Illinois General Assembly - Full Text of Public Act 096-1123
Illinois General Assembly

Previous General Assemblies

Public Act 096-1123


 

Public Act 1123 96TH GENERAL ASSEMBLY

  
  
  

 


 
Public Act 096-1123
 
SB3290 EnrolledLRB096 20040 KTG 35543 b

    AN ACT concerning public aid.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Alternative Health Care Delivery Act is
amended by changing Section 30 as follows:
 
    (210 ILCS 3/30)
    Sec. 30. Demonstration program requirements. The
requirements set forth in this Section shall apply to
demonstration programs.
    (a) 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 2 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 subsections (a-10) and
(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) this amendatory Act
of the 96th General Assembly 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) The Department of Healthcare and Family
Services (formerly Illinois Department of Public Aid), in
cooperation with the Illinois Department of Public Health,
shall develop and implement a reimbursement methodology for all
facilities participating in the demonstration program. The
Department of Healthcare and Family Services shall keep a
record of services provided under the demonstration program to
recipients of medical assistance under the Illinois Public Aid
Code and shall submit an annual report of that information to
the Illinois Department of Public Health.
    (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; revised 11-4-09.)
 
    Section 10. The Illinois Public Aid Code is amended by
changing Sections 5-2 and 5-5.5 and by adding Section 12-8.2 as
follows:
 
