgical recovery care
    center shall be no larger than 20 beds. A postsurgical
    recovery care center shall be located within 15 minutes
    travel time from the general acute care hospital with which
    the center maintains a contractual relationship, including
    a transfer agreement, as required under this paragraph.
        No postsurgical recovery care center shall
    discriminate against any patient requiring treatment
    because of the source of payment for services, including
    Medicare and Medicaid recipients.
        The Department shall adopt rules to implement the
    provisions of Public Act 88-441 concerning postsurgical
    recovery care centers within 9 months after August 20,
    1993.
        (3) Alternative health care delivery model; children's
    community-based health care center. A children's
    community-based health care center model is a designated
    site that provides nursing care, clinical support
    services, and therapies for a period of one to 14 days for
    short-term stays and 120 days to facilitate transitions to
    home or other appropriate settings for medically fragile
    children, technology dependent children, and children with
    special health care needs who are deemed clinically stable
    by a physician and are younger than 22 years of age. This
    care is to be provided in a home-like environment that
    serves no more than 12 children at a time. Children's
    community-based health care center services must be
    available through the model to all families, including
    those whose care is paid for through the Department of
    Healthcare and Family Services, the Department of Children
    and Family Services, the Department of Human Services, and
    insurance companies who cover home health care services or
    private duty nursing care in the home.
        Each children's community-based health care center
    model location shall be physically separate and apart from
    any other facility licensed by the Department of Public
    Health under this or any other Act and shall provide the
    following services: respite care, registered nursing or
    licensed practical nursing care, transitional care to
    facilitate home placement or other appropriate settings
    and reunite families, medical day care, weekend camps, and
    diagnostic studies typically done in the home setting.
        Coverage for the services provided by the Department of
    Healthcare and Family Services under this paragraph (3) is
    contingent upon federal waiver approval and is provided
    only to Medicaid eligible clients participating in the home
    and community based services waiver designated in Section
    1915(c) of the Social Security Act for medically frail and
    technologically dependent children or children in
    Department of Children and Family Services foster care who
    receive home health benefits.
        (4) Alternative health care delivery model; community
    based residential rehabilitation center. A community-based
    residential rehabilitation center model is a designated
    site that provides rehabilitation or support, or both, for
    persons who have experienced severe brain injury, who are
    medically stable, and who no longer require acute
    rehabilitative care or intense medical or nursing
    services. The average length of stay in a community-based
    residential rehabilitation center shall not exceed 4
    months. As an integral part of the services provided,
    individuals are housed in a supervised living setting while
    having immediate access to the community. The residential
    rehabilitation center authorized by the Department may
    have more than one residence included under the license. A
    residence may be no larger than 12 beds and shall be
    located as an integral part of the community. Day treatment
    or individualized outpatient services shall be provided
    for persons who reside in their own home. Functional
    outcome goals shall be established for each individual.
    Services shall include, but are not limited to, case
    management, training and assistance with activities of
    daily living, nursing consultation, traditional therapies
    (physical, occupational, speech), functional interventions
    in the residence and community (job placement, shopping,
    banking, recreation), counseling, self-management
    strategies, productive activities, and multiple
    opportunities for skill acquisition and practice
    throughout the day. The design of individualized program
    plans shall be consistent with the outcome goals that are
    established for each resident. The programs provided in
    this setting shall be accredited by the Commission on
    Accreditation of Rehabilitation Facilities (CARF). The
    program shall have been accredited by CARF as a Brain
    Injury Community-Integrative Program for at least 3 years.
        (5) Alternative health care delivery model;
    Alzheimer's disease management center. An Alzheimer's
    disease management center model is a designated site that
    provides a safe and secure setting for care of persons
    diagnosed with Alzheimer's disease. An Alzheimer's disease
    management center model shall be a facility separate from
    any other facility licensed by the Department of Public
    Health under this or any other Act. An Alzheimer's disease
    management center shall conduct and document an assessment
    of each resident every 6 months. The assessment shall
    include an evaluation of daily functioning, cognitive
    status, other medical conditions, and behavioral problems.
    An Alzheimer's disease management center shall develop and
    implement an ongoing treatment plan for each resident. The
    treatment plan shall have defined goals. The Alzheimer's
    disease management center shall treat behavioral problems
    and mood disorders using nonpharmacologic approaches such
    as environmental modification, task simplification, and
    other appropriate activities. All staff must have
    necessary training to care for all stages of Alzheimer's
    Disease. An Alzheimer's disease management center shall
    provide education and support for residents and
    caregivers. The education and support shall include
    referrals to support organizations for educational
    materials on community resources, support groups, legal
    and financial issues, respite care, and future care needs
    and options. The education and support shall also include a
    discussion of the resident's need to make advance
    directives and to identify surrogates for medical and legal
    decision-making. The provisions of this paragraph
    establish the minimum level of services that must be
    provided by an Alzheimer's disease management center. An
    Alzheimer's disease management center model shall have no
    more than 100 residents. Nothing in this paragraph (5)
    shall be construed as prohibiting a person or facility from
    providing services and care to persons with Alzheimer's
    disease as otherwise authorized under State law.
        (6) Alternative health care delivery model; birth
    center. A birth center shall be exclusively dedicated to
    serving the childbirth-related needs of women and their
    newborns and shall have no more than 10 beds. A birth
    center is a designated site that is away from the mother's
    usual place of residence and in which births are planned to
    occur following a normal, uncomplicated, and low-risk
    pregnancy. A birth center shall offer prenatal care and
    community education services and shall coordinate these
    services with other health care services available in the
    community.
            (A) A birth center shall not be separately licensed
