Bill Text: IL SB0026 | 2013-2014 | 98th General Assembly | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Amends the Medical Assistance Article of the Illinois Public Aid Code. Beginning January 1, 2014, extends benefits under the State's medical assistance program to persons aged 19 or older, but younger than 65, who are not otherwise eligible for medical assistance under the Code, who qualify for medical assistance under specified provisions of the Social Security Act, and who have income at or below 133% of the federal poverty level plus 5% for the applicable family size. Provides that the 4-year moratorium on the expansion of medical assistance eligibility through increasing financial eligibility standards shall not apply to this new class of persons. Provides that such persons shall receive coverage for the Health Benefits Service Package. Defines "Health Benefits Service Package". Provides that if Illinois' federal medical assistance percentage (FMAP) is reduced below 90% for persons eligible for medical assistance under the specified provisions, medical assistance eligibility for this new class of persons shall cease no later than the end of the third month following the month in which the reduction in FMAP takes effect. Effective immediately.

Spectrum: Partisan Bill (Democrat 65-0)

Status: (Passed) 2013-07-22 - Public Act . . . . . . . . . 98-0104 [SB0026 Detail]

Download: Illinois-2013-SB0026-Amended.html

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Rep. Sara Feigenholtz

Filed: 5/27/2013

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AMENDMENT TO SENATE BILL 26
AMENDMENT NO. ______. Amend Senate Bill 26, AS AMENDED,
with reference to page and line numbers of House Amendment No.
1 as follows:
on page 4, by inserting immediately below line 8 the following:
""Abuse" means any physical or mental injury or sexual
assault inflicted on a consumer other than by accidental means
in a facility."; and
on page 6, line 19, after "triage", by inserting "center"; and
on page 9, immediately below line 13, by inserting the
following:
""Identified offender" means a person who meets any of the
following criteria:
(1) Has been convicted of, found guilty of, adjudicated
delinquent for, found not guilty by reason of insanity for,

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or found unfit to stand trial for, any felony offense
listed in Section 25 of the Health Care Worker Background
Check Act, except for the following:
(i) a felony offense described in Section 10-5 of
the Nurse Practice Act;
(ii) a felony offense described in Section 4, 5, 6,
8, or 17.02 of the Illinois Credit Card and Debit Card
Act;
(iii) a felony offense described in Section 5, 5.1,
5.2, 7, or 9 of the Cannabis Control Act;
(iv) a felony offense described in Section 401,
401.1, 404, 405, 405.1, 407, or 407.1 of the Illinois
Controlled Substances Act; and
(v) a felony offense described in the
Methamphetamine Control and Community Protection Act.
(2) Has been convicted of, adjudicated delinquent for,
found not guilty by reason of insanity for, or found unfit
to stand trial for, any sex offense as defined in
subsection (c) of Section 10 of the Sex Offender Management
Board Act."; and
on page 12, immediately below line 9, by inserting the
following:
"Section 2-100. Rulemaking. The Department is empowered to
promulgate any rules necessary to ensure proper implementation

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and administration of this Act."; and
on page 15, immediately below line 1, by inserting the
following:
"Section 2-104. Screening prior to admission.
(a) A facility shall within 24 hours after admission,
request a criminal history background check pursuant to the
Uniform Conviction Information Act for all persons age 18 or
older seeking admission to the facility, unless a background
check was initiated by a hospital pursuant to subsection (d) of
Section 6.09 of the Hospital Licensing Act. Background checks
conducted pursuant to this Section shall be based on the
consumer's name, date of birth, and other identifiers as
required by the Department of State Police. If the results of
the background check are inconclusive, the facility shall
initiate a fingerprint-based check, unless the fingerprint
check is waived by the Director of Public Health based on
verification by the facility that the consumer meets criteria
related to the consumer's health or lack of potential risk
which may be established by Departmental rule. A waiver issued
pursuant to this Section shall be valid only while the consumer
is immobile or while the criteria supporting the waiver exist.
The facility shall provide for or arrange for any required
fingerprint-based checks to be taken on the premises of the
facility. If a fingerprint-based check is required, the