    (305 ILCS 5/5-2)  (from Ch. 23, par. 5-2)
    Sec. 5-2. Classes of Persons Eligible. Medical assistance
under this Article shall be available to any of the following
classes of persons in respect to whom a plan for coverage has
been submitted to the Governor by the Illinois Department and
approved by him:
        1. Recipients of basic maintenance grants under
    Articles III and IV.
        2. Persons otherwise eligible for basic maintenance
    under Articles III and IV, excluding any eligibility
    requirements that are inconsistent with any federal law or
    federal regulation, as interpreted by the U.S. Department
    of Health and Human Services, but who fail to qualify
    thereunder on the basis of need or who qualify but are not
    receiving basic maintenance under Article IV, and who have
    insufficient income and resources to meet the costs of
    necessary medical care, including but not limited to the
    following:
            (a) All persons otherwise eligible for basic
        maintenance under Article III but who fail to qualify
        under that Article on the basis of need and who meet
        either of the following requirements:
                (i) their income, as determined by the
            Illinois Department in accordance with any federal
            requirements, is equal to or less than 70% in
            fiscal year 2001, equal to or less than 85% in
            fiscal year 2002 and until a date to be determined
            by the Department by rule, and equal to or less
            than 100% beginning on the date determined by the
            Department by rule, of the nonfarm income official
            poverty line, as defined by the federal Office of
            Management and Budget and revised annually in
            accordance with Section 673(2) of the Omnibus
            Budget Reconciliation Act of 1981, applicable to
            families of the same size; or
                (ii) their income, after the deduction of
            costs incurred for medical care and for other types
            of remedial care, is equal to or less than 70% in
            fiscal year 2001, equal to or less than 85% in
            fiscal year 2002 and until a date to be determined
            by the Department by rule, and equal to or less
            than 100% beginning on the date determined by the
            Department by rule, of the nonfarm income official
            poverty line, as defined in item (i) of this
            subparagraph (a).
            (b) All persons who, excluding any eligibility
        requirements that are inconsistent with any federal
        law or federal regulation, as interpreted by the U.S.
        Department of Health and Human Services, would be
        determined eligible for such basic maintenance under
        Article IV by disregarding the maximum earned income
        permitted by federal law.
        3. Persons who would otherwise qualify for Aid to the
    Medically Indigent under Article VII.
        4. Persons not eligible under any of the preceding
    paragraphs who fall sick, are injured, or die, not having
    sufficient money, property or other resources to meet the
    costs of necessary medical care or funeral and burial
    expenses.
        5.(a) Women during pregnancy, after the fact of
    pregnancy has been determined by medical diagnosis, and
    during the 60-day period beginning on the last day of the
    pregnancy, together with their infants and children born
    after September 30, 1983, whose income and resources are
    insufficient to meet the costs of necessary medical care to
    the maximum extent possible under Title XIX of the Federal
    Social Security Act.
        (b) The Illinois Department and the Governor shall
    provide a plan for coverage of the persons eligible under
    paragraph 5(a) by April 1, 1990. Such plan shall provide
    ambulatory prenatal care to pregnant women during a
    presumptive eligibility period and establish an income
    eligibility standard that is equal to 133% of the nonfarm
    income official poverty line, as defined by the federal
    Office of Management and Budget and revised annually in
    accordance with Section 673(2) of the Omnibus Budget
    Reconciliation Act of 1981, applicable to families of the
    same size, provided that costs incurred for medical care
    are not taken into account in determining such income
    eligibility.
        (c) The Illinois Department may conduct a
    demonstration in at least one county that will provide
    medical assistance to pregnant women, together with their
    infants and children up to one year of age, where the
    income eligibility standard is set up to 185% of the
    nonfarm income official poverty line, as defined by the
    federal Office of Management and Budget. The Illinois
    Department shall seek and obtain necessary authorization
    provided under federal law to implement such a
    demonstration. Such demonstration may establish resource
    standards that are not more restrictive than those
    established under Article IV of this Code.
        6. Persons under the age of 18 who fail to qualify as
    dependent under Article IV and who have insufficient income
    and resources to meet the costs of necessary medical care
    to the maximum extent permitted under Title XIX of the
    Federal Social Security Act.
        7. Persons who are under 21 years of age and would
    qualify as disabled as defined under the Federal
    Supplemental Security Income Program, provided medical
    service for such persons would be eligible for Federal
    Financial Participation, and provided the Illinois
    Department determines that:
            (a) the person requires a level of care provided by
        a hospital, skilled nursing facility, or intermediate
        care facility, as determined by a physician licensed to
        practice medicine in all its branches;
            (b) it is appropriate to provide such care outside
        of an institution, as determined by a physician
        licensed to practice medicine in all its branches;
            (c) the estimated amount which would be expended
        for care outside the institution is not greater than
        the estimated amount which would be expended in an
        institution.
        8. Persons who become ineligible for basic maintenance
    assistance under Article IV of this Code in programs
    administered by the Illinois Department due to employment
    earnings and persons in assistance units comprised of
    adults and children who become ineligible for basic
    maintenance assistance under Article VI of this Code due to
    employment earnings. The plan for coverage for this class
    of persons shall:
            (a) extend the medical assistance coverage for up
