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91_SB0807
LRB9106074MWmb
1 AN ACT in relation to the Health Facilities Planning
2 Board, amending and repealing named Acts.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Illinois Health Finance Reform Act is
6 amended by changing Section 2-2 as follows:
7 (20 ILCS 2215/2-2) (from Ch. 111 1/2, par. 6502-2)
8 Sec. 2-2. Council Duties. The Council shall be
9 responsible for:
10 (a) Collecting and publicizing hospital financing and
11 cost data pursuant to Article IV for the purposes of carrying
12 out its duties under this Act.
13 (b) Studying the health care financing system in the
14 State of Illinois, and recommending to the General Assembly
15 what it deems to be the most appropriate and comprehensive
16 cost containment system for the State. In its deliberations,
17 the Council shall consider:
18 (1) The health care delivery system in the State of
19 Illinois and hospitals' role in that system;
20 (2) Minimizing cost shifting between publicly supported
21 patients and private payors;
22 (3) The quality of care provided by hospitals as it
23 relates to their level of reimbursement;
24 (4) Cost containment alternatives for Illinois State
25 employees' health benefit plans currently available under
26 Illinois law;
27 (5) The efficacy of current certificate of need
28 processes under the Illinois Health Facilities Planning Act
29 and possible alternative measures to contain costs, including
30 capital expenditure caps;
31 (6) The efficacy of the current State health planning
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1 process;
2 (7) The efficacy of State bonding authorities for health
3 facilities construction and development;
4 (8) The financial hardships experienced by hospitals
5 primarily serving the poor; and
6 (9) Accessibility of hospital care.
7 (c) Monitoring the extent to which hospitals in general
8 and each individual hospital in the State limit price
9 increases to the rate of increase of prices in the general
10 economy.
11 (d) Promoting and counseling the general public on more
12 effective procurement and utilization of health services,
13 through a special Health Care Consumer Affairs Advisor to be
14 employed by the Council.
15 (Source: P.A. 83-1243.)
16 (20 ILCS 3960/Act rep.)
17 Section 10. The Illinois Health Facilities Planning Act
18 is repealed.
19 (30 ILCS 105/5.213 rep.)
20 Section 15. The State Finance Act is amended by
21 repealing Section 5.213.
22 Section 20. The Hospital District Law is amended by
23 changing Section 15 as follows:
24 (70 ILCS 910/15) (from Ch. 23, par. 1265)
25 Sec. 15. A Hospital District shall constitute a
26 municipal corporation and body politic separate and apart
27 from any other municipality, the State of Illinois or any
28 other public or governmental agency and shall have and
29 exercise the following governmental powers, and all other
30 powers incidental, necessary, convenient, or desirable to
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1 carry out and effectuate such express powers.
2 1. To establish and maintain a hospital and hospital
3 facilities within or outside its corporate limits, and to
4 construct, acquire, develop, expand, extend and improve any
5 such hospital or hospital facility. If a Hospital District
6 utilizes its authority to levy a tax pursuant to Section 20
7 of this Act for the purpose of establishing and maintaining
8 hospitals or hospital facilities, such District shall be
9 prohibited from establishing and maintaining hospitals or
10 hospital facilities located outside of its district unless so
11 authorized by referendum. To approve the provision of any
12 service and to approve any contract or other arrangement not
13 prohibited by a hospital licensed under the Hospital
14 Licensing Act, incorporated under the General Not-For-Profit
15 Corporation Act, and exempt from taxation under paragraph (3)
16 of subsection (c) of Section 501 of the Internal Revenue
17 Code.
18 2. To acquire land in fee simple, rights in land and
19 easements upon, over or across land and leasehold interests
20 in land and tangible and intangible personal property used or
21 useful for the location, establishment, maintenance,
22 development, expansion, extension or improvement of any such
23 hospital or hospital facility. Such acquisition may be by
24 dedication, purchase, gift, agreement, lease, use or adverse
25 possession or by condemnation.
26 3. To operate, maintain and manage such hospital and
27 hospital facility, and to make and enter into contracts for
28 the use, operation or management of and to provide rules and
29 regulations for the operation, management or use of such
30 hospital or hospital facility.
31 Such contracts may include the lease by the District of
32 all or any portion of its facilities to a not-for-profit
33 corporation organized by the District's board of directors.
34 The rent to be paid pursuant to any such lease shall be in an
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1 amount deemed appropriate by the board of directors. Any of
2 the remaining assets which are not the subject of such a
3 lease may be conveyed and transferred to the not-for-profit
4 corporation organized by the District's board of directors
5 provided that the not-for-profit corporation agrees to
6 discharge or assume such debts, liabilities, and obligations
7 of the District as determined to be appropriate by the
8 District's board of directors.
9 4. To fix, charge and collect reasonable fees and
10 compensation for the use or occupancy of such hospital or any
11 part thereof, or any hospital facility, and for nursing care,
12 medicine, attendance, or other services furnished by such
13 hospital or hospital facilities, according to the rules and
14 regulations prescribed by the board from time to time.
15 5. To borrow money and to issue general obligation
16 bonds, revenue bonds, notes, certificates, or other evidences
17 of indebtedness for the purpose of accomplishing any of its
18 corporate purposes, subject to compliance with any conditions
19 or limitations set forth in this Act or the Health Facilities
20 Planning Act or otherwise provided by the constitution of the
21 State of Illinois.
22 6. To employ or enter into contracts for the employment
23 of any person, firm, or corporation, and for professional
24 services, necessary or desirable for the accomplishment of
25 the corporate objects of the District or the proper
26 administration, management, protection or control of its
27 property.
28 7. To maintain such hospital for the benefit of the
29 inhabitants of the area comprising the District who are sick,
30 injured, or maimed regardless of race, creed, religion, sex,
31 national origin or color, and to adopt such reasonable rules
32 and regulations as may be necessary to render the use of the
33 hospital of the greatest benefit to the greatest number; to
34 exclude from the use of the hospital all persons who wilfully
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1 disregard any of the rules and regulations so established; to
2 extend the privileges and use of the hospital to persons
3 residing outside the area of the District upon such terms and
4 conditions as the board of directors prescribes by its rules
5 and regulations.
