Bill Text: IL SB3290 | 2009-2010 | 96th General Assembly | Enrolled

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Bill Title: Amends the Alternative Health Care Delivery Act and the Illinois Public Aid Code. Creates the Medical Assistance Dental Reimbursement Revolving Fund, to be held by the Director of the Department of Healthcare and Family Services, outside of the State Treasury. Provides that the Fund shall contain all funds to pay for dental services provided by enrolled dental service providers for services to participants in the medical programs administered by the Department and any interest accrued by the Fund. Eliminates a provision requiring the Department, in cooperation with the Department of Public Health, to develop and implement a reimbursement methodology for all facilities participating in an alternative health care demonstration program. Eliminates a provision requiring the Department to adopt rules governing reimbursement for resident services provided by skilled nursing and intermediate care facilities. Repeals provisions providing that the Department shall tender payments for exceptional care to skilled nursing and intermediate care facilities only. Repeals provisions requiring the Department to submit a report concerning the Healthy Moms/Healthy Kids Program.

Sponsorship: Partisan Bill (Democrat 1)

Status: (Passed) 2010-07-20 - Public Act . . . . . . . . . 96-1123 [SB3290 Detail]

Download: Illinois-2009-SB3290-Enrolled.html

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AN ACT concerning public aid.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Alternative Health Care Delivery Act is
amended by changing Section 30 as follows:
(210 ILCS 3/30)
Sec. 30. Demonstration program requirements. The
requirements set forth in this Section shall apply to
demonstration programs.
(a) There shall be no more than:
(i) 3 subacute care hospital alternative health care
models in the City of Chicago (one of which shall be
located on a designated site and shall have been licensed
as a hospital under the Illinois Hospital Licensing Act
within the 10 years immediately before the application for
a license);
(ii) 2 subacute care hospital alternative health care
models in the demonstration program for each of the
following areas:
(1) Cook County outside the City of Chicago.
(2) DuPage, Kane, Lake, McHenry, and Will
Counties.
(3) Municipalities with a population greater than

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50,000 not located in the areas described in item (i)
of subsection (a) and paragraphs (1) and (2) of item
(ii) of subsection (a); and
(iii) 4 subacute care hospital alternative health care
models in the demonstration program for rural areas.
In selecting among applicants for these licenses in rural
areas, the Health Facilities and Services Review Board and the
Department shall give preference to hospitals that may be
unable for economic reasons to provide continued service to the
community in which they are located unless the hospital were to
receive an alternative health care model license.
(a-5) There shall be no more than the total number of
postsurgical recovery care centers with a certificate of need
for beds as of January 1, 2008.
(a-10) There shall be no more than a total of 9 children's
respite care center alternative health care models in the
demonstration program, which shall be located as follows:
(1) Two in the City of Chicago.
(2) One in Cook County outside the City of Chicago.
(3) A total of 2 in the area comprised of DuPage, Kane,
Lake, McHenry, and Will counties.
(4) A total of 2 in municipalities with a population of
50,000 or more and not located in the areas described in
paragraphs (1), (2), or (3).
(5) A total of 2 in rural areas, as defined by the
Health Facilities and Services Review Board.

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No more than one children's respite care model owned and
operated by a licensed skilled pediatric facility shall be
located in each of the areas designated in this subsection
(a-10).
(a-15) There shall be 2 authorized community-based
residential rehabilitation center alternative health care
models in the demonstration program.
(a-20) There shall be an authorized Alzheimer's disease
management center alternative health care model in the
demonstration program. The Alzheimer's disease management
center shall be located in Will County, owned by a
not-for-profit entity, and endorsed by a resolution approved by
the county board before the effective date of this amendatory
Act of the 91st General Assembly.
(a-25) There shall be no more than 10 birth center
alternative health care models in the demonstration program,
located as follows:
(1) Four in the area comprising Cook, DuPage, Kane,
Lake, McHenry, and Will counties, one of which shall be
owned or operated by a hospital and one of which shall be
owned or operated by a federally qualified health center.
(2) Three in municipalities with a population of 50,000
or more not located in the area described in paragraph (1)
of this subsection, one of which shall be owned or operated
by a hospital and one of which shall be owned or operated
by a federally qualified health center.

