Public Act 094-0342
 		





SB1651 Enrolled
LRB094 11173 DRJ 41829 b






    AN ACT concerning public aid.

 
    Be it enacted by the People of the State of Illinois,
 
represented in the General Assembly:


 
    Section 5. The Illinois Health Facilities Planning Act is 
amended  by changing Section 3 as follows:
 



    (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)



    (Section scheduled to be repealed on July 1, 2006)

    Sec. 3. Definitions. As used in this Act:

    "Health care facilities" means and includes
the following 
facilities and organizations:


        1. An ambulatory surgical treatment center required to 
    be licensed
pursuant to the Ambulatory Surgical Treatment 
    Center Act;


        2. An institution, place, building, or agency required 
    to be licensed
pursuant to the Hospital Licensing Act;


        3. Skilled and intermediate long term care facilities 
    licensed under the
Nursing
Home Care Act;


        3. Skilled and intermediate long term care facilities 
    licensed under the
Nursing
Home Care Act;


        4. Hospitals, nursing homes, ambulatory surgical 
    treatment centers, or
kidney disease treatment centers

    maintained by the State or any department or agency 
    thereof;


        5. Kidney disease treatment centers, including a 
    free-standing
hemodialysis unit required to be licensed 
    under the End Stage Renal Disease Facility Act; and


        6. An institution, place, building, or room used for 
    the performance of
outpatient surgical procedures that is 
    leased, owned, or operated by or on
behalf of an 
    out-of-state facility.

    No federally owned facility shall be subject to the 
provisions of this
Act, nor facilities used solely for healing 
by prayer or spiritual means.

    No facility licensed under the Supportive Residences 
Licensing Act or the
Assisted Living and Shared Housing Act

shall be subject to the provisions of this Act.

    A facility designated as a supportive living facility that 
is in good
standing with the program
demonstration project

established under Section 5-5.01a of
the Illinois Public Aid 
Code shall not be subject to the provisions of this
Act.

    This Act does not apply to facilities granted waivers under 
Section 3-102.2
of the Nursing Home Care Act.  However, if a 
demonstration project under that
Act applies for a certificate

of need to convert to a nursing facility, it shall meet the 
licensure and
certificate of need requirements in effect as of 
the date of application.
    This Act does not apply to a dialysis facility that 
provides only dialysis training, support, and related services 
to individuals with end stage renal disease who have elected to 
receive home dialysis.  This Act does not apply to a dialysis 
unit located in a licensed nursing home that offers or provides 
dialysis-related services to residents with end stage renal 
disease who have elected to receive home dialysis  within the 
nursing home. The Board, however, may require these dialysis 
facilities and licensed nursing homes to report statistical 
information on a quarterly basis to the Board to be used by the 
Board to conduct analyses on the need for proposed kidney 
disease treatment centers.


    This Act shall not apply to the closure of an entity or a 
portion of an
entity licensed under the Nursing Home Care Act 
that elects to convert, in
whole or in part, to an assisted 
living or shared housing establishment
licensed under the 
Assisted Living and Shared Housing Act.

    With the exception of those health care facilities 
specifically
included in this Section, nothing in this Act 
shall be intended to
include facilities operated as a part of 
the practice of a physician or
other licensed health care 
professional, whether practicing in his
individual capacity or 
within the legal structure of any partnership,
medical or 
professional corporation, or unincorporated medical or

professional group. Further, this Act shall not apply to 
physicians or
other licensed health care professional's 
practices where such practices
are carried out in a portion of 
a health care facility under contract
with such health care 
facility by a physician or by other licensed
health care 
professionals, whether practicing in his individual capacity

or within the legal structure of any partnership, medical or

professional corporation, or unincorporated medical or 
professional
groups.  This Act shall apply to construction or

modification and to establishment by such health care facility 
of such
contracted portion which is subject to facility 
licensing requirements,
irrespective of the party responsible 
for such action or attendant
financial obligation.

    "Person" means any one or more natural persons, legal 
entities,
governmental bodies other than federal, or any 
combination thereof.

    "Consumer" means any person other than a person (a) whose 
major
occupation currently involves or whose official capacity 
within the last
12 months has involved the providing, 
administering or financing of any
type of health care facility, 
(b) who is engaged in health research or
the teaching of 
health, (c) who has a material financial interest in any

activity which involves the providing, administering or 
financing of any
type of health care facility, or (d) who is or 
ever has been a member of
the immediate family of the person 
defined by (a), (b), or (c).

    "State Board" means the Health Facilities Planning Board.

