State of Illinois
2015 and 2016


Introduced , by Rep. Pamela Reaves-Harris


See Index

    Amends the Emergency Medical Services (EMS) Systems Act. Authorizes the Department of Public Health to license freestanding rapid treatment emergency centers. Contains provisions concerning the requirements a facility must meet to be licensed as a freestanding rapid treatment emergency center. Requires the Department of Public Health to establish provisional licensure and licensing procedures by emergency rule. Makes related changes in the Emergency Medical Treatment Act, the Health Care Worker Background Check Act, the Abandoned Newborn Infant Protection Act, and the Illinois Controlled Substances Act. Amends the Illinois Health Facilities Planning Act. Prohibits a person from constructing, modifying, or establishing a freestanding rapid treatment emergency center without obtaining a certificate of need permit from the Health Facilities and Services Review Board. Requires the Health Facilities and Services Review Board to establish provisional permit application guidelines by emergency rule. Amends the Illinois Insurance Code. Contains provisions concerning reimbursements to freestanding rapid treatment emergency centers. Amends the Illinois Public Aid Code. Directs the Department of Healthcare and Family Services to adopt rates to be paid for services delivered by a freestanding rapid treatment emergency center. Effective immediately.

LRB099 10156 RPS 30379 b






HB3221LRB099 10156 RPS 30379 b

1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Illinois Health Facilities Planning Act is
5amended by changing Section 3 and by adding Section 5.1b as
7    (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
8    (Section scheduled to be repealed on December 31, 2019)
9    Sec. 3. Definitions. As used in this Act:
10    "Health care facilities" means and includes the following
11facilities, organizations, and related persons:
12        (1) An ambulatory surgical treatment center required
13    to be licensed pursuant to the Ambulatory Surgical
14    Treatment Center Act.
15        (2) An institution, place, building, or agency
16    required to be licensed pursuant to the Hospital Licensing
17    Act.
18        (3) Skilled and intermediate long term care facilities
19    licensed under the Nursing Home Care Act.
20            (A) If a demonstration project under the Nursing
21        Home Care Act applies for a certificate of need to
22        convert to a nursing facility, it shall meet the
23        licensure and certificate of need requirements in



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1        effect as of the date of application.
2            (B) Except as provided in item (A) of this
3        subsection, this Act does not apply to facilities
4        granted waivers under Section 3-102.2 of the Nursing
5        Home Care Act.
6        (3.5) Skilled and intermediate care facilities
7    licensed under the ID/DD Community Care Act. (A) No permit
8    or exemption is required for a facility licensed under the
9    ID/DD Community Care Act prior to the reduction of the
10    number of beds at a facility. If there is a total reduction
11    of beds at a facility licensed under the ID/DD Community
12    Care Act, this is a discontinuation or closure of the
13    facility. If a facility licensed under the ID/DD Community
14    Care Act reduces the number of beds or discontinues the
15    facility, that facility must notify the Board as provided
16    in Section 14.1 of this Act.
17        (3.7) Facilities licensed under the Specialized Mental
18    Health Rehabilitation Act of 2013.
19        (4) Hospitals, nursing homes, ambulatory surgical
20    treatment centers, or kidney disease treatment centers
21    maintained by the State or any department or agency
22    thereof.
23        (5) Kidney disease treatment centers, including a
24    free-standing hemodialysis unit required to be licensed
25    under the End Stage Renal Disease Facility Act.
26            (A) This Act does not apply to a dialysis facility



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1        that provides only dialysis training, support, and
2        related services to individuals with end stage renal
3        disease who have elected to receive home dialysis.
4            (B) This Act does not apply to a dialysis unit
5        located in a licensed nursing home that offers or
6        provides dialysis-related services to residents with
7        end stage renal disease who have elected to receive
8        home dialysis within the nursing home.
9            (C) The Board, however, may require dialysis
10        facilities and licensed nursing homes under items (A)
11        and (B) of this subsection to report statistical
12        information on a quarterly basis to the Board to be
13        used by the Board to conduct analyses on the need for
14        proposed kidney disease treatment centers.
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, including,
21    but not limited to, cardiac catheterization and open heart
22    surgery.
23        (8) An institution, place, building, or room housing
24    major medical equipment used in the direct clinical
25    diagnosis or treatment of patients, and whose project cost
26    is in excess of the capital expenditure minimum.



HB3221- 4 -LRB099 10156 RPS 30379 b

1    "Health care facilities" does not include the following
2entities or facility transactions:
3        (1) Federally-owned facilities.
4        (2) Facilities used solely for healing by prayer or
5    spiritual means.
6        (3) An existing facility located on any campus facility
7    as defined in Section 5-5.8b of the Illinois Public Aid
8    Code, provided that the campus facility encompasses 30 or
9    more contiguous acres and that the new or renovated
10    facility is intended for use by a licensed residential
11    facility.
12        (4) Facilities licensed under the Supportive
13    Residences Licensing Act or the Assisted Living and Shared
14    Housing Act.
15        (5) Facilities designated as supportive living
16    facilities that are in good standing with the program
17    established under Section 5-5.01a of the Illinois Public
18    Aid Code.
19        (6) Facilities established and operating under the
20    Alternative Health Care Delivery Act as a children's
21    community-based health care center children's respite care
22    center alternative health care model demonstration program
23    or as an Alzheimer's Disease Management Center alternative
24    health care model demonstration program.
25        (7) The closure of an entity or a portion of an entity
26    licensed under the Nursing Home Care Act, the Specialized



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1    Mental Health Rehabilitation Act of 2013, or the ID/DD
2    Community Care Act, with the exception of facilities
3    operated by a county or Illinois Veterans Homes, that elect
4    to convert, in whole or in part, to an assisted living or
5    shared housing establishment licensed under the Assisted
6    Living and Shared Housing Act and with the exception of a
7    facility licensed under the Specialized Mental Health
8    Rehabilitation Act of 2013 in connection with a proposal to
9    close a facility and re-establish the facility in another
10    location.
11        (8) Any change of ownership of a health care healthcare
12    facility that is licensed under the Nursing Home Care Act,
13    the Specialized Mental Health Rehabilitation Act of 2013,
14    or the ID/DD Community Care Act, with the exception of
15    facilities operated by a county or Illinois Veterans Homes.
16    Changes of ownership of facilities licensed under the
17    Nursing Home Care Act must meet the requirements set forth
18    in Sections 3-101 through 3-119 of the Nursing Home Care
19    Act. children's community-based health care center of 2013
20    and with the exception of a facility licensed under the
21    Specialized Mental Health Rehabilitation Act of 2013 in
22    connection with a proposal to close a facility and
23    re-establish the facility in another location of 2013
24    With the exception of those health care facilities
25specifically included in this Section, nothing in this Act
26shall be intended to include facilities operated as a part of



