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| [ House Amendment 001 ] |
91_HB1356
LRB9101824DJpk
1 AN ACT to amend the Alternative Health Care Delivery Act
2 by changing Section 35.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Alternative Health Care Delivery Act is
6 amended by changing Section 35 as follows:
7 (210 ILCS 3/35)
8 Sec. 35. Alternative health care models authorized.
9 Notwithstanding any other law to the contrary, alternative
10 health care models described in this Section may be
11 established on a demonstration basis.
12 (1) Alternative health care model; subacute care
13 hospital. A subacute care hospital is a designated site
14 which provides medical specialty care for patients who
15 need a greater intensity or complexity of care than
16 generally provided in a skilled nursing facility but who
17 no longer require acute hospital care. The average length
18 of stay for patients treated in subacute care hospitals
19 shall not be less than 20 days, and for individual
20 patients, the expected length of stay at the time of
21 admission shall not be less than 10 days. Variations
22 from minimum lengths of stay shall be reported to the
23 Department. There shall be no more than 13 subacute care
24 hospitals authorized to operate by the Department.
25 Subacute care includes physician supervision, registered
26 nursing, and physiological monitoring on a continual
27 basis. A subacute care hospital is either a freestanding
28 building or a distinct physical and operational entity
29 within a hospital or nursing home building. A subacute
30 care hospital shall only consist of beds currently
31 existing in licensed hospitals or skilled nursing
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1 facilities, except, in the City of Chicago, on a
2 designated site that was licensed as a hospital under the
3 Illinois Hospital Licensing Act within the 10 years
4 immediately before the application for an alternative
5 health care model license. During the period of operation
6 of the demonstration project, the existing licensed beds
7 shall remain licensed as hospital or skilled nursing
8 facility beds as well as being licensed under this Act.
9 In order to handle cases of complications, emergencies,
10 or exigent circumstances, a subacute care hospital shall
11 maintain a contractual relationship, including a transfer
12 agreement, with a general acute care hospital. If a
13 subacute care model is located in a general acute care
14 hospital, it shall utilize all or a portion of the bed
15 capacity of that existing hospital. In no event shall a
16 subacute care hospital use the word "hospital" in its
17 advertising or marketing activities or represent or hold
18 itself out to the public as a general acute care
19 hospital.
20 (2) Alternative health care delivery model;
21 postsurgical recovery care center. A postsurgical
22 recovery care center is a designated site which provides
23 postsurgical recovery care for generally healthy patients
24 undergoing surgical procedures that require overnight
25 nursing care, pain control, or observation that would
26 otherwise be provided in an inpatient setting. A
27 postsurgical recovery care center is either freestanding
28 or a defined unit of an ambulatory surgical treatment
29 center or hospital. No facility, or portion of a
30 facility, may participate in a demonstration program as a
31 postsurgical recovery care center unless the facility has
32 been licensed as an ambulatory surgical treatment center
33 or hospital for at least 2 years before August 20, 1993
34 (the effective date of Public Act 88-441). The maximum
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1 length of stay for patients in a postsurgical recovery
2 care center is not to exceed 48 hours unless the treating
3 physician requests an extension of time from the recovery
4 center's medical director on the basis of medical or
5 clinical documentation that an additional care period is
6 required for the recovery of a patient and the medical
7 director approves the extension of time. In no case,
8 however, shall a patient's length of stay in a
9 postsurgical recovery care center be longer than 72
10 hours. If a patient requires an additional care period
11 after the expiration of the 72-hour limit, the patient
12 shall be transferred to an appropriate facility. Reports
13 on variances from the 48-hour limit shall be sent to the
14 Department for its evaluation. The reports shall, before
15 submission to the Department, have removed from them all
16 patient and physician identifiers. In order to handle
17 cases of complications, emergencies, or exigent
18 circumstances, every postsurgical recovery care center as
19 defined in this paragraph shall maintain a contractual
20 relationship, including a transfer agreement, with a
21 general acute care hospital. A postsurgical recovery
22 care center shall be no larger than 20 beds. A
23 postsurgical recovery care center shall be located within
24 15 minutes travel time from the general acute care
25 hospital with which the center maintains a contractual
26 relationship, including a transfer agreement, as required
27 under this paragraph.