        if it is one of the following:
                (1) A part of a hospital; or
                (2) A freestanding facility that is physically
            distinct from a hospital but is operated under a
            license issued to a hospital under the Hospital
            Licensing Act.
            (B) A separate birth center license shall be
        required if the birth center is operated as:
                (1) A part of the operation of a federally
            qualified health center as designated by the
            United States Department of Health and Human
            Services; or
                (2) A facility other than one described in
            subparagraph (A)(1), (A)(2), or (B)(1) of this
            paragraph (6) whose costs are reimbursable under
            Title XIX of the federal Social Security Act.
        In adopting rules for birth centers, the Department
    shall consider: the American Association of Birth Centers'
    Standards for Freestanding Birth Centers; the American
    Academy of Pediatrics/American College of Obstetricians
    and Gynecologists Guidelines for Perinatal Care; and the
    Regionalized Perinatal Health Care Code. The Department's
    rules shall stipulate the eligibility criteria for birth
    center admission. The Department's rules shall stipulate
    the necessary equipment for emergency care according to the
    American Association of Birth Centers' standards and any
    additional equipment deemed necessary by the Department.
    The Department's rules shall provide for a time period
    within which each birth center not part of a hospital must
    become accredited by either the Commission for the
    Accreditation of Freestanding Birth Centers or The Joint
    Commission.
        A birth center shall be certified to participate in the
    Medicare and Medicaid programs under Titles XVIII and XIX,
    respectively, of the federal Social Security Act. To the
    extent necessary, the Illinois Department of Healthcare
    and Family Services shall apply for a waiver from the
    United States Health Care Financing Administration to
    allow birth centers to be reimbursed under Title XIX of the
    federal Social Security Act.
        A birth center that is not operated under a hospital
    license shall be located within a ground travel time
    distance from the general acute care hospital with which
    the birth center maintains a contractual relationship,
    including a transfer agreement, as required under this
    paragraph, that allows for an emergency caesarian delivery
    to be started within 30 minutes of the decision a caesarian
    delivery is necessary. A birth center operating under a
    hospital license shall be located within a ground travel
    time distance from the licensed hospital that allows for an
    emergency caesarian delivery to be started within 30
    minutes of the decision a caesarian delivery is necessary.
        The services of a medical director physician, licensed
    to practice medicine in all its branches, who is certified
    or eligible for certification by the American College of
    Obstetricians and Gynecologists or the American Board of
    Osteopathic Obstetricians and Gynecologists or has
    hospital obstetrical privileges are required in birth
    centers. The medical director in consultation with the
    Director of Nursing and Midwifery Services shall
    coordinate the clinical staff and overall provision of
    patient care. The medical director or his or her physician
    designee shall be available on the premises or within a
    close proximity as defined by rule. The medical director
    and the Director of Nursing and Midwifery Services shall
    jointly develop and approve policies defining the criteria
    to determine which pregnancies are accepted as normal,
    uncomplicated, and low-risk, and the anesthesia services
    available at the center. No general anesthesia may be
    administered at the center.
        If a birth center employs certified nurse midwives, a
    certified nurse midwife shall be the Director of Nursing
    and Midwifery Services who is responsible for the
    development of policies and procedures for services as
    provided by Department rules.
        An obstetrician, family practitioner, or certified
    nurse midwife shall attend each woman in labor from the
    time of admission through birth and throughout the
    immediate postpartum period. Attendance may be delegated
    only to another physician or certified nurse midwife.
    Additionally, a second staff person shall also be present
    at each birth who is licensed or certified in Illinois in a
    health-related field and under the supervision of the
    physician or certified nurse midwife in attendance, has
    specialized training in labor and delivery techniques and
    care of newborns, and receives planned and ongoing training
    as needed to perform assigned duties effectively.
        The maximum length of stay in a birth center shall be
    consistent with existing State laws allowing a 48-hour stay
    or appropriate post-delivery care, if discharged earlier
    than 48 hours.
        A birth center shall participate in the Illinois
    Perinatal System under the Developmental Disability
    Prevention Act. At a minimum, this participation shall
    require a birth center to establish a letter of agreement
    with a hospital designated under the Perinatal System. A
    hospital that operates or has a letter of agreement with a
    birth center shall include the birth center under its
    maternity service plan under the Hospital Licensing Act and
    shall include the birth center in the hospital's letter of
    agreement with its regional perinatal center.
        A birth center may not discriminate against any patient
    requiring treatment because of the source of payment for
    services, including Medicare and Medicaid recipients.
        No general anesthesia and no surgery may be performed
    at a birth center. The Department may by rule add birth
    center patient eligibility criteria or standards as it
    deems necessary. The Department shall by rule require each
    birth center to report the information which the Department
    shall make publicly available, which shall include, but is
    not limited to, the following:
            (i) Birth center ownership.
            (ii) Sources of payment for services.
            (iii) Utilization data involving patient length of
        stay.
            (iv) Admissions and discharges.
            (v) Complications.
            (vi) Transfers.
            (vii) Unusual incidents.
            (viii) Deaths.
            (ix) Any other publicly reported data required
        under the Illinois Consumer Guide.
            (x) Post-discharge patient status data where
        patients are followed for 14 days after discharge from
        the birth center to determine whether the mother or
        baby developed a complication or infection.
        Within 9 months after the effective date of this
    amendatory Act of the 95th General Assembly, the Department
    shall adopt rules that are developed with consideration of:
    the American Association of Birth Centers' Standards for
    Freestanding Birth Centers; the American Academy of
    Pediatrics/American College of Obstetricians and
    Gynecologists Guidelines for Perinatal Care; and the
    Regionalized Perinatal Health Care Code.
        The Department shall adopt other rules as necessary to
    implement the provisions of this amendatory Act of the 95th
    General Assembly within 9 months after the effective date
    of this amendatory Act of the 95th General Assembly.
(Source: P.A. 95-331, eff. 8-21-07; 95-445, eff. 1-1-08.)
 
