Bill Text: IL HB0240 | 2021-2022 | 102nd General Assembly | Enrolled

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

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Bill Title: Amends the Hospital Licensing Act. Provides that, on and after January 1, 2023, "hospital" includes rural emergency hospitals, as defined under specified federal provisions. Allows the Department of Public Health to adopt emergency rules and makes a conforming change in the Illinois Administrative Procedure Act. Amends the Illinois Health Facilities Planning Act. Provides that any party that has previously received approval by the Health Facilities and Services Review Board to re-establish a previously discontinued general acute care hospital in accordance with a specified provision of the Act shall have the automatic right to extend the project completion date listed by the party in the party's certificate of exemption application by providing notice to the Board of the new project completion date. Amends the Nursing Home Care Act. Provides that beginning January 1, 2025, monetary penalties shall be imposed on facilities subject to the Act for non-compliance with certain staffing ratio requirements. Amends the Behavior Analyst Licensing Act. Provides that a person qualifies to be licensed as a behavior analyst or an assistant behavior analyst if that person is a graduate of a graduate level program in the field of behavior analysis or a related field with an equivalent course of study in behavior analysis (rather than just the field of behavior analysis). Provides that notwithstanding the provisions providing that the Act does not prohibit an individual from implementing a behavior analytic treatment plan under the extended authority, direction, and supervision of a licensed behavior analyst or licensed assistant behavior analyst, no business organization shall provide, attempt to provide, or offer to provide behavior analysis services unless every individual who holds an ownership interest holds a currently valid licensed issued under the Act. Amends the Podiatric Medical Practice Act of 1987. Provides a one-time fee waiver for Fiscal Year 2023. Provides that no individual may benefit from such waiver more than once. Provides that if an individual has already paid a fee for Fiscal Year 2023, then the Department of Financial and Professional Regulation shall apply the moneys to the next required fee. Amends the Specialized Mental Health Rehabilitation Act of 2013. Excludes from the definition of "consumer" individuals who are subject to a court order requiring placement in secure inpatient care in the custody of the Department of Human Services. Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that by December 31, 2022, the Department Healthcare and Family Services shall obtain appropriate documentation from Qualifying Ground Ambulance Service Providers to ascertain an accurate count of the number of licensed vehicles available to serve enrollees in the State's medical assistance programs. Provides that by February 28, 2023, Qualifying Ground Ambulance Service Providers shall be initially notified of their eligible award. Provides that after March 31, 2024, any unobligated funds shall be reallocated pro rata to the remaining Qualifying Ground Ambulance Service Providers that are able to prove up eligible expenses in excess of their initial award amount until all such appropriated funds are exhausted. Makes changes in a provision on funds awarded for a COVID-19 response support initiative. Makes changes concerning the Medicaid Access Adjustment for nursing facilities. Amends the Long-Term Care Provider Funding Article of the Illinois Public Aid Code. Provides that, subject to federal approval, a $7 occupied bed day assessment shall be imposed on any nursing facility owned and operated by a county government. Amends the Rebuild Illinois Mental Health Workforce Act. In provisions concerning Medicaid funding for community mental health services, provides that, subject to federal approval, a one-time directed payment must be made in calendar year 2023 for community mental health services provided by community mental health providers. Requires the one-time directed payment to be for an amount appropriated for these purposes and to be for services for Integrated Assessment and Treatment Planning and other intensive services, including, but not limited to, services for Mobile Crisis Response, crisis intervention, medication monitoring, and group services. Provides that no base Medicaid rate payment or any other payment for the provision of Medicaid community mental health services in place on January 1, 2023 shall be diminished or changed to make the required reimbursement changes required under the Act. Amends the Code of Criminal Procedure of 1963. Contains provisions concerning court orders for inpatient treatment for defendants with a mental disability. Effective immediately.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Passed) 2023-01-18 - Public Act . . . . . . . . . 102-1118 [HB0240 Detail]

Download: Illinois-2021-HB0240-Enrolled.html

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AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 1. The Illinois Administrative Procedure Act is
amended by adding Section 5-45.35 as follows:
(5 ILCS 100/5-45.35 new)
Sec. 5-45.35. Emergency rulemaking; rural emergency
hospitals. To provide for the expeditious and timely
implementation of this amendatory Act of the 102nd General
Assembly, emergency rules implementing the inclusion of rural
emergency hospitals in the definition of "hospital" in Section
3 of the Hospital Licensing Act may be adopted in accordance
with Section 5-45 by the Department of Public Health. The
adoption of emergency rules authorized by Section 5-45 and
this Section is deemed to be necessary for the public
interest, safety, and welfare.
This Section is repealed one year after the effective date
of this amendatory Act of the 102nd General Assembly.
Section 5. The Illinois Health Facilities Planning Act is
amended by adding Section 8.9a as follows:
(20 ILCS 3960/8.9a new)

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Sec. 8.9a. Extension of project completion date. Any party
that has previously received approval by the State Board to
re-establish a previously discontinued general acute care
hospital in accordance with Section 8.9 of this Act shall have
the automatic right to extend the project completion date
listed by the party in the party's certificate of exemption
application by providing notice to the State Board of the new
project completion date.
Section 10. The Nursing Home Care Act is amended by
changing Section 3-202.05 as follows:
(210 ILCS 45/3-202.05)
Sec. 3-202.05. Staffing ratios effective July 1, 2010 and
thereafter.
(a) For the purpose of computing staff to resident ratios,
direct care staff shall include:
(1) registered nurses;
(2) licensed practical nurses;
(3) certified nurse assistants;
(4) psychiatric services rehabilitation aides;
(5) rehabilitation and therapy aides;
(6) psychiatric services rehabilitation coordinators;
(7) assistant directors of nursing;
(8) 50% of the Director of Nurses' time; and
(9) 30% of the Social Services Directors' time.

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The Department shall, by rule, allow certain facilities
subject to 77 Ill. Adm. Admin. Code 300.4000 and following
(Subpart S) to utilize specialized clinical staff, as defined
in rules, to count towards the staffing ratios.
Within 120 days of June 14, 2012 (the effective date of
Public Act 97-689) this amendatory Act of the 97th General
Assembly, the Department shall promulgate rules specific to
the staffing requirements for facilities federally defined as
Institutions for Mental Disease. These rules shall recognize
the unique nature of individuals with chronic mental health
conditions, shall include minimum requirements for specialized
clinical staff, including clinical social workers,
psychiatrists, psychologists, and direct care staff set forth
in paragraphs (4) through (6) and any other specialized staff
which may be utilized and deemed necessary to count toward
staffing ratios.
Within 120 days of June 14, 2012 (the effective date of
Public Act 97-689) this amendatory Act of the 97th General
Assembly, the Department shall promulgate rules specific to
the staffing requirements for facilities licensed under the
Specialized Mental Health Rehabilitation Act of 2013. These
rules shall recognize the unique nature of individuals with
chronic mental health conditions, shall include minimum
requirements for specialized clinical staff, including
clinical social workers, psychiatrists, psychologists, and
direct care staff set forth in paragraphs (4) through (6) and