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facility shall arrange for it to be conducted in a manner that
is respectful of the consumer's dignity and that minimizes any
emotional or physical hardship to the consumer.
(b) If the results of a consumer's criminal history
background check reveal that the consumer is an identified
offender as defined in this Act, the facility shall do the
following:
(1) Immediately notify the Department of State Police,
in the form and manner required by the Department of State
Police, in collaboration with the Department of Public
Health, that the consumer is an identified offender.
(2) Within 72 hours, arrange for a fingerprint-based
criminal history record inquiry to be requested on the
identified offender consumer. The inquiry shall be based on
the subject's name, sex, race, date of birth, fingerprint
images, and other identifiers required by the Department of
State Police. The inquiry shall be processed through the
files of the Department of State Police and the Federal
Bureau of Investigation to locate any criminal history
record information that may exist regarding the subject.
The Federal Bureau of Investigation shall furnish to the
Department of State Police, pursuant to an inquiry under
this paragraph (2), any criminal history record
information contained in its files.
Section 2-105. Criminal History Report.

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(a) The Department of State Police shall prepare a Criminal
History Report when it receives information, through the
criminal history background check required pursuant to
subsection (d) of Section 6.09 of the Hospital Licensing Act or
subsection (c) of Section 2-201.5 of the Nursing Home Care Act,
or through any other means, that a consumer of a facility is an
identified offender.
(b) The Department of State Police shall complete the
Criminal History Report within 10 business days after receiving
information under subsection (a) that a consumer is an
identified offender.
(c) The Criminal History Report shall include, but not be
limited to, the following:
(1) Copies of the identified offender's parole,
mandatory supervised release, or probation orders.
(2) An interview with the identified offender.
(3) A detailed summary of the entire criminal history
of the offender, including arrests, convictions, and the
date of the identified offender's last conviction relative
to the date of admission to a long-term care facility.
(4) If the identified offender is a convicted or
registered sex offender, a review of any and all sex
offender evaluations conducted on that offender. If there
is no sex offender evaluation available, the Department of
State Police shall arrange, through the Department of
Public Health, for a sex offender evaluation to be

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conducted on the identified offender. If the convicted or
registered sex offender is under supervision by the
Illinois Department of Corrections or a county probation
department, the sex offender evaluation shall be arranged
by and at the expense of the supervising agency. All
evaluations conducted on convicted or registered sex
offenders under this Act shall be conducted by sex offender
evaluators approved by the Sex Offender Management Board.
(d) The Department of State Police shall provide the
Criminal History Report to a licensed forensic psychologist.
After (i) consideration of the Criminal History Report, (ii)
consultation with the facility administrator or the facility
medical director, or both, regarding the mental and physical
condition of the identified offender, and (iii) reviewing the
facility's file on the identified offender, including all
incident reports, all information regarding medication and
medication compliance, and all information regarding previous
discharges or transfers from other facilities, the licensed
forensic psychologist shall prepare an Identified Offender
Report and Recommendation. The Identified Offender Report and
Recommendation shall detail whether and to what extent the
identified offender's criminal history necessitates the
implementation of security measures within the long-term care
facility. If the identified offender is a convicted or
registered sex offender or if the Identified Offender Report
and Recommendation reveals that the identified offender poses a

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significant risk of harm to others within the facility, the
offender shall be required to have his or her own room within
the facility.
(e) The licensed forensic psychologist shall complete the
Identified Offender Report and Recommendation within 14
business days after receiving the Criminal History Report and
shall promptly provide the Identified Offender Report and
Recommendation to the Department of State Police, which shall
provide the Identified Offender Report and Recommendation to
the following:
(1) The facility within which the identified offender
resides.
(2) The Chief of Police of the municipality in which
the facility is located.
(3) The State of Illinois Long Term Care Ombudsman.
(4) The Department of Public Health.
(e-5) The Department of Public Health shall keep a
continuing record of all consumers determined to be identified
offenders as defined in Section 1-114.01 of the Nursing Home
Care Act and shall report the number of identified offender
consumers annually to the General Assembly.
(f) The facility shall incorporate the Identified Offender
Report and Recommendation into the identified offender's care
plan created pursuant to 42 CFR 483.20.
(g) If, based on the Identified Offender Report and
Recommendation, a facility determines that it cannot manage the

