Rep. Barbara Flynn Currie

Filed: 5/18/2011





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2    AMENDMENT NO. ______. Amend Senate Bill 40 as follows:
3on page 1, line 5, after "Sections", by inserting "3,"; and
4on page 1, immediately below line 6, by inserting the
6    "(20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
7    (Section scheduled to be repealed on December 31, 2019)
8    Sec. 3. Definitions. As used in this Act:
9    "Health care facilities" means and includes the following
10facilities and organizations:
11        1. An ambulatory surgical treatment center required to
12    be licensed pursuant to the Ambulatory Surgical Treatment
13    Center Act;
14        2. An institution, place, building, or agency required
15    to be licensed pursuant to the Hospital Licensing Act;



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1        3. Skilled and intermediate long term care facilities
2    licensed under the Nursing Home Care Act;
3        3.5. Skilled and intermediate care facilities licensed
4    under the MR/DD Community Care Act;
5        4. Hospitals, nursing homes, ambulatory surgical
6    treatment centers, or kidney disease treatment centers
7    maintained by the State or any department or agency
8    thereof;
9        5. Kidney disease treatment centers, including a
10    free-standing hemodialysis unit required to be licensed
11    under the End Stage Renal Disease Facility Act;
12        6. An institution, place, building, or room used for
13    the performance of outpatient surgical procedures that is
14    leased, owned, or operated by or on behalf of an
15    out-of-state facility;
16        7. An institution, place, building, or room used for
17    provision of a health care category of service as defined
18    by the Board, including, but not limited to, cardiac
19    catheterization and open heart surgery; and
20        8. An institution, place, building, or room used for
21    provision of major medical equipment used in the direct
22    clinical diagnosis or treatment of patients, and whose
23    project cost is in excess of the capital expenditure
24    minimum.
25    This Act shall not apply to the construction of any new
26facility or the renovation of any existing facility located on



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1any campus facility as defined in Section 5-5.8b of the
2Illinois Public Aid Code, provided that the campus facility
3encompasses 30 or more contiguous acres and that the new or
4renovated facility is intended for use by a licensed
5residential facility.
6    No federally owned facility shall be subject to the
7provisions of this Act, nor facilities used solely for healing
8by prayer or spiritual means.
9    No facility licensed under the Supportive Residences
10Licensing Act or the Assisted Living and Shared Housing Act
11shall be subject to the provisions of this Act.
12    No facility established and operating under the
13Alternative Health Care Delivery Act as a children's respite
14care center alternative health care model demonstration
15program or as an Alzheimer's Disease Management Center
16alternative health care model demonstration program shall be
17subject to the provisions of this Act.
18    A facility designated as a supportive living facility that
19is in good standing with the program established under Section
205-5.01a of the Illinois Public Aid Code shall not be subject to
21the provisions of this Act.
22    This Act does not apply to facilities granted waivers under
23Section 3-102.2 of the Nursing Home Care Act. However, if a
24demonstration project under that Act applies for a certificate
25of need to convert to a nursing facility, it shall meet the
26licensure and certificate of need requirements in effect as of



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1the date of application.
2    This Act does not apply to a dialysis facility that
3provides only dialysis training, support, and related services
4to individuals with end stage renal disease who have elected to
5receive home dialysis. This Act does not apply to a dialysis
6unit located in a licensed nursing home that offers or provides
7dialysis-related services to residents with end stage renal
8disease who have elected to receive home dialysis within the
9nursing home. The Board, however, may require these dialysis
10facilities and licensed nursing homes to report statistical
11information on a quarterly basis to the Board to be used by the
12Board to conduct analyses on the need for proposed kidney
13disease treatment centers.
14    This Act shall not apply to the closure of an entity or a
15portion of an entity licensed under the Nursing Home Care Act
16or the MR/DD Community Care Act, with the exceptions of
17facilities operated by a county or Illinois Veterans Homes,
18that elects to convert, in whole or in part, to an assisted
19living or shared housing establishment licensed under the
20Assisted Living and Shared Housing Act.
21    This Act does not apply to any change of ownership of a
22healthcare facility that is licensed under the Nursing Home
23Care Act or the MR/DD Community Care Act, with the exceptions
24of facilities operated by a county or Illinois Veterans Homes.
25Changes of ownership of facilities licensed under the Nursing
26Home Care Act must meet the requirements set forth in Sections



