| ||||
| Public Act 098-0629 | ||||
| ||||
| ||||
AN ACT concerning regulation.
| ||||
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(Section scheduled to be repealed on December 31, 2019) | ||||
Sec. 3. Definitions. As used in this Act:
| ||||
"Health care facilities" means and includes
the following | ||||
facilities, organizations, and related persons:
| ||||
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;
| ||||
3.5. Skilled and intermediate care facilities licensed | ||||
under the ID/DD Community Care Act; | ||||
3.7. Facilities licensed under the Specialized Mental | ||||
Health Rehabilitation 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;
| ||
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;
| ||
7. An institution, place, building, or room used for | ||
provision of a health care category of service, including, | ||
but not limited to, cardiac catheterization and open heart | ||
surgery; and | ||
8. An institution, place, building, or room used for | ||
provision of major medical equipment used in the direct | ||
clinical diagnosis or treatment of patients, and whose | ||
project cost is in excess of the capital expenditure | ||
minimum. | ||
This Act shall not apply to the construction of any new | ||
facility or the renovation of any existing facility located on | ||
any campus facility as defined in Section 5-5.8b of the | ||
Illinois Public Aid Code, provided that the campus facility | ||
encompasses 30 or more contiguous acres and that the new or | ||
renovated facility is intended for use by a licensed | ||
residential 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.
| ||
No facility established and operating under the | ||
Alternative Health Care Delivery Act as a children's | ||
community-based health care center children's respite care | ||
center alternative health care model demonstration program or | ||
as an Alzheimer's Disease Management Center alternative health | ||
care model demonstration program 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
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, | ||
the Specialized Mental Health Rehabilitation Act, or the ID/DD | ||
Community Care Act, with the exceptions of facilities operated | ||
by a county or Illinois Veterans Homes, 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.
| ||
This Act does not apply to any change of ownership of a | ||
healthcare facility that is licensed under the Nursing Home | ||
Care Act, the Specialized Mental Health Rehabilitation Act, or | ||
the ID/DD Community Care Act, with the exceptions of facilities | ||
operated by a county or Illinois Veterans Homes. Changes of | ||
ownership of facilities licensed under the Nursing Home Care | ||
Act must meet the requirements set forth in Sections 3-101 | ||
through 3-119 of the Nursing Home Care 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, unless the entity constructs, modifies, | ||
or establishes a health care facility as specifically defined | ||
in this Section. 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. | ||
No permit or exemption is required for a facility licensed | ||
under the ID/DD Community Care Act prior to the reduction of | ||
the number of beds at a facility. If there is a total reduction | ||
of beds at a facility licensed under the ID/DD Community Care | ||
Act, this is a discontinuation or closure of the facility. | ||
However, if a facility licensed under the ID/DD Community Care | ||
Act reduces the number of beds or discontinues the facility, | ||
that facility must notify the Board as provided in Section 14.1 | ||
of this Act.
| ||
"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" or "Board" means the Health Facilities and | ||
Services Review 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 or the initiation of a category of service.
| ||
"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.
Unless otherwise interdependent, or | ||
submitted as one project by the applicant, components of | ||
construction or modification undertaken by means of a single | ||
construction contract or financed through the issuance of a | ||
single debt instrument shall not be grouped together as one | ||
project. 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 $11,500,000 for | ||
projects by hospital applicants, $6,500,000 for applicants for | ||
projects related to skilled and intermediate care long-term | ||
care facilities licensed under the Nursing Home Care Act, and | ||
$3,000,000 for projects by all other applicants, 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.
| ||
"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".
| ||
"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.
| ||
"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. | ||
"Freestanding emergency center" means a facility subject | ||
to licensure under Section 32.5 of the Emergency Medical | ||
Services (EMS) Systems Act. | ||
"Category of service" means a grouping by generic class of | ||
various types or levels of support functions, equipment, care, | ||
or treatment provided to patients or residents, including, but | ||
not limited to, classes such as medical-surgical, pediatrics, | ||
or cardiac catheterization. A category of service may include | ||
subcategories or levels of care that identify a particular | ||
degree or type of care within the category of service. Nothing | ||
in this definition shall be construed to include the practice | ||
of a physician or other licensed health care professional while | ||
functioning in an office providing for the care, diagnosis, or | ||
treatment of patients. A category of service that is subject to | ||
the Board's jurisdiction must be designated in rules adopted by | ||
the Board. | ||
(Source: P.A. 97-38, eff. 6-28-11; 97-277, eff. 1-1-12; 97-813, | ||
eff. 7-13-12; 97-980, eff. 8-17-12; 98-414, eff. 1-1-14.) | ||
Section 10. The Alternative Health Care Delivery Act is | ||
amended by changing Sections 15 and 30 as follows:
| ||
(210 ILCS 3/15)
| ||
Sec. 15. License required. No health care facility or | ||
program that
meets the definition and scope of an alternative | ||
health care model shall
operate as such unless it is a | ||
participant in a demonstration program under
this Act and | ||
licensed by the Department as an alternative health care model.