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(3) Three in rural areas, one of which shall be owned
or operated by a hospital and one of which shall be owned
or operated by a federally qualified health center.
The first 3 birth centers authorized to operate by the
Department shall be located in or predominantly serve the
residents of a health professional shortage area as determined
by the United States Department of Health and Human Services.
There shall be no more than 2 birth centers authorized to
operate in any single health planning area for obstetric
services as determined under the Illinois Health Facilities
Planning Act. If a birth center is located outside of a health
professional shortage area, (i) the birth center shall be
located in a health planning area with a demonstrated need for
obstetrical service beds, as determined by the Health
Facilities and Services Review Board or (ii) there must be a
reduction in the existing number of obstetrical service beds in
the planning area so that the establishment of the birth center
does not result in an increase in the total number of
obstetrical service beds in the health planning area.
(b) Alternative health care models, other than a model
authorized under subsection (a-10) or subsections (a-10) and
(a-20), shall obtain a certificate of need from the Health
Facilities and Services Review Board under the Illinois Health
Facilities Planning Act before receiving a license by the
Department. If, after obtaining its initial certificate of
need, an alternative health care delivery model that is a

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community based residential rehabilitation center seeks to
increase the bed capacity of that center, it must obtain a
certificate of need from the Health Facilities and Services
Review Board before increasing the bed capacity. Alternative
health care models in medically underserved areas shall receive
priority in obtaining a certificate of need.
(c) An alternative health care model license shall be
issued for a period of one year and shall be annually renewed
if the facility or program is in substantial compliance with
the Department's rules adopted under this Act. A licensed
alternative health care model that continues to be in
substantial compliance after the conclusion of the
demonstration program shall be eligible for annual renewals
unless and until a different licensure program for that type of
health care model is established by legislation, except that a
postsurgical recovery care center meeting the following
requirements may apply within 3 years after August 25, 2009
(the effective date of Public Act 96-669) this amendatory Act
of the 96th General Assembly for a Certificate of Need permit
to operate as a hospital:
(1) The postsurgical recovery care center shall apply
to the Illinois Health Facilities Planning Board for a
Certificate of Need permit to discontinue the postsurgical
recovery care center and to establish a hospital.
(2) If the postsurgical recovery care center obtains a
Certificate of Need permit to operate as a hospital, it

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shall apply for licensure as a hospital under the Hospital
Licensing Act and shall meet all statutory and regulatory
requirements of a hospital.
(3) After obtaining licensure as a hospital, any
license as an ambulatory surgical treatment center and any
license as a post-surgical recovery care center shall be
null and void.
(4) The former postsurgical recovery care center that
receives a hospital license must seek and use its best
efforts to maintain certification under Titles XVIII and
XIX of the federal Social Security Act.
The Department may issue a provisional license to any
alternative health care model that does not substantially
comply with the provisions of this Act and the rules adopted
under this Act if (i) the Department finds that the alternative
health care model has undertaken changes and corrections which
upon completion will render the alternative health care model
in substantial compliance with this Act and rules and (ii) the
health and safety of the patients of the alternative health
care model will be protected during the period for which the
provisional license is issued. The Department shall advise the
licensee of the conditions under which the provisional license
is issued, including the manner in which the alternative health
care model fails to comply with the provisions of this Act and
rules, and the time within which the changes and corrections
necessary for the alternative health care model to

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substantially comply with this Act and rules shall be
completed.
(d) Alternative health care models shall seek
certification under Titles XVIII and XIX of the federal Social
Security Act. In addition, alternative health care models shall
provide charitable care consistent with that provided by
comparable health care providers in the geographic area.
(d-5) (Blank) The Department of Healthcare and Family
Services (formerly Illinois Department of Public Aid), in
cooperation with the Illinois Department of Public Health,
shall develop and implement a reimbursement methodology for all
facilities participating in the demonstration program. The
Department of Healthcare and Family Services shall keep a
record of services provided under the demonstration program to
recipients of medical assistance under the Illinois Public Aid
Code and shall submit an annual report of that information to
the Illinois Department of Public Health.
(e) Alternative health care models shall, to the extent
possible, link and integrate their services with nearby health
care facilities.
(f) Each alternative health care model shall implement a
quality assurance program with measurable benefits and at
reasonable cost.
(Source: P.A. 95-331, eff. 8-21-07; 95-445, eff. 1-1-08; 96-31,
eff. 6-30-09; 96-129, eff. 8-4-09; 96-669, eff. 8-25-09;
96-812, eff. 1-1-10; revised 11-4-09.)

