Bill Text: IL HB0384 | 2017-2018 | 100th General Assembly | Introduced


Bill Title: Repeals the Illinois Health Facilities Planning Act and abolishes the Health Facilities and Services Review Board. Amends the Health Care Self-Referral Act to transfer the Board's functions under that Act to the Department of Public Health. Amends various other Acts to eliminate references to the Board or the Illinois Health Facilities Planning Act.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Failed) 2019-01-08 - Session Sine Die [HB0384 Detail]

Download: Illinois-2017-HB0384-Introduced.html


100TH GENERAL ASSEMBLY
State of Illinois
2017 and 2018
HB0384

Introduced , by Rep. David Harris - Margo McDermed

SYNOPSIS AS INTRODUCED:
See Index

Repeals the Illinois Health Facilities Planning Act and abolishes the Health Facilities and Services Review Board. Amends the Health Care Self-Referral Act to transfer the Board's functions under that Act to the Department of Public Health. Amends various other Acts to eliminate references to the Board or the Illinois Health Facilities Planning Act.
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FISCAL NOTE ACT MAY APPLY

A BILL FOR

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1 AN ACT concerning government.
2 Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4 Section 5. The Open Meetings Act is amended by changing
5Section 1.02 as follows:
6 (5 ILCS 120/1.02) (from Ch. 102, par. 41.02)
7 Sec. 1.02. For the purposes of this Act:
8 "Meeting" means any gathering, whether in person or by
9video or audio conference, telephone call, electronic means
10(such as, without limitation, electronic mail, electronic
11chat, and instant messaging), or other means of contemporaneous
12interactive communication, of a majority of a quorum of the
13members of a public body held for the purpose of discussing
14public business or, for a 5-member public body, a quorum of the
15members of a public body held for the purpose of discussing
16public business.
17 Accordingly, for a 5-member public body, 3 members of the
18body constitute a quorum and the affirmative vote of 3 members
19is necessary to adopt any motion, resolution, or ordinance,
20unless a greater number is otherwise required.
21 "Public body" includes all legislative, executive,
22administrative or advisory bodies of the State, counties,
23townships, cities, villages, incorporated towns, school

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1districts and all other municipal corporations, boards,
2bureaus, committees or commissions of this State, and any
3subsidiary bodies of any of the foregoing including but not
4limited to committees and subcommittees which are supported in
5whole or in part by tax revenue, or which expend tax revenue,
6except the General Assembly and committees or commissions
7thereof. "Public body" includes tourism boards and convention
8or civic center boards located in counties that are contiguous
9to the Mississippi River with populations of more than 250,000
10but less than 300,000. "Public body" includes the Health
11Facilities and Services Review Board. "Public body" does not
12include a child death review team or the Illinois Child Death
13Review Teams Executive Council established under the Child
14Death Review Team Act, an ethics commission acting under the
15State Officials and Employees Ethics Act, a regional youth
16advisory board or the Statewide Youth Advisory Board
17established under the Department of Children and Family
18Services Statewide Youth Advisory Board Act, or the Illinois
19Independent Tax Tribunal.
20(Source: P.A. 97-1129, eff. 8-28-12; 98-806, eff. 1-1-15.)
21 Section 10. The State Officials and Employees Ethics Act is
22amended by changing Section 5-50 as follows:
23 (5 ILCS 430/5-50)
24 Sec. 5-50. Ex parte communications; special government

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1agents.
2 (a) This Section applies to ex parte communications made to
3any agency listed in subsection (e).
4 (b) "Ex parte communication" means any written or oral
5communication by any person that imparts or requests material
6information or makes a material argument regarding potential
7action concerning regulatory, quasi-adjudicatory, investment,
8or licensing matters pending before or under consideration by
9the agency. "Ex parte communication" does not include the
10following: (i) statements by a person publicly made in a public
11forum; (ii) statements regarding matters of procedure and
12practice, such as format, the number of copies required, the
13manner of filing, and the status of a matter; and (iii)
14statements made by a State employee of the agency to the agency
15head or other employees of that agency.
16 (b-5) An ex parte communication received by an agency,
17agency head, or other agency employee from an interested party
18or his or her official representative or attorney shall
19promptly be memorialized and made a part of the record.
20 (c) An ex parte communication received by any agency,
21agency head, or other agency employee, other than an ex parte
22communication described in subsection (b-5), shall immediately
23be reported to that agency's ethics officer by the recipient of
24the communication and by any other employee of that agency who
25responds to the communication. The ethics officer shall require
26that the ex parte communication be promptly made a part of the

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1record. The ethics officer shall promptly file the ex parte
2communication with the Executive Ethics Commission, including
3all written communications, all written responses to the
4communications, and a memorandum prepared by the ethics officer
5stating the nature and substance of all oral communications,
6the identity and job title of the person to whom each
7communication was made, all responses made, the identity and
8job title of the person making each response, the identity of
9each person from whom the written or oral ex parte
10communication was received, the individual or entity
11represented by that person, any action the person requested or
12recommended, and any other pertinent information. The
13disclosure shall also contain the date of any ex parte
14communication.
15 (d) "Interested party" means a person or entity whose
16rights, privileges, or interests are the subject of or are
17directly affected by a regulatory, quasi-adjudicatory,
18investment, or licensing matter.
19 (e) This Section applies to the following agencies:
20Executive Ethics Commission
21Illinois Commerce Commission
22Educational Labor Relations Board
23State Board of Elections
24Illinois Gaming Board
25Health Facilities and Services Review Board
26Illinois Workers' Compensation Commission

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1Illinois Labor Relations Board
2Illinois Liquor Control Commission
3Pollution Control Board
4Property Tax Appeal Board
5Illinois Racing Board
6Illinois Purchased Care Review Board
7Department of State Police Merit Board
8Motor Vehicle Review Board
9Prisoner Review Board
10Civil Service Commission
11Personnel Review Board for the Treasurer
12Merit Commission for the Secretary of State
13Merit Commission for the Office of the Comptroller
14Court of Claims
15Board of Review of the Department of Employment Security
16Department of Insurance
17Department of Professional Regulation and licensing boards
18 under the Department
19Department of Public Health and licensing boards under the
20 Department
21Office of Banks and Real Estate and licensing boards under
22 the Office
23State Employees Retirement System Board of Trustees
24Judges Retirement System Board of Trustees
25General Assembly Retirement System Board of Trustees
26Illinois Board of Investment

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1State Universities Retirement System Board of Trustees
2Teachers Retirement System Officers Board of Trustees
3 (f) Any person who fails to (i) report an ex parte
4communication to an ethics officer, (ii) make information part
5of the record, or (iii) make a filing with the Executive Ethics
6Commission as required by this Section or as required by
7Section 5-165 of the Illinois Administrative Procedure Act
8violates this Act.
9(Source: P.A. 95-331, eff. 8-21-07; 96-31, eff. 6-30-09.)
10 Section 15. The Department of Public Health Powers and
11Duties Law of the Civil Administrative Code of Illinois is
12amended by changing Sections 2310-217 and 2310-640 as follows:
13 (20 ILCS 2310/2310-217)
14 (Section scheduled to be repealed on January 1, 2017)
15 Sec. 2310-217. Center for Comprehensive Health Planning.
16 (a) The Center for Comprehensive Health Planning
17("Center") is hereby created to promote the distribution of
18health care services and improve the healthcare delivery system
19in Illinois by establishing a statewide Comprehensive Health
20Plan and ensuring a predictable, transparent, and efficient
21Certificate of Need process under the Illinois Health
22Facilities Planning Act. The objectives of the Comprehensive
23Health Plan include: to assess existing community resources and
24determine health care needs; to support safety net services for

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1uninsured and underinsured residents; to promote adequate
2financing for health care services; and to recognize and
3respond to changes in community health care needs, including
4public health emergencies and natural disasters. The Center
5shall comprehensively assess health and mental health
6services; assess health needs with a special focus on the
7identification of health disparities; identify State-level and
8regional needs; and make findings that identify the impact of
9market forces on the access to high quality services for
10uninsured and underinsured residents. The Center shall conduct
11a biennial comprehensive assessment of health resources and
12service needs, including, but not limited to, facilities,
13clinical services, and workforce; conduct needs assessments
14using key indicators of population health status and
15determinations of potential benefits that could occur with
16certain changes in the health care delivery system; collect and
17analyze relevant, objective, and accurate data, including
18health care utilization data; identify issues related to health
19care financing such as revenue streams, federal opportunities,
20better utilization of existing resources, development of
21resources, and incentives for new resource development;
22evaluate findings by the needs assessments; and annually report
23to the General Assembly and the public.
24 The Illinois Department of Public Health shall establish a
25Center for Comprehensive Health Planning to develop a
26long-range Comprehensive Health Plan, which Plan shall guide

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1the development of clinical services, facilities, and
2workforce that meet the health and mental health care needs of
3this State.
4 (b) Center for Comprehensive Health Planning.
5 (1) Responsibilities and duties of the Center include:
6 (A) (blank); providing technical assistance to the
7 Health Facilities and Services Review Board to permit
8 that Board to apply relevant components of the
9 Comprehensive Health Plan in its deliberations;
10 (B) attempting to identify unmet health needs and
11 assist in any inter-agency State planning for health
12 resource development;
13 (C) considering health plans and other related
14 publications that have been developed in Illinois and
15 nationally;
16 (D) establishing priorities and recommend methods
17 for meeting identified health service, facilities, and
18 workforce needs. Plan recommendations shall be
19 short-term, mid-term, and long-range;
20 (E) conducting an analysis regarding the
21 availability of long-term care resources throughout
22 the State, using data and plans developed under the
23 Illinois Older Adult Services Act, to adjust existing
24 bed need criteria and standards under the Health
25 Facilities Planning Act for changes in utilization of
26 institutional and non-institutional care options, with

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1 special consideration of the availability of the
2 least-restrictive options in accordance with the needs
3 and preferences of persons requiring long-term care;
4 and
5 (F) considering and recognizing health resource
6 development projects or information on methods by
7 which a community may receive benefit, that are
8 consistent with health resource needs identified
9 through the comprehensive health planning process.
10 (2) A Comprehensive Health Planner shall be appointed
11 by the Governor, with the advice and consent of the Senate,
12 to supervise the Center and its staff for a paid 3-year
13 term, subject to review and re-approval every 3 years. The
14 Planner shall receive an annual salary of $120,000, or an
15 amount set by the Compensation Review Board, whichever is
16 greater. The Planner shall prepare a budget for review and
17 approval by the Illinois General Assembly, which shall
18 become part of the annual report available on the
19 Department website.
20 (c) Comprehensive Health Plan.
21 (1) The Plan shall be developed with a 5 to 10 year
22 range, and updated every 2 years, or annually, if needed.
23 (2) Components of the Plan shall include:
24 (A) an inventory to map the State for growth,
25 population shifts, and utilization of available
26 healthcare resources, using both State-level and

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1 regionally defined areas;
2 (B) an evaluation of health service needs,
3 addressing gaps in service, over-supply, and
4 continuity of care, including an assessment of
5 existing safety net services;
6 (C) an inventory of health care facility
7 infrastructure, including regulated facilities and
8 services, and unregulated facilities and services, as
9 determined by the Center;
10 (D) recommendations on ensuring access to care,
11 especially for safety net services, including rural
12 and medically underserved communities; and
13 (E) an integration between health planning for
14 clinical services, facilities and workforce under the
15 Illinois Health Facilities Planning Act and other
16 health planning laws and activities of the State.
17 (3) (Blank). Components of the Plan may include
18 recommendations that will be integrated into any relevant
19 certificate of need review criteria, standards, and
20 procedures.
21 (d) Within 60 days of receiving the Comprehensive Health
22Plan, the State Board of Health shall review and comment upon
23the Plan and any policy change recommendations. The first Plan
24shall be submitted to the State Board of Health within one year
25after hiring the Comprehensive Health Planner. The Plan shall
26be submitted to the General Assembly by the following March 1.

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1The Center and State Board shall hold public hearings on the
2Plan and its updates. The Center shall permit the public to
3request the Plan to be updated more frequently to address
4emerging population and demographic trends.
5 (e) Current comprehensive health planning data and
6information about Center funding shall be available to the
7public on the Department website.
8 (f) The Department shall submit to a performance audit of
9the Center by the Auditor General in order to assess whether
10progress is being made to develop a Comprehensive Health Plan
11and whether resources are sufficient to meet the goals of the
12Center for Comprehensive Health Planning.
13(Source: P.A. 96-31, eff. 6-30-09. Repealed by P.A. 99-527,
14eff. 1-1-17.)
15 (20 ILCS 2310/2310-640)
16 Sec. 2310-640. Hospital Capital Investment Program.
17 (a) Subject to appropriation, the Department shall
18establish and administer a program to award capital grants to
19Illinois hospitals licensed under the Hospital Licensing Act.
20Grants awarded under this program shall only be used to fund
21capital projects to improve or renovate the hospital's facility
22or to improve, replace or acquire the hospital's equipment or
23technology. Such projects may include, but are not limited to,
24projects to satisfy any building code, safety standard or life
25safety code; projects to maintain, improve, renovate, expand or

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1construct buildings or structures; projects to maintain,
2establish or improve health information technology; or
3projects to maintain or improve patient safety, quality of care
4or access to care.
5 The Department shall establish rules necessary to
6implement the Hospital Capital Investment Program, including
7application standards, requirements for the distribution and
8obligation of grant funds, accounting for the use of the funds,
9reporting the status of funded projects, and standards for
10monitoring compliance with standards. In awarding grants under
11this Section, the Department shall consider criteria that
12include but are not limited to: the financial requirements of
13the project and the extent to which the grant makes it possible
14to implement the project; the proposed project's likely benefit
15in terms of patient safety or quality of care; and the proposed
16project's likely benefit in terms of maintaining or improving
17access to care.
18 The Department shall approve a hospital's eligibility for a
19hospital capital investment grant pursuant to the standards
20established by this Section. The Department shall determine
21eligible project costs, including but not limited to the use of
22funds for the acquisition, development, construction,
23reconstruction, rehabilitation, improvement, architectural
24planning, engineering, and installation of capital facilities
25consisting of buildings, structures, technology and durable
26equipment for hospital purposes. No portion of a hospital

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1capital investment grant awarded by the Department may be used
2by a hospital to pay for any on-going operational costs, pay
3outstanding debt, or be allocated to an endowment or other
4invested fund.
5 Nothing in this Section shall exempt nor relieve any
6hospital receiving a grant under this Section from any
7requirement of the Illinois Health Facilities Planning Act.
8 (b) Safety Net Hospital Grants. The Department shall make
9capital grants to hospitals eligible for safety net hospital
10grants under this subsection. The total amount of grants to any
11individual hospital shall be no less than $2,500,000 and no
12more than $7,000,000. The total amount of grants to hospitals
13under this subsection shall not exceed $100,000,000. Hospitals
14that satisfy one of the following criteria shall be eligible to
15apply for safety net hospital grants:
16 (1) Any general acute care hospital located in a county
17 of over 3,000,000 inhabitants that has a Medicaid inpatient
18 utilization rate for the rate year beginning on October 1,
19 2008 greater than 43%, that is not affiliated with a
20 hospital system that owns or operates more than 3
21 hospitals, and that has more than 13,500 Medicaid inpatient
22 days.
23 (2) Any general acute care hospital that is located in
24 a county of more than 3,000,000 inhabitants and has a
25 Medicaid inpatient utilization rate for the rate year
26 beginning on October 1, 2008 greater than 55% and has

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1 authorized beds for the obstetric-gynecology category of
2 service as reported in the 2008 Annual Hospital Bed Report,
3 issued by the Illinois Department of Public Health.
4 (3) Any hospital that is defined in 89 Illinois
5 Administrative Code Section 149.50(c)(3)(A) and that has
6 less than 20,000 Medicaid inpatient days.
7 (4) Any general acute care hospital that is located in
8 a county of less than 3,000,000 inhabitants and has a
9 Medicaid inpatient utilization rate for the rate year
10 beginning on October 1, 2008 greater than 64%.
11 (5) Any general acute care hospital that is located in
12 a county of over 3,000,000 inhabitants and a city of less
13 than 1,000,000 inhabitants, that has a Medicaid inpatient
14 utilization rate for the rate year beginning on October 1,
15 2008 greater than 22%, that has more than 12,000 Medicaid
16 inpatient days, and that has a case mix index greater than
17 0.71.
18 (c) Community Hospital Grants. The Department shall make a
19one-time capital grant to any public or not-for-profit
20hospitals located in counties of less than 3,000,000
21inhabitants that are not otherwise eligible for a grant under
22subsection (b) of this Section and that have a Medicaid
23inpatient utilization rate for the rate year beginning on
24October 1, 2008 of at least 10%. The total amount of grants
25under this subsection shall not exceed $50,000,000. This grant
26shall be the sum of the following payments:

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1 (1) For each acute care hospital, a base payment of:
2 (i) $170,000 if it is located in an urban area; or
3 (ii) $340,000 if it is located in a rural area.
4 (2) A payment equal to the product of $45 multiplied by
5 total Medicaid inpatient days for each hospital.
6 (d) Annual report. The Department of Public Health shall
7prepare and submit to the Governor and the General Assembly an
8annual report by January 1 of each year regarding its
9administration of the Hospital Capital Investment Program,
10including an overview of the program and information about the
11specific purpose and amount of each grant and the status of
12funded projects. The report shall include information as to
13whether each project is subject to and authorized under the
14Illinois Health Facilities Planning Act, if applicable.
15 (e) Definitions. As used in this Section, the following
16terms shall be defined as follows:
17 "General acute care hospital" shall have the same meaning
18as general acute care hospital in Section 5A-12.2 of the
19Illinois Public Aid Code.
20 "Hospital" shall have the same meaning as defined in
21Section 3 of the Hospital Licensing Act, but in no event shall
22it include a hospital owned or operated by a State agency, a
23State university, or a county with a population of 3,000,000 or
24more.
25 "Medicaid inpatient day" shall have the same meaning as
26defined in Section 5A-12.2(n) of the Illinois Public Aid Code.

