Illinois General Assembly - Full Text of SB1332
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Full Text of SB1332  93rd General Assembly

SB1332eng 93rd General Assembly


SB1332 Engrossed                     LRB093 09788 AMC 10033 b

 1        AN ACT concerning hospitals.

 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:

 4        Section  5.   The  Hospital  Licensing  Act is amended by
 5    changing Sections 8, 8.5, 9, 9.2, and 9.3 and adding Sections
 6    9.4, 9.5, and 9.6 as follows:

 7        (210 ILCS 85/8) (from Ch. 111 1/2, par. 149)
 8        Sec. 8. Facility plan review; fees.
 9        (a)  Before commencing construction of new facilities  or
10    specified  types  of  alteration  or additions to an existing
11    hospital involving major construction, as defined by rule  by
12    the Department, with an estimated cost greater than $100,000,
13    architectural  plans  and  specifications  therefor  shall be
14    submitted by the licensee to the Department  for  review  and
15    approval.  A  hospital  may submit architectural drawings and
16    specifications for other construction projects for Department
17    review according to subsection (b) that shall not be  subject
18    to  fees  under  subsection  (d).  The Department must give a
19    hospital that is planning to submit  a  construction  project
20    for   review   the  opportunity  to  discuss  its  plans  and
21    specifications  with  the  Department  before  the   hospital
22    formally  submits the plans and specifications for Department
23    review.  Review  of  drawings  and  specifications  shall  be
24    conducted by  an  employee  of  the  Department  meeting  the
25    qualifications  established  by  the  Department  of  Central
26    Management   Services   class   specifications  for  such  an
27    individual's position or by a  person  contracting  with  the
28    Department   who  meets  those  class  specifications.  Final
29    approval of the plans and specifications for compliance  with
30    design  and construction standards shall be obtained from the
31    Department  before   the   alteration,   addition,   or   new
SB1332 Engrossed            -2-      LRB093 09788 AMC 10033 b
 1    construction is begun.
 2        (b)  The  Department shall inform an applicant in writing
 3    within  10  working  days  after   receiving   drawings   and
 4    specifications  and  the  required  fee,  if  any,  from  the
 5    applicant  whether  the applicant's submission is complete or
 6    incomplete.  Failure  to  provide  the  applicant  with  this
 7    notice  within 10 working days shall result in the submission
 8    being deemed complete for purposes of initiating  the  60-day
 9    review  period  under  this  Section.   If  the submission is
10    incomplete, the Department shall inform the applicant of  the
11    deficiencies   with   the  submission  in  writing.   If  the
12    submission is complete and the required fee, if any, has been
13    paid, the Department shall approve or disapprove drawings and
14    specifications submitted to the Department no later  than  60
15    days  following  receipt by the Department.  The drawings and
16    specifications shall be of sufficient detail, as provided  by
17    Department  rule,  to  enable  the  Department  to  render  a
18    determination  of  compliance  with  design  and construction
19    standards under this Act.  If the Department finds  that  the
20    drawings  are  not  of  sufficient  detail for it to render a
21    determination of compliance, the plans shall be determined to
22    be incomplete and shall not be  considered  for  purposes  of
23    initiating  the  60  day  review  period.  If a submission of
24    drawings and specifications is incomplete, the applicant  may
25    submit  additional  information.   The  60-day  review period
26    shall not commence until the  Department  determines  that  a
27    submission  of drawings and specifications is complete or the
28    submission is deemed complete.  If  the  Department  has  not
29    approved  or  disapproved  the  drawings  and  specifications
30    within  60  days,  the  construction,  major  alteration,  or
31    addition  shall  be  deemed  approved.   If  the drawings and
32    specifications are disapproved, the Department shall state in
33    writing, with specificity, the reasons for  the  disapproval.
34    The  entity  submitting  the  drawings and specifications may
SB1332 Engrossed            -3-      LRB093 09788 AMC 10033 b
 1    submit additional information  in  response  to  the  written
 2    comments  from the Department or request a reconsideration of
 3    the disapproval.  A final decision of approval or disapproval
 4    shall be made within 45 days of the receipt of the additional
 5    information  or  reconsideration  request.   If  denied,  the
 6    Department shall state the specific reasons  for  the  denial
 7    and  the  applicant  may  elect  to  seek  dispute resolution
 8    pursuant to Section 25 of the  Illinois  Building  Commission
 9    Act, which the Department must participate in.
10        (c)  The  Department  shall  provide written approval for
11    occupancy pursuant to subsection (g) and shall  not  issue  a
12    violation  to  a  facility  as  a  result  of  a licensure or
13    complaint survey based upon the facility's physical structure
14    if:
15             (1)  the Department reviewed and approved or  deemed
16        approved  the  drawing  and specifications for compliance
17        with design and construction standards;
18             (2)  the construction, major alteration, or addition
19        was built as submitted;
20             (3)  the law or rules have not  been  amended  since
21        the original approval; and