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Section 10. The Illinois Public Aid Code is amended by
changing Sections 5-2 and 5-5.5 and by adding Section 12-8.2 as
follows:
(305 ILCS 5/5-2) (from Ch. 23, par. 5-2)
Sec. 5-2. Classes of Persons Eligible. Medical assistance
under this Article shall be available to any of the following
classes of persons in respect to whom a plan for coverage has
been submitted to the Governor by the Illinois Department and
approved by him:
1. Recipients of basic maintenance grants under
Articles III and IV.
2. Persons otherwise eligible for basic maintenance
under Articles III and IV, excluding any eligibility
requirements that are inconsistent with any federal law or
federal regulation, as interpreted by the U.S. Department
of Health and Human Services, but who fail to qualify
thereunder on the basis of need or who qualify but are not
receiving basic maintenance under Article IV, and who have
insufficient income and resources to meet the costs of
necessary medical care, including but not limited to the
following:
(a) All persons otherwise eligible for basic
maintenance under Article III but who fail to qualify
under that Article on the basis of need and who meet

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either of the following requirements:
(i) their income, as determined by the
Illinois Department in accordance with any federal
requirements, is equal to or less than 70% in
fiscal year 2001, equal to or less than 85% in
fiscal year 2002 and until a date to be determined
by the Department by rule, and equal to or less
than 100% beginning on the date determined by the
Department by rule, of the nonfarm income official
poverty line, as defined by the federal Office of
Management and Budget and revised annually in
accordance with Section 673(2) of the Omnibus
Budget Reconciliation Act of 1981, applicable to
families of the same size; or
(ii) their income, after the deduction of
costs incurred for medical care and for other types
of remedial care, is equal to or less than 70% in
fiscal year 2001, equal to or less than 85% in
fiscal year 2002 and until a date to be determined
by the Department by rule, and equal to or less
than 100% beginning on the date determined by the
Department by rule, of the nonfarm income official
poverty line, as defined in item (i) of this
subparagraph (a).
(b) All persons who, excluding any eligibility
requirements that are inconsistent with any federal

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law or federal regulation, as interpreted by the U.S.
Department of Health and Human Services, would be
determined eligible for such basic maintenance under
Article IV by disregarding the maximum earned income
permitted by federal law.
3. Persons who would otherwise qualify for Aid to the
Medically Indigent under Article VII.
4. Persons not eligible under any of the preceding
paragraphs who fall sick, are injured, or die, not having
sufficient money, property or other resources to meet the
costs of necessary medical care or funeral and burial
expenses.
5.(a) Women during pregnancy, after the fact of
pregnancy has been determined by medical diagnosis, and
during the 60-day period beginning on the last day of the
pregnancy, together with their infants and children born
after September 30, 1983, whose income and resources are
insufficient to meet the costs of necessary medical care to
the maximum extent possible under Title XIX of the Federal
Social Security Act.
(b) The Illinois Department and the Governor shall
provide a plan for coverage of the persons eligible under
paragraph 5(a) by April 1, 1990. Such plan shall provide
ambulatory prenatal care to pregnant women during a
presumptive eligibility period and establish an income
eligibility standard that is equal to 133% of the nonfarm

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income official poverty line, as defined by the federal
Office of Management and Budget and revised annually in
accordance with Section 673(2) of the Omnibus Budget
Reconciliation Act of 1981, applicable to families of the
same size, provided that costs incurred for medical care
are not taken into account in determining such income
eligibility.
(c) The Illinois Department may conduct a
demonstration in at least one county that will provide
medical assistance to pregnant women, together with their
infants and children up to one year of age, where the
income eligibility standard is set up to 185% of the
nonfarm income official poverty line, as defined by the
federal Office of Management and Budget. The Illinois
Department shall seek and obtain necessary authorization
provided under federal law to implement such a
demonstration. Such demonstration may establish resource
standards that are not more restrictive than those
established under Article IV of this Code.
6. Persons under the age of 18 who fail to qualify as
dependent under Article IV and who have insufficient income
and resources to meet the costs of necessary medical care
to the maximum extent permitted under Title XIX of the
Federal Social Security Act.
7. Persons who are under 21 years of age and would
qualify as disabled as defined under the Federal