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1the practice of a physician or other licensed health care
2professional, whether practicing in his individual capacity or
3within the legal structure of any partnership, medical or
4professional corporation, or unincorporated medical or
5professional group. Further, this Act shall not apply to
6physicians or other licensed health care professional's
7practices where such practices are carried out in a portion of
8a health care facility under contract with such health care
9facility by a physician or by other licensed health care
10professionals, whether practicing in his individual capacity
11or within the legal structure of any partnership, medical or
12professional corporation, or unincorporated medical or
13professional groups, unless the entity constructs, modifies,
14or establishes a health care facility as specifically defined
15in this Section. This Act shall apply to construction or
16modification and to establishment by such health care facility
17of such contracted portion which is subject to facility
18licensing requirements, irrespective of the party responsible
19for such action or attendant financial obligation.
20    "Person" means any one or more natural persons, legal
21entities, governmental bodies other than federal, or any
22combination thereof.
23    "Consumer" means any person other than a person (a) whose
24major occupation currently involves or whose official capacity
25within the last 12 months has involved the providing,
26administering or financing of any type of health care facility,



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1(b) who is engaged in health research or the teaching of
2health, (c) who has a material financial interest in any
3activity which involves the providing, administering or
4financing of any type of health care facility, or (d) who is or
5ever has been a member of the immediate family of the person
6defined by (a), (b), or (c).
7    "State Board" or "Board" means the Health Facilities and
8Services Review Board.
9    "Construction or modification" means the establishment,
10erection, building, alteration, reconstruction, modernization,
11improvement, extension, discontinuation, change of ownership,
12of or by a health care facility, or the purchase or acquisition
13by or through a health care facility of equipment or service
14for diagnostic or therapeutic purposes or for facility
15administration or operation, or any capital expenditure made by
16or on behalf of a health care facility which exceeds the
17capital expenditure minimum; however, any capital expenditure
18made by or on behalf of a health care facility for (i) the
19construction or modification of a facility licensed under the
20Assisted Living and Shared Housing Act or (ii) a conversion
21project undertaken in accordance with Section 30 of the Older
22Adult Services Act shall be excluded from any obligations under
23this Act.
24    "Establish" means the construction of a health care
25facility or the replacement of an existing facility on another
26site or the initiation of a category of service.



HB3221- 8 -LRB099 10156 RPS 30379 b

1    "Major medical equipment" means medical equipment which is
2used for the provision of medical and other health services and
3which costs in excess of the capital expenditure minimum,
4except that such term does not include medical equipment
5acquired by or on behalf of a clinical laboratory to provide
6clinical laboratory services if the clinical laboratory is
7independent of a physician's office and a hospital and it has
8been determined under Title XVIII of the Social Security Act to
9meet the requirements of paragraphs (10) and (11) of Section
101861(s) of such Act. In determining whether medical equipment
11has a value in excess of the capital expenditure minimum, the
12value of studies, surveys, designs, plans, working drawings,
13specifications, and other activities essential to the
14acquisition of such equipment shall be included.
15    "Capital Expenditure" means an expenditure: (A) made by or
16on behalf of a health care facility (as such a facility is
17defined in this Act); and (B) which under generally accepted
18accounting principles is not properly chargeable as an expense
19of operation and maintenance, or is made to obtain by lease or
20comparable arrangement any facility or part thereof or any
21equipment for a facility or part; and which exceeds the capital
22expenditure minimum.
23    For the purpose of this paragraph, the cost of any studies,
24surveys, designs, plans, working drawings, specifications, and
25other activities essential to the acquisition, improvement,
26expansion, or replacement of any plant or equipment with



HB3221- 9 -LRB099 10156 RPS 30379 b

1respect to which an expenditure is made shall be included in
2determining if such expenditure exceeds the capital
3expenditures minimum. Unless otherwise interdependent, or
4submitted as one project by the applicant, components of
5construction or modification undertaken by means of a single
6construction contract or financed through the issuance of a
7single debt instrument shall not be grouped together as one
8project. Donations of equipment or facilities to a health care
9facility which if acquired directly by such facility would be
10subject to review under this Act shall be considered capital
11expenditures, and a transfer of equipment or facilities for
12less than fair market value shall be considered a capital
13expenditure for purposes of this Act if a transfer of the
14equipment or facilities at fair market value would be subject
15to review.
16    "Capital expenditure minimum" means $11,500,000 for
17projects by hospital applicants, $6,500,000 for applicants for
18projects related to skilled and intermediate care long-term
19care facilities licensed under the Nursing Home Care Act, and
20$3,000,000 for projects by all other applicants, which shall be
21annually adjusted to reflect the increase in construction costs
22due to inflation, for major medical equipment and for all other
23capital expenditures.
24    "Non-clinical service area" means an area (i) for the
25benefit of the patients, visitors, staff, or employees of a
26health care facility and (ii) not directly related to the



HB3221- 10 -LRB099 10156 RPS 30379 b

1diagnosis, treatment, or rehabilitation of persons receiving
2services from the health care facility. "Non-clinical service
3areas" include, but are not limited to, chapels; gift shops;
4news stands; computer systems; tunnels, walkways, and
5elevators; telephone systems; projects to comply with life
6safety codes; educational facilities; student housing;
7patient, employee, staff, and visitor dining areas;
8administration and volunteer offices; modernization of
9structural components (such as roof replacement and masonry
10work); boiler repair or replacement; vehicle maintenance and
11storage facilities; parking facilities; mechanical systems for
12heating, ventilation, and air conditioning; loading docks; and
13repair or replacement of carpeting, tile, wall coverings,
14window coverings or treatments, or furniture. Solely for the
15purpose of this definition, "non-clinical service area" does
16not include health and fitness centers.
17    "Areawide" means a major area of the State delineated on a
18geographic, demographic, and functional basis for health
19planning and for health service and having within it one or
20more local areas for health planning and health service. The
21term "region", as contrasted with the term "subregion", and the
22word "area" may be used synonymously with the term "areawide".
23    "Local" means a subarea of a delineated major area that on
24a geographic, demographic, and functional basis may be
25considered to be part of such major area. The term "subregion"
26may be used synonymously with the term "local".



