Public Act 098-0629
 
HB1584 EnrolledLRB098 08118 DRJ 38209 b


  
    AN ACT concerning regulation.
  
 
    Be it enacted by the People of the State of Illinois,
 
represented in the General Assembly:
  


 
    Section 5. The Illinois Health Facilities Planning Act is 
amended by changing Section 3 as follows:
 



    (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)




    (Section scheduled to be repealed on December 31, 2019)
    Sec. 3. Definitions. As used in this Act:

    "Health care facilities" means and includes
the following 
facilities, organizations, and related persons:


        1. An ambulatory surgical treatment center required to 
    be licensed
pursuant to the Ambulatory Surgical Treatment 
    Center Act;


        2. An institution, place, building, or agency required 
    to be licensed
pursuant to the Hospital Licensing Act;


        3. Skilled and intermediate long term care facilities 
    licensed under the
Nursing
Home Care Act;

        3.5. Skilled and intermediate care facilities licensed 
    under the ID/DD Community Care Act;
        3.7. Facilities licensed under the Specialized Mental 
    Health Rehabilitation Act; 

        4. Hospitals, nursing homes, ambulatory surgical 
    treatment centers, or
kidney disease treatment centers

    maintained by the State or any department or agency 
    thereof;


        5. Kidney disease treatment centers, including a 
    free-standing
hemodialysis unit required to be licensed 
    under the End Stage Renal Disease Facility Act;


        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;

        7. An institution, place, building, or room used for 
    provision of a health care category of service, including, 
    but not limited to, cardiac catheterization and open heart 
    surgery; and
        8. An institution, place, building, or room used for 
    provision of major medical equipment used in the direct 
    clinical diagnosis or treatment of patients, and whose 
    project cost is in excess of the capital expenditure 
    minimum. 
    This Act shall not apply to the construction of any new 
facility or the renovation of any existing facility located on 
any campus facility as defined in Section 5-5.8b of the 
Illinois Public Aid Code, provided that the campus facility 
encompasses 30 or more contiguous acres and that the new or 
renovated facility is intended for use by a licensed 
residential facility. 
    No federally owned facility shall be subject to the 
provisions of this
Act, nor facilities used solely for healing 
by prayer or spiritual means.

    No facility licensed under the Supportive Residences 
Licensing Act or the
Assisted Living and Shared Housing Act

shall be subject to the provisions of this Act.

    No facility established and operating under the 
Alternative Health Care Delivery Act as a children's 
community-based health care center children's respite care 
center alternative health care model demonstration program or 
as an Alzheimer's Disease Management Center alternative health 
care model demonstration program shall be subject to the 
provisions of this Act. 
    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.

    This Act does not apply to facilities granted waivers under 
Section 3-102.2
of the Nursing Home Care Act.  However, if a 
demonstration project under that
Act applies for a certificate

of need to convert to a nursing facility, it shall meet the 
licensure and
certificate of need requirements in effect as of 
the date of application.
    This Act does not apply to a dialysis facility that 
provides only dialysis training, support, and related services 
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.


    This Act shall not apply to the closure of an entity or a 
portion of an
entity licensed under the Nursing Home Care Act, 
the Specialized Mental Health Rehabilitation Act, or the ID/DD 
Community Care Act, with the exceptions of facilities operated 
by a county or Illinois Veterans Homes, 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.

    This Act does not apply to any change of ownership of a 
healthcare facility that is licensed under the Nursing Home 
Care Act, the Specialized Mental Health Rehabilitation Act, or 
the ID/DD Community Care Act, with the exceptions of facilities 
operated by a county or Illinois Veterans Homes.  Changes of 
ownership of facilities licensed under the Nursing Home Care 
Act must meet the requirements set forth in Sections 3-101 
through 3-119 of the Nursing Home Care Act.

    With the exception of those health care facilities 
specifically
included in this Section, nothing in this Act 
shall be intended to
include facilities operated as a part of 
the practice of a physician or
other licensed health care 
professional, whether practicing in his
individual capacity or 
within the legal structure of any partnership,
medical or 
professional corporation, or unincorporated medical or

professional group. Further, this Act shall not apply to 
physicians or
other licensed health care professional's 
practices where such practices
are carried out in a portion of 
a health care facility under contract
with such health care 
facility by a physician or by other licensed
health care 
professionals, whether practicing in his individual capacity

or within the legal structure of any partnership, medical or

professional corporation, or unincorporated medical or 
professional
groups, unless the entity constructs, modifies, 
or establishes a health care facility as specifically defined 
in this Section.  This Act shall apply to construction or

modification and to establishment by such health care facility 
of such
contracted portion which is subject to facility 
licensing requirements,
irrespective of the party responsible 
for such action or attendant
financial obligation.   
    No permit or exemption is required for a facility licensed 
under the ID/DD Community Care Act prior to the reduction of 
the number of beds at a facility.  If there is a total reduction 
of beds at a facility licensed under the ID/DD Community Care 
Act, this is a discontinuation or closure of the facility.  
However, if a facility licensed under the ID/DD Community Care 
Act reduces the number of beds or discontinues the facility, 
that facility must notify the Board as provided in Section 14.1 
of this Act. 