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Supplemental Security Income Program, provided medical
service for such persons would be eligible for Federal
Financial Participation, and provided the Illinois
Department determines that:
(a) the person requires a level of care provided by
a hospital, skilled nursing facility, or intermediate
care facility, as determined by a physician licensed to
practice medicine in all its branches;
(b) it is appropriate to provide such care outside
of an institution, as determined by a physician
licensed to practice medicine in all its branches;
(c) the estimated amount which would be expended
for care outside the institution is not greater than
the estimated amount which would be expended in an
institution.
8. Persons who become ineligible for basic maintenance
assistance under Article IV of this Code in programs
administered by the Illinois Department due to employment
earnings and persons in assistance units comprised of
adults and children who become ineligible for basic
maintenance assistance under Article VI of this Code due to
employment earnings. The plan for coverage for this class
of persons shall:
(a) extend the medical assistance coverage for up
to 12 months following termination of basic
maintenance assistance; and

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(b) offer persons who have initially received 6
months of the coverage provided in paragraph (a) above,
the option of receiving an additional 6 months of
coverage, subject to the following:
(i) such coverage shall be pursuant to
provisions of the federal Social Security Act;
(ii) such coverage shall include all services
covered while the person was eligible for basic
maintenance assistance;
(iii) no premium shall be charged for such
coverage; and
(iv) such coverage shall be suspended in the
event of a person's failure without good cause to
file in a timely fashion reports required for this
coverage under the Social Security Act and
coverage shall be reinstated upon the filing of
such reports if the person remains otherwise
eligible.
9. Persons with acquired immunodeficiency syndrome
(AIDS) or with AIDS-related conditions with respect to whom
there has been a determination that but for home or
community-based services such individuals would require
the level of care provided in an inpatient hospital,
skilled nursing facility or intermediate care facility the
cost of which is reimbursed under this Article. Assistance
shall be provided to such persons to the maximum extent

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permitted under Title XIX of the Federal Social Security
Act.
10. Participants in the long-term care insurance
partnership program established under the Illinois
Long-Term Care Partnership Program Act who meet the
qualifications for protection of resources described in
Section 15 of that Act.
11. Persons with disabilities who are employed and
eligible for Medicaid, pursuant to Section
1902(a)(10)(A)(ii)(xv) of the Social Security Act, and,
subject to federal approval, persons with a medically
improved disability who are employed and eligible for
Medicaid pursuant to Section 1902(a)(10)(A)(ii)(xvi) of
the Social Security Act, as provided by the Illinois
Department by rule. In establishing eligibility standards
under this paragraph 11, the Department shall, subject to
federal approval:
(a) set the income eligibility standard at not
lower than 350% of the federal poverty level;
(b) exempt retirement accounts that the person
cannot access without penalty before the age of 59 1/2,
and medical savings accounts established pursuant to
26 U.S.C. 220;
(c) allow non-exempt assets up to $25,000 as to
those assets accumulated during periods of eligibility
under this paragraph 11; and

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(d) continue to apply subparagraphs (b) and (c) in
determining the eligibility of the person under this
Article even if the person loses eligibility under this
paragraph 11.
12. Subject to federal approval, persons who are
eligible for medical assistance coverage under applicable
provisions of the federal Social Security Act and the
federal Breast and Cervical Cancer Prevention and
Treatment Act of 2000. Those eligible persons are defined
to include, but not be limited to, the following persons:
(1) persons who have been screened for breast or
cervical cancer under the U.S. Centers for Disease
Control and Prevention Breast and Cervical Cancer
Program established under Title XV of the federal
Public Health Services Act in accordance with the
requirements of Section 1504 of that Act as
administered by the Illinois Department of Public
Health; and
(2) persons whose screenings under the above
program were funded in whole or in part by funds
appropriated to the Illinois Department of Public
Health for breast or cervical cancer screening.
"Medical assistance" under this paragraph 12 shall be
identical to the benefits provided under the State's
approved plan under Title XIX of the Social Security Act.
The Department must request federal approval of the

