Full Text of HB0614 95th General Assembly
HB0614eng 95TH GENERAL ASSEMBLY
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LRB095 09381 DRJ 29577 b |
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| AN ACT concerning regulation.
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| Be it enacted by the People of the State of Illinois,
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| represented in the General Assembly:
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| Section 5. The Alternative Health Care Delivery Act is | 5 |
| amended by changing Section 35 as follows:
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| (210 ILCS 3/35)
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| Sec. 35. Alternative health care models authorized. | 8 |
| Notwithstanding
any other law to the contrary, alternative | 9 |
| health care models
described in this Section may be established | 10 |
| on a demonstration basis.
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| (1) Alternative health care model; subacute care | 12 |
| hospital. A subacute
care hospital is a designated site | 13 |
| which provides medical specialty care for
patients who need | 14 |
| a greater intensity or complexity of care than generally
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| provided in a skilled nursing facility but who no longer | 16 |
| require acute hospital
care. The average length of stay for | 17 |
| patients treated in subacute care
hospitals shall not be | 18 |
| less than 20 days, and for individual patients, the
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| expected length of stay at the time of admission shall not | 20 |
| be less than 10
days. Variations from minimum lengths of | 21 |
| stay shall be reported to the
Department. There shall be no | 22 |
| more than 13 subacute care hospitals
authorized to operate | 23 |
| by the Department. Subacute care includes physician
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| supervision, registered nursing, and physiological | 2 |
| monitoring on a continual
basis. A subacute care hospital | 3 |
| is either a freestanding building or a distinct
physical | 4 |
| and operational entity within a hospital or nursing home | 5 |
| building. A
subacute care hospital shall only consist of | 6 |
| beds currently existing in
licensed hospitals or skilled | 7 |
| nursing facilities, except, in the City of
Chicago, on a | 8 |
| designated site that was licensed as a hospital under the
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| Illinois Hospital Licensing Act within the 10 years | 10 |
| immediately before the
application for an alternative | 11 |
| health care model license. During the period of
operation | 12 |
| of the demonstration project, the existing licensed beds | 13 |
| shall remain
licensed as hospital or skilled nursing | 14 |
| facility beds as well as being licensed
under this Act. In | 15 |
| order to handle cases of
complications, emergencies, or | 16 |
| exigent circumstances, a subacute care hospital
shall | 17 |
| maintain a contractual relationship, including a transfer | 18 |
| agreement, with
a general acute care hospital. If a | 19 |
| subacute care model is located in a
general acute care | 20 |
| hospital, it shall utilize all or a portion of the bed
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| capacity of that existing hospital. In no event shall a | 22 |
| subacute care hospital
use the word "hospital" in its | 23 |
| advertising or marketing activities or represent
or hold | 24 |
| itself out to the public as a general acute care hospital.
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| (2) Alternative health care delivery model; | 26 |
| postsurgical recovery care
center. A postsurgical recovery |
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LRB095 09381 DRJ 29577 b |
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| care center is a designated site which
provides | 2 |
| postsurgical recovery care for generally healthy patients
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| undergoing surgical procedures that require overnight | 4 |
| nursing care, pain
control, or observation that would | 5 |
| otherwise be provided in an inpatient
setting. A | 6 |
| postsurgical recovery care center is either freestanding | 7 |
| or a
defined unit of an ambulatory surgical treatment | 8 |
| center or hospital.
No facility, or portion of a facility, | 9 |
| may participate in a demonstration
program as a | 10 |
| postsurgical recovery care center unless the facility has | 11 |
| been
licensed as an ambulatory surgical treatment center or | 12 |
| hospital for at least 2
years before August 20, 1993 (the | 13 |
| effective date of Public Act 88-441). The
maximum length of | 14 |
| stay for patients in a
postsurgical recovery care center is | 15 |
| not to exceed 48 hours unless the treating
physician | 16 |
| requests an extension of time from the recovery center's | 17 |
| medical
director on the basis of medical or clinical | 18 |
| documentation that an additional
care period is required | 19 |
| for the recovery of a patient and the medical director
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| approves the extension of time. In no case, however, shall | 21 |
| a patient's length
of stay in a postsurgical recovery care | 22 |
| center be longer than 72 hours. If a
patient requires an | 23 |
| additional care period after the expiration of the 72-hour
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| limit, the patient shall be transferred to an appropriate | 25 |
| facility. Reports on
variances from the 48-hour limit shall | 26 |
| be sent to the Department for its
evaluation. The reports |
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| shall, before submission to the Department, have
removed | 2 |
| from them all patient and physician identifiers. In order | 3 |
| to handle
cases of complications, emergencies, or exigent | 4 |
| circumstances, every
postsurgical recovery care center as | 5 |
| defined in this paragraph shall maintain a
contractual | 6 |
| relationship, including a transfer agreement, with a | 7 |
| general acute
care hospital. A postsurgical recovery care | 8 |
| center shall be no larger than 20
beds. A postsurgical | 9 |
| recovery care center shall be located within 15 minutes
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| travel time from the general acute care hospital with which | 11 |
| the center
maintains a contractual relationship, including | 12 |
| a transfer agreement, as
required under this paragraph.