    Section 15. The Nursing Home Care Act is amended by
changing Sections 2-106 and 3-804 as follows:
 
    (210 ILCS 45/2-106)  (from Ch. 111 1/2, par. 4152-106)
    Sec. 2-106. (a) For purposes of this Act, (i) a physical
restraint is any manual method or physical or mechanical
device, material, or equipment attached or adjacent to a
resident's body that the resident cannot remove easily and
restricts freedom of movement or normal access to one's body.
Devices used for positioning, including but not limited to bed
rails, gait belts, and cushions, shall not be considered to be
restraints for purposes of this Section; (ii) a chemical
restraint is any drug used for discipline or convenience and
not required to treat medical symptoms. The Department shall by
rule, designate certain devices as restraints, including at
least all those devices which have been determined to be
restraints by the United States Department of Health and Human
Services in interpretive guidelines issued for the purposes of
administering Titles XVIII and XIX of the Social Security Act.
    (b) Neither restraints nor confinements shall be employed
for the purpose of punishment or for the convenience of any
facility personnel. No restraints or confinements shall be
employed except as ordered by a physician who documents the
need for such restraints or confinements in the resident's
clinical record. Each facility licensed under this Act must
have a written policy to address the use of restraints and
seclusion. The Department shall establish by rule the
provisions that the policy must include, which, to the extent
practicable, should be consistent with the requirements for
participation in the federal Medicare program. Each policy
shall include periodic review of the use of restraints.
    (c) A restraint may be used only with the informed consent
of the resident, the resident's guardian, or other authorized
representative. A restraint may be used only for specific
periods, if it is the least restrictive means necessary to
attain and maintain the resident's highest practicable
physical, mental or psychosocial well-being, including brief
periods of time to provide necessary life-saving treatment. A
restraint may be used only after consultation with appropriate
health professionals, such as occupational or physical
therapists, and a trial of less restrictive measures has led to
the determination that the use of less restrictive measures
would not attain or maintain the resident's highest practicable
physical, mental or psychosocial well-being. However, if the
resident needs emergency care, restraints may be used for brief
periods to permit medical treatment to proceed unless the
facility has notice that the resident has previously made a
valid refusal of the treatment in question.
    (d) A restraint may be applied only by a person trained in
the application of the particular type of restraint.
    (e) Whenever a period of use of a restraint is initiated,
the resident shall be advised of his or her right to have a
person or organization of his or her choosing, including the
Guardianship and Advocacy Commission, notified of the use of
the restraint. A recipient who is under guardianship may
request that a person or organization of his or her choosing be
notified of the restraint, whether or not the guardian approves
the notice. If the resident so chooses, the facility shall make
the notification within 24 hours, including any information
about the period of time that the restraint is to be used.
Whenever the Guardianship and Advocacy Commission is notified
that a resident has been restrained, it shall contact the
resident to determine the circumstances of the restraint and
whether further action is warranted.
    (f) Whenever a restraint is used on a resident whose
primary mode of communication is sign language, the resident
shall be permitted to have his or her hands free from restraint
for brief periods each hour, except when this freedom may
result in physical harm to the resident or others.
    (g) The requirements of this Section are intended to
control in any conflict with the requirements of Sections 1-126
and 2-108 of the Mental Health and Developmental Disabilities
Code.
(Source: P.A. 95-331, eff. 8-21-07.)
 