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1 "Medicaid inpatient utilization rate" shall have the same
2meaning as provided in Title 89, Chapter I, subchapter d, Part
3148, Section 148.120 of the Illinois Administrative Code.
4 "Rural" shall have the same meaning as provided in Title
589, Chapter I, subchapter d, Part 148, Section 148.25(g)(3) of
6the Illinois Administrative Code.
7 "Urban" shall have the same meaning as provided in Title
889, Chapter I, subchapter d, Part 148, Section 148.25(g)(4) of
9the Illinois Administrative Code.
10(Source: P.A. 96-37, eff. 7-13-09; 96-1000, eff. 7-2-10.)
11 (20 ILCS 3960/Act rep.)
12 Section 20. The Illinois Health Facilities Planning Act is
13repealed.
14 (20 ILCS 4050/15 rep.)
15 Section 25. The Hospital Basic Services Preservation Act is
16amended by repealing Section 15.
17 Section 30. The Illinois State Auditing Act is amended by
18changing Section 3-1 as follows:
19 (30 ILCS 5/3-1) (from Ch. 15, par. 303-1)
20 Sec. 3-1. Jurisdiction of Auditor General. The Auditor
21General has jurisdiction over all State agencies to make post
22audits and investigations authorized by or under this Act or

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1the Constitution.
2 The Auditor General has jurisdiction over local government
3agencies and private agencies only:
4 (a) to make such post audits authorized by or under
5 this Act as are necessary and incidental to a post audit of
6 a State agency or of a program administered by a State
7 agency involving public funds of the State, but this
8 jurisdiction does not include any authority to review local
9 governmental agencies in the obligation, receipt,
10 expenditure or use of public funds of the State that are
11 granted without limitation or condition imposed by law,
12 other than the general limitation that such funds be used
13 for public purposes;
14 (b) to make investigations authorized by or under this
15 Act or the Constitution; and
16 (c) to make audits of the records of local government
17 agencies to verify actual costs of state-mandated programs
18 when directed to do so by the Legislative Audit Commission
19 at the request of the State Board of Appeals under the
20 State Mandates Act.
21 In addition to the foregoing, the Auditor General may
22conduct an audit of the Metropolitan Pier and Exposition
23Authority, the Regional Transportation Authority, the Suburban
24Bus Division, the Commuter Rail Division and the Chicago
25Transit Authority and any other subsidized carrier when
26authorized by the Legislative Audit Commission. Such audit may

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1be a financial, management or program audit, or any combination
2thereof.
3 The audit shall determine whether they are operating in
4accordance with all applicable laws and regulations. Subject to
5the limitations of this Act, the Legislative Audit Commission
6may by resolution specify additional determinations to be
7included in the scope of the audit.
8 In addition to the foregoing, the Auditor General must also
9conduct a financial audit of the Illinois Sports Facilities
10Authority's expenditures of public funds in connection with the
11reconstruction, renovation, remodeling, extension, or
12improvement of all or substantially all of any existing
13"facility", as that term is defined in the Illinois Sports
14Facilities Authority Act.
15 The Auditor General may also conduct an audit, when
16authorized by the Legislative Audit Commission, of any hospital
17which receives 10% or more of its gross revenues from payments
18from the State of Illinois, Department of Healthcare and Family
19Services (formerly Department of Public Aid), Medical
20Assistance Program.
21 The Auditor General is authorized to conduct financial and
22compliance audits of the Illinois Distance Learning Foundation
23and the Illinois Conservation Foundation.
24 As soon as practical after the effective date of this
25amendatory Act of 1995, the Auditor General shall conduct a
26compliance and management audit of the City of Chicago and any

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1other entity with regard to the operation of Chicago O'Hare
2International Airport, Chicago Midway Airport and Merrill C.
3Meigs Field. The audit shall include, but not be limited to, an
4examination of revenues, expenses, and transfers of funds;
5purchasing and contracting policies and practices; staffing
6levels; and hiring practices and procedures. When completed,
7the audit required by this paragraph shall be distributed in
8accordance with Section 3-14.
9 The Auditor General shall conduct a financial and
10compliance and program audit of distributions from the
11Municipal Economic Development Fund during the immediately
12preceding calendar year pursuant to Section 8-403.1 of the
13Public Utilities Act at no cost to the city, village, or
14incorporated town that received the distributions.
15 The Auditor General must conduct an audit of the Health
16Facilities and Services Review Board pursuant to Section 19.5
17of the Illinois Health Facilities Planning Act.
18 The Auditor General of the State of Illinois shall annually
19conduct or cause to be conducted a financial and compliance
20audit of the books and records of any county water commission
21organized pursuant to the Water Commission Act of 1985 and
22shall file a copy of the report of that audit with the Governor
23and the Legislative Audit Commission. The filed audit shall be
24open to the public for inspection. The cost of the audit shall
25be charged to the county water commission in accordance with
26Section 6z-27 of the State Finance Act. The county water

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1commission shall make available to the Auditor General its
2books and records and any other documentation, whether in the
3possession of its trustees or other parties, necessary to
4conduct the audit required. These audit requirements apply only
5through July 1, 2007.
6 The Auditor General must conduct audits of the Rend Lake
7Conservancy District as provided in Section 25.5 of the River
8Conservancy Districts Act.
9 The Auditor General must conduct financial audits of the
10Southeastern Illinois Economic Development Authority as
11provided in Section 70 of the Southeastern Illinois Economic
12Development Authority Act.
13 The Auditor General shall conduct a compliance audit in
14accordance with subsections (d) and (f) of Section 30 of the
15Innovation Development and Economy Act.
16(Source: P.A. 95-331, eff. 8-21-07; 96-31, eff. 6-30-09;
1796-939, eff. 6-24-10.)
18 (30 ILCS 105/5.213 rep.) (from Ch. 127, par. 141.213)
19 Section 35. The State Finance Act is amended by repealing
20Section 5.213.
21 Section 40. The Hospital District Law is amended by
22changing Section 15 as follows:
23 (70 ILCS 910/15) (from Ch. 23, par. 1265)

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1 Sec. 15. A Hospital District shall constitute a municipal
2corporation and body politic separate and apart from any other
3municipality, the State of Illinois or any other public or
4governmental agency and shall have and exercise the following
5governmental powers, and all other powers incidental,
6necessary, convenient, or desirable to carry out and effectuate
7such express powers.
8 1. To establish and maintain a hospital and hospital
9facilities within or outside its corporate limits, and to
10construct, acquire, develop, expand, extend and improve any
11such hospital or hospital facility. If a Hospital District
12utilizes its authority to levy a tax pursuant to Section 20 of
13this Act for the purpose of establishing and maintaining
14hospitals or hospital facilities, such District shall be
15prohibited from establishing and maintaining hospitals or
16hospital facilities located outside of its district unless so
17authorized by referendum. To approve the provision of any
18service and to approve any contract or other arrangement not
19prohibited by a hospital licensed under the Hospital Licensing
20Act, incorporated under the General Not-For-Profit Corporation
21Act, and exempt from taxation under paragraph (3) of subsection
22(c) of Section 501 of the Internal Revenue Code.
23 2. To acquire land in fee simple, rights in land and
24easements upon, over or across land and leasehold interests in
25land and tangible and intangible personal property used or
26useful for the location, establishment, maintenance,

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1development, expansion, extension or improvement of any such
2hospital or hospital facility. Such acquisition may be by
3dedication, purchase, gift, agreement, lease, use or adverse
4possession or by condemnation.
5 3. To operate, maintain and manage such hospital and
6hospital facility, and to make and enter into contracts for the
7use, operation or management of and to provide rules and
8regulations for the operation, management or use of such
9hospital or hospital facility.
10 Such contracts may include the lease by the District of all
11or any portion of its facilities to a not-for-profit
12corporation organized by the District's board of directors. The
13rent to be paid pursuant to any such lease shall be in an
14amount deemed appropriate by the board of directors. Any of the
15remaining assets which are not the subject of such a lease may
16be conveyed and transferred to the not-for-profit corporation
17organized by the District's board of directors provided that
18the not-for-profit corporation agrees to discharge or assume
19such debts, liabilities, and obligations of the District as
20determined to be appropriate by the District's board of
21directors.
22 4. To fix, charge and collect reasonable fees and
23compensation for the use or occupancy of such hospital or any
24part thereof, or any hospital facility, and for nursing care,
25medicine, attendance, or other services furnished by such
26hospital or hospital facilities, according to the rules and

HB0384- 23 -LRB100 05886 RJF 15912 b
1regulations prescribed by the board from time to time.
2 5. To borrow money and to issue general obligation bonds,
3revenue bonds, notes, certificates, or other evidences of
4indebtedness for the purpose of accomplishing any of its
5corporate purposes, subject to compliance with any conditions
6or limitations set forth in this Act or the Health Facilities
7Planning Act or otherwise provided by the constitution of the
8State of Illinois and to execute, deliver, and perform
9mortgages and security agreements to secure such borrowing.
10 6. To employ or enter into contracts for the employment of
11any person, firm, or corporation, and for professional
12services, necessary or desirable for the accomplishment of the
13corporate objects of the District or the proper administration,
14management, protection or control of its property.
15 7. To maintain such hospital for the benefit of the
16inhabitants of the area comprising the District who are sick,
17injured, or maimed regardless of race, creed, religion, sex,
18national origin or color, and to adopt such reasonable rules
19and regulations as may be necessary to render the use of the
20hospital of the greatest benefit to the greatest number; to
21exclude from the use of the hospital all persons who wilfully
22disregard any of the rules and regulations so established; to
23extend the privileges and use of the hospital to persons
24residing outside the area of the District upon such terms and
25conditions as the board of directors prescribes by its rules
26and regulations.

HB0384- 24 -LRB100 05886 RJF 15912 b
1 8. To police its property and to exercise police powers in
2respect thereto or in respect to the enforcement of any rule or
3regulation provided by the ordinances of the District and to
4employ and commission police officers and other qualified
5persons to enforce the same.
6 The use of any such hospital or hospital facility of a
7District shall be subject to the reasonable regulation and
8control of the District and upon such reasonable terms and
9conditions as shall be established by its board of directors.
10 A regulatory ordinance of a District adopted under any
11provision of this Section may provide for a suspension or
12revocation of any rights or privileges within the control of
13the District for a violation of any such regulatory ordinance.
14 Nothing in this Section or in other provisions of this Act
15shall be construed to authorize the District or board to
16establish or enforce any regulation or rule in respect to
17hospitalization or in the operation or maintenance of such
18hospital or any hospital facilities within its jurisdiction
19which is in conflict with any federal or state law or
20regulation applicable to the same subject matter.
21 9. To provide for the benefit of its employees group life,
22health, accident, hospital and medical insurance, or any
23combination of such types of insurance, and to further provide
24for its employees by the establishment of a pension or
25retirement plan or system; to effectuate the establishment of
26any such insurance program or pension or retirement plan or

HB0384- 25 -LRB100 05886 RJF 15912 b
1system, a Hospital District may make, enter into or subscribe
2to agreements, contracts, policies or plans with private
3insurance companies. Such insurance may include provisions for
4employees who rely on treatment by spiritual means alone
5through prayer for healing in accord with the tenets and
6practice of a well-recognized religious denomination. The
7board of directors of a Hospital District may provide for
8payment by the District of a portion of the premium or charge
9for such insurance or for a pension or retirement plan for
10employees with the employee paying the balance of such premium
11or charge. If the board of directors of a Hospital District
12undertakes a plan pursuant to which the Hospital District pays
13a portion of such premium or charge, the board shall provide
14for the withholding and deducting from the compensation of such
15employees as consent to joining such insurance program or
16pension or retirement plan or system, the balance of the
17premium or charge for such insurance or plan or system.
18 If the board of directors of a Hospital District does not
19provide for a program or plan pursuant to which such District
20pays a portion of the premium or charge for any group insurance
21program or pension or retirement plan or system, the board may
22provide for the withholding and deducting from the compensation
23of such employees as consent thereto the premium or charge for
24any group life, health, accident, hospital and medical
25insurance or for any pension or retirement plan or system.
26 A Hospital District deducting from the compensation of its

HB0384- 26 -LRB100 05886 RJF 15912 b
1employees for any group insurance program or pension or
2retirement plan or system, pursuant to this Section, may agree
3to receive and may receive reimbursement from the insurance
4company for the cost of withholding and transferring such
5amount to the company.
6 10. Except as provided in Section 15.3, to sell at public
7auction or by sealed bid and convey any real estate held by the
8District which the board of directors, by ordinance adopted by
9at least 2/3rds of the members of the board then holding
10office, has determined to be no longer necessary or useful to,
11or for the best interests of, the District.
12 An ordinance directing the sale of real estate shall
13include the legal description of the real estate, its present
14use, a statement that the property is no longer necessary or
15useful to, or for the best interests of, the District, the
16terms and conditions of the sale, whether the sale is to be at
17public auction or sealed bid, and the date, time, and place the
18property is to be sold at auction or sealed bids opened.
19 Before making a sale by virtue of the ordinance, the board
20of directors shall cause notice of the proposal to sell to be
21published once each week for 3 successive weeks in a newspaper
22published, or, if none is published, having a general
23circulation, in the district, the first publication to be not
24less than 30 days before the day provided in the notice for the
25public sale or opening of bids for the real estate.
26 The notice of the proposal to sell shall include the same

HB0384- 27 -LRB100 05886 RJF 15912 b
1information included in the ordinance directing the sale and
2shall advertise for bids therefor. A sale of property by public
3auction shall be held at the property to be sold at a time and
4date determined by the board of directors. The board of
5directors may accept the high bid or any other bid determined
6to be in the best interests of the district by a vote of 2/3rds
7of the board then holding office, but by a majority vote of
8those holding office, they may reject any and all bids.
9 The chairman and secretary of the board of directors shall
10execute all documents necessary for the conveyance of such real
11property sold pursuant to the foregoing authority.
12 11. To establish and administer a program of loans for
13postsecondary students pursuing degrees in accredited public
14health-related educational programs at public institutions of
15higher education. If a student is awarded a loan, the
16individual shall agree to accept employment within the hospital
17district upon graduation from the public institution of higher
18education. For the purposes of this Act, "public institutions
19of higher education" means the University of Illinois; Southern
20Illinois University; Chicago State University; Eastern
21Illinois University; Governors State University; Illinois
22State University; Northeastern Illinois University; Northern
23Illinois University; Western Illinois University; the public
24community colleges of the State; and any other public colleges,
25universities or community colleges now or hereafter
26established or authorized by the General Assembly. The

HB0384- 28 -LRB100 05886 RJF 15912 b
1district's board of directors shall by resolution provide for
2eligibility requirements, award criteria, terms of financing,
3duration of employment accepted within the district and such
4other aspects of the loan program as its establishment and
5administration may necessitate.
6 12. To establish and maintain congregate housing units; to
7acquire land in fee simple and leasehold interests in land for
8the location, establishment, maintenance, and development of
9those housing units; to borrow funds and give debt instruments,
10real estate mortgages, and security interests in personal
11property, contract rights, and general intangibles; and to
12enter into any contract required for participation in any
13federal or State programs.
14(Source: P.A. 92-534, eff. 5-14-02; 92-611, eff. 7-3-02.)
15 Section 45. The Alternative Health Care Delivery Act is
16amended by changing Sections 20, 30, and 36.5 as follows:
17 (210 ILCS 3/20)
18 Sec. 20. Board responsibilities. The State Board of Health
19shall have the responsibilities set forth in this Section.
20 (a) The Board shall investigate new health care delivery
21models and recommend to the Governor and the General Assembly,
22through the Department, those models that should be authorized
23as alternative health care models for which demonstration
24programs should be initiated. In its deliberations, the Board

HB0384- 29 -LRB100 05886 RJF 15912 b
1shall use the following criteria:
2 (1) The feasibility of operating the model in Illinois,
3 based on a review of the experience in other states
4 including the impact on health professionals of other
5 health care programs or facilities.
6 (2) The potential of the model to meet an unmet need.
7 (3) The potential of the model to reduce health care
8 costs to consumers, costs to third party payors, and
9 aggregate costs to the public.
10 (4) The potential of the model to maintain or improve
11 the standards of health care delivery in some measurable
12 fashion.
13 (5) The potential of the model to provide increased
14 choices or access for patients.
15 (b) The Board shall evaluate and make recommendations to
16the Governor and the General Assembly, through the Department,
17regarding alternative health care model demonstration programs
18established under this Act, at the midpoint and end of the
19period of operation of the demonstration programs. The report
20shall include, at a minimum, the following:
21 (1) Whether the alternative health care models
22 improved access to health care for their service
23 populations in the State.
24 (2) The quality of care provided by the alternative
25 health care models as may be evidenced by health outcomes,
26 surveillance reports, and administrative actions taken by

HB0384- 30 -LRB100 05886 RJF 15912 b
1 the Department.
2 (3) The cost and cost effectiveness to the public,
3 third-party payors, and government of the alternative
4 health care models, including the impact of pilot programs
5 on aggregate health care costs in the area. In addition to
6 any other information collected by the Board under this
7 Section, the Board shall collect from postsurgical
8 recovery care centers uniform billing data substantially
9 the same as specified in Section 4-2(e) of the Illinois
10 Health Finance Reform Act. To facilitate its evaluation of
11 that data, the Board shall forward a copy of the data to
12 the Illinois Health Care Cost Containment Council. All
13 patient identifiers shall be removed from the data before
14 it is submitted to the Board or Council.
15 (4) The impact of the alternative health care models on
16 the health care system in that area, including changing
17 patterns of patient demand and utilization, financial
18 viability, and feasibility of operation of service in
19 inpatient and alternative models in the area.
20 (5) The implementation by alternative health care
21 models of any special commitments made during application
22 review to the Health Facilities and Services Review Board.
23 (6) The continuation, expansion, or modification of
24 the alternative health care models.
25 (c) The Board shall advise the Department on the definition
26and scope of alternative health care models demonstration