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| No postsurgical recovery care center shall | 14 |
| discriminate against any patient
requiring treatment | 15 |
| because of the source of payment for services, including
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| Medicare and Medicaid recipients.
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| The Department shall adopt rules to implement the | 18 |
| provisions of Public
Act 88-441 concerning postsurgical | 19 |
| recovery care centers within 9 months after
August 20, | 20 |
| 1993.
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| (3) Alternative health care delivery model; children's | 22 |
| community-based
health care center. A children's | 23 |
| community-based health care center model is a
designated | 24 |
| site that provides nursing care, clinical support | 25 |
| services, and
therapies for a period of one to 14 days for | 26 |
| short-term stays and 120 days to
facilitate transitions to |
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| home or other appropriate settings for medically
fragile | 2 |
| children, technology
dependent children, and children with | 3 |
| special health care needs who are deemed
clinically stable | 4 |
| by a physician and are younger than 22 years of age. This
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| care is to be provided in a home-like environment that | 6 |
| serves no more than 12
children at a time. Children's | 7 |
| community-based health care center
services must be | 8 |
| available through the model to all families, including | 9 |
| those
whose care is paid for through the Department of | 10 |
| Healthcare and Family Services
Public Aid , the Department | 11 |
| of
Children and Family Services, the Department of Human | 12 |
| Services, and insurance
companies who cover home health | 13 |
| care services or private duty nursing care in
the home.
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| Each children's community-based health care center | 15 |
| model location shall be
physically separate and
apart from | 16 |
| any other facility licensed by the Department of Public | 17 |
| Health under
this or any other Act and shall provide the | 18 |
| following services: respite care,
registered nursing or | 19 |
| licensed practical nursing care, transitional care to
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| facilitate home placement or other appropriate settings | 21 |
| and reunite families,
medical day care, weekend
camps, and | 22 |
| diagnostic studies typically done in the home setting.
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| Coverage for the services provided by the Illinois
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| Department of Healthcare and Family Services
Public
Aid
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| under this paragraph (3) is contingent upon federal waiver | 26 |
| approval and is
provided only to Medicaid eligible clients |
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| participating in the home and
community based services | 2 |
| waiver designated in Section 1915(c) of the Social
Security | 3 |
| Act for medically frail and technologically dependent | 4 |
| children or
children in Department of Children and Family | 5 |
| Services foster care who receive
home health benefits.
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| (4) Alternative health care delivery model; community | 7 |
| based residential
rehabilitation center.
A community-based | 8 |
| residential rehabilitation center model is a designated
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| site that provides rehabilitation or support, or both, for | 10 |
| persons who have
experienced severe brain injury, who are | 11 |
| medically stable, and who no longer
require acute | 12 |
| rehabilitative care or intense medical or nursing | 13 |
| services. The
average length of stay in a community-based | 14 |
| residential rehabilitation center
shall not exceed 4 | 15 |
| months. As an integral part of the services provided,
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| individuals are housed in a supervised living setting while | 17 |
| having immediate
access to the community. The residential | 18 |
| rehabilitation center authorized by
the Department may | 19 |
| have more than one residence included under the license.
A | 20 |
| residence may be no larger than 12 beds and shall be | 21 |
| located as an integral
part of the community. Day treatment | 22 |
| or
individualized outpatient services shall be provided | 23 |
| for persons who reside in
their own home. Functional | 24 |
| outcome goals shall be established for each
individual. | 25 |
| Services shall include, but are not limited to, case | 26 |
| management,
training and assistance with activities of |
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| daily living, nursing
consultation, traditional therapies | 2 |
| (physical, occupational, speech),
functional interventions | 3 |
| in the residence and community (job placement,
shopping, | 4 |
| banking, recreation), counseling, self-management | 5 |
| strategies,
productive activities, and multiple | 6 |
| opportunities for skill acquisition and
practice | 7 |
| throughout the day. The design of individualized program | 8 |
| plans shall
be consistent with the outcome goals that are | 9 |
| established for each resident.
The programs provided in | 10 |
| this setting shall be accredited by the
Commission
on | 11 |
| Accreditation of Rehabilitation Facilities (CARF). The | 12 |
| program shall have
been accredited by CARF as a Brain | 13 |
| Injury Community-Integrative Program for at
least 3 years.