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coverage under this paragraph 12 within 30 days after the
effective date of this amendatory Act of the 92nd General
Assembly.
13. Subject to appropriation and to federal approval,
persons living with HIV/AIDS who are not otherwise eligible
under this Article and who qualify for services covered
under Section 5-5.04 as provided by the Illinois Department
by rule.
14. Subject to the availability of funds for this
purpose, the Department may provide coverage under this
Article to persons who reside in Illinois who are not
eligible under any of the preceding paragraphs and who meet
the income guidelines of paragraph 2(a) of this Section and
(i) have an application for asylum pending before the
federal Department of Homeland Security or on appeal before
a court of competent jurisdiction and are represented
either by counsel or by an advocate accredited by the
federal Department of Homeland Security and employed by a
not-for-profit organization in regard to that application
or appeal, or (ii) are receiving services through a
federally funded torture treatment center. Medical
coverage under this paragraph 14 may be provided for up to
24 continuous months from the initial eligibility date so
long as an individual continues to satisfy the criteria of
this paragraph 14. If an individual has an appeal pending
regarding an application for asylum before the Department

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of Homeland Security, eligibility under this paragraph 14
may be extended until a final decision is rendered on the
appeal. The Department may adopt rules governing the
implementation of this paragraph 14.
15. Family Care Eligibility.
(a) A caretaker relative who is 19 years of age or
older when countable income is at or below 185% of the
Federal Poverty Level Guidelines, as published
annually in the Federal Register, for the appropriate
family size. A person may not spend down to become
eligible under this paragraph 15.
(b) Eligibility shall be reviewed annually.
(c) Caretaker relatives enrolled under this
paragraph 15 in families with countable income above
150% and at or below 185% of the Federal Poverty Level
Guidelines shall be counted as family members and pay
premiums as established under the Children's Health
Insurance Program Act.
(d) Premiums shall be billed by and payable to the
Department or its authorized agent, on a monthly basis.
(e) The premium due date is the last day of the
month preceding the month of coverage.
(f) Individuals shall have a grace period through
30 days the month of coverage to pay the premium.
(g) Failure to pay the full monthly premium by the
last day of the grace period shall result in

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termination of coverage.
(h) Partial premium payments shall not be
refunded.
(i) Following termination of an individual's
coverage under this paragraph 15, the following action
is required before the individual can be re-enrolled:
(1) A new application must be completed and the
individual must be determined otherwise eligible.
(2) There must be full payment of premiums due
under this Code, the Children's Health Insurance
Program Act, the Covering ALL KIDS Health
Insurance Act, or any other healthcare program
administered by the Department for periods in
which a premium was owed and not paid for the
individual.
(3) The first month's premium must be paid if
there was an unpaid premium on the date the
individual's previous coverage was canceled.
The Department is authorized to implement the
provisions of this amendatory Act of the 95th General
Assembly by adopting the medical assistance rules in effect
as of October 1, 2007, at 89 Ill. Admin. Code 125, and at
89 Ill. Admin. Code 120.32 along with only those changes
necessary to conform to federal Medicaid requirements,
federal laws, and federal regulations, including but not
limited to Section 1931 of the Social Security Act (42

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U.S.C. Sec. 1396u-1), as interpreted by the U.S. Department
of Health and Human Services, and the countable income
eligibility standard authorized by this paragraph 15. The
Department may not otherwise adopt any rule to implement
this increase except as authorized by law, to meet the
eligibility standards authorized by the federal government
in the Medicaid State Plan or the Title XXI Plan, or to
meet an order from the federal government or any court.
16. 15. Subject to appropriation, uninsured persons
who are not otherwise eligible under this Section who have
been certified and referred by the Department of Public
Health as having been screened and found to need diagnostic
evaluation or treatment, or both diagnostic evaluation and
treatment, for prostate or testicular cancer. For the
purposes of this paragraph 16 15, uninsured persons are
those who do not have creditable coverage, as defined under
the Health Insurance Portability and Accountability Act,
or have otherwise exhausted any insurance benefits they may
have had, for prostate or testicular cancer diagnostic
evaluation or treatment, or both diagnostic evaluation and
treatment. To be eligible, a person must furnish a Social
Security number. A person's assets are exempt from
consideration in determining eligibility under this
paragraph 16 15. Such persons shall be eligible for medical
assistance under this paragraph 16 15 for so long as they
need treatment for the cancer. A person shall be considered