| ||
The provisions of this Act concerning children's | ||
community-based health care centers children's respite care | ||
centers
shall not apply to any facility licensed under the | ||
Hospital Licensing Act, the
Nursing Home Care Act, the | ||
Specialized Mental Health Rehabilitation Act, the ID/DD | ||
Community Care Act, or the University of Illinois Hospital Act | ||
that provides
respite care services to children.
| ||
(Source: P.A. 96-339, eff. 7-1-10; 97-38, eff. 6-28-11; 97-135, | ||
eff. 7-14-11; 97-227, eff. 1-1-12; 97-813, eff. 7-13-12.)
| ||
(210 ILCS 3/30)
| ||
Sec. 30. Demonstration program requirements. The | ||
requirements set forth in
this Section shall apply to | ||
demonstration programs.
| ||
(a) (Blank).
| ||
(a-5) There shall be no more than the total number of | ||
postsurgical
recovery care centers with a certificate of need | ||
for beds as of January 1, 2008.
| ||
(a-10) There shall be no more than a total of 9 children's | ||
community-based health care center children's respite care
| ||
center alternative health care models in the demonstration | ||
program, which shall
be located as follows:
| ||
(1) Two in the City of Chicago.
| ||
(2) One in Cook County outside the City of Chicago.
| ||
(3) A total of 2 in the area comprised of DuPage, Kane, | ||
Lake, McHenry, and
Will counties.
| ||
(4) A total of 2 in municipalities with a population of | ||
50,000 or more and
not
located in the areas described in | ||
paragraphs (1), (2), or (3).
| ||
(5) A total of 2 in rural areas, as defined by the | ||
Health Facilities
and Services Review Board.
| ||
No more than one children's community-based health care | ||
center children's respite care model owned and operated by a
| ||
licensed skilled pediatric facility shall be located in each of | ||
the areas
designated in this subsection (a-10).
| ||
(a-15) There shall be 5 authorized community-based | ||
residential
rehabilitation center alternative health care | ||
models in the demonstration
program.
| ||
(a-20) There shall be an authorized
Alzheimer's disease | ||
management center alternative health care model in the
| ||
demonstration program. The Alzheimer's disease management | ||
center shall be
located in Will
County, owned by a
| ||
not-for-profit entity, and endorsed by a resolution approved by | ||
the county
board before the effective date of this amendatory | ||
Act of the 91st General
Assembly.
| ||
(a-25) There shall be no more than 10 birth center | ||
alternative health care
models in the demonstration program, | ||
located as follows:
| ||
(1) Four in the area comprising Cook, DuPage, Kane, | ||
Lake, McHenry, and
Will counties, one of
which shall be | ||
owned or operated by a hospital and one of which shall be | ||
owned
or operated by a federally qualified health center.
| ||
(2) Three in municipalities with a population of 50,000 | ||
or more not
located in the area described in paragraph (1) | ||
of this subsection, one of
which shall be owned or operated | ||
by a hospital and one of which shall be owned
or operated | ||
by a federally qualified health center.
| ||
(3) Three in rural areas, one of which shall be owned | ||
or operated by a
hospital and one of which shall be owned | ||
or operated by a federally qualified
health center.
| ||
The first 3 birth centers authorized to operate by the | ||
Department shall be
located in or predominantly serve the | ||
residents of a health professional
shortage area as determined | ||
by the United States Department of Health and Human
Services. | ||
There shall be no more than 2 birth centers authorized to | ||
operate in
any single health planning area for obstetric | ||
services as determined under the
Illinois Health Facilities | ||
Planning Act. If a birth center is located outside
of a
health | ||
professional shortage area, (i) the birth center shall be | ||
located in a
health planning
area with a demonstrated need for | ||
obstetrical service beds, as determined by
the Health | ||
Facilities and Services Review Board or (ii) there must be a
| ||
reduction in
the existing number of obstetrical service beds in | ||
the planning area so that
the establishment of the birth center | ||
does not result in an increase in the
total number of | ||
obstetrical service beds in the health planning area.
| ||
(b) Alternative health care models, other than a model | ||
authorized under subsection (a-10) or
(a-20), shall obtain a | ||
certificate of
need from the Health Facilities and Services | ||
Review Board under the Illinois
Health Facilities Planning Act | ||
before receiving a license by the
Department.