HB3221- 11 -LRB099 10156 RPS 30379 b

1    "Physician" means a person licensed to practice in
2accordance with the Medical Practice Act of 1987, as amended.
3    "Licensed health care professional" means a person
4licensed to practice a health profession under pertinent
5licensing statutes of the State of Illinois.
6    "Director" means the Director of the Illinois Department of
7Public Health.
8    "Agency" means the Illinois Department of Public Health.
9    "Alternative health care model" means a facility or program
10authorized under the Alternative Health Care Delivery Act.
11    "Out-of-state facility" means a person that is both (i)
12licensed as a hospital or as an ambulatory surgery center under
13the laws of another state or that qualifies as a hospital or an
14ambulatory surgery center under regulations adopted pursuant
15to the Social Security Act and (ii) not licensed under the
16Ambulatory Surgical Treatment Center Act, the Hospital
17Licensing Act, or the Nursing Home Care Act. Affiliates of
18out-of-state facilities shall be considered out-of-state
19facilities. Affiliates of Illinois licensed health care
20facilities 100% owned by an Illinois licensed health care
21facility, its parent, or Illinois physicians licensed to
22practice medicine in all its branches shall not be considered
23out-of-state facilities. Nothing in this definition shall be
24construed to include an office or any part of an office of a
25physician licensed to practice medicine in all its branches in
26Illinois that is not required to be licensed under the



HB3221- 12 -LRB099 10156 RPS 30379 b

1Ambulatory Surgical Treatment Center Act.
2    "Change of ownership of a health care facility" means a
3change in the person who has ownership or control of a health
4care facility's physical plant and capital assets. A change in
5ownership is indicated by the following transactions: sale,
6transfer, acquisition, lease, change of sponsorship, or other
7means of transferring control.
8    "Related person" means any person that: (i) is at least 50%
9owned, directly or indirectly, by either the health care
10facility or a person owning, directly or indirectly, at least
1150% of the health care facility; or (ii) owns, directly or
12indirectly, at least 50% of the health care facility.
13    "Charity care" means care provided by a health care
14facility for which the provider does not expect to receive
15payment from the patient or a third-party payer.
16    "Freestanding emergency center" means a facility subject
17to licensure under Section 32.5 of the Emergency Medical
18Services (EMS) Systems Act.
19    "Freestanding rapid treatment emergency center" means a
20facility subject to licensure under Section 32.6 of the
21Emergency Medical Services (EMS) Systems Act.
22    "Category of service" means a grouping by generic class of
23various types or levels of support functions, equipment, care,
24or treatment provided to patients or residents, including, but
25not limited to, classes such as medical-surgical, pediatrics,
26or cardiac catheterization. A category of service may include



HB3221- 13 -LRB099 10156 RPS 30379 b

1subcategories or levels of care that identify a particular
2degree or type of care within the category of service. Nothing
3in this definition shall be construed to include the practice
4of a physician or other licensed health care professional while
5functioning in an office providing for the care, diagnosis, or
6treatment of patients. A category of service that is subject to
7the Board's jurisdiction must be designated in rules adopted by
8the Board.
9    "State Board Staff Report" means the document that sets
10forth the review and findings of the State Board staff, as
11prescribed by the State Board, regarding applications subject
12to Board jurisdiction.
13(Source: P.A. 97-38, eff. 6-28-11; 97-277, eff. 1-1-12; 97-813,
14eff. 7-13-12; 97-980, eff. 8-17-12; 98-414, eff. 1-1-14;
1598-629, eff. 1-1-15; 98-651, eff. 6-16-14; 98-1086, eff.
168-26-14; revised 10-22-14.)
17    (20 ILCS 3960/5.1b new)
18    Sec. 5.1b. Freestanding rapid treatment emergency centers.
19No person shall construct, modify, or establish a freestanding
20rapid treatment emergency center in Illinois, or acquire major
21medical equipment or make capital expenditures in relation to
22such a facility in excess of the capital expenditure minimum,
23as defined by this Act, without first obtaining a certificate
24of need permit from the State Board in accordance with
25criteria, standards, and procedures adopted by the State Board



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1for freestanding rapid treatment emergency centers that ensure
2the availability of and community access to essential emergency
3medical services. The State Board is granted the authority
4under this Act to establish provisional certificate of need
5permit application guidelines by emergency rule and shall do so
6within 120 days of the effective date of this amendatory Act of
7the 99th General Assembly.
8    Section 10. The Emergency Medical Services (EMS) Systems
9Act is amended by changing Section 3.20 and by adding Section
1032.6 as follows:
11    (210 ILCS 50/3.20)
12    Sec. 3.20. Emergency Medical Services (EMS) Systems.
13    (a) "Emergency Medical Services (EMS) System" means an
14organization of hospitals, vehicle service providers and
15personnel approved by the Department in a specific geographic
16area, which coordinates and provides pre-hospital and
17inter-hospital emergency care and non-emergency medical
18transports at a BLS, ILS and/or ALS level pursuant to a System
19program plan submitted to and approved by the Department, and
20pursuant to the EMS Region Plan adopted for the EMS Region in
21which the System is located.
22    (b) One hospital in each System program plan must be
23designated as the Resource Hospital. All other hospitals which
24are located within the geographic boundaries of a System and



HB3221- 15 -LRB099 10156 RPS 30379 b

1which have standby, basic or comprehensive level emergency
2departments must function in that EMS System as either an
3Associate Hospital or Participating Hospital and follow all
4System policies specified in the System Program Plan, including
5but not limited to the replacement of drugs and equipment used
6by providers who have delivered patients to their emergency
7departments. All hospitals and vehicle service providers
8participating in an EMS System must specify their level of
9participation in the System Program Plan.
10    (c) The Department shall have the authority and
11responsibility to:
12        (1) Approve BLS, ILS and ALS level EMS Systems which
13    meet minimum standards and criteria established in rules
14    adopted by the Department pursuant to this Act, including
15    the submission of a Program Plan for Department approval.
16    Beginning September 1, 1997, the Department shall approve
17    the development of a new EMS System only when a local or
18    regional need for establishing such System has been
19    verified by the Department. This shall not be construed as
20    a needs assessment for health planning or other purposes
21    outside of this Act. Following Department approval, EMS
22    Systems must be fully operational within one year from the
23    date of approval.
24        (2) Monitor EMS Systems, based on minimum standards for
25    continuing operation as prescribed in rules adopted by the
26    Department pursuant to this Act, which shall include