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to need treatment if, in the opinion of the person's
treating physician, the person requires therapy directed
toward cure or palliation of prostate or testicular cancer,
including recurrent metastatic cancer that is a known or
presumed complication of prostate or testicular cancer and
complications resulting from the treatment modalities
themselves. Persons who require only routine monitoring
services are not considered to need treatment. "Medical
assistance" under this paragraph 16 15 shall be identical
to the benefits provided under the State's approved plan
under Title XIX of the Social Security Act. Notwithstanding
any other provision of law, the Department (i) does not
have a claim against the estate of a deceased recipient of
services under this paragraph 16 15 and (ii) does not have
a lien against any homestead property or other legal or
equitable real property interest owned by a recipient of
services under this paragraph 16 15.
In implementing the provisions of Public Act 96-20 this
amendatory Act of the 96th General Assembly, the Department is
authorized to adopt only those rules necessary, including
emergency rules. Nothing in Public Act 96-20 this amendatory
Act of the 96th General Assembly permits the Department to
adopt rules or issue a decision that expands eligibility for
the FamilyCare Program to a person whose income exceeds 185% of
the Federal Poverty Level as determined from time to time by
the U.S. Department of Health and Human Services, unless the

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Department is provided with express statutory authority.
The Illinois Department and the Governor shall provide a
plan for coverage of the persons eligible under paragraph 7 as
soon as possible after July 1, 1984.
The eligibility of any such person for medical assistance
under this Article is not affected by the payment of any grant
under the Senior Citizens and Disabled Persons Property Tax
Relief and Pharmaceutical Assistance Act or any distributions
or items of income described under subparagraph (X) of
paragraph (2) of subsection (a) of Section 203 of the Illinois
Income Tax Act. The Department shall by rule establish the
amounts of assets to be disregarded in determining eligibility
for medical assistance, which shall at a minimum equal the
amounts to be disregarded under the Federal Supplemental
Security Income Program. The amount of assets of a single
person to be disregarded shall not be less than $2,000, and the
amount of assets of a married couple to be disregarded shall
not be less than $3,000.
To the extent permitted under federal law, any person found
guilty of a second violation of Article VIIIA shall be
ineligible for medical assistance under this Article, as
provided in Section 8A-8.
The eligibility of any person for medical assistance under
this Article shall not be affected by the receipt by the person
of donations or benefits from fundraisers held for the person
in cases of serious illness, as long as neither the person nor

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members of the person's family have actual control over the
donations or benefits or the disbursement of the donations or
benefits.
(Source: P.A. 95-546, eff. 8-29-07; 95-1055, eff. 4-10-09;
96-20, eff. 6-30-09; 96-181, eff. 8-10-09; 96-328, eff.
8-11-09; 96-567, eff. 1-1-10; revised 9-25-09.)
(305 ILCS 5/5-5.5) (from Ch. 23, par. 5-5.5)
Sec. 5-5.5. Elements of Payment Rate.
(a) The Department of Healthcare and Family Services shall
develop a prospective method for determining payment rates for
skilled nursing and intermediate care services in nursing
facilities composed of the following cost elements:
(1) Standard Services, with the cost of this component
being determined by taking into account the actual costs to
the facilities of these services subject to cost ceilings
to be defined in the Department's rules.
(2) Resident Services, with the cost of this component
being determined by taking into account the actual costs,
needs and utilization of these services, as derived from an
assessment of the resident needs in the nursing facilities.
The Department shall adopt rules governing reimbursement
for resident services as listed in Section 5-1.1. Surveys
or assessments of resident needs under this Section shall
include a review by the facility of the results of such
assessments and a discussion of issues in dispute with