6 8. To police its property and to exercise police powers
7 in respect thereto or in respect to the enforcement of any
8 rule or regulation provided by the ordinances of the District
9 and to employ and commission police officers and other
10 qualified persons to enforce the same.
11 The use of any such hospital or hospital facility of a
12 District shall be subject to the reasonable regulation and
13 control of the District and upon such reasonable terms and
14 conditions as shall be established by its board of directors.
15 A regulatory ordinance of a District adopted under any
16 provision of this Section may provide for a suspension or
17 revocation of any rights or privileges within the control of
18 the District for a violation of any such regulatory
19 ordinance.
20 Nothing in this Section or in other provisions of this
21 Act shall be construed to authorize the District or board to
22 establish or enforce any regulation or rule in respect to
23 hospitalization or in the operation or maintenance of such
24 hospital or any hospital facilities within its jurisdiction
25 which is in conflict with any federal or state law or
26 regulation applicable to the same subject matter.
27 9. To provide for the benefit of its employees group
28 life, health, accident, hospital and medical insurance, or
29 any combination of such types of insurance, and to further
30 provide for its employees by the establishment of a pension
31 or retirement plan or system; to effectuate the establishment
32 of any such insurance program or pension or retirement plan
33 or system, a Hospital District may make, enter into or
34 subscribe to agreements, contracts, policies or plans with
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1 private insurance companies. Such insurance may include
2 provisions for employees who rely on treatment by spiritual
3 means alone through prayer for healing in accord with the
4 tenets and practice of a well-recognized religious
5 denomination. The board of directors of a Hospital District
6 may provide for payment by the District of a portion of the
7 premium or charge for such insurance or for a pension or
8 retirement plan for employees with the employee paying the
9 balance of such premium or charge. If the board of directors
10 of a Hospital District undertakes a plan pursuant to which
11 the Hospital District pays a portion of such premium or
12 charge, the board shall provide for the withholding and
13 deducting from the compensation of such employees as consent
14 to joining such insurance program or pension or retirement
15 plan or system, the balance of the premium or charge for such
16 insurance or plan or system.
17 If the board of directors of a Hospital District does not
18 provide for a program or plan pursuant to which such District
19 pays a portion of the premium or charge for any group
20 insurance program or pension or retirement plan or system,
21 the board may provide for the withholding and deducting from
22 the compensation of such employees as consent thereto the
23 premium or charge for any group life, health, accident,
24 hospital and medical insurance or for any pension or
25 retirement plan or system.
26 A Hospital District deducting from the compensation of
27 its employees for any group insurance program or pension or
28 retirement plan or system, pursuant to this Section, may
29 agree to receive and may receive reimbursement from the
30 insurance company for the cost of withholding and
31 transferring such amount to the company.
32 10. To sell at public auction or by sealed bid and
33 convey any real estate held by the District which the board
34 of directors, by ordinance adopted by at least 2/3rds of the
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1 members of the board then holding office, has determined to
2 be no longer necessary or useful to, or for the best
3 interests of, the District.
4 An ordinance directing the sale of real estate shall
5 include the legal description of the real estate, its present
6 use, a statement that the property is no longer necessary or
7 useful to, or for the best interests of, the District, the
8 terms and conditions of the sale, whether the sale is to be
9 at public auction or sealed bid, and the date, time, and
10 place the property is to be sold at auction or sealed bids
11 opened.
12 Before making a sale by virtue of the ordinance, the
13 board of directors shall cause notice of the proposal to sell
14 to be published once each week for 3 successive weeks in a
15 newspaper published, or, if none is published, having a
16 general circulation, in the district, the first publication
17 to be not less than 30 days before the day provided in the
18 notice for the public sale or opening of bids for the real
19 estate.
20 The notice of the proposal to sell shall include the same
21 information included in the ordinance directing the sale and
22 shall advertise for bids therefor. A sale of property by
23 public auction shall be held at the property to be sold at a
24 time and date determined by the board of directors. The
25 board of directors may accept the high bid or any other bid
26 determined to be in the best interests of the district by a
27 vote of 2/3rds of the board then holding office, but by a
28 majority vote of those holding office, they may reject any
29 and all bids.
30 The chairman and secretary of the board of directors
31 shall execute all documents necessary for the conveyance of
32 such real property sold pursuant to the foregoing authority.
33 11. To establish and administer a program of loans for
34 postsecondary students pursuing degrees in accredited public
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1 health-related educational programs at public institutions of
2 higher education. If a student is awarded a loan, the
3 individual shall agree to accept employment within the
4 hospital district upon graduation from the public institution
5 of higher education. For the purposes of this Act, "public
6 institutions of higher education" means the University of
7 Illinois; Southern Illinois University; Chicago State
8 University; Eastern Illinois University; Governors State
9 University; Illinois State University; Northeastern Illinois
10 University; Northern Illinois University; Western Illinois
11 University; the public community colleges of the State; and
12 any other public colleges, universities or community colleges
13 now or hereafter established or authorized by the General
14 Assembly. The district's board of directors shall by
15 resolution provide for eligibility requirements, award
16 criteria, terms of financing, duration of employment accepted
17 within the district and such other aspects of the loan
18 program as its establishment and administration may
19 necessitate.
20 12. To establish and maintain congregate housing units;
21 to acquire land in fee simple and leasehold interests in land
22 for the location, establishment, maintenance, and development
23 of those housing units; to borrow funds and give debt
24 instruments, real estate mortgages, and security interests in
25 personal property, contract rights, and general intangibles;
26 and to enter into any contract required for participation in
27 any federal or State programs.
28 (Source: P.A. 89-4, eff. 1-1-96; 89-104, eff. 7-7-95; 89-626,
29 eff. 8-9-96.)
30 Section 25. The Alternative Health Care Delivery Act is
31 amended by changing Sections 20 and 30 as follows:
32 (210 ILCS 3/20)
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1 Sec. 20. Board responsibilities. The State Board of
2 Health shall have the responsibilities set forth in this
3 Section.
4 (a) The Board shall investigate new health care delivery
5 models and recommend to the Governor and the General
6 Assembly, through the Department, those models that should be
7 authorized as alternative health care models for which
8 demonstration programs should be initiated. In its
9 deliberations, the Board shall use the following criteria:
10 (1) The feasibility of operating the model in
11 Illinois, based on a review of the experience in other
12 states including the impact on health professionals of
13 other health care programs or facilities.