22             (4)  the  conditions  at  the facility indicate that
23        there is a reasonable degree of safety provided  for  the
24        patients; and
25             (5)  the  inspected  aspects  of  the  facility were
26        found to be in compliance with applicable standards,  the
27        relevant  law  or  rules  have not been amended since the
28        facility was found to be in compliance, conditions at the
29        facility reasonably protect the safety of  its  patients,
30        and new hazards have not been identified.
31        (d)  The  Department  shall  charge the following fees in
32    connection with its reviews conducted before  June  30,  2004
33    under this Section:
34             (1)  (Blank).
SB1332 Engrossed            -4-      LRB093 09788 AMC 10033 b
 1             (2)  (Blank).
 2             (3)  If  the  estimated  dollar  value  of the major
 3        construction is greater than $500,000, the fee  shall  be
 4        established  by  the  Department  pursuant  to rules that
 5        reflect the reasonable and direct cost of the  Department
 6        in  conducting  the  architectural reviews required under
 7        this Section. The estimated dollar  value  of  the  major
 8        construction  subject  to review under this Section shall
 9        be  annually  readjusted  to  reflect  the  increase   in
10        construction costs due to inflation.
11        The  fees provided in this subsection (d) shall not apply
12    to major construction  projects  involving  facility  changes
13    that  are  required  by  Department  rule  amendments  or  to
14    projects related to homeland security.
15        The  fees  provided in this subsection (d) shall also not
16    apply to major construction projects if 51% or  more  of  the
17    estimated  cost  of  the  project  is  attributed  to capital
18    equipment.  For major construction projects where 51% or more
19    of the estimated cost of the project is attributed to capital
20    equipment, the Department shall by rule establish a fee  that
21    is reasonably related to the cost of reviewing the project.
22        Disproportionate  share  hospitals  and  rural  hospitals
23    shall  only  pay  one-half  of  the  fees  required  in  this
24    subsection  (d). For the purposes of this subsection (d), (i)
25    "disproportionate share hospital" means a hospital  described
26    in  items (1) through (5) of subsection (b) of Section 5-5.02
27    of the Illinois Public Aid Code  and  (ii)  "rural  hospital"
28    means  a  hospital that is (A) located outside a metropolitan
29    statistical area or (B) located  15  miles  or  less  from  a
30    county that is outside a metropolitan statistical area and is
31    licensed  to perform medical/surgical or obstetrical services
32    and has a combined total bed capacity of 75 or fewer beds  in
33    these 2 service categories as of July 14, 1993, as determined
34    by the Department.
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 1        The  Department  shall  not  commence  the  facility plan
 2    review process under this Section until  the  applicable  fee
 3    has been paid.
 4        (e)  All  fees  received  by  the  Department  under this
 5    Section shall be deposited  into  the  Health  Facility  Plan
 6    Review  Fund,  a  special fund created in the State treasury.
 7    All fees paid by hospitals under subsection (d) shall be used
 8    only to cover the direct and reasonable costs relating to the
 9    Department's review of hospital projects under this  Section.
10    Moneys shall be appropriated from that Fund to the Department
11    only  to  pay  the  costs  of  conducting  reviews under this
12    Section. None of the  moneys  in  the  Health  Facility  Plan
13    Review  Fund  shall  be  used to reduce the amount of General
14    Revenue  Fund  moneys  appropriated  to  the  Department  for
15    facility plan reviews conducted pursuant to this Section.
16        (f) (Blank).
17        (g)  The Department shall conduct an  on-site  inspection
18    of  the  completed  project no later than 10 business 30 days
19    after notification from the applicant that  the  project  has
20    been   completed  and  all  certifications  required  by  the
21    Department have been received and accepted by the Department.
22    The Department shall provide written approval  for  occupancy
23    to  the  applicant  within 5 working days of the Department's
24    final inspection, provided  the  applicant  has  demonstrated
25    substantial   compliance   as  defined  by  Department  rule.
26    Occupancy of  new  major  construction  is  prohibited  until
27    Department  approval  is  received, unless the Department has
28    not acted within the time frames provided in this  subsection
29    (g), in which case the construction shall be deemed approved.
30    Occupancy  shall  be  authorized  after  any  required health
31    inspection by the Department has been conducted.
32        (h)  The Department shall establish, by rule, a procedure
33    to  conduct  interim  on-site  review  of  large  or  complex
34    construction projects.
SB1332 Engrossed            -6-      LRB093 09788 AMC 10033 b
 1        (i)  The  Department  shall  establish,   by   rule,   an
 2    expedited  process  for  emergency  repairs or replacement of
 3    like equipment.
 4        (j)  Nothing in this Section shall be construed to  apply
 5    to  maintenance,  upkeep,  or renovation that does not affect
 6    the structural integrity of the building, does not  add  beds
 7    or  services  over  the  number  for  which  the  facility is
 8    licensed, and provides a reasonable degree of safety for  the
 9    patients.
10    (Source:  P.A.  91-712,  eff.  7-1-00;  92-563, eff. 6-24-02;
11    92-803, eff. 8-16-02; revised 9-19-02.)