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any other specialized staff which may be utilized and deemed
necessary to count toward staffing ratios.
(b) (Blank).
(b-5) For purposes of the minimum staffing ratios in this
Section, all residents shall be classified as requiring either
skilled care or intermediate care.
As used in this subsection:
"Intermediate care" means basic nursing care and other
restorative services under periodic medical direction.
"Skilled care" means skilled nursing care, continuous
skilled nursing observations, restorative nursing, and other
services under professional direction with frequent medical
supervision.
(c) Facilities shall notify the Department within 60 days
after July 29, 2010 (the effective date of Public Act 96-1372)
this amendatory Act of the 96th General Assembly, in a form and
manner prescribed by the Department, of the staffing ratios in
effect on July 29, 2010 (the effective date of Public Act
96-1372) this amendatory Act of the 96th General Assembly for
both intermediate and skilled care and the number of residents
receiving each level of care.
(d)(1) (Blank).
(2) (Blank).
(3) (Blank).
(4) (Blank).
(5) Effective January 1, 2014, the minimum staffing ratios

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shall be increased to 3.8 hours of nursing and personal care
each day for a resident needing skilled care and 2.5 hours of
nursing and personal care each day for a resident needing
intermediate care.
(e) Ninety days after June 14, 2012 (the effective date of
Public Act 97-689) this amendatory Act of the 97th General
Assembly, a minimum of 25% of nursing and personal care time
shall be provided by licensed nurses, with at least 10% of
nursing and personal care time provided by registered nurses.
These minimum requirements shall remain in effect until an
acuity based registered nurse requirement is promulgated by
rule concurrent with the adoption of the Resource Utilization
Group classification-based payment methodology, as provided in
Section 5-5.2 of the Illinois Public Aid Code. Registered
nurses and licensed practical nurses employed by a facility in
excess of these requirements may be used to satisfy the
remaining 75% of the nursing and personal care time
requirements. Notwithstanding this subsection, no staffing
requirement in statute in effect on June 14, 2012 (the
effective date of Public Act 97-689) this amendatory Act of
the 97th General Assembly shall be reduced on account of this
subsection.
(f) The Department shall submit proposed rules for
adoption by January 1, 2020 establishing a system for
determining compliance with minimum staffing set forth in this
Section and the requirements of 77 Ill. Adm. Code 300.1230

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adjusted for any waivers granted under Section 3-303.1.
Compliance shall be determined quarterly by comparing the
number of hours provided per resident per day using the
Centers for Medicare and Medicaid Services' payroll-based
journal and the facility's daily census, broken down by
intermediate and skilled care as self-reported by the facility
to the Department on a quarterly basis. The Department shall
use the quarterly payroll-based journal and the self-reported
census to calculate the number of hours provided per resident
per day and compare this ratio to the minimum staffing
standards required under this Section, as impacted by any
waivers granted under Section 3-303.1. Discrepancies between
job titles contained in this Section and the payroll-based
journal shall be addressed by rule. The manner in which the
Department requests payroll-based journal information to be
submitted shall align with the federal Centers for Medicare
and Medicaid Services' requirements that allow providers to
submit the quarterly data in an aggregate manner.
(g) Monetary penalties for non-compliance. The Department
shall submit proposed rules for adoption by January 1, 2020
establishing monetary penalties for facilities not in
compliance with minimum staffing standards under this Section.
Facilities shall be required to comply with the provisions of
this subsection beginning January 1, 2025. No monetary penalty
may be issued for noncompliance prior to during the revised
implementation date period, which shall be January 1, 2025

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July 1, 2020 through December 31, 2021. If a facility is found
to be noncompliant prior to during the revised implementation
date period, the Department shall provide a written notice
identifying the staffing deficiencies and require the facility
to provide a sufficiently detailed correction plan that
describes proposed and completed actions the facility will
take or has taken, including hiring actions, to address the
facility's failure to meet the statutory minimum staffing
levels. Monetary penalties shall be imposed beginning no later
than July 1, 2025, based on data for the quarter beginning
January 1, 2025 through March 31, 2025 January 1, 2022 and
quarterly thereafter and shall be based on the latest quarter
for which the Department has data. Monetary penalties shall be
established based on a formula that calculates on a daily
basis the cost of wages and benefits for the missing staffing
hours. All notices of noncompliance shall include the
computations used to determine noncompliance and establishing
the variance between minimum staffing ratios and the
Department's computations. The penalty for the first offense
shall be 125% of the cost of wages and benefits for the missing
staffing hours. The penalty shall increase to 150% of the cost
of wages and benefits for the missing staffing hours for the
second offense and 200% the cost of wages and benefits for the
missing staffing hours for the third and all subsequent
offenses. The penalty shall be imposed regardless of whether
the facility has committed other violations of this Act during

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the same period that the staffing offense occurred. The
penalty may not be waived, but the Department shall have the
discretion to determine the gravity of the violation in
situations where there is no more than a 10% deviation from the
staffing requirements and make appropriate adjustments to the
penalty. The Department is granted discretion to waive the
penalty when unforeseen circumstances have occurred that
resulted in call-offs of scheduled staff. This provision shall
be applied no more than 6 times per quarter. Nothing in this
Section diminishes a facility's right to appeal the imposition
of a monetary penalty. No facility may appeal a notice of
noncompliance issued during the revised implementation period.
(Source: P.A. 101-10, eff. 6-5-19; 102-16, eff. 6-17-21;
revised 2-28-22.)
Section 15. The Specialized Mental Health Rehabilitation
Act of 2013 is amended by changing Section 1-102 as follows:
(210 ILCS 49/1-102)
Sec. 1-102. Definitions. For the purposes of this Act,
unless the context otherwise requires:
"Abuse" means any physical or mental injury or sexual
assault inflicted on a consumer other than by accidental means
in a facility.
"Accreditation" means any of the following:
(1) the Joint Commission;

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(2) the Commission on Accreditation of Rehabilitation
Facilities;
(3) the Healthcare Facilities Accreditation Program;
or
(4) any other national standards of care as approved
by the Department.
"APRN" means an Advanced Practice Registered Nurse,
nationally certified as a mental health or psychiatric nurse
practitioner and licensed under the Nurse Practice Act.
"Applicant" means any person making application for a
license or a provisional license under this Act.
"Consumer" means a person, 18 years of age or older,
admitted to a mental health rehabilitation facility for
evaluation, observation, diagnosis, treatment, stabilization,
recovery, and rehabilitation.
"Consumer" does not mean any of the following:
(i) an individual requiring a locked setting;
(ii) an individual requiring psychiatric
hospitalization because of an acute psychiatric crisis;
(iii) an individual under 18 years of age;
(iv) an individual who is actively suicidal or violent
toward others;
(v) an individual who has been found unfit to stand
trial and is currently subject to a court order requiring
placement in secure inpatient care in the custody of the
Department of Human Services pursuant to Section 104-17 of

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the Code of Criminal Procedure of 1963;
(vi) an individual who has been found not guilty by
reason of insanity and is currently subject to a court
order requiring placement in secure inpatient care in the
custody of the Department of Human Services pursuant to
Section 5-2-4 of the Unified Code of Corrections based on
committing a violent act, such as sexual assault, assault
with a deadly weapon, arson, or murder;
(vii) an individual subject to temporary detention and
examination under Section 3-607 of the Mental Health and
Developmental Disabilities Code;
(viii) an individual deemed clinically appropriate for
inpatient admission in a State psychiatric hospital; and
(ix) an individual transferred by the Department of
Corrections pursuant to Section 3-8-5 of the Unified Code
of Corrections.
"Consumer record" means a record that organizes all
information on the care, treatment, and rehabilitation
services rendered to a consumer in a specialized mental health
rehabilitation facility.
"Controlled drugs" means those drugs covered under the
federal Comprehensive Drug Abuse Prevention Control Act of
1970, as amended, or the Illinois Controlled Substances Act.
"Department" means the Department of Public Health.
"Discharge" means the full release of any consumer from a
facility.