    (210 ILCS 45/3-804)  (from Ch. 111 1/2, par. 4153-804)
    Sec. 3-804. The Department shall report to the General
Assembly by July April 1 of each year upon the performance of
its inspection, survey and evaluation duties under this Act,
including the number and needs of the Department personnel
engaged in such activities. The report shall also describe the
Department's actions in enforcement of this Act, including the
number and needs of personnel so engaged. The report shall also
include the number of valid and invalid complaints filed with
the Department within the last calendar year.
(Source: P.A. 84-1322.)
 
    Section 20. The Illinois Migrant Labor Camp Law is amended
by changing Sections 4 and 6 as follows:
 
    (210 ILCS 110/4)  (from Ch. 111 1/2, par. 185.4)
    Sec. 4. Applications for a license to operate or maintain a
Migrant Labor Camp or for a renewal thereof shall be made upon
forms to be furnished by the Department. Such application shall
include:
    (a) The name and address of the applicant or applicants. If
the applicant is a partnership, the names and addresses of all
the partners shall also be given. If the applicant is a
corporation, the names and addresses of the principal officers
of the corporation shall be given.
    (b) The approximate legal description and the address of
the tract of land upon which the applicant proposes to operate
and maintain such Migrant Labor Camp.
    (c) A general plan or sketch of the camp site showing the
location of the buildings or facilities together with a
description of the buildings, of the water supply, of the
toilet, bathing and laundry facilities, and of the fire
protection equipment.
    (d) The date upon which the occupancy and use of the
Migrant Labor Camp will commence.
    The application for the original license or for any renewal
thereof shall be accompanied by a fee of $100.
    Application for the original license or any renewal thereof
shall be filed with the Department in the office of the
Director at least 60 days prior to the date on which the
occupancy and use of such camp is to commence. Application for
a renewal license shall be filed with the Department at least
60 days prior to the expiration date of the current license.
The camp shall be ready for inspection at least 30 days prior
to the date upon which the occupancy and use of such camp is to
commence.
(Source: P.A. 86-595.)
 
