Illinois General Assembly - Full Text of SB3608
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Full Text of SB3608  97th General Assembly




State of Illinois
2011 and 2012


Introduced 2/10/2012, by Sen. Kyle McCarter - William E. Brady


See Index

    Amends the Illinois Health Facilities Planning Act. Provides that the Health Facilities and Services Review Board is hereby dissolved and the terms of its members shall cease. Amends various other Acts to make corresponding changes. Effective July 1, 2013.

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SB3608LRB097 19792 DRJ 65062 b

1    AN ACT concerning health facilities.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Open Meetings Act is amended by changing
5Section 1.02 as follows:
6    (5 ILCS 120/1.02)  (from Ch. 102, par. 41.02)
7    Sec. 1.02. For the purposes of this Act:
8    "Meeting" means any gathering, whether in person or by
9video or audio conference, telephone call, electronic means
10(such as, without limitation, electronic mail, electronic
11chat, and instant messaging), or other means of contemporaneous
12interactive communication, of a majority of a quorum of the
13members of a public body held for the purpose of discussing
14public business or, for a 5-member public body, a quorum of the
15members of a public body held for the purpose of discussing
16public business.
17    Accordingly, for a 5-member public body, 3 members of the
18body constitute a quorum and the affirmative vote of 3 members
19is necessary to adopt any motion, resolution, or ordinance,
20unless a greater number is otherwise required.
21    "Public body" includes all legislative, executive,
22administrative or advisory bodies of the State, counties,
23townships, cities, villages, incorporated towns, school



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1districts and all other municipal corporations, boards,
2bureaus, committees or commissions of this State, and any
3subsidiary bodies of any of the foregoing including but not
4limited to committees and subcommittees which are supported in
5whole or in part by tax revenue, or which expend tax revenue,
6except the General Assembly and committees or commissions
7thereof. "Public body" includes tourism boards and convention
8or civic center boards located in counties that are contiguous
9to the Mississippi River with populations of more than 250,000
10but less than 300,000. "Public body" includes the Health
11Facilities and Services Review Board. "Public body" does not
12include a child death review team or the Illinois Child Death
13Review Teams Executive Council established under the Child
14Death Review Team Act or an ethics commission acting under the
15State Officials and Employees Ethics Act.
16(Source: P.A. 95-245, eff. 8-17-07; 96-31, eff. 6-30-09.)
17    Section 10. The State Officials and Employees Ethics Act is
18amended by changing Section 5-50 as follows:
19    (5 ILCS 430/5-50)
20    Sec. 5-50. Ex parte communications; special government
22    (a) This Section applies to ex parte communications made to
23any agency listed in subsection (e).
24    (b) "Ex parte communication" means any written or oral



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1communication by any person that imparts or requests material
2information or makes a material argument regarding potential
3action concerning regulatory, quasi-adjudicatory, investment,
4or licensing matters pending before or under consideration by
5the agency. "Ex parte communication" does not include the
6following: (i) statements by a person publicly made in a public
7forum; (ii) statements regarding matters of procedure and
8practice, such as format, the number of copies required, the
9manner of filing, and the status of a matter; and (iii)
10statements made by a State employee of the agency to the agency
11head or other employees of that agency.
12    (b-5) An ex parte communication received by an agency,
13agency head, or other agency employee from an interested party
14or his or her official representative or attorney shall
15promptly be memorialized and made a part of the record.
16    (c) An ex parte communication received by any agency,
17agency head, or other agency employee, other than an ex parte
18communication described in subsection (b-5), shall immediately
19be reported to that agency's ethics officer by the recipient of
20the communication and by any other employee of that agency who
21responds to the communication. The ethics officer shall require
22that the ex parte communication be promptly made a part of the
23record. The ethics officer shall promptly file the ex parte
24communication with the Executive Ethics Commission, including
25all written communications, all written responses to the
26communications, and a memorandum prepared by the ethics officer



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1stating the nature and substance of all oral communications,
2the identity and job title of the person to whom each
3communication was made, all responses made, the identity and
4job title of the person making each response, the identity of
5each person from whom the written or oral ex parte
6communication was received, the individual or entity
7represented by that person, any action the person requested or
8recommended, and any other pertinent information. The
9disclosure shall also contain the date of any ex parte
11    (d) "Interested party" means a person or entity whose
12rights, privileges, or interests are the subject of or are
13directly affected by a regulatory, quasi-adjudicatory,
14investment, or licensing matter.
15    (e) This Section applies to the following agencies:
16Executive Ethics Commission
17Illinois Commerce Commission
18Educational Labor Relations Board
19State Board of Elections
20Illinois Gaming Board
21Health Facilities and Services Review Board 
22Illinois Workers' Compensation Commission
23Illinois Labor Relations Board
24Illinois Liquor Control Commission
25Pollution Control Board
26Property Tax Appeal Board



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1Illinois Racing Board
2Illinois Purchased Care Review Board
3Department of State Police Merit Board
4Motor Vehicle Review Board
5Prisoner Review Board
6Civil Service Commission
7Personnel Review Board for the Treasurer
8Merit Commission for the Secretary of State
9Merit Commission for the Office of the Comptroller
10Court of Claims
11Board of Review of the Department of Employment Security
12Department of Insurance
13Department of Professional Regulation and licensing boards
14  under the Department
15Department of Public Health and licensing boards under the
16  Department
17Office of Banks and Real Estate and licensing boards under
18  the Office
19State Employees Retirement System Board of Trustees
20Judges Retirement System Board of Trustees
21General Assembly Retirement System Board of Trustees
22Illinois Board of Investment
23State Universities Retirement System Board of Trustees
24Teachers Retirement System Officers Board of Trustees
25    (f) Any person who fails to (i) report an ex parte
26communication to an ethics officer, (ii) make information part



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1of the record, or (iii) make a filing with the Executive Ethics
2Commission as required by this Section or as required by
3Section 5-165 of the Illinois Administrative Procedure Act
4violates this Act.
5(Source: P.A. 95-331, eff. 8-21-07; 96-31, eff. 6-30-09.)
6    Section 15. The Department of Public Health Powers and
7Duties Law of the Civil Administrative Code of Illinois is
8amended by changing Section 2310-217 as follows:
9    (20 ILCS 2310/2310-217)
10    Sec. 2310-217. Center for Comprehensive Health Planning.
11    (a) The Center for Comprehensive Health Planning
12("Center") is hereby created to promote the distribution of
13health care services and improve the healthcare delivery system
14in Illinois by establishing a statewide Comprehensive Health
15Plan and ensuring a predictable, transparent, and efficient
16Certificate of Need process under the Illinois Health
17Facilities Planning Act. The objectives of the Comprehensive
18Health Plan include: to assess existing community resources and
19determine health care needs; to support safety net services for
20uninsured and underinsured residents; to promote adequate
21financing for health care services; and to recognize and
22respond to changes in community health care needs, including
23public health emergencies and natural disasters. The Center
24shall comprehensively assess health and mental health



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1services; assess health needs with a special focus on the
2identification of health disparities; identify State-level and
3regional needs; and make findings that identify the impact of
4market forces on the access to high quality services for
5uninsured and underinsured residents. The Center shall conduct
6a biennial comprehensive assessment of health resources and
7service needs, including, but not limited to, facilities,
8clinical services, and workforce; conduct needs assessments
9using key indicators of population health status and
10determinations of potential benefits that could occur with
11certain changes in the health care delivery system; collect and
12analyze relevant, objective, and accurate data, including
13health care utilization data; identify issues related to health
14care financing such as revenue streams, federal opportunities,
15better utilization of existing resources, development of
16resources, and incentives for new resource development;
17evaluate findings by the needs assessments; and annually report
18to the General Assembly and the public.
19    The Illinois Department of Public Health shall establish a
20Center for Comprehensive Health Planning to develop a
21long-range Comprehensive Health Plan, which Plan shall guide
22the development of clinical services, facilities, and
23workforce that meet the health and mental health care needs of
24this State.
25    (b) Center for Comprehensive Health Planning.
26        (1) Responsibilities and duties of the Center include:



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1            (A) (blank); providing technical assistance to the
2        Health Facilities and Services Review Board to permit
3        that Board to apply relevant components of the
4        Comprehensive Health Plan in its deliberations;
5            (B) attempting to identify unmet health needs and
6        assist in any inter-agency State planning for health
7        resource development;
8            (C) considering health plans and other related
9        publications that have been developed in Illinois and
10        nationally;
11            (D) establishing priorities and recommend methods
12        for meeting identified health service, facilities, and
13        workforce needs. Plan recommendations shall be
14        short-term, mid-term, and long-range;
15            (E) conducting an analysis regarding the
16        availability of long-term care resources throughout
17        the State, using data and plans developed under the
18        Illinois Older Adult Services Act, to adjust existing
19        bed need criteria and standards under the Health
20        Facilities Planning Act for changes in utilization of
21        institutional and non-institutional care options, with
22        special consideration of the availability of the
23        least-restrictive options in accordance with the needs
24        and preferences of persons requiring long-term care;
25        and
26            (F) considering and recognizing health resource



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1        development projects or information on methods by
2        which a community may receive benefit, that are
3        consistent with health resource needs identified
4        through the comprehensive health planning process.
5        (2) A Comprehensive Health Planner shall be appointed
6    by the Governor, with the advice and consent of the Senate,
7    to supervise the Center and its staff for a paid 3-year
8    term, subject to review and re-approval every 3 years. The
9    Planner shall receive an annual salary of $120,000, or an
10    amount set by the Compensation Review Board, whichever is
11    greater. The Planner shall prepare a budget for review and
12    approval by the Illinois General Assembly, which shall
13    become part of the annual report available on the
14    Department website.
15    (c) Comprehensive Health Plan.
16        (1) The Plan shall be developed with a 5 to 10 year
17    range, and updated every 2 years, or annually, if needed.
18        (2) Components of the Plan shall include:
19            (A) an inventory to map the State for growth,
20        population shifts, and utilization of available
21        healthcare resources, using both State-level and
22        regionally defined areas;
23            (B) an evaluation of health service needs,
24        addressing gaps in service, over-supply, and
25        continuity of care, including an assessment of
26        existing safety net services;



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1            (C) an inventory of health care facility
2        infrastructure, including regulated facilities and
3        services, and unregulated facilities and services, as
4        determined by the Center;
5            (D) recommendations on ensuring access to care,
6        especially for safety net services, including rural
7        and medically underserved communities; and
8            (E) an integration between health planning for
9        clinical services, facilities and workforce under the
10        Illinois Health Facilities Planning Act and other
11        health planning laws and activities of the State.
12        (3) Components of the Plan may include recommendations
13    that will be integrated into any relevant certificate of
14    need review criteria, standards, and procedures.
15    (d) Within 60 days of receiving the Comprehensive Health
16Plan, the State Board of Health shall review and comment upon
17the Plan and any policy change recommendations. The first Plan
18shall be submitted to the State Board of Health within one year
19after hiring the Comprehensive Health Planner. The Plan shall
20be submitted to the General Assembly by the following March 1.
21The Center and State Board shall hold public hearings on the
22Plan and its updates. The Center shall permit the public to
23request the Plan to be updated more frequently to address
24emerging population and demographic trends.
25    (e) Current comprehensive health planning data and
26information about Center funding shall be available to the



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1public on the Department website.
2    (f) The Department shall submit to a performance audit of
3the Center by the Auditor General in order to assess whether
4progress is being made to develop a Comprehensive Health Plan
5and whether resources are sufficient to meet the goals of the
6Center for Comprehensive Health Planning.
7(Source: P.A. 96-31, eff. 6-30-09.)
8    Section 20. The Illinois Health Facilities Planning Act is
9amended by changing Sections 2, 3, 8.5, and 19.5 and by adding
10Section 2.5 as follows:
11    (20 ILCS 3960/2)  (from Ch. 111 1/2, par. 1152)
12    (Section scheduled to be repealed on December 31, 2019)
13    Sec. 2. Purpose of the Act. This Act shall establish a
14procedure (1) which requires a person establishing,
15constructing or modifying a health care facility, as herein
16defined, to have the qualifications, background, character and
17financial resources to adequately provide a proper service for
18the community; (2) that promotes, through the process of
19comprehensive health planning, the orderly and economic
20development of health care facilities in the State of Illinois
21that avoids unnecessary duplication of such facilities; (3)
22that promotes planning for and development of health care
23facilities needed for comprehensive health care especially in
24areas where the health planning process has identified unmet