28 No postsurgical recovery care center shall
29 discriminate against any patient requiring treatment
30 because of the source of payment for services, including
31 Medicare and Medicaid recipients.
32 The Department shall adopt rules to implement the
33 provisions of Public Act 88-441 concerning postsurgical
34 recovery care centers within 9 months after August 20,
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1 1993.
2 (2.5) A postsurgical recovery care center
3 established under item (2) of this Section may request
4 permission from the Department to expand the scope of the
5 services provided by the center to allow the treatment of
6 nonsurgical patients. The center must make the request in
7 the manner required by the Department. The proposed
8 services must meet all of the following criteria:
9 (A) The center may provide the services only to
10 generally healthy patients who:
11 (i) have a medical condition that is not
12 life-threatening;
13 (ii) would require non-intensive patient
14 medical management with a defined therapeutic
15 goal; and
16 (iii) would require an anticipated length
17 of stay not longer than 48 hours.
18 (B) The center's qualified consulting
19 committee, composed of physicians, must review and
20 approve the proposed services.
21 (C) The Director must review and approve the
22 proposed services.
23 In reviewing the proposed services, the Director may
24 consider the qualifications and training of the center's
25 staff, the safety and efficiency of performing the
26 services within the center, and statistical information
27 regarding the proposed medical management. The Director
28 may not unnecessarily withhold approval of a center's
29 request to provide services under this item (2.5).
30 If the Director approves a center's request to
31 provide services under this item (2.5), the center must
32 maintain records of all patients admitted for those
33 services. The records must include the medical treatment
34 or treatments provided to each patient. For statistical
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1 purposes and to assist the Department in its analysis of
2 alternative health care delivery services under this Act,
3 the center must provide information to the Department
4 regarding services provided under item (2) of this
5 Section separately from information regarding services
6 provided under this item (2.5).
7 If the Director does not approve a center's request
8 to provide services under this item (2.5), the Director
9 must send a notice of disapproval to the center. The
10 disapproval is effective on the date the Director issues
11 the notice. The notice must include the Director's
12 rationale for disapproving the request. The notice must
13 also inform the center that within 15 days after issuance
14 of the notice, the center may request a hearing for the
15 purpose of contesting the disapproval of its request. If
16 the center requests such a hearing, the Department must
17 conduct the hearing in accordance with the Department's
18 administrative rules and the Illinois Administrative
19 Procedure Act.
20 (3) Alternative health care delivery model;
21 children's respite care center. A children's childrens'
22 respite care center model is a designated site that
23 provides respite for medically frail, technologically
24 dependent, clinically stable children, up to age 18, for
25 a period of one to 14 days. This care is to be provided
26 in a home-like environment that serves no more than 10
27 children at a time. Children's respite care center
28 services must be available through the model to all
29 families, including those whose care is paid for through
30 the Illinois Department of Public Aid or the Illinois
31 Department of Children and Family Services. Each respite
32 care model location shall be a facility physically
33 separate and apart from any other facility licensed by
34 the Department of Public Health under this or any other
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1 Act and shall provide, at a minimum, the following
2 services: out-of-home respite care; hospital to home
3 training for families and caregivers; short term
4 transitional care to facilitate placement and training
5 for foster care parents; parent and family support
6 groups.
7 Coverage for the services provided by the Illinois
8 Department of Public Aid under this paragraph (3) is
9 contingent upon federal waiver approval and is provided
10 only to Medicaid eligible clients participating in the
11 home and community based services waiver designated in
12 Section 1915(c) of the Social Security Act for medically
13 frail and technologically dependent children.
14 (Source: P.A. 88-441; 88-490; 88-670, eff. 12-2-94; 89-393,
15 eff. 8-20-95; revised 10-31-98.)