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Public Act 095-0584
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| SB1579 Enrolled |
LRB095 09004 DRJ 31315 b |
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AN ACT concerning regulation.
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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 5. The Illinois Health Facilities Planning Act is |
amended by changing Section 3 and adding Section 5.1a as |
follows:
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(20 ILCS 3960/3) (from Ch. 111 1/2, par. 1153)
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(Section scheduled to be repealed on May 31, 2007)
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Sec. 3. Definitions. As used in this Act:
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"Health care facilities" means and includes
the following |
facilities and organizations:
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1. An ambulatory surgical treatment center required to |
be licensed
pursuant to the Ambulatory Surgical Treatment |
Center Act;
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2. An institution, place, building, or agency required |
to be licensed
pursuant to the Hospital Licensing Act;
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3. Skilled and intermediate long term care facilities |
licensed under the
Nursing
Home Care Act;
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3. Skilled and intermediate long term care facilities |
licensed under the
Nursing
Home Care Act;
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4. Hospitals, nursing homes, ambulatory surgical |
treatment centers, or
kidney disease treatment centers
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maintained by the State or any department or agency |
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thereof;
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5. Kidney disease treatment centers, including a |
free-standing
hemodialysis unit required to be licensed |
under the End Stage Renal Disease Facility Act; and
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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.
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No federally owned facility shall be subject to the |
provisions of this
Act, nor facilities used solely for healing |
by prayer or spiritual means.
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No facility licensed under the Supportive Residences |
Licensing Act or the
Assisted Living and Shared Housing Act
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shall be subject to the provisions of this Act.
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A facility designated as a supportive living facility that |
is in good
standing with the program
established under Section |
5-5.01a of
the Illinois Public Aid Code shall not be subject to |
the provisions of this
Act.
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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
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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 does not apply to a dialysis facility that |
provides only dialysis training, support, and related services |
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to individuals with end stage renal disease who have elected to |
receive home dialysis. This Act does not apply to a dialysis |
unit located in a licensed nursing home that offers or provides |
dialysis-related services to residents with end stage renal |
disease who have elected to receive home dialysis within the |
nursing home. The Board, however, may require these dialysis |
facilities and licensed nursing homes to report statistical |
information on a quarterly basis to the Board to be used by the |
Board to conduct analyses on the need for proposed kidney |
disease treatment centers.
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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.
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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
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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 |
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facility by a physician or by other licensed
health care |
professionals, whether practicing in his individual capacity
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or within the legal structure of any partnership, medical or
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professional corporation, or unincorporated medical or |
professional
groups. This Act shall apply to construction or
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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.
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"Person" means any one or more natural persons, legal |
entities,
governmental bodies other than federal, or any |
combination thereof.
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"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
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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).
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"State Board" means the Health Facilities Planning Board.
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"Construction or modification" means the establishment, |
erection,
building, alteration, reconstruction, modernization, |
improvement,
extension, discontinuation, change of ownership, |
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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
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or on behalf of a health care facility which
exceeds the |
capital expenditure minimum; however, any capital expenditure
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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.
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"Establish" means the construction of a health care |
facility or the
replacement of an existing facility on another |
site.
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"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
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1861(s) of such Act. In determining whether medical equipment |
has a value
in excess of the capital expenditure minimum, the |
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value of studies, surveys,
designs, plans, working drawings, |
specifications, and other activities
essential to the |
acquisition of such equipment shall be included.
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"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
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equipment for a facility or part; and which exceeds the capital |
expenditure
minimum.
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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
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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.
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"Capital expenditure minimum" means $6,000,000, which |
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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.
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"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;
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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
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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 |
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purpose of this definition, "non-clinical service
area" does |
not include health and fitness centers.
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"Areawide" means a major area of the State delineated on a
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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".
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"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".
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"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.
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"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.
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"Physician" means a person licensed to practice in |
accordance with
the Medical Practice Act of 1987, as amended.