14 (2) The potential of the model to meet an unmet
15 need.
16 (3) The potential of the model to reduce health
17 care costs to consumers, costs to third party payors, and
18 aggregate costs to the public.
19 (4) The potential of the model to maintain or
20 improve the standards of health care delivery in some
21 measurable fashion.
22 (5) The potential of the model to provide increased
23 choices or access for patients.
24 (b) The Board shall evaluate and make recommendations to
25 the Governor and the General Assembly, through the
26 Department, regarding alternative health care model
27 demonstration programs established under this Act, at the
28 midpoint and end of the period of operation of the
29 demonstration programs. The report shall include, at a
30 minimum, the following:
31 (1) Whether the alternative health care models
32 improved access to health care for their service
33 populations in the State.
34 (2) The quality of care provided by the alternative
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1 health care models as may be evidenced by health
2 outcomes, surveillance reports, and administrative
3 actions taken by the Department.
4 (3) The cost and cost effectiveness to the public,
5 third-party payors, and government of the alternative
6 health care models, including the impact of pilot
7 programs on aggregate health care costs in the area. In
8 addition to any other information collected by the Board
9 under this Section, the Board shall collect from
10 postsurgical recovery care centers uniform billing data
11 substantially the same as specified in Section 4-2(e) of
12 the Illinois Health Finance Reform Act. To facilitate
13 its evaluation of that data, the Board shall forward a
14 copy of the data to the Illinois Health Care Cost
15 Containment Council. All patient identifiers shall be
16 removed from the data before it is submitted to the Board
17 or Council.
18 (4) The impact of the alternative health care
19 models on the health care system in that area, including
20 changing patterns of patient demand and utilization,
21 financial viability, and feasibility of operation of
22 service in inpatient and alternative models in the area.
23 (5) The implementation by alternative health care
24 models of any special commitments made during application
25 review to the Illinois Health Facilities Planning Board.
26 (6) The continuation, expansion, or modification of
27 the alternative health care models.
28 (c) The Board shall advise the Department on the
29 definition and scope of alternative health care models
30 demonstration programs.
31 (d) In carrying out its responsibilities under this
32 Section, the Board shall seek the advice of other Department
33 advisory boards or committees that may be impacted by the
34 alternative health care model or the proposed model of health
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1 care delivery. The Board shall also seek input from other
2 interested parties, which may include holding public
3 hearings.
4 (e) The Board shall otherwise advise the Department on
5 the administration of the Act as the Board deems appropriate.
6 (Source: P.A. 87-1188; 88-441.)
7 (210 ILCS 3/30)
8 Sec. 30. Demonstration program requirements. The
9 requirements set forth in this Section shall apply to
10 demonstration programs.
11 (a) There shall be no more than:
12 (i) 3 subacute care hospital alternative health
13 care models in the City of Chicago (one of which shall be
14 located on a designated site and shall have been licensed
15 as a hospital under the Illinois Hospital Licensing Act
16 within the 10 years immediately before the application
17 for a license);
18 (ii) 2 subacute care hospital alternative health
19 care models in the demonstration program for each of the
20 following areas:
21 (1) Cook County outside the City of Chicago.
22 (2) DuPage, Kane, Lake, McHenry, and Will
23 Counties.
24 (3) Municipalities with a population greater
25 than 50,000 not located in the areas described in
26 item (i) of subsection (a) and paragraphs (1) and
27 (2) of item (ii) of subsection (a); and
28 (iii) 4 subacute care hospital alternative health
29 care models in the demonstration program for rural areas.
30 In selecting among applicants for these licenses in rural
31 areas, the Health Facilities Planning Board and the
32 Department shall give preference to hospitals that may be
33 unable for economic reasons to provide continued service to
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1 the community in which they are located unless the hospital
2 were to receive an alternative health care model license.
3 (a-5) There shall be no more than a total of 12
4 postsurgical recovery care center alternative health care
5 models in the demonstration program, located as follows:
6 (1) Two in the City of Chicago.
7 (2) Two in Cook County outside the City of Chicago.
8 At least one of these shall be owned or operated by a
9 hospital devoted exclusively to caring for children.
10 (3) Two in Kane, Lake, and McHenry Counties.
11 (4) Four in municipalities with a population of
12 50,000 or more not located in the areas described in
13 paragraphs (1), (2), and (3), 3 of which shall be owned
14 or operated by hospitals, at least 2 of which shall be
15 located in counties with a population of less than
16 175,000, according to the most recent decennial census
17 for which data are available, and one of which shall be
18 owned or operated by an ambulatory surgical treatment
19 center.
20 (5) Two in rural areas, both of which shall be
21 owned or operated by hospitals.
22 There shall be no postsurgical recovery care center
23 alternative health care models located in counties with
24 populations greater than 600,000 but less than 1,000,000. A
25 proposed postsurgical recovery care center must be owned or
26 operated by a hospital if it is to be located within, or will
27 primarily serve the residents of, a health service area in
28 which more than 60% of the gross patient revenue of the
29 hospitals within that health service area are derived from
30 Medicaid and Medicare, according to the most recently
31 available calendar year data from the Illinois Health Care
32 Cost Containment Council. Nothing in this paragraph shall
33 preclude a hospital and an ambulatory surgical treatment
34 center from forming a joint venture or developing a
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1 collaborative agreement to own or operate a postsurgical
2 recovery care center.
3 (a-10) There shall be no more than a total of 8
4 children's respite care center alternative health care models
5 in the demonstration program, which shall be located as
6 follows:
7 (1) One in the City of Chicago.
8 (2) One in Cook County outside the City of Chicago.
9 (3) A total of 2 in the area comprised of DuPage,
10 Kane, Lake, McHenry, and Will counties.
11 (4) A total of 2 in municipalities with a
12 population of 50,000 or more and not located in the
13 areas described in paragraphs (1), (2), or (3).