        to 12 months following termination of basic
        maintenance assistance; and
            (b) offer persons who have initially received 6
        months of the coverage provided in paragraph (a) above,
        the option of receiving an additional 6 months of
        coverage, subject to the following:
                (i) such coverage shall be pursuant to
            provisions of the federal Social Security Act;
                (ii) such coverage shall include all services
            covered while the person was eligible for basic
            maintenance assistance;
                (iii) no premium shall be charged for such
            coverage; and
                (iv) such coverage shall be suspended in the
            event of a person's failure without good cause to
            file in a timely fashion reports required for this
            coverage under the Social Security Act and
            coverage shall be reinstated upon the filing of
            such reports if the person remains otherwise
            eligible.
        9. Persons with acquired immunodeficiency syndrome
    (AIDS) or with AIDS-related conditions with respect to whom
    there has been a determination that but for home or
    community-based services such individuals would require
    the level of care provided in an inpatient hospital,
    skilled nursing facility or intermediate care facility the
    cost of which is reimbursed under this Article. Assistance
    shall be provided to such persons to the maximum extent
    permitted under Title XIX of the Federal Social Security
    Act.
        10. Participants in the long-term care insurance
    partnership program established under the Illinois
    Long-Term Care Partnership Program Act who meet the
    qualifications for protection of resources described in
    Section 15 of that Act.
        11. Persons with disabilities who are employed and
    eligible for Medicaid, pursuant to Section
    1902(a)(10)(A)(ii)(xv) of the Social Security Act, and,
    subject to federal approval, persons with a medically
    improved disability who are employed and eligible for
    Medicaid pursuant to Section 1902(a)(10)(A)(ii)(xvi) of
    the Social Security Act, as provided by the Illinois
    Department by rule. In establishing eligibility standards
    under this paragraph 11, the Department shall, subject to
    federal approval:
            (a) set the income eligibility standard at not
        lower than 350% of the federal poverty level;
            (b) exempt retirement accounts that the person
        cannot access without penalty before the age of 59 1/2,
        and medical savings accounts established pursuant to
        26 U.S.C. 220;
            (c) allow non-exempt assets up to $25,000 as to
        those assets accumulated during periods of eligibility
        under this paragraph 11; and
            (d) continue to apply subparagraphs (b) and (c) in
        determining the eligibility of the person under this
        Article even if the person loses eligibility under this
        paragraph 11.
        12. Subject to federal approval, persons who are
    eligible for medical assistance coverage under applicable
    provisions of the federal Social Security Act and the
    federal Breast and Cervical Cancer Prevention and
    Treatment Act of 2000. Those eligible persons are defined
    to include, but not be limited to, the following persons:
            (1) persons who have been screened for breast or
        cervical cancer under the U.S. Centers for Disease
        Control and Prevention Breast and Cervical Cancer
        Program established under Title XV of the federal
        Public Health Services Act in accordance with the
        requirements of Section 1504 of that Act as
        administered by the Illinois Department of Public
        Health; and
            (2) persons whose screenings under the above
        program were funded in whole or in part by funds
        appropriated to the Illinois Department of Public
        Health for breast or cervical cancer screening.
        "Medical assistance" under this paragraph 12 shall be
    identical to the benefits provided under the State's
    approved plan under Title XIX of the Social Security Act.
    The Department must request federal approval of the
    coverage under this paragraph 12 within 30 days after the
    effective date of this amendatory Act of the 92nd General
    Assembly.
        13. Subject to appropriation and to federal approval,
    persons living with HIV/AIDS who are not otherwise eligible
    under this Article and who qualify for services covered
    under Section 5-5.04 as provided by the Illinois Department
    by rule.
        14. Subject to the availability of funds for this
    purpose, the Department may provide coverage under this
    Article to persons who reside in Illinois who are not
    eligible under any of the preceding paragraphs and who meet
    the income guidelines of paragraph 2(a) of this Section and
    (i) have an application for asylum pending before the
    federal Department of Homeland Security or on appeal before
    a court of competent jurisdiction and are represented
    either by counsel or by an advocate accredited by the
    federal Department of Homeland Security and employed by a
    not-for-profit organization in regard to that application
    or appeal, or (ii) are receiving services through a
    federally funded torture treatment center. Medical
    coverage under this paragraph 14 may be provided for up to
    24 continuous months from the initial eligibility date so
    long as an individual continues to satisfy the criteria of
    this paragraph 14. If an individual has an appeal pending
    regarding an application for asylum before the Department
    of Homeland Security, eligibility under this paragraph 14
    may be extended until a final decision is rendered on the
    appeal. The Department may adopt rules governing the
    implementation of this paragraph 14.
        15. Family Care Eligibility.
            (a) A caretaker relative who is 19 years of age or
        older when countable income is at or below 185% of the
        Federal Poverty Level Guidelines, as published
        annually in the Federal Register, for the appropriate
        family size. A person may not spend down to become
        eligible under this paragraph 15.
            (b) Eligibility shall be reviewed annually.
            (c) Caretaker relatives enrolled under this
        paragraph 15 in families with countable income above
        150% and at or below 185% of the Federal Poverty Level
        Guidelines shall be counted as family members and pay
        premiums as established under the Children's Health
        Insurance Program Act.