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identified offender consumer safely within the facility, it
shall commence involuntary transfer or discharge proceedings
pursuant to Section 3-402.
(h) Except for willful and wanton misconduct, any person
authorized to participate in the development of a Criminal
History Report or Identified Offender Report and
Recommendation is immune from criminal or civil liability for
any acts or omissions as the result of his or her good faith
effort to comply with this Section."; and
on page 19, line 19, after "authorized", by inserting "under
Illinois law"; and
on page 20, line 2, by replacing the period with "to the
Department within 24 hours. Facilities shall comply with
Sections 3-610 and 3-810 of the Nursing Home Care Act. The
provisions under Sections 3-610 and 3-810 of the Nursing Home
Care Act shall apply to employees of facilities licensed under
this Act."; and
on page 20, line 4, by replacing "or crisis stabilization" with
"centers"; and
on page 20, line 13, by replacing "knock" with "reasonably
announce their intent to enter"; and

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on page 20, immediately below line 15, by inserting the
following:
"Consumers shall be free to leave at any time. If a
consumer in a triage center expresses a desire to contact a
third party for any purpose, the facility staff shall contact
that third party on behalf of the consumer."; and
on page 21, line 6, by replacing "or crisis stabilization" with
"centers"; and
on page 22, line 12, after the period, by inserting "The
Department shall by rule establish criteria, hearings, and
procedures for involuntary discharge."; and
on page 23, by inserting immediately below line 7 the
following:
"Section 3-115. Informed consent; restraints. Informed
consent shall be required for restraints consistent with the
requirements contained in subsection (c) of Section 2-106 of
the Nursing Home Care Act.
Section 3-116. Experimental research. No consumer shall be
subjected to experimental research or treatment without first
obtaining his or her informed, written consent. The conduct of
any experimental research or treatment shall be authorized and

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monitored by an institutional review board appointed by the
executive director. The membership, operating procedures and
review criteria for the institutional review board shall be
prescribed under rules and regulations of the Department and
shall comply with the requirements for institutional review
boards established by the federal Food and Drug Administration.
No person who has received compensation in the prior 3 years
from an entity that manufactures, distributes, or sells
pharmaceuticals, biologics, or medical devices may serve on the
institutional review board.
No facility shall permit experimental research or
treatment to be conducted on a consumer, or give access to any
person or person's records for a retrospective study about the
safety or efficacy of any care or treatment, without the prior
written approval of the institutional review board. No
executive director, or person licensed by the State to provide
medical care or treatment to any person, may assist or
participate in any experimental research on or treatment of a
consumer, including a retrospective study, that does not have
the prior written approval of the board. Such conduct shall be
grounds for professional discipline by the Department of
Financial and Professional Regulation.
The institutional review board may exempt from ongoing
review research or treatment initiated on a consumer before the
individual's admission to a facility and for which the board
determines there is adequate ongoing oversight by another

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institutional review board. Nothing in this Section shall
prevent a facility, any facility employee, or any other person
from assisting or participating in any experimental research on
or treatment of a consumer, if the research or treatment began
before the person's admission to a facility, until the board
has reviewed the research or treatment and decided to grant or
deny approval or to exempt the research or treatment from
ongoing review."; and
on page 23, line 15, by replacing "units" with "centers"; and
on page 30, line 12, by replacing "units" with "centers"; and
on page 30, line 24, after "triage", by inserting "centers";
and
on page 31, line 7, after "checks", by inserting ", consistent
with Section 1-114.01, subsections (b) and (c) of Section
2-201.5, and Section 2-201.6 of the Nursing Home Care Act"; and
on page 31, line 16, after "check", by inserting ", consistent
with the Health Care Worker Background Check Act"; and
on page 33, line 14 by inserting after "Act" the following:
"and the rules promulgated under this Act. The Department shall
have access to and may reproduce or photocopy any books,