14 (5) A total of 2 in rural areas, as defined by the
15 Health Facilities Planning Board.
16 No more than one children's respite care model owned and
17 operated by a licensed skilled pediatric facility shall be
18 located in each of the areas designated in this subsection
19 (a-10).
20 (b) (Blank). Alternative health care models shall
21 obtain a certificate of need from the Illinois Health
22 Facilities Planning Board under the Illinois Health
23 Facilities Planning Act before receiving a license by the
24 Department. Alternative health care models in medically
25 underserved areas shall receive priority in obtaining a
26 certificate of need.
27 (c) An alternative health care model license shall be
28 issued for a period of one year and shall be annually renewed
29 if the facility or program is in substantial compliance with
30 the Department's rules adopted under this Act. A licensed
31 alternative health care model that continues to be in
32 substantial compliance after the conclusion of the
33 demonstration program shall be eligible for annual renewals
34 unless and until a different licensure program for that type
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1 of health care model is established by legislation. The
2 Department may issue a provisional license to any alternative
3 health care model that does not substantially comply with the
4 provisions of this Act and the rules adopted under this Act
5 if (i) the Department finds that the alternative health care
6 model has undertaken changes and corrections which upon
7 completion will render the alternative health care model in
8 substantial compliance with this Act and rules and (ii) the
9 health and safety of the patients of the alternative health
10 care model will be protected during the period for which the
11 provisional license is issued. The Department shall advise
12 the licensee of the conditions under which the provisional
13 license is issued, including the manner in which the
14 alternative health care model fails to comply with the
15 provisions of this Act and rules, and the time within which
16 the changes and corrections necessary for the alternative
17 health care model to substantially comply with this Act and
18 rules shall be completed.
19 (d) Alternative health care models shall seek
20 certification under Titles XVIII and XIX of the federal
21 Social Security Act. In addition, alternative health care
22 models shall provide charitable care consistent with that
23 provided by comparable health care providers in the
24 geographic area.
25 (d-5) The Illinois Department of Public Aid, in
26 cooperation with the Illinois Department of Public Health,
27 shall develop and implement a reimbursement methodology for
28 all facilities participating in the demonstration program.
29 The Illinois Department of Public Aid shall keep a record of
30 services provided under the demonstration program to
31 recipients of medical assistance under the Illinois Public
32 Aid Code and shall submit an annual report of that
33 information to the Illinois Department of Public Health.
34 (e) Alternative health care models shall, to the extent
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1 possible, link and integrate their services with nearby
2 health care facilities.
3 (f) Each alternative health care model shall implement a
4 quality assurance program with measurable benefits and at
5 reasonable cost.
6 (Source: P.A. 88-441; 88-490; 88-670, eff. 12-2-94; 89-393,
7 eff. 8-20-95.)
8 (210 ILCS 3/36.5 rep.)
9 Section 30. The Alternative Health Care Delivery Act is
10 amended by repealing Section 36.5.
11 Section 35. The Life Care Facilities Act is amended by
12 changing Sections 2 and 7 as follows:
13 (210 ILCS 40/2) (from Ch. 111 1/2, par. 4160-2)
14 Sec. 2. As used in this Act, unless the context
15 otherwise requires:
16 (a) "Department" means the Department of Public Health.
17 (b) "Director" means the Director of the Department.
18 (c) "Life care contract" means a contract to provide to
19 a person for the duration of such person's life or for a term
20 in excess of one year, nursing services, medical services or
21 personal care services, in addition to maintenance services
22 for such person in a facility, conditioned upon the transfer
23 of an entrance fee to the provider of such services in
24 addition to or in lieu of the payment of regular periodic
25 charges for the care and services involved.
26 (d) "Provider" means a person who provides services
27 pursuant to a life care contract.
28 (e) "Resident" means a person who enters into a life
29 care contract with a provider, or who is designated in a life
30 care contract to be a person provided with maintenance and
31 nursing, medical or personal care services.
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1 (f) "Facility" means a place or places in which a
2 provider undertakes to provide a resident with nursing
3 services, medical services or personal care services, in
4 addition to maintenance services for a term in excess of one
5 year or for life pursuant to a life care contract. The term
6 also means a place or places in which a provider undertakes
7 to provide such services to a non-resident.
8 (g) "Living unit" means an apartment, room or other area
9 within a facility set aside for the exclusive use of one or
10 more identified residents.
11 (h) "Entrance fee" means an initial or deferred transfer
12 to a provider of a sum of money or property, made or promised
13 to be made by a person entering into a life care contract,
14 which assures a resident of services pursuant to a life care
15 contract.
16 (i) "Permit" means a written authorization to enter into
17 life care contracts issued by the Department to a provider.
18 (j) "Medical services" means those services pertaining
19 to medical or dental care that are performed in behalf of
20 patients at the direction of a physician licensed under the
21 Medical Practice Act of 1987 or a dentist licensed under the
22 Illinois Dental Practice Act by such physicians or dentists,
23 or by a registered or licensed practical nurse as defined in
24 the Nursing and Advanced Practice Nursing Act or by other
25 professional and technical personnel.
26 (k) "Nursing services" means those services pertaining
27 to the curative, restorative and preventive aspects of
28 nursing care that are performed at the direction of a
29 physician licensed under the Medical Practice Act of 1987 by
30 or under the supervision of a registered or licensed
31 practical nurse as defined in the Nursing and Advanced
32 Practice Nursing Act.
33 (l) "Personal care services" means assistance with
34 meals, dressing, movement, bathing or other personal needs or
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1 maintenance, or general supervision and oversight of the
2 physical and mental well-being of an individual, who is
3 incapable of maintaining a private, independent residence or
4 who is incapable of managing his person whether or not a
5 guardian has been appointed for such individual.
6 (m) "Maintenance services" means food, shelter and
7 laundry services.
8 (n) (Blank). "Certificates of Need" means those permits
9 issued pursuant to the Illinois Health Facilities Planning
10 Act as now or hereafter amended.
11 (o) "Non-resident" means a person admitted to a facility
12 who has not entered into a life care contract.
13 (Source: P.A. 90-742, eff. 8-13-98.)