If, after | ||
obtaining its initial certificate of need, an alternative | ||
health
care delivery model that is a community based | ||
residential rehabilitation center
seeks to
increase the bed | ||
capacity of that center, it must obtain a certificate of need
| ||
from the Health Facilities and Services Review Board before | ||
increasing the bed
capacity. Alternative
health care models in | ||
medically underserved areas
shall receive priority in | ||
obtaining a certificate of need.
| ||
(c) An alternative health care model license shall be | ||
issued for a
period of one year and shall be annually renewed | ||
if the facility or
program is in substantial compliance with | ||
the Department's rules
adopted under this Act. A licensed | ||
alternative health care model that continues
to be in | ||
substantial compliance after the conclusion of the | ||
demonstration
program shall be eligible for annual renewals | ||
unless and until a different
licensure program for that type of | ||
health care model is established by
legislation, except that a | ||
postsurgical recovery care center meeting the following | ||
requirements may apply within 3 years after August 25, 2009 | ||
(the effective date of Public Act 96-669) for a Certificate of | ||
Need permit to operate as a hospital: | ||
(1) The postsurgical recovery care center shall apply | ||
to the Health Facilities and Services Review Board for a | ||
Certificate of Need permit to discontinue the postsurgical | ||
recovery care center and to establish a hospital. | ||
(2) If the postsurgical recovery care center obtains a | ||
Certificate of Need permit to operate as a hospital, it | ||
shall apply for licensure as a hospital under the Hospital | ||
Licensing Act and shall meet all statutory and regulatory | ||
requirements of a hospital. | ||
(3) After obtaining licensure as a hospital, any | ||
license as an ambulatory surgical treatment center and any | ||
license as a post-surgical recovery care center shall be | ||
null and void. | ||
(4) The former postsurgical recovery care center that | ||
receives a hospital license must seek and use its best | ||
efforts to maintain certification under Titles XVIII and | ||
XIX of the federal Social Security Act. | ||
The Department may issue a provisional license to any
| ||
alternative health care model that does not substantially | ||
comply with the
provisions of this Act and the rules adopted | ||
under this Act if (i)
the Department finds that the alternative | ||
health care model has undertaken
changes and corrections which | ||
upon completion will render the alternative
health care model | ||
in substantial compliance with this Act and rules and
(ii) the | ||
health and safety of the patients of the alternative
health | ||
care model will be protected during the period for which the | ||
provisional
license is issued. The Department shall advise the | ||
licensee of
the conditions under which the provisional license | ||
is issued, including
the manner in which the alternative health | ||
care model fails to comply with
the provisions of this Act and | ||
rules, and the time within which the changes
and corrections | ||
necessary for the alternative health care model to
| ||
substantially comply with this Act and rules shall be | ||
completed.
| ||
(d) Alternative health care models shall seek | ||
certification under Titles
XVIII and XIX of the federal Social | ||
Security Act. In addition, alternative
health care models shall | ||
provide charitable care consistent with that provided
by | ||
comparable health care providers in the geographic area.
| ||
(d-5) (Blank).
| ||
(e) Alternative health care models shall, to the extent | ||
possible,
link and integrate their services with nearby health | ||
care facilities.
| ||
(f) Each alternative health care model shall implement a | ||
quality
assurance program with measurable benefits and at | ||
reasonable cost.
| ||
(Source: P.A. 96-31, eff. 6-30-09; 96-129, eff. 8-4-09; 96-669, | ||
eff. 8-25-09; 96-812, eff. 1-1-10; 96-1000, eff. 7-2-10; | ||
96-1071, eff. 7-16-10; 96-1123, eff. 1-1-11; 97-135, eff. | ||
7-14-11; 97-333, eff. 8-12-11; 97-813, eff. 7-13-12.)
| ||