    "Construction or modification" means the establishment, 
erection,
building, alteration, reconstruction, modernization, 
improvement,
extension, discontinuation, change of ownership, 
of or by a health care
facility, or the purchase or acquisition 
by or through a health care facility
of
equipment or service 
for diagnostic or therapeutic purposes or for
facility 
administration or operation, or any capital expenditure made by

or on behalf of a health care facility which
exceeds the 
capital expenditure minimum; however, any capital expenditure

made by or on behalf of a health care facility for (i) the 
construction or
modification of a facility licensed under the 
Assisted Living and Shared
Housing Act or (ii) a conversion 
project undertaken in accordance with Section 30 of the Older 
Adult Services Act shall be excluded from any obligations under 
this Act.

    "Establish" means the construction of a health care 
facility or the
replacement of an existing facility on another 
site.

    "Major medical equipment" means medical equipment which is 
used for the
provision of medical and other health services and 
which costs in excess
of the capital expenditure minimum, 
except that such term does not include
medical equipment 
acquired
by or on behalf of a clinical laboratory to provide 
clinical laboratory
services if the clinical laboratory is 
independent of a physician's office
and a hospital and it has 
been determined under Title XVIII of the Social
Security Act to 
meet the requirements of paragraphs (10) and (11) of Section

1861(s) of such Act.  In determining whether medical equipment 
has a value
in excess of the capital expenditure minimum, the 
value of studies, surveys,
designs, plans, working drawings, 
specifications, and other activities
essential to the 
acquisition of such equipment shall be included.

    "Capital Expenditure" means an expenditure:  (A) made by or 
on behalf of
a health care facility (as such a facility is 
defined in this Act); and
(B) which under generally accepted 
accounting principles is not properly
chargeable as an expense 
of operation and maintenance, or is made to obtain
by lease or 
comparable arrangement any facility or part thereof or any

equipment for a facility or part; and which exceeds the capital 
expenditure
minimum.

    For the purpose of this paragraph, the cost of any studies, 
surveys, designs,
plans, working drawings, specifications, and 
other activities essential
to the acquisition, improvement, 
expansion, or replacement of any plant
or equipment with 
respect to which an expenditure is made shall be included
in 
determining if such expenditure exceeds the capital 
expenditures minimum.
Donations of equipment
or facilities to a 
health care facility which if acquired directly by such

facility would be subject to review under this Act shall be 
considered capital
expenditures, and a transfer of equipment or 
facilities for less than fair
market value shall be considered 
a capital expenditure for purposes of this
Act if a transfer of 
the equipment or facilities at fair market value would
be 
subject to review.

    "Capital expenditure minimum" means $6,000,000, which 
shall be annually
adjusted to reflect the increase in 
construction costs due to inflation, for major medical 
equipment and for all other
capital expenditures; provided, 
however, that when a capital expenditure is
for the 
construction or modification of a health and fitness center, 
"capital
expenditure minimum" means the capital expenditure 
minimum for all other
capital expenditures in effect on March 
1, 2000, which shall be annually
adjusted to reflect the 
increase in construction costs due to inflation.

    "Non-clinical service area" means an area (i) for the 
benefit of the
patients, visitors, staff, or employees of a 
health care facility and (ii) not
directly related to the 
diagnosis, treatment, or rehabilitation of persons
receiving 
services from the health care facility.  "Non-clinical service 
areas"
include, but are not limited to, chapels; gift shops; 
news stands; computer
systems; tunnels, walkways, and 
elevators; telephone systems; projects to
comply with life 
safety codes; educational facilities; student housing;

patient, employee, staff, and visitor dining areas; 
administration and
volunteer offices; modernization of 
structural components (such as roof
replacement and masonry 
work); boiler repair or replacement; vehicle
maintenance and 
storage facilities; parking facilities; mechanical systems for

heating, ventilation, and air conditioning; loading docks; and 
repair or
replacement of carpeting, tile, wall coverings, 
window coverings or treatments,
or furniture.  Solely for the 
purpose of this definition, "non-clinical service
area" does 
not include health and fitness centers.

    "Areawide" means a major area of the State delineated on a

geographic, demographic, and functional basis for health 
planning and
for health service and having within it one or 
more local areas for
health planning and health service.  The 
term "region", as contrasted
with the term "subregion", and the 
word "area" may be used synonymously
with the term "areawide".

    "Local" means a subarea of a delineated major area that on 
a
geographic, demographic, and functional basis may be 
considered to be
part of such major area.  The term "subregion" 
may be used synonymously
with the term "local".