HB3221- 16 -LRB099 10156 RPS 30379 b

1    requirements for submitting Program Plan amendments to the
2    Department for approval.
3        (3) Renew EMS System approvals every 4 years, after an
4    inspection, based on compliance with the standards for
5    continuing operation prescribed in rules adopted by the
6    Department pursuant to this Act.
7        (4) Suspend, revoke, or refuse to renew approval of any
8    EMS System, after providing an opportunity for a hearing,
9    when findings show that it does not meet the minimum
10    standards for continuing operation as prescribed by the
11    Department, or is found to be in violation of its
12    previously approved Program Plan.
13        (5) Require each EMS System to adopt written protocols
14    for the bypassing of or diversion to any hospital, trauma
15    center or regional trauma center, which provide that a
16    person shall not be transported to a facility other than
17    the nearest hospital, regional trauma center or trauma
18    center unless the medical benefits to the patient
19    reasonably expected from the provision of appropriate
20    medical treatment at a more distant facility outweigh the
21    increased risks to the patient from transport to the more
22    distant facility, or the transport is in accordance with
23    the System's protocols for patient choice or refusal.
24        (6) Require that the EMS Medical Director of an ILS or
25    ALS level EMS System be a physician licensed to practice
26    medicine in all of its branches in Illinois, and certified



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1    by the American Board of Emergency Medicine or the American
2    Osteopathic Board of Emergency Medicine, and that the EMS
3    Medical Director of a BLS level EMS System be a physician
4    licensed to practice medicine in all of its branches in
5    Illinois, with regular and frequent involvement in
6    pre-hospital emergency medical services. In addition, all
7    EMS Medical Directors shall:
8            (A) Have experience on an EMS vehicle at the
9        highest level available within the System, or make
10        provision to gain such experience within 12 months
11        prior to the date responsibility for the System is
12        assumed or within 90 days after assuming the position;
13            (B) Be thoroughly knowledgeable of all skills
14        included in the scope of practices of all levels of EMS
15        personnel within the System;
16            (C) Have or make provision to gain experience
17        instructing students at a level similar to that of the
18        levels of EMS personnel within the System; and
19            (D) For ILS and ALS EMS Medical Directors,
20        successfully complete a Department-approved EMS
21        Medical Director's Course.
22        (7) Prescribe statewide EMS data elements to be
23    collected and documented by providers in all EMS Systems
24    for all emergency and non-emergency medical services, with
25    a one-year phase-in for commencing collection of such data
26    elements.



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1        (8) Define, through rules adopted pursuant to this Act,
2    the terms "Resource Hospital", "Associate Hospital",
3    "Participating Hospital", "Basic Emergency Department",
4    "Standby Emergency Department", "Comprehensive Emergency
5    Department", "EMS Medical Director", "EMS Administrative
6    Director", and "EMS System Coordinator".
7            (A) (Blank).
8            (B) (Blank).
9        (9) Investigate the circumstances that caused a
10    hospital in an EMS system to go on bypass status to
11    determine whether that hospital's decision to go on bypass
12    status was reasonable. The Department may impose
13    sanctions, as set forth in Section 3.140 of the Act, upon a
14    Department determination that the hospital unreasonably
15    went on bypass status in violation of the Act.
16        (10) Evaluate the capacity and performance of any
17    freestanding emergency center established under Section
18    32.5 of this Act in meeting emergency medical service needs
19    of the public, including compliance with applicable
20    emergency medical standards and assurance of the
21    availability of and immediate access to the highest quality
22    of medical care possible.
23        (11) Permit limited EMS System participation by
24    facilities operated by the United States Department of
25    Veterans Affairs, Veterans Health Administration. Subject
26    to patient preference, Illinois EMS providers may



HB3221- 19 -LRB099 10156 RPS 30379 b

1    transport patients to Veterans Health Administration
2    facilities that voluntarily participate in an EMS System.
3    Any Veterans Health Administration facility seeking
4    limited participation in an EMS System shall agree to
5    comply with all Department administrative rules
6    implementing this Section. The Department may promulgate
7    rules, including, but not limited to, the types of Veterans
8    Health Administration facilities that may participate in
9    an EMS System and the limitations of participation.
10        (12) Evaluate the capacity and performance of any
11    freestanding rapid treatment emergency center established
12    under Section 32.6 of this Act in meeting emergency medical
13    service needs of the public, including compliance with
14    applicable emergency medical standards and assurance of
15    the availability of and immediate access to the highest
16    quality of medical care possible.
17(Source: P.A. 97-333, eff. 8-12-11; 98-973, eff. 8-15-14.)
18    (210 ILCS 50/32.6 new)
19    Sec. 32.6. Freestanding Rapid Treatment Emergency Center.
20    (a) The Department shall issue an annual Freestanding Rapid
21Treatment Emergency Center (FRTEC) license to a facility that
22has received a certificate of need permit from the Health
23Facilities and Services Review Board to establish a FRTEC and:
24        (1) is located: (A) in a municipality with a population
25    in excess of 1,000,000 inhabitants; (B) within or serving



HB3221- 20 -LRB099 10156 RPS 30379 b

1    an area designated by the United States Department of
2    Health and Human Services as a medically underserved area
3    or population; (C) within or serving an area designated by
4    the United States Department of Health and Human Services
5    as a health professional shortage area; and (D) within one
6    mile of the location of a general acute care hospital that
7    closed between January 1, 2013 and December 31, 2013;
8        (2) is affiliated with, by contractual or other means,
9    one or more acute care hospitals located within 5 miles of
10    the FRTEC, which shall serve as backup hospital providers
11    for the FRTEC, and is not a part of any affiliate
12    hospital's physical plant;
13        (3) meets the standards adopted by the Department by
14    rule for licensed FRTECs, including, but not limited to:
15    (A) facility design, specification, operation, and
16    maintenance standards; (B) equipment standards; and (C)
17    the number and qualifications of emergency medical
18    personnel and other staff, which must include at least one
19    board certified emergency physician present at the FRTEC 24
20    hours per day;
21        (4) limits its participation in the EMS System strictly
22    to receiving patients within the capabilities of the FRTEC,
23    which shall be determined according to protocols jointly
24    developed between the FRTEC and the Resource Hospital in
25    the relevant trauma region; these protocols must be
26    approved by the FRTEC's Medical Director, the Resource