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"Licensed health care professional" means a person |
licensed to
practice a health profession under pertinent |
licensing statutes of the
State of Illinois.
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"Director" means the Director of the Illinois Department of |
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Public Health.
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"Agency" means the Illinois Department of Public Health.
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"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.
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"Alternative health care model" means a facility or program |
authorized
under the Alternative Health Care Delivery Act.
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"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
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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
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construed to include an office or any part of an office of a |
physician licensed
to practice medicine in all its branches in |
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Illinois that is not required to be
licensed under the |
Ambulatory Surgical Treatment Center Act.
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"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.
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"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.
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"Charity care" means care provided by a health care |
facility for which the provider does not expect to receive |
payment from the patient or a third-party payer. |
"Freestanding emergency center" means a facility subject |
to licensure under Section 32.5 of the Emergency Medical |
Services (EMS) Systems Act.
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(Source: P.A. 93-41, eff. 6-27-03; 93-766, eff. 7-20-04; |
93-935, eff. 1-1-05; 93-1031, eff. 8-27-04; 94-342, eff. |
7-26-05; revised 4-3-07.)
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(20 ILCS 3960/5.1a new)
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Sec. 5.1a. No person shall construct, modify, or establish |
a freestanding emergency center in Illinois, or acquire major |
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medical equipment or make capital expenditures in relation to |
such a facility in excess of the capital expenditure minimum, |
as defined by this Act, without first obtaining a permit from |
the State Board in accordance with criteria, standards, and |
procedures adopted by the State Board for freestanding |
emergency centers that ensure the availability of and community |
access to essential emergency medical services.
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Section 10. The Emergency Medical Services (EMS) Systems |
Act is amended by changing Sections 3.20 and 32.5 as follows:
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(210 ILCS 50/3.20)
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Sec. 3.20. Emergency Medical Services (EMS) Systems.
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(a) "Emergency Medical Services (EMS) System" means an
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organization of hospitals, vehicle service providers and
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personnel approved by the Department in a specific
geographic |
area, which coordinates and provides pre-hospital
and |
inter-hospital emergency care and non-emergency medical
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transports at a BLS, ILS and/or ALS level pursuant to a
System |
program plan submitted to and approved by the
Department, and |
pursuant to the EMS Region Plan adopted for
the EMS Region in |
which the System is located.
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(b) One hospital in each System program plan must be
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designated as the Resource Hospital. All other hospitals
which |
are located within the geographic boundaries of a
System and |
which have standby, basic or comprehensive level
emergency |
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departments must function in that EMS System as
either an |
Associate Hospital or Participating Hospital and
follow all |
System policies specified in the System Program
Plan, including |
but not limited to the replacement of drugs
and equipment used |
by providers who have delivered patients
to their emergency |
departments. All hospitals and vehicle
service providers |
participating in an EMS System must
specify their level of |
participation in the System Program
Plan.
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(c) The Department shall have the authority and
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responsibility to:
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(1) Approve BLS, ILS and ALS level EMS Systems which
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meet minimum standards and criteria established in rules
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adopted by the Department pursuant to this Act, including
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the submission of a Program Plan for Department approval.
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Beginning September 1, 1997, the Department shall approve
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the development of a new EMS System only when a local or
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regional need for establishing such System has been
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identified. This shall not be construed as a needs |
assessment for health
planning or
other purposes outside of |
this Act.
Following Department approval, EMS Systems must
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be fully operational within one year from the date of
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approval.
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(2) Monitor EMS Systems, based on minimum standards for
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continuing operation as prescribed in rules adopted by the
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Department pursuant to this Act, which shall include
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requirements for submitting Program Plan amendments to the
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Department for approval.
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(3) Renew EMS System approvals every 4 years, after
an |
inspection, based on compliance with the standards for
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continuing operation prescribed in rules adopted by the
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Department pursuant to this Act.
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(4) Suspend, revoke, or refuse to renew approval of
any |
EMS System, after providing an opportunity for a
hearing, |
when findings show that it does not meet the
minimum |
standards for continuing operation as prescribed by
the |
Department, or is found to be in violation of its
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previously approved Program Plan.