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"Drug administration" means the act in which a single dose
of a prescribed drug or biological is given to a consumer. The
complete act of administration entails removing an individual
dose from a container, verifying the dose with the
prescriber's orders, giving the individual dose to the
consumer, and promptly recording the time and dose given.
"Drug dispensing" means the act entailing the following of
a prescription order for a drug or biological and proper
selection, measuring, packaging, labeling, and issuance of the
drug or biological to a consumer.
"Emergency" means a situation, physical condition, or one
or more practices, methods, or operations which present
imminent danger of death or serious physical or mental harm to
consumers of a facility.
"Facility" means a specialized mental health
rehabilitation facility that provides at least one of the
following services: (1) triage center; (2) crisis
stabilization; (3) recovery and rehabilitation supports; or
(4) transitional living units for 3 or more persons. The
facility shall provide a 24-hour program that provides
intensive support and recovery services designed to assist
persons, 18 years or older, with mental disorders to develop
the skills to become self-sufficient and capable of increasing
levels of independent functioning. It includes facilities that
meet the following criteria:
(1) 100% of the consumer population of the facility

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has a diagnosis of serious mental illness;
(2) no more than 15% of the consumer population of the
facility is 65 years of age or older;
(3) none of the consumers are non-ambulatory;
(4) none of the consumers have a primary diagnosis of
moderate, severe, or profound intellectual disability; and
(5) the facility must have been licensed under the
Specialized Mental Health Rehabilitation Act or the
Nursing Home Care Act immediately preceding July 22, 2013
(the effective date of this Act) and qualifies as an
institute for mental disease under the federal definition
of the term.
"Facility" does not include the following:
(1) a home, institution, or place operated by the
federal government or agency thereof, or by the State of
Illinois;
(2) a hospital, sanitarium, or other institution whose
principal activity or business is the diagnosis, care, and
treatment of human illness through the maintenance and
operation as organized facilities therefor which is
required to be licensed under the Hospital Licensing Act;
(3) a facility for child care as defined in the Child
Care Act of 1969;
(4) a community living facility as defined in the
Community Living Facilities Licensing Act;
(5) a nursing home or sanitarium sanatorium operated

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solely by and for persons who rely exclusively upon
treatment by spiritual means through prayer, in accordance
with the creed or tenets of any well-recognized church or
religious denomination; however, such nursing home or
sanitarium sanatorium shall comply with all local laws and
rules relating to sanitation and safety;
(6) a facility licensed by the Department of Human
Services as a community-integrated living arrangement as
defined in the Community-Integrated Living Arrangements
Licensure and Certification Act;
(7) a supportive residence licensed under the
Supportive Residences Licensing Act;
(8) a supportive living facility in good standing with
the program established under Section 5-5.01a of the
Illinois Public Aid Code, except only for purposes of the
employment of persons in accordance with Section 3-206.01
of the Nursing Home Care Act;
(9) an assisted living or shared housing establishment
licensed under the Assisted Living and Shared Housing Act,
except only for purposes of the employment of persons in
accordance with Section 3-206.01 of the Nursing Home Care
Act;
(10) an Alzheimer's disease management center
alternative health care model licensed under the
Alternative Health Care Delivery Act;
(11) a home, institution, or other place operated by

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or under the authority of the Illinois Department of
Veterans' Affairs;
(12) a facility licensed under the ID/DD Community
Care Act;
(13) a facility licensed under the Nursing Home Care
Act after July 22, 2013 (the effective date of this Act);
or
(14) a facility licensed under the MC/DD Act.
"Executive director" means a person who is charged with
the general administration and supervision of a facility
licensed under this Act and who is a licensed nursing home
administrator, licensed practitioner of the healing arts, or
qualified mental health professional.
"Guardian" means a person appointed as a guardian of the
person or guardian of the estate, or both, of a consumer under
the Probate Act of 1975.
"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, 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,

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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.
"Transitional living units" are residential units within a
facility that have the purpose of assisting the consumer in
developing and reinforcing the necessary skills to live
independently outside of the facility. The duration of stay in
such a setting shall not exceed 120 days for each consumer.
Nothing in this definition shall be construed to be a
prerequisite for transitioning out of a facility.
"Licensee" means the person, persons, firm, partnership,
association, organization, company, corporation, or business
trust to which a license has been issued.
"Misappropriation of a consumer's property" means the
deliberate misplacement, exploitation, or wrongful temporary

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or permanent use of a consumer's belongings or money without
the consent of a consumer or his or her guardian.
"Neglect" means a facility's failure to provide, or
willful withholding of, adequate medical care, mental health
treatment, psychiatric rehabilitation, personal care, or
assistance that is necessary to avoid physical harm and mental
anguish of a consumer.
"Personal care" means assistance with meals, dressing,
movement, bathing, or other personal needs, maintenance, or
general supervision and oversight of the physical and mental
well-being of an individual who is incapable of maintaining a
private, independent residence or who is incapable of managing
his or her person, whether or not a guardian has been appointed
for such individual. "Personal care" shall not be construed to
confine or otherwise constrain a facility's pursuit to develop
the skills and abilities of a consumer to become
self-sufficient and capable of increasing levels of
independent functioning.
"Recovery and rehabilitation supports" means a program
that facilitates a consumer's longer-term symptom management
and stabilization while preparing the consumer for
transitional living units by improving living skills and
community socialization. The duration of stay in such a
setting shall be established by the Department by rule.
"Restraint" means:
(i) a physical restraint that is any manual method or

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physical or mechanical device, material, or equipment
attached or adjacent to a consumer's body that the
consumer cannot remove easily and restricts freedom of
movement or normal access to one's body; devices used for
positioning, including, but not limited to, bed rails,
gait belts, and cushions, shall not be considered to be
restraints for purposes of this Section; or
(ii) a chemical restraint that is any drug used for
discipline or convenience and not required to treat
medical symptoms; the Department shall, by rule, designate
certain devices as restraints, including at least all
those devices that have been determined to be restraints
by the United States Department of Health and Human
Services in interpretive guidelines issued for the
purposes of administering Titles XVIII and XIX of the
federal Social Security Act. For the purposes of this Act,
restraint shall be administered only after utilizing a
coercive free environment and culture.
"Self-administration of medication" means consumers shall
be responsible for the control, management, and use of their
own medication.
"Crisis stabilization" means a secure and separate unit
that provides short-term behavioral, emotional, or psychiatric
crisis stabilization as an alternative to hospitalization or
re-hospitalization for consumers from residential or community
placement. The duration of stay in such a setting shall not