    "Areawide health planning organization" or "Comprehensive 
health
planning organization" means the health systems agency 
designated by the
Secretary, Department of Health and Human 
Services or any successor agency.

    "Local health planning organization" means those local 
health
planning organizations that are designated as such by 
the areawide
health planning organization of the appropriate 
area.

    "Physician" means a person licensed to practice in 
accordance with
the Medical Practice Act of 1987, as amended.

    "Licensed health care professional" means a person 
licensed to
practice a health profession under pertinent 
licensing statutes of the
State of Illinois.

    "Director" means the  Director of the Illinois Department of 
Public Health.

    "Agency" means the Illinois Department of Public Health.

    "Comprehensive health planning" means health planning 
concerned with
the total population and all health and 
associated problems that affect
the well-being of people and 
that encompasses health services, health
manpower, and health 
facilities; and the coordination among these and
with those 
social, economic, and environmental factors that affect 
health.

    "Alternative health care model" means a facility or program 
authorized
under the Alternative Health Care Delivery Act.

    "Out-of-state facility" means a person that is both (i) 
licensed as a
hospital or as an ambulatory surgery center under 
the laws of another state
or that
qualifies as a hospital or an 
ambulatory surgery center under regulations
adopted pursuant 
to the Social Security Act and (ii) not licensed under the

Ambulatory Surgical Treatment Center Act, the Hospital 
Licensing Act, or the
Nursing Home Care Act.  Affiliates of 
out-of-state facilities shall be
considered out-of-state 
facilities.  Affiliates of Illinois licensed health
care 
facilities 100% owned by an Illinois licensed health care 
facility, its
parent, or Illinois physicians licensed to 
practice medicine in all its
branches shall not be considered 
out-of-state facilities.  Nothing in
this definition shall be

construed to include an office or any part of an office of a 
physician licensed
to practice medicine in all its branches in 
Illinois that is not required to be
licensed under the 
Ambulatory Surgical Treatment Center Act.

    "Change of ownership of a health care facility" means a 
change in the
person
who has ownership or
control of a health 
care facility's physical plant and capital assets. A change
in 
ownership is indicated by
the following transactions: sale, 
transfer, acquisition, lease, change of
sponsorship, or other 
means of
transferring control.

    "Related person" means any person that: (i) is at least 50% 
owned, directly
or indirectly, by
either the health care 
facility or a person owning, directly or indirectly, at
least 
50% of the health
care facility; or (ii) owns, directly or 
indirectly, at least 50% of the
health care facility.

    "Charity care" means care provided by a health care 
facility for which the provider does not expect to receive 
payment from the patient or a third-party payer.
(Source: P.A. 93-41, eff. 6-27-03; 93-766, eff. 7-20-04; 
93-935, eff. 1-1-05; 93-1031, eff. 8-27-04; revised 10-25-04.)

 
    Section 10. The Nursing Home Care Act is amended  by 
changing Section 1-113 as follows:
 



    (210 ILCS 45/1-113)  (from Ch. 111 1/2, par. 4151-113)



    Sec. 1-113. "Facility" or "long-term care facility" means a 
private home,
institution, building, residence, or any other 
place, whether operated for
profit or not, or a county home for 
the infirm and chronically ill operated
pursuant to Division 
5-21 or 5-22 of the Counties Code, or any similar
institution 
operated by a political subdivision of the State of Illinois, 
which
provides, through its ownership or management, personal 
care, sheltered care or
nursing for 3 or more persons, not 
related to the applicant or owner by blood
or marriage.  It 
includes skilled nursing facilities and intermediate care

facilities as those terms are defined in Title XVIII and Title 
XIX of the
Federal Social Security Act.
It also includes homes, 
institutions, or
other places operated by or under the 
authority of the Illinois Department of
Veterans' Affairs.

    "Facility" does not include the following:

    (1) A home, institution, or other place operated by the 
federal government
or agency thereof, or by the State of 
Illinois, other than homes,
institutions, or other places 
operated by or under the authority of the
Illinois Department 
of Veterans' Affairs;

    (2) A hospital, sanitarium, or other institution whose 
principal activity
or business is the diagnosis, care, and 
treatment of human illness through
the maintenance and 
operation as organized facilities therefor, which is
required 
to be licensed under the Hospital Licensing Act;

    (3) Any "facility for child care" as defined in the Child 
Care Act of
1969;

    (4) Any "Community Living Facility" as defined in the 
Community Living
Facilities Licensing Act;