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(5) Require each EMS System to adopt written protocols
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for the bypassing of or diversion to any hospital, trauma
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center or regional trauma center, which provide that a |
person
shall not be transported to a facility other than |
the nearest
hospital, regional trauma center or trauma |
center unless the
medical benefits to the patient |
reasonably expected from the
provision of appropriate |
medical treatment at a more distant
facility outweigh the |
increased risks to the patient from
transport to the more |
distant facility, or the transport is in
accordance with |
the System's protocols for patient
choice or refusal.
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(6) Require that the EMS Medical Director of an ILS or
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ALS level EMS System be a physician licensed to practice
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medicine in all of its branches in Illinois, and certified |
by
the American Board of Emergency Medicine or the American |
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Board
of Osteopathic Emergency Medicine, and that the EMS |
Medical
Director of a BLS level EMS System be a physician |
licensed to
practice medicine in all of its branches in |
Illinois, with
regular and frequent involvement in |
pre-hospital emergency
medical services. In addition, all |
EMS Medical Directors shall:
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(A) Have experience on an EMS vehicle at the
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highest level available within the System, or make |
provision
to gain such experience within 12 months |
prior to the
date responsibility for the System is |
assumed or within 90
days after assuming the position;
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(B) Be thoroughly knowledgeable of all skills
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included in the scope of practices of all levels of EMS
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personnel within the System;
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(C) Have or make provision to gain experience
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instructing students at a level similar to that of the |
levels
of EMS personnel within the System; and
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(D) For ILS and ALS EMS Medical Directors,
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successfully complete a Department-approved EMS |
Medical
Director's Course.
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(7) Prescribe statewide EMS data elements to be
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collected and documented by providers in all EMS Systems |
for
all emergency and non-emergency medical services, with |
a
one-year phase-in for commencing collection of such data
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elements.
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(8) Define, through rules adopted pursuant to this Act,
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the terms "Resource Hospital", "Associate Hospital",
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"Participating Hospital", "Basic Emergency Department",
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"Standby Emergency Department", "Comprehensive Emergency |
Department", "EMS
Medical Director", "EMS Administrative
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Director", and "EMS System Coordinator".
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(A) Upon the effective date of this amendatory Act |
of 1995,
all existing Project Medical Directors shall |
be considered EMS
Medical Directors, and all persons |
serving in such capacities
on the effective date of |
this amendatory Act of 1995 shall be exempt from
the |
requirements of paragraph (7) of this subsection;
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(B) Upon the effective date of this amendatory Act |
of 1995, all
existing EMS System Project Directors |
shall be considered EMS
Administrative Directors.
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(9) Investigate the
circumstances that caused a |
hospital
in an EMS system
to go on
bypass status to |
determine whether that hospital's decision to go on bypass
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status was reasonable. The Department may impose |
sanctions, as
set forth in Section 3.140 of the Act, upon a |
Department determination that the
hospital unreasonably
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went on bypass status in violation of the Act.
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(10) Evaluate the capacity and performance of any |
freestanding emergency center established under Section |
32.5 of this Act in meeting emergency medical service needs |
of the public, including compliance with applicable |
emergency medical standards and assurance of the |
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availability of and immediate access to the highest quality |
of medical care possible.
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(Source: P.A. 91-357, eff. 7-29-99.)
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(210 ILCS 50/32.5)
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Sec. 32.5. Freestanding Emergency Center.