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records, and other documents maintained by the facility to the
extent necessary to carry out this Act and the rules
promulgated under this Act. The Department shall not divulge or
disclose the contents of a record under this Section as
otherwise prohibited by this Act. Any holder of a license or
applicant for a license shall be deemed to have given consent
to any authorized officer, employee, or agent of the Department
to enter and inspect the facility in accordance with this
Article. Refusal to permit such entry or inspection shall
constitute grounds for denial, suspension, or revocation of a
license under this Act"; and
on page 33, line 15, by deleting "scheduled"; and
on page 33, line 16, by deleting "unscheduled"; and
on page 34, by replacing lines 2 and 3 with the following:
"(a) The Department may revoke a license for any failure to
substantially comply with this Act and the rules promulgated
under this Act, including, but not limited to, the following:";
and
on page 34, line 5, by replacing "or" with "and"; and
on page 35, line 3, by replacing "the standards of this" with
"this Act and the rules promulgated under this Act."; and

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on page 35, by deleting line 4; and
on page 35, line 5, by replacing "the standards" with "this Act
and the rules promulgated under this Act"; and
on page 35, line 8, by replacing "the standards" with "this Act
and the rules promulgated under this Act"; and
on page 35, line 11, by replacing "the standards" with "this
Act and the rules promulgated under this Act"; and
on page 35, lines 15 and 16, by replacing "the standards. The
agency" with "this Act and the rules promulgated under this
Act. The facility"; and
on page 36, line 7, by replacing "Part" with "Act or the rules
promulgated under this Act"; and
on page 36, line 8, by replacing "agency" with "facility"; and
on page 36, line 17, by replacing "Part" with "Act or the rules
promulgated under this Act"; and
on page 36, line 18, by replacing "standards" with "this Act
and the rules promulgated under this Act"; and

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on page 36, line 22, by replacing "agency" with "facility"; and
on page 36, line 23, by replacing "agency" with "facility"; and
on page 37, line 10, by replacing "agency" with "facility"; and
on page 37, line 11, by replacing "agency" with "facility"; and
on page 39, by inserting immediately below line 1 the
following:
"Section 4-111. Notwithstanding the existence or pursuit
of any other remedy, the Director of the Department may, in the
manner provided by law, upon the advice of the Attorney General
who shall represent the Director of the Department in the
proceedings, maintain an action in the name of the State for
injunction or other process against any person or governmental
unit to restrain or prevent the establishment of a facility
without a license issued pursuant to this Act, or to restrain
or prevent the opening, conduction, operating, or maintaining
of a facility without a license issued pursuant to this Act. In
addition, the Director of the Department may, in the manner
provided by law, in the name of the People of the State and
through the Attorney General who shall represent the Director
of the Department in the proceedings, maintain an action for

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injunction or other relief or process against any licensee or
other person to enforce and compel compliance with the
provisions of this Act and the standards, rules, and
regulations established by virtue of this Act and any order
entered for any response action pursuant to this Act and such
standards, rules, and regulations."; and
by deleting lines 7 through 23 of page 490, all of pages 491
through 538, and lines 1 through 20 of page 539; and
on page 539, immediately below line 21, by inserting the
following:
"Section 11-1. The Illinois Public Aid Code is amended by
changing Section 14-8 as follows:
(305 ILCS 5/14-8) (from Ch. 23, par. 14-8)
Sec. 14-8. Disbursements to Hospitals.
(a) For inpatient hospital services rendered on and after
September 1, 1991, the Illinois Department shall reimburse
hospitals for inpatient services at an inpatient payment rate
calculated for each hospital based upon the Medicare
Prospective Payment System as set forth in Sections 1886(b),
(d), (g), and (h) of the federal Social Security Act, and the
regulations, policies, and procedures promulgated thereunder,
except as modified by this Section. Payment rates for inpatient