12        (210 ILCS 85/8.5)
13        Sec. 8.5. Waiver of compliance with  rules  or  standards
14    for  construction  or  physical plant.  Upon application by a
15    hospital, the Department may grant or renew the waiver of the
16    hospital's compliance with a construction or  physical  plant
17    rule  or  standard,  including  without  limitation rules and
18    standards for (i) design and construction,  (ii)  engineering
19    and  maintenance  of the physical plant, site, equipment, and
20    systems (heating, cooling, electrical, ventilation, plumbing,
21    water, sewer, and solid waste disposal), and (iii)  fire  and
22    safety,  and (iv) other rules or standards that may present a
23    barrier to the development, adoption, or implementation of an
24    innovation designed to improve patient care, for a period not
25    to exceed the duration of the current license or, in the case
26    of an application for license renewal, the  duration  of  the
27    renewal  period.  The  waiver  may  be  conditioned  upon the
28    hospital taking action prescribed  by  the  Department  as  a
29    measure  equivalent  to compliance. In determining whether to
30    grant or renew a waiver, the Department  shall  consider  the
31    duration and basis for any current waiver with respect to the
32    same  rule  or  standard  and  the  validity  and effect upon
33    patient health and safety of extending it on the same  basis,
SB1332 Engrossed            -7-      LRB093 09788 AMC 10033 b
 1    the  effect  upon  the  health  and  safety  of patients, the
 2    quality of patient care, the hospital's history of compliance
 3    with the rules and standards of this Act, and the  hospital's
 4    attempts  to  comply  with the particular rule or standard in
 5    question. The  Department  may  provide,  by  rule,  for  the
 6    automatic  renewal  of  waivers  concerning  construction  or
 7    physical  plant  requirements  upon the renewal of a license.
 8    The Department shall renew waivers relating  to  construction
 9    or  physical  plant standards issued pursuant to this Section
10    at the time of the indicated reviews, unless it can show  why
11    such  waivers  should  not  be  extended  for  the  following
12    reasons:
13             (1)  the   condition   of  the  physical  plant  has
14        deteriorated or its use substantially changed so that the
15        basis upon which the  waiver  was  issued  is  materially
16        different; or
17             (2)  the  hospital  is  renovated  or  substantially
18        remodeled  in such a way as to permit compliance with the
19        applicable  rules  and  standards   without   substantial
20        increase in cost.
21        A copy of each waiver application and each waiver granted
22    or renewed shall be on file with the Department and available
23    for public inspection.
24        The  Department  shall advise hospitals of any applicable
25    federal waivers about which it is aware  and  for  which  the
26    hospital may apply.
27        In  the event that the Department does not grant or renew
28    a waiver of a rule or standard, the  Department  must  notify
29    the  hospital  in  writing detailing the specific reasons for
30    not granting or renewing the waiver and must discuss possible
31    options, if any, the hospital could take to have  the  waiver
32    approved.
33        This  Section  shall  apply  to  both  new  and  existing
34    construction.
SB1332 Engrossed            -8-      LRB093 09788 AMC 10033 b
 1    (Source: P.A. 92-803, eff. 8-16-02.)

