Public Act 93-0402
SB359 Enrolled LRB093 05213 AMC 05273 b
AN ACT concerning health facilities.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Alternative Health Care Delivery Act is
amended by changing Section 35 as follows:
(210 ILCS 3/35)
Sec. 35. Alternative health care models authorized.
Notwithstanding any other law to the contrary, alternative
health care models described in this Section may be
established on a demonstration basis.
(1) Alternative health care model; subacute care
hospital. A subacute care hospital is a designated site
which provides medical specialty care for patients who
need a greater intensity or complexity of care than
generally provided in a skilled nursing facility but who
no longer require acute hospital care. The average length
of stay for patients treated in subacute care hospitals
shall not be less than 20 days, and for individual
patients, the expected length of stay at the time of
admission shall not be less than 10 days. Variations
from minimum lengths of stay shall be reported to the
Department. There shall be no more than 13 subacute care
hospitals authorized to operate by the Department.
Subacute care includes physician supervision, registered
nursing, and physiological monitoring on a continual
basis. A subacute care hospital is either a freestanding
building or a distinct physical and operational entity
within a hospital or nursing home building. A subacute
care hospital shall only consist of beds currently
existing in licensed hospitals or skilled nursing
facilities, except, in the City of Chicago, on a
designated site that was licensed as a hospital under the
Illinois Hospital Licensing Act within the 10 years
immediately before the application for an alternative
health care model license. During the period of operation
of the demonstration project, the existing licensed beds
shall remain licensed as hospital or skilled nursing
facility beds as well as being licensed under this Act.
In order to handle cases of complications, emergencies,
or exigent circumstances, a subacute care hospital shall
maintain a contractual relationship, including a transfer
agreement, with a general acute care hospital. If a
subacute care model is located in a general acute care
hospital, it shall utilize all or a portion of the bed
capacity of that existing hospital. In no event shall a
subacute care hospital use the word "hospital" in its
advertising or marketing activities or represent or hold
itself out to the public as a general acute care
hospital.
(2) Alternative health care delivery model;
postsurgical recovery care center. A postsurgical
recovery care center is a designated site which provides
postsurgical recovery care for generally healthy patients
undergoing surgical procedures that require overnight
nursing care, pain control, or observation that would
otherwise be provided in an inpatient setting. A
postsurgical recovery care center is either freestanding
or a defined unit of an ambulatory surgical treatment
center or hospital. No facility, or portion of a
facility, may participate in a demonstration program as a
postsurgical recovery care center unless the facility has
been licensed as an ambulatory surgical treatment center
or hospital for at least 2 years before August 20, 1993
(the effective date of Public Act 88-441). The maximum
length of stay for patients in a postsurgical recovery
care center is not to exceed 48 hours unless the treating
physician requests an extension of time from the recovery
center's medical director on the basis of medical or
clinical documentation that an additional care period is
required for the recovery of a patient and the medical
director approves the extension of time. In no case,
however, shall a patient's length of stay in a
postsurgical recovery care center be longer than 72
hours. If a patient requires an additional care period
after the expiration of the 72-hour limit, the patient
shall be transferred to an appropriate facility. Reports
on variances from the 48-hour limit shall be sent to the
Department for its evaluation. The reports shall, before
submission to the Department, have removed from them all
patient and physician identifiers. In order to handle
cases of complications, emergencies, or exigent
circumstances, every postsurgical recovery care center as
defined in this paragraph shall maintain a contractual
relationship, including a transfer agreement, with a
general acute care hospital. A postsurgical recovery
care center shall be no larger than 20 beds. A
postsurgical recovery care center shall be located within
15 minutes travel time from the general acute care
hospital with which the center maintains a contractual
relationship, including a transfer agreement, as required
under this paragraph.
No postsurgical recovery care center shall
discriminate against any patient requiring treatment
because of the source of payment for services, including
Medicare and Medicaid recipients.
The Department shall adopt rules to implement the
provisions of Public Act 88-441 concerning postsurgical
recovery care centers within 9 months after August 20,
1993.
(3) Alternative health care delivery model;
children's community-based health care center. A
children's community-based health care center model is a
designated site that provides nursing care, clinical
support services, and therapies for a period of one to 14
days for short-term stays and 120 days to facilitate
transitions to home or other appropriate settings for
medically fragile children, technology dependent
children, and children with special health care needs who
are deemed clinically stable by a physician and are
younger than 22 years of age. This care is to be
provided in a home-like environment that serves no more
than 12 children at a time. Children's community-based
health care center services must be available through the
model to all families, including those whose care is paid
for through the Department of Public Aid, the Department
of Children and Family Services, the Department of Human
Services, and insurance companies who cover home health
care services or private duty nursing care in the home.