HB3221- 21 -LRB099 10156 RPS 30379 b

1    Hospital, and the Department;
2        (5) provides comprehensive emergency treatment
3    services, as defined in the rules adopted by the Department
4    under the Hospital Licensing Act, 24 hours per day, on an
5    outpatient basis;
6        (6) provides an ambulance and maintains on site
7    ambulance services staffed with paramedics 24 hours per
8    day;
9        (7) complies with all State and federal patient rights
10    provisions, including, but not limited to, the Emergency
11    Medical Treatment Act and the federal Emergency Medical
12    Treatment and Active Labor Act;
13        (8) maintains a referral network with one or more acute
14    care backup provider hospitals located within 5 miles of
15    the FRTEC, on a contractual basis; the contract with the
16    referral hospital shall include, but not be limited to, a
17    requirement to maintain a communication system with the
18    referral hospital;
19        (9) reports to the Department any patient transfers
20    from the FRTEC to any of its affiliated acute care
21    hospitals within 48 hours of the transfer plus any other
22    data determined to be relevant by the Department;
23        (10) submits to the Department, on a quarterly basis,
24    the FRTEC's morbidity and mortality rates for patients
25    treated at the FRTEC and other data determined to be
26    relevant by the Department;



HB3221- 22 -LRB099 10156 RPS 30379 b

1        (11) does not describe itself or hold itself out to the
2    general public as a full service hospital or a hospital's
3    emergency department in its advertising or marketing
4    activities;
5        (12) complies with any other rules adopted by the
6    Department under this Act that relate to FRTECs;
7        (13) passes the Department's site inspection for
8    compliance with the FRTEC requirements of this Act;
9        (14) submits a copy of the certificate of need permit
10    issued by the Health Facilities and Services Review Board
11    indicating that the facility has complied with the Illinois
12    Health Facilities Planning Act with respect to all health
13    services to be provided at the FRTEC;
14        (15) submits an application for designation as a FRTEC
15    in a manner and form prescribed by the Department by rule;
16    and
17        (16) pays the annual license fee as determined by the
18    Department by rule.
19    (b) The Department:
20        (1) shall annually inspect facilities of initial FRTEC
21    applicants and licensed FRTECs, and issue annual licenses
22    to or annually relicense FRTECs that satisfy the
23    Department's licensure requirements as set forth in
24    subsection (a);
25        (2) shall suspend, revoke, refuse to issue, or refuse
26    to renew the license of any FRTEC, after notice and an



HB3221- 23 -LRB099 10156 RPS 30379 b

1    opportunity for a hearing, when the Department finds that
2    the FRTEC has failed to comply with the standards and
3    requirements of this Act or rules adopted by the Department
4    under this Act;
5        (3) shall issue an emergency suspension order for any
6    FRTEC when the Director or his or her designee has
7    determined that the continued operation of the FRTEC poses
8    an immediate and serious danger to the public health,
9    safety, and welfare; an opportunity for a hearing shall be
10    promptly initiated after an emergency suspension order has
11    been issued; and
12        (4) is granted the authority under this Act to
13    establish provisional licensure and licensing procedures
14    under this Act by emergency rule and shall do so within 120
15    days of the effective date of this amendatory Act of the
16    99th General Assembly.
17    Section 15. The Emergency Medical Treatment Act is amended
18by changing Section 2 as follows:
19    (210 ILCS 70/2)
20    Sec. 2. Findings; prohibited terms.
21    (a) The Illinois General Assembly makes all of the
22following findings:
23        (1) Hospital emergency services are not always the most
24    appropriate level of care for patients seeking unscheduled



HB3221- 24 -LRB099 10156 RPS 30379 b

1    medical care or for patients who do not have a regular
2    physician who can treat a significant or acute medical
3    condition not considered critical, debilitating, or
4    life-threatening.
5        (2) Hospital emergency rooms are over-utilized and too
6    often over-burdened with many injuries or illnesses that
7    could be managed in a less intensive clinical setting or
8    physician's office.
9        (3) Over-utilization of hospital emergency departments
10    contributes to excess medical and health insurance costs.
11        (4) The use of the term "emergi-" or a similar term in
12    a facility's posted or advertised name may confuse the
13    public and prospective patients regarding the type of
14    services offered relative to those provided by a hospital
15    emergency department. There is significant risk to the
16    public health and safety if persons requiring treatment for
17    a critical or life-threatening condition inappropriately
18    use such facilities.
19        (5) Many times patients are not clearly aware of the
20    policies and procedures of their insurer or health plan
21    that must be followed in the use of emergency rooms versus
22    non-emergent clinics and what rights they have under the
23    law in regard to appropriately sought emergency care.
24        (6) There is a need to more effectively educate health
25    care payers and consumers about the most appropriate use of
26    the various available levels of medical care and



HB3221- 25 -LRB099 10156 RPS 30379 b

1    particularly the use of hospital emergency rooms and
2    walk-in medical clinics that do not require appointments.
3    (b) No person, facility, or entity shall hold itself out to
4the public as an "emergi-" or "emergent" care center or use any
5similar term, as defined by rule, that would give the
6impression that emergency medical treatment is provided by the
7person or entity or at the facility unless the facility is the
8emergency room of a facility licensed as a hospital under the
9Hospital Licensing Act or a facility licensed as a freestanding
10emergency center or a freestanding rapid treatment emergency
11center under the Emergency Medical Services (EMS) Systems Act.
12This Section does not prohibit a person, facility, or entity
13from holding itself out to the public as an "urgi-" or "urgent"
14care center.
15    (c) Violation of this Section constitutes a business
16offense with a minimum fine of $5,000 plus $1,000 per day for a
17continuing violation, with a maximum of $25,000.
18    (d) The Director of Public Health in the name of the people
19of the State, through the Attorney General, may bring an action
20for an injunction or to restrain a violation of this Section or
21the rules adopted pursuant to this Section or to enjoin the
22future operation or maintenance of any facility in violation of
23this Section or the rules adopted pursuant to this Section.
24    (e) The Department of Public Health shall adopt rules
25necessary for the implementation of this Section.
26(Source: P.A. 98-977, eff. 1-1-15.)