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13-101 through 3-119 of the Nursing Home Care Act.
2    This Act does not apply to public hospitals and health
3clinics operated by a county with a population of 3,000,000 or
4more inhabitants or by a governing authority established by the
5board of commissioners of a county with a population of
63,000,000 or more inhabitants. The State Board, however, may
7require these public hospitals and health clinics to report
8statistical and other information to the Board to be used by
9the Board to conduct statewide inventories of health care
10facilities under Section 12 of this Act.
11    With the exception of those health care facilities
12specifically included in this Section, nothing in this Act
13shall be intended to include facilities operated as a part of
14the practice of a physician or other licensed health care
15professional, whether practicing in his individual capacity or
16within the legal structure of any partnership, medical or
17professional corporation, or unincorporated medical or
18professional group. Further, this Act shall not apply to
19physicians or other licensed health care professional's
20practices where such practices are carried out in a portion of
21a health care facility under contract with such health care
22facility by a physician or by other licensed health care
23professionals, whether practicing in his individual capacity
24or within the legal structure of any partnership, medical or
25professional corporation, or unincorporated medical or
26professional groups. This Act shall apply to construction or



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1modification and to establishment by such health care facility
2of such contracted portion which is subject to facility
3licensing requirements, irrespective of the party responsible
4for such action or attendant financial obligation.
5    "Person" means any one or more natural persons, legal
6entities, governmental bodies other than federal, or any
7combination thereof.
8    "Consumer" means any person other than a person (a) whose
9major occupation currently involves or whose official capacity
10within the last 12 months has involved the providing,
11administering or financing of any type of health care facility,
12(b) who is engaged in health research or the teaching of
13health, (c) who has a material financial interest in any
14activity which involves the providing, administering or
15financing of any type of health care facility, or (d) who is or
16ever has been a member of the immediate family of the person
17defined by (a), (b), or (c).
18    "State Board" or "Board" means the Health Facilities and
19Services Review Board.
20    "Construction or modification" means the establishment,
21erection, building, alteration, reconstruction, modernization,
22improvement, extension, discontinuation, change of ownership,
23of or by a health care facility, or the purchase or acquisition
24by or through a health care facility of equipment or service
25for diagnostic or therapeutic purposes or for facility
26administration or operation, or any capital expenditure made by



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1or on behalf of a health care facility which exceeds the
2capital expenditure minimum; however, any capital expenditure
3made by or on behalf of a health care facility for (i) the
4construction or modification of a facility licensed under the
5Assisted Living and Shared Housing Act or (ii) a conversion
6project undertaken in accordance with Section 30 of the Older
7Adult Services Act shall be excluded from any obligations under
8this Act.
9    "Establish" means the construction of a health care
10facility or the replacement of an existing facility on another
11site or the initiation of a category of service as defined by
12the Board.
13    "Major medical equipment" means medical equipment which is
14used for the provision of medical and other health services and
15which costs in excess of the capital expenditure minimum,
16except that such term does not include medical equipment
17acquired by or on behalf of a clinical laboratory to provide
18clinical laboratory services if the clinical laboratory is
19independent of a physician's office and a hospital and it has
20been determined under Title XVIII of the Social Security Act to
21meet the requirements of paragraphs (10) and (11) of Section
221861(s) of such Act. In determining whether medical equipment
23has a value in excess of the capital expenditure minimum, the
24value of studies, surveys, designs, plans, working drawings,
25specifications, and other activities essential to the
26acquisition of such equipment shall be included.



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1    "Capital Expenditure" means an expenditure: (A) made by or
2on behalf of a health care facility (as such a facility is
3defined in this Act); and (B) which under generally accepted
4accounting principles is not properly chargeable as an expense
5of operation and maintenance, or is made to obtain by lease or
6comparable arrangement any facility or part thereof or any
7equipment for a facility or part; and which exceeds the capital
8expenditure minimum.
9    For the purpose of this paragraph, the cost of any studies,
10surveys, designs, plans, working drawings, specifications, and
11other activities essential to the acquisition, improvement,
12expansion, or replacement of any plant or equipment with
13respect to which an expenditure is made shall be included in
14determining if such expenditure exceeds the capital
15expenditures minimum. Unless otherwise interdependent, or
16submitted as one project by the applicant, components of
17construction or modification undertaken by means of a single
18construction contract or financed through the issuance of a
19single debt instrument shall not be grouped together as one
20project. Donations of equipment or facilities to a health care
21facility which if acquired directly by such facility would be
22subject to review under this Act shall be considered capital
23expenditures, and a transfer of equipment or facilities for
24less than fair market value shall be considered a capital
25expenditure for purposes of this Act if a transfer of the
26equipment or facilities at fair market value would be subject