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hospital services rendered on or after September 1, 1991 and on
or before September 30, 1992 shall be calculated using the
Medicare Prospective Payment rates in effect on September 1,
1991. Payment rates for inpatient hospital services rendered on
or after October 1, 1992 and on or before March 31, 1994 shall
be calculated using the Medicare Prospective Payment rates in
effect on September 1, 1992. Payment rates for inpatient
hospital services rendered on or after April 1, 1994 shall be
calculated using the Medicare Prospective Payment rates
(including the Medicare grouping methodology and weighting
factors as adjusted pursuant to paragraph (1) of this
subsection) in effect 90 days prior to the date of admission.
For services rendered on or after July 1, 1995, the
reimbursement methodology implemented under this subsection
shall not include those costs referred to in Sections
1886(d)(5)(B) and 1886(h) of the Social Security Act. The
additional payment amounts required under Section
1886(d)(5)(F) of the Social Security Act, for hospitals serving
a disproportionate share of low-income or indigent patients,
are not required under this Section. For hospital inpatient
services rendered on or after July 1, 1995, the Illinois
Department shall reimburse hospitals using the relative
weighting factors and the base payment rates calculated for
each hospital that were in effect on June 30, 1995, less the
portion of such rates attributed by the Illinois Department to
the cost of medical education.

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(1) The weighting factors established under Section
1886(d)(4) of the Social Security Act shall not be used in
the reimbursement system established under this Section.
Rather, the Illinois Department shall establish by rule
Medicaid weighting factors to be used in the reimbursement
system established under this Section.
(2) The Illinois Department shall define by rule those
hospitals or distinct parts of hospitals that shall be
exempt from the reimbursement system established under
this Section. In defining such hospitals, the Illinois
Department shall take into consideration those hospitals
exempt from the Medicare Prospective Payment System as of
September 1, 1991. For hospitals defined as exempt under
this subsection, the Illinois Department shall by rule
establish a reimbursement system for payment of inpatient
hospital services rendered on and after September 1, 1991.
For all hospitals that are children's hospitals as defined
in Section 5-5.02 of this Code, the reimbursement
methodology shall, through June 30, 1992, net of all
applicable fees, at least equal each children's hospital
1990 ICARE payment rates, indexed to the current year by
application of the DRI hospital cost index from 1989 to the
year in which payments are made. Excepting county providers
as defined in Article XV of this Code, hospitals licensed
under the University of Illinois Hospital Act, and
facilities operated by the Department of Mental Health and

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Developmental Disabilities (or its successor, the
Department of Human Services) for hospital inpatient
services rendered on or after July 1, 1995, the Illinois
Department shall reimburse children's hospitals, as
defined in 89 Illinois Administrative Code Section
149.50(c)(3), at the rates in effect on June 30, 1995, and
shall reimburse all other hospitals at the rates in effect
on June 30, 1995, less the portion of such rates attributed
by the Illinois Department to the cost of medical
education. For inpatient hospital services provided on or
after August 1, 1998, the Illinois Department may establish
by rule a means of adjusting the rates of children's
hospitals, as defined in 89 Illinois Administrative Code
Section 149.50(c)(3), that did not meet that definition
before February 28, 2013 on June 30, 1995, in order for the
inpatient hospital rates of such hospitals to take into
account the average inpatient hospital rates of those
children's hospitals that did meet the definition of
children's hospitals before February 28, 2013. The
Department shall adopt any emergency rules necessary to
implement this Section on June 30, 1995.
(3) (Blank).
(4) Notwithstanding any other provision of this
Section, hospitals that on August 31, 1991, have a contract
with the Illinois Department under Section 3-4 of the
Illinois Health Finance Reform Act may elect to continue to

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be reimbursed at rates stated in such contracts for general
and specialty care.
(5) In addition to any payments made under this
subsection (a), the Illinois Department shall make the
adjustment payments required by Section 5-5.02 of this
Code; provided, that in the case of any hospital reimbursed
under a per case methodology, the Illinois Department shall
add an amount equal to the product of the hospital's
average length of stay, less one day, multiplied by 20, for
inpatient hospital services rendered on or after September
1, 1991 and on or before September 30, 1992.
(b) (Blank).
(b-5) Excepting county providers as defined in Article XV
of this Code, hospitals licensed under the University of
Illinois Hospital Act, and facilities operated by the Illinois
Department of Mental Health and Developmental Disabilities (or
its successor, the Department of Human Services), for
outpatient services rendered on or after July 1, 1995 and
before July 1, 1998 the Illinois Department shall reimburse
children's hospitals, as defined in the Illinois
Administrative Code Section 149.50(c)(3), at the rates in
effect on June 30, 1995, less that portion of such rates
attributed by the Illinois Department to the outpatient
indigent volume adjustment and shall reimburse all other
hospitals at the rates in effect on June 30, 1995, less the
portions of such rates attributed by the Illinois Department to