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exceed 21 days for each consumer.
"Therapeutic separation" means the removal of a consumer
from the milieu to a room or area which is designed to aid in
the emotional or psychiatric stabilization of that consumer.
"Triage center" means a non-residential 23-hour center
that serves as an alternative to emergency room care,
hospitalization, or re-hospitalization for consumers in need
of short-term crisis stabilization. Consumers may access a
triage center from a number of referral sources, including
family, emergency rooms, hospitals, community behavioral
health providers, federally qualified health providers, or
schools, including colleges or universities. A triage center
may be located in a building separate from the licensed
location of a facility, but shall not be more than 1,000 feet
from the licensed location of the facility and must meet all of
the facility standards applicable to the licensed location. If
the triage center does operate in a separate building, safety
personnel shall be provided, on site, 24 hours per day and the
triage center shall meet all other staffing requirements
without counting any staff employed in the main facility
building.
(Source: P.A. 102-1053, eff. 6-10-22; revised 8-24-22.)
Section 20. The Hospital Licensing Act is amended by
changing Section 3 as follows:

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(210 ILCS 85/3)
Sec. 3. As used in this Act:
(A) "Hospital" means any institution, place, building,
buildings on a campus, or agency, public or private, whether
organized for profit or not, devoted primarily to the
maintenance and operation of facilities for the diagnosis and
treatment or care of 2 or more unrelated persons admitted for
overnight stay or longer in order to obtain medical, including
obstetric, psychiatric and nursing, care of illness, disease,
injury, infirmity, or deformity.
The term "hospital", without regard to length of stay,
shall also include:
(a) any facility which is devoted primarily to
providing psychiatric and related services and programs
for the diagnosis and treatment or care of 2 or more
unrelated persons suffering from emotional or nervous
diseases;
(b) all places where pregnant females are received,
cared for, or treated during delivery irrespective of the
number of patients received; and .
(c) on and after January 1, 2023, a rural emergency
hospital, as that term is defined under subsection
(kkk)(2) of Section 1861 of the federal Social Security
Act; to provide for the expeditious and timely
implementation of this amendatory Act of the 102nd General
Assembly, emergency rules to implement the changes made to

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the definition of "hospital" by this amendatory Act of the
102nd General Assembly may be adopted by the Department
subject to the provisions of Section 5-45 of the Illinois
Administrative Procedure Act.
The term "hospital" includes general and specialized
hospitals, tuberculosis sanitaria, mental or psychiatric
hospitals and sanitaria, and includes maternity homes,
lying-in homes, and homes for unwed mothers in which care is
given during delivery.
The term "hospital" does not include:
(1) any person or institution required to be licensed
pursuant to the Nursing Home Care Act, the Specialized
Mental Health Rehabilitation Act of 2013, the ID/DD
Community Care Act, or the MC/DD Act;
(2) hospitalization or care facilities maintained by
the State or any department or agency thereof, where such
department or agency has authority under law to establish
and enforce standards for the hospitalization or care
facilities under its management and control;
(3) hospitalization or care facilities maintained by
the federal government or agencies thereof;
(4) hospitalization or care facilities maintained by
any university or college established under the laws of
this State and supported principally by public funds
raised by taxation;
(5) any person or facility required to be licensed

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pursuant to the Substance Use Disorder Act;
(6) any facility operated solely by and for persons
who rely exclusively upon treatment by spiritual means
through prayer, in accordance with the creed or tenets of
any well-recognized church or religious denomination;
(7) an Alzheimer's disease management center
alternative health care model licensed under the
Alternative Health Care Delivery Act; or
(8) any veterinary hospital or clinic operated by a
veterinarian or veterinarians licensed under the
Veterinary Medicine and Surgery Practice Act of 2004 or
maintained by a State-supported or publicly funded
university or college.
(B) "Person" means the State, and any political
subdivision or municipal corporation, individual, firm,
partnership, corporation, company, association, or joint stock
association, or the legal successor thereof.
(C) "Department" means the Department of Public Health of
the State of Illinois.
(D) "Director" means the Director of Public Health of the
State of Illinois.
(E) "Perinatal" means the period of time between the
conception of an infant and the end of the first month after
birth.
(F) "Federally designated organ procurement agency" means
the organ procurement agency designated by the Secretary of

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the U.S. Department of Health and Human Services for the
service area in which a hospital is located; except that in the
case of a hospital located in a county adjacent to Wisconsin
which currently contracts with an organ procurement agency
located in Wisconsin that is not the organ procurement agency
designated by the U.S. Secretary of Health and Human Services
for the service area in which the hospital is located, if the
hospital applies for a waiver pursuant to 42 U.S.C. USC
1320b-8(a), it may designate an organ procurement agency
located in Wisconsin to be thereafter deemed its federally
designated organ procurement agency for the purposes of this
Act.
(G) "Tissue bank" means any facility or program operating
in Illinois that is certified by the American Association of
Tissue Banks or the Eye Bank Association of America and is
involved in procuring, furnishing, donating, or distributing
corneas, bones, or other human tissue for the purpose of
injecting, transfusing, or transplanting any of them into the
human body. "Tissue bank" does not include a licensed blood
bank. For the purposes of this Act, "tissue" does not include
organs.
(H) "Campus", as this term terms applies to operations,
has the same meaning as the term "campus" as set forth in
federal Medicare regulations, 42 CFR 413.65.
(Source: P.A. 99-180, eff. 7-29-15; 100-759, eff. 1-1-19.)

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Section 25. The Behavior Analyst Licensing Act is amended
by changing Sections 30, 35, and 150 as follows:
(225 ILCS 6/30)
(Section scheduled to be repealed on January 1, 2028)
Sec. 30. Qualifications for behavior analyst license.
(a) A person qualifies to be licensed as a behavior
analyst if that person:
(1) has applied in writing or electronically on forms
prescribed by the Department;
(2) is a graduate of a graduate level program in the
field of behavior analysis or a related field with an
equivalent course of study in behavior analysis approved
by the Department from a regionally accredited university
approved by the Department;
(3) has completed at least 500 hours of supervision of
behavior analysis, as defined by rule;
(4) has qualified for and passed the examination for
the practice of behavior analysis as authorized by the
Department; and
(5) has paid the required fees.
(b) The Department may issue a license to a certified
behavior analyst seeking licensure as a licensed behavior
analyst who (i) does not have the supervised experience as
described in paragraph (3) of subsection (a), (ii) applies for
licensure before July 1, 2028, and (iii) has completed all of