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(a) Until June 30, 2009, the
The Department shall issue an |
annual Freestanding Emergency Center (FEC)
license to any |
facility that:
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(1) is located: (A)
(i)(A) in a municipality with
a |
population
of 75,000 or fewer inhabitants; (B) within 20
15 |
miles of the
hospital that owns or controls the FEC; and |
(C) within 20
10 miles of the Resource
Hospital affiliated |
with the FEC as part of the EMS System; or (ii)
(A) in a |
municipality that has a
hospital that has been providing |
emergency services but is expected to close
by the end of |
1997 and (B) in a county with a population of more
than
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350,000 but
less than 525,000 inhabitants;
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(2) is wholly owned or controlled by an Associate or |
Resource Hospital,
but is not a part of the hospital's |
physical plant;
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(3) meets the standards for licensed FECs, adopted by |
rule of the
Department, including, but not limited to:
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(A) facility design, specification, operation, and |
maintenance
standards;
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(B) equipment standards; and
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(C) the number and qualifications of emergency |
medical personnel and
other staff, which must include |
at least one board certified emergency
physician |
present at the FEC 24 hours per day.
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(4) limits its participation in the EMS System strictly |
to receiving a
limited number of BLS runs by emergency |
medical vehicles according to protocols
developed by the |
Resource Hospital within the FEC's
designated EMS System |
and approved by the Project Medical Director and the
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Department;
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(5) provides comprehensive emergency treatment |
services, as defined in the
rules adopted by the Department |
pursuant to the Hospital Licensing Act, 24
hours per day, |
on an outpatient basis;
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(6) provides an ambulance and
maintains on site |
ambulance services staffed with paramedics 24 hours per |
day;
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(7) maintains helicopter landing capabilities approved |
by appropriate
State and federal authorities;
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(8) complies with all State and federal patient rights |
provisions,
including, but not limited to, the Emergency |
Medical Treatment Act and the
federal Emergency
Medical |
Treatment and Active Labor Act;
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(9) maintains a communications system that is fully |
integrated with
its Resource Hospital within the FEC's |
designated EMS System;
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(10) reports to the Department any patient transfers |
from the FEC to a
hospital within 48 hours of the transfer |
plus any other
data
determined to be relevant by the |
Department;
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(11) submits to the Department, on a quarterly basis, |
the FEC's morbidity
and mortality rates for patients |
treated at the FEC and other data determined
to be relevant |
by the Department;
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(12) does not describe itself or hold itself out to the |
general public as
a full service hospital or hospital |
emergency department in its advertising or
marketing
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activities;
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(13) complies with any other rules adopted by the
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Department
under this Act that relate to FECs;
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(14) passes the Department's site inspection for |
compliance with the FEC
requirements of this Act;
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(15) submits a copy of the
a certificate of need or |
other permit issued by
the Illinois Health Facilities |
Planning Board indicating that the facility has complied |
with the Illinois Health Facilities Planning Act with |
respect to the health services to be provided at the |
facility
that
will
house the proposed FEC complies with |
State health planning laws; provided,
however, that the |
Illinois Health Facilities Planning Board shall waive this
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certificate of need or permit requirement for any proposed |
FEC that, as of the
effective date of this amendatory Act |
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of 1996, meets the criteria for providing
comprehensive |
emergency treatment services, as defined by the rules
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promulgated under the Hospital Licensing Act, but is not a |
licensed hospital;
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(16) submits an application for designation as an FEC |
in a manner and form
prescribed by the Department by rule; |
and
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(17) pays the annual license fee as determined by the |
Department by
rule. ; and
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(18) participated in the demonstration program.
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(b) The Department shall:
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(1) annually inspect facilities of initial FEC |
applicants and licensed
FECs, and issue
annual licenses to |
or annually relicense FECs that
satisfy the Department's |
licensure requirements as set forth in subsection (a);
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(2) suspend, revoke, refuse to issue, or refuse to |
renew the license of
any
FEC, after notice and an |
opportunity for a hearing, when the Department finds
that |
the FEC has failed to comply with the standards and |
requirements of the
Act or rules adopted by the Department |
under the
Act;
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(3) issue an Emergency Suspension Order for any FEC |
when the
Director or his or her designee has determined |
that the continued operation of
the FEC poses an immediate |
and serious danger to
the public health, safety, and |
welfare.
An opportunity for a
hearing shall be promptly |