14 (210 ILCS 40/7) (from Ch. 111 1/2, par. 4160-7)
15 Sec. 7. As a condition for the issuance of a permit
16 pursuant to this Act, the provider shall establish and
17 maintain on a current basis, a letter of credit or an escrow
18 account with a bank, trust company, or other financial
19 institution located in the State of Illinois. The letter of
20 credit shall be in an amount and form acceptable to the
21 Department, but in no event shall the amount exceed that
22 applicable to the corresponding escrow agreement alternative,
23 as described below. The terms of the escrow agreement shall
24 meet the following provisions:
25 (a) Requirements for new facilities.
26 (1) If the entrance fee applies to a living unit which
27 has not previously been occupied by any resident, all
28 entrance fee payments representing either all or any smaller
29 portion of the total entrance fee shall be paid to the escrow
30 agent by the resident.
31 (2) When the provider has sold at least 1/2 of its
32 living units, obtained a mortgage commitment, if needed, and
33 obtained all necessary zoning permits and Certificates of
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1 Need, if required, the escrow agent may release a sum
2 representing 1/5 of the resident's total entrance fee to the
3 provider. Upon completion of the foundation of the living
4 unit an additional 1/5 of the resident's total entrance fee
5 may be released to the provider. When the living unit is
6 under roof a further and additional 1/5 of the resident's
7 total entrance fee may be released to the provider. All
8 remaining monies, if any, shall remain in escrow until the
9 resident's living unit is substantially completed and ready
10 for occupancy by the resident. When the living unit is ready
11 for occupancy the escrow agent may release the remaining
12 escrow amount to the provider and further entrance fee
13 payments, if any, may be paid by the resident to the provider
14 directly. All monies released from escrow shall be used for
15 the facility and for no other purpose.
16 (b) General requirements for all facilities, including
17 new and existing facilities.
18 (1) At the time of resident occupancy and at all times
19 thereafter, the escrow amount shall be in an amount which
20 equals or exceeds the aggregate principal and interest
21 payments due during the next 6 months on account of any first
22 mortgage or other long-term financing of the facility.
23 Existing facilities shall have 2 years from the date of this
24 Act becoming law to comply with this subsection. Upon
25 application from a facility showing good cause, the Director
26 may extend compliance with this subsection one additional
27 year.
28 (2) Notwithstanding paragraph (1) of this subsection,
29 the escrow monies required under paragraph (1) of this
30 subsection may be released to the provider upon approval by
31 the Director. The Director may attach such conditions on the
32 release of monies as he deems fit including, but not limited
33 to, the performance of an audit which satisfies the Director
34 that the facility is solvent, a plan from the facility to
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1 bring the facility back in compliance with paragraph (1) of
2 this subsection, and a repayment schedule.
3 (3) The principal of the escrow account may be invested
4 with the earnings thereon payable to the provider as it
5 accrues.
6 (4) If the facility ceases to operate all monies in the
7 escrow account except the amount representing principal and
8 interest shall be repaid by the escrow agent to the resident.
9 (5) Balloon payments due at conclusion of the mortgage
10 shall not be subject to the escrow requirements of paragraph
11 (1) this subsection.
12 (Source: P.A. 85-1349.)
13 Section 40. The Nursing Home Care Act is amended by
14 changing Sections 3-102.2 and 3-103 as follows:
15 (210 ILCS 45/3-102.2)
16 Sec. 3-102.2. Supported congregate living arrangement
17 demonstration. The Illinois Department may grant no more
18 than 3 waivers from the requirements of this Act for
19 facilities participating in the supported congregate living
20 arrangement demonstration. A joint waiver request must be
21 made by an applicant and the Department on Aging. If the
22 Department on Aging does not act upon an application within
23 60 days, the applicant may submit a written waiver request on
24 its own behalf. The waiver request must include a specific
25 program plan describing the types of residents to be served
26 and the services that will be provided in the facility. The
27 Department shall conduct an on-site review at each facility
28 annually or as often as necessary to ascertain compliance
29 with the program plan. The Department may revoke the waiver
30 if it determines that the facility is not in compliance with
31 the program plan. Nothing in this Section prohibits the
32 Department from conducting complaint investigations.
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1 A facility granted a waiver under this Section is not
2 subject to the Illinois Health Facilities Planning Act,
3 unless it subsequently applies for a certificate of need to
4 convert to a nursing facility. A facility applying for
5 conversion shall meet the licensure and certificate of need
6 requirements in effect as of the date of application, and
7 this provision may not be waived.
8 (Source: P.A. 89-530, eff. 7-19-96.)
9 (210 ILCS 45/3-103) (from Ch. 111 1/2, par. 4153-103)
10 Sec. 3-103. The procedure for obtaining a valid license
11 shall be as follows:
12 (1) Application to operate a facility shall be made to
13 the Department on forms furnished by the Department.
14 (2) All applications, except those of homes for the
15 aged, shall be accompanied by an application fee of $200 for
16 an annual license and $400 for a 2 year license. The fee
17 shall be deposited with the State Treasurer into the Long
18 Term Care Monitor/Receiver Fund, which is hereby created as a
19 special fund in the State Treasury. This special fund is to
20 be used by the Department for expenses related to the
21 appointment of monitors and receivers as contained in
22 Sections 3-501 through 3-517. At the end of each fiscal
23 year, any funds in excess of $1,000,000 held in the Long Term
24 Care Monitor/Receiver Fund shall be deposited in the State's
25 General Revenue Fund. The application shall be under oath and
26 the submission of false or misleading information shall be a
27 Class A misdemeanor. The application shall contain the
28 following information:
29 (a) The name and address of the applicant if an
30 individual, and if a firm, partnership, or association,
31 of every member thereof, and in the case of a
32 corporation, the name and address thereof and of its
33 officers and its registered agent, and in the case of a
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1 unit of local government, the name and address of its
2 chief executive officer;
3 (b) The name and location of the facility for which
4 a license is sought;
5 (c) The name of the person or persons under whose
6 management or supervision the facility will be conducted;
7 (d) The number and type of residents for which
8 maintenance, personal care, or nursing is to be provided;
9 and
10 (e) Such information relating to the number,
11 experience, and training of the employees of the
12 facility, any management agreements for the operation of
13 the facility, and of the moral character of the applicant
14 and employees as the Department may deem necessary.