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1to review.
2    "Capital expenditure minimum" means $11,500,000 for
3projects by hospital applicants, $6,500,000 for applicants for
4projects related to skilled and intermediate care long-term
5care facilities licensed under the Nursing Home Care Act, and
6$3,000,000 for projects by all other applicants, which shall be
7annually adjusted to reflect the increase in construction costs
8due to inflation, for major medical equipment and for all other
9capital expenditures.
10    "Non-clinical service area" means an area (i) for the
11benefit of the patients, visitors, staff, or employees of a
12health care facility and (ii) not directly related to the
13diagnosis, treatment, or rehabilitation of persons receiving
14services from the health care facility. "Non-clinical service
15areas" include, but are not limited to, chapels; gift shops;
16news stands; computer systems; tunnels, walkways, and
17elevators; telephone systems; projects to comply with life
18safety codes; educational facilities; student housing;
19patient, employee, staff, and visitor dining areas;
20administration and volunteer offices; modernization of
21structural components (such as roof replacement and masonry
22work); boiler repair or replacement; vehicle maintenance and
23storage facilities; parking facilities; mechanical systems for
24heating, ventilation, and air conditioning; loading docks; and
25repair or replacement of carpeting, tile, wall coverings,
26window coverings or treatments, or furniture. Solely for the



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1purpose of this definition, "non-clinical service area" does
2not include health and fitness centers.
3    "Areawide" means a major area of the State delineated on a
4geographic, demographic, and functional basis for health
5planning and for health service and having within it one or
6more local areas for health planning and health service. The
7term "region", as contrasted with the term "subregion", and the
8word "area" may be used synonymously with the term "areawide".
9    "Local" means a subarea of a delineated major area that on
10a geographic, demographic, and functional basis may be
11considered to be part of such major area. The term "subregion"
12may be used synonymously with the term "local".
13    "Physician" means a person licensed to practice in
14accordance with the Medical Practice Act of 1987, as amended.
15    "Licensed health care professional" means a person
16licensed to practice a health profession under pertinent
17licensing statutes of the State of Illinois.
18    "Director" means the Director of the Illinois Department of
19Public Health.
20    "Agency" means the Illinois Department of Public Health.
21    "Alternative health care model" means a facility or program
22authorized under the Alternative Health Care Delivery Act.
23    "Out-of-state facility" means a person that is both (i)
24licensed as a hospital or as an ambulatory surgery center under
25the laws of another state or that qualifies as a hospital or an
26ambulatory surgery center under regulations adopted pursuant



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1to the Social Security Act and (ii) not licensed under the
2Ambulatory Surgical Treatment Center Act, the Hospital
3Licensing Act, or the Nursing Home Care Act. Affiliates of
4out-of-state facilities shall be considered out-of-state
5facilities. Affiliates of Illinois licensed health care
6facilities 100% owned by an Illinois licensed health care
7facility, its parent, or Illinois physicians licensed to
8practice medicine in all its branches shall not be considered
9out-of-state facilities. Nothing in this definition shall be
10construed to include an office or any part of an office of a
11physician licensed to practice medicine in all its branches in
12Illinois that is not required to be licensed under the
13Ambulatory Surgical Treatment Center Act.
14    "Change of ownership of a health care facility" means a
15change in the person who has ownership or control of a health
16care facility's physical plant and capital assets. A change in
17ownership is indicated by the following transactions: sale,
18transfer, acquisition, lease, change of sponsorship, or other
19means of transferring control.
20    "Related person" means any person that: (i) is at least 50%
21owned, directly or indirectly, by either the health care
22facility or a person owning, directly or indirectly, at least
2350% of the health care facility; or (ii) owns, directly or
24indirectly, at least 50% of the health care facility.
25    "Charity care" means care provided by a health care
26facility for which the provider does not expect to receive



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1payment from the patient or a third-party payer.
2    "Freestanding emergency center" means a facility subject
3to licensure under Section 32.5 of the Emergency Medical
4Services (EMS) Systems Act.
5(Source: P.A. 95-331, eff. 8-21-07; 95-543, eff. 8-28-07;
695-584, eff. 8-31-07; 95-727, eff. 6-30-08; 95-876, eff.
78-21-08; 96-31, eff. 6-30-09; 96-339, eff. 7-1-10; 96-1000,
8eff. 7-2-10.)".