    (5) Any "community residential alternative" as defined
in 
the Community Residential Alternatives Licensing Act;

    (6) Any nursing home or sanatorium operated solely by and 
for persons
who rely exclusively upon treatment by spiritual 
means through prayer, in
accordance with the creed or tenets of 
any well-recognized church or
religious denomination. However, 
such nursing home or sanatorium shall
comply with all local 
laws and rules relating to sanitation and safety;

    (7) Any facility licensed by the Department of Human 
Services as a
community-integrated living arrangement as

defined in the Community-Integrated Living Arrangements 
Licensure and
Certification Act;

    (8) Any "Supportive Residence" licensed under the 
Supportive
Residences Licensing Act;

    (9) Any "supportive living facility" in good standing with 
the program
demonstration
project established under Section 
5-5.01a of the Illinois Public Aid Code;

    (10) Any assisted living or shared housing establishment 
licensed under
the Assisted Living and Shared Housing Act; or

    (11) An Alzheimer's disease management center alternative 
health care
model licensed under the Alternative Health Care 
Delivery Act.

(Source: P.A. 90-14, eff. 7-1-97; 90-763, eff. 8-14-98; 91-656, 
eff.
1-1-01; 91-838, eff. 6-16-00.)

 
    Section 15. The Illinois Public Aid Code is amended  by 
changing Section 5-5.01a as follows:
 



    (305 ILCS 5/5-5.01a)



    Sec. 5-5.01a. Supportive living facilities program

demonstration project. The
For the purpose of studying 
alternative settings for long term care, the
Department shall

may establish and provide oversight for a program
demonstration 
project to
determine the viability of supportive living 
facilities that seek to promote
resident independence, 
dignity, respect, and well-being in the most
cost-effective 
manner.

    A supportive living facility is either a free-standing 
facility or a distinct
physical and operational entity within a 
nursing facility.  A supportive
living facility integrates 
housing with health, personal care, and supportive
services and 
is a designated setting that offers residents their own

separate, private, and distinct living units.

    Sites for the operation of the program
Demonstration sites

shall be selected by the Department based upon criteria
that 
may include the need for services in a geographic area, the

availability of funding, and the site's ability to meet the 
standards.

    The Department may adopt rules to implement this Section.  
Rules that
establish or modify the services, standards, and 
conditions for participation
in the program
demonstration 
project shall be adopted by the Department in consultation
with 
the Department on Aging, the Department of Rehabilitation 
Services, and
the Department of Mental Health and Developmental 
Disabilities (or their
successor agencies).

    Facilities or distinct parts of facilities which are 
selected as supportive
living facilities and are in good 
standing with the Department's rules are
exempt from the 
provisions of the Nursing Home Care Act and the Illinois Health

Facilities Planning Act.

(Source: P.A. 89-499, eff. 6-28-96.)

 
    Section 20. The Older Adult Services Act is amended  by 
changing Section 20 as follows:
 
    (320 ILCS 42/20)

    Sec. 20. Priority service areas; service expansion. 
    (a) The requirements of this Section are subject to the 
availability of funding.
    (b) The Department shall expand older adult services that 
promote independence and permit older adults to remain in their 
own homes and communities.   Priority shall be given to both the 
expansion of services and the development of new services in 
priority service areas.
    (c) Inventory of services.  The Department shall develop and 
maintain an inventory and assessment of (i) the types and 
quantities of public older adult services and, to the extent 
possible, privately provided older adult services, including 
the unduplicated count, location, and characteristics of 
individuals served by each facility, program, or service and 
(ii) the resources supporting those services.
    (d) Priority service areas.  The Departments shall assess 
the current and projected need for older adult services 
throughout the State, analyze the results of the inventory, and 
identify priority service areas, which shall serve as the basis 
for a priority service plan to be filed with the Governor and 
the General Assembly no later than July 1, 2006, and every 5 
years thereafter.
    (e) Moneys appropriated by the General Assembly for the 
purpose of this Section, receipts from donations, grants, fees, 
or taxes that may accrue from any public or private sources to 
the Department for the purpose of this Section, and savings 
attributable to the nursing home conversion program as 
calculated in subsection (h) shall be deposited into the 
Department on Aging State Projects Fund.  Interest earned by 
those moneys in the Fund shall be credited to the Fund.
    (f) Moneys described in subsection (e) from the Department 
on Aging State Projects Fund shall be used for older adult 
services, regardless of where the older adult receives the 
service, with priority given to both the expansion of services 
and the development of new services in priority service areas.  
Fundable services shall include:
        (1) Housing, health services, and supportive services:
            (A) adult day care;
            (B) adult day care for persons with Alzheimer's 
        disease and related disorders;
            (C) activities of daily living;
            (D) care-related supplies and equipment;
            (E) case management;
            (F) community reintegration;
            (G)  companion;
            (H) congregate meals;
            (I) counseling and education;
            (J) elder abuse prevention and intervention;
            (K) emergency response and monitoring;
            (L) environmental modifications;
            (M) family caregiver support;
            (N) financial;
            (O) home delivered meals;