15 (3) Each initial application shall be accompanied by a
16 financial statement setting forth the financial condition of
17 the applicant and by a statement from the unit of local
18 government having zoning jurisdiction over the facility's
19 location stating that the location of the facility is not in
20 violation of a zoning ordinance. An initial application for a
21 new facility shall be accompanied by a permit as required by
22 the "Illinois Health Facilities Planning Act". After the
23 application is approved, the applicant shall advise the
24 Department every 6 months of any changes in the information
25 originally provided in the application.
26 (4) Other information necessary to determine the
27 identity and qualifications of an applicant to operate a
28 facility in accordance with this Act shall be included in the
29 application as required by the Department in regulations.
30 (Source: P.A. 86-663; 87-1102.)
31 Section 45. The Emergency Medical Services (EMS) Systems
32 Act is amended by changing Section 32.5 as follows:
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1 (210 ILCS 50/32.5)
2 Sec. 32.5. Freestanding Emergency Center; demonstration
3 program.
4 (a) The Department shall issue an annual Freestanding
5 Emergency Center (FEC) license to any facility that:
6 (1) is located: (i) in a municipality with a
7 population of 60,000 or fewer inhabitants; (ii) either in
8 a municipality that has a hospital that has been
9 providing emergency services but is expected to close by
10 the end of 1997 or in a county with a population of more
11 than 350,000 but less than 500,000 inhabitants; (iii)
12 within 15 miles of the hospital that owns or controls the
13 FEC; and (iv) within 10 miles of the Resource Hospital
14 affiliated with the FEC as part of the EMS System;
15 (2) is wholly owned or controlled by an Associate
16 or Resource Hospital, but is not a part of the hospital's
17 physical plant;
18 (3) meets the standards for licensed FECs, adopted
19 by rule of the Department, including, but not limited to:
20 (A) facility design, specification, operation,
21 and maintenance standards;
22 (B) equipment standards; and
23 (C) the number and qualifications of emergency
24 medical personnel and other staff, which must
25 include at least one board certified emergency
26 physician present at the FEC 24 hours per day.
27 (4) limits its participation in the EMS System
28 strictly to receiving a limited number of BLS runs by
29 emergency medical vehicles according to protocols
30 developed by the Resource Hospital within the FEC's
31 designated EMS System and approved by the Project Medical
32 Director and the Department;
33 (5) provides comprehensive emergency treatment
34 services, as defined in the rules adopted by the
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1 Department pursuant to the Hospital Licensing Act, 24
2 hours per day, on an outpatient basis;
3 (6) provides an ambulance and maintains on site
4 ambulance services staffed with paramedics 24 hours per
5 day;
6 (7) maintains helicopter landing capabilities
7 approved by appropriate State and federal authorities;
8 (8) complies with all State and federal patient
9 rights provisions, including, but not limited to, the
10 Emergency Medical Treatment Act and the federal Emergency
11 Medical Treatment and Active Labor Act;
12 (9) maintains a communications system that is fully
13 integrated with its Resource Hospital within the FEC's
14 designated EMS System;
15 (10) reports to the Department any patient
16 transfers from the FEC to a hospital within 48 hours of
17 the transfer plus any other data determined to be
18 relevant by the Department;
19 (11) submits to the Department, on a quarterly
20 basis, the FEC's morbidity and mortality rates for
21 patients treated at the FEC and other data determined to
22 be relevant by the Department;
23 (12) does not describe itself or hold itself out to
24 the general public as a full service hospital or hospital
25 emergency department in its advertising or marketing
26 activities;
27 (13) complies with any other rules adopted by the
28 Department under this Act that relate to FECs;
29 (14) passes the Department's site inspection for
30 compliance with the FEC requirements of this Act;
31 (15) (Blank); submits a copy of a certificate of
32 need or other permit issued by the Illinois Health
33 Facilities Planning Board indicating that the facility
34 that will house the proposed FEC complies with State
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1 health planning laws; provided, however, that the
2 Illinois Health Facilities Planning Board shall waive
3 this certificate of need or permit requirement for any
4 proposed FEC that, as of the effective date of this
5 amendatory Act of 1996, meets the criteria for providing
6 comprehensive emergency treatment services, as defined by
7 the rules promulgated under the Hospital Licensing Act,
8 but is not a licensed hospital;
9 (16) submits an application for designation as an
10 FEC in a manner and form prescribed by the Department by
11 rule; and
12 (17) pays the annual license fee as determined by
13 the Department by rule.
14 (b) The Department shall:
15 (1) annually inspect facilities of initial FEC
16 applicants and licensed FECs, and issue annual licenses
17 to or annually relicense FECs that satisfy the
18 Department's licensure requirements as set forth in
19 subsection (a);
20 (2) suspend, revoke, refuse to issue, or refuse to
21 renew the license of any FEC, after notice and an
22 opportunity for a hearing, when the Department finds that
23 the FEC has failed to comply with the standards and
24 requirements of the Act or rules adopted by the
25 Department under the Act;
26 (3) issue an Emergency Suspension Order for any FEC
27 when the Director or his or her designee has determined
28 that the continued operation of the FEC poses an
29 immediate and serious danger to the public health,
30 safety, and welfare. An opportunity for a hearing shall
31 be promptly initiated after an Emergency Suspension Order
32 has been issued; and
33 (4) adopt rules as needed to implement this
34 Section.
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1 (c) The FEC demonstration program shall be conducted for
2 an initial period concluding on September 1, 1999. If, by
3 that date, the Department determines that the demonstration
4 program is operating in a manner consistent with the purposes
5 of this Act, the program shall continue and sunset on
6 September 1, 2001. The Department shall submit a report
7 concerning the effectiveness of the demonstration program to
8 the General Assembly by September 1, 2000.
9 An FEC license issued pursuant to this Section shall
10 expire upon the termination of the demonstration program.
11 (Source: P.A. 89-516, eff. 7-18-96; 90-67, eff. 7-8-97.)
12 Section 50. The Hospital Licensing Act is amended by
13 changing Section 4.5 as follows:
14 (210 ILCS 85/4.5)
15 Sec. 4.5. Hospital with multiple locations; single
16 license.