 2        (210 ILCS 85/9) (from Ch. 111 1/2, par. 150)
 3        Sec.  9.  Inspections  and investigations. The Department
 4    shall  make  or  cause  to  be  made  such  inspections   and
 5    investigations  as  it  deems  necessary. Upon arrival at the
 6    hospital, the Department's  inspector  or  investigator  must
 7    inform  the  hospital  of the scope of the investigation with
 8    references  to  the  particular   statutory   or   regulatory
 9    provisions  triggering  the  inspection or investigation.  If
10    the scope of  an  inspection  is  expanded  beyond  what  was
11    originally  disclosed  to  the  hospital,  the  surveyor must
12    inform  the  hospital's  administrator  or  designee.    This
13    information   must   be  provided  before  the  inspector  or
14    investigator  leaves  the  hospital   premises.   Information
15    received by the Department through filed reports, inspection,
16    or  as  otherwise  authorized  under  this  Act  shall not be
17    disclosed publicly in such manner as to identify  individuals
18    or  hospitals,  except  (i)  in  a  proceeding  involving the
19    denial, suspension, or revocation of a permit to establish  a
20    hospital or a proceeding involving the denial, suspension, or
21    revocation  of  a  license  to  open,  conduct,  operate, and
22    maintain a hospital, (ii) to the Department of  Children  and
23    Family  Services  in  the  course of a child abuse or neglect
24    investigation  conducted  by  that  Department  or   by   the
25    Department of Public Health, (iii) in accordance with Section
26    6.14a  of  this Act, or (iv) in other circumstances as may be
27    approved by the Hospital Licensing Board.
28    (Source: P.A. 90-608, eff. 6-30-98; 91-242, eff. 1-1-00.)

29        (210 ILCS 85/9.2)
30        Sec. 9.2.  Disclosure. Prior to conducting a survey of  a
31    hospital  operating under an approved waiver, equivalency, or
32    other approval, a surveyor must be made aware of the  waiver,
SB1332 Engrossed            -9-      LRB093 09788 AMC 10033 b
 1    equivalency,   or   other  approval  prior  to  entering  the
 2    hospital. Prior to commencing an inspection,  the  Department
 3    must  provide the hospital with documentation that the survey
 4    is  being  conducted,  with  consideration  of  the  relevant
 5    waiver,  equivalency,  or  approval.  After  conducting   the
 6    survey,  the  Department  must  conduct  a comprehensive exit
 7    interview with designated hospital representatives  at  which
 8    the  hospital  may  present  additional information regarding
 9    findings.
10    (Source: P.A. 92-803, eff. 8-16-02.)

