093_SB0359eng SB359 Engrossed LRB093 05213 AMC 05273 b 1 AN ACT concerning health facilities. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 5. The Alternative Health Care Delivery Act is 5 amended by changing Section 35 as follows: 6 (210 ILCS 3/35) 7 Sec. 35. Alternative health care models authorized. 8 Notwithstanding any other law to the contrary, alternative 9 health care models described in this Section may be 10 established on a demonstration basis. 11 (1) Alternative health care model; subacute care 12 hospital. A subacute care hospital is a designated site 13 which provides medical specialty care for patients who 14 need a greater intensity or complexity of care than 15 generally provided in a skilled nursing facility but who 16 no longer require acute hospital care. The average length 17 of stay for patients treated in subacute care hospitals 18 shall not be less than 20 days, and for individual 19 patients, the expected length of stay at the time of 20 admission shall not be less than 10 days. Variations 21 from minimum lengths of stay shall be reported to the 22 Department. There shall be no more than 13 subacute care 23 hospitals authorized to operate by the Department. 24 Subacute care includes physician supervision, registered 25 nursing, and physiological monitoring on a continual 26 basis. A subacute care hospital is either a freestanding 27 building or a distinct physical and operational entity 28 within a hospital or nursing home building. A subacute 29 care hospital shall only consist of beds currently 30 existing in licensed hospitals or skilled nursing 31 facilities, except, in the City of Chicago, on a SB359 Engrossed -2- LRB093 05213 AMC 05273 b 1 designated site that was licensed as a hospital under the 2 Illinois Hospital Licensing Act within the 10 years 3 immediately before the application for an alternative 4 health care model license. During the period of operation 5 of the demonstration project, the existing licensed beds 6 shall remain licensed as hospital or skilled nursing 7 facility beds as well as being licensed under this Act. 8 In order to handle cases of complications, emergencies, 9 or exigent circumstances, a subacute care hospital shall 10 maintain a contractual relationship, including a transfer 11 agreement, with a general acute care hospital. If a 12 subacute care model is located in a general acute care 13 hospital, it shall utilize all or a portion of the bed 14 capacity of that existing hospital. In no event shall a 15 subacute care hospital use the word "hospital" in its 16 advertising or marketing activities or represent or hold 17 itself out to the public as a general acute care 18 hospital. 19 (2) Alternative health care delivery model; 20 postsurgical recovery care center. A postsurgical 21 recovery care center is a designated site which provides 22 postsurgical recovery care for generally healthy patients 23 undergoing surgical procedures that require overnight 24 nursing care, pain control, or observation that would 25 otherwise be provided in an inpatient setting. A 26 postsurgical recovery care center is either freestanding 27 or a defined unit of an ambulatory surgical treatment 28 center or hospital. No facility, or portion of a 29 facility, may participate in a demonstration program as a 30 postsurgical recovery care center unless the facility has 31 been licensed as an ambulatory surgical treatment center 32 or hospital for at least 2 years before August 20, 1993 33 (the effective date of Public Act 88-441). The maximum 34 length of stay for patients in a postsurgical recovery SB359 Engrossed -3- LRB093 05213 AMC 05273 b 1 care center is not to exceed 48 hours unless the treating 2 physician requests an extension of time from the recovery 3 center's medical director on the basis of medical or 4 clinical documentation that an additional care period is 5 required for the recovery of a patient and the medical 6 director approves the extension of time. In no case, 7 however, shall a patient's length of stay in a 8 postsurgical recovery care center be longer than 72 9 hours. If a patient requires an additional care period 10 after the expiration of the 72-hour limit, the patient 11 shall be transferred to an appropriate facility. Reports 12 on variances from the 48-hour limit shall be sent to the 13 Department for its evaluation. The reports shall, before 14 submission to the Department, have removed from them all 15 patient and physician identifiers. In order to handle 16 cases of complications, emergencies, or exigent 17 circumstances, every postsurgical recovery care center as 18 defined in this paragraph shall maintain a contractual 19 relationship, including a transfer agreement, with a 20 general acute care hospital. A postsurgical recovery 21 care center shall be no larger than 20 beds. A 22 postsurgical recovery care center shall be located within 23 15 minutes travel time from the general acute care 24 hospital with which the center maintains a contractual 25 relationship, including a transfer agreement, as required 26 under this paragraph. 27 No postsurgical recovery care center shall 28 discriminate against any patient requiring treatment 29 because of the source of payment for services, including 30 Medicare and Medicaid recipients. 31 The Department shall adopt rules to implement the 32 provisions of Public Act 88-441 concerning postsurgical 33 recovery care centers within 9 months after August 20, 34 1993. SB359 Engrossed -4- LRB093 05213 AMC 05273 b 1 (3) Alternative health care delivery model; 2 children's community-based health care center. A 3 children's community-based health care center model is a 4 designated site that provides nursing care, clinical 5 support services, and therapies for a period of one to 14 6 days for short-term stays and 120 days to facilitate 7 transitions to home or other appropriate settings for 8 medically fragile children, technology dependent 9 children, and children with special health care needs who 10 are deemed clinically stable by a physician and are 11 younger than 22 years of age. This care is to be 12 provided in a home-like environment that serves no more 13 than 12 children at a time. Children's community-based 14 health care center services must be available through the 15 model to all families, including those whose care is paid 16 for through the Department of Public Aid, the Department 17 of Children and Family Services, the Department of Human 18 Services, and insurance companies who cover