17 (a) A hospital located in a county with fewer than
18 3,000,000 inhabitants may apply to the Department for
19 approval to conduct its operations from more than one
20 location within the county under a single license.
21 (b) The facilities or buildings at those locations must
22 be owned or operated together by a single corporation or
23 other legal entity serving as the licensee and must share:
24 (1) a single board of directors with responsibility
25 for governance, including financial oversight and the
26 authority to designate or remove the chief executive
27 officer;
28 (2) a single medical staff accountable to the board
29 of directors and governed by a single set of medical
30 staff bylaws, rules, and regulations with responsibility
31 for the quality of the medical services; and
32 (3) a single chief executive officer, accountable
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1 to the board of directors, with management
2 responsibility.
3 (c) Each hospital building or facility that is located
4 on a site geographically separate from the campus or premises
5 of another hospital building or facility operated by the
6 licensee must, at a minimum, individually comply with the
7 Department's hospital licensing requirements for emergency
8 services.
9 (d) The hospital shall submit to the Department a
10 comprehensive plan in relation to the waiver or waivers
11 requested describing the services and operations of each
12 facility or building and how common services or operations
13 will be coordinated between the various locations. With the
14 exception of items required by subsection (c), the Department
15 is authorized to waive compliance with the hospital licensing
16 requirements for specific buildings or facilities, provided
17 that the hospital has documented which other building or
18 facility under its single license provides that service or
19 operation, and that doing so would not endanger the public's
20 health, safety, or welfare. Nothing in this Section relieves
21 a hospital from the requirements of the Health Facilities
22 Planning Act.
23 (Source: P.A. 89-171, eff. 7-19-95.)
24 Section 55. The Health Care Worker Self-Referral Act is
25 amended by changing Sections 5, 15, and 30 as follows:
26 (225 ILCS 47/5)
27 Sec. 5. Legislative intent. The General Assembly
28 recognizes that patient referrals by health care workers for
29 health services to an entity in which the referring health
30 care worker has an investment interest may present a
31 potential conflict of interest. The General Assembly finds
32 that these referral practices may limit or completely
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1 eliminate competitive alternatives in the health care market.
2 In some instances, these referral practices may expand and
3 improve care or may make services available which were
4 previously unavailable. They may also provide lower cost
5 options to patients or increase competition. Generally,
6 referral practices are positive occurrences. However,
7 self-referrals may result in over utilization of health
8 services, increased overall costs of the health care systems,
9 and may affect the quality of health care.
10 It is the intent of the General Assembly to provide
11 guidance to health care workers regarding acceptable patient
12 referrals, to prohibit patient referrals to entities
13 providing health services in which the referring health care
14 worker has an investment interest, and to protect the
15 citizens of Illinois from unnecessary and costly health care
16 expenditures.
17 Recognizing the need for flexibility to quickly respond
18 to changes in the delivery of health services, to avoid
19 results beyond the limitations on self referral provided
20 under this Act and to provide minimal disruption to the
21 appropriate delivery of health care, the Illinois Department
22 of Public Health may adopt rules Facilities Planning Board
23 shall be exclusively and solely authorized to implement and
24 interpret this Act through adopted rules.
25 The General Assembly recognizes that changes in delivery
26 of health care has resulted in various methods by which
27 health care workers practice their professions. It is not
28 the intent of the General Assembly to limit appropriate
29 delivery of care, nor force unnecessary changes in the
30 structures created by workers for the health and convenience
31 of their patients.
32 (Source: P.A. 87-1207.)
33 (225 ILCS 47/15)
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1 Sec. 15. Definitions. In this Act:
2 (a) "Board" means: (1) until the effective date of this
3 amendatory Act of the 91st General Assembly, the Health
4 Facilities Planning Board; and (2) beginning on the effective
5 date of this amendatory Act of the 91st General Assembly, the
6 Illinois Department of Public Health.
7 (b) "Entity" means any individual, partnership, firm,
8 corporation, or other business that provides health services
9 but does not include an individual who is a health care
10 worker who provides professional services to an individual.
11 (c) "Group practice" means a group of 2 or more health
12 care workers legally organized as a partnership, professional
13 corporation, not-for-profit corporation, faculty practice
14 plan or a similar association in which:
15 (1) each health care worker who is a member or
16 employee or an independent contractor of the group
17 provides substantially the full range of services that
18 the health care worker routinely provides, including
19 consultation, diagnosis, or treatment, through the use of
20 office space, facilities, equipment, or personnel of the
21 group;
22 (2) the services of the health care workers are
23 provided through the group, and payments received for
24 health services are treated as receipts of the group; and
25 (3) the overhead expenses and the income from the
26 practice are distributed by methods previously determined
27 by the group.
28 (d) "Health care worker" means any individual licensed
29 under the laws of this State to provide health services,
30 including but not limited to: dentists licensed under the
31 Illinois Dental Practice Act; dental hygienists licensed
32 under the Illinois Dental Practice Act; nurses and advanced
33 practice nurses licensed under the Nursing and Advanced
34 Practice Nursing Act; occupational therapists licensed under
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1 the Illinois Occupational Therapy Practice Act; optometrists
2 licensed under the Illinois Optometric Practice Act of 1987;
3 pharmacists licensed under the Pharmacy Practice Act of 1987;
4 physical therapists licensed under the Illinois Physical
5 Therapy Act; physicians licensed under the Medical Practice
6 Act of 1987; physician assistants licensed under the
7 Physician Assistant Practice Act of 1987; podiatrists
8 licensed under the Podiatric Medical Practice Act of 1987;
9 clinical psychologists licensed under the Clinical
10 Psychologist Licensing Act; clinical social workers licensed
11 under the Clinical Social Work and Social Work Practice Act;
12 speech-language pathologists and audiologists licensed under
13 the Illinois Speech-Language Pathology and Audiology Practice
14 Act; or hearing instrument dispensers licensed under the
15 Hearing Instrument Consumer Protection Act, or any of their
16 successor Acts.
17 (e) "Health services" means health care procedures and
18 services provided by or through a health care worker.