    "Person" means any one or more natural persons, legal 
entities,
governmental bodies other than federal, or any 
combination thereof.

    "Consumer" means any person other than a person (a) whose 
major
occupation currently involves or whose official capacity 
within the last
12 months has involved the providing, 
administering or financing of any
type of health care facility, 
(b) who is engaged in health research or
the teaching of 
health, (c) who has a material financial interest in any

activity which involves the providing, administering or 
financing of any
type of health care facility, or (d) who is or 
ever has been a member of
the immediate family of the person 
defined by (a), (b), or (c).

    "State Board" or "Board" means the Health Facilities and 
Services Review Board.

    "Construction or modification" means the establishment, 
erection,
building, alteration, reconstruction, modernization, 
improvement,
extension, discontinuation, change of ownership, 
of or by a health care
facility, or the purchase or acquisition 
by or through a health care facility
of
equipment or service 
for diagnostic or therapeutic purposes or for
facility 
administration or operation, or any capital expenditure made by

or on behalf of a health care facility which
exceeds the 
capital expenditure minimum; however, any capital expenditure

made by or on behalf of a health care facility for (i) the 
construction or
modification of a facility licensed under the 
Assisted Living and Shared
Housing Act or (ii) a conversion 
project undertaken in accordance with Section 30 of the Older 
Adult Services Act shall be excluded from any obligations under 
this Act.

    "Establish" means the construction of a health care 
facility or the
replacement of an existing facility on another 
site or the initiation of a category of service.

    "Major medical equipment" means medical equipment which is 
used for the
provision of medical and other health services and 
which costs in excess
of the capital expenditure minimum, 
except that such term does not include
medical equipment 
acquired
by or on behalf of a clinical laboratory to provide 
clinical laboratory
services if the clinical laboratory is 
independent of a physician's office
and a hospital and it has 
been determined under Title XVIII of the Social
Security Act to 
meet the requirements of paragraphs (10) and (11) of Section

1861(s) of such Act.  In determining whether medical equipment 
has a value
in excess of the capital expenditure minimum, the 
value of studies, surveys,
designs, plans, working drawings, 
specifications, and other activities
essential to the 
acquisition of such equipment shall be included.

    "Capital Expenditure" means an expenditure:  (A) made by or 
on behalf of
a health care facility (as such a facility is 
defined in this Act); and
(B) which under generally accepted 
accounting principles is not properly
chargeable as an expense 
of operation and maintenance, or is made to obtain
by lease or 
comparable arrangement any facility or part thereof or any

equipment for a facility or part; and which exceeds the capital 
expenditure
minimum.

    For the purpose of this paragraph, the cost of any studies, 
surveys, designs,
plans, working drawings, specifications, and 
other activities essential
to the acquisition, improvement, 
expansion, or replacement of any plant
or equipment with 
respect to which an expenditure is made shall be included
in 
determining if such expenditure exceeds the capital 
expenditures minimum.
Unless otherwise interdependent, or 
submitted as one project by the applicant, components of 
construction or modification undertaken by means of a single 
construction contract or financed through the issuance of a 
single debt instrument shall not be grouped together as one 
project. Donations of equipment
or facilities to a health care 
facility which if acquired directly by such
facility would be 
subject to review under this Act shall be considered capital

expenditures, and a transfer of equipment or facilities for 
less than fair
market value shall be considered a capital 
expenditure for purposes of this
Act if a transfer of the 
equipment or facilities at fair market value would
be subject 
to review.

    "Capital expenditure minimum" means $11,500,000 for 
projects by hospital applicants, $6,500,000 for applicants for 
projects related to skilled and intermediate care long-term 
care facilities licensed under the Nursing Home Care Act, and 
$3,000,000 for projects by  all other applicants, which shall be 
annually
adjusted to reflect the increase in construction costs 
due to inflation, for major medical equipment and for all other

capital expenditures.

    "Non-clinical service area" means an area (i) for the 
benefit of the
patients, visitors, staff, or employees of a 
health care facility and (ii) not
directly related to the 
diagnosis, treatment, or rehabilitation of persons
receiving 
services from the health care facility.  "Non-clinical service 
areas"
include, but are not limited to, chapels; gift shops; 
news stands; computer
systems; tunnels, walkways, and 
elevators; telephone systems; projects to
comply with life 
safety codes; educational facilities; student housing;

patient, employee, staff, and visitor dining areas; 
administration and
volunteer offices; modernization of 
structural components (such as roof
replacement and masonry 
work); boiler repair or replacement; vehicle
maintenance and 
storage facilities; parking facilities; mechanical systems for

heating, ventilation, and air conditioning; loading docks; and 
repair or
replacement of carpeting, tile, wall coverings, 
window coverings or treatments,
or furniture.  Solely for the 
purpose of this definition, "non-clinical service
area" does 
not include health and fitness centers.