    (210 ILCS 110/6)  (from Ch. 111 1/2, par. 185.6)
    Sec. 6. Upon receipt of an application for a license, the
Department shall inspect the camp site and the facilities
described in the application approximately 30 days prior to the
date on which the occupancy and use of such camp is to
commence. If the Department finds that the Migrant Labor Camp
described in the application meets and complies with the
provisions of this Act and the rules and regulations of the
Department in relation thereto, the Director shall, not less
than 15 days prior to the date on which the occupancy and use
of such camp is to commence, issue a license to the applicant
for the operation of the camp.
    If the application is denied, the Department shall notify
the applicant in writing of such denial not less than 15 days
prior to the date on which the occupancy and use of such camp
is to commence, setting forth the reasons therefor. If the
conditions constituting the basis for such denial are
remediable, the applicant may correct such conditions and
notify the Department in writing indicating therein the manner
in which such conditions have been remedied. Notifications of
corrections shall be processed in the same manner as the
original application.
(Source: Laws 1965, p. 2356.)
 
    Section 25. The Poison Control System Act is amended by
changing Section 15 as follows:
 
    (410 ILCS 47/15)
    Sec. 15. Regional center designation. By January 1, 1993,
the Director of the Illinois Department of Public Health shall
designate at least one 2 and no more than 3 human poison
control centers. The director of the Illinois Department of
Agriculture shall designate one 1 animal poison control center
as regional poison control center to provide comprehensive
poison control center services for animal exposures by January
1, 1993. The services provided by the centers shall adhere to
the appropriate national standards promulgated by the American
Association of Poison Control Centers and the Illinois State
Veterinary Medical Association; adherence to these standards
shall occur within 2 years after designation by the respective
departments, unless the center has been granted an extension by
the Illinois Department of Public Health or the Illinois
Department of Agriculture. The 2-year period shall
automatically be extended for an additional 2 years if funding
was not secured after a poison control center's initial
designation. The designated departments shall set standards of
operation after consulting with current poison control service
providers. Poison control centers shall cooperate to reduce the
cost of operations, collect information on poisoning
exposures, and provide education to the public and health
professionals. A regional poison control center shall continue
to operate unless it voluntarily closes or the designating
departments revoke the designation for failure to comply with
the standards. Centers designated under this Act shall be
considered State agencies for purposes of the State Employee
Indemnification Act.
(Source: P.A. 87-1145.)
 
    Section 30. The Illinois Food, Drug and Cosmetic Act is
amended by changing Section 21.3 as follows:
 
    (410 ILCS 620/21.3)
    Sec. 21.3. Certificates of free sale; health certificates;
shellfish certificates.
    (a) The Department is authorized, upon request, to issue
certificates of free sale, health certificates, or an
equivalent, to Illinois food, dairy, drug, cosmetic, or medical
device manufacturers, processors, packers, or warehousers. The
Department shall charge a fee of $10 for issuing a certificate
of free sale, health certificate, or equivalent.
    (b) The Department shall issue an Illinois shellfish
certificate, upon request, to shellfish firms in compliance
with the National Shellfish Sanitation Program Model Ordinance
Interstate Shellfish Sanitation Conference.
    (c) This Section applies on and after January 1, 2003.
(Source: P.A. 92-769, eff. 1-1-03.)
 
    Section 35. The Grade A Pasteurized Milk and Milk Products
Act is amended by changing Section 3 as follows:
 