19 (f) "Immediate family member" means a health care
20 worker's spouse, child, child's spouse, or a parent.
21 (g) "Investment interest" means an equity or debt
22 security issued by an entity, including, without limitation,
23 shares of stock in a corporation, units or other interests in
24 a partnership, bonds, debentures, notes, or other equity
25 interests or debt instruments except that investment interest
26 for purposes of Section 20 does not include interest in a
27 hospital licensed under the laws of the State of Illinois.
28 (h) "Investor" means an individual or entity directly or
29 indirectly owning a legal or beneficial ownership or
30 investment interest, (such as through an immediate family
31 member, trust, or another entity related to the investor).
32 (i) "Office practice" includes the facility or
33 facilities at which a health care worker, on an ongoing
34 basis, provides or supervises the provision of professional
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1 health services to individuals.
2 (j) "Referral" means any referral of a patient for
3 health services, including, without limitation:
4 (1) The forwarding of a patient by one health care
5 worker to another health care worker or to an entity
6 outside the health care worker's office practice or group
7 practice that provides health services.
8 (2) The request or establishment by a health care
9 worker of a plan of care outside the health care worker's
10 office practice or group practice that includes the
11 provision of any health services.
12 (Source: P.A. 89-72, eff. 12-31-95; 90-742, eff. 8-13-98.)
13 (225 ILCS 47/30)
14 Sec. 30. Rulemaking. The Health Facilities Planning
15 Board shall adopt rules to exclusively and solely implement
16 the provisions of this Act pursuant to rules adopted in
17 accordance with the Illinois Administrative Procedure Act
18 concerning, but not limited to:
19 (a) Standards and procedures for the administration
20 of this Act.
21 (b) Procedures and criteria for exceptions from the
22 prohibitions set forth in Section 20.
23 (c) Procedures and criteria for determining
24 practical compliance with the needs and alternative
25 investor criteria in Section 20.
26 (d) Procedures and criteria for determining when a
27 written request for an opinion set forth in Section 20 is
28 complete.
29 (e) Procedures and criteria for advising health
30 care workers of the applicability of this Act to
31 practices pursuant to written requests.
32 Rules adopted under this Act by the Health Facilities
33 Planning Board shall remain in effect until amended or
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1 repealed by the Department.
2 (Source: P.A. 87-1207.)
3 Section 60. The Nurse Agency Licensing Act is amended by
4 changing Section 3 as follows:
5 (225 ILCS 510/3) (from Ch. 111, par. 953)
6 Sec. 3. Definitions. As used in this Act:
7 (a) "Certified nurse aide" means an individual certified
8 as defined in Section 3-206 of the Nursing Home Care Act, as
9 now or hereafter amended.
10 (b) "Department" means the Department of Labor.
11 (c) "Director" means the Director of Labor.
12 (d) "Health care facilities" means and includes the
13 following facilities and organizations:
14 (1) An ambulatory surgical treatment center
15 required to be licensed pursuant to the Ambulatory
16 Surgical Treatment Center Act;
17 (2) An institution, place, building, or agency
18 required to be licensed pursuant to the Hospital
19 Licensing Act;
20 (3) Any institution required to be licensed
21 pursuant to the Nursing Home Care Act;
22 (4) Hospitals, nursing homes, ambulatory surgical
23 treatment centers, or kidney disease treatment centers
24 maintained by the State or any department or agency
25 thereof; and
26 (5) Kidney disease treatment centers, including a
27 free-standing hemodialysis unit. "Health care facility"
28 is defined as in Section 3 of the Illinois Health
29 Facilities Planning Act, as now or hereafter amended.
30 (e) "Licensee" means any nursing agency which is
31 properly licensed under this Act.
32 (f) "Nurse" means a registered nurse or a licensed
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1 practical nurse as defined in the Nursing and Advanced
2 Practice Nursing Act.
3 (g) "Nurse agency" means any individual, firm,
4 corporation, partnership or other legal entity that employs,
5 assigns or refers nurses or certified nurse aides to a health
6 care facility for a fee. The term "nurse agency" includes
7 nurses registries. The term "nurse agency" does not include
8 services provided by home health agencies licensed and
9 operated under the Home Health Agency Licensing Act or a
10 licensed or certified individual who provides his or her own
11 services as a regular employee of a health care facility, nor
12 does it apply to a health care facility's organizing
13 nonsalaried employees to provide services only in that
14 facility.
15 (Source: P.A. 90-742, eff. 8-13-98.)
16 Section 65. The Illinois Public Aid Code is amended by
17 changing Section 5-5.01a as follows:
18 (305 ILCS 5/5-5.01a)
19 Sec. 5-5.01a. Supportive living facilities demonstration
20 project. For the purpose of studying alternative settings
21 for long term care, the Department may establish and provide
22 oversight for a demonstration project to determine the
23 viability of supportive living facilities that seek to
24 promote resident independence, dignity, respect, and
25 well-being in the most cost-effective manner.
26 A supportive living facility is either a free-standing
27 facility or a distinct physical and operational entity within
28 a nursing facility. A supportive living facility integrates
29 housing with health, personal care, and supportive services
30 and is a designated setting that offers residents their own
31 separate, private, and distinct living units.
32 Demonstration sites shall be selected by the Department
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1 based upon criteria that may include the need for services in
2 a geographic area, the availability of funding, and the
3 site's ability to meet the standards.
4 The Department may adopt rules to implement this Section.
5 Rules that establish or modify the services, standards, and
6 conditions for participation in the demonstration project
7 shall be adopted by the Department in consultation with the
8 Department on Aging, the Department of Rehabilitation
9 Services, and the Department of Mental Health and
10 Developmental Disabilities (or their successor agencies).
11 Facilities or distinct parts of facilities which are
12 selected as supportive living facilities and are in good
13 standing with the Department's rules are exempt from the
14 provisions of the Nursing Home Care Act and the Illinois
15 Health Facilities Planning Act.
16 (Source: P.A. 89-499, eff. 6-28-96.)
17 (405 ILCS 25/4.03 rep.)
18 Section 70. The Specialized Living Centers Act is
19 amended by repealing Section 4.03.
20 Section 99. Effective date. This Act takes effect upon
21 becoming law.