11        (210 ILCS 85/9.3)
12        Sec. 9.3.  Informal dispute resolution.   The  Department
13    must  offer  an  opportunity  for informal dispute resolution
14    concerning the application of  building  codes  for  new  and
15    existing  construction and other related Department rules and
16    standards before the advisory committee under subsection  (b)
17    of Section 2310-560 of the Department of Public Health Powers
18    and  Duties Law of the Civil Administrative Code of Illinois.
19    Participants in this  process  must  include  representatives
20    from  the  Department,  representatives  of the hospital, and
21    additional representatives deemed appropriate by both parties
22    with expertise regarding the contested deficiencies  and  the
23    management of health care facilities.  If the Department does
24    not  resolve disputed deficiencies after the informal dispute
25    resolution process, the Department  must  provide  a  written
26    explanation  to the hospital of why the deficiencies have not
27    been removed from the statement of deficiencies.
28    (Source: P.A. 92-803, eff. 8-16-02.)

29        (210 ILCS 85/9.4 new)
30        Sec.  9.4.  Status  and  exit  briefings.  If  there  are
31    significant findings during inspections,  investigations,  or
32    surveys,  the  Department  must offer a daily status briefing
SB1332 Engrossed            -10-     LRB093 09788 AMC 10033 b
 1    with the hospital administrator or his  or  her  designee  to
 2    disclose  the findings before the inspector, investigator, or
 3    surveyor leaves for the day. At the end of  each  inspection,
 4    investigation,  or survey the Department must have a detailed
 5    and comprehensive exit briefing with the hospital to disclose
 6    its preliminary findings and conclusions. As  part  of  these
 7    briefings,   the   Department   inspector,  investigator,  or
 8    surveyor must explain to the provider  what the deficiency is
 9    in terms specific enough to allow a reasonably  knowledgeable
10    person   to  understand  why  the  requirement  is  not  met.
11    Surveyors must explain the requirements and why something  is
12    a  deficiency.   A data tag or reiteration of the regulations
13    must not be used as a substitute for an explanation.

14        (210 ILCS 85/9.5 new)
15        Sec.  9.5.  Findings,  conclusions,  and  citations.  The
16    Department must consider any factual information  offered  by
17    the hospital during the survey, inspection, or investigation,
18    at  daily status briefings, and in the exit briefing required
19    under  Section  9.4  before   making   final   findings   and
20    conclusions   or   issuing  citations.  The  Department  must
21    document receipt of such information and provide the hospital
22    with its findings and conclusions regarding this  information
23    in  addition  to  any  other  findings and conclusions of its
24    survey, investigation, or  inspection.  The  Department  must
25    provide  the hospital with written notice of its findings and
26    conclusions within 10 days  of  the  exit  briefing  required
27    under  Section  9.4.  This  notice must provide the following
28    information: (i) identification of all deficiencies and areas
29    of noncompliance with applicable law; (ii) identification  of
30    the applicable statutes, rules, codes, or standards that were
31    violated;  and (iii) the factual basis for each deficiency or
32    violation.
SB1332 Engrossed            -11-     LRB093 09788 AMC 10033 b
 1        (210 ILCS 85/9.6 new)
 2        Sec. 9.6.  Reviewer quality improvement.  The  Department
 3    must implement a reviewer performance improvement program for
 4    hospital  survey,  inspection,  and investigation staff.  The
 5    Department  must  also  review  the  work  of  each  of   its
 6    surveyors, inspectors, and investigators on a quarterly basis
 7    to    assess   whether   its   surveyors,   inspectors,   and
 8    investigators: (i) apply  the  same  protocols  and  criteria
 9    consistently  to substantially similar situations; (ii) reach
10    similar findings and conclusions when reviewing substantially
11    similar situations; (iii) conduct  surveys,  inspections,  or
12    investigations in a professional manner; and (iv) comply with
13    the  provisions  of  this  Act.   The  Department  must  also
14    implement  continuing  education  programs for its surveyors,
15    inspectors, and investigators to correct review inconsistency
16    and to reduce review time and expense.