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the cost of medical education and attributed by the Illinois
Department to the outpatient indigent volume adjustment. For
outpatient services provided on or after July 1, 1998,
reimbursement rates shall be established by rule.
(c) In addition to any other payments under this Code, the
Illinois Department shall develop a hospital disproportionate
share reimbursement methodology that, effective July 1, 1991,
through September 30, 1992, shall reimburse hospitals
sufficiently to expend the fee monies described in subsection
(b) of Section 14-3 of this Code and the federal matching funds
received by the Illinois Department as a result of expenditures
made by the Illinois Department as required by this subsection
(c) and Section 14-2 that are attributable to fee monies
deposited in the Fund, less amounts applied to adjustment
payments under Section 5-5.02.
(d) Critical Care Access Payments.
(1) In addition to any other payments made under this
Code, the Illinois Department shall develop a
reimbursement methodology that shall reimburse Critical
Care Access Hospitals for the specialized services that
qualify them as Critical Care Access Hospitals. No
adjustment payments shall be made under this subsection on
or after July 1, 1995.
(2) "Critical Care Access Hospitals" includes, but is
not limited to, hospitals that meet at least one of the
following criteria:

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(A) Hospitals located outside of a metropolitan
statistical area that are designated as Level II
Perinatal Centers and that provide a disproportionate
share of perinatal services to recipients; or
(B) Hospitals that are designated as Level I Trauma
Centers (adult or pediatric) and certain Level II
Trauma Centers as determined by the Illinois
Department; or
(C) Hospitals located outside of a metropolitan
statistical area and that provide a disproportionate
share of obstetrical services to recipients.
(e) Inpatient high volume adjustment. For hospital
inpatient services, effective with rate periods beginning on or
after October 1, 1993, in addition to rates paid for inpatient
services by the Illinois Department, the Illinois Department
shall make adjustment payments for inpatient services
furnished by Medicaid high volume hospitals. The Illinois
Department shall establish by rule criteria for qualifying as a
Medicaid high volume hospital and shall establish by rule a
reimbursement methodology for calculating these adjustment
payments to Medicaid high volume hospitals. No adjustment
payment shall be made under this subsection for services
rendered on or after July 1, 1995.
(f) The Illinois Department shall modify its current rules
governing adjustment payments for targeted access, critical
care access, and uncompensated care to classify those

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adjustment payments as not being payments to disproportionate
share hospitals under Title XIX of the federal Social Security
Act. Rules adopted under this subsection shall not be effective
with respect to services rendered on or after July 1, 1995. The
Illinois Department has no obligation to adopt or implement any
rules or make any payments under this subsection for services
rendered on or after July 1, 1995.
(f-5) The State recognizes that adjustment payments to
hospitals providing certain services or incurring certain
costs may be necessary to assure that recipients of medical
assistance have adequate access to necessary medical services.
These adjustments include payments for teaching costs and
uncompensated care, trauma center payments, rehabilitation
hospital payments, perinatal center payments, obstetrical care
payments, targeted access payments, Medicaid high volume
payments, and outpatient indigent volume payments. On or before
April 1, 1995, the Illinois Department shall issue
recommendations regarding (i) reimbursement mechanisms or
adjustment payments to reflect these costs and services,
including methods by which the payments may be calculated and
the method by which the payments may be financed, and (ii)
reimbursement mechanisms or adjustment payments to reflect
costs and services of federally qualified health centers with
respect to recipients of medical assistance.
(g) If one or more hospitals file suit in any court
challenging any part of this Article XIV, payments to hospitals