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1needs; and (4) that carries out these purposes in coordination
2with the Center for Comprehensive Health Planning and the
3Comprehensive Health Plan developed by that Center.
4    The changes made to this Act by this amendatory Act of the
596th General Assembly are intended to accomplish the following
6objectives: to improve the financial ability of the public to
7obtain necessary health services; to establish an orderly and
8comprehensive health care delivery system that will guarantee
9the availability of quality health care to the general public;
10to maintain and improve the provision of essential health care
11services and increase the accessibility of those services to
12the medically underserved and indigent; to assure that the
13reduction and closure of health care services or facilities is
14performed in an orderly and timely manner, and that these
15actions are deemed to be in the best interests of the public;
16and to assess the financial burden to patients caused by
17unnecessary health care construction and modification. The
18Health Facilities and Services Review Board must apply the
19findings from the Comprehensive Health Plan to update review
20standards and criteria, as well as better identify needs and
21evaluate applications, and establish mechanisms to support
22adequate financing of the health care delivery system in
23Illinois, for the development and preservation of safety net
24services. The Board must provide written and consistent
25decisions that are based on the findings from the Comprehensive
26Health Plan, as well as other issue or subject specific plans,



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1recommended by the Center for Comprehensive Health Planning.
2Policies and procedures must include criteria and standards for
3plan variations and deviations that must be updated.
4Evidence-based assessments, projections and decisions will be
5applied regarding capacity, quality, value and equity in the
6delivery of health care services in Illinois. The integrity of
7the Certificate of Need process is ensured through revised
8ethics and communications procedures. Cost containment and
9support for safety net services must continue to be central
10tenets of the Certificate of Need process.
11(Source: P.A. 96-31, eff. 6-30-09.)
12    (20 ILCS 3960/2.5 new)
13    Sec. 2.5. Dissolution of Health Facilities and Services
14Review Board. The Health Facilities and Services Review Board
15is hereby dissolved and the terms of its members shall cease.
16    (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
17    (Section scheduled to be repealed on December 31, 2019)
18    Sec. 3. Definitions. As used in this Act:
19    "Health care facilities" means and includes the following
20facilities and organizations:
21        1. An ambulatory surgical treatment center required to
22    be licensed pursuant to the Ambulatory Surgical Treatment
23    Center Act;
24        2. An institution, place, building, or agency required



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1    to be licensed pursuant to the Hospital Licensing Act;
2        3. Skilled and intermediate long term care facilities
3    licensed under the Nursing Home Care Act;
4        3.5. Skilled and intermediate care facilities licensed
5    under the ID/DD Community Care Act;
6        3.7. Facilities licensed under the Specialized Mental
7    Health Rehabilitation Act;
8        4. Hospitals, nursing homes, ambulatory surgical
9    treatment centers, or kidney disease treatment centers
10    maintained by the State or any department or agency
11    thereof;
12        5. Kidney disease treatment centers, including a
13    free-standing hemodialysis unit required to be licensed
14    under the End Stage Renal Disease Facility Act;
15        6. An institution, place, building, or room used for
16    the performance of outpatient surgical procedures that is
17    leased, owned, or operated by or on behalf of an
18    out-of-state facility;
19        7. An institution, place, building, or room used for
20    provision of a health care category of service as defined
21    by the Board, including, but not limited to, cardiac
22    catheterization and open heart surgery; and
23        8. An institution, place, building, or room used for
24    provision of major medical equipment used in the direct
25    clinical diagnosis or treatment of patients, and whose
26    project cost is in excess of the capital expenditure



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1    minimum.
2    This Act shall not apply to the construction of any new
3facility or the renovation of any existing facility located on
4any campus facility as defined in Section 5-5.8b of the
5Illinois Public Aid Code, provided that the campus facility
6encompasses 30 or more contiguous acres and that the new or
7renovated facility is intended for use by a licensed
8residential facility.
9    No federally owned facility shall be subject to the
10provisions of this Act, nor facilities used solely for healing
11by prayer or spiritual means.
12    No facility licensed under the Supportive Residences
13Licensing Act or the Assisted Living and Shared Housing Act
14shall be subject to the provisions of this Act.
15    No facility established and operating under the
16Alternative Health Care Delivery Act as a children's respite
17care center alternative health care model demonstration
18program or as an Alzheimer's Disease Management Center
19alternative health care model demonstration program shall be
20subject to the provisions of this Act.
21    A facility designated as a supportive living facility that
22is in good standing with the program established under Section
235-5.01a of the Illinois Public Aid Code shall not be subject to
24the provisions of this Act.
25    This Act does not apply to facilities granted waivers under
26Section 3-102.2 of the Nursing Home Care Act. However, if a



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



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1Care Act, the Specialized Mental Health Rehabilitation Act, or
2the ID/DD Community Care Act, with the exceptions of facilities
3operated by a county or Illinois Veterans Homes. Changes of
4ownership of facilities licensed under the Nursing Home Care
5Act must meet the requirements set forth in Sections 3-101
6through 3-119 of the Nursing Home Care Act.
7    With the exception of those health care facilities
8specifically included in this Section, nothing in this Act
9shall be intended to include facilities operated as a part of
10the practice of a physician or other licensed health care
11professional, whether practicing in his individual capacity or
12within the legal structure of any partnership, medical or
13professional corporation, or unincorporated medical or
14professional group. Further, this Act shall not apply to
15physicians or other licensed health care professional's
16practices where such practices are carried out in a portion of
17a health care facility under contract with such health care
18facility by a physician or by other licensed health care
19professionals, whether practicing in his individual capacity
20or within the legal structure of any partnership, medical or
21professional corporation, or unincorporated medical or
22professional groups. This Act shall apply to construction or
23modification and to establishment by such health care facility
24of such contracted portion which is subject to facility
25licensing requirements, irrespective of the party responsible
26for such action or attendant financial obligation.



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



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1Assisted Living and Shared Housing Act or (ii) a conversion
2project undertaken in accordance with Section 30 of the Older
3Adult Services Act shall be excluded from any obligations under
4this Act.
5    "Establish" means the construction of a health care
6facility or the replacement of an existing facility on another
7site or the initiation of a category of service as defined by
8the Board.
9    "Major medical equipment" means medical equipment which is
10used for the provision of medical and other health services and
11which costs in excess of the capital expenditure minimum,
12except that such term does not include medical equipment
13acquired by or on behalf of a clinical laboratory to provide
14clinical laboratory services if the clinical laboratory is
15independent of a physician's office and a hospital and it has
16been determined under Title XVIII of the Social Security Act to
17meet the requirements of paragraphs (10) and (11) of Section
181861(s) of such Act. In determining whether medical equipment
19has a value in excess of the capital expenditure minimum, the
20value of studies, surveys, designs, plans, working drawings,
21specifications, and other activities essential to the
22acquisition of such equipment shall be included.
23    "Capital Expenditure" means an expenditure: (A) made by or
24on behalf of a health care facility (as such a facility is
25defined in this Act); and (B) which under generally accepted
26accounting principles is not properly chargeable as an expense



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1of operation and maintenance, or is made to obtain by lease or
2comparable arrangement any facility or part thereof or any
3equipment for a facility or part; and which exceeds the capital
4expenditure minimum.
5    For the purpose of this paragraph, the cost of any studies,
6surveys, designs, plans, working drawings, specifications, and
7other activities essential to the acquisition, improvement,
8expansion, or replacement of any plant or equipment with
9respect to which an expenditure is made shall be included in
10determining if such expenditure exceeds the capital
11expenditures minimum. Unless otherwise interdependent, or
12submitted as one project by the applicant, components of
13construction or modification undertaken by means of a single
14construction contract or financed through the issuance of a
15single debt instrument shall not be grouped together as one
16project. Donations of equipment or facilities to a health care
17facility which if acquired directly by such facility would be
18subject to review under this Act shall be considered capital
19expenditures, and a transfer of equipment or facilities for
20less than fair market value shall be considered a capital
21expenditure for purposes of this Act if a transfer of the
22equipment or facilities at fair market value would be subject
23to review.
24    "Capital expenditure minimum" means $11,500,000 for
25projects by hospital applicants, $6,500,000 for applicants for
26projects related to skilled and intermediate care long-term



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



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



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1facilities. Affiliates of Illinois licensed health care
2facilities 100% owned by an Illinois licensed health care
3facility, its parent, or Illinois physicians licensed to
4practice medicine in all its branches shall not be considered
5out-of-state facilities. Nothing in this definition shall be
6construed to include an office or any part of an office of a
7physician licensed to practice medicine in all its branches in
8Illinois that is not required to be licensed under the
9Ambulatory Surgical Treatment Center Act.
10    "Change of ownership of a health care facility" means a
11change in the person who has ownership or control of a health
12care facility's physical plant and capital assets. A change in
13ownership is indicated by the following transactions: sale,
14transfer, acquisition, lease, change of sponsorship, or other
15means of transferring control.
16    "Related person" means any person that: (i) is at least 50%
17owned, directly or indirectly, by either the health care
18facility or a person owning, directly or indirectly, at least
1950% of the health care facility; or (ii) owns, directly or
20indirectly, at least 50% of the health care facility.
21    "Charity care" means care provided by a health care
22facility for which the provider does not expect to receive
23payment from the patient or a third-party payer.
24    "Freestanding emergency center" means a facility subject
25to licensure under Section 32.5 of the Emergency Medical
26Services (EMS) Systems Act.



SB3608- 24 -LRB097 19792 DRJ 65062 b

1(Source: P.A. 96-31, eff. 6-30-09; 96-339, eff. 7-1-10;
296-1000, eff. 7-2-10; 97-38, eff. 6-28-11; 97-277, eff. 1-1-12;
3revised 9-7-11.)
4    (20 ILCS 3960/8.5)
5    (Section scheduled to be repealed on December 31, 2019)
6    Sec. 8.5. Certificate of exemption for change of ownership
7of a health care facility; public notice and public hearing.
8    (a) Upon a finding by the Department of Public Health that
9an application for a change of ownership is complete, the
10Department of Public Health shall publish a legal notice on 3
11consecutive days in a newspaper of general circulation in the
12area or community to be affected and afford the public an
13opportunity to request a hearing. If the application is for a
14facility located in a Metropolitan Statistical Area, an
15additional legal notice shall be published in a newspaper of
16limited circulation, if one exists, in the area in which the
17facility is located. If the newspaper of limited circulation is
18published on a daily basis, the additional legal notice shall
19be published on 3 consecutive days. The legal notice shall also
20be posted on the Health Facilities and Services Review Board's
21web site and sent to the State Representative and State Senator
22of the district in which the health care facility is located.
23The Department of Public Health shall not find that an
24application for change of ownership of a hospital is complete
25without a signed certification that for a period of 2 years



SB3608- 25 -LRB097 19792 DRJ 65062 b

1after the change of ownership transaction is effective, the
2hospital will not adopt a charity care policy that is more
3restrictive than the policy in effect during the year prior to
4the transaction.
5    For the purposes of this subsection, "newspaper of limited
6circulation" means a newspaper intended to serve a particular
7or defined population of a specific geographic area within a
8Metropolitan Statistical Area such as a municipality, town,
9village, township, or community area, but does not include
10publications of professional and trade associations.
11    (b) If a public hearing is requested, it shall be held at
12least 15 days but no more than 30 days after the date of
13publication of the legal notice in the community in which the
14facility is located. The hearing shall be held in a place of
15reasonable size and accessibility and a full and complete
16written transcript of the proceedings shall be made. The
17applicant shall provide a summary of the proposed change of
18ownership for distribution at the public hearing.
19(Source: P.A. 96-31, eff. 6-30-09.)
20    (20 ILCS 3960/19.5)
21    (Section scheduled to be repealed on December 31, 2019 and
22as provided internally)
23    Sec. 19.5. Audit. The Twenty-four months after the last
24member of the 9-member Board is appointed, as required under
25this amendatory Act of the 96th General Assembly, and 36 months