            (P) homemaker;
            (Q) home health;
            (R) hospice;
            (S) laundry;
            (T) long-term care ombudsman;
            (U) medication reminders;

            (V) money management;
            (W) nutrition services;

            (X) personal care;
            (Y) respite care;
            (Z) residential care;
            (AA) senior benefits outreach;
            (BB) senior centers;
            (CC) services provided under the Assisted Living 
        and Shared Housing Act, or sheltered care services that 
        meet the requirements of the Assisted Living and Shared 
        Housing Act, or services provided under Section 
        5-5.01a of the Illinois Public Aid Code (the Supportive 
        Living Facilities Pilot Program);
            (DD) telemedicine devices to monitor recipients in 
        their own homes as an alternative to hospital care, 
        nursing home care, or home visits;
            (EE) training for direct family caregivers;
            (FF) transition;
            (GG) transportation;
            (HH) wellness and fitness programs; and
            (II) other programs designed to assist older 
        adults in Illinois to remain independent and receive 
        services in the most integrated residential setting 
        possible for that person.
        (2) Older Adult Services Demonstration Grants, 
    pursuant to subsection (g) of this Section.
    (g)  Older Adult Services Demonstration Grants. The 
Department shall establish a program of demonstration grants to 
assist in the restructuring of the delivery system for older 
adult services and provide funding for innovative service 
delivery models and system change and integration initiatives. 
The Department shall prescribe, by rule, the grant application 
process.  At a minimum, every application must include:
        (1) The type of grant sought;
        (2) A description of the project;
        (3) The objective of the project;
        (4) The likelihood of the project meeting identified 
    needs;
        (5) The plan for financing, administration, and 
    evaluation of the project;
        (6) The timetable for implementation;
        (7) The roles and capabilities of responsible 
    individuals and organizations;
        (8) Documentation of collaboration with other service 
    providers, local community government leaders, and other 
    stakeholders, other providers, and any other stakeholders 
    in the community;
        (9) Documentation of community support for the 
    project, including support by other service providers, 
    local community government leaders, and other 
    stakeholders;

        (10) The total budget for the project;
        (11) The financial condition of the applicant; and
        (12) Any other application requirements that may be 
    established by the Department by rule.
    Each project may include provisions for a designated staff 
person who is responsible for the development of the project 
and recruitment of providers.
    Projects may include, but are not limited to: adult family 
foster care; family adult day care; assisted living in a 
supervised apartment; personal services in a subsidized 
housing project; evening and weekend home care coverage; small 
incentive grants to attract new providers; money following the 
person; cash and counseling; managed long-term care; and at 
least one respite care project that establishes a local 
coordinated network of volunteer and paid respite workers, 
coordinates assignment of respite workers to caregivers and 
older adults, ensures the health and safety of the older adult, 
provides training for caregivers, and ensures that support 
groups are available in the community.
    A demonstration project funded in whole or in part by an 
Older Adult Services Demonstration Grant is exempt from the 
requirements of the Illinois Health Facilities Planning Act.  To 
the extent applicable, however, for the purpose of maintaining 
the statewide inventory authorized by the Illinois Health 
Facilities Planning Act, the Department shall send to the 
Health Facilities Planning Board a copy of each grant award 
made under this subsection (g).
    The Department, in collaboration with the Departments of 
Public Health and Public Aid, shall evaluate the effectiveness 
of the projects receiving grants under this Section.
    (h) No later than July 1 of each year, the Department of 
Public Health shall provide information to the Department of 
Public Aid to enable the Department of Public Aid  to annually 
document and verify the savings attributable to the nursing 
home conversion program for the previous fiscal year to 
estimate an annual amount of such savings that may be 
appropriated to the Department on Aging State Projects Fund and 
notify the General Assembly, the Department on Aging, the 
Department of Human Services, and the Advisory Committee of the 
savings no later than October 1 of the same fiscal year.


(Source: P.A. 93-1031, eff. 8-27-04.)

 
    Section 99. Effective date. This Act takes effect upon 
becoming law.