home health 19 care services or private duty nursing care in the home. 20 Each children's community-based health care center 21 model location shall be physically separate and apart 22 from any other facility licensed by the Department of 23 Public Health under this or any other Act and shall 24 provide the following services: respite care, registered 25 nursing or licensed practical nursing care, transitional 26 care to facilitate home placement or other appropriate 27 settings and reunite families, medical day care, weekend 28 camps, and diagnostic studies typically done in the home 29 setting.Alternative health care delivery model;30children's respite care center. A children's respite31care center model is a designated site that provides32respite for medically frail, technologically dependent,33clinically stable children, up to age 18, for a period of34one to 14 days. This care is to be provided in aSB359 Engrossed -5- LRB093 05213 AMC 05273 b 1home-like environment that serves no more than 102children at a time. Children's respite care center3services must be available through the model to all4families, including those whose care is paid for through5the Illinois Department of Public Aid or the Illinois6Department of Children and Family Services. Each respite7care model location shall be a facility physically8separate and apart from any other facility licensed by9the Department of Public Health under this or any other10Act and shall provide, at a minimum, the following11services: out-of-home respite care; hospital to home12training for families and caregivers; short term13transitional care to facilitate placement and training14for foster care parents; parent and family support15groups.16 Coverage for the services provided by the Illinois 17 Department of Public Aid under this paragraph (3) is 18 contingent upon federal waiver approval and is provided 19 only to Medicaid eligible clients participating in the 20 home and community based services waiver designated in 21 Section 1915(c) of the Social Security Act for medically 22 frail and technologically dependent children or children 23 in Department of Children and Family Services foster care 24 who receive home health benefits. 25 (4) Alternative health care delivery model; 26 community based residential rehabilitation center. A 27 community-based residential rehabilitation center model 28 is a designated site that provides rehabilitation or 29 support, or both, for persons who have experienced severe 30 brain injury, who are medically stable, and who no longer 31 require acute rehabilitative care or intense medical or 32 nursing services. The average length of stay in a 33 community-based residential rehabilitation center shall 34 not exceed 4 months. As an integral part of the services SB359 Engrossed -6- LRB093 05213 AMC 05273 b 1 provided, individuals are housed in a supervised living 2 setting while having immediate access to the community. 3 The residential rehabilitation center authorized by the 4 Department may have more than one residence included 5 under the license. A residence may be no larger than 12 6 beds and shall be located as an integral part of the 7 community. Day treatment or individualized outpatient 8 services shall be provided for persons who reside in 9 their own home. Functional outcome goals shall be 10 established for each individual. Services shall include, 11 but are not limited to, case management, training and 12 assistance with activities of daily living, nursing 13 consultation, traditional therapies (physical, 14 occupational, speech), functional interventions in the 15 residence and community (job placement, shopping, 16 banking, recreation), counseling, self-management 17 strategies, productive activities, and multiple 18 opportunities for skill acquisition and practice 19 throughout the day. The design of individualized program 20 plans shall be consistent with the outcome goals that are 21 established for each resident. The programs provided in 22 this setting shall be accredited by the Commission on 23 Accreditation of Rehabilitation Facilities (CARF). The 24 program shall have been accredited by CARF as a Brain 25 Injury Community-Integrative Program for at least 3 26 years. 27 (5) Alternative health care delivery model; 28 Alzheimer's disease management center. An Alzheimer's 29 disease management center model is a designated site that 30 provides a safe and secure setting for care of persons 31 diagnosed with Alzheimer's disease. An Alzheimer's 32 disease management center model shall be a facility 33 separate from any other facility licensed by the 34 Department of Public Health under this or any other Act. SB359 Engrossed -7- LRB093 05213 AMC 05273 b 1 An Alzheimer's disease management center shall conduct 2 and document an assessment of each resident every 6 3 months. The assessment shall include an evaluation of 4 daily functioning, cognitive status, other medical 5 conditions, and behavioral problems. An Alzheimer's 6 disease management center shall develop and implement an 7 ongoing treatment plan for each resident. The treatment 8 plan shall have defined goals. The Alzheimer's disease 9 management center shall treat behavioral problems and 10 mood disorders using nonpharmacologic approaches such as 11 environmental modification, task simplification, and 12 other appropriate activities. All staff must have 13 necessary training to care for all stages of Alzheimer's 14 Disease. An Alzheimer's disease management center shall 15 provide education and support for residents and 16 caregivers. The education and support shall include 17 referrals to support organizations for educational 18 materials on community resources, support groups, legal 19 and financial issues, respite care, and future care needs 20 and options. The education and support shall also 21 include a discussion of the resident's need to make 22 advance directives and to identify surrogates for medical 23 and legal decision-making. The provisions of this 24 paragraph establish the minimum level of services that 25 must be provided by an Alzheimer's disease management 26 center. An Alzheimer's disease management center model 27 shall have no more than 100 residents. Nothing in this 28 paragraph (5) shall be construed as prohibiting a person 29 or facility from providing services and care to persons 30 with Alzheimer's disease as otherwise authorized under 31 State law. 32 (Source: P.A. 91-65, eff. 7-9-99; 91-357, eff. 7-29-99; 33 91-838, eff. 6-16-00.)