    (410 ILCS 635/3)  (from Ch. 56 1/2, par. 2203)
    Sec. 3. Definitions.
    (a) As used in this Act "Grade A" means that milk and milk
products are produced and processed in accordance with the
current Grade A Pasteurized Milk Ordinance as adopted by the
National Conference on Interstate Milk Shipments and the latest
United States Public Health Service - Food and Drug
Administration and all other applicable federal regulations
Grade A Pasteurized Milk Ordinance as may be amended. The term
Grade A is applicable to "dairy farm", "milk hauler-sampler",
"milk plant", "milk product", "receiving station", "transfer
station", "milk tank truck", and "certified pasteurizer
sealer" whenever used in this Act.
    (b) Unless the context clearly indicates otherwise, terms
have the meaning ascribed as follows:
        (1) "Dairy farm" means any place or premise where one
    or more cows or goats are kept, and from which a part or
    all of the milk or milk products are provided, sold, or
    offered for sale to a milk plant, transfer station, or
    receiving station.
        (2) "Milk" means the milk of cows or goats and includes
    skim milk and cream.
        (3) "Milk plant" means any place, premise, or
    establishment where milk or milk products are collected,
    handled, processed, stored, pasteurized, aseptically
    processed, bottled, or prepared for distribution.
        (4) "Milk product" means any product including cream,
    light cream, light whipping cream, heavy cream, heavy
    whipping cream, whipped cream, whipped light cream, sour
    cream, acidified light cream, cultured sour cream,
    half-and-half, sour half-and-half, acidified sour
    half-and-half, cultured half-and-half, reconstituted or
    recombined milk and milk products, concentrated milk,
    concentrated milk products, skim milk, lowfat milk, frozen
    milk concentrate, eggnog, buttermilk, cultured milk,
    cultured lowfat milk or skim milk, cottage cheese, yogurt,
    lowfat yogurt, nonfat yogurt, acidified milk, acidified
    lowfat milk or skim milk, low-sodium milk, low-sodium
    lowfat milk, low-sodium skim milk, lactose-reduced milk,
    lactose-reduced lowfat milk, lactose-reduced skim milk,
    aseptically processed and packaged milk and milk products,
    and milk, lowfat milk or skim milk with added safe and
    suitable microbial organisms.
        (5) "Receiving station" means any place, premise, or
    establishment where raw milk is received, collected,
    handled, stored or cooled and prepared for further
    transporting.
        (6) "Transfer station" means any place, premise, or
    establishment where milk or milk products are transferred
    directly from one milk tank truck to another.
        (7) "Department" means the Illinois Department of
    Public Health.
        (8) "Director" means the Director of the Illinois
    Department of Public Health.
        (9) "Embargo or hold for investigation" means a
    detention or seizure designed to deny the use of milk or
    milk products which may be unwholesome or to prohibit the
    use of equipment which may result in contaminated or
    unwholesome milk or dairy products.
        (10) "Imminent hazard to the public health" means any
    hazard to the public health when the evidence is sufficient
    to show that a product or practice, posing or contributing
    to a significant threat of danger to health, creates or may
    create a public health situation (1) that should be
    corrected immediately to prevent injury and (2) that should
    not be permitted to continue while a hearing or other
    formal proceeding is being held.
        (11) "Person" means any individual, group of
    individuals, association, trust, partnership, corporation,
    person doing business under an assumed name, the State of
    Illinois, or any political subdivision or department
    thereof, or any other entity.
        (12) "Enforcing agency" means the Illinois Department
    of Public Health or a unit of local government electing to
    administer and enforce this Act as provided for in this
    Act.
        (13) "Permit" means a document awarded to a person for
    compliance with the provisions of and under conditions set
    forth in this Act.
        (14) "Milk hauler-sampler" means a person who is
    qualified and trained for the grading and sampling of raw
    milk in accordance with federal and State quality standards
    and procedures.
        (15) "Cleaning and sanitizing facility" means any
    place, premise or establishment where milk tank trucks are
    cleaned and sanitized.
        (16) "Milk tank truck" includes both a bulk pickup tank
    and a milk transport tank.
            (A) "Bulk milk pickup tank" means the tank, and
        those appurtenances necessary for its use, used by a
        milk hauler-sampler to transport bulk raw milk for
        pasteurization from a dairy farm to a milk plant,
        receiving station, or transfer station.
            (B) "Milk transport tank" means a vehicle,
        including the truck and tank, used by a milk hauler to
        transport bulk shipments of milk from a transfer
        station, receiving station, or milk plant to another
        transfer station, receiving station, or milk plant.
        (17) "Certified pasteurizer sealer" means a person who
    has satisfactorily completed a course of instruction and
    has demonstrated the ability to satisfactorily conduct all
    pasteurization control tests, as required by rules adopted
    by the Department.
(Source: P.A. 92-216, eff. 1-1-02.)
 
    (210 ILCS 3/36.5 rep.)
    Section 40. The Alternative Health Care Delivery Act is
amended by repealing Section 36.5.
 
    Section 99. Effective date. This Act takes effect upon
becoming law.