            (d) Premiums shall be billed by and payable to the
        Department or its authorized agent, on a monthly basis.
            (e) The premium due date is the last day of the
        month preceding the month of coverage.
            (f) Individuals shall have a grace period through
        30 days the month of coverage to pay the premium.
            (g) Failure to pay the full monthly premium by the
        last day of the grace period shall result in
        termination of coverage.
            (h) Partial premium payments shall not be
        refunded.
            (i) Following termination of an individual's
        coverage under this paragraph 15, the following action
        is required before the individual can be re-enrolled:
                (1) A new application must be completed and the
            individual must be determined otherwise eligible.
                (2) There must be full payment of premiums due
            under this Code, the Children's Health Insurance
            Program Act, the Covering ALL KIDS Health
            Insurance Act, or any other healthcare program
            administered by the Department for periods in
            which a premium was owed and not paid for the
            individual.
                (3) The first month's premium must be paid if
            there was an unpaid premium on the date the
            individual's previous coverage was canceled.
        The Department is authorized to implement the
    provisions of this amendatory Act of the 95th General
    Assembly by adopting the medical assistance rules in effect
    as of October 1, 2007, at 89 Ill. Admin. Code 125, and at
    89 Ill. Admin. Code 120.32 along with only those changes
    necessary to conform to federal Medicaid requirements,
    federal laws, and federal regulations, including but not
    limited to Section 1931 of the Social Security Act (42
    U.S.C. Sec. 1396u-1), as interpreted by the U.S. Department
    of Health and Human Services, and the countable income
    eligibility standard authorized by this paragraph 15. The
    Department may not otherwise adopt any rule to implement
    this increase except as authorized by law, to meet the
    eligibility standards authorized by the federal government
    in the Medicaid State Plan or the Title XXI Plan, or to
    meet an order from the federal government or any court.
        16. 15. Subject to appropriation, uninsured persons
    who are not otherwise eligible under this Section who have
    been certified and referred by the Department of Public
    Health as having been screened and found to need diagnostic
    evaluation or treatment, or both diagnostic evaluation and
    treatment, for prostate or testicular cancer. For the
    purposes of this paragraph 16 15, uninsured persons are
    those who do not have creditable coverage, as defined under
    the Health Insurance Portability and Accountability Act,
    or have otherwise exhausted any insurance benefits they may
    have had, for prostate or testicular cancer diagnostic
    evaluation or treatment, or both diagnostic evaluation and
    treatment. To be eligible, a person must furnish a Social
    Security number. A person's assets are exempt from
    consideration in determining eligibility under this
    paragraph 16 15. Such persons shall be eligible for medical
    assistance under this paragraph 16 15 for so long as they
    need treatment for the cancer. A person shall be considered
    to need treatment if, in the opinion of the person's
    treating physician, the person requires therapy directed
    toward cure or palliation of prostate or testicular cancer,
    including recurrent metastatic cancer that is a known or
    presumed complication of prostate or testicular cancer and
    complications resulting from the treatment modalities
    themselves. Persons who require only routine monitoring
    services are not considered to need treatment. "Medical
    assistance" under this paragraph 16 15 shall be identical
    to the benefits provided under the State's approved plan
    under Title XIX of the Social Security Act. Notwithstanding
    any other provision of law, the Department (i) does not
    have a claim against the estate of a deceased recipient of
    services under this paragraph 16 15 and (ii) does not have
    a lien against any homestead property or other legal or
    equitable real property interest owned by a recipient of
    services under this paragraph 16 15.
    In implementing the provisions of Public Act 96-20 this
amendatory Act of the 96th General Assembly, the Department is
authorized to adopt only those rules necessary, including
emergency rules. Nothing in Public Act 96-20 this amendatory
Act of the 96th General Assembly permits the Department to
adopt rules or issue a decision that expands eligibility for
the FamilyCare Program to a person whose income exceeds 185% of
the Federal Poverty Level as determined from time to time by
the U.S. Department of Health and Human Services, unless the
Department is provided with express statutory authority.
    The Illinois Department and the Governor shall provide a
plan for coverage of the persons eligible under paragraph 7 as
soon as possible after July 1, 1984.
    The eligibility of any such person for medical assistance
under this Article is not affected by the payment of any grant
under the Senior Citizens and Disabled Persons Property Tax
Relief and Pharmaceutical Assistance Act or any distributions
or items of income described under subparagraph (X) of
paragraph (2) of subsection (a) of Section 203 of the Illinois
Income Tax Act. The Department shall by rule establish the
amounts of assets to be disregarded in determining eligibility
for medical assistance, which shall at a minimum equal the
amounts to be disregarded under the Federal Supplemental
Security Income Program. The amount of assets of a single
person to be disregarded shall not be less than $2,000, and the
amount of assets of a married couple to be disregarded shall
not be less than $3,000.
    To the extent permitted under federal law, any person found
guilty of a second violation of Article VIIIA shall be
ineligible for medical assistance under this Article, as
provided in Section 8A-8.
    The eligibility of any person for medical assistance under
this Article shall not be affected by the receipt by the person
of donations or benefits from fundraisers held for the person
in cases of serious illness, as long as neither the person nor
members of the person's family have actual control over the
donations or benefits or the disbursement of the donations or
benefits.
(Source: P.A. 95-546, eff. 8-29-07; 95-1055, eff. 4-10-09;
96-20, eff. 6-30-09; 96-181, eff. 8-10-09; 96-328, eff.
8-11-09; 96-567, eff. 1-1-10; revised 9-25-09.)
 