HB3221- 26 -LRB099 10156 RPS 30379 b

1    Section 20. The Illinois Insurance Code is amended by
2adding Section 370b.2 as follows:
3    (215 ILCS 5/370b.2 new)
4    Sec. 370b.2. Reimbursement of freestanding rapid treatment
5emergency centers.
6    (a) An individual or group policy of accident and health
7insurance shall have copayments or coinsurance for emergency
8services provided at a freestanding rapid treatment emergency
9center at the same levels the plan provides for emergency
10services delivered in other health care facilities covered
11under the plan.
12    (b) Reimbursement to a freestanding rapid treatment
13emergency center licensed under the Emergency Medical Services
14(EMS) Systems Act that performs emergency services
15reimburseable under an individual or group policy of accident
16and health insurance shall be at a rate substantially similar
17to the rate paid to a hospital licensed under the Hospital
18Licensing Act with a hospital-based emergency department or at
19a freestanding emergency center licensed under the Emergency
20Medical Services (EMS) Systems Act, which shall include, but
21not be limited to, facility fees and professional fees.
22    Section 25. The Health Care Worker Background Check Act is
23amended by changing Section 15 as follows:



HB3221- 27 -LRB099 10156 RPS 30379 b

1    (225 ILCS 46/15)
2    Sec. 15. Definitions. In this Act:
3    "Applicant" means an individual seeking employment with a
4health care employer who has received a bona fide conditional
5offer of employment.
6    "Conditional offer of employment" means a bona fide offer
7of employment by a health care employer to an applicant, which
8is contingent upon the receipt of a report from the Department
9of Public Health indicating that the applicant does not have a
10record of conviction of any of the criminal offenses enumerated
11in Section 25.
12    "Direct care" means the provision of nursing care or
13assistance with feeding, dressing, movement, bathing,
14toileting, or other personal needs, including home services as
15defined in the Home Health, Home Services, and Home Nursing
16Agency Licensing Act. The entity responsible for inspecting and
17licensing, certifying, or registering the health care employer
18may, by administrative rule, prescribe guidelines for
19interpreting this definition with regard to the health care
20employers that it licenses.
21    "Disqualifying offenses" means those offenses set forth in
22Section 25 of this Act.
23    "Employee" means any individual hired, employed, or
24retained to which this Act applies.
25    "Fingerprint-based criminal history records check" means a



HB3221- 28 -LRB099 10156 RPS 30379 b

1livescan fingerprint-based criminal history records check
2submitted as a fee applicant inquiry in the form and manner
3prescribed by the Department of State Police.
4    "Health care employer" means:
5        (1) the owner or licensee of any of the following:
6            (i) a community living facility, as defined in the
7        Community Living Facilities Act;
8            (ii) a life care facility, as defined in the Life
9        Care Facilities Act;
10            (iii) a long-term care facility;
11            (iv) a home health agency, home services agency, or
12        home nursing agency as defined in the Home Health, Home
13        Services, and Home Nursing Agency Licensing Act;
14            (v) a hospice care program or volunteer hospice
15        program, as defined in the Hospice Program Licensing
16        Act;
17            (vi) a hospital, as defined in the Hospital
18        Licensing Act;
19            (vii) (blank);
20            (viii) a nurse agency, as defined in the Nurse
21        Agency Licensing Act;
22            (ix) a respite care provider, as defined in the
23        Respite Program Act;
24            (ix-a) an establishment licensed under the
25        Assisted Living and Shared Housing Act;
26            (x) a supportive living program, as defined in the



HB3221- 29 -LRB099 10156 RPS 30379 b

1        Illinois Public Aid Code;
2            (xi) early childhood intervention programs as
3        described in 59 Ill. Adm. Code 121;
4            (xii) the University of Illinois Hospital,
5        Chicago;
6            (xiii) programs funded by the Department on Aging
7        through the Community Care Program;
8            (xiv) programs certified to participate in the
9        Supportive Living Program authorized pursuant to
10        Section 5-5.01a of the Illinois Public Aid Code;
11            (xv) programs listed by the Emergency Medical
12        Services (EMS) Systems Act as Freestanding Emergency
13        Centers or Freestanding Rapid Treatment Emergency
14        Centers;
15            (xvi) locations licensed under the Alternative
16        Health Care Delivery Act;
17        (2) a day training program certified by the Department
18    of Human Services;
19        (3) a community integrated living arrangement operated
20    by a community mental health and developmental service
21    agency, as defined in the Community-Integrated Living
22    Arrangements Licensing and Certification Act; or
23        (4) the State Long Term Care Ombudsman Program,
24    including any regional long term care ombudsman programs
25    under Section 4.04 of the Illinois Act on the Aging, only
26    for the purpose of securing background checks.



HB3221- 30 -LRB099 10156 RPS 30379 b

1    "Initiate" means obtaining from a student, applicant, or
2employee his or her social security number, demographics, a
3disclosure statement, and an authorization for the Department
4of Public Health or its designee to request a fingerprint-based
5criminal history records check; transmitting this information
6electronically to the Department of Public Health; conducting
7Internet searches on certain web sites, including without
8limitation the Illinois Sex Offender Registry, the Department
9of Corrections' Sex Offender Search Engine, the Department of
10Corrections' Inmate Search Engine, the Department of
11Corrections Wanted Fugitives Search Engine, the National Sex
12Offender Public Registry, and the website of the Health and
13Human Services Office of Inspector General to determine if the
14applicant has been adjudicated a sex offender, has been a
15prison inmate, or has committed Medicare or Medicaid fraud, or
16conducting similar searches as defined by rule; and having the
17student, applicant, or employee's fingerprints collected and
18transmitted electronically to the Department of State Police.
19    "Livescan vendor" means an entity whose equipment has been
20certified by the Department of State Police to collect an
21individual's demographics and inkless fingerprints and, in a
22manner prescribed by the Department of State Police and the
23Department of Public Health, electronically transmit the
24fingerprints and required data to the Department of State
25Police and a daily file of required data to the Department of
26Public Health. The Department of Public Health shall negotiate