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the following:
(1) has applied in writing or electronically on forms
prescribed by the Department;
(2) is a graduate of a graduate level program in the
field of behavior analysis from a regionally accredited
university approved by the Department;
(3) submits evidence of certification by an
appropriate national certifying body as determined by rule
of the Department;
(4) has passed the examination for the practice of
behavior analysis as authorized by the Department; and
(5) has paid the required fees.
(c) An applicant has 3 years after the date of application
to complete the application process. If the process has not
been completed in 3 years, the application shall be denied,
the fee shall be forfeited, and the applicant must reapply and
meet the requirements in effect at the time of reapplication.
(d) Each applicant for licensure as a an behavior analyst
shall have his or her fingerprints submitted to the Illinois
State Police in an electronic format that complies with the
form and manner for requesting and furnishing criminal history
record information as prescribed by the Illinois State Police.
These fingerprints shall be transmitted through a live scan
fingerprint vendor licensed by the Department. These
fingerprints shall be checked against the Illinois State
Police and Federal Bureau of Investigation criminal history

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record databases now and hereafter filed, including, but not
limited to, civil, criminal, and latent fingerprint databases.
The Illinois State Police shall charge a fee for conducting
the criminal history records check, which shall be deposited
in the State Police Services Fund and shall not exceed the
actual cost of the records check. The Illinois State Police
shall furnish, pursuant to positive identification, records of
Illinois convictions as prescribed under the Illinois Uniform
Conviction Information Act and shall forward the national
criminal history record information to the Department.
(Source: P.A. 102-953, eff. 5-27-22; revised 8-19-22.)
(225 ILCS 6/35)
(Section scheduled to be repealed on January 1, 2028)
Sec. 35. Qualifications for assistant behavior analyst
license.
(a) A person qualifies to be licensed as an assistant
behavior analyst if that person:
(1) has applied in writing or electronically on forms
prescribed by the Department;
(2) is a graduate of a bachelor's level program in the
field of behavior analysis or a related field with an
equivalent course of study in behavior analysis approved
by the Department from a regionally accredited university
approved by the Department;
(3) has met the supervised work experience;

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(4) has qualified for and passed the examination for
the practice of behavior analysis as a licensed assistant
behavior analyst as authorized by the Department; and
(5) has paid the required fees.
(b) The Department may issue a license to a certified
assistant behavior analyst seeking licensure as a licensed
assistant behavior analyst who (i) does not have the
supervised experience as described in paragraph (3) of
subsection (a), (ii) applies for licensure before July 1,
2028, and (iii) has completed all of the following:
(1) has applied in writing or electronically on forms
prescribed by the Department;
(2) is a graduate of a bachelor's bachelors level
program in the field of behavior analysis;
(3) submits evidence of certification by an
appropriate national certifying body as determined by rule
of the Department;
(4) has passed the examination for the practice of
behavior analysis as authorized by the Department; and
(5) has paid the required fees.
(c) An applicant has 3 years after the date of application
to complete the application process. If the process has not
been completed in 3 years, the application shall be denied,
the fee shall be forfeited, and the applicant must reapply and
meet the requirements in effect at the time of reapplication.
(d) Each applicant for licensure as an assistant behavior

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analyst shall have his or her fingerprints submitted to the
Illinois State Police in an electronic format that complies
with the form and manner for requesting and furnishing
criminal history record information as prescribed by the
Illinois State Police. These fingerprints shall be transmitted
through a live scan fingerprint vendor licensed by the
Department. These fingerprints shall be checked against the
Illinois State Police and Federal Bureau of Investigation
criminal history record databases now and hereafter filed,
including, but not limited to, civil, criminal, and latent
fingerprint databases. The Illinois State Police shall charge
a fee for conducting the criminal history records check, which
shall be deposited in the State Police Services Fund and shall
not exceed the actual cost of the records check. The Illinois
State Police shall furnish, pursuant to positive
identification, records of Illinois convictions as prescribed
under the Illinois Uniform Conviction Information Act and
shall forward the national criminal history record information
to the Department.
(Source: P.A. 102-953, eff. 5-27-22; revised 8-19-22.)
(225 ILCS 6/150)
(Section scheduled to be repealed on January 1, 2028)
Sec. 150. License restrictions and limitations.
Notwithstanding the exclusion in paragraph (2) of subsection
(c) of Section 20 that permits an individual to implement a

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behavior analytic treatment plan under the extended authority,
direction, and supervision of a licensed behavior analyst or
licensed assistant behavior analyst, no No business
organization shall provide, attempt to provide, or offer to
provide behavior analysis services unless every member,
partner, shareholder, director, officer, holder of any other
ownership interest, agent, and employee who renders applied
behavior analysis services holds a currently valid license
issued under this Act. No business shall be created that (i)
has a stated purpose that includes behavior analysis, or (ii)
practices or holds itself out as available to practice
behavior analysis therapy, unless it is organized under the
Professional Service Corporation Act or Professional Limited
Liability Company Act. Nothing in this Act shall preclude
individuals licensed under this Act from practicing directly
or indirectly for a physician licensed to practice medicine in
all its branches under the Medical Practice Act of 1987 or for
any legal entity as provided under subsection (c) of Section
22.2 of the Medical Practice Act of 1987.
(Source: P.A. 102-953, eff. 5-27-22.)
Section 30. The Podiatric Medical Practice Act of 1987 is
amended by adding Section 18.1 as follows:
(225 ILCS 100/18.1 new)
Sec. 18.1. Fee waivers. Notwithstanding any provision of

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law to the contrary, during State Fiscal Year 2023, the
Department shall allow individuals a one-time waiver of fees
imposed under Section 18 of this Act. No individual may
benefit from such a waiver more than once. If an individual has
already paid a fee required under Section 18 for Fiscal Year
2023, then the Department shall apply the money paid for that
fee as a credit to the next required fee.
Section 35. The Illinois Public Aid Code is amended by
changing Sections 5-5.2, 5-5.7b, and 5B-2 follows:
(305 ILCS 5/5-5.2) (from Ch. 23, par. 5-5.2)
Sec. 5-5.2. Payment.
(a) All nursing facilities that are grouped pursuant to
Section 5-5.1 of this Act shall receive the same rate of
payment for similar services.
(b) It shall be a matter of State policy that the Illinois
Department shall utilize a uniform billing cycle throughout
the State for the long-term care providers.
(c) (Blank).
(c-1) Notwithstanding any other provisions of this Code,
the methodologies for reimbursement of nursing services as
provided under this Article shall no longer be applicable for
bills payable for nursing services rendered on or after a new
reimbursement system based on the Patient Driven Payment Model
(PDPM) has been fully operationalized, which shall take effect

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for services provided on or after the implementation of the
PDPM reimbursement system begins. For the purposes of this
amendatory Act of the 102nd General Assembly, the
implementation date of the PDPM reimbursement system and all
related provisions shall be July 1, 2022 if the following
conditions are met: (i) the Centers for Medicare and Medicaid
Services has approved corresponding changes in the
reimbursement system and bed assessment; and (ii) the
Department has filed rules to implement these changes no later
than June 1, 2022. Failure of the Department to file rules to
implement the changes provided in this amendatory Act of the
102nd General Assembly no later than June 1, 2022 shall result
in the implementation date being delayed to October 1, 2022.
(d) The new nursing services reimbursement methodology
utilizing the Patient Driven Payment Model, which shall be
referred to as the PDPM reimbursement system, taking effect
July 1, 2022, upon federal approval by the Centers for
Medicare and Medicaid Services, shall be based on the
following:
(1) The methodology shall be resident-centered,
facility-specific, cost-based, and based on guidance from
the Centers for Medicare and Medicaid Services.
(2) Costs shall be annually rebased and case mix index
quarterly updated. The nursing services methodology will
be assigned to the Medicaid enrolled residents on record
as of 30 days prior to the beginning of the rate period in

