Full Text of HB0503 96th General Assembly
HB0503ham001 96TH GENERAL ASSEMBLY
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Executive Committee
Filed: 2/25/2009
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| AMENDMENT TO HOUSE BILL 503
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| AMENDMENT NO. ______. Amend House Bill 503 by replacing | 3 |
| everything after the enacting clause with the following:
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| "Section 5. The Illinois Public Aid Code is amended by | 5 |
| changing Section 5-5.5 as follows: | 6 |
| (305 ILCS 5/5-5.5) (from Ch. 23, par. 5-5.5)
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| Sec. 5-5.5. Elements of Payment Rate.
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| (a) The The Department of Healthcare and Family Services | 9 |
| shall develop a prospective method for
determining payment | 10 |
| rates for skilled nursing and intermediate care
services in | 11 |
| nursing facilities composed of the following cost elements:
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| (1) Standard Services, with the cost of this component | 13 |
| being determined
by taking into account the actual costs to | 14 |
| the facilities of these services
subject to cost ceilings | 15 |
| to be defined in the Department's rules.
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| (2) Resident Services, with the cost of this component |
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| being
determined by taking into account the actual costs, | 2 |
| needs and utilization
of these services, as derived from an | 3 |
| assessment of the resident needs in
the nursing facilities. | 4 |
| The Department shall adopt rules governing
reimbursement | 5 |
| for resident services as listed in Section 5-1.1. Surveys | 6 |
| or
assessments of resident needs under this Section shall | 7 |
| include a review by
the facility of the results of such | 8 |
| assessments and a discussion of issues
in dispute with | 9 |
| authorized survey staff, unless the facility elects not to
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| participate in such a review process. Surveys or | 11 |
| assessments of resident
needs under this Section may be | 12 |
| conducted semi-annually and payment rates
relating to | 13 |
| resident services may be changed on a semi-annual basis. | 14 |
| The
Illinois Department shall initiate a project, either on | 15 |
| a pilot basis or
Statewide, to reimburse the cost of | 16 |
| resident services based on a
methodology which utilizes an | 17 |
| assessment of resident needs to determine the
level of | 18 |
| reimbursement. This methodology shall be different from | 19 |
| the
payment criteria for resident services utilized by the | 20 |
| Illinois Department
on July 1, 1981. On March 1, 1982, and | 21 |
| each year thereafter, until such
time when the Illinois | 22 |
| Department adopts the methodology used in such
project for | 23 |
| use statewide,
the Illinois Department shall report to the | 24 |
| General Assembly on the
implementation and progress of such | 25 |
| project. The report shall include:
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| (A) A statement of the Illinois Department's goals |
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| and objectives
for such project;
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| (B) A description of such project, including the | 3 |
| number and type of
nursing facilities involved in the | 4 |
| project;
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| (C) A description of the methodology used in such | 6 |
| project;
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| (D) A description of the Illinois Department's | 8 |
| application of the
methodology;
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| (E) A statement on the methodology's effect on the | 10 |
| quality of care
given to residents in the sample | 11 |
| nursing facilities; and
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| (F) A statement on the cost of the methodology used | 13 |
| in such project
and a comparison of this cost with the | 14 |
| cost of the current payment criteria.
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| (3) Ancillary Services, with the payment rate being | 16 |
| developed for
each individual type of service. Payment | 17 |
| shall be made only when
authorized under procedures | 18 |
| developed by the Department of Healthcare and Family | 19 |
| Services.
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| (4) Nurse's Aide Training, with the cost of this | 21 |
| component being
determined by taking into account the | 22 |
| actual cost to the facilities of
such training.
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| (5) Real Estate Taxes, with the cost of this component | 24 |
| being
determined by taking into account the figures | 25 |
| contained in the most
currently available cost reports | 26 |
| (with no imposition of maximums) updated
to the midpoint of |
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| the current rate year for long term care services
rendered | 2 |
| between July 1, 1984 and June 30, 1985, and with the cost | 3 |
| of this
component being determined by taking into account | 4 |
| the actual 1983 taxes for
which the nursing homes were | 5 |
| assessed (with no imposition of maximums)
updated to the | 6 |
| midpoint of the current rate year for long term care
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| services rendered between July 1, 1985 and June 30, 1986.
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| (b) In developing a prospective method for determining | 9 |
| payment rates
for skilled nursing and intermediate care | 10 |
| services in nursing facilities,
the Department of Healthcare | 11 |
| and Family Services shall consider the following cost elements:
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| (1) Reasonable capital cost determined by utilizing | 13 |
| incurred interest
rate and the current value of the | 14 |
| investment, including land, utilizing
composite rates, or | 15 |
| by utilizing such other reasonable cost related methods
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| determined by the Department. However, beginning with the | 17 |
| rate
reimbursement period effective July 1, 1987, the | 18 |
| Department shall be
prohibited from establishing, | 19 |
| including, and implementing any depreciation
factor in | 20 |
| calculating the capital cost element.
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| (2) Profit, with the actual amount being produced and | 22 |
| accruing to
the providers in the form of a return on their | 23 |
| total investment, on the
basis of their ability to | 24 |
| economically and efficiently deliver a type
of service. The | 25 |
| method of payment may assure the opportunity for a
profit, | 26 |
| but shall not guarantee or establish a specific amount as a |
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| cost.
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| (c) The Illinois Department may implement the amendatory | 3 |
| changes to
this Section made by this amendatory Act of 1991 | 4 |
| through the use of
emergency rules in accordance with the | 5 |
| provisions of Section 5.02 of the
Illinois Administrative | 6 |
| Procedure Act. For purposes of the Illinois
Administrative | 7 |
| Procedure Act, the adoption of rules to implement the
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| amendatory changes to this Section made by this amendatory
Act | 9 |
| of 1991 shall be deemed an emergency and necessary for the | 10 |
| public
interest, safety and welfare.
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| (d) No later than January 1, 2001, the Department of Public | 12 |
| Aid shall file
with the Joint Committee on Administrative | 13 |
| Rules, pursuant to the Illinois
Administrative Procedure
Act,
a | 14 |
| proposed rule, or a proposed amendment to an existing rule, | 15 |
| regarding payment
for appropriate services, including | 16 |
| assessment, care planning, discharge
planning, and treatment
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| provided by nursing facilities to residents who have a serious | 18 |
| mental
illness.
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| (Source: P.A. 95-331, eff. 8-21-07.)".
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