HB3221- 31 -LRB099 10156 RPS 30379 b

1a contract with one or more vendors that effectively
2demonstrate that the vendor has 2 or more years of experience
3transmitting fingerprints electronically to the Department of
4State Police and that the vendor can successfully transmit the
5required data in a manner prescribed by the Department of
6Public Health. Vendor authorization may be further defined by
7administrative rule.
8    "Long-term care facility" means a facility licensed by the
9State or certified under federal law as a long-term care
10facility, including without limitation facilities licensed
11under the Nursing Home Care Act, the Specialized Mental Health
12Rehabilitation Act of 2013, or the ID/DD Community Care Act, a
13supportive living facility, an assisted living establishment,
14or a shared housing establishment or registered as a board and
15care home.
16(Source: P.A. 97-38, eff. 6-28-11; 97-227, eff. 1-1-12; 97-813,
17eff. 7-13-12; 98-104, eff. 7-22-13.)
18    Section 30. The Illinois Public Aid Code is amended by
19adding Section 5-35 as follows:
20    (305 ILCS 5/5-35 new)
21    Sec. 5-35. Freestanding rapid treatment emergency center
22reimbursement. The Illinois Department shall adopt rates to be
23paid for services delivered by freestanding rapid treatment
24emergency centers licensed under the Emergency Medical



HB3221- 32 -LRB099 10156 RPS 30379 b

1Services (EMS) Systems Act to qualified individuals. The rates
2established by the Illinois Department shall be substantially
3similar to the rates paid for services delivered to qualified
4individuals in an emergency room of a hospital licensed under
5the Hospital Licensing Act or a freestanding emergency center
6licensed under the Emergency Medical Services (EMS) Systems
7Act. Rates shall be established no later than 90 days after the
8effective date of this amendatory Act of the 99th General
10    Section 35. The Abandoned Newborn Infant Protection Act is
11amended by changing Section 10 as follows:
12    (325 ILCS 2/10)
13    Sec. 10. Definitions. In this Act:
14    "Abandon" has the same meaning as in the Abused and
15Neglected Child Reporting Act.
16    "Abused child" has the same meaning as in the Abused and
17Neglected Child Reporting Act.
18    "Child-placing agency" means a licensed public or private
19agency that receives a child for the purpose of placing or
20arranging for the placement of the child in a foster family
21home or other facility for child care, apart from the custody
22of the child's parents.
23    "Department" or "DCFS" means the Illinois Department of
24Children and Family Services.



HB3221- 33 -LRB099 10156 RPS 30379 b

1    "Emergency medical facility" means a freestanding
2emergency center, freestanding rapid treatment emergency
3center, or trauma center, as defined in the Emergency Medical
4Services (EMS) Systems Act.
5    "Emergency medical professional" includes licensed
6physicians, and any emergency medical technician, emergency
7medical technician-intermediate, advanced emergency medical
8technician, paramedic, trauma nurse specialist, and
9pre-hospital registered nurse, as defined in the Emergency
10Medical Services (EMS) Systems Act.
11    "Fire station" means a fire station within the State with
12at least one staff person.
13    "Hospital" has the same meaning as in the Hospital
14Licensing Act.
15    "Legal custody" means the relationship created by a court
16order in the best interest of a newborn infant that imposes on
17the infant's custodian the responsibility of physical
18possession of the infant, the duty to protect, train, and
19discipline the infant, and the duty to provide the infant with
20food, shelter, education, and medical care, except as these are
21limited by parental rights and responsibilities.
22    "Neglected child" has the same meaning as in the Abused and
23Neglected Child Reporting Act.
24    "Newborn infant" means a child who a licensed physician
25reasonably believes is 30 days old or less at the time the
26child is initially relinquished to a hospital, police station,



HB3221- 34 -LRB099 10156 RPS 30379 b

1fire station, or emergency medical facility, and who is not an
2abused or a neglected child.
3    "Police station" means a municipal police station, a county
4sheriff's office, a campus police department located on any
5college or university owned or controlled by the State or any
6private college or private university that is not owned or
7controlled by the State when employees of the campus police
8department are present, or any of the district headquarters of
9the Illinois State Police.
10    "Relinquish" means to bring a newborn infant, who a
11licensed physician reasonably believes is 30 days old or less,
12to a hospital, police station, fire station, or emergency
13medical facility and to leave the infant with personnel of the
14facility, if the person leaving the infant does not express an
15intent to return for the infant or states that he or she will
16not return for the infant. In the case of a mother who gives
17birth to an infant in a hospital, the mother's act of leaving
18that newborn infant at the hospital (i) without expressing an
19intent to return for the infant or (ii) stating that she will
20not return for the infant is not a "relinquishment" under this
22    "Temporary protective custody" means the temporary
23placement of a newborn infant within a hospital or other
24medical facility out of the custody of the infant's parent.
25(Source: P.A. 97-293, eff. 8-11-11; 98-973, eff. 8-15-14.)



HB3221- 35 -LRB099 10156 RPS 30379 b

1    Section 40. The Illinois Controlled Substances Act is
2amended by changing Section 318 as follows:
3    (720 ILCS 570/318)
4    Sec. 318. Confidentiality of information.
5    (a) Information received by the central repository under
6Section 316 and former Section 321 is confidential.
7    (b) The Department must carry out a program to protect the
8confidentiality of the information described in subsection
9(a). The Department may disclose the information to another
10person only under subsection (c), (d), or (f) and may charge a
11fee not to exceed the actual cost of furnishing the
13    (c) The Department may disclose confidential information
14described in subsection (a) to any person who is engaged in
15receiving, processing, or storing the information.
16    (d) The Department may release confidential information
17described in subsection (a) to the following persons:
18        (1) A governing body that licenses practitioners and is
19    engaged in an investigation, an adjudication, or a
20    prosecution of a violation under any State or federal law
21    that involves a controlled substance.
22        (2) An investigator for the Consumer Protection
23    Division of the office of the Attorney General, a
24    prosecuting attorney, the Attorney General, a deputy
25    Attorney General, or an investigator from the office of the