    (305 ILCS 5/5-5.5)  (from Ch. 23, par. 5-5.5)
    Sec. 5-5.5. Elements of Payment Rate.
    (a) The Department of Healthcare and Family Services shall
develop a prospective method for determining payment rates for
skilled nursing and intermediate care services in nursing
facilities composed of the following cost elements:
        (1) Standard Services, with the cost of this component
    being determined by taking into account the actual costs to
    the facilities of these services subject to cost ceilings
    to be defined in the Department's rules.
        (2) Resident Services, with the cost of this component
    being determined by taking into account the actual costs,
    needs and utilization of these services, as derived from an
    assessment of the resident needs in the nursing facilities.
    The Department shall adopt rules governing reimbursement
    for resident services as listed in Section 5-1.1. Surveys
    or assessments of resident needs under this Section shall
    include a review by the facility of the results of such
    assessments and a discussion of issues in dispute with
    authorized survey staff, unless the facility elects not to
    participate in such a review process. Surveys or
    assessments of resident needs under this Section may be
    conducted semi-annually and payment rates relating to
    resident services may be changed on a semi-annual basis.
    The Illinois Department shall initiate a project, either on
    a pilot basis or Statewide, to reimburse the cost of
    resident services based on a methodology which utilizes an
    assessment of resident needs to determine the level of
    reimbursement. This methodology shall be different from
    the payment criteria for resident services utilized by the
    Illinois Department on July 1, 1981. On March 1, 1982, and
    each year thereafter, until such time when the Illinois
    Department adopts the methodology used in such project for
    use statewide, the Illinois Department shall report to the
    General Assembly on the implementation and progress of such
    project. The report shall include:
            (A) A statement of the Illinois Department's goals
        and objectives for such project;
            (B) A description of such project, including the
        number and type of nursing facilities involved in the
        project;
            (C) A description of the methodology used in such
        project;
            (D) A description of the Illinois Department's
        application of the methodology;
            (E) A statement on the methodology's effect on the
        quality of care given to residents in the sample
        nursing facilities; and
            (F) A statement on the cost of the methodology used
        in such project and a comparison of this cost with the
        cost of the current payment criteria.
        (3) Ancillary Services, with the payment rate being
    developed for each individual type of service. Payment
    shall be made only when authorized under procedures
    developed by the Department of Healthcare and Family
    Services.
        (4) Nurse's Aide Training, with the cost of this
    component being determined by taking into account the
    actual cost to the facilities of such training.
        (5) Real Estate Taxes, with the cost of this component
    being determined by taking into account the figures
    contained in the most currently available cost reports
    (with no imposition of maximums) updated to the midpoint of
    the current rate year for long term care services rendered
    between July 1, 1984 and June 30, 1985, and with the cost
    of this component being determined by taking into account
    the actual 1983 taxes for which the nursing homes were
    assessed (with no imposition of maximums) updated to the
    midpoint of the current rate year for long term care
    services rendered between July 1, 1985 and June 30, 1986.
    (b) In developing a prospective method for determining
payment rates for skilled nursing and intermediate care
services in nursing facilities, the Department of Healthcare
and Family Services shall consider the following cost elements:
        (1) Reasonable capital cost determined by utilizing
    incurred interest rate and the current value of the
    investment, including land, utilizing composite rates, or
    by utilizing such other reasonable cost related methods
    determined by the Department. However, beginning with the
    rate reimbursement period effective July 1, 1987, the
    Department shall be prohibited from establishing,
    including, and implementing any depreciation factor in
    calculating the capital cost element.
        (2) Profit, with the actual amount being produced and
    accruing to the providers in the form of a return on their
    total investment, on the basis of their ability to
    economically and efficiently deliver a type of service. The
    method of payment may assure the opportunity for a profit,
    but shall not guarantee or establish a specific amount as a
    cost.
    (c) The Illinois Department may implement the amendatory
changes to this Section made by this amendatory Act of 1991
through the use of emergency rules in accordance with the
provisions of Section 5.02 of the Illinois Administrative
Procedure Act. For purposes of the Illinois Administrative
Procedure Act, the adoption of rules to implement the
amendatory changes to this Section made by this amendatory Act
of 1991 shall be deemed an emergency and necessary for the
public interest, safety and welfare.
    (d) No later than January 1, 2001, the Department of Public
Aid shall file with the Joint Committee on Administrative
Rules, pursuant to the Illinois Administrative Procedure Act, a
proposed rule, or a proposed amendment to an existing rule,
regarding payment for appropriate services, including
assessment, care planning, discharge planning, and treatment
provided by nursing facilities to residents who have a serious
mental illness.
(Source: P.A. 95-331, eff. 8-21-07.)
 
    (305 ILCS 5/12-8.2 new)
    Sec. 12-8.2. Medical Assistance Dental Reimbursement
Revolving Fund. There is created a revolving fund to be known
as the Medical Assistance Dental Reimbursement Revolving Fund,
to be held by the Director of the Department of Healthcare and
Family Services, outside of the State treasury, for the
following purposes:
        (1) The deposit of all funds to pay for dental services
    provided by enrolled dental service providers for services
    to participants in the medical programs administered by the
    Department.
        (2) The deposit of any interest accrued by the
    revolving fund, which interest shall be available to pay
    for dental services provided by enrolled dental service
    providers for services to participants in the medical
    programs administered by the Department.
        (3) The payment of amounts to enrolled dental service
    providers for dental services provided to participants in
    the medical programs administered by the Department.
 
    (305 ILCS 5/5-5.8a rep.)
    (305 ILCS 5/5-22 rep.)
    Section 15. The Illinois Public Aid Code is amended by
repealing Sections 5-5.8a and 5-22.

Effective Date: 1/1/2011