SB3608- 26 -LRB097 19792 DRJ 65062 b

1thereafter, the Auditor General shall commence a performance
2audit of the Center for Comprehensive Health Planning, State
3Board, and the Certificate of Need processes to determine:
4        (1) whether progress is being made to develop a
5    Comprehensive Health Plan and whether resources are
6    sufficient to meet the goals of the Center for
7    Comprehensive Health Planning;
8        (2) whether changes to the Certificate of Need
9    processes are being implemented effectively, as well as
10    their impact, if any, on access to safety net services; and
11        (3) whether fines and settlements are fair,
12    consistent, and in proportion to the degree of violations.
13    The Auditor General must report on the results of the audit
14to the General Assembly.
15    This Section is repealed when the Auditor General files his
16or her report with the General Assembly.
17(Source: P.A. 96-31, eff. 6-30-09.)
18    Section 25. The Hospital Basic Services Preservation Act is
19amended by changing Section 15 as follows:
20    (20 ILCS 4050/15)
21    Sec. 15. Basic services loans.
22    (a) Essential community hospitals seeking
23collateralization of loans under this Act must apply to the
24Health Facilities and Services Review Board on a form



SB3608- 27 -LRB097 19792 DRJ 65062 b

1prescribed by the Health Facilities and Services Review Board
2by rule. The Health Facilities and Services Review Board shall
3review the application and, if it approves the applicant's
4plan, shall forward the application and its approval to the
5Hospital Basic Services Review Board on a form prescribed by
6the Hospital Basic Services Review Board.
7    (b) Upon receipt of the applicant's application and
8approval from the Health Facilities and Services Review Board,
9the Hospital Basic Services Review Board shall request from the
10applicant and the applicant shall submit to the Hospital Basic
11Services Review Board all of the following information:
12        (1) A copy of the hospital's last audited financial
13    statement.
14        (2) The percentage of the hospital's patients each year
15    who are Medicaid patients.
16        (3) The percentage of the hospital's patients each year
17    who are Medicare patients.
18        (4) The percentage of the hospital's patients each year
19    who are uninsured.
20        (5) The percentage of services provided by the hospital
21    each year for which the hospital expected payment but for
22    which no payment was received.
23        (6) Any other information required by the Hospital
24    Basic Services Review Board by rule.
25The Hospital Basic Services Review Board shall review the
26applicant's original application, the approval of the Health



SB3608- 28 -LRB097 19792 DRJ 65062 b

1Facilities and Services Review Board, and the information
2provided by the applicant to the Hospital Basic Services Review
3Board under this Section and make a recommendation to the State
4Treasurer to accept or deny the application.
5    (c) If the Hospital Basic Services Review Board recommends
6that the application be accepted, the State Treasurer may
7collateralize the applicant's basic service loan for eligible
8expenses related to completing, attaining, or upgrading basic
9services, including, but not limited to, delivery,
10installation, staff training, and other eligible expenses as
11defined by the State Treasurer by rule. The total cost for any
12one project to be undertaken by the applicants shall not exceed
13$10,000,000 and the amount of each basic services loan
14collateralized under this Act shall not exceed $5,000,000.
15Expenditures related to basic service loans shall not exceed
16the amount available in the Fund necessary to collateralize the
17loans. The terms of any basic services loan collateralized
18under this Act must be approved by the State Treasurer in
19accordance with standards established by the State Treasurer by
21(Source: P.A. 96-31, eff. 6-30-09.)
22    Section 30. The Illinois State Auditing Act is amended by
23changing Section 3-1 as follows:
24    (30 ILCS 5/3-1)  (from Ch. 15, par. 303-1)



SB3608- 29 -LRB097 19792 DRJ 65062 b

1    Sec. 3-1. Jurisdiction of Auditor General. The Auditor
2General has jurisdiction over all State agencies to make post
3audits and investigations authorized by or under this Act or
4the Constitution.
5    The Auditor General has jurisdiction over local government
6agencies and private agencies only:
7        (a) to make such post audits authorized by or under
8    this Act as are necessary and incidental to a post audit of
9    a State agency or of a program administered by a State
10    agency involving public funds of the State, but this
11    jurisdiction does not include any authority to review local
12    governmental agencies in the obligation, receipt,
13    expenditure or use of public funds of the State that are
14    granted without limitation or condition imposed by law,
15    other than the general limitation that such funds be used
16    for public purposes;
17        (b) to make investigations authorized by or under this
18    Act or the Constitution; and
19        (c) to make audits of the records of local government
20    agencies to verify actual costs of state-mandated programs
21    when directed to do so by the Legislative Audit Commission
22    at the request of the State Board of Appeals under the
23    State Mandates Act.
24    In addition to the foregoing, the Auditor General may
25conduct an audit of the Metropolitan Pier and Exposition
26Authority, the Regional Transportation Authority, the Suburban



SB3608- 30 -LRB097 19792 DRJ 65062 b

1Bus Division, the Commuter Rail Division and the Chicago
2Transit Authority and any other subsidized carrier when
3authorized by the Legislative Audit Commission. Such audit may
4be a financial, management or program audit, or any combination
6    The audit shall determine whether they are operating in
7accordance with all applicable laws and regulations. Subject to
8the limitations of this Act, the Legislative Audit Commission
9may by resolution specify additional determinations to be
10included in the scope of the audit.
11    In addition to the foregoing, the Auditor General must also
12conduct a financial audit of the Illinois Sports Facilities
13Authority's expenditures of public funds in connection with the
14reconstruction, renovation, remodeling, extension, or
15improvement of all or substantially all of any existing
16"facility", as that term is defined in the Illinois Sports
17Facilities Authority Act.
18    The Auditor General may also conduct an audit, when
19authorized by the Legislative Audit Commission, of any hospital
20which receives 10% or more of its gross revenues from payments
21from the State of Illinois, Department of Healthcare and Family
22Services (formerly Department of Public Aid), Medical
23Assistance Program.
24    The Auditor General is authorized to conduct financial and
25compliance audits of the Illinois Distance Learning Foundation
26and the Illinois Conservation Foundation.



SB3608- 31 -LRB097 19792 DRJ 65062 b

1    As soon as practical after the effective date of this
2amendatory Act of 1995, the Auditor General shall conduct a
3compliance and management audit of the City of Chicago and any
4other entity with regard to the operation of Chicago O'Hare
5International Airport, Chicago Midway Airport and Merrill C.
6Meigs Field. The audit shall include, but not be limited to, an
7examination of revenues, expenses, and transfers of funds;
8purchasing and contracting policies and practices; staffing
9levels; and hiring practices and procedures. When completed,
10the audit required by this paragraph shall be distributed in
11accordance with Section 3-14.
12    The Auditor General shall conduct a financial and
13compliance and program audit of distributions from the
14Municipal Economic Development Fund during the immediately
15preceding calendar year pursuant to Section 8-403.1 of the
16Public Utilities Act at no cost to the city, village, or
17incorporated town that received the distributions.
18    The Auditor General must conduct an audit of the Health
19Facilities and Services Review Board pursuant to Section 19.5
20of the Illinois Health Facilities Planning Act.
21    The Auditor General of the State of Illinois shall annually
22conduct or cause to be conducted a financial and compliance
23audit of the books and records of any county water commission
24organized pursuant to the Water Commission Act of 1985 and
25shall file a copy of the report of that audit with the Governor
26and the Legislative Audit Commission. The filed audit shall be



SB3608- 32 -LRB097 19792 DRJ 65062 b

1open to the public for inspection. The cost of the audit shall
2be charged to the county water commission in accordance with
3Section 6z-27 of the State Finance Act. The county water
4commission shall make available to the Auditor General its
5books and records and any other documentation, whether in the
6possession of its trustees or other parties, necessary to
7conduct the audit required. These audit requirements apply only
8through July 1, 2007.
9    The Auditor General must conduct audits of the Rend Lake
10Conservancy District as provided in Section 25.5 of the River
11Conservancy Districts Act.
12    The Auditor General must conduct financial audits of the
13Southeastern Illinois Economic Development Authority as
14provided in Section 70 of the Southeastern Illinois Economic
15Development Authority Act.
16    The Auditor General shall conduct a compliance audit in
17accordance with subsections (d) and (f) of Section 30 of the
18Innovation Development and Economy Act.
19(Source: P.A. 95-331, eff. 8-21-07; 96-31, eff. 6-30-09;
2096-939, eff. 6-24-10.)
21    Section 35. The Alternative Health Care Delivery Act is
22amended by changing Sections 20 and 30 as follows:
23    (210 ILCS 3/20)
24    Sec. 20. Board responsibilities. The State Board of Health



SB3608- 33 -LRB097 19792 DRJ 65062 b

1shall have the responsibilities set forth in this Section.
2    (a) The Board shall investigate new health care delivery
3models and recommend to the Governor and the General Assembly,
4through the Department, those models that should be authorized
5as alternative health care models for which demonstration
6programs should be initiated. In its deliberations, the Board
7shall use the following criteria:
8        (1) The feasibility of operating the model in Illinois,
9    based on a review of the experience in other states
10    including the impact on health professionals of other
11    health care programs or facilities.
12        (2) The potential of the model to meet an unmet need.
13        (3) The potential of the model to reduce health care
14    costs to consumers, costs to third party payors, and
15    aggregate costs to the public.
16        (4) The potential of the model to maintain or improve
17    the standards of health care delivery in some measurable
18    fashion.
19        (5) The potential of the model to provide increased
20    choices or access for patients.
21    (b) The Board shall evaluate and make recommendations to
22the Governor and the General Assembly, through the Department,
23regarding alternative health care model demonstration programs
24established under this Act, at the midpoint and end of the
25period of operation of the demonstration programs. The report
26shall include, at a minimum, the following:



SB3608- 34 -LRB097 19792 DRJ 65062 b

1        (1) Whether the alternative health care models
2    improved access to health care for their service
3    populations in the State.
4        (2) The quality of care provided by the alternative
5    health care models as may be evidenced by health outcomes,
6    surveillance reports, and administrative actions taken by
7    the Department.
8        (3) The cost and cost effectiveness to the public,
9    third-party payors, and government of the alternative
10    health care models, including the impact of pilot programs
11    on aggregate health care costs in the area. In addition to
12    any other information collected by the Board under this
13    Section, the Board shall collect from postsurgical
14    recovery care centers uniform billing data substantially
15    the same as specified in Section 4-2(e) of the Illinois
16    Health Finance Reform Act. To facilitate its evaluation of
17    that data, the Board shall forward a copy of the data to
18    the Illinois Health Care Cost Containment Council. All
19    patient identifiers shall be removed from the data before
20    it is submitted to the Board or Council.
21        (4) The impact of the alternative health care models on
22    the health care system in that area, including changing
23    patterns of patient demand and utilization, financial
24    viability, and feasibility of operation of service in
25    inpatient and alternative models in the area.
26        (5) (Blank). The implementation by alternative health



SB3608- 35 -LRB097 19792 DRJ 65062 b

1    care models of any special commitments made during
2    application review to the Health Facilities and Services
3    Review Board.
4        (6) The continuation, expansion, or modification of
5    the alternative health care models.
6    (c) The Board shall advise the Department on the definition
7and scope of alternative health care models demonstration
9    (d) In carrying out its responsibilities under this
10Section, the Board shall seek the advice of other Department
11advisory boards or committees that may be impacted by the
12alternative health care model or the proposed model of health
13care delivery. The Board shall also seek input from other
14interested parties, which may include holding public hearings.
15    (e) The Board shall otherwise advise the Department on the
16administration of the Act as the Board deems appropriate.
17(Source: P.A. 96-31, eff. 6-30-09.)
18    (210 ILCS 3/30)
19    Sec. 30. Demonstration program requirements. The
20requirements set forth in this Section shall apply to
21demonstration programs.
22    (a) (Blank).
23    (a-5) There shall be no more than the total number of
24postsurgical recovery care centers with a certificate of need
25for beds as of January 1, 2008.