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the Department's Medicaid Management Information System
(MMIS) as present on the last day of the second quarter
preceding the rate period based upon the Assessment
Reference Date of the Minimum Data Set (MDS).
(3) Regional wage adjustors based on the Health
Service Areas (HSA) groupings and adjusters in effect on
April 30, 2012 shall be included, except no adjuster shall
be lower than 1.06.
(4) PDPM nursing case mix indices in effect on March
1, 2022 shall be assigned to each resident class at no less
than 0.7858 of the Centers for Medicare and Medicaid
Services PDPM unadjusted case mix values, in effect on
March 1, 2022, utilizing an index maximization approach.
(5) The pool of funds available for distribution by
case mix and the base facility rate shall be determined
using the formula contained in subsection (d-1).
(6) The Department shall establish a variable per diem
staffing add-on in accordance with the most recent
available federal staffing report, currently the Payroll
Based Journal, for the same period of time, and if
applicable adjusted for acuity using the same quarter's
MDS. The Department shall rely on Payroll Based Journals
provided to the Department of Public Health to make a
determination of non-submission. If the Department is
notified by a facility of missing or inaccurate Payroll
Based Journal data or an incorrect calculation of

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staffing, the Department must make a correction as soon as
the error is verified for the applicable quarter.
Facilities with at least 70% of the staffing indicated
by the STRIVE study shall be paid a per diem add-on of $9,
increasing by equivalent steps for each whole percentage
point until the facilities reach a per diem of $14.88.
Facilities with at least 80% of the staffing indicated by
the STRIVE study shall be paid a per diem add-on of $14.88,
increasing by equivalent steps for each whole percentage
point until the facilities reach a per diem add-on of
$23.80. Facilities with at least 92% of the staffing
indicated by the STRIVE study shall be paid a per diem
add-on of $23.80, increasing by equivalent steps for each
whole percentage point until the facilities reach a per
diem add-on of $29.75. Facilities with at least 100% of
the staffing indicated by the STRIVE study shall be paid a
per diem add-on of $29.75, increasing by equivalent steps
for each whole percentage point until the facilities reach
a per diem add-on of $35.70. Facilities with at least 110%
of the staffing indicated by the STRIVE study shall be
paid a per diem add-on of $35.70, increasing by equivalent
steps for each whole percentage point until the facilities
reach a per diem add-on of $38.68. Facilities with at
least 125% or higher of the staffing indicated by the
STRIVE study shall be paid a per diem add-on of $38.68.
Beginning April 1, 2023, no nursing facility's variable

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staffing per diem add-on shall be reduced by more than 5%
in 2 consecutive quarters. For the quarters beginning July
1, 2022 and October 1, 2022, no facility's variable per
diem staffing add-on shall be calculated at a rate lower
than 85% of the staffing indicated by the STRIVE study. No
facility below 70% of the staffing indicated by the STRIVE
study shall receive a variable per diem staffing add-on
after December 31, 2022.
(7) For dates of services beginning July 1, 2022, the
PDPM nursing component per diem for each nursing facility
shall be the product of the facility's (i) statewide PDPM
nursing base per diem rate, $92.25, adjusted for the
facility average PDPM case mix index calculated quarterly
and (ii) the regional wage adjuster, and then add the
Medicaid access adjustment as defined in (e-3) of this
Section. Transition rates for services provided between
July 1, 2022 and October 1, 2023 shall be the greater of
the PDPM nursing component per diem or:
(A) for the quarter beginning July 1, 2022, the
RUG-IV nursing component per diem;
(B) for the quarter beginning October 1, 2022, the
sum of the RUG-IV nursing component per diem
multiplied by 0.80 and the PDPM nursing component per
diem multiplied by 0.20;
(C) for the quarter beginning January 1, 2023, the
sum of the RUG-IV nursing component per diem

HB0240 Enrolled - 34 - LRB102 05098 BMS 15118 b
multiplied by 0.60 and the PDPM nursing component per
diem multiplied by 0.40;
(D) for the quarter beginning April 1, 2023, the
sum of the RUG-IV nursing component per diem
multiplied by 0.40 and the PDPM nursing component per
diem multiplied by 0.60;
(E) for the quarter beginning July 1, 2023, the
sum of the RUG-IV nursing component per diem
multiplied by 0.20 and the PDPM nursing component per
diem multiplied by 0.80; or
(F) for the quarter beginning October 1, 2023 and
each subsequent quarter, the transition rate shall end
and a nursing facility shall be paid 100% of the PDPM
nursing component per diem.
(d-1) Calculation of base year Statewide RUG-IV nursing
base per diem rate.
(1) Base rate spending pool shall be:
(A) The base year resident days which are
calculated by multiplying the number of Medicaid
residents in each nursing home as indicated in the MDS
data defined in paragraph (4) by 365.
(B) Each facility's nursing component per diem in
effect on July 1, 2012 shall be multiplied by
subsection (A).
(C) Thirteen million is added to the product of
subparagraph (A) and subparagraph (B) to adjust for

HB0240 Enrolled - 35 - LRB102 05098 BMS 15118 b
the exclusion of nursing homes defined in paragraph
(5).
(2) For each nursing home with Medicaid residents as
indicated by the MDS data defined in paragraph (4),
weighted days adjusted for case mix and regional wage
adjustment shall be calculated. For each home this
calculation is the product of:
(A) Base year resident days as calculated in
subparagraph (A) of paragraph (1).
(B) The nursing home's regional wage adjustor
based on the Health Service Areas (HSA) groupings and
adjustors in effect on April 30, 2012.
(C) Facility weighted case mix which is the number
of Medicaid residents as indicated by the MDS data
defined in paragraph (4) multiplied by the associated
case weight for the RUG-IV 48 grouper model using
standard RUG-IV procedures for index maximization.
(D) The sum of the products calculated for each
nursing home in subparagraphs (A) through (C) above
shall be the base year case mix, rate adjusted
weighted days.
(3) The Statewide RUG-IV nursing base per diem rate:
(A) on January 1, 2014 shall be the quotient of the
paragraph (1) divided by the sum calculated under
subparagraph (D) of paragraph (2);
(B) on and after July 1, 2014 and until July 1,

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2022, shall be the amount calculated under
subparagraph (A) of this paragraph (3) plus $1.76; and
(C) beginning July 1, 2022 and thereafter, $7
shall be added to the amount calculated under
subparagraph (B) of this paragraph (3) of this
Section.
(4) Minimum Data Set (MDS) comprehensive assessments
for Medicaid residents on the last day of the quarter used
to establish the base rate.
(5) Nursing facilities designated as of July 1, 2012
by the Department as "Institutions for Mental Disease"
shall be excluded from all calculations under this
subsection. The data from these facilities shall not be
used in the computations described in paragraphs (1)
through (4) above to establish the base rate.
(e) Beginning July 1, 2014, the Department shall allocate
funding in the amount up to $10,000,000 for per diem add-ons to
the RUGS methodology for dates of service on and after July 1,
2014:
(1) $0.63 for each resident who scores in I4200
Alzheimer's Disease or I4800 non-Alzheimer's Dementia.
(2) $2.67 for each resident who scores either a "1" or
"2" in any items S1200A through S1200I and also scores in
RUG groups PA1, PA2, BA1, or BA2.
(e-1) (Blank).
(e-2) For dates of services beginning January 1, 2014 and