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| (5) Alternative health care delivery model; | 15 |
| Alzheimer's disease
management center. An Alzheimer's | 16 |
| disease management center model is a
designated site that | 17 |
| provides a safe and secure setting for care of persons
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| diagnosed with Alzheimer's disease. An Alzheimer's disease | 19 |
| management center
model shall be a facility separate from | 20 |
| any other facility licensed by the
Department of Public | 21 |
| Health under this or any other Act. An Alzheimer's
disease | 22 |
| management center shall conduct and document an assessment | 23 |
| of each
resident every 6 months. The assessment shall | 24 |
| include an evaluation of daily
functioning, cognitive | 25 |
| status, other medical conditions, and behavioral
problems. | 26 |
| An Alzheimer's disease management center shall develop and |
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| implement
an ongoing treatment plan for each resident. The | 2 |
| treatment
plan shall have defined goals.
The
Alzheimer's | 3 |
| disease management center shall treat behavioral problems | 4 |
| and mood
disorders using nonpharmacologic approaches such | 5 |
| as environmental modification,
task simplification, and | 6 |
| other appropriate activities.
All staff must have | 7 |
| necessary
training to care for all stages of Alzheimer's | 8 |
| Disease. An
Alzheimer's disease
management center shall | 9 |
| provide education and support for residents and
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| caregivers. The
education and support shall include | 11 |
| referrals to support organizations for
educational | 12 |
| materials on community resources, support groups, legal | 13 |
| and
financial issues, respite care, and future care needs | 14 |
| and options. The
education and support shall also include a | 15 |
| discussion of the resident's need to
make advance | 16 |
| directives and to identify surrogates for medical and legal
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| decision-making. The provisions of this paragraph | 18 |
| establish the minimum level
of services that must be | 19 |
| provided by an Alzheimer's disease management
center. An | 20 |
| Alzheimer's disease management center model shall have no | 21 |
| more
than 100 residents. Nothing in this paragraph (5) | 22 |
| shall be construed as
prohibiting a person or facility from | 23 |
| providing services and care to persons
with Alzheimer's | 24 |
| disease as otherwise authorized under State law.
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| (6) Alternative health care model; long term acute care | 26 |
| hospital conversion. A long term acute care hospital |
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| conversion is a Long Term Acute Care Hospital (LTACH) | 2 |
| created by converting a facility or a portion of a facility | 3 |
| previously licensed as a long-term care facility under the | 4 |
| Nursing Home Care Act. This model shall allow for a maximum | 5 |
| of 4 such LTACH conversions, one of which shall be located | 6 |
| in the area of Illinois within the St. Louis Metropolitan | 7 |
| Statistical Area. The LTACH conversions shall each have no | 8 |
| more than 60 beds and provide services to patients whose | 9 |
| medical condition requires long-term medical care as | 10 |
| described in Section 1886(d)(i)(B)(n) of the Social | 11 |
| Security Act as hospitals that have an average Medicare | 12 |
| inpatient length of stay greater than 25 days. The LTACH | 13 |
| conversion shall provide extended medical and | 14 |
| rehabilitative care, such as but not limited to | 15 |
| comprehensive rehabilitation, respiratory therapy, cancer | 16 |
| treatment, head trauma treatment, and pain management, for | 17 |
| patients who are clinically complex and may suffer from | 18 |
| multiple acute or chronic conditions. Facilities licensed | 19 |
| under this model shall be exempt from the requirements of | 20 |
| the Illinois Health Facilities Planning Act. The | 21 |
| Department shall adopt rules specifying criteria, | 22 |
| standards, and procedures for the establishment, | 23 |
| licensure, and operation of LTACH conversions as | 24 |
| authorized under this Act. These rules shall create a new | 25 |
| category of licensure, which shall be consistent with the | 26 |
| LTACH requirements under the applicable provisions of the |
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| Social Security Act to ensure that the LTACH conversions | 2 |
| can be certified under Medicare to provide such services. | 3 |
| The Department shall also adopt rules that identify the | 4 |
| applicable building codes for licensure of LTACH | 5 |
| conversions. The rules shall allow existing licensed and | 6 |
| certified buildings to be reviewed under "existing | 7 |
| construction" standards in the applicable codes. For | 8 |
| purposes of this Act, the facility must maintain a 2-hour | 9 |
| separation in accordance with the applicable construction | 10 |
| codes, for purposes of fire safety. This separation may be | 11 |
| vertical, horizontal, or a combination of both. For the | 12 |
| purpose of defining a horizontal building separation, a | 13 |
| barrier of 2.5 inches or more of concrete, or any other | 14 |
| tested assembly that has a rating of 2 hours or more, will | 15 |
| be acceptable.
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| The Department shall adopt the rules implementing this | 17 |
| model within 6 months after the effective date of this | 18 |
| amendatory Act of the 95th General Assembly. If the | 19 |
| Department fails to adopt rules by the required date, the | 20 |
| Department shall proceed with licensure utilizing the | 21 |
| applicable Medicare conditions of participation. | 22 |
| (Source: P.A. 93-402, eff. 1-1-04; revised 12-15-05.)
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| Section 99. Effective date. This Act takes effect upon | 24 |
| becoming law.
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