HB0384- 31 -LRB100 05886 RJF 15912 b
1programs.
2 (d) In carrying out its responsibilities under this
3Section, the Board shall seek the advice of other Department
4advisory boards or committees that may be impacted by the
5alternative health care model or the proposed model of health
6care delivery. The Board shall also seek input from other
7interested parties, which may include holding public hearings.
8 (e) The Board shall otherwise advise the Department on the
9administration of the Act as the Board deems appropriate.
10(Source: P.A. 96-31, eff. 6-30-09.)
11 (210 ILCS 3/30)
12 Sec. 30. Demonstration program requirements. The
13requirements set forth in this Section shall apply to
14demonstration programs.
15 (a) (Blank).
16 (a-5) (Blank). There shall be no more than the total number
17of postsurgical recovery care centers with a certificate of
18need for beds as of January 1, 2008.
19 (a-10) There shall be no more than a total of 9 children's
20community-based health care center alternative health care
21models in the demonstration program, which shall be located as
22follows:
23 (1) Two in the City of Chicago.
24 (2) One in Cook County outside the City of Chicago.
25 (3) A total of 2 in the area comprised of DuPage, Kane,

HB0384- 32 -LRB100 05886 RJF 15912 b
1 Lake, McHenry, and Will counties.
2 (4) A total of 2 in municipalities with a population of
3 50,000 or more and not located in the areas described in
4 paragraphs (1), (2), or (3).
5 (5) A total of 2 in rural areas, as defined by the
6 Health Facilities and Services Review Board.
7 No more than one children's community-based health care
8center owned and operated by a licensed skilled pediatric
9facility shall be located in each of the areas designated in
10this subsection (a-10).
11 (a-15) There shall be 5 authorized community-based
12residential rehabilitation center alternative health care
13models in the demonstration program.
14 (a-20) There shall be an authorized Alzheimer's disease
15management center alternative health care model in the
16demonstration program. The Alzheimer's disease management
17center shall be located in Will County, owned by a
18not-for-profit entity, and endorsed by a resolution approved by
19the county board before the effective date of this amendatory
20Act of the 91st General Assembly.
21 (a-25) There shall be no more than 10 birth center
22alternative health care models in the demonstration program,
23located as follows:
24 (1) Four in the area comprising Cook, DuPage, Kane,
25 Lake, McHenry, and Will counties, one of which shall be
26 owned or operated by a hospital and one of which shall be

HB0384- 33 -LRB100 05886 RJF 15912 b
1 owned or operated by a federally qualified health center.
2 (2) Three in municipalities with a population of 50,000
3 or more not located in the area described in paragraph (1)
4 of this subsection, one of which shall be owned or operated
5 by a hospital and one of which shall be owned or operated
6 by a federally qualified health center.
7 (3) Three in rural areas, one of which shall be owned
8 or operated by a hospital and one of which shall be owned
9 or operated by a federally qualified health center.
10 The first 3 birth centers authorized to operate by the
11Department shall be located in or predominantly serve the
12residents of a health professional shortage area as determined
13by the United States Department of Health and Human Services.
14There shall be no more than 2 birth centers authorized to
15operate in any single health planning area for obstetric
16services as determined under the Illinois Health Facilities
17Planning Act. If a birth center is located outside of a health
18professional shortage area, (i) the birth center shall be
19located in a health planning area with a demonstrated need for
20obstetrical service beds, as determined by the Health
21Facilities and Services Review Board or (ii) there must be a
22reduction in the existing number of obstetrical service beds in
23the planning area so that the establishment of the birth center
24does not result in an increase in the total number of
25obstetrical service beds in the health planning area.
26 (b) (Blank). Alternative health care models, other than a

HB0384- 34 -LRB100 05886 RJF 15912 b
1model authorized under subsection (a-10) or (a-20), shall
2obtain a certificate of need from the Health Facilities and
3Services Review Board under the Illinois Health Facilities
4Planning Act before receiving a license by the Department. If,
5after obtaining its initial certificate of need, an alternative
6health care delivery model that is a community based
7residential rehabilitation center seeks to increase the bed
8capacity of that center, it must obtain a certificate of need
9from the Health Facilities and Services Review Board before
10increasing the bed capacity. Alternative health care models in
11medically underserved areas shall receive priority in
12obtaining a certificate of need.
13 (c) An alternative health care model license shall be
14issued for a period of one year and shall be annually renewed
15if the facility or program is in substantial compliance with
16the Department's rules adopted under this Act. A licensed
17alternative health care model that continues to be in
18substantial compliance after the conclusion of the
19demonstration program shall be eligible for annual renewals
20unless and until a different licensure program for that type of
21health care model is established by legislation, except that a
22postsurgical recovery care center meeting the following
23requirements may apply within 3 years after August 25, 2009
24(the effective date of Public Act 96-669) for a Certificate of
25Need permit to operate as a hospital:
26 (1) (Blank). The postsurgical recovery care center

HB0384- 35 -LRB100 05886 RJF 15912 b
1 shall apply to the Health Facilities and Services Review
2 Board for a Certificate of Need permit to discontinue the
3 postsurgical recovery care center and to establish a
4 hospital.
5 (2) The If the postsurgical recovery care center
6 obtains a Certificate of Need permit to operate as a
7 hospital, it shall apply for licensure as a hospital under
8 the Hospital Licensing Act and shall meet all statutory and
9 regulatory requirements of a hospital.
10 (3) After obtaining licensure as a hospital, any
11 license as an ambulatory surgical treatment center and any
12 license as a postsurgical recovery care center shall be
13 null and void.
14 (4) The former postsurgical recovery care center that
15 receives a hospital license must seek and use its best
16 efforts to maintain certification under Titles XVIII and
17 XIX of the federal Social Security Act.
18 The Department may issue a provisional license to any
19alternative health care model that does not substantially
20comply with the provisions of this Act and the rules adopted
21under this Act if (i) the Department finds that the alternative
22health care model has undertaken changes and corrections which
23upon completion will render the alternative health care model
24in substantial compliance with this Act and rules and (ii) the
25health and safety of the patients of the alternative health
26care model will be protected during the period for which the

HB0384- 36 -LRB100 05886 RJF 15912 b
1provisional license is issued. The Department shall advise the
2licensee of the conditions under which the provisional license
3is issued, including the manner in which the alternative health
4care model fails to comply with the provisions of this Act and
5rules, and the time within which the changes and corrections
6necessary for the alternative health care model to
7substantially comply with this Act and rules shall be
8completed.
9 (d) Alternative health care models shall seek
10certification under Titles XVIII and XIX of the federal Social
11Security Act. In addition, alternative health care models shall
12provide charitable care consistent with that provided by
13comparable health care providers in the geographic area.
14 (d-5) (Blank).
15 (e) Alternative health care models shall, to the extent
16possible, link and integrate their services with nearby health
17care facilities.
18 (f) Each alternative health care model shall implement a
19quality assurance program with measurable benefits and at
20reasonable cost.
21(Source: P.A. 98-629, eff. 1-1-15; 98-756, eff. 7-16-14; 99-78,
22eff. 7-20-15.)
23 Section 50. The Assisted Living and Shared Housing Act is
24amended by changing Sections 10, 145, and 155 as follows:

HB0384- 37 -LRB100 05886 RJF 15912 b
1 (210 ILCS 9/10)
2 Sec. 10. Definitions. For purposes of this Act:
3 "Activities of daily living" means eating, dressing,
4bathing, toileting, transferring, or personal hygiene.
5 "Assisted living establishment" or "establishment" means a
6home, building, residence, or any other place where sleeping
7accommodations are provided for at least 3 unrelated adults, at
8least 80% of whom are 55 years of age or older and where the
9following are provided consistent with the purposes of this
10Act:
11 (1) services consistent with a social model that is
12 based on the premise that the resident's unit in assisted
13 living and shared housing is his or her own home;
14 (2) community-based residential care for persons who
15 need assistance with activities of daily living, including
16 personal, supportive, and intermittent health-related
17 services available 24 hours per day, if needed, to meet the
18 scheduled and unscheduled needs of a resident;
19 (3) mandatory services, whether provided directly by
20 the establishment or by another entity arranged for by the
21 establishment, with the consent of the resident or
22 resident's representative; and
23 (4) a physical environment that is a homelike setting
24 that includes the following and such other elements as
25 established by the Department: individual living units
26 each of which shall accommodate small kitchen appliances

HB0384- 38 -LRB100 05886 RJF 15912 b
1 and contain private bathing, washing, and toilet
2 facilities, or private washing and toilet facilities with a
3 common bathing room readily accessible to each resident.
4 Units shall be maintained for single occupancy except in
5 cases in which 2 residents choose to share a unit.
6 Sufficient common space shall exist to permit individual
7 and group activities.
8 "Assisted living establishment" or "establishment" does
9not mean any of the following:
10 (1) A home, institution, or similar place operated by
11 the federal government or the State of Illinois.
12 (2) A long term care facility licensed under the
13 Nursing Home Care Act, a facility licensed under the
14 Specialized Mental Health Rehabilitation Act of 2013, a
15 facility licensed under the ID/DD Community Care Act, or a
16 facility licensed under the MC/DD Act. However, a facility
17 licensed under any of those Acts may convert distinct parts
18 of the facility to assisted living. If the facility elects
19 to do so, the facility shall retain the Certificate of Need
20 for its nursing and sheltered care beds that were
21 converted.
22 (3) A hospital, sanitarium, or other institution, the
23 principal activity or business of which is the diagnosis,
24 care, and treatment of human illness and that is required
25 to be licensed under the Hospital Licensing Act.
26 (4) A facility for child care as defined in the Child

HB0384- 39 -LRB100 05886 RJF 15912 b
1 Care Act of 1969.
2 (5) A community living facility as defined in the
3 Community Living Facilities Licensing Act.
4 (6) A nursing home or sanitarium operated solely by and
5 for persons who rely exclusively upon treatment by
6 spiritual means through prayer in accordance with the creed
7 or tenants of a well-recognized church or religious
8 denomination.
9 (7) A facility licensed by the Department of Human
10 Services as a community-integrated living arrangement as
11 defined in the Community-Integrated Living Arrangements
12 Licensure and Certification Act.
13 (8) A supportive residence licensed under the
14 Supportive Residences Licensing Act.
15 (9) The portion of a life care facility as defined in
16 the Life Care Facilities Act not licensed as an assisted
17 living establishment under this Act; a life care facility
18 may apply under this Act to convert sections of the
19 community to assisted living.
20 (10) A free-standing hospice facility licensed under
21 the Hospice Program Licensing Act.
22 (11) A shared housing establishment.
23 (12) A supportive living facility as described in
24 Section 5-5.01a of the Illinois Public Aid Code.
25 "Department" means the Department of Public Health.
26 "Director" means the Director of Public Health.

HB0384- 40 -LRB100 05886 RJF 15912 b
1 "Emergency situation" means imminent danger of death or
2serious physical harm to a resident of an establishment.
3 "License" means any of the following types of licenses
4issued to an applicant or licensee by the Department:
5 (1) "Probationary license" means a license issued to an
6 applicant or licensee that has not held a license under
7 this Act prior to its application or pursuant to a license
8 transfer in accordance with Section 50 of this Act.
9 (2) "Regular license" means a license issued by the
10 Department to an applicant or licensee that is in
11 substantial compliance with this Act and any rules
12 promulgated under this Act.
13 "Licensee" means a person, agency, association,
14corporation, partnership, or organization that has been issued
15a license to operate an assisted living or shared housing
16establishment.
17 "Licensed health care professional" means a registered
18professional nurse, an advanced practice nurse, a physician
19assistant, and a licensed practical nurse.
20 "Mandatory services" include the following:
21 (1) 3 meals per day available to the residents prepared
22 by the establishment or an outside contractor;
23 (2) housekeeping services including, but not limited
24 to, vacuuming, dusting, and cleaning the resident's unit;
25 (3) personal laundry and linen services available to
26 the residents provided or arranged for by the

HB0384- 41 -LRB100 05886 RJF 15912 b
1 establishment;
2 (4) security provided 24 hours each day including, but
3 not limited to, locked entrances or building or contract
4 security personnel;
5 (5) an emergency communication response system, which
6 is a procedure in place 24 hours each day by which a
7 resident can notify building management, an emergency
8 response vendor, or others able to respond to his or her
9 need for assistance; and
10 (6) assistance with activities of daily living as
11 required by each resident.
12 "Negotiated risk" is the process by which a resident, or
13his or her representative, may formally negotiate with
14providers what risks each are willing and unwilling to assume
15in service provision and the resident's living environment. The
16provider assures that the resident and the resident's
17representative, if any, are informed of the risks of these
18decisions and of the potential consequences of assuming these
19risks.
20 "Owner" means the individual, partnership, corporation,
21association, or other person who owns an assisted living or
22shared housing establishment. In the event an assisted living
23or shared housing establishment is operated by a person who
24leases or manages the physical plant, which is owned by another
25person, "owner" means the person who operates the assisted
26living or shared housing establishment, except that if the

HB0384- 42 -LRB100 05886 RJF 15912 b
1person who owns the physical plant is an affiliate of the
2person who operates the assisted living or shared housing
3establishment and has significant control over the day to day
4operations of the assisted living or shared housing
5establishment, the person who owns the physical plant shall
6incur jointly and severally with the owner all liabilities
7imposed on an owner under this Act.
8 "Physician" means a person licensed under the Medical
9Practice Act of 1987 to practice medicine in all of its
10branches.
11 "Resident" means a person residing in an assisted living or
12shared housing establishment.
13 "Resident's representative" means a person, other than the
14owner, agent, or employee of an establishment or of the health
15care provider unless related to the resident, designated in
16writing by a resident to be his or her representative. This
17designation may be accomplished through the Illinois Power of
18Attorney Act, pursuant to the guardianship process under the
19Probate Act of 1975, or pursuant to an executed designation of
20representative form specified by the Department.
21 "Self" means the individual or the individual's designated
22representative.
23 "Shared housing establishment" or "establishment" means a
24publicly or privately operated free-standing residence for 16
25or fewer persons, at least 80% of whom are 55 years of age or
26older and who are unrelated to the owners and one manager of

HB0384- 43 -LRB100 05886 RJF 15912 b
1the residence, where the following are provided:
2 (1) services consistent with a social model that is
3 based on the premise that the resident's unit is his or her
4 own home;
5 (2) community-based residential care for persons who
6 need assistance with activities of daily living, including
7 housing and personal, supportive, and intermittent
8 health-related services available 24 hours per day, if
9 needed, to meet the scheduled and unscheduled needs of a
10 resident; and
11 (3) mandatory services, whether provided directly by
12 the establishment or by another entity arranged for by the
13 establishment, with the consent of the resident or the
14 resident's representative.
15 "Shared housing establishment" or "establishment" does not
16mean any of the following:
17 (1) A home, institution, or similar place operated by
18 the federal government or the State of Illinois.
19 (2) A long term care facility licensed under the
20 Nursing Home Care Act, a facility licensed under the
21 Specialized Mental Health Rehabilitation Act of 2013, a
22 facility licensed under the ID/DD Community Care Act, or a
23 facility licensed under the MC/DD Act. A facility licensed
24 under any of those Acts may, however, convert sections of
25 the facility to assisted living. If the facility elects to
26 do so, the facility shall retain the Certificate of Need

HB0384- 44 -LRB100 05886 RJF 15912 b
1 for its nursing beds that were converted.
2 (3) A hospital, sanitarium, or other institution, the
3 principal activity or business of which is the diagnosis,
4 care, and treatment of human illness and that is required
5 to be licensed under the Hospital Licensing Act.
6 (4) A facility for child care as defined in the Child
7 Care Act of 1969.
8 (5) A community living facility as defined in the
9 Community Living Facilities Licensing Act.
10 (6) A nursing home or sanitarium operated solely by and
11 for persons who rely exclusively upon treatment by
12 spiritual means through prayer in accordance with the creed
13 or tenants of a well-recognized church or religious
14 denomination.
15 (7) A facility licensed by the Department of Human
16 Services as a community-integrated living arrangement as
17 defined in the Community-Integrated Living Arrangements
18 Licensure and Certification Act.
19 (8) A supportive residence licensed under the
20 Supportive Residences Licensing Act.
21 (9) A life care facility as defined in the Life Care
22 Facilities Act; a life care facility may apply under this
23 Act to convert sections of the community to assisted
24 living.
25 (10) A free-standing hospice facility licensed under
26 the Hospice Program Licensing Act.

HB0384- 45 -LRB100 05886 RJF 15912 b
1 (11) An assisted living establishment.
2 (12) A supportive living facility as described in
3 Section 5-5.01a of the Illinois Public Aid Code.
4 "Total assistance" means that staff or another individual
5performs the entire activity of daily living without
6participation by the resident.
7(Source: P.A. 98-104, eff. 7-22-13; 99-180, eff. 7-29-15.)
8 (210 ILCS 9/145)
9 Sec. 145. Conversion of facilities. Entities licensed as
10facilities under the Nursing Home Care Act, the Specialized
11Mental Health Rehabilitation Act of 2013, the ID/DD Community
12Care Act, or the MC/DD Act may elect to convert to a license
13under this Act. Any facility that chooses to convert, in whole
14or in part, shall follow the requirements in the Nursing Home
15Care Act, the Specialized Mental Health Rehabilitation Act of
162013, the ID/DD Community Care Act, or the MC/DD Act, as
17applicable, and rules promulgated under those Acts regarding
18voluntary closure and notice to residents. Any conversion of
19existing beds licensed under the Nursing Home Care Act, the
20Specialized Mental Health Rehabilitation Act of 2013, the ID/DD
21Community Care Act, or the MC/DD Act to licensure under this
22Act is exempt from review by the Health Facilities and Services
23Review Board.
24(Source: P.A. 98-104, eff. 7-22-13; 99-180, eff. 7-29-15.)