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authorized survey staff, unless the facility elects not to
participate in such a review process. Surveys or
assessments of resident needs under this Section may be
conducted semi-annually and payment rates relating to
resident services may be changed on a semi-annual basis.
The Illinois Department shall initiate a project, either on
a pilot basis or Statewide, to reimburse the cost of
resident services based on a methodology which utilizes an
assessment of resident needs to determine the level of
reimbursement. This methodology shall be different from
the payment criteria for resident services utilized by the
Illinois Department on July 1, 1981. On March 1, 1982, and
each year thereafter, until such time when the Illinois
Department adopts the methodology used in such project for
use statewide, the Illinois Department shall report to the
General Assembly on the implementation and progress of such
project. The report shall include:
(A) A statement of the Illinois Department's goals
and objectives for such project;
(B) A description of such project, including the
number and type of nursing facilities involved in the
project;
(C) A description of the methodology used in such
project;
(D) A description of the Illinois Department's
application of the methodology;

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(E) A statement on the methodology's effect on the
quality of care given to residents in the sample
nursing facilities; and
(F) A statement on the cost of the methodology used
in such project and a comparison of this cost with the
cost of the current payment criteria.
(3) Ancillary Services, with the payment rate being
developed for each individual type of service. Payment
shall be made only when authorized under procedures
developed by the Department of Healthcare and Family
Services.
(4) Nurse's Aide Training, with the cost of this
component being determined by taking into account the
actual cost to the facilities of such training.
(5) Real Estate Taxes, with the cost of this component
being determined by taking into account the figures
contained in the most currently available cost reports
(with no imposition of maximums) updated to the midpoint of
the current rate year for long term care services rendered
between July 1, 1984 and June 30, 1985, and with the cost
of this component being determined by taking into account
the actual 1983 taxes for which the nursing homes were
assessed (with no imposition of maximums) updated to the
midpoint of the current rate year for long term care
services rendered between July 1, 1985 and June 30, 1986.
(b) In developing a prospective method for determining

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payment rates for skilled nursing and intermediate care
services in nursing facilities, the Department of Healthcare
and Family Services shall consider the following cost elements:
(1) Reasonable capital cost determined by utilizing
incurred interest rate and the current value of the
investment, including land, utilizing composite rates, or
by utilizing such other reasonable cost related methods
determined by the Department. However, beginning with the
rate reimbursement period effective July 1, 1987, the
Department shall be prohibited from establishing,
including, and implementing any depreciation factor in
calculating the capital cost element.
(2) Profit, with the actual amount being produced and
accruing to the providers in the form of a return on their
total investment, on the basis of their ability to
economically and efficiently deliver a type of service. The
method of payment may assure the opportunity for a profit,
but shall not guarantee or establish a specific amount as a
cost.
(c) The Illinois Department may implement the amendatory
changes to this Section made by this amendatory Act of 1991
through the use of emergency rules in accordance with the
provisions of Section 5.02 of the Illinois Administrative
Procedure Act. For purposes of the Illinois Administrative
Procedure Act, the adoption of rules to implement the
amendatory changes to this Section made by this amendatory Act

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of 1991 shall be deemed an emergency and necessary for the
public interest, safety and welfare.
(d) No later than January 1, 2001, the Department of Public
Aid shall file with the Joint Committee on Administrative
Rules, pursuant to the Illinois Administrative Procedure Act, a
proposed rule, or a proposed amendment to an existing rule,
regarding payment for appropriate services, including
assessment, care planning, discharge planning, and treatment
provided by nursing facilities to residents who have a serious
mental illness.
(Source: P.A. 95-331, eff. 8-21-07.)
(305 ILCS 5/12-8.2 new)
Sec. 12-8.2. Medical Assistance Dental Reimbursement
Revolving Fund. There is created a revolving fund to be known
as the Medical Assistance Dental Reimbursement Revolving Fund,
to be held by the Director of the Department of Healthcare and
Family Services, outside of the State treasury, for the
following purposes:
(1) The deposit of all funds to pay for dental services
provided by enrolled dental service providers for services
to participants in the medical programs administered by the
Department.
(2) The deposit of any interest accrued by the
revolving fund, which interest shall be available to pay
for dental services provided by enrolled dental service

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providers for services to participants in the medical
programs administered by the Department.
(3) The payment of amounts to enrolled dental service
providers for dental services provided to participants in
the medical programs administered by the Department.
(305 ILCS 5/5-5.8a rep.)
(305 ILCS 5/5-22 rep.)
Section 15. The Illinois Public Aid Code is amended by
repealing Sections 5-5.8a and 5-22.