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ending September 30, 2023, 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 adjustor. For dates of
service beginning July 1, 2022 and ending September 30, 2023,
the Medicaid access adjustment described in subsection (e-3)
shall be added to the product.
(e-3) A Medicaid Access Adjustment of $4 adjusted for the
facility average PDPM case mix index calculated quarterly
shall be added to the statewide PDPM nursing per diem for all
facilities with annual Medicaid bed days of at least 70% of all
occupied bed days adjusted quarterly. For each new calendar
year and for the 6-month period beginning July 1, 2022, the
percentage of a facility's occupied bed days comprised of
Medicaid bed days shall be determined by the Department
quarterly. For dates of service beginning January 1, 2023, the
Medicaid Access Adjustment shall be increased to $4.75. This
subsection shall be inoperative on and after January 1, 2028.
(f) (Blank).
(g) Notwithstanding any other provision of this Code, on
and after July 1, 2012, for facilities not designated by the
Department of Healthcare and Family Services as "Institutions
for Mental Disease", rates effective May 1, 2011 shall be
adjusted as follows:
(1) (Blank);
(2) (Blank);

HB0240 Enrolled - 38 - LRB102 05098 BMS 15118 b
(3) Facility rates for the capital and support
components shall be reduced by 1.7%.
(h) Notwithstanding any other provision of this Code, on
and after July 1, 2012, nursing facilities designated by the
Department of Healthcare and Family Services as "Institutions
for Mental Disease" and "Institutions for Mental Disease" that
are facilities licensed under the Specialized Mental Health
Rehabilitation Act of 2013 shall have the nursing,
socio-developmental, capital, and support components of their
reimbursement rate effective May 1, 2011 reduced in total by
2.7%.
(i) On and after July 1, 2014, the reimbursement rates for
the support component of the nursing facility rate for
facilities licensed under the Nursing Home Care Act as skilled
or intermediate care facilities shall be the rate in effect on
June 30, 2014 increased by 8.17%.
(j) Notwithstanding any other provision of law, subject to
federal approval, effective July 1, 2019, sufficient funds
shall be allocated for changes to rates for facilities
licensed under the Nursing Home Care Act as skilled nursing
facilities or intermediate care facilities for dates of
services on and after July 1, 2019: (i) to establish, through
June 30, 2022 a per diem add-on to the direct care per diem
rate not to exceed $70,000,000 annually in the aggregate
taking into account federal matching funds for the purpose of
addressing the facility's unique staffing needs, adjusted

HB0240 Enrolled - 39 - LRB102 05098 BMS 15118 b
quarterly and distributed by a weighted formula based on
Medicaid bed days on the last day of the second quarter
preceding the quarter for which the rate is being adjusted.
Beginning July 1, 2022, the annual $70,000,000 described in
the preceding sentence shall be dedicated to the variable per
diem add-on for staffing under paragraph (6) of subsection
(d); and (ii) in an amount not to exceed $170,000,000 annually
in the aggregate taking into account federal matching funds to
permit the support component of the nursing facility rate to
be updated as follows:
(1) 80%, or $136,000,000, of the funds shall be used
to update each facility's rate in effect on June 30, 2019
using the most recent cost reports on file, which have had
a limited review conducted by the Department of Healthcare
and Family Services and will not hold up enacting the rate
increase, with the Department of Healthcare and Family
Services.
(2) After completing the calculation in paragraph (1),
any facility whose rate is less than the rate in effect on
June 30, 2019 shall have its rate restored to the rate in
effect on June 30, 2019 from the 20% of the funds set
aside.
(3) The remainder of the 20%, or $34,000,000, shall be
used to increase each facility's rate by an equal
percentage.
(k) During the first quarter of State Fiscal Year 2020,

HB0240 Enrolled - 40 - LRB102 05098 BMS 15118 b
the Department of Healthcare of Family Services must convene a
technical advisory group consisting of members of all trade
associations representing Illinois skilled nursing providers
to discuss changes necessary with federal implementation of
Medicare's Patient-Driven Payment Model. Implementation of
Medicare's Patient-Driven Payment Model shall, by September 1,
2020, end the collection of the MDS data that is necessary to
maintain the current RUG-IV Medicaid payment methodology. The
technical advisory group must consider a revised reimbursement
methodology that takes into account transparency,
accountability, actual staffing as reported under the
federally required Payroll Based Journal system, changes to
the minimum wage, adequacy in coverage of the cost of care, and
a quality component that rewards quality improvements.
(l) The Department shall establish per diem add-on
payments to improve the quality of care delivered by
facilities, including:
(1) Incentive payments determined by facility
performance on specified quality measures in an initial
amount of $70,000,000. Nothing in this subsection shall be
construed to limit the quality of care payments in the
aggregate statewide to $70,000,000, and, if quality of
care has improved across nursing facilities, the
Department shall adjust those add-on payments accordingly.
The quality payment methodology described in this
subsection must be used for at least State Fiscal Year

HB0240 Enrolled - 41 - LRB102 05098 BMS 15118 b
2023. Beginning with the quarter starting July 1, 2023,
the Department may add, remove, or change quality metrics
and make associated changes to the quality payment
methodology as outlined in subparagraph (E). Facilities
designated by the Centers for Medicare and Medicaid
Services as a special focus facility or a hospital-based
nursing home do not qualify for quality payments.
(A) Each quality pool must be distributed by
assigning a quality weighted score for each nursing
home which is calculated by multiplying the nursing
home's quality base period Medicaid days by the
nursing home's star rating weight in that period.
(B) Star rating weights are assigned based on the
nursing home's star rating for the LTS quality star
rating. As used in this subparagraph, "LTS quality
star rating" means the long-term stay quality rating
for each nursing facility, as assigned by the Centers
for Medicare and Medicaid Services under the Five-Star
Quality Rating System. The rating is a number ranging
from 0 (lowest) to 5 (highest).
(i) Zero-star or one-star rating has a weight
of 0.
(ii) Two-star rating has a weight of 0.75.
(iii) Three-star rating has a weight of 1.5.
(iv) Four-star rating has a weight of 2.5.
(v) Five-star rating has a weight of 3.5.