HB0384- 46 -LRB100 05886 RJF 15912 b
1 (210 ILCS 9/155)
2 Sec. 155. Application of Act. An establishment licensed
3under this Act shall obtain and maintain all other licenses,
4permits, certificates, and other governmental approvals
5required of it, except that a licensed assisted living or
6shared housing establishment is exempt from the provisions of
7the Illinois Health Facilities Planning Act. An establishment
8licensed under this Act shall comply with the requirements of
9all local, State, federal, and other applicable laws, rules,
10and ordinances and the National Fire Protection Association's
11Life Safety Code.
12(Source: P.A. 91-656, eff. 1-1-01.)
13 Section 55. The Life Care Facilities Act is amended by
14changing Sections 2 and 7 as follows:
15 (210 ILCS 40/2) (from Ch. 111 1/2, par. 4160-2)
16 Sec. 2. As used in this Act, unless the context otherwise
17requires:
18 (a) "Department" means the Department of Public Health.
19 (b) "Director" means the Director of the Department.
20 (c) "Life care contract" means a contract to provide to a
21person for the duration of such person's life or for a term in
22excess of one year, nursing services, medical services or
23personal care services, in addition to maintenance services for
24such person in a facility, conditioned upon the transfer of an

HB0384- 47 -LRB100 05886 RJF 15912 b
1entrance fee to the provider of such services in addition to or
2in lieu of the payment of regular periodic charges for the care
3and services involved.
4 (d) "Provider" means a person who provides services
5pursuant to a life care contract.
6 (e) "Resident" means a person who enters into a life care
7contract with a provider, or who is designated in a life care
8contract to be a person provided with maintenance and nursing,
9medical or personal care services.
10 (f) "Facility" means a place or places in which a provider
11undertakes to provide a resident with nursing services, medical
12services or personal care services, in addition to maintenance
13services for a term in excess of one year or for life pursuant
14to a life care contract. The term also means a place or places
15in which a provider undertakes to provide such services to a
16non-resident.
17 (g) "Living unit" means an apartment, room or other area
18within a facility set aside for the exclusive use of one or
19more identified residents.
20 (h) "Entrance fee" means an initial or deferred transfer to
21a provider of a sum of money or property, made or promised to
22be made by a person entering into a life care contract, which
23assures a resident of services pursuant to a life care
24contract.
25 (i) "Permit" means a written authorization to enter into
26life care contracts issued by the Department to a provider.

HB0384- 48 -LRB100 05886 RJF 15912 b
1 (j) "Medical services" means those services pertaining to
2medical or dental care that are performed in behalf of patients
3at the direction of a physician licensed under the Medical
4Practice Act of 1987 or a dentist licensed under the Illinois
5Dental Practice Act by such physicians or dentists, or by a
6registered or licensed practical nurse as defined in the Nurse
7Practice Act or by other professional and technical personnel.
8 (k) "Nursing services" means those services pertaining to
9the curative, restorative and preventive aspects of nursing
10care that are performed at the direction of a physician
11licensed under the Medical Practice Act of 1987 by or under the
12supervision of a registered or licensed practical nurse as
13defined in the Nurse Practice Act.
14 (l) "Personal care services" means assistance with meals,
15dressing, movement, bathing or other personal needs or
16maintenance, or general supervision and oversight of the
17physical and mental well-being of an individual, who is
18incapable of maintaining a private, independent residence or
19who is incapable of managing his person whether or not a
20guardian has been appointed for such individual.
21 (m) "Maintenance services" means food, shelter and laundry
22services.
23 (n) (Blank) "Certificates of Need" means those permits
24issued pursuant to the Illinois Health Facilities Planning Act
25as now or hereafter amended.
26 (o) "Non-resident" means a person admitted to a facility

HB0384- 49 -LRB100 05886 RJF 15912 b
1who has not entered into a life care contract.
2(Source: P.A. 95-639, eff. 10-5-07.)
3 (210 ILCS 40/7) (from Ch. 111 1/2, par. 4160-7)
4 Sec. 7. As a condition for the issuance of a permit
5pursuant to this Act, the provider shall establish and maintain
6on a current basis, a letter of credit or an escrow account
7with a bank, trust company, or other financial institution
8located in the State of Illinois. The letter of credit shall be
9in an amount and form acceptable to the Department, but in no
10event shall the amount exceed that applicable to the
11corresponding escrow agreement alternative, as described
12below. The terms of the escrow agreement shall meet the
13following provisions:
14 (a) Requirements for new facilities.
15 (1) If the entrance fee applies to a living unit which has
16not previously been occupied by any resident, all entrance fee
17payments representing either all or any smaller portion of the
18total entrance fee shall be paid to the escrow agent by the
19resident.
20 (2) When the provider has sold at least 1/2 of its living
21units, obtained a mortgage commitment, if needed, and obtained
22all necessary zoning permits and Certificates of Need, if
23required, the escrow agent may release a sum representing 1/5
24of the resident's total entrance fee to the provider. Upon
25completion of the foundation of the living unit an additional

HB0384- 50 -LRB100 05886 RJF 15912 b
11/5 of the resident's total entrance fee may be released to the
2provider. When the living unit is under roof a further and
3additional 1/5 of the resident's total entrance fee may be
4released to the provider. All remaining monies, if any, shall
5remain in escrow until the resident's living unit is
6substantially completed and ready for occupancy by the
7resident. When the living unit is ready for occupancy the
8escrow agent may release the remaining escrow amount to the
9provider and further entrance fee payments, if any, may be paid
10by the resident to the provider directly. All monies released
11from escrow shall be used for the facility and for no other
12purpose.
13 (b) General requirements for all facilities, including new
14and existing facilities.
15 (1) At the time of resident occupancy and at all times
16thereafter, the escrow amount shall be in an amount which
17equals or exceeds the aggregate principal and interest payments
18due during the next 6 months on account of any first mortgage
19or other long-term financing of the facility. Existing
20facilities shall have 2 years from the date of this Act
21becoming law to comply with this subsection. Upon application
22from a facility showing good cause, the Director may extend
23compliance with this subsection one additional year.
24 (2) Notwithstanding paragraph (1) of this subsection, the
25escrow monies required under paragraph (1) of this subsection
26may be released to the provider upon approval by the Director.

HB0384- 51 -LRB100 05886 RJF 15912 b
1The Director may attach such conditions on the release of
2monies as he deems fit including, but not limited to, the
3performance of an audit which satisfies the Director that the
4facility is solvent, a plan from the facility to bring the
5facility back in compliance with paragraph (1) of this
6subsection, and a repayment schedule.
7 (3) The principal of the escrow account may be invested
8with the earnings thereon payable to the provider as it
9accrues.
10 (4) If the facility ceases to operate all monies in the
11escrow account except the amount representing principal and
12interest shall be repaid by the escrow agent to the resident.
13 (5) Balloon payments due at conclusion of the mortgage
14shall not be subject to the escrow requirements of paragraph
15(1) this subsection.
16(Source: P.A. 85-1349.)
17 Section 60. The Nursing Home Care Act is amended by
18changing Sections 3-102.2 and 3-103 as follows:
19 (210 ILCS 45/3-102.2)
20 Sec. 3-102.2. Supported congregate living arrangement
21demonstration. The Illinois Department may grant no more than 3
22waivers from the requirements of this Act for facilities
23participating in the supported congregate living arrangement
24demonstration. A joint waiver request must be made by an

HB0384- 52 -LRB100 05886 RJF 15912 b
1applicant and the Department on Aging. If the Department on
2Aging does not act upon an application within 60 days, the
3applicant may submit a written waiver request on its own
4behalf. The waiver request must include a specific program plan
5describing the types of residents to be served and the services
6that will be provided in the facility. The Department shall
7conduct an on-site review at each facility annually or as often
8as necessary to ascertain compliance with the program plan. The
9Department may revoke the waiver if it determines that the
10facility is not in compliance with the program plan. Nothing in
11this Section prohibits the Department from conducting
12complaint investigations.
13 A facility granted a waiver under this Section is not
14subject to the Illinois Health Facilities Planning Act, unless
15it subsequently applies for a certificate of need to convert to
16a nursing facility. A facility applying for conversion shall
17meet the licensure and certificate of need requirements in
18effect as of the date of application, and this provision may
19not be waived.
20(Source: P.A. 89-530, eff. 7-19-96.)
21 (210 ILCS 45/3-103) (from Ch. 111 1/2, par. 4153-103)
22 Sec. 3-103. The procedure for obtaining a valid license
23shall be as follows:
24 (1) Application to operate a facility shall be made to
25 the Department on forms furnished by the Department.

HB0384- 53 -LRB100 05886 RJF 15912 b
1 (2) All license applications shall be accompanied with
2 an application fee. The fee for an annual license shall be
3 $1,990. Facilities that pay a fee or assessment pursuant to
4 Article V-C of the Illinois Public Aid Code shall be exempt
5 from the license fee imposed under this item (2). The fee
6 for a 2-year license shall be double the fee for the annual
7 license. The fees collected shall be deposited with the
8 State Treasurer into the Long Term Care Monitor/Receiver
9 Fund, which has been created as a special fund in the State
10 treasury. This special fund is to be used by the Department
11 for expenses related to the appointment of monitors and
12 receivers as contained in Sections 3-501 through 3-517 of
13 this Act, for the enforcement of this Act, for expenses
14 related to surveyor development, and for implementation of
15 the Abuse Prevention Review Team Act. All federal moneys
16 received as a result of expenditures from the Fund shall be
17 deposited into the Fund. The Department may reduce or waive
18 a penalty pursuant to Section 3-308 only if that action
19 will not threaten the ability of the Department to meet the
20 expenses required to be met by the Long Term Care
21 Monitor/Receiver Fund. The application shall be under oath
22 and the submission of false or misleading information shall
23 be a Class A misdemeanor. The application shall contain the
24 following information:
25 (a) The name and address of the applicant if an
26 individual, and if a firm, partnership, or

HB0384- 54 -LRB100 05886 RJF 15912 b
1 association, of every member thereof, and in the case
2 of a corporation, the name and address thereof and of
3 its officers and its registered agent, and in the case
4 of a unit of local government, the name and address of
5 its chief executive officer;
6 (b) The name and location of the facility for which
7 a license is sought;
8 (c) The name of the person or persons under whose
9 management or supervision the facility will be
10 conducted;
11 (d) The number and type of residents for which
12 maintenance, personal care, or nursing is to be
13 provided; and
14 (e) Such information relating to the number,
15 experience, and training of the employees of the
16 facility, any management agreements for the operation
17 of the facility, and of the moral character of the
18 applicant and employees as the Department may deem
19 necessary.
20 (3) Each initial application shall be accompanied by a
21 financial statement setting forth the financial condition
22 of the applicant and by a statement from the unit of local
23 government having zoning jurisdiction over the facility's
24 location stating that the location of the facility is not
25 in violation of a zoning ordinance. An initial application
26 for a new facility shall be accompanied by a permit as

HB0384- 55 -LRB100 05886 RJF 15912 b
1 required by the "Illinois Health Facilities Planning Act".
2 After the application is approved, the applicant shall
3 advise the Department every 6 months of any changes in the
4 information originally provided in the application.
5 (4) Other information necessary to determine the
6 identity and qualifications of an applicant to operate a
7 facility in accordance with this Act shall be included in
8 the application as required by the Department in
9 regulations.
10(Source: P.A. 96-758, eff. 8-25-09; 96-1372, eff. 7-29-10;
1196-1504, eff. 1-27-11; 96-1530, eff. 2-16-11; 97-489, eff.
121-1-12.)
13 Section 65. The ID/DD Community Care Act is amended by
14changing Section 3-103 as follows:
15 (210 ILCS 47/3-103)
16 Sec. 3-103. Application for license; financial statement.
17The procedure for obtaining a valid license shall be as
18follows:
19 (1) Application to operate a facility shall be made to
20 the Department on forms furnished by the Department.
21 (2) All license applications shall be accompanied with
22 an application fee. The fee for an annual license shall be
23 $995. Facilities that pay a fee or assessment pursuant to
24 Article V-C of the Illinois Public Aid Code shall be exempt

HB0384- 56 -LRB100 05886 RJF 15912 b
1 from the license fee imposed under this item (2). The fee
2 for a 2-year license shall be double the fee for the annual
3 license set forth in the preceding sentence. The fees
4 collected shall be deposited with the State Treasurer into
5 the Long Term Care Monitor/Receiver Fund, which has been
6 created as a special fund in the State treasury. This
7 special fund is to be used by the Department for expenses
8 related to the appointment of monitors and receivers as
9 contained in Sections 3-501 through 3-517. At the end of
10 each fiscal year, any funds in excess of $1,000,000 held in
11 the Long Term Care Monitor/Receiver Fund shall be deposited
12 in the State's General Revenue Fund. The application shall
13 be under oath and the submission of false or misleading
14 information shall be a Class A misdemeanor. The application
15 shall contain the following information:
16 (a) The name and address of the applicant if an
17 individual, and if a firm, partnership, or
18 association, of every member thereof, and in the case
19 of a corporation, the name and address thereof and of
20 its officers and its registered agent, and in the case
21 of a unit of local government, the name and address of
22 its chief executive officer;
23 (b) The name and location of the facility for which
24 a license is sought;
25 (c) The name of the person or persons under whose
26 management or supervision the facility will be

HB0384- 57 -LRB100 05886 RJF 15912 b
1 conducted;
2 (d) The number and type of residents for which
3 maintenance, personal care, or nursing is to be
4 provided; and
5 (e) Such information relating to the number,
6 experience, and training of the employees of the
7 facility, any management agreements for the operation
8 of the facility, and of the moral character of the
9 applicant and employees as the Department may deem
10 necessary.
11 (3) Each initial application shall be accompanied by a
12 financial statement setting forth the financial condition
13 of the applicant and by a statement from the unit of local
14 government having zoning jurisdiction over the facility's
15 location stating that the location of the facility is not
16 in violation of a zoning ordinance. An initial application
17 for a new facility shall be accompanied by a permit as
18 required by the Illinois Health Facilities Planning Act.
19 After the application is approved, the applicant shall
20 advise the Department every 6 months of any changes in the
21 information originally provided in the application.
22 (4) Other information necessary to determine the
23 identity and qualifications of an applicant to operate a
24 facility in accordance with this Act shall be included in
25 the application as required by the Department in
26 regulations.

HB0384- 58 -LRB100 05886 RJF 15912 b
1(Source: P.A. 96-339, eff. 7-1-10.)
2 Section 70. The Specialized Mental Health Rehabilitation
3Act of 2013 is amended by changing Section 1-101.5 as follows:
4 (210 ILCS 49/1-101.5)
5 Sec. 1-101.5. Prior law.
6 (a) This Act provides for licensure of long term care
7facilities that are federally designated as institutions for
8the mentally diseased on the effective date of this Act and
9specialize in providing services to individuals with a serious
10mental illness. On and after the effective date of this Act,
11these facilities shall be governed by this Act instead of the
12Nursing Home Care Act.
13 (b) All consent decrees that apply to facilities federally
14designated as institutions for the mentally diseased shall
15continue to apply to facilities licensed under this Act.
16 (c) A facility licensed under this Act may voluntarily
17close, and the facility may reopen in an underserved region of
18the State, if the facility receives a certificate of need from
19the Health Facilities and Services Review Board. At no time
20shall the total number of licensed beds under this Act exceed
21the total number of licensed beds existing on July 22, 2013
22(the effective date of Public Act 98-104).
23(Source: P.A. 98-104, eff. 7-22-13; 98-651, eff. 6-16-14.)