SB3608- 36 -LRB097 19792 DRJ 65062 b

1    (a-10) There shall be no more than a total of 9 children's
2respite care center alternative health care models in the
3demonstration program, which shall be located as follows:
4        (1) Two in the City of Chicago.
5        (2) One in Cook County outside the City of Chicago.
6        (3) A total of 2 in the area comprised of DuPage, Kane,
7    Lake, McHenry, and Will counties.
8        (4) A total of 2 in municipalities with a population of
9    50,000 or more and not located in the areas described in
10    paragraphs (1), (2), or (3).
11        (5) A total of 2 in rural areas, as defined by the
12    Health Facilities and Services Review Board.
13    No more than one children's respite care model owned and
14operated by a licensed skilled pediatric facility shall be
15located in each of the areas designated in this subsection
17    (a-15) There shall be 5 authorized community-based
18residential rehabilitation center alternative health care
19models in the demonstration program.
20    (a-20) There shall be an authorized Alzheimer's disease
21management center alternative health care model in the
22demonstration program. The Alzheimer's disease management
23center shall be located in Will County, owned by a
24not-for-profit entity, and endorsed by a resolution approved by
25the county board before the effective date of this amendatory
26Act of the 91st General Assembly.



SB3608- 37 -LRB097 19792 DRJ 65062 b

1    (a-25) There shall be no more than 10 birth center
2alternative health care models in the demonstration program,
3located as follows:
4        (1) Four in the area comprising Cook, DuPage, Kane,
5    Lake, McHenry, and Will counties, one of which shall be
6    owned or operated by a hospital and one of which shall be
7    owned or operated by a federally qualified health center.
8        (2) Three in municipalities with a population of 50,000
9    or more not located in the area described in paragraph (1)
10    of this subsection, one of which shall be owned or operated
11    by a hospital and one of which shall be owned or operated
12    by a federally qualified health center.
13        (3) Three in rural areas, one of which shall be owned
14    or operated by a hospital and one of which shall be owned
15    or operated by a federally qualified health center.
16    The first 3 birth centers authorized to operate by the
17Department shall be located in or predominantly serve the
18residents of a health professional shortage area as determined
19by the United States Department of Health and Human Services.
20There shall be no more than 2 birth centers authorized to
21operate in any single health planning area for obstetric
22services as determined under the Illinois Health Facilities
23Planning Act. If a birth center is located outside of a health
24professional shortage area, (i) the birth center shall be
25located in a health planning area with a demonstrated need for
26obstetrical service beds, as determined by the Health



SB3608- 38 -LRB097 19792 DRJ 65062 b

1Facilities and Services Review Board or (ii) there must be a
2reduction in the existing number of obstetrical service beds in
3the planning area so that the establishment of the birth center
4does not result in an increase in the total number of
5obstetrical service beds in the health planning area.
6    (b) (Blank). Alternative health care models, other than a
7model authorized under subsection (a-10) or (a-20), shall
8obtain a certificate of need from the Health Facilities and
9Services Review Board under the Illinois Health Facilities
10Planning Act before receiving a license by the Department. If,
11after obtaining its initial certificate of need, an alternative
12health care delivery model that is a community based
13residential rehabilitation center seeks to increase the bed
14capacity of that center, it must obtain a certificate of need
15from the Health Facilities and Services Review Board before
16increasing the bed capacity. Alternative health care models in
17medically underserved areas shall receive priority in
18obtaining a certificate of need.
19    (c) An alternative health care model license shall be
20issued for a period of one year and shall be annually renewed
21if the facility or program is in substantial compliance with
22the Department's rules adopted under this Act. A licensed
23alternative health care model that continues to be in
24substantial compliance after the conclusion of the
25demonstration program shall be eligible for annual renewals
26unless and until a different licensure program for that type of



SB3608- 39 -LRB097 19792 DRJ 65062 b

1health care model is established by legislation, except that a
2postsurgical recovery care center meeting the following
3requirements may apply within 3 years after August 25, 2009
4(the effective date of Public Act 96-669) for a Certificate of
5Need permit to operate as a hospital:
6        (1) (Blank). The postsurgical recovery care center
7    shall apply to the Illinois Health Facilities Planning
8    Board for a Certificate of Need permit to discontinue the
9    postsurgical recovery care center and to establish a
10    hospital.
11        (2) If the postsurgical recovery care center obtains a
12    Certificate of Need permit to operate as a hospital, it
13    shall apply for licensure as a hospital under the Hospital
14    Licensing Act and shall meet all statutory and regulatory
15    requirements of a hospital.
16        (3) After obtaining licensure as a hospital, any
17    license as an ambulatory surgical treatment center and any
18    license as a post-surgical recovery care center shall be
19    null and void.
20        (4) The former postsurgical recovery care center that
21    receives a hospital license must seek and use its best
22    efforts to maintain certification under Titles XVIII and
23    XIX of the federal Social Security Act.
24    The Department may issue a provisional license to any
25alternative health care model that does not substantially
26comply with the provisions of this Act and the rules adopted



SB3608- 40 -LRB097 19792 DRJ 65062 b

1under this Act if (i) the Department finds that the alternative
2health care model has undertaken changes and corrections which
3upon completion will render the alternative health care model
4in substantial compliance with this Act and rules and (ii) the
5health and safety of the patients of the alternative health
6care model will be protected during the period for which the
7provisional license is issued. The Department shall advise the
8licensee of the conditions under which the provisional license
9is issued, including the manner in which the alternative health
10care model fails to comply with the provisions of this Act and
11rules, and the time within which the changes and corrections
12necessary for the alternative health care model to
13substantially comply with this Act and rules shall be
15    (d) Alternative health care models shall seek
16certification under Titles XVIII and XIX of the federal Social
17Security Act. In addition, alternative health care models shall
18provide charitable care consistent with that provided by
19comparable health care providers in the geographic area.
20    (d-5) (Blank).
21    (e) Alternative health care models shall, to the extent
22possible, link and integrate their services with nearby health
23care facilities.
24    (f) Each alternative health care model shall implement a
25quality assurance program with measurable benefits and at
26reasonable cost.



SB3608- 41 -LRB097 19792 DRJ 65062 b

1(Source: P.A. 96-31, eff. 6-30-09; 96-129, eff. 8-4-09; 96-669,
2eff. 8-25-09; 96-812, eff. 1-1-10; 96-1000, eff. 7-2-10;
396-1071, eff. 7-16-10; 96-1123, eff. 1-1-11; 97-135, eff.
47-14-11; 97-333, eff. 8-12-11; revised 11-18-11.)
5    Section 40. The Assisted Living and Shared Housing Act is
6amended by changing Section 145 as follows:
7    (210 ILCS 9/145)
8    Sec. 145. Conversion of facilities. Entities licensed as
9facilities under the Nursing Home Care Act, the Specialized
10Mental Health Rehabilitation Act, or the ID/DD Community Care
11Act may elect to convert to a license under this Act. Any
12facility that chooses to convert, in whole or in part, shall
13follow the requirements in the Nursing Home Care Act, the
14Specialized Mental Health Rehabilitation Act, or the ID/DD
15Community Care Act, as applicable, and rules promulgated under
16those Acts regarding voluntary closure and notice to residents.
17Any conversion of existing beds licensed under the Nursing Home
18Care Act, the Specialized Mental Health Rehabilitation Act, or
19the ID/DD Community Care Act to licensure under this Act is
20exempt from review by the Health Facilities and Services Review
22(Source: P.A. 96-31, eff. 6-30-09; 96-339, eff. 7-1-10;
2396-1000, eff. 7-2-10; 97-38, eff. 6-28-11; 97-227, eff. 1-1-12;
24revised 9-28-11.)



SB3608- 42 -LRB097 19792 DRJ 65062 b

1    Section 45. The Emergency Medical Services (EMS) Systems
2Act is amended by changing Section 32.5 as follows:
3    (210 ILCS 50/32.5)
4    Sec. 32.5. Freestanding Emergency Center.
5    (a) The Department shall issue an annual Freestanding
6Emergency Center (FEC) license to any facility that has
7received a permit from the Health Facilities and Services
8Review Board to establish a Freestanding Emergency Center if
9the application for the permit has been deemed complete by the
10Department of Public Health by March 1, 2009, and:
11        (1) is located: (A) in a municipality with a population
12    of 75,000 or fewer inhabitants; (B) within 20 miles of the
13    hospital that owns or controls the FEC; and (C) within 20
14    miles of the Resource Hospital affiliated with the FEC as
15    part of the EMS System;
16        (2) is wholly owned or controlled by an Associate or
17    Resource Hospital, but is not a part of the hospital's
18    physical plant;
19        (3) meets the standards for licensed FECs, adopted by
20    rule of the Department, including, but not limited to:
21            (A) facility design, specification, operation, and
22        maintenance standards;
23            (B) equipment standards; and
24            (C) the number and qualifications of emergency



SB3608- 43 -LRB097 19792 DRJ 65062 b

1        medical personnel and other staff, which must include
2        at least one board certified emergency physician
3        present at the FEC 24 hours per day.
4        (4) limits its participation in the EMS System strictly
5    to receiving a limited number of BLS runs by emergency
6    medical vehicles according to protocols developed by the
7    Resource Hospital within the FEC's designated EMS System
8    and approved by the Project Medical Director and the
9    Department;
10        (5) provides comprehensive emergency treatment
11    services, as defined in the rules adopted by the Department
12    pursuant to the Hospital Licensing Act, 24 hours per day,
13    on an outpatient basis;
14        (6) provides an ambulance and maintains on site
15    ambulance services staffed with paramedics 24 hours per
16    day;
17        (7) (blank);
18        (8) complies with all State and federal patient rights
19    provisions, including, but not limited to, the Emergency
20    Medical Treatment Act and the federal Emergency Medical
21    Treatment and Active Labor Act;
22        (9) maintains a communications system that is fully
23    integrated with its Resource Hospital within the FEC's
24    designated EMS System;
25        (10) reports to the Department any patient transfers
26    from the FEC to a hospital within 48 hours of the transfer



SB3608- 44 -LRB097 19792 DRJ 65062 b

1    plus any other data determined to be relevant by the
2    Department;
3        (11) submits to the Department, on a quarterly basis,
4    the FEC's morbidity and mortality rates for patients
5    treated at the FEC and other data determined to be relevant
6    by the Department;
7        (12) does not describe itself or hold itself out to the
8    general public as a full service hospital or hospital
9    emergency department in its advertising or marketing
10    activities;
11        (13) complies with any other rules adopted by the
12    Department under this Act that relate to FECs;
13        (14) passes the Department's site inspection for
14    compliance with the FEC requirements of this Act;
15        (15) (blank) submits a copy of the permit issued by the
16    Health Facilities and Services Review Board indicating
17    that the facility has complied with the Illinois Health
18    Facilities Planning Act with respect to the health services
19    to be provided at the facility;
20        (16) submits an application for designation as an FEC
21    in a manner and form prescribed by the Department by rule;
22    and
23        (17) pays the annual license fee as determined by the
24    Department by rule.
25    (a-5) Notwithstanding any other provision of this Section,
26the Department may issue an annual FEC license to a facility



SB3608- 45 -LRB097 19792 DRJ 65062 b

1that is located in a county that does not have a licensed
2general acute care hospital if the facility's application for a
3permit from the Illinois Health Facilities Planning Board has
4been deemed complete by the Department of Public Health by
5March 1, 2009 and if the facility complies with the
6requirements set forth in paragraphs (1) through (17) of
7subsection (a).
8    (a-10) Notwithstanding any other provision of this
9Section, the Department may issue an annual FEC license to a
10facility if the facility has, by March 31, 2009, filed a letter
11of intent to establish an FEC and if the facility complies with
12the requirements set forth in paragraphs (1) through (17) of
13subsection (a).
14    (b) The Department shall:
15        (1) annually inspect facilities of initial FEC
16    applicants and licensed FECs, and issue annual licenses to
17    or annually relicense FECs that satisfy the Department's
18    licensure requirements as set forth in subsection (a);
19        (2) suspend, revoke, refuse to issue, or refuse to
20    renew the license of any FEC, after notice and an
21    opportunity for a hearing, when the Department finds that
22    the FEC has failed to comply with the standards and
23    requirements of the Act or rules adopted by the Department
24    under the Act;
25        (3) issue an Emergency Suspension Order for any FEC
26    when the Director or his or her designee has determined