HB3221- 36 -LRB099 10156 RPS 30379 b

1    Attorney General, who is engaged in any of the following
2    activities involving controlled substances:
3            (A) an investigation;
4            (B) an adjudication; or
5            (C) a prosecution of a violation under any State or
6        federal law that involves a controlled substance.
7        (3) A law enforcement officer who is:
8            (A) authorized by the Illinois State Police or the
9        office of a county sheriff or State's Attorney or
10        municipal police department of Illinois to receive
11        information of the type requested for the purpose of
12        investigations involving controlled substances; or
13            (B) approved by the Department to receive
14        information of the type requested for the purpose of
15        investigations involving controlled substances; and
16            (C) engaged in the investigation or prosecution of
17        a violation under any State or federal law that
18        involves a controlled substance.
19    (e) Before the Department releases confidential
20information under subsection (d), the applicant must
21demonstrate in writing to the Department that:
22        (1) the applicant has reason to believe that a
23    violation under any State or federal law that involves a
24    controlled substance has occurred; and
25        (2) the requested information is reasonably related to
26    the investigation, adjudication, or prosecution of the



HB3221- 37 -LRB099 10156 RPS 30379 b

1    violation described in subdivision (1).
2    (f) The Department may receive and release prescription
3record information under Section 316 and former Section 321 to:
4        (1) a governing body that licenses practitioners;
5        (2) an investigator for the Consumer Protection
6    Division of the office of the Attorney General, a
7    prosecuting attorney, the Attorney General, a deputy
8    Attorney General, or an investigator from the office of the
9    Attorney General;
10        (3) any Illinois law enforcement officer who is:
11            (A) authorized to receive the type of information
12        released; and
13            (B) approved by the Department to receive the type
14        of information released; or
15        (4) prescription monitoring entities in other states
16    per the provisions outlined in subsection (g) and (h)
17    below;
18confidential prescription record information collected under
19Sections 316 and 321 (now repealed) that identifies vendors or
20practitioners, or both, who are prescribing or dispensing large
21quantities of Schedule II, III, IV, or V controlled substances
22outside the scope of their practice, pharmacy, or business, as
23determined by the Advisory Committee created by Section 320.
24    (g) The information described in subsection (f) may not be
25released until it has been reviewed by an employee of the
26Department who is licensed as a prescriber or a dispenser and



HB3221- 38 -LRB099 10156 RPS 30379 b

1until that employee has certified that further investigation is
2warranted. However, failure to comply with this subsection (g)
3does not invalidate the use of any evidence that is otherwise
4admissible in a proceeding described in subsection (h).
5    (h) An investigator or a law enforcement officer receiving
6confidential information under subsection (c), (d), or (f) may
7disclose the information to a law enforcement officer or an
8attorney for the office of the Attorney General for use as
9evidence in the following:
10        (1) A proceeding under any State or federal law that
11    involves a controlled substance.
12        (2) A criminal proceeding or a proceeding in juvenile
13    court that involves a controlled substance.
14    (i) The Department may compile statistical reports from the
15information described in subsection (a). The reports must not
16include information that identifies, by name, license or
17address, any practitioner, dispenser, ultimate user, or other
18person administering a controlled substance.
19    (j) Based upon federal, initial and maintenance funding, a
20prescriber and dispenser inquiry system shall be developed to
21assist the health care community in its goal of effective
22clinical practice and to prevent patients from diverting or
23abusing medications.
24        (1) An inquirer shall have read-only access to a
25    stand-alone database which shall contain records for the
26    previous 12 months.



HB3221- 39 -LRB099 10156 RPS 30379 b

1        (2) Dispensers may, upon positive and secure
2    identification, make an inquiry on a patient or customer
3    solely for a medical purpose as delineated within the
4    federal HIPAA law.
5        (3) The Department shall provide a one-to-one secure
6    link and encrypted software necessary to establish the link
7    between an inquirer and the Department. Technical
8    assistance shall also be provided.
9        (4) Written inquiries are acceptable but must include
10    the fee and the requestor's Drug Enforcement
11    Administration license number and submitted upon the
12    requestor's business stationery.
13        (5) As directed by the Prescription Monitoring Program
14    Advisory Committee and the Clinical Director for the
15    Prescription Monitoring Program, aggregate data that does
16    not indicate any prescriber, practitioner, dispenser, or
17    patient may be used for clinical studies.
18        (6) Tracking analysis shall be established and used per
19    administrative rule.
20        (7) Nothing in this Act or Illinois law shall be
21    construed to require a prescriber or dispenser to make use
22    of this inquiry system.
23        (8) If there is an adverse outcome because of a
24    prescriber or dispenser making an inquiry, which is
25    initiated in good faith, the prescriber or dispenser shall
26    be held harmless from any civil liability.



HB3221- 40 -LRB099 10156 RPS 30379 b

1    (k) The Department shall establish, by rule, the process by
2which to evaluate possible erroneous association of
3prescriptions to any licensed prescriber or end user of the
4Illinois Prescription Information Library (PIL).
5    (l) The Prescription Monitoring Program Advisory Committee
6is authorized to evaluate the need for and method of
7establishing a patient specific identifier.
8    (m) Patients who identify prescriptions attributed to them
9that were not obtained by them shall be given access to their
10personal prescription history pursuant to the validation
11process as set forth by administrative rule.
12    (n) The Prescription Monitoring Program is authorized to
13develop operational push reports to entities with compatible
14electronic medical records. The process shall be covered within
15administrative rule established by the Department.
16    (o) Hospital emergency departments and freestanding
17healthcare facilities, including, but not limited to,
18freestanding emergency centers and freestanding rapid
19treatment emergency centers, providing healthcare to walk-in
20patients may obtain, for the purpose of improving patient care,
21a unique identifier for each shift to utilize the PIL system.
22(Source: P.A. 97-334, eff. 1-1-12; 97-813, eff. 7-13-12.)
23    Section 99. Effective date. This Act takes effect upon
24becoming law.



HB3221- 41 -LRB099 10156 RPS 30379 b

2 Statutes amended in order of appearance
3    20 ILCS 3960/3from Ch. 111 1/2, par. 1153
4    20 ILCS 3960/5.1b new
5    210 ILCS 50/3.20
6    210 ILCS 50/32.6 new
7    210 ILCS 70/2
8    215 ILCS 5/370b.2 new
9    225 ILCS 46/15
10    305 ILCS 5/5-35 new
11    325 ILCS 2/10
12    720 ILCS 570/318