HB0384- 59 -LRB100 05886 RJF 15912 b
1 Section 75. The Emergency Medical Services (EMS) Systems
2Act is amended by changing Section 32.5 as follows:
3 (210 ILCS 50/32.5)
4 Sec. 32.5. Freestanding Emergency Center.
5 (a) The Department shall issue an annual Freestanding
6Emergency Center (FEC) license to any facility that has
7received a permit from the Health Facilities and Services
8Review Board to establish a Freestanding Emergency Center by
9January 1, 2015, and:
10 (1) is located: (A) in a municipality with a population
11 of 50,000 or fewer inhabitants; (B) within 50 miles of the
12 hospital that owns or controls the FEC; and (C) within 50
13 miles of the Resource Hospital affiliated with the FEC as
14 part of the EMS System;
15 (2) is wholly owned or controlled by an Associate or
16 Resource Hospital, but is not a part of the hospital's
17 physical plant;
18 (3) meets the standards for licensed FECs, adopted by
19 rule of the Department, including, but not limited to:
20 (A) facility design, specification, operation, and
21 maintenance standards;
22 (B) equipment standards; and
23 (C) the number and qualifications of emergency
24 medical personnel and other staff, which must include
25 at least one board certified emergency physician

HB0384- 60 -LRB100 05886 RJF 15912 b
1 present at the FEC 24 hours per day.
2 (4) limits its participation in the EMS System strictly
3 to receiving a limited number of patients by ambulance: (A)
4 according to the FEC's 24-hour capabilities; (B) according
5 to protocols developed by the Resource Hospital within the
6 FEC's designated EMS System; and (C) as pre-approved by
7 both the EMS Medical Director and the Department;
8 (5) provides comprehensive emergency treatment
9 services, as defined in the rules adopted by the Department
10 pursuant to the Hospital Licensing Act, 24 hours per day,
11 on an outpatient basis;
12 (6) provides an ambulance and maintains on site
13 ambulance services staffed with paramedics 24 hours per
14 day;
15 (7) (blank);
16 (8) complies with all State and federal patient rights
17 provisions, including, but not limited to, the Emergency
18 Medical Treatment Act and the federal Emergency Medical
19 Treatment and Active Labor Act;
20 (9) maintains a communications system that is fully
21 integrated with its Resource Hospital within the FEC's
22 designated EMS System;
23 (10) reports to the Department any patient transfers
24 from the FEC to a hospital within 48 hours of the transfer
25 plus any other data determined to be relevant by the
26 Department;

HB0384- 61 -LRB100 05886 RJF 15912 b
1 (11) submits to the Department, on a quarterly basis,
2 the FEC's morbidity and mortality rates for patients
3 treated at the FEC and other data determined to be relevant
4 by the Department;
5 (12) does not describe itself or hold itself out to the
6 general public as a full service hospital or hospital
7 emergency department in its advertising or marketing
8 activities;
9 (13) complies with any other rules adopted by the
10 Department under this Act that relate to FECs;
11 (14) passes the Department's site inspection for
12 compliance with the FEC requirements of this Act;
13 (15) (blank); submits a copy of the permit issued by
14 the Health Facilities and Services Review Board indicating
15 that the facility has complied with the Illinois Health
16 Facilities Planning Act with respect to the health services
17 to be provided at the facility;
18 (16) submits an application for designation as an FEC
19 in a manner and form prescribed by the Department by rule;
20 and
21 (17) pays the annual license fee as determined by the
22 Department by rule.
23 (a-5) Notwithstanding any other provision of this Section,
24the Department may issue an annual FEC license to a facility
25that is located in a county that does not have a licensed
26general acute care hospital if the facility's application for a

HB0384- 62 -LRB100 05886 RJF 15912 b
1permit from the Illinois Health Facilities Planning Board has
2been deemed complete by the Department of Public Health by
3January 1, 2014 and if the facility complies with the
4requirements set forth in paragraphs (1) through (17) of
5subsection (a).
6 (a-10) Notwithstanding any other provision of this
7Section, the Department may issue an annual FEC license to a
8facility if the facility has, by January 1, 2014, filed a
9letter of intent to establish an FEC and if the facility
10complies with the requirements set forth in paragraphs (1)
11through (17) of subsection (a).
12 (a-15) Notwithstanding any other provision of this
13Section, the Department shall issue an annual FEC license to a
14facility if the facility: (i) discontinues operation as a
15hospital within 180 days after the effective date of this
16amendatory Act of the 99th General Assembly with a Health
17Facilities and Services Review Board project number of
18E-017-15; (ii) has an application for a permit to establish an
19FEC from the Health Facilities and Services Review Board that
20is deemed complete by January 1, 2017; and (iii) complies with
21the requirements set forth in paragraphs (1) through (17) of
22subsection (a) of this Section.
23 (b) The Department shall:
24 (1) annually inspect facilities of initial FEC
25 applicants and licensed FECs, and issue annual licenses to
26 or annually relicense FECs that satisfy the Department's

HB0384- 63 -LRB100 05886 RJF 15912 b
1 licensure requirements as set forth in subsection (a);
2 (2) suspend, revoke, refuse to issue, or refuse to
3 renew the license of any FEC, after notice and an
4 opportunity for a hearing, when the Department finds that
5 the FEC has failed to comply with the standards and
6 requirements of the Act or rules adopted by the Department
7 under the Act;
8 (3) issue an Emergency Suspension Order for any FEC
9 when the Director or his or her designee has determined
10 that the continued operation of the FEC poses an immediate
11 and serious danger to the public health, safety, and
12 welfare. An opportunity for a hearing shall be promptly
13 initiated after an Emergency Suspension Order has been
14 issued; and
15 (4) adopt rules as needed to implement this Section.
16(Source: P.A. 99-490, eff. 12-4-15; 99-710, eff. 8-5-16.)
17 Section 80. The Hospital Emergency Service Act is amended
18by changing Section 1.3 as follows:
19 (210 ILCS 80/1.3)
20 Sec. 1.3. Long-term acute care hospitals and
21rehabilitation hospitals. For the purpose of this Act, general
22acute care hospitals designated by Medicare as long-term acute
23care hospitals and rehabilitation hospitals are not required to
24provide hospital emergency services described in Section 1 of

HB0384- 64 -LRB100 05886 RJF 15912 b
1this Act. Hospitals defined in this Section may provide
2hospital emergency services at their option.
3 Any long-term acute care hospital that opts to discontinue
4or otherwise not provide emergency services described in
5Section 1 shall:
6 (1) comply with all provisions of the federal Emergency
7 Medical Treatment and Labor Act (EMTALA);
8 (2) comply with all provisions required under the
9 Social Security Act;
10 (3) provide annual notice to communities in the
11 hospital's service area about available emergency medical
12 services; and
13 (4) make educational materials available to
14 individuals who are present at the hospital concerning the
15 availability of medical services within the hospital's
16 service area.
17 Long-term acute care hospitals that operate standby
18emergency services as of January 1, 2011 may discontinue
19hospital emergency services by notifying the Department of
20Public Health. Long-term acute care hospitals that operate
21basic or comprehensive emergency services must notify the
22Department of Public Health Health Facilities and Services
23Review Board and follow the appropriate procedures.
24 Any rehabilitation hospital that opts to discontinue or
25otherwise not provide emergency services described in Section 1
26shall:

HB0384- 65 -LRB100 05886 RJF 15912 b
1 (1) comply with all provisions of the federal Emergency
2 Medical Treatment and Active Labor Act (EMTALA);
3 (2) comply with all provisions required under the
4 Social Security Act;
5 (3) provide annual notice to communities in the
6 hospital's service area about available emergency medical
7 services;
8 (4) make educational materials available to
9 individuals who are present at the hospital concerning the
10 availability of medical services within the hospital's
11 service area;
12 (5) not use the term "hospital" in its name or on any
13 signage; and
14 (6) notify in writing the Department and the Health
15 Facilities and Services Review Board of the
16 discontinuation.
17(Source: P.A. 97-667, eff. 1-13-12; 98-683, eff. 6-30-14;
1898-756, eff. 7-16-14.)
19 Section 85. The Hospital Licensing Act is amended by
20changing Sections 4.5, 4.6, 4.7 and 10.8 as follows:
21 (210 ILCS 85/4.5)
22 Sec. 4.5. Hospital with multiple locations; single
23license.
24 (a) A hospital located in a county with fewer than

HB0384- 66 -LRB100 05886 RJF 15912 b
13,000,000 inhabitants may apply to the Department for approval
2to conduct its operations from more than one location within
3the county under a single license.
4 (b) The facilities or buildings at those locations must be
5owned or operated together by a single corporation or other
6legal entity serving as the licensee and must share:
7 (1) a single board of directors with responsibility for
8 governance, including financial oversight and the
9 authority to designate or remove the chief executive
10 officer;
11 (2) a single medical staff accountable to the board of
12 directors and governed by a single set of medical staff
13 bylaws, rules, and regulations with responsibility for the
14 quality of the medical services; and
15 (3) a single chief executive officer, accountable to
16 the board of directors, with management responsibility.
17 (c) Each hospital building or facility that is located on a
18site geographically separate from the campus or premises of
19another hospital building or facility operated by the licensee
20must, at a minimum, individually comply with the Department's
21hospital licensing requirements for emergency services.
22 (d) The hospital shall submit to the Department a
23comprehensive plan in relation to the waiver or waivers
24requested describing the services and operations of each
25facility or building and how common services or operations will
26be coordinated between the various locations. With the

HB0384- 67 -LRB100 05886 RJF 15912 b
1exception of items required by subsection (c), the Department
2is authorized to waive compliance with the hospital licensing
3requirements for specific buildings or facilities, provided
4that the hospital has documented which other building or
5facility under its single license provides that service or
6operation, and that doing so would not endanger the public's
7health, safety, or welfare. Nothing in this Section relieves a
8hospital from the requirements of the Health Facilities
9Planning Act.
10(Source: P.A. 89-171, eff. 7-19-95.)
11 (210 ILCS 85/4.6)
12 Sec. 4.6. Additional licensing requirements.
13 (a) Notwithstanding any other law or rule to the contrary,
14the Department may license as a hospital a building that (i) is
15owned or operated by a hospital licensed under this Act, (ii)
16is located in a municipality with a population of less than
1760,000, and (iii) includes a postsurgical recovery care center
18licensed under the Alternative Health Care Delivery Act for a
19period of not less than 2 years, an ambulatory surgical
20treatment center licensed under the Ambulatory Surgical
21Treatment Center Act, and a Freestanding Emergency Center
22licensed under the Emergency Medical Services (EMS) Systems
23Act. Only the components of the building which are currently
24licensed shall be eligible under the provisions of this
25Section.

HB0384- 68 -LRB100 05886 RJF 15912 b
1 (b) Prior to issuing a license, the Department shall
2inspect the facility and require the facility to meet such of
3the Department's rules relating to the establishment of
4hospitals as the Department determines are appropriate to such
5facility. Once the Department approves the facility and issues
6a hospital license, all other licenses as listed in subsection
7(a) above shall be null and void.
8 (c) Only one license may be issued under the authority of
9this Section. No license may be issued after 18 months after
10the effective date of this amendatory Act of the 91st General
11Assembly.
12 (d) Beginning on the effective date of this amendatory Act
13of the 96th General Assembly, each hospital building or
14facility that is (i) located on the campus of the licensee but
15on a site that is not contiguous, adjacent, or otherwise
16attached to the main hospital building of the campus of the
17licensee, (ii) operated by the licensee, and (iii) provides
18inpatient services to patients at this building or facility
19shall, at a minimum, individually comply with the Department's
20hospital licensing requirements for emergency services. The
21hospital shall submit to the Department a comprehensive plan
22describing the services and operations of each facility or
23building and how common services or operations will be
24coordinated between the various locations. The Department
25shall review the plan and may authorize a waiver granting an
26exemption for compliance with the hospital licensing

HB0384- 69 -LRB100 05886 RJF 15912 b
1requirements for specific buildings or facilities, including
2requirements for emergency services, provided that the
3hospital has documented which other building or facility under
4its single license provides that service or operation, and that
5doing so would not endanger the public's health, safety, or
6welfare. Nothing in this Section relieves a hospital from the
7requirements of the Illinois Health Facilities Planning Act.
8(Source: P.A. 96-1515, eff. 2-4-11.)
9 (210 ILCS 85/4.7)
10 Sec. 4.7. Additional licensing requirements.
11 (a) A hospital located in a county with fewer than 325,000
12inhabitants may apply to the Department for approval to conduct
13its operations from more than one location within the county
14under a single license at a separate building or facility
15already licensed as a hospital. The operations shall be limited
16to psychiatric services. The host hospital shall house the
17licensee. The licensee's application shall be supported by
18information that its operations at the host hospital will
19provide access to necessary services for the region that the
20host hospital does not provide. The services proposed by the
21licensee at the host hospital shall not consist of emergency
22services.
23 (b) The portion of the facilities or buildings operated by
24the licensee at the host hospital shall be leased in part and
25operated by a single corporation or other legal entity serving

HB0384- 70 -LRB100 05886 RJF 15912 b
1as the licensee and shall have a single:
2 (1) board of directors with the responsibility for
3 governance, including financial oversight and authority to
4 designate or remove the chief executive officer;
5 (2) medical staff accountable to the board of directors
6 of the licensee and governed by a single set of medical
7 staff bylaws and associated rules and regulation of the
8 licensee, with responsibility for the quality of the
9 medical services provided by the licensee at the host
10 hospital side; and
11 (3) chief executive officer, accountable to the board
12 of directors of the licensee, with management
13 responsibility for the licensee's operations at the host
14 hospital site.
15 The host hospital and licensee shall be jointly responsible
16for hospital licensing requirements relating to design and
17construction, engineering and maintenance of the physical
18plan, waste disposal, and fire safety.
19 (c) The licensee and host hospital shall notify the public
20and patients through general signage and written notification
21provided upon admission that services are provided at the host
22hospital site by 2 separately licensed hospitals. The signage
23shall specify which services are provided by the host hospital
24or the licensee or both.
25 (d) One emergency department shall serve the host hospital.
26Patients shall be notified that emergency services are provided

HB0384- 71 -LRB100 05886 RJF 15912 b
1by the host hospital. Those patients that require admission
2from the emergency department to a service that is operated by
3the licensee shall be admitted according to the Emergency
4Medical Treatment and Active Labor Act regulations and
5transferred to the licensee. The admission, registration, and
6consent form documents shall be specific to the licensee.
7 (e) The licensee and host hospital shall submit to the
8Department a comprehensive plan describing the services and
9operations of each facility or building and between the
10licensee and host hospital, and how common services or
11operations will be coordinated between the various locations.
12Nothing in this Section relieves a hospital from the
13requirements in the Illinois Health Facilities Planning Act.
14(Source: P.A. 96-1505, eff. 1-27-11.)
15 (210 ILCS 85/10.8)
16 Sec. 10.8. Requirements for employment of physicians.
17 (a) Physician employment by hospitals and hospital
18affiliates. Employing entities may employ physicians to
19practice medicine in all of its branches provided that the
20following requirements are met:
21 (1) The employed physician is a member of the medical
22 staff of either the hospital or hospital affiliate. If a
23 hospital affiliate decides to have a medical staff, its
24 medical staff shall be organized in accordance with written
25 bylaws where the affiliate medical staff is responsible for

HB0384- 72 -LRB100 05886 RJF 15912 b
1 making recommendations to the governing body of the
2 affiliate regarding all quality assurance activities and
3 safeguarding professional autonomy. The affiliate medical
4 staff bylaws may not be unilaterally changed by the
5 governing body of the affiliate. Nothing in this Section
6 requires hospital affiliates to have a medical staff.
7 (2) Independent physicians, who are not employed by an
8 employing entity, periodically review the quality of the
9 medical services provided by the employed physician to
10 continuously improve patient care.
11 (3) The employing entity and the employed physician
12 sign a statement acknowledging that the employer shall not
13 unreasonably exercise control, direct, or interfere with
14 the employed physician's exercise and execution of his or
15 her professional judgment in a manner that adversely
16 affects the employed physician's ability to provide
17 quality care to patients. This signed statement shall take
18 the form of a provision in the physician's employment
19 contract or a separate signed document from the employing
20 entity to the employed physician. This statement shall
21 state: "As the employer of a physician, (employer's name)
22 shall not unreasonably exercise control, direct, or
23 interfere with the employed physician's exercise and
24 execution of his or her professional judgment in a manner
25 that adversely affects the employed physician's ability to
26 provide quality care to patients."

HB0384- 73 -LRB100 05886 RJF 15912 b
1 (4) The employing entity shall establish a mutually
2 agreed upon independent review process with criteria under
3 which an employed physician may seek review of the alleged
4 violation of this Section by physicians who are not
5 employed by the employing entity. The affiliate may arrange
6 with the hospital medical staff to conduct these reviews.
7 The independent physicians shall make findings and
8 recommendations to the employing entity and the employed
9 physician within 30 days of the conclusion of the gathering
10 of the relevant information.
11 (b) Definitions. For the purpose of this Section:
12 "Employing entity" means a hospital licensed under the
13Hospital Licensing Act or a hospital affiliate.
14 "Employed physician" means a physician who receives an IRS
15W-2 form, or any successor federal income tax form, from an
16employing entity.
17 "Hospital" means a hospital licensed under the Hospital
18Licensing Act, except county hospitals as defined in subsection
19(c) of Section 15-1 of the Illinois Public Aid Code.
20 "Hospital affiliate" means a corporation, partnership,
21joint venture, limited liability company, or similar
22organization, other than a hospital, that is devoted primarily
23to the provision, management, or support of health care
24services and that directly or indirectly controls, is
25controlled by, or is under common control of the hospital.
26"Control" means having at least an equal or a majority

HB0384- 74 -LRB100 05886 RJF 15912 b
1ownership or membership interest. A hospital affiliate shall be
2100% owned or controlled by any combination of hospitals, their
3parent corporations, or physicians licensed to practice
4medicine in all its branches in Illinois. "Hospital affiliate"
5does not include a health maintenance organization regulated
6under the Health Maintenance Organization Act.
7 "Physician" means an individual licensed to practice
8medicine in all its branches in Illinois.
9 "Professional judgment" means the exercise of a
10physician's independent clinical judgment in providing
11medically appropriate diagnoses, care, and treatment to a
12particular patient at a particular time. Situations in which an
13employing entity does not interfere with an employed
14physician's professional judgment include, without limitation,
15the following:
16 (1) practice restrictions based upon peer review of the
17 physician's clinical practice to assess quality of care and
18 utilization of resources in accordance with applicable
19 bylaws;
20 (2) supervision of physicians by appropriately
21 licensed medical directors, medical school faculty,
22 department chairpersons or directors, or supervising
23 physicians;
24 (3) written statements of ethical or religious
25 directives; and
26 (4) reasonable referral restrictions that do not, in

HB0384- 75 -LRB100 05886 RJF 15912 b
1 the reasonable professional judgment of the physician,
2 adversely affect the health or welfare of the patient.
3 (c) Private enforcement. An employed physician aggrieved
4by a violation of this Act may seek to obtain an injunction or
5reinstatement of employment with the employing entity as the
6court may deem appropriate. Nothing in this Section limits or
7abrogates any common law cause of action. Nothing in this
8Section shall be deemed to alter the law of negligence.
9 (d) Department enforcement. The Department may enforce the
10provisions of this Section, but nothing in this Section shall
11require or permit the Department to license, certify, or
12otherwise investigate the activities of a hospital affiliate
13not otherwise required to be licensed by the Department.
14 (e) Retaliation prohibited. No employing entity shall
15retaliate against any employed physician for requesting a
16hearing or review under this Section. No action may be taken
17that affects the ability of a physician to practice during this
18review, except in circumstances where the medical staff bylaws
19authorize summary suspension.
20 (f) Physician collaboration. No employing entity shall
21adopt or enforce, either formally or informally, any policy,
22rule, regulation, or practice inconsistent with the provision
23of adequate collaboration, including medical direction of
24licensed advanced practice nurses or supervision of licensed
25physician assistants and delegation to other personnel under
26Section 54.5 of the Medical Practice Act of 1987.