SB3608- 46 -LRB097 19792 DRJ 65062 b

1    that the continued operation of the FEC poses an immediate
2    and serious danger to the public health, safety, and
3    welfare. An opportunity for a hearing shall be promptly
4    initiated after an Emergency Suspension Order has been
5    issued; and
6        (4) adopt rules as needed to implement this Section.
7(Source: P.A. 96-23, eff. 6-30-09; 96-31, eff. 6-30-09; 96-883,
8eff. 3-1-10; 96-1000, eff. 7-2-10; 97-333, eff. 8-12-11.)
9    Section 50. The Health Care Worker Self-Referral Act is
10amended by changing Sections 5, 15, and 20 as follows:
11    (225 ILCS 47/5)
12    Sec. 5. Legislative intent. The General Assembly
13recognizes that patient referrals by health care workers for
14health services to an entity in which the referring health care
15worker has an investment interest may present a potential
16conflict of interest. The General Assembly finds that these
17referral practices may limit or completely eliminate
18competitive alternatives in the health care market. In some
19instances, these referral practices may expand and improve care
20or may make services available which were previously
21unavailable. They may also provide lower cost options to
22patients or increase competition. Generally, referral
23practices are positive occurrences. However, self-referrals
24may result in over utilization of health services, increased



SB3608- 47 -LRB097 19792 DRJ 65062 b

1overall costs of the health care systems, and may affect the
2quality of health care.
3    It is the intent of the General Assembly to provide
4guidance to health care workers regarding acceptable patient
5referrals, to prohibit patient referrals to entities providing
6health services in which the referring health care worker has
7an investment interest, and to protect the citizens of Illinois
8from unnecessary and costly health care expenditures.
9    Recognizing the need for flexibility to quickly respond to
10changes in the delivery of health services, to avoid results
11beyond the limitations on self referral provided under this Act
12and to provide minimal disruption to the appropriate delivery
13of health care, the Health Facilities and Services Review Board
14shall be exclusively and solely authorized to implement and
15interpret this Act through adopted rules.
16    The General Assembly recognizes that changes in delivery of
17health care has resulted in various methods by which health
18care workers practice their professions. It is not the intent
19of the General Assembly to limit appropriate delivery of care,
20nor force unnecessary changes in the structures created by
21workers for the health and convenience of their patients.
22(Source: P.A. 96-31, eff. 6-30-09.)
23    (225 ILCS 47/15)
24    Sec. 15. Definitions. In this Act:
25    (a) (Blank) "Board" means the Health Facilities and



SB3608- 48 -LRB097 19792 DRJ 65062 b

1Services Review Board.
2    (b) "Entity" means any individual, partnership, firm,
3corporation, or other business that provides health services
4but does not include an individual who is a health care worker
5who provides professional services to an individual.
6    (c) "Group practice" means a group of 2 or more health care
7workers legally organized as a partnership, professional
8corporation, not-for-profit corporation, faculty practice plan
9or a similar association in which:
10        (1) each health care worker who is a member or employee
11    or an independent contractor of the group provides
12    substantially the full range of services that the health
13    care worker routinely provides, including consultation,
14    diagnosis, or treatment, through the use of office space,
15    facilities, equipment, or personnel of the group;
16        (2) the services of the health care workers are
17    provided through the group, and payments received for
18    health services are treated as receipts of the group; and
19        (3) the overhead expenses and the income from the
20    practice are distributed by methods previously determined
21    by the group.
22    (d) "Health care worker" means any individual licensed
23under the laws of this State to provide health services,
24including but not limited to: dentists licensed under the
25Illinois Dental Practice Act; dental hygienists licensed under
26the Illinois Dental Practice Act; nurses and advanced practice



SB3608- 49 -LRB097 19792 DRJ 65062 b

1nurses licensed under the Nurse Practice Act; occupational
2therapists licensed under the Illinois Occupational Therapy
3Practice Act; optometrists licensed under the Illinois
4Optometric Practice Act of 1987; pharmacists licensed under the
5Pharmacy Practice Act; physical therapists licensed under the
6Illinois Physical Therapy Act; physicians licensed under the
7Medical Practice Act of 1987; physician assistants licensed
8under the Physician Assistant Practice Act of 1987; podiatrists
9licensed under the Podiatric Medical Practice Act of 1987;
10clinical psychologists licensed under the Clinical
11Psychologist Licensing Act; clinical social workers licensed
12under the Clinical Social Work and Social Work Practice Act;
13speech-language pathologists and audiologists licensed under
14the Illinois Speech-Language Pathology and Audiology Practice
15Act; or hearing instrument dispensers licensed under the
16Hearing Instrument Consumer Protection Act, or any of their
17successor Acts.
18    (e) "Health services" means health care procedures and
19services provided by or through a health care worker.
20    (f) "Immediate family member" means a health care worker's
21spouse, child, child's spouse, or a parent.
22    (g) "Investment interest" means an equity or debt security
23issued by an entity, including, without limitation, shares of
24stock in a corporation, units or other interests in a
25partnership, bonds, debentures, notes, or other equity
26interests or debt instruments except that investment interest



SB3608- 50 -LRB097 19792 DRJ 65062 b

1for purposes of Section 20 does not include interest in a
2hospital licensed under the laws of the State of Illinois.
3    (h) "Investor" means an individual or entity directly or
4indirectly owning a legal or beneficial ownership or investment
5interest, (such as through an immediate family member, trust,
6or another entity related to the investor).
7    (i) "Office practice" includes the facility or facilities
8at which a health care worker, on an ongoing basis, provides or
9supervises the provision of professional health services to
11    (j) "Referral" means any referral of a patient for health
12services, including, without limitation:
13        (1) The forwarding of a patient by one health care
14    worker to another health care worker or to an entity
15    outside the health care worker's office practice or group
16    practice that provides health services.
17        (2) The request or establishment by a health care
18    worker of a plan of care outside the health care worker's
19    office practice or group practice that includes the
20    provision of any health services.
21(Source: P.A. 95-639, eff. 10-5-07; 95-689, eff. 10-29-07;
2295-876, eff. 8-21-08; 96-31, eff. 6-30-09.)
23    (225 ILCS 47/20)
24    Sec. 20. Prohibited referrals and claims for payment.
25    (a) A health care worker shall not refer a patient for



SB3608- 51 -LRB097 19792 DRJ 65062 b

1health services to an entity outside the health care worker's
2office or group practice in which the health care worker is an
3investor, unless the health care worker directly provides
4health services within the entity and will be personally
5involved with the provision of care to the referred patient.
6    (b) A Pursuant to Board determination that the following
7exception is applicable, a health care worker may invest in and
8refer to an entity, whether or not the health care worker
9provides direct services within said entity, if there is a
10demonstrated need in the community for the entity and
11alternative financing is not available. For purposes of this
12subsection (b), "demonstrated need" in the community for the
13entity may exist if (1) there is no facility of reasonable
14quality that provides medically appropriate service, (2) use of
15existing facilities is onerous or creates too great a hardship
16for patients, or (3) the entity is formed to own or lease
17medical equipment which replaces obsolete or otherwise
18inadequate equipment in or under the control of a hospital
19located in a federally designated health manpower shortage
20area, or (4) such other standards as established, by rule, by
21the Board. "Community" shall be defined as a metropolitan area
22for a city, and a county for a rural area. In addition, the
23following provisions must be met to be exempt under this
25        (1) Individuals who are not in a position to refer
26    patients to an entity are given a bona fide opportunity to



SB3608- 52 -LRB097 19792 DRJ 65062 b

1    also invest in the entity on the same terms as those
2    offered a referring health care worker; and
3        (2) No health care worker who invests shall be required
4    or encouraged to make referrals to the entity or otherwise
5    generate business as a condition of becoming or remaining
6    an investor; and
7        (3) The entity shall market or furnish its services to
8    referring health care worker investors and other investors
9    on equal terms; and
10        (4) The entity shall not loan funds or guarantee any
11    loans for health care workers who are in a position to
12    refer to an entity; and
13        (5) The income on the health care worker's investment
14    shall be tied to the health care worker's equity in the
15    facility rather than to the volume of referrals made; and
16        (6) Any investment contract between the entity and the
17    health care worker shall not include any covenant or
18    non-competition clause that prevents a health care worker
19    from investing in other entities; and
20        (7) When making a referral, a health care worker must
21    disclose his investment interest in an entity to the
22    patient being referred to such entity. If alternative
23    facilities are reasonably available, the health care
24    worker must provide the patient with a list of alternative
25    facilities. The health care worker shall inform the patient
26    that they have the option to use an alternative facility



SB3608- 53 -LRB097 19792 DRJ 65062 b

1    other than one in which the health care worker has an
2    investment interest and the patient will not be treated
3    differently by the health care worker if the patient
4    chooses to use another entity. This shall be applicable to
5    all health care worker investors, including those who
6    provide direct care or services for their patients in
7    entities outside their office practices; and
8        (8) If a third party payor requests information with
9    regard to a health care worker's investment interest, the
10    same shall be disclosed; and
11        (9) The entity shall establish an internal utilization
12    review program to ensure that investing health care workers
13    provided appropriate or necessary utilization; and
14        (10) If a health care worker's financial interest in an
15    entity is incompatible with a referred patient's interest,
16    the health care worker shall make alternative arrangements
17    for the patient's care.
18    The Board shall make such a determination for a health care
19worker within 90 days of a completed written request. Failure
20to make such a determination within the 90 day time frame shall
21mean that no alternative is practical based upon the facts set
22forth in the completed written request.
23    (c) It shall not be a violation of this Act for a health
24care worker to refer a patient for health services to a
25publicly traded entity in which he or she has an investment
26interest provided that:



SB3608- 54 -LRB097 19792 DRJ 65062 b

1        (1) the entity is listed for trading on the New York
2    Stock Exchange or on the American Stock Exchange, or is a
3    national market system security traded under an automated
4    inter-dealer quotation system operated by the National
5    Association of Securities Dealers; and
6        (2) the entity had, at the end of the corporation's
7    most recent fiscal year, total net assets of at least
8    $30,000,000 related to the furnishing of health services;
9    and
10        (3) any investment interest obtained after the
11    effective date of this Act is traded on the exchanges
12    listed in paragraph 1 of subsection (c) of this Section
13    after the entity became a publicly traded corporation; and
14        (4) the entity markets or furnishes its services to
15    referring health care worker investors and other health
16    care workers on equal terms; and
17        (5) all stock held in such publicly traded companies,
18    including stock held in the predecessor privately held
19    company, shall be of one class without preferential
20    treatment as to status or remuneration; and
21        (6) the entity does not loan funds or guarantee any
22    loans for health care workers who are in a position to be
23    referred to an entity; and
24        (7) the income on the health care worker's investment
25    is tied to the health care worker's equity in the entity
26    rather than to the volume of referrals made; and



SB3608- 55 -LRB097 19792 DRJ 65062 b

1        (8) the investment interest does not exceed 1/2 of 1%
2    of the entity's total equity.
3    (d) Any hospital licensed under the Hospital Licensing Act
4shall not discriminate against or otherwise penalize a health
5care worker for compliance with this Act.
6    (e) Any health care worker or other entity shall not enter
7into an arrangement or scheme seeking to make referrals to
8another health care worker or entity based upon the condition
9that the health care worker or entity will make referrals with
10an intent to evade the prohibitions of this Act by inducing
11patient referrals which would be prohibited by this Section if
12the health care worker or entity made the referral directly.
13    (f) If compliance with the need and alternative investor
14criteria is not practical, the health care worker shall
15identify to the patient reasonably available alternative
16facilities. The Board shall, by rule, designate when compliance
17is "not practical".
18    (g) (Blank). Health care workers may request from the Board
19that it render an advisory opinion that a referral to an
20existing or proposed entity under specified circumstances does
21or does not violate the provisions of this Act. The Board's
22opinion shall be presumptively correct. Failure to render such
23an advisory opinion within 90 days of a completed written
24request pursuant to this Section shall create a rebuttable
25presumption that a referral described in the completed written
26request is not or will not be a violation of this Act.