Each children's community-based health care center
model location shall be physically separate and apart
from any other facility licensed by the Department of
Public Health under this or any other Act and shall
provide the following services: respite care, registered
nursing or licensed practical nursing care, transitional
care to facilitate home placement or other appropriate
settings and reunite families, medical day care, weekend
camps, and diagnostic studies typically done in the home
setting. Alternative health care delivery model;
children's respite care center. A children's respite
care center model is a designated site that provides
respite for medically frail, technologically dependent,
clinically stable children, up to age 18, for a period of
one to 14 days. This care is to be provided in a
home-like environment that serves no more than 10
children at a time. Children's respite care center
services must be available through the model to all
families, including those whose care is paid for through
the Illinois Department of Public Aid or the Illinois
Department of Children and Family Services. Each respite
care model location shall be a facility physically
separate and apart from any other facility licensed by
the Department of Public Health under this or any other
Act and shall provide, at a minimum, the following
services: out-of-home respite care; hospital to home
training for families and caregivers; short term
transitional care to facilitate placement and training
for foster care parents; parent and family support
groups.
Coverage for the services provided by the Illinois
Department of Public Aid under this paragraph (3) is
contingent upon federal waiver approval and is provided
only to Medicaid eligible clients participating in the
home and community based services waiver designated in
Section 1915(c) of the Social Security Act for medically
frail and technologically dependent children or children
in Department of Children and Family Services foster care
who receive home health benefits.
(4) Alternative health care delivery model;
community based residential rehabilitation center. A
community-based residential rehabilitation center model
is a designated site that provides rehabilitation or
support, or both, for persons who have experienced severe
brain injury, who are medically stable, and who no longer
require acute rehabilitative care or intense medical or
nursing services. The average length of stay in a
community-based residential rehabilitation center shall
not exceed 4 months. As an integral part of the services
provided, individuals are housed in a supervised living
setting while having immediate access to the community.
The residential rehabilitation center authorized by the
Department may have more than one residence included
under the license. A residence may be no larger than 12
beds and shall be located as an integral part of the
community. Day treatment or individualized outpatient
services shall be provided for persons who reside in
their own home. Functional outcome goals shall be
established for each individual. Services shall include,
but are not limited to, case management, training and
assistance with activities of daily living, nursing
consultation, traditional therapies (physical,
occupational, speech), functional interventions in the
residence and community (job placement, shopping,
banking, recreation), counseling, self-management
strategies, productive activities, and multiple
opportunities for skill acquisition and practice
throughout the day. The design of individualized program
plans shall be consistent with the outcome goals that are
established for each resident. The programs provided in
this setting shall be accredited by the Commission on
Accreditation of Rehabilitation Facilities (CARF). The
program shall have been accredited by CARF as a Brain
Injury Community-Integrative Program for at least 3
years.
(5) Alternative health care delivery model;
Alzheimer's disease management center. An Alzheimer's
disease management center model is a designated site that
provides a safe and secure setting for care of persons
diagnosed with Alzheimer's disease. An Alzheimer's
disease management center model shall be a facility
separate from any other facility licensed by the
Department of Public Health under this or any other Act.
An Alzheimer's disease management center shall conduct
and document an assessment of each resident every 6
months. The assessment shall include an evaluation of
daily functioning, cognitive status, other medical
conditions, and behavioral problems. An Alzheimer's
disease management center shall develop and implement an
ongoing treatment plan for each resident. The treatment
plan shall have defined goals. The Alzheimer's disease
management center shall treat behavioral problems and
mood disorders using nonpharmacologic approaches such as
environmental modification, task simplification, and
other appropriate activities. All staff must have
necessary training to care for all stages of Alzheimer's
Disease. An Alzheimer's disease management center shall
provide education and support for residents and
caregivers. The education and support shall include
referrals to support organizations for educational
materials on community resources, support groups, legal
and financial issues, respite care, and future care needs
and options. The education and support shall also
include a discussion of the resident's need to make
advance directives and to identify surrogates for medical
and legal decision-making. The provisions of this
paragraph establish the minimum level of services that
must be provided by an Alzheimer's disease management
center. An Alzheimer's disease management center model
shall have no more than 100 residents. Nothing in this
paragraph (5) shall be construed as prohibiting a person
or facility from providing services and care to persons
with Alzheimer's disease as otherwise authorized under
State law.
(Source: P.A. 91-65, eff. 7-9-99; 91-357, eff. 7-29-99;
91-838, eff. 6-16-00.)
Effective Date: 1/1/2004