HB0240 Enrolled - 42 - LRB102 05098 BMS 15118 b
(C) Each nursing home's quality weight score is
divided by the sum of all quality weight scores for
qualifying nursing homes to determine the proportion
of the quality pool to be paid to the nursing home.
(D) The quality pool is no less than $70,000,000
annually or $17,500,000 per quarter. The Department
shall publish on its website the estimated payments
and the associated weights for each facility 45 days
prior to when the initial payments for the quarter are
to be paid. The Department shall assign each facility
the most recent and applicable quarter's STAR value
unless the facility notifies the Department within 15
days of an issue and the facility provides reasonable
evidence demonstrating its timely compliance with
federal data submission requirements for the quarter
of record. If such evidence cannot be provided to the
Department, the STAR rating assigned to the facility
shall be reduced by one from the prior quarter.
(E) The Department shall review quality metrics
used for payment of the quality pool and make
recommendations for any associated changes to the
methodology for distributing quality pool payments in
consultation with associations representing long-term
care providers, consumer advocates, organizations
representing workers of long-term care facilities, and
payors. The Department may establish, by rule, changes

HB0240 Enrolled - 43 - LRB102 05098 BMS 15118 b
to the methodology for distributing quality pool
payments.
(F) The Department shall disburse quality pool
payments from the Long-Term Care Provider Fund on a
monthly basis in amounts proportional to the total
quality pool payment determined for the quarter.
(G) The Department shall publish any changes in
the methodology for distributing quality pool payments
prior to the beginning of the measurement period or
quality base period for any metric added to the
distribution's methodology.
(2) Payments based on CNA tenure, promotion, and CNA
training for the purpose of increasing CNA compensation.
It is the intent of this subsection that payments made in
accordance with this paragraph be directly incorporated
into increased compensation for CNAs. As used in this
paragraph, "CNA" means a certified nursing assistant as
that term is described in Section 3-206 of the Nursing
Home Care Act, Section 3-206 of the ID/DD Community Care
Act, and Section 3-206 of the MC/DD Act. The Department
shall establish, by rule, payments to nursing facilities
equal to Medicaid's share of the tenure wage increments
specified in this paragraph for all reported CNA employee
hours compensated according to a posted schedule
consisting of increments at least as large as those
specified in this paragraph. The increments are as

HB0240 Enrolled - 44 - LRB102 05098 BMS 15118 b
follows: an additional $1.50 per hour for CNAs with at
least one and less than 2 years' experience plus another
$1 per hour for each additional year of experience up to a
maximum of $6.50 for CNAs with at least 6 years of
experience. For purposes of this paragraph, Medicaid's
share shall be the ratio determined by paid Medicaid bed
days divided by total bed days for the applicable time
period used in the calculation. In addition, and additive
to any tenure increments paid as specified in this
paragraph, the Department shall establish, by rule,
payments supporting Medicaid's share of the
promotion-based wage increments for CNA employee hours
compensated for that promotion with at least a $1.50
hourly increase. Medicaid's share shall be established as
it is for the tenure increments described in this
paragraph. Qualifying promotions shall be defined by the
Department in rules for an expected 10-15% subset of CNAs
assigned intermediate, specialized, or added roles such as
CNA trainers, CNA scheduling "captains", and CNA
specialists for resident conditions like dementia or
memory care or behavioral health.
(m) The Department shall work with nursing facility
industry representatives to design policies and procedures to
permit facilities to address the integrity of data from
federal reporting sites used by the Department in setting
facility rates.

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(Source: P.A. 101-10, eff. 6-5-19; 101-348, eff. 8-9-19;
102-77, eff. 7-9-21; 102-558, eff. 8-20-21; 102-1035, eff.
5-31-22.)
(305 ILCS 5/5-5.7b)
Sec. 5-5.7b. Pandemic related stability payments to
ambulance service providers in response to COVID-19.
(a) Definitions. As used in this Section:
"Ambulance Services Industry" means the industry that is
comprised of "Qualifying Ground Ambulance Service Providers",
as defined in this Section.
"Qualifying Ground Ambulance Service Provider" means a
"vehicle service provider," as that term is defined in Section
3.85 of the Emergency Medical Services (EMS) Systems Act,
which operates licensed ambulances for the purpose of
providing emergency, non-emergency ambulance services, or both
emergency and non-emergency ambulance services. The term
"Qualifying Ground Ambulance Service Provider" is limited to
ambulance and EMS agencies that are privately held and
nonprofit organizations headquartered within the State and
licensed by the Department of Public Health as of March 12,
2020.
"Eligible worker" means a staff member of a Qualifying
Ground Ambulance Service Provider engaged in "essential work",
as defined by Section 9901 of the ARPA and related federal
guidance, and (1) whose total pay is below 150% of the average

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annual wage for all occupations in the worker's county of
residence, as defined by the BLS Occupational Employment and
Wage Statistics or (2) is not exempt from the federal Fair
Labor Standards Act overtime provisions.
(b) Purpose. The Department may receive federal funds
under the authority of legislation passed in response to the
Coronavirus epidemic, including, but not limited to, the
American Rescue Plan Act of 2021, P.L. 117-2 (the "ARPA").
Upon receipt or availability of such State or federal funds,
and subject to appropriations for their use, the Department
shall establish and administer programs for purposes allowable
under Section 9901 of the ARPA to provide financial assistance
to Qualifying Ground Ambulance Service Providers for premium
pay for eligible workers, to provide reimbursement for
eligible expenditures, and to provide support following the
negative economic impact of the COVID-19 public health
emergency on the Ambulance Services Industry. Financial
assistance may include, but is not limited to, grants, expense
reimbursements, or subsidies.
(b-1) By December 31, 2022, the Department shall obtain
appropriate documentation from Qualifying Ground Ambulance
Service Providers to ascertain an accurate count of the number
of licensed vehicles available to serve enrollees in the
State's medical assistance programs, which shall be known as
the "total eligible vehicles". By February 28, 2023,
Qualifying Ground Ambulance Service Providers shall be

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initially notified of their eligible award, which shall be the
product of (i) the total amount of funds allocated under this
Section and (ii) a quotient, the numerator of which is the
number of licensed ground ambulance vehicles of an individual
Qualifying Ground Ambulance Service Provider and the
denominator of which is the total eligible vehicles. After
March 31, 2024, any unobligated funds shall be reallocated pro
rata to the remaining Qualifying Ground Ambulance Service
Providers that are able to prove up eligible expenses in
excess of their initial award amount until all such
appropriated funds are exhausted.
Providers shall indicate to the Department what portion of
their award they wish to allocate under the purposes outlined
under paragraphs (d), (e), or (f), if applicable, of this
Section.
(c) Non-Emergency Service Certification. To be eligible
for funding under this Section, a Qualifying Ground Ambulance
Service Provider that provides non-emergency services to
institutional residents must certify whether or not it is able
to that it will provide non-emergency ambulance services to
individuals enrolled in the State's Medical Assistance Program
and residing in non-institutional settings for at least one
year following the receipt of funding pursuant to this
amendatory Act of the 102nd General Assembly. Certification
indicating that a provider has such an ability does not mean
that a provider is required to accept any or all requested

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transports. The provider shall maintain the certification in
its records. The provider shall also maintain documentation of
all non-emergency ambulance services for the period covered by
the certification. The provider shall produce the
certification and supporting documentation upon demand by the
Department or its representative. Failure to comply shall
result in recovery of any payments made by the Department.
(d) Premium Pay Initiative. Subject to paragraph (c) of
this Section, the Department shall establish a Premium Pay
Initiative to distribute awards