SB3608- 56 -LRB097 19792 DRJ 65062 b

1    (h) Notwithstanding any provision of this Act to the
2contrary, a health care worker may refer a patient, who is a
3member of a health maintenance organization "HMO" licensed in
4this State, for health services to an entity, outside the
5health care worker's office or group practice, in which the
6health care worker is an investor, provided that any such
7referral is made pursuant to a contract with the HMO.
8Furthermore, notwithstanding any provision of this Act to the
9contrary, a health care worker may refer an enrollee of a
10"managed care community network", as defined in subsection (b)
11of Section 5-11 of the Illinois Public Aid Code, for health
12services to an entity, outside the health care worker's office
13or group practice, in which the health care worker is an
14investor, provided that any such referral is made pursuant to a
15contract with the managed care community network.
16(Source: P.A. 92-370, eff. 8-15-01.)
17    (225 ILCS 47/30 rep.)
18    (225 ILCS 47/35 rep.)
19    (225 ILCS 47/40 rep.)
20    Section 52. The Health Care Worker Self-Referral Act is
21amended by repealing Sections 30, 35, and 40.
22    Section 55. The Illinois Public Aid Code is amended by
23changing Section 5-5.02 as follows:



SB3608- 57 -LRB097 19792 DRJ 65062 b

1    (305 ILCS 5/5-5.02)  (from Ch. 23, par. 5-5.02)
2    Sec. 5-5.02. Hospital reimbursements.
3    (a) Reimbursement to Hospitals; July 1, 1992 through
4September 30, 1992. Notwithstanding any other provisions of
5this Code or the Illinois Department's Rules promulgated under
6the Illinois Administrative Procedure Act, reimbursement to
7hospitals for services provided during the period July 1, 1992
8through September 30, 1992, shall be as follows:
9        (1) For inpatient hospital services rendered, or if
10    applicable, for inpatient hospital discharges occurring,
11    on or after July 1, 1992 and on or before September 30,
12    1992, the Illinois Department shall reimburse hospitals
13    for inpatient services under the reimbursement
14    methodologies in effect for each hospital, and at the
15    inpatient payment rate calculated for each hospital, as of
16    June 30, 1992. For purposes of this paragraph,
17    "reimbursement methodologies" means all reimbursement
18    methodologies that pertain to the provision of inpatient
19    hospital services, including, but not limited to, any
20    adjustments for disproportionate share, targeted access,
21    critical care access and uncompensated care, as defined by
22    the Illinois Department on June 30, 1992.
23        (2) For the purpose of calculating the inpatient
24    payment rate for each hospital eligible to receive
25    quarterly adjustment payments for targeted access and
26    critical care, as defined by the Illinois Department on



SB3608- 58 -LRB097 19792 DRJ 65062 b

1    June 30, 1992, the adjustment payment for the period July
2    1, 1992 through September 30, 1992, shall be 25% of the
3    annual adjustment payments calculated for each eligible
4    hospital, as of June 30, 1992. The Illinois Department
5    shall determine by rule the adjustment payments for
6    targeted access and critical care beginning October 1,
7    1992.
8        (3) For the purpose of calculating the inpatient
9    payment rate for each hospital eligible to receive
10    quarterly adjustment payments for uncompensated care, as
11    defined by the Illinois Department on June 30, 1992, the
12    adjustment payment for the period August 1, 1992 through
13    September 30, 1992, shall be one-sixth of the total
14    uncompensated care adjustment payments calculated for each
15    eligible hospital for the uncompensated care rate year, as
16    defined by the Illinois Department, ending on July 31,
17    1992. The Illinois Department shall determine by rule the
18    adjustment payments for uncompensated care beginning
19    October 1, 1992.
20    (b) Inpatient payments. For inpatient services provided on
21or after October 1, 1993, in addition to rates paid for
22hospital inpatient services pursuant to the Illinois Health
23Finance Reform Act, as now or hereafter amended, or the
24Illinois Department's prospective reimbursement methodology,
25or any other methodology used by the Illinois Department for
26inpatient services, the Illinois Department shall make



SB3608- 59 -LRB097 19792 DRJ 65062 b

1adjustment payments, in an amount calculated pursuant to the
2methodology described in paragraph (c) of this Section, to
3hospitals that the Illinois Department determines satisfy any
4one of the following requirements:
5        (1) Hospitals that are described in Section 1923 of the
6    federal Social Security Act, as now or hereafter amended;
7    or
8        (2) Illinois hospitals that have a Medicaid inpatient
9    utilization rate which is at least one-half a standard
10    deviation above the mean Medicaid inpatient utilization
11    rate for all hospitals in Illinois receiving Medicaid
12    payments from the Illinois Department; or
13        (3) Illinois hospitals that on July 1, 1991 had a
14    Medicaid inpatient utilization rate, as defined in
15    paragraph (h) of this Section, that was at least the mean
16    Medicaid inpatient utilization rate for all hospitals in
17    Illinois receiving Medicaid payments from the Illinois
18    Department and which were located in a planning area with
19    one-third or fewer excess beds as determined by the Health
20    Facilities and Services Review Board, and that, as of June
21    30, 1992, were located in a federally designated Health
22    Manpower Shortage Area; or
23        (4) Illinois hospitals that:
24            (A) have a Medicaid inpatient utilization rate
25        that is at least equal to the mean Medicaid inpatient
26        utilization rate for all hospitals in Illinois



SB3608- 60 -LRB097 19792 DRJ 65062 b

1        receiving Medicaid payments from the Department; and
2            (B) also have a Medicaid obstetrical inpatient
3        utilization rate that is at least one standard
4        deviation above the mean Medicaid obstetrical
5        inpatient utilization rate for all hospitals in
6        Illinois receiving Medicaid payments from the
7        Department for obstetrical services; or
8        (5) Any children's hospital, which means a hospital
9    devoted exclusively to caring for children. A hospital
10    which includes a facility devoted exclusively to caring for
11    children shall be considered a children's hospital to the
12    degree that the hospital's Medicaid care is provided to
13    children if either (i) the facility devoted exclusively to
14    caring for children is separately licensed as a hospital by
15    a municipality prior to September 30, 1998 or (ii) the
16    hospital has been designated by the State as a Level III
17    perinatal care facility, has a Medicaid Inpatient
18    Utilization rate greater than 55% for the rate year 2003
19    disproportionate share determination, and has more than
20    10,000 qualified children days as defined by the Department
21    in rulemaking.
22    (c) Inpatient adjustment payments. The adjustment payments
23required by paragraph (b) shall be calculated based upon the
24hospital's Medicaid inpatient utilization rate as follows:
25        (1) hospitals with a Medicaid inpatient utilization
26    rate below the mean shall receive a per day adjustment



SB3608- 61 -LRB097 19792 DRJ 65062 b

1    payment equal to $25;
2        (2) hospitals with a Medicaid inpatient utilization
3    rate that is equal to or greater than the mean Medicaid
4    inpatient utilization rate but less than one standard
5    deviation above the mean Medicaid inpatient utilization
6    rate shall receive a per day adjustment payment equal to
7    the sum of $25 plus $1 for each one percent that the
8    hospital's Medicaid inpatient utilization rate exceeds the
9    mean Medicaid inpatient utilization rate;
10        (3) hospitals with a Medicaid inpatient utilization
11    rate that is equal to or greater than one standard
12    deviation above the mean Medicaid inpatient utilization
13    rate but less than 1.5 standard deviations above the mean
14    Medicaid inpatient utilization rate shall receive a per day
15    adjustment payment equal to the sum of $40 plus $7 for each
16    one percent that the hospital's Medicaid inpatient
17    utilization rate exceeds one standard deviation above the
18    mean Medicaid inpatient utilization rate; and
19        (4) hospitals with a Medicaid inpatient utilization
20    rate that is equal to or greater than 1.5 standard
21    deviations above the mean Medicaid inpatient utilization
22    rate shall receive a per day adjustment payment equal to
23    the sum of $90 plus $2 for each one percent that the
24    hospital's Medicaid inpatient utilization rate exceeds 1.5
25    standard deviations above the mean Medicaid inpatient
26    utilization rate.



SB3608- 62 -LRB097 19792 DRJ 65062 b

1    (d) Supplemental adjustment payments. In addition to the
2adjustment payments described in paragraph (c), hospitals as
3defined in clauses (1) through (5) of paragraph (b), excluding
4county hospitals (as defined in subsection (c) of Section 15-1
5of this Code) and a hospital organized under the University of
6Illinois Hospital Act, shall be paid supplemental inpatient
7adjustment payments of $60 per day. For purposes of Title XIX
8of the federal Social Security Act, these supplemental
9adjustment payments shall not be classified as adjustment
10payments to disproportionate share hospitals.
11    (e) The inpatient adjustment payments described in
12paragraphs (c) and (d) shall be increased on October 1, 1993
13and annually thereafter by a percentage equal to the lesser of
14(i) the increase in the DRI hospital cost index for the most
15recent 12 month period for which data are available, or (ii)
16the percentage increase in the statewide average hospital
17payment rate over the previous year's statewide average
18hospital payment rate. The sum of the inpatient adjustment
19payments under paragraphs (c) and (d) to a hospital, other than
20a county hospital (as defined in subsection (c) of Section 15-1
21of this Code) or a hospital organized under the University of
22Illinois Hospital Act, however, shall not exceed $275 per day;
23that limit shall be increased on October 1, 1993 and annually
24thereafter by a percentage equal to the lesser of (i) the
25increase in the DRI hospital cost index for the most recent
2612-month period for which data are available or (ii) the



SB3608- 63 -LRB097 19792 DRJ 65062 b

1percentage increase in the statewide average hospital payment
2rate over the previous year's statewide average hospital
3payment rate.
4    (f) Children's hospital inpatient adjustment payments. For
5children's hospitals, as defined in clause (5) of paragraph
6(b), the adjustment payments required pursuant to paragraphs
7(c) and (d) shall be multiplied by 2.0.
8    (g) County hospital inpatient adjustment payments. For
9county hospitals, as defined in subsection (c) of Section 15-1
10of this Code, there shall be an adjustment payment as
11determined by rules issued by the Illinois Department.
12    (h) For the purposes of this Section the following terms
13shall be defined as follows:
14        (1) "Medicaid inpatient utilization rate" means a
15    fraction, the numerator of which is the number of a
16    hospital's inpatient days provided in a given 12-month
17    period to patients who, for such days, were eligible for
18    Medicaid under Title XIX of the federal Social Security
19    Act, and the denominator of which is the total number of
20    the hospital's inpatient days in that same period.
21        (2) "Mean Medicaid inpatient utilization rate" means
22    the total number of Medicaid inpatient days provided by all
23    Illinois Medicaid-participating hospitals divided by the
24    total number of inpatient days provided by those same
25    hospitals.
26        (3) "Medicaid obstetrical inpatient utilization rate"



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1    means the ratio of Medicaid obstetrical inpatient days to
2    total Medicaid inpatient days for all Illinois hospitals
3    receiving Medicaid payments from the Illinois Department.
4    (i) Inpatient adjustment payment limit. In order to meet
5the limits of Public Law 102-234 and Public Law 103-66, the
6Illinois Department shall by rule adjust disproportionate
7share adjustment payments.
8    (j) University of Illinois Hospital inpatient adjustment
9payments. For hospitals organized under the University of
10Illinois Hospital Act, there shall be an adjustment payment as
11determined by rules adopted by the Illinois Department.
12    (k) The Illinois Department may by rule establish criteria
13for and develop methodologies for adjustment payments to
14hospitals participating under this Article.
15(Source: P.A. 96-31, eff. 6-30-09.)
16    Section 60. The Older Adult Services Act is amended by
17changing Sections 20, 25, and 30 as follows:
18    (320 ILCS 42/20)
19    Sec. 20. Priority service areas; service expansion.
20    (a) The requirements of this Section are subject to the
21availability of funding.
22    (b) The Department, subject to appropriation, shall expand
23older adult services that promote independence and permit older
24adults to remain in their own homes and communities. Priority