HB0384- 76 -LRB100 05886 RJF 15912 b
1 (g) Physician disciplinary actions. Nothing in this
2Section shall be construed to limit or prohibit the governing
3body of an employing entity or its medical staff, if any, from
4taking disciplinary actions against a physician as permitted by
5law.
6 (h) Physician review. Nothing in this Section shall be
7construed to prohibit a hospital or hospital affiliate from
8making a determination not to pay for a particular health care
9service or to prohibit a medical group, independent practice
10association, hospital medical staff, or hospital governing
11body from enforcing reasonable peer review or utilization
12review protocols or determining whether the employed physician
13complied with those protocols.
14 (i) (Blank). Review. Nothing in this Section may be used or
15construed to establish that any activity of a hospital or
16hospital affiliate is subject to review under the Illinois
17Health Facilities Planning Act.
18 (j) Rules. The Department shall adopt any rules necessary
19to implement this Section.
20(Source: P.A. 92-455, eff. 9-30-01; revised 10-26-16.)
21 (225 ILCS 7/4 rep.)
22 Section 90. The Board and Care Home Act is amended by
23repealing Section 4.
24 Section 95. The Health Care Worker Self-Referral Act is

HB0384- 77 -LRB100 05886 RJF 15912 b
1amended by changing Sections 5, 15, 20, 30, 35, and 40 as
2follows:
3 (225 ILCS 47/5)
4 Sec. 5. Legislative intent. The General Assembly
5recognizes that patient referrals by health care workers for
6health services to an entity in which the referring health care
7worker has an investment interest may present a potential
8conflict of interest. The General Assembly finds that these
9referral practices may limit or completely eliminate
10competitive alternatives in the health care market. In some
11instances, these referral practices may expand and improve care
12or may make services available which were previously
13unavailable. They may also provide lower cost options to
14patients or increase competition. Generally, referral
15practices are positive occurrences. However, self-referrals
16may result in over utilization of health services, increased
17overall costs of the health care systems, and may affect the
18quality of health care.
19 It is the intent of the General Assembly to provide
20guidance to health care workers regarding acceptable patient
21referrals, to prohibit patient referrals to entities providing
22health services in which the referring health care worker has
23an investment interest, and to protect the citizens of Illinois
24from unnecessary and costly health care expenditures.
25 Recognizing the need for flexibility to quickly respond to

HB0384- 78 -LRB100 05886 RJF 15912 b
1changes in the delivery of health services, to avoid results
2beyond the limitations on self referral provided under this Act
3and to provide minimal disruption to the appropriate delivery
4of health care, the Department of Public Health may adopt rules
5Health Facilities and Services Review Board shall be
6exclusively and solely authorized to implement and interpret
7this Act through adopted rules.
8 The General Assembly recognizes that changes in delivery of
9health care has resulted in various methods by which health
10care workers practice their professions. It is not the intent
11of the General Assembly to limit appropriate delivery of care,
12nor force unnecessary changes in the structures created by
13workers for the health and convenience of their patients.
14(Source: P.A. 96-31, eff. 6-30-09.)
15 (225 ILCS 47/15)
16 Sec. 15. Definitions. In this Act:
17 (a) "Department" means the Department of Public Health.
18"Board" means the Health Facilities and Services Review Board.
19 (b) "Entity" means any individual, partnership, firm,
20corporation, or other business that provides health services
21but does not include an individual who is a health care worker
22who provides professional services to an individual.
23 (c) "Group practice" means a group of 2 or more health care
24workers legally organized as a partnership, professional
25corporation, not-for-profit corporation, faculty practice plan

HB0384- 79 -LRB100 05886 RJF 15912 b
1or a similar association in which:
2 (1) each health care worker who is a member or employee
3 or an independent contractor of the group provides
4 substantially the full range of services that the health
5 care worker routinely provides, including consultation,
6 diagnosis, or treatment, through the use of office space,
7 facilities, equipment, or personnel of the group;
8 (2) the services of the health care workers are
9 provided through the group, and payments received for
10 health services are treated as receipts of the group; and
11 (3) the overhead expenses and the income from the
12 practice are distributed by methods previously determined
13 by the group.
14 (d) "Health care worker" means any individual licensed
15under the laws of this State to provide health services,
16including but not limited to: dentists licensed under the
17Illinois Dental Practice Act; dental hygienists licensed under
18the Illinois Dental Practice Act; nurses and advanced practice
19nurses licensed under the Nurse Practice Act; occupational
20therapists licensed under the Illinois Occupational Therapy
21Practice Act; optometrists licensed under the Illinois
22Optometric Practice Act of 1987; pharmacists licensed under the
23Pharmacy Practice Act; physical therapists licensed under the
24Illinois Physical Therapy Act; physicians licensed under the
25Medical Practice Act of 1987; physician assistants licensed
26under the Physician Assistant Practice Act of 1987; podiatric

HB0384- 80 -LRB100 05886 RJF 15912 b
1physicians licensed under the Podiatric Medical Practice Act of
21987; clinical psychologists licensed under the Clinical
3Psychologist Licensing Act; clinical social workers licensed
4under the Clinical Social Work and Social Work Practice Act;
5speech-language pathologists and audiologists licensed under
6the Illinois Speech-Language Pathology and Audiology Practice
7Act; or hearing instrument dispensers licensed under the
8Hearing Instrument Consumer Protection Act, or any of their
9successor Acts.
10 (e) "Health services" means health care procedures and
11services provided by or through a health care worker.
12 (f) "Immediate family member" means a health care worker's
13spouse, child, child's spouse, or a parent.
14 (g) "Investment interest" means an equity or debt security
15issued by an entity, including, without limitation, shares of
16stock in a corporation, units or other interests in a
17partnership, bonds, debentures, notes, or other equity
18interests or debt instruments except that investment interest
19for purposes of Section 20 does not include interest in a
20hospital licensed under the laws of the State of Illinois.
21 (h) "Investor" means an individual or entity directly or
22indirectly owning a legal or beneficial ownership or investment
23interest, (such as through an immediate family member, trust,
24or another entity related to the investor).
25 (i) "Office practice" includes the facility or facilities
26at which a health care worker, on an ongoing basis, provides or

HB0384- 81 -LRB100 05886 RJF 15912 b
1supervises the provision of professional health services to
2individuals.
3 (j) "Referral" means any referral of a patient for health
4services, including, without limitation:
5 (1) The forwarding of a patient by one health care
6 worker to another health care worker or to an entity
7 outside the health care worker's office practice or group
8 practice that provides health services.
9 (2) The request or establishment by a health care
10 worker of a plan of care outside the health care worker's
11 office practice or group practice that includes the
12 provision of any health services.
13(Source: P.A. 98-214, eff. 8-9-13.)
14 (225 ILCS 47/20)
15 Sec. 20. Prohibited referrals and claims for payment.
16 (a) A health care worker shall not refer a patient for
17health services to an entity outside the health care worker's
18office or group practice in which the health care worker is an
19investor, unless the health care worker directly provides
20health services within the entity and will be personally
21involved with the provision of care to the referred patient.
22 (b) Pursuant to Department Board determination that the
23following exception is applicable, a health care worker may
24invest in and refer to an entity, whether or not the health
25care worker provides direct services within said entity, if

HB0384- 82 -LRB100 05886 RJF 15912 b
1there is a demonstrated need in the community for the entity
2and alternative financing is not available. For purposes of
3this subsection (b), "demonstrated need" in the community for
4the entity may exist if (1) there is no facility of reasonable
5quality that provides medically appropriate service, (2) use of
6existing facilities is onerous or creates too great a hardship
7for patients, (3) the entity is formed to own or lease medical
8equipment which replaces obsolete or otherwise inadequate
9equipment in or under the control of a hospital located in a
10federally designated health manpower shortage area, or (4) such
11other standards as established, by rule, by the Department
12Board. "Community" shall be defined as a metropolitan area for
13a city, and a county for a rural area. In addition, the
14following provisions must be met to be exempt under this
15Section:
16 (1) Individuals who are not in a position to refer
17 patients to an entity are given a bona fide opportunity to
18 also invest in the entity on the same terms as those
19 offered a referring health care worker; and
20 (2) No health care worker who invests shall be required
21 or encouraged to make referrals to the entity or otherwise
22 generate business as a condition of becoming or remaining
23 an investor; and
24 (3) The entity shall market or furnish its services to
25 referring health care worker investors and other investors
26 on equal terms; and

HB0384- 83 -LRB100 05886 RJF 15912 b
1 (4) The entity shall not loan funds or guarantee any
2 loans for health care workers who are in a position to
3 refer to an entity; and
4 (5) The income on the health care worker's investment
5 shall be tied to the health care worker's equity in the
6 facility rather than to the volume of referrals made; and
7 (6) Any investment contract between the entity and the
8 health care worker shall not include any covenant or
9 non-competition clause that prevents a health care worker
10 from investing in other entities; and
11 (7) When making a referral, a health care worker must
12 disclose his investment interest in an entity to the
13 patient being referred to such entity. If alternative
14 facilities are reasonably available, the health care
15 worker must provide the patient with a list of alternative
16 facilities. The health care worker shall inform the patient
17 that they have the option to use an alternative facility
18 other than one in which the health care worker has an
19 investment interest and the patient will not be treated
20 differently by the health care worker if the patient
21 chooses to use another entity. This shall be applicable to
22 all health care worker investors, including those who
23 provide direct care or services for their patients in
24 entities outside their office practices; and
25 (8) If a third party payor requests information with
26 regard to a health care worker's investment interest, the

HB0384- 84 -LRB100 05886 RJF 15912 b
1 same shall be disclosed; and
2 (9) The entity shall establish an internal utilization
3 review program to ensure that investing health care workers
4 provided appropriate or necessary utilization; and
5 (10) If a health care worker's financial interest in an
6 entity is incompatible with a referred patient's interest,
7 the health care worker shall make alternative arrangements
8 for the patient's care.
9 The Department Board shall make such a determination for a
10health care worker within 90 days of a completed written
11request. Failure to make such a determination within the 90 day
12time frame shall mean that no alternative is practical based
13upon the facts set forth in the completed written request.
14 (c) It shall not be a violation of this Act for a health
15care worker to refer a patient for health services to a
16publicly traded entity in which he or she has an investment
17interest provided that:
18 (1) the entity is listed for trading on the New York
19 Stock Exchange or on the American Stock Exchange, or is a
20 national market system security traded under an automated
21 inter-dealer quotation system operated by the National
22 Association of Securities Dealers; and
23 (2) the entity had, at the end of the corporation's
24 most recent fiscal year, total net assets of at least
25 $30,000,000 related to the furnishing of health services;
26 and

HB0384- 85 -LRB100 05886 RJF 15912 b
1 (3) any investment interest obtained after the
2 effective date of this Act is traded on the exchanges
3 listed in paragraph 1 of subsection (c) of this Section
4 after the entity became a publicly traded corporation; and
5 (4) the entity markets or furnishes its services to
6 referring health care worker investors and other health
7 care workers on equal terms; and
8 (5) all stock held in such publicly traded companies,
9 including stock held in the predecessor privately held
10 company, shall be of one class without preferential
11 treatment as to status or remuneration; and
12 (6) the entity does not loan funds or guarantee any
13 loans for health care workers who are in a position to be
14 referred to an entity; and
15 (7) the income on the health care worker's investment
16 is tied to the health care worker's equity in the entity
17 rather than to the volume of referrals made; and
18 (8) the investment interest does not exceed 1/2 of 1%
19 of the entity's total equity.
20 (d) Any hospital licensed under the Hospital Licensing Act
21shall not discriminate against or otherwise penalize a health
22care worker for compliance with this Act.
23 (e) Any health care worker or other entity shall not enter
24into an arrangement or scheme seeking to make referrals to
25another health care worker or entity based upon the condition
26that the health care worker or entity will make referrals with

HB0384- 86 -LRB100 05886 RJF 15912 b
1an intent to evade the prohibitions of this Act by inducing
2patient referrals which would be prohibited by this Section if
3the health care worker or entity made the referral directly.
4 (f) If compliance with the need and alternative investor
5criteria is not practical, the health care worker shall
6identify to the patient reasonably available alternative
7facilities. The Department Board shall, by rule, designate when
8compliance is "not practical".
9 (g) Health care workers may request from the Department
10Board that it render an advisory opinion that a referral to an
11existing or proposed entity under specified circumstances does
12or does not violate the provisions of this Act. The
13Department's Board's opinion shall be presumptively correct.
14Failure to render such an advisory opinion within 90 days of a
15completed written request pursuant to this Section shall create
16a rebuttable presumption that a referral described in the
17completed written request is not or will not be a violation of
18this Act.
19 (h) Notwithstanding any provision of this Act to the
20contrary, a health care worker may refer a patient, who is a
21member of a health maintenance organization "HMO" licensed in
22this State, for health services to an entity, outside the
23health care worker's office or group practice, in which the
24health care worker is an investor, provided that any such
25referral is made pursuant to a contract with the HMO.
26Furthermore, notwithstanding any provision of this Act to the

HB0384- 87 -LRB100 05886 RJF 15912 b
1contrary, a health care worker may refer an enrollee of a
2"managed care community network", as defined in subsection (b)
3of Section 5-11 of the Illinois Public Aid Code, for health
4services to an entity, outside the health care worker's office
5or group practice, in which the health care worker is an
6investor, provided that any such referral is made pursuant to a
7contract with the managed care community network.
8(Source: P.A. 92-370, eff. 8-15-01.)
9 (225 ILCS 47/30)
10 Sec. 30. Rulemaking. The Department Health Facilities and
11Services Review Board shall exclusively and solely implement
12the provisions of this Act pursuant to rules adopted in
13accordance with the Illinois Administrative Procedure Act
14concerning, but not limited to:
15 (a) Standards and procedures for the administration of this
16Act.
17 (b) Procedures and criteria for exceptions from the
18prohibitions set forth in Section 20.
19 (c) Procedures and criteria for determining practical
20compliance with the needs and alternative investor criteria in
21Section 20.
22 (d) Procedures and criteria for determining when a written
23request for an opinion set forth in Section 20 is complete.
24 (e) Procedures and criteria for advising health care
25workers of the applicability of this Act to practices pursuant

HB0384- 88 -LRB100 05886 RJF 15912 b
1to written requests.
2 (f) Any rules of the Health Facilities and Services Review
3Board adopted under the Health Care Worker Self-Referral Act
4that are in full force on the effective date of this amendatory
5Act of the 100th General Assembly shall become the rules of the
6Department. This amendatory Act of the 100th General Assembly
7does not affect the legality of any such rules in the Illinois
8Administrative Code.
9 Any proposed rules filed with the Secretary of State by the
10Health Facilities and Services Review Board that are pending in
11the rulemaking process on the effective date of this amendatory
12Act of the 100th General Assembly and pertain to the Health
13Care Worker Self-Referral Act shall be deemed to have been
14filed by the Department. As soon as practicable hereafter, the
15Department shall revise and clarify the rules transferred to it
16under this amendatory Act of the 100th General Assembly to
17reflect the reorganization of powers, duties, rights, and
18responsibilities affected by this amendatory Act, using the
19procedures for recodification of rules available under the
20Illinois Administrative Procedure Act, except that existing
21title, part, and section numbering for the affected rules may
22be retained.
23 The Department may propose and adopt under the Illinois
24Administrative Procedure Act such other rules of the Health
25Facilities and Services Review Board that may be useful to its
26administration of the Health Care Worker Self-Referral Act.

HB0384- 89 -LRB100 05886 RJF 15912 b
1(Source: P.A. 96-31, eff. 6-30-09.)
2 (225 ILCS 47/35)
3 Sec. 35. Administrative Procedure Act; application. The
4Illinois Administrative Procedure Act is hereby expressly
5adopted and incorporated herein and shall apply to the
6Department Board as if all of the provisions of such Act were
7included in this Act; except that in case of a conflict between
8the Illinois Administrative Procedure Act and this Act the
9provisions of this Act shall control.
10(Source: P.A. 87-1207.)
11 (225 ILCS 47/40)
12 Sec. 40. Review under Administrative Review Law. Any person
13who is adversely affected by a final decision of the Department
14Board may have such decision judicially reviewed. The
15provisions of the Administrative Review Law and the rules
16adopted pursuant thereto shall apply to and govern all
17proceedings for the judicial review of final administrative
18decisions of the Department Board. The term "administrative
19decisions" is as defined in Section 3-101 of the Code of Civil
20Procedure.
21(Source: P.A. 87-1207.)
22 Section 100. The Nurse Agency Licensing Act is amended by
23changing Section 3 as follows:

HB0384- 90 -LRB100 05886 RJF 15912 b
1 (225 ILCS 510/3) (from Ch. 111, par. 953)
2 Sec. 3. Definitions. As used in this Act:
3 (a) "Certified nurse aide" means an individual certified as
4defined in Section 3-206 of the Nursing Home Care Act, Section
53-206 of the ID/DD Community Care Act, or Section 3-206 of the
6MC/DD Act, as now or hereafter amended.
7 (b) "Department" means the Department of Labor.
8 (c) "Director" means the Director of Labor.
9 (d) "Health care facility" means and includes the following
10facilities and organizations: is defined as in Section 3 of the
11Illinois Health Facilities Planning Act, as now or hereafter
12amended.
13 (1) an ambulatory surgical treatment center required
14 to be licensed pursuant to the Ambulatory Surgical
15 Treatment Center Act;
16 (2) an institution, place, building, or agency
17 required to be licensed pursuant to the Hospital Licensing
18 Act;
19 (3) skilled and intermediate long term care facilities
20 licensed under the Nursing Home Care Act;
21 (4) hospitals, nursing homes, ambulatory surgical
22 treatment centers, or kidney disease treatment centers
23 maintained by the State or any department or agency
24 thereof;
25 (5) kidney disease treatment centers, including a

HB0384- 91 -LRB100 05886 RJF 15912 b
1 free-standing hemodialysis unit; and
2 (6) an institution, place, building, or room used for
3 the performance of outpatient surgical procedures that is
4 leased, owned, or operated by or on behalf of an
5 out-of-state facility.
6 (e) "Licensee" means any nursing agency which is properly
7licensed under this Act.
8 (f) "Nurse" means a registered nurse or a licensed
9practical nurse as defined in the Nurse Practice Act.
10 (g) "Nurse agency" means any individual, firm,
11corporation, partnership or other legal entity that employs,
12assigns or refers nurses or certified nurse aides to a health
13care facility for a fee. The term "nurse agency" includes
14nurses registries. The term "nurse agency" does not include
15services provided by home health agencies licensed and operated
16under the Home Health, Home Services, and Home Nursing Agency
17Licensing Act or a licensed or certified individual who
18provides his or her own services as a regular employee of a
19health care facility, nor does it apply to a health care
20facility's organizing nonsalaried employees to provide
21services only in that facility.
22(Source: P.A. 98-104, eff. 7-22-13; 99-180, eff. 7-29-15.)
23 Section 105. The Illinois Public Aid Code is amended by
24changing Sections 5-5.01a and 5-5.02 as follows:

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1 (305 ILCS 5/5-5.01a)
2 Sec. 5-5.01a. Supportive living facilities program. The
3Department shall establish and provide oversight for a program
4of supportive living facilities that seek to promote resident
5independence, dignity, respect, and well-being in the most
6cost-effective manner.
7 A supportive living facility is either a free-standing
8facility or a distinct physical and operational entity within a
9nursing facility. A supportive living facility integrates
10housing with health, personal care, and supportive services and
11is a designated setting that offers residents their own
12separate, private, and distinct living units.
13 Sites for the operation of the program shall be selected by
14the Department based upon criteria that may include the need
15for services in a geographic area, the availability of funding,
16and the site's ability to meet the standards.
17 Beginning July 1, 2014, subject to federal approval, the
18Medicaid rates for supportive living facilities shall be equal
19to the supportive living facility Medicaid rate effective on
20June 30, 2014 increased by 8.85%. Once the assessment imposed
21at Article V-G of this Code is determined to be a permissible
22tax under Title XIX of the Social Security Act, the Department
23shall increase the Medicaid rates for supportive living
24facilities effective on July 1, 2014 by 9.09%. The Department
25shall apply this increase retroactively to coincide with the
26imposition of the assessment in Article V-G of this Code in

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1accordance with the approval for federal financial
2participation by the Centers for Medicare and Medicaid
3Services.
4 The Department may adopt rules to implement this Section.
5Rules that establish or modify the services, standards, and
6conditions for participation in the program shall be adopted by
7the Department in consultation with the Department on Aging,
8the Department of Rehabilitation Services, and the Department
9of Mental Health and Developmental Disabilities (or their
10successor agencies).
11 Facilities or distinct parts of facilities which are
12selected as supportive living facilities and are in good
13standing with the Department's rules are exempt from the
14provisions of the Nursing Home Care Act and the Illinois Health
15Facilities Planning Act.
16(Source: P.A. 98-651, eff. 6-16-14.)
17 (305 ILCS 5/5-5.02) (from Ch. 23, par. 5-5.02)
18 Sec. 5-5.02. Hospital reimbursements.
19 (a) Reimbursement to Hospitals; July 1, 1992 through
20September 30, 1992. Notwithstanding any other provisions of
21this Code or the Illinois Department's Rules promulgated under
22the Illinois Administrative Procedure Act, reimbursement to
23hospitals for services provided during the period July 1, 1992
24through September 30, 1992, shall be as follows:
25 (1) For inpatient hospital services rendered, or if

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1 applicable, for inpatient hospital discharges occurring,
2 on or after July 1, 1992 and on or before September 30,
3 1992, the Illinois Department shall reimburse hospitals
4 for inpatient services under the reimbursement
5 methodologies in effect for each hospital, and at the
6 inpatient payment rate calculated for each hospital, as of
7 June 30, 1992. For purposes of this paragraph,
8 "reimbursement methodologies" means all reimbursement
9 methodologies that pertain to the provision of inpatient
10 hospital services, including, but not limited to, any
11 adjustments for disproportionate share, targeted access,
12 critical care access and uncompensated care, as defined by
13 the Illinois Department on June 30, 1992.
14 (2) For the purpose of calculating the inpatient
15 payment rate for each hospital eligible to receive
16 quarterly adjustment payments for targeted access and
17 critical care, as defined by the Illinois Department on
18 June 30, 1992, the adjustment payment for the period July
19 1, 1992 through September 30, 1992, shall be 25% of the
20 annual adjustment payments calculated for each eligible
21 hospital, as of June 30, 1992. The Illinois Department
22 shall determine by rule the adjustment payments for
23 targeted access and critical care beginning October 1,
24 1992.
25 (3) For the purpose of calculating the inpatient
26 payment rate for each hospital eligible to receive

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1 quarterly adjustment payments for uncompensated care, as
2 defined by the Illinois Department on June 30, 1992, the
3 adjustment payment for the period August 1, 1992 through
4 September 30, 1992, shall be one-sixth of the total
5 uncompensated care adjustment payments calculated for each
6 eligible hospital for the uncompensated care rate year, as
7 defined by the Illinois Department, ending on July 31,
8 1992. The Illinois Department shall determine by rule the
9 adjustment payments for uncompensated care beginning
10 October 1, 1992.
11 (b) Inpatient payments. For inpatient services provided on
12or after October 1, 1993, in addition to rates paid for
13hospital inpatient services pursuant to the Illinois Health
14Finance Reform Act, as now or hereafter amended, or the
15Illinois Department's prospective reimbursement methodology,
16or any other methodology used by the Illinois Department for
17inpatient services, the Illinois Department shall make
18adjustment payments, in an amount calculated pursuant to the
19methodology described in paragraph (c) of this Section, to
20hospitals that the Illinois Department determines satisfy any
21one of the following requirements:
22 (1) Hospitals that are described in Section 1923 of the
23 federal Social Security Act, as now or hereafter amended,
24 except that for rate year 2015 and after a hospital
25 described in Section 1923(b)(1)(B) of the federal Social
26 Security Act and qualified for the payments described in

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1 subsection (c) of this Section for rate year 2014 provided
2 the hospital continues to meet the description in Section
3 1923(b)(1)(B) in the current determination year; or
4 (2) Illinois hospitals that have a Medicaid inpatient
5 utilization rate which is at least one-half a standard
6 deviation above the mean Medicaid inpatient utilization
7 rate for all hospitals in Illinois receiving Medicaid
8 payments from the Illinois Department; or
9 (3) Illinois hospitals that on July 1, 1991 had a
10 Medicaid inpatient utilization rate, as defined in
11 paragraph (h) of this Section, that was at least the mean
12 Medicaid inpatient utilization rate for all hospitals in
13 Illinois receiving Medicaid payments from the Illinois
14 Department and which were located in a planning area with
15 one-third or fewer excess beds as determined by the Health
16 Facilities and Services Review Board, and that, as of June
17 30, 1992, were located in a federally designated Health
18 Manpower Shortage Area; or
19 (4) Illinois hospitals that:
20 (A) have a Medicaid inpatient utilization rate
21 that is at least equal to the mean Medicaid inpatient
22 utilization rate for all hospitals in Illinois
23 receiving Medicaid payments from the Department; and
24 (B) also have a Medicaid obstetrical inpatient
25 utilization rate that is at least one standard
26 deviation above the mean Medicaid obstetrical

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1 inpatient utilization rate for all hospitals in
2 Illinois receiving Medicaid payments from the
3 Department for obstetrical services; or
4 (5) Any children's hospital, which means a hospital
5 devoted exclusively to caring for children. A hospital
6 which includes a facility devoted exclusively to caring for
7 children shall be considered a children's hospital to the
8 degree that the hospital's Medicaid care is provided to
9 children if either (i) the facility devoted exclusively to
10 caring for children is separately licensed as a hospital by
11 a municipality prior to February 28, 2013 or (ii) the
12 hospital has been designated by the State as a Level III
13 perinatal care facility, has a Medicaid Inpatient
14 Utilization rate greater than 55% for the rate year 2003
15 disproportionate share determination, and has more than
16 10,000 qualified children days as defined by the Department
17 in rulemaking.
18 (c) Inpatient adjustment payments. The adjustment payments
19required by paragraph (b) shall be calculated based upon the
20hospital's Medicaid inpatient utilization rate as follows:
21 (1) hospitals with a Medicaid inpatient utilization
22 rate below the mean shall receive a per day adjustment
23 payment equal to $25;
24 (2) hospitals with a Medicaid inpatient utilization
25 rate that is equal to or greater than the mean Medicaid
26 inpatient utilization rate but less than one standard

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1 deviation above the mean Medicaid inpatient utilization
2 rate shall receive a per day adjustment payment equal to
3 the sum of $25 plus $1 for each one percent that the
4 hospital's Medicaid inpatient utilization rate exceeds the
5 mean Medicaid inpatient utilization rate;
6 (3) hospitals with a Medicaid inpatient utilization
7 rate that is equal to or greater than one standard
8 deviation above the mean Medicaid inpatient utilization
9 rate but less than 1.5 standard deviations above the mean
10 Medicaid inpatient utilization rate shall receive a per day
11 adjustment payment equal to the sum of $40 plus $7 for each
12 one percent that the hospital's Medicaid inpatient
13 utilization rate exceeds one standard deviation above the
14 mean Medicaid inpatient utilization rate; and
15 (4) hospitals with a Medicaid inpatient utilization
16 rate that is equal to or greater than 1.5 standard
17 deviations above the mean Medicaid inpatient utilization
18 rate shall receive a per day adjustment payment equal to
19 the sum of $90 plus $2 for each one percent that the
20 hospital's Medicaid inpatient utilization rate exceeds 1.5
21 standard deviations above the mean Medicaid inpatient
22 utilization rate.
23 (d) Supplemental adjustment payments. In addition to the
24adjustment payments described in paragraph (c), hospitals as
25defined in clauses (1) through (5) of paragraph (b), excluding
26county hospitals (as defined in subsection (c) of Section 15-1

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1of this Code) and a hospital organized under the University of
2Illinois Hospital Act, shall be paid supplemental inpatient
3adjustment payments of $60 per day. For purposes of Title XIX
4of the federal Social Security Act, these supplemental
5adjustment payments shall not be classified as adjustment
6payments to disproportionate share hospitals.
7 (e) The inpatient adjustment payments described in
8paragraphs (c) and (d) shall be increased on October 1, 1993
9and annually thereafter by a percentage equal to the lesser of
10(i) the increase in the DRI hospital cost index for the most
11recent 12 month period for which data are available, or (ii)
12the percentage increase in the statewide average hospital
13payment rate over the previous year's statewide average
14hospital payment rate. The sum of the inpatient adjustment
15payments under paragraphs (c) and (d) to a hospital, other than
16a county hospital (as defined in subsection (c) of Section 15-1
17of this Code) or a hospital organized under the University of
18Illinois Hospital Act, however, shall not exceed $275 per day;
19that limit shall be increased on October 1, 1993 and annually
20thereafter by a percentage equal to the lesser of (i) the
21increase in the DRI hospital cost index for the most recent
2212-month period for which data are available or (ii) the
23percentage increase in the statewide average hospital payment
24rate over the previous year's statewide average hospital
25payment rate.
26 (f) Children's hospital inpatient adjustment payments. For

HB0384- 100 -LRB100 05886 RJF 15912 b
1children's hospitals, as defined in clause (5) of paragraph
2(b), the adjustment payments required pursuant to paragraphs
3(c) and (d) shall be multiplied by 2.0.
4 (g) County hospital inpatient adjustment payments. For
5county hospitals, as defined in subsection (c) of Section 15-1
6of this Code, there shall be an adjustment payment as
7determined by rules issued by the Illinois Department.
8 (h) For the purposes of this Section the following terms
9shall be defined as follows:
10 (1) "Medicaid inpatient utilization rate" means a
11 fraction, the numerator of which is the number of a
12 hospital's inpatient days provided in a given 12-month
13 period to patients who, for such days, were eligible for
14 Medicaid under Title XIX of the federal Social Security
15 Act, and the denominator of which is the total number of
16 the hospital's inpatient days in that same period.
17 (2) "Mean Medicaid inpatient utilization rate" means
18 the total number of Medicaid inpatient days provided by all
19 Illinois Medicaid-participating hospitals divided by the
20 total number of inpatient days provided by those same
21 hospitals.
22 (3) "Medicaid obstetrical inpatient utilization rate"
23 means the ratio of Medicaid obstetrical inpatient days to
24 total Medicaid inpatient days for all Illinois hospitals
25 receiving Medicaid payments from the Illinois Department.
26 (i) Inpatient adjustment payment limit. In order to meet

HB0384- 101 -LRB100 05886 RJF 15912 b
1the limits of Public Law 102-234 and Public Law 103-66, the
2Illinois Department shall by rule adjust disproportionate
3share adjustment payments.
4 (j) University of Illinois Hospital inpatient adjustment
5payments. For hospitals organized under the University of
6Illinois Hospital Act, there shall be an adjustment payment as
7determined by rules adopted by the Illinois Department.
8 (k) The Illinois Department may by rule establish criteria
9for and develop methodologies for adjustment payments to
10hospitals participating under this Article.
11 (l) On and after July 1, 2012, the Department shall reduce
12any rate of reimbursement for services or other payments or
13alter any methodologies authorized by this Code to reduce any
14rate of reimbursement for services or other payments in
15accordance with Section 5-5e.
16(Source: P.A. 97-689, eff. 6-14-12; 98-104, eff. 7-22-13.)
17 Section 110. The Older Adult Services Act is amended by
18changing Sections 20, 25, and 30 as follows:
19 (320 ILCS 42/20)
20 Sec. 20. Priority service areas; service expansion.
21 (a) The requirements of this Section are subject to the
22availability of funding.
23 (b) The Department, subject to appropriation, shall expand
24older adult services that promote independence and permit older

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1adults to remain in their own homes and communities. Priority
2shall be given to both the expansion of services and the
3development of new services in priority service areas.
4 (c) Inventory of services. The Department shall develop and
5maintain an inventory and assessment of (i) the types and
6quantities of public older adult services and, to the extent
7possible, privately provided older adult services, including
8the unduplicated count, location, and characteristics of
9individuals served by each facility, program, or service and
10(ii) the resources supporting those services, no later than
11July 1, 2012. The Department shall investigate the cost of
12compliance with this provision and report these findings to the
13appropriation committees of both chambers assigned to hear the
14agency's budget no later than January 1, 2012. If the
15Department determines that compliance is cost prohibitive, it
16shall recommend action in the alternative to achieve the intent
17of this Section and identify priority service areas for the
18purpose of directing the allocation of new resources and the
19reallocation of existing resources to areas of greatest need.
20 (d) Priority service areas. The Departments shall assess
21the current and projected need for older adult services
22throughout the State, analyze the results of the inventory, and
23identify priority service areas, which shall serve as the basis
24for a priority service plan to be filed with the Governor and
25the General Assembly no later than July 1, 2006, and every 5
26years thereafter. The January 1, 2012 report required under

HB0384- 103 -LRB100 05886 RJF 15912 b
1subsection (c) of this Section shall serve as compliance with
2the July 1, 2011 reporting requirement.
3 (e) Moneys appropriated by the General Assembly for the
4purpose of this Section, receipts from transfers, donations,
5grants, fees, or taxes that may accrue from any public or
6private sources to the Department for the purpose of providing
7services and care to older adults, and savings attributable to
8the nursing home conversion program as calculated in subsection
9(h) shall be deposited into the Department on Aging State
10Projects Fund. Interest earned by those moneys in the Fund
11shall be credited to the Fund.
12 (f) Moneys described in subsection (e) from the Department
13on Aging State Projects Fund shall be used for older adult
14services, regardless of where the older adult receives the
15service, with priority given to both the expansion of services
16and the development of new services in priority service areas.
17Fundable services shall include:
18 (1) Housing, health services, and supportive services:
19 (A) adult day care;
20 (B) adult day care for persons with Alzheimer's
21 disease and related disorders;
22 (C) activities of daily living;
23 (D) care-related supplies and equipment;
24 (E) case management;
25 (F) community reintegration;
26 (G) companion;

HB0384- 104 -LRB100 05886 RJF 15912 b
1 (H) congregate meals;
2 (I) counseling and education;
3 (J) elder abuse prevention and intervention;
4 (K) emergency response and monitoring;
5 (L) environmental modifications;
6 (M) family caregiver support;
7 (N) financial;
8 (O) home delivered meals;
9 (P) homemaker;
10 (Q) home health;
11 (R) hospice;
12 (S) laundry;
13 (T) long-term care ombudsman;
14 (U) medication reminders;
15 (V) money management;
16 (W) nutrition services;
17 (X) personal care;
18 (Y) respite care;
19 (Z) residential care;
20 (AA) senior benefits outreach;
21 (BB) senior centers;
22 (CC) services provided under the Assisted Living
23 and Shared Housing Act, or sheltered care services that
24 meet the requirements of the Assisted Living and Shared
25 Housing Act, or services provided under Section
26 5-5.01a of the Illinois Public Aid Code (the Supportive

HB0384- 105 -LRB100 05886 RJF 15912 b
1 Living Facilities Program);
2 (DD) telemedicine devices to monitor recipients in
3 their own homes as an alternative to hospital care,
4 nursing home care, or home visits;
5 (EE) training for direct family caregivers;
6 (FF) transition;
7 (GG) transportation;
8 (HH) wellness and fitness programs; and
9 (II) other programs designed to assist older
10 adults in Illinois to remain independent and receive
11 services in the most integrated residential setting
12 possible for that person.
13 (2) Older Adult Services Demonstration Grants,
14 pursuant to subsection (g) of this Section.
15 (g) Older Adult Services Demonstration Grants. The
16Department may establish a program of demonstration grants to
17assist in the restructuring of the delivery system for older
18adult services and provide funding for innovative service
19delivery models and system change and integration initiatives.
20The Department shall prescribe, by rule, the grant application
21process. At a minimum, every application must include:
22 (1) The type of grant sought;
23 (2) A description of the project;
24 (3) The objective of the project;
25 (4) The likelihood of the project meeting identified
26 needs;