    "Areawide" means a major area of the State delineated on a

geographic, demographic, and functional basis for health 
planning and
for health service and having within it one or 
more local areas for
health planning and health service.  The 
term "region", as contrasted
with the term "subregion", and the 
word "area" may be used synonymously
with the term "areawide".

    "Local" means a subarea of a delineated major area that on 
a
geographic, demographic, and functional basis may be 
considered to be
part of such major area.  The term "subregion" 
may be used synonymously
with the term "local".



    "Physician" means a person licensed to practice in 
accordance with
the Medical Practice Act of 1987, as amended.

    "Licensed health care professional" means a person 
licensed to
practice a health profession under pertinent 
licensing statutes of the
State of Illinois.

    "Director" means the  Director of the Illinois Department of 
Public Health.

    "Agency" means the Illinois Department of Public Health.


    "Alternative health care model" means a facility or program 
authorized
under the Alternative Health Care Delivery Act.

    "Out-of-state facility" means a person that is both (i) 
licensed as a
hospital or as an ambulatory surgery center under 
the laws of another state
or that
qualifies as a hospital or an 
ambulatory surgery center under regulations
adopted pursuant 
to the Social Security Act and (ii) not licensed under the

Ambulatory Surgical Treatment Center Act, the Hospital 
Licensing Act, or the
Nursing Home Care Act.  Affiliates of 
out-of-state facilities shall be
considered out-of-state 
facilities.  Affiliates of Illinois licensed health
care 
facilities 100% owned by an Illinois licensed health care 
facility, its
parent, or Illinois physicians licensed to 
practice medicine in all its
branches shall not be considered 
out-of-state facilities.  Nothing in
this definition shall be

construed to include an office or any part of an office of a 
physician licensed
to practice medicine in all its branches in 
Illinois that is not required to be
licensed under the 
Ambulatory Surgical Treatment Center Act.

    "Change of ownership of a health care facility" means a 
change in the
person
who has ownership or
control of a health 
care facility's physical plant and capital assets. A change
in 
ownership is indicated by
the following transactions: sale, 
transfer, acquisition, lease, change of
sponsorship, or other 
means of
transferring control.

    "Related person" means any person that: (i) is at least 50% 
owned, directly
or indirectly, by
either the health care 
facility or a person owning, directly or indirectly, at
least 
50% of the health
care facility; or (ii) owns, directly or 
indirectly, at least 50% of the
health care facility.

    "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.
    "Category of service" means a grouping by generic class of 
various types or levels of support functions, equipment, care, 
or treatment provided to patients or residents, including, but 
not limited to, classes such as medical-surgical, pediatrics, 
or cardiac catheterization. A category of service may include 
subcategories or levels of care that identify a particular 
degree or type of care within the category of service. Nothing 
in this definition shall be construed to include the practice 
of a physician or other licensed health care professional while 
functioning in an office providing for the care, diagnosis, or 
treatment of patients. A category of service that is subject to 
the Board's jurisdiction must be designated in rules adopted by 
the Board. 
(Source: P.A. 97-38, eff. 6-28-11; 97-277, eff. 1-1-12; 97-813, 
eff. 7-13-12; 97-980, eff. 8-17-12; 98-414, eff. 1-1-14.)
 
    Section 10. The Alternative Health Care Delivery Act is 
amended  by changing Sections 15 and 30 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 Act concerning children's 
community-based health care centers children's respite care 
centers
shall not apply to any facility licensed under the 
Hospital Licensing Act, the
Nursing Home Care Act, the 
Specialized Mental Health Rehabilitation Act, the ID/DD 
Community Care Act, or the University of Illinois Hospital Act 
that provides
respite care services to children.

(Source: P.A. 96-339, eff. 7-1-10; 97-38, eff. 6-28-11; 97-135, 
eff. 7-14-11; 97-227, eff. 1-1-12; 97-813, eff. 7-13-12.)

 
 

    (210 ILCS 3/30)

 
    Sec. 30. Demonstration program requirements. The 
requirements set forth in
this Section shall apply to 
demonstration programs.

    (a) (Blank).








    (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 
community-based health care center 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 community-based health care 
center 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 Health Facilities and Services Review 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. 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; 97-135, eff. 
7-14-11; 97-333, eff. 8-12-11; 97-813, eff. 7-13-12.)