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1shall be given to both the expansion of services and the
2development of new services in priority service areas.
3    (c) Inventory of services. The Department shall develop and
4maintain an inventory and assessment of (i) the types and
5quantities of public older adult services and, to the extent
6possible, privately provided older adult services, including
7the unduplicated count, location, and characteristics of
8individuals served by each facility, program, or service and
9(ii) the resources supporting those services, no later than
10July 1, 2012. The Department shall investigate the cost of
11compliance with this provision and report these findings to the
12appropriation committees of both chambers assigned to hear the
13agency's budget no later than January 1, 2012. If the
14Department determines that compliance is cost prohibitive, it
15shall recommend action in the alternative to achieve the intent
16of this Section and identify priority service areas for the
17purpose of directing the allocation of new resources and the
18reallocation of existing resources to areas of greatest need.
19    (d) Priority service areas. The Departments shall assess
20the current and projected need for older adult services
21throughout the State, analyze the results of the inventory, and
22identify priority service areas, which shall serve as the basis
23for a priority service plan to be filed with the Governor and
24the General Assembly no later than July 1, 2006, and every 5
25years thereafter. The January 1, 2012 report required under
26subsection (c) of this Section shall serve as compliance with



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1the July 1, 2011 reporting requirement.
2    (e) Moneys appropriated by the General Assembly for the
3purpose of this Section, receipts from transfers, donations,
4grants, fees, or taxes that may accrue from any public or
5private sources to the Department for the purpose of providing
6services and care to older adults, and savings attributable to
7the nursing home conversion program as calculated in subsection
8(h) shall be deposited into the Department on Aging State
9Projects Fund. Interest earned by those moneys in the Fund
10shall be credited to the Fund.
11    (f) Moneys described in subsection (e) from the Department
12on Aging State Projects Fund shall be used for older adult
13services, regardless of where the older adult receives the
14service, with priority given to both the expansion of services
15and the development of new services in priority service areas.
16Fundable services shall include:
17        (1) Housing, health services, and supportive services:
18            (A) adult day care;
19            (B) adult day care for persons with Alzheimer's
20        disease and related disorders;
21            (C) activities of daily living;
22            (D) care-related supplies and equipment;
23            (E) case management;
24            (F) community reintegration;
25            (G) companion;
26            (H) congregate meals;



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1            (I) counseling and education;
2            (J) elder abuse prevention and intervention;
3            (K) emergency response and monitoring;
4            (L) environmental modifications;
5            (M) family caregiver support;
6            (N) financial;
7            (O) home delivered meals;
8            (P) homemaker;
9            (Q) home health;
10            (R) hospice;
11            (S) laundry;
12            (T) long-term care ombudsman;
13            (U) medication reminders;
14            (V) money management;
15            (W) nutrition services;
16            (X) personal care;
17            (Y) respite care;
18            (Z) residential care;
19            (AA) senior benefits outreach;
20            (BB) senior centers;
21            (CC) services provided under the Assisted Living
22        and Shared Housing Act, or sheltered care services that
23        meet the requirements of the Assisted Living and Shared
24        Housing Act, or services provided under Section
25        5-5.01a of the Illinois Public Aid Code (the Supportive
26        Living Facilities Program);



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1            (DD) telemedicine devices to monitor recipients in
2        their own homes as an alternative to hospital care,
3        nursing home care, or home visits;
4            (EE) training for direct family caregivers;
5            (FF) transition;
6            (GG) transportation;
7            (HH) wellness and fitness programs; and
8            (II) other programs designed to assist older
9        adults in Illinois to remain independent and receive
10        services in the most integrated residential setting
11        possible for that person.
12        (2) Older Adult Services Demonstration Grants,
13    pursuant to subsection (g) of this Section.
14    (g) Older Adult Services Demonstration Grants. The
15Department may establish a program of demonstration grants to
16assist in the restructuring of the delivery system for older
17adult services and provide funding for innovative service
18delivery models and system change and integration initiatives.
19The Department shall prescribe, by rule, the grant application
20process. At a minimum, every application must include:
21        (1) The type of grant sought;
22        (2) A description of the project;
23        (3) The objective of the project;
24        (4) The likelihood of the project meeting identified
25    needs;
26        (5) The plan for financing, administration, and



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1    evaluation of the project;
2        (6) The timetable for implementation;
3        (7) The roles and capabilities of responsible
4    individuals and organizations;
5        (8) Documentation of collaboration with other service
6    providers, local community government leaders, and other
7    stakeholders, other providers, and any other stakeholders
8    in the community;
9        (9) Documentation of community support for the
10    project, including support by other service providers,
11    local community government leaders, and other
12    stakeholders;
13        (10) The total budget for the project;
14        (11) The financial condition of the applicant; and
15        (12) Any other application requirements that may be
16    established by the Department by rule.
17    Each project may include provisions for a designated staff
18person who is responsible for the development of the project
19and recruitment of providers.
20    Projects may include, but are not limited to: adult family
21foster care; family adult day care; assisted living in a
22supervised apartment; personal services in a subsidized
23housing project; training for caregivers; specialized assisted
24living units; evening and weekend home care coverage; small
25incentive grants to attract new providers; money following the
26person; cash and counseling; managed long-term care; and



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1respite care projects that establish a local coordinated
2network of volunteer and paid respite workers, coordinate
3assignment of respite workers to caregivers and older adults,
4ensure the health and safety of the older adult, provide
5training for caregivers, and ensure that support groups are
6available in the community.
7    A demonstration project funded in whole or in part by an
8Older Adult Services Demonstration Grant is exempt from the
9requirements of the Illinois Health Facilities Planning Act. To
10the extent applicable, however, for the purpose of maintaining
11the statewide inventory authorized by the Illinois Health
12Facilities Planning Act, the Department shall send to the
13Health Facilities and Services Review Board a copy of each
14grant award made under this subsection (g).
15    The Department, in collaboration with the Departments of
16Public Health and Healthcare and Family Services, shall
17evaluate the effectiveness of the projects receiving grants
18under this Section.
19    (h) No later than July 1 of each year, the Department of
20Public Health shall provide information to the Department of
21Healthcare and Family Services to enable the Department of
22Healthcare and Family Services to annually document and verify
23the savings attributable to the nursing home conversion program
24for the previous fiscal year to estimate an annual amount of
25such savings that may be appropriated to the Department on
26Aging State Projects Fund and notify the General Assembly, the



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1Department on Aging, the Department of Human Services, and the
2Advisory Committee of the savings no later than October 1 of
3the same fiscal year.
4(Source: P.A. 96-31, eff. 6-30-09; 97-448, eff. 8-19-11.)
5    (320 ILCS 42/25)
6    Sec. 25. Older adult services restructuring. No later than
7January 1, 2005, the Department shall commence the process of
8restructuring the older adult services delivery system.
9Priority shall be given to both the expansion of services and
10the development of new services in priority service areas.
11Subject to the availability of funding, the restructuring shall
12include, but not be limited to, the following:
13    (1) Planning. The Department on Aging and the Departments
14of Public Health and Healthcare and Family Services shall
15develop a plan to restructure the State's service delivery
16system for older adults pursuant to this Act no later than
17September 30, 2010. The plan shall include a schedule for the
18implementation of the initiatives outlined in this Act and all
19other initiatives identified by the participating agencies to
20fulfill the purposes of this Act and shall protect the rights
21of all older Illinoisans to services based on their health
22circumstances and functioning level, regardless of whether
23they receive their care in their homes, in a community setting,
24or in a residential facility. Financing for older adult
25services shall be based on the principle that "money follows



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1the individual" taking into account individual preference, but
2shall not jeopardize the health, safety, or level of care of
3nursing home residents. The plan shall also identify potential
4impediments to delivery system restructuring and include any
5known regulatory or statutory barriers.
6    (2) Comprehensive case management. The Department shall
7implement a statewide system of holistic comprehensive case
8management. The system shall include the identification and
9implementation of a universal, comprehensive assessment tool
10to be used statewide to determine the level of functional,
11cognitive, socialization, and financial needs of older adults.
12This tool shall be supported by an electronic intake,
13assessment, and care planning system linked to a central
14location. "Comprehensive case management" includes services
15and coordination such as (i) comprehensive assessment of the
16older adult (including the physical, functional, cognitive,
17psycho-social, and social needs of the individual); (ii)
18development and implementation of a service plan with the older
19adult to mobilize the formal and family resources and services
20identified in the assessment to meet the needs of the older
21adult, including coordination of the resources and services
22with any other plans that exist for various formal services,
23such as hospital discharge plans, and with the information and
24assistance services; (iii) coordination and monitoring of
25formal and family service delivery, including coordination and
26monitoring to ensure that services specified in the plan are



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1being provided; (iv) periodic reassessment and revision of the
2status of the older adult with the older adult or, if
3necessary, the older adult's designated representative; and
4(v) in accordance with the wishes of the older adult, advocacy
5on behalf of the older adult for needed services or resources.
6    (3) Coordinated point of entry. The Department shall
7implement and publicize a statewide coordinated point of entry
8using a uniform name, identity, logo, and toll-free number.
9    (4) Public web site. The Department shall develop a public
10web site that provides links to available services, resources,
11and reference materials concerning caregiving, diseases, and
12best practices for use by professionals, older adults, and
13family caregivers.
14    (5) Expansion of older adult services. The Department shall
15expand older adult services that promote independence and
16permit older adults to remain in their own homes and
18    (6) Consumer-directed home and community-based services.
19The Department shall expand the range of service options
20available to permit older adults to exercise maximum choice and
21control over their care.
22    (7) Comprehensive delivery system. The Department shall
23expand opportunities for older adults to receive services in
24systems that integrate acute and chronic care.
25    (8) Enhanced transition and follow-up services. The
26Department shall implement a program of transition from one



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1residential setting to another and follow-up services,
2regardless of residential setting, pursuant to rules with
3respect to (i) resident eligibility, (ii) assessment of the
4resident's health, cognitive, social, and financial needs,
5(iii) development of transition plans, and (iv) the level of
6services that must be available before transitioning a resident
7from one setting to another.
8    (9) Family caregiver support. The Department shall develop
9strategies for public and private financing of services that
10supplement and support family caregivers.
11    (10) Quality standards and quality improvement. The
12Department shall establish a core set of uniform quality
13standards for all providers that focus on outcomes and take
14into consideration consumer choice and satisfaction, and the
15Department shall require each provider to implement a
16continuous quality improvement process to address consumer
17issues. The continuous quality improvement process must
18benchmark performance, be person-centered and data-driven, and
19focus on consumer satisfaction.
20    (11) Workforce. The Department shall develop strategies to
21attract and retain a qualified and stable worker pool, provide
22living wages and benefits, and create a work environment that
23is conducive to long-term employment and career development.
24Resources such as grants, education, and promotion of career
25opportunities may be used.
26    (12) Coordination of services. The Department shall



SB3608- 75 -LRB097 19792 DRJ 65062 b

1identify methods to better coordinate service networks to
2maximize resources and minimize duplication of services and
3ease of application.
4    (13) Barriers to services. The Department shall identify
5barriers to the provision, availability, and accessibility of
6services and shall implement a plan to address those barriers.
7The plan shall: (i) identify barriers, including but not
8limited to, statutory and regulatory complexity, reimbursement
9issues, payment issues, and labor force issues; (ii) recommend
10changes to State or federal laws or administrative rules or
11regulations; (iii) recommend application for federal waivers
12to improve efficiency and reduce cost and paperwork; (iv)
13develop innovative service delivery models; and (v) recommend
14application for federal or private service grants.
15    (14) Reimbursement and funding. The Department shall
16investigate and evaluate costs and payments by defining costs
17to implement a uniform, audited provider cost reporting system
18to be considered by all Departments in establishing payments.
19To the extent possible, multiple cost reporting mandates shall
20not be imposed.
21    (15) Medicaid nursing home cost containment and Medicare
22utilization. The Department of Healthcare and Family Services
23(formerly Department of Public Aid), in collaboration with the
24Department on Aging and the Department of Public Health and in
25consultation with the Advisory Committee, shall propose a plan
26to contain Medicaid nursing home costs and maximize Medicare