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under this Article XIV shall be made only to the extent that
sufficient monies are available in the Fund and only to the
extent that any monies in the Fund are not prohibited from
disbursement under any order of the court.
(h) Payments under the disbursement methodology described
in this Section are subject to approval by the federal
government in an appropriate State plan amendment.
(i) The Illinois Department may by rule establish criteria
for and develop methodologies for adjustment payments to
hospitals participating under this Article.
(j) Hospital Residing Long Term Care Services. In addition
to any other payments made under this Code, the Illinois
Department may by rule establish criteria and develop
methodologies for payments to hospitals for Hospital Residing
Long Term Care Services.
(k) Critical Access Hospital outpatient payments. In
addition to any other payments authorized under this Code, the
Illinois Department shall reimburse critical access hospitals,
as designated by the Illinois Department of Public Health in
accordance with 42 CFR 485, Subpart F, for outpatient services
at an amount that is no less than the cost of providing such
services, based on Medicare cost principles. Payments under
this subsection shall be subject to appropriation.
(l) On and after July 1, 2012, the Department shall reduce
any rate of reimbursement for services or other payments or
alter any methodologies authorized by this Code to reduce any

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rate of reimbursement for services or other payments in
accordance with Section 5-5e.
(Source: P.A. 96-1382, eff. 1-1-11; 97-689, eff. 6-14-12;
revised 8-3-12.)"; and
on page 544, line 26, after "research", by inserting "and
education"; and
on page 545, line 17, after "research", by inserting "and
education"; and
on page 548, by deleting lines 8 and 9; and
on page 561, by replacing lines 15 through 16 with "a
municipality prior to September 30, 1998 or (ii) the hospital
has been designated by the State"; and
on page 578, line 24 by replacing "resident" with "residents";
and
on page 582, line 12 by inserting before "Transition" the
following:
"For dates of services beginning January 1, 2014, the RUG-IV
nursing component per diem for a nursing home shall be the
product of the statewide RUG-IV nursing base per diem rate, the
facility average case mix index, and the regional wage

09800SB0026ham004 - 25 - LRB098 05310 KTG 46464 a
adjustor."; and
on page 582, line 15 by replacing "subsection (d-1)" with "this
subsection (e-2)"; and
on page 582, line 25 by replacing "subsection (d-1)" with "this
subsection (e-2)"; and
on page 584, line 21, after "triage" by inserting "center"; and
on page 585, by inserting immediately below line 13 the
following:
"Section 11-45. The Illinois Public Aid Code is amended by
adding Section 5-5.4h as follows:
(305 ILCS 5/5-5.4h new)
Sec. 5-5.4h. Medicaid reimbursement for pediatric skilled
nursing facilities.
(a) Facilities uniquely licensed as pediatric skilled
nursing facilities that serve severely and chronically ill
pediatric patients shall have a specific reimbursement system
designed to recognize the characteristics and needs of the
patients they serve.
(b) For dates of services starting July 1, 2013 and until a
new reimbursement system is designed, pediatric skilled

09800SB0026ham004 - 26 - LRB098 05310 KTG 46464 a
nursing facilities that meet the following criteria:
(1) serve exceptional care patients; and
(2) have 30% or more of their patients receiving
ventilator care;
shall receive Medicaid reimbursement on a 30-day expedited
schedule."; and
on page 596, line 11, by replacing "60" with "75"; and
on page 597, by replacing lines 1 through 3 with the following:
"the portions of the health and life safety survey
associated with federal certification and State licensure
surveys must be started within 7 working days of each
other. Nothing in this paragraph (1) of subsection (f) of
this Section applies to a complaint investigation."; and
on page 597, line 4, after "complaint", by inserting "and
incident report"; and
on page 597, by replacing lines 5 and 6 with the following:
"shall permit the facility to challenge the amount of the fine
due to the excessive length of"; and
on page 597, immediately below line 15, by inserting the
following:

09800SB0026ham004 - 27 - LRB098 05310 KTG 46464 a
"This paragraph (2) does not apply to complaint
investigations exited within 14 working days or a situation
that triggers an extended survey."; and
on page 624, line 8, after "occurred,", by inserting "and the
facility in which the applicant resides is notified,"; and
on page 625, line 5, by replacing "2014" with "2013"; and
on page 625, line 6, by replacing "2015" with "2014".