HB0384- 106 -LRB100 05886 RJF 15912 b
1 (5) The plan for financing, administration, and
2 evaluation of the project;
3 (6) The timetable for implementation;
4 (7) The roles and capabilities of responsible
5 individuals and organizations;
6 (8) Documentation of collaboration with other service
7 providers, local community government leaders, and other
8 stakeholders, other providers, and any other stakeholders
9 in the community;
10 (9) Documentation of community support for the
11 project, including support by other service providers,
12 local community government leaders, and other
13 stakeholders;
14 (10) The total budget for the project;
15 (11) The financial condition of the applicant; and
16 (12) Any other application requirements that may be
17 established by the Department by rule.
18 Each project may include provisions for a designated staff
19person who is responsible for the development of the project
20and recruitment of providers.
21 Projects may include, but are not limited to: adult family
22foster care; family adult day care; assisted living in a
23supervised apartment; personal services in a subsidized
24housing project; training for caregivers; specialized assisted
25living units; evening and weekend home care coverage; small
26incentive grants to attract new providers; money following the

HB0384- 107 -LRB100 05886 RJF 15912 b
1person; cash and counseling; managed long-term care; and
2respite care projects that establish a local coordinated
3network of volunteer and paid respite workers, coordinate
4assignment of respite workers to caregivers and older adults,
5ensure the health and safety of the older adult, provide
6training for caregivers, and ensure that support groups are
7available in the community.
8 A demonstration project funded in whole or in part by an
9Older Adult Services Demonstration Grant is exempt from the
10requirements of the Illinois Health Facilities Planning Act. To
11the extent applicable, however, for the purpose of maintaining
12the statewide inventory authorized by the Illinois Health
13Facilities Planning Act, the Department shall send to the
14Health Facilities and Services Review Board a copy of each
15grant award made under this subsection (g).
16 The Department, in collaboration with the Departments of
17Public Health and Healthcare and Family Services, shall
18evaluate the effectiveness of the projects receiving grants
19under this Section.
20 (h) No later than July 1 of each year, the Department of
21Public Health shall provide information to the Department of
22Healthcare and Family Services to enable the Department of
23Healthcare and Family Services to annually document and verify
24the savings attributable to the nursing home conversion program
25for the previous fiscal year to estimate an annual amount of
26such savings that may be appropriated to the Department on

HB0384- 108 -LRB100 05886 RJF 15912 b
1Aging State Projects Fund and notify the General Assembly, the
2Department on Aging, the Department of Human Services, and the
3Advisory Committee of the savings no later than October 1 of
4the same fiscal year.
5(Source: P.A. 96-31, eff. 6-30-09; 97-448, eff. 8-19-11.)
6 (320 ILCS 42/25)
7 Sec. 25. Older adult services restructuring. No later than
8January 1, 2005, the Department shall commence the process of
9restructuring the older adult services delivery system.
10Priority shall be given to both the expansion of services and
11the development of new services in priority service areas.
12Subject to the availability of funding, the restructuring shall
13include, but not be limited to, the following:
14 (1) Planning. The Department on Aging and the Departments
15of Public Health and Healthcare and Family Services shall
16develop a plan to restructure the State's service delivery
17system for older adults pursuant to this Act no later than
18September 30, 2010. The plan shall include a schedule for the
19implementation of the initiatives outlined in this Act and all
20other initiatives identified by the participating agencies to
21fulfill the purposes of this Act and shall protect the rights
22of all older Illinoisans to services based on their health
23circumstances and functioning level, regardless of whether
24they receive their care in their homes, in a community setting,
25or in a residential facility. Financing for older adult

HB0384- 109 -LRB100 05886 RJF 15912 b
1services shall be based on the principle that "money follows
2the individual" taking into account individual preference, but
3shall not jeopardize the health, safety, or level of care of
4nursing home residents. The plan shall also identify potential
5impediments to delivery system restructuring and include any
6known regulatory or statutory barriers.
7 (2) Comprehensive case management. The Department shall
8implement a statewide system of holistic comprehensive case
9management. The system shall include the identification and
10implementation of a universal, comprehensive assessment tool
11to be used statewide to determine the level of functional,
12cognitive, socialization, and financial needs of older adults.
13This tool shall be supported by an electronic intake,
14assessment, and care planning system linked to a central
15location. "Comprehensive case management" includes services
16and coordination such as (i) comprehensive assessment of the
17older adult (including the physical, functional, cognitive,
18psycho-social, and social needs of the individual); (ii)
19development and implementation of a service plan with the older
20adult to mobilize the formal and family resources and services
21identified in the assessment to meet the needs of the older
22adult, including coordination of the resources and services
23with any other plans that exist for various formal services,
24such as hospital discharge plans, and with the information and
25assistance services; (iii) coordination and monitoring of
26formal and family service delivery, including coordination and

HB0384- 110 -LRB100 05886 RJF 15912 b
1monitoring to ensure that services specified in the plan are
2being provided; (iv) periodic reassessment and revision of the
3status of the older adult with the older adult or, if
4necessary, the older adult's designated representative; and
5(v) in accordance with the wishes of the older adult, advocacy
6on behalf of the older adult for needed services or resources.
7 (3) Coordinated point of entry. The Department shall
8implement and publicize a statewide coordinated point of entry
9using a uniform name, identity, logo, and toll-free number.
10 (4) Public web site. The Department shall develop a public
11web site that provides links to available services, resources,
12and reference materials concerning caregiving, diseases, and
13best practices for use by professionals, older adults, and
14family caregivers.
15 (5) Expansion of older adult services. The Department shall
16expand older adult services that promote independence and
17permit older adults to remain in their own homes and
18communities.
19 (6) Consumer-directed home and community-based services.
20The Department shall expand the range of service options
21available to permit older adults to exercise maximum choice and
22control over their care.
23 (7) Comprehensive delivery system. The Department shall
24expand opportunities for older adults to receive services in
25systems that integrate acute and chronic care.
26 (8) Enhanced transition and follow-up services. The

HB0384- 111 -LRB100 05886 RJF 15912 b
1Department shall implement a program of transition from one
2residential setting to another and follow-up services,
3regardless of residential setting, pursuant to rules with
4respect to (i) resident eligibility, (ii) assessment of the
5resident's health, cognitive, social, and financial needs,
6(iii) development of transition plans, and (iv) the level of
7services that must be available before transitioning a resident
8from one setting to another.
9 (9) Family caregiver support. The Department shall develop
10strategies for public and private financing of services that
11supplement and support family caregivers.
12 (10) Quality standards and quality improvement. The
13Department shall establish a core set of uniform quality
14standards for all providers that focus on outcomes and take
15into consideration consumer choice and satisfaction, and the
16Department shall require each provider to implement a
17continuous quality improvement process to address consumer
18issues. The continuous quality improvement process must
19benchmark performance, be person-centered and data-driven, and
20focus on consumer satisfaction.
21 (11) Workforce. The Department shall develop strategies to
22attract and retain a qualified and stable worker pool, provide
23living wages and benefits, and create a work environment that
24is conducive to long-term employment and career development.
25Resources such as grants, education, and promotion of career
26opportunities may be used.

HB0384- 112 -LRB100 05886 RJF 15912 b
1 (12) Coordination of services. The Department shall
2identify methods to better coordinate service networks to
3maximize resources and minimize duplication of services and
4ease of application.
5 (13) Barriers to services. The Department shall identify
6barriers to the provision, availability, and accessibility of
7services and shall implement a plan to address those barriers.
8The plan shall: (i) identify barriers, including but not
9limited to, statutory and regulatory complexity, reimbursement
10issues, payment issues, and labor force issues; (ii) recommend
11changes to State or federal laws or administrative rules or
12regulations; (iii) recommend application for federal waivers
13to improve efficiency and reduce cost and paperwork; (iv)
14develop innovative service delivery models; and (v) recommend
15application for federal or private service grants.
16 (14) Reimbursement and funding. The Department shall
17investigate and evaluate costs and payments by defining costs
18to implement a uniform, audited provider cost reporting system
19to be considered by all Departments in establishing payments.
20To the extent possible, multiple cost reporting mandates shall
21not be imposed.
22 (15) Medicaid nursing home cost containment and Medicare
23utilization. The Department of Healthcare and Family Services
24(formerly Department of Public Aid), in collaboration with the
25Department on Aging and the Department of Public Health and in
26consultation with the Advisory Committee, shall propose a plan

HB0384- 113 -LRB100 05886 RJF 15912 b
1to contain Medicaid nursing home costs and maximize Medicare
2utilization. The plan must not impair the ability of an older
3adult to choose among available services. The plan shall
4include, but not be limited to, (i) techniques to maximize the
5use of the most cost-effective services without sacrificing
6quality and (ii) methods to identify and serve older adults in
7need of minimal services to remain independent, but who are
8likely to develop a need for more extensive services in the
9absence of those minimal services.
10 (16) Bed reduction. The Department of Public Health shall
11implement a nursing home conversion program to reduce the
12number of Medicaid-certified nursing home beds in areas with
13excess beds. The Department of Healthcare and Family Services
14shall investigate changes to the Medicaid nursing facility
15reimbursement system in order to reduce beds. Such changes may
16include, but are not limited to, incentive payments that will
17enable facilities to adjust to the restructuring and expansion
18of services required by the Older Adult Services Act, including
19adjustments for the voluntary closure or layaway of nursing
20home beds certified under Title XIX of the federal Social
21Security Act. Any savings shall be reallocated to fund
22home-based or community-based older adult services pursuant to
23Section 20.
24 (17) Financing. The Department shall investigate and
25evaluate financing options for older adult services and shall
26make recommendations in the report required by Section 15

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1concerning the feasibility of these financing arrangements.
2These arrangements shall include, but are not limited to:
3 (A) private long-term care insurance coverage for
4 older adult services;
5 (B) enhancement of federal long-term care financing
6 initiatives;
7 (C) employer benefit programs such as medical savings
8 accounts for long-term care;
9 (D) individual and family cost-sharing options;
10 (E) strategies to reduce reliance on government
11 programs;
12 (F) fraudulent asset divestiture and financial
13 planning prevention; and
14 (G) methods to supplement and support family and
15 community caregiving.
16 (18) Older Adult Services Demonstration Grants. The
17Department shall implement a program of demonstration grants
18that will assist in the restructuring of the older adult
19services delivery system, and shall provide funding for
20innovative service delivery models and system change and
21integration initiatives pursuant to subsection (g) of Section
2220.
23 (19) (Blank). Bed need methodology update. For the purposes
24of determining areas with excess beds, the Departments shall
25provide information and assistance to the Health Facilities and
26Services Review Board to update the Bed Need Methodology for

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1Long-Term Care to update the assumptions used to establish the
2methodology to make them consistent with modern older adult
3services.
4 (20) Affordable housing. The Departments shall utilize the
5recommendations of Illinois' Annual Comprehensive Housing
6Plan, as developed by the Affordable Housing Task Force through
7the Governor's Executive Order 2003-18, in their efforts to
8address the affordable housing needs of older adults.
9 The Older Adult Services Advisory Committee shall
10investigate innovative and promising practices operating as
11demonstration or pilot projects in Illinois and in other
12states. The Department on Aging shall provide the Older Adult
13Services Advisory Committee with a list of all demonstration or
14pilot projects funded by the Department on Aging, including
15those specified by rule, law, policy memorandum, or funding
16arrangement. The Committee shall work with the Department on
17Aging to evaluate the viability of expanding these programs
18into other areas of the State.
19(Source: P.A. 96-31, eff. 6-30-09; 96-248, eff. 8-11-09;
2096-1000, eff. 7-2-10.)
21 (320 ILCS 42/30)
22 Sec. 30. Nursing home conversion program.
23 (a) The Department of Public Health, in collaboration with
24the Department on Aging and the Department of Healthcare and
25Family Services, shall establish a nursing home conversion

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1program. Start-up grants, pursuant to subsections (l) and (m)
2of this Section, shall be made available to nursing homes as
3appropriations permit as an incentive to reduce certified beds,
4retrofit, and retool operations to meet new service delivery
5expectations and demands.
6 (b) Grant moneys shall be made available for capital and
7other costs related to: (1) the conversion of all or a part of
8a nursing home to an assisted living establishment or a special
9program or unit for persons with Alzheimer's disease or related
10disorders licensed under the Assisted Living and Shared Housing
11Act or a supportive living facility established under Section
125-5.01a of the Illinois Public Aid Code; (2) the conversion of
13multi-resident bedrooms in the facility into single-occupancy
14rooms; and (3) the development of any of the services
15identified in a priority service plan that can be provided by a
16nursing home within the confines of a nursing home or
17transportation services. Grantees shall be required to provide
18a minimum of a 20% match toward the total cost of the project.
19 (c) Nothing in this Act shall prohibit the co-location of
20services or the development of multifunctional centers under
21subsection (f) of Section 20, including a nursing home offering
22community-based services or a community provider establishing
23a residential facility.
24 (d) A certified nursing home with at least 50% of its
25resident population having their care paid for by the Medicaid
26program is eligible to apply for a grant under this Section.

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1 (e) Any nursing home receiving a grant under this Section
2shall reduce the number of certified nursing home beds by a
3number equal to or greater than the number of beds being
4converted for one or more of the permitted uses under item (1)
5or (2) of subsection (b). The nursing home shall retain the
6Certificate of Need for its nursing and sheltered care beds
7that were converted for 15 years. If the beds are reinstated by
8the provider or its successor in interest, the provider shall
9pay to the fund from which the grant was awarded, on an
10amortized basis, the amount of the grant. The Department shall
11establish, by rule, the bed reduction methodology for nursing
12homes that receive a grant pursuant to item (3) of subsection
13(b).
14 (f) Any nursing home receiving a grant under this Section
15shall agree that, for a minimum of 10 years after the date that
16the grant is awarded, a minimum of 50% of the nursing home's
17resident population shall have their care paid for by the
18Medicaid program. If the nursing home provider or its successor
19in interest ceases to comply with the requirement set forth in
20this subsection, the provider shall pay to the fund from which
21the grant was awarded, on an amortized basis, the amount of the
22grant.
23 (g) Before awarding grants, the Department of Public Health
24shall seek recommendations from the Department on Aging and the
25Department of Healthcare and Family Services. The Department of
26Public Health shall attempt to balance the distribution of

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1grants among geographic regions, and among small and large
2nursing homes. The Department of Public Health shall develop,
3by rule, the criteria for the award of grants based upon the
4following factors:
5 (1) the unique needs of older adults (including those
6 with moderate and low incomes), caregivers, and providers
7 in the geographic area of the State the grantee seeks to
8 serve;
9 (2) whether the grantee proposes to provide services in
10 a priority service area;
11 (3) the extent to which the conversion or transition
12 will result in the reduction of certified nursing home beds
13 in an area with excess beds;
14 (4) the compliance history of the nursing home; and
15 (5) any other relevant factors identified by the
16 Department, including standards of need.
17 (h) A conversion funded in whole or in part by a grant
18under this Section must not:
19 (1) diminish or reduce the quality of services
20 available to nursing home residents;
21 (2) force any nursing home resident to involuntarily
22 accept home-based or community-based services instead of
23 nursing home services;
24 (3) diminish or reduce the supply and distribution of
25 nursing home services in any community below the level of
26 need, as defined by the Department by rule; or

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1 (4) cause undue hardship on any person who requires
2 nursing home care.
3 (i) The Department shall prescribe, by rule, the grant
4application process. At a minimum, every application must
5include:
6 (1) the type of grant sought;
7 (2) a description of the project;
8 (3) the objective of the project;
9 (4) the likelihood of the project meeting identified
10 needs;
11 (5) the plan for financing, administration, and
12 evaluation of the project;
13 (6) the timetable for implementation;
14 (7) the roles and capabilities of responsible
15 individuals and organizations;
16 (8) documentation of collaboration with other service
17 providers, local community government leaders, and other
18 stakeholders, other providers, and any other stakeholders
19 in the community;
20 (9) documentation of community support for the
21 project, including support by other service providers,
22 local community government leaders, and other
23 stakeholders;
24 (10) the total budget for the project;
25 (11) the financial condition of the applicant; and
26 (12) any other application requirements that may be

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1 established by the Department by rule.
2 (j) (Blank). A conversion project funded in whole or in
3part by a grant under this Section is exempt from the
4requirements of the Illinois Health Facilities Planning Act.
5The Department of Public Health, however, shall send to the
6Health Facilities and Services Review Board a copy of each
7grant award made under this Section.
8 (k) Applications for grants are public information, except
9that nursing home financial condition and any proprietary data
10shall be classified as nonpublic data.
11 (l) The Department of Public Health may award grants from
12the Long Term Care Civil Money Penalties Fund established under
13Section 1919(h)(2)(A)(ii) of the Social Security Act and 42 CFR
14488.422(g) if the award meets federal requirements.
15 (m) (Blank).
16(Source: P.A. 99-576, eff. 7-15-16.)
17 (405 ILCS 25/4.03 rep.) (from Ch. 91 1/2, par. 604.03)
18 Section 115. The Specialized Living Centers Act is amended
19by repealing Section 4.03.

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1 INDEX
2 Statutes amended in order of appearance
3 5 ILCS 120/1.02from Ch. 102, par. 41.02
4 5 ILCS 430/5-50
5 20 ILCS 2310/2310-217
6 20 ILCS 2310/2310-640
7 20 ILCS 3960/Act rep.
8 20 ILCS 4050/15 rep.
9 30 ILCS 5/3-1from Ch. 15, par. 303-1
10 30 ILCS 105/5.213 rep.from Ch. 127, par. 141.213
11 70 ILCS 910/15from Ch. 23, par. 1265
12 210 ILCS 3/20
13 210 ILCS 3/30
14 210 ILCS 9/10
15 210 ILCS 9/145
16 210 ILCS 9/155
17 210 ILCS 40/2from Ch. 111 1/2, par. 4160-2
18 210 ILCS 40/7from Ch. 111 1/2, par. 4160-7
19 210 ILCS 45/3-102.2
20 210 ILCS 45/3-103from Ch. 111 1/2, par. 4153-103
21 210 ILCS 47/3-103
22 210 ILCS 49/1-101.5
23 210 ILCS 50/32.5
24 210 ILCS 80/1.3
25 210 ILCS 85/4.5

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