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1utilization. The plan must not impair the ability of an older
2adult to choose among available services. The plan shall
3include, but not be limited to, (i) techniques to maximize the
4use of the most cost-effective services without sacrificing
5quality and (ii) methods to identify and serve older adults in
6need of minimal services to remain independent, but who are
7likely to develop a need for more extensive services in the
8absence of those minimal services.
9    (16) Bed reduction. The Department of Public Health shall
10implement a nursing home conversion program to reduce the
11number of Medicaid-certified nursing home beds in areas with
12excess beds. The Department of Healthcare and Family Services
13shall investigate changes to the Medicaid nursing facility
14reimbursement system in order to reduce beds. Such changes may
15include, but are not limited to, incentive payments that will
16enable facilities to adjust to the restructuring and expansion
17of services required by the Older Adult Services Act, including
18adjustments for the voluntary closure or layaway of nursing
19home beds certified under Title XIX of the federal Social
20Security Act. Any savings shall be reallocated to fund
21home-based or community-based older adult services pursuant to
22Section 20.
23    (17) Financing. The Department shall investigate and
24evaluate financing options for older adult services and shall
25make recommendations in the report required by Section 15
26concerning the feasibility of these financing arrangements.



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1These arrangements shall include, but are not limited to:
2        (A) private long-term care insurance coverage for
3    older adult services;
4        (B) enhancement of federal long-term care financing
5    initiatives;
6        (C) employer benefit programs such as medical savings
7    accounts for long-term care;
8        (D) individual and family cost-sharing options;
9        (E) strategies to reduce reliance on government
10    programs;
11        (F) fraudulent asset divestiture and financial
12    planning prevention; and
13        (G) methods to supplement and support family and
14    community caregiving.
15    (18) Older Adult Services Demonstration Grants. The
16Department shall implement a program of demonstration grants
17that will assist in the restructuring of the older adult
18services delivery system, and shall provide funding for
19innovative service delivery models and system change and
20integration initiatives pursuant to subsection (g) of Section
22    (19) (Blank). Bed need methodology update. For the purposes
23of determining areas with excess beds, the Departments shall
24provide information and assistance to the Health Facilities and
25Services Review Board to update the Bed Need Methodology for
26Long-Term Care to update the assumptions used to establish the



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1methodology to make them consistent with modern older adult
3    (20) Affordable housing. The Departments shall utilize the
4recommendations of Illinois' Annual Comprehensive Housing
5Plan, as developed by the Affordable Housing Task Force through
6the Governor's Executive Order 2003-18, in their efforts to
7address the affordable housing needs of older adults.
8    The Older Adult Services Advisory Committee shall
9investigate innovative and promising practices operating as
10demonstration or pilot projects in Illinois and in other
11states. The Department on Aging shall provide the Older Adult
12Services Advisory Committee with a list of all demonstration or
13pilot projects funded by the Department on Aging, including
14those specified by rule, law, policy memorandum, or funding
15arrangement. The Committee shall work with the Department on
16Aging to evaluate the viability of expanding these programs
17into other areas of the State.
18(Source: P.A. 96-31, eff. 6-30-09; 96-248, eff. 8-11-09;
1996-1000, eff. 7-2-10.)
20    (320 ILCS 42/30)
21    Sec. 30. Nursing home conversion program.
22    (a) The Department of Public Health, in collaboration with
23the Department on Aging and the Department of Healthcare and
24Family Services, shall establish a nursing home conversion
25program. Start-up grants, pursuant to subsections (l) and (m)



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1of this Section, shall be made available to nursing homes as
2appropriations permit as an incentive to reduce certified beds,
3retrofit, and retool operations to meet new service delivery
4expectations and demands.
5    (b) Grant moneys shall be made available for capital and
6other costs related to: (1) the conversion of all or a part of
7a nursing home to an assisted living establishment or a special
8program or unit for persons with Alzheimer's disease or related
9disorders licensed under the Assisted Living and Shared Housing
10Act or a supportive living facility established under Section
115-5.01a of the Illinois Public Aid Code; (2) the conversion of
12multi-resident bedrooms in the facility into single-occupancy
13rooms; and (3) the development of any of the services
14identified in a priority service plan that can be provided by a
15nursing home within the confines of a nursing home or
16transportation services. Grantees shall be required to provide
17a minimum of a 20% match toward the total cost of the project.
18    (c) Nothing in this Act shall prohibit the co-location of
19services or the development of multifunctional centers under
20subsection (f) of Section 20, including a nursing home offering
21community-based services or a community provider establishing
22a residential facility.
23    (d) A certified nursing home with at least 50% of its
24resident population having their care paid for by the Medicaid
25program is eligible to apply for a grant under this Section.
26    (e) Any nursing home receiving a grant under this Section



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1shall reduce the number of certified nursing home beds by a
2number equal to or greater than the number of beds being
3converted for one or more of the permitted uses under item (1)
4or (2) of subsection (b). The nursing home shall retain the
5Certificate of Need for its nursing and sheltered care beds
6that were converted for 15 years. If the beds are reinstated by
7the provider or its successor in interest, the provider shall
8pay to the fund from which the grant was awarded, on an
9amortized basis, the amount of the grant. The Department shall
10establish, by rule, the bed reduction methodology for nursing
11homes that receive a grant pursuant to item (3) of subsection
13    (f) Any nursing home receiving a grant under this Section
14shall agree that, for a minimum of 10 years after the date that
15the grant is awarded, a minimum of 50% of the nursing home's
16resident population shall have their care paid for by the
17Medicaid program. If the nursing home provider or its successor
18in interest ceases to comply with the requirement set forth in
19this subsection, the provider shall pay to the fund from which
20the grant was awarded, on an amortized basis, the amount of the
22    (g) Before awarding grants, the Department of Public Health
23shall seek recommendations from the Department on Aging and the
24Department of Healthcare and Family Services. The Department of
25Public Health shall attempt to balance the distribution of
26grants among geographic regions, and among small and large



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1nursing homes. The Department of Public Health shall develop,
2by rule, the criteria for the award of grants based upon the
3following factors:
4        (1) the unique needs of older adults (including those
5    with moderate and low incomes), caregivers, and providers
6    in the geographic area of the State the grantee seeks to
7    serve;
8        (2) whether the grantee proposes to provide services in
9    a priority service area;
10        (3) the extent to which the conversion or transition
11    will result in the reduction of certified nursing home beds
12    in an area with excess beds;
13        (4) the compliance history of the nursing home; and
14        (5) any other relevant factors identified by the
15    Department, including standards of need.
16    (h) A conversion funded in whole or in part by a grant
17under this Section must not:
18        (1) diminish or reduce the quality of services
19    available to nursing home residents;
20        (2) force any nursing home resident to involuntarily
21    accept home-based or community-based services instead of
22    nursing home services;
23        (3) diminish or reduce the supply and distribution of
24    nursing home services in any community below the level of
25    need, as defined by the Department by rule; or
26        (4) cause undue hardship on any person who requires



SB3608- 82 -LRB097 19792 DRJ 65062 b

1    nursing home care.
2    (i) The Department shall prescribe, by rule, the grant
3application process. At a minimum, every application must
5        (1) the type of grant sought;
6        (2) a description of the project;
7        (3) the objective of the project;
8        (4) the likelihood of the project meeting identified
9    needs;
10        (5) the plan for financing, administration, and
11    evaluation of the project;
12        (6) the timetable for implementation;
13        (7) the roles and capabilities of responsible
14    individuals and organizations;
15        (8) documentation of collaboration with other service
16    providers, local community government leaders, and other
17    stakeholders, other providers, and any other stakeholders
18    in the community;
19        (9) documentation of community support for the
20    project, including support by other service providers,
21    local community government leaders, and other
22    stakeholders;
23        (10) the total budget for the project;
24        (11) the financial condition of the applicant; and
25        (12) any other application requirements that may be
26    established by the Department by rule.



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1    (j) A conversion project funded in whole or in part by a
2grant under this Section is exempt from the requirements of the
3Illinois Health Facilities Planning Act. The Department of
4Public Health, however, shall send to the Health Facilities and
5Services Review Board a copy of each grant award made under
6this Section.
7    (k) Applications for grants are public information, except
8that nursing home financial condition and any proprietary data
9shall be classified as nonpublic data.
10    (l) The Department of Public Health may award grants from
11the Long Term Care Civil Money Penalties Fund established under
12Section 1919(h)(2)(A)(ii) of the Social Security Act and 42 CFR
13488.422(g) if the award meets federal requirements.
14    (m) The Nursing Home Conversion Fund is created as a
15special fund in the State treasury. Moneys appropriated by the
16General Assembly or transferred from other sources for the
17purposes of this Section shall be deposited into the Fund. All
18interest earned on moneys in the fund shall be credited to the
19fund. Moneys contained in the fund shall be used to support the
20purposes of this Section.
21(Source: P.A. 95-331, eff. 8-21-07; 96-31, eff. 6-30-09;
2296-758, eff. 8-25-09; 96-1000, eff. 7-2-10.)
23    (20 ILCS 3960/4 rep.)
24    (20 ILCS 3960/4.2 rep.)
25    (20 ILCS 3960/5 rep.)



SB3608- 84 -LRB097 19792 DRJ 65062 b

1    (20 ILCS 3960/5.4 rep.)
2    (20 ILCS 3960/6 rep.)
3    (20 ILCS 3960/12 rep.)
4    (20 ILCS 3960/12.2 rep.)
5    (20 ILCS 3960/12.3 rep.)
6    (20 ILCS 3960/15.1 rep.)
7    Section 90. The Illinois Health Facilities Planning Act is
8amended by repealing Sections 4, 4.2, 5, 5.4, 6, 12, 12.2,
912.3, and 15.1.
10    Section 99. Effective date. This Act takes effect July 1,



SB3608- 85 -LRB097 19792 DRJ 65062 b

2 Statutes amended in order of appearance
3    5 ILCS 120/1.02from Ch. 102, par. 41.02
4    5 ILCS 430/5-50
5    20 ILCS 2310/2310-217
6    20 ILCS 3960/2from Ch. 111 1/2, par. 1152
7    20 ILCS 3960/2.5 new
8    20 ILCS 3960/3from Ch. 111 1/2, par. 1153
9    20 ILCS 3960/8.5
10    20 ILCS 3960/19.5
11    20 ILCS 4050/15
12    30 ILCS 5/3-1from Ch. 15, par. 303-1
13    210 ILCS 3/20
14    210 ILCS 3/30
15    210 ILCS 9/145
16    210 ILCS 50/32.5
17    225 ILCS 47/5
18    225 ILCS 47/15
19    225 ILCS 47/20
20    225 ILCS 47/30 rep.
21    225 ILCS 47/35 rep.
22    225 ILCS 47/40 rep.
23    305 ILCS 5/5-5.02from Ch. 23, par. 5-5.02
24    320 ILCS 42/20
25    320 ILCS 42/25



SB3608- 86 -LRB097 19792 DRJ 65062 b

1    320 ILCS 42/30
2    20 ILCS 3960/4 rep.
3    20 ILCS 3960/4.2 rep.
4    20 ILCS 3960/5 rep.
5    20 ILCS 3960/5.4 rep.
6    20 ILCS 3960/6 rep.
7    20 ILCS 3960/12 rep.
8    20 ILCS 3960/12.2 rep.
9    20 ILCS 3960/12.3 rep.
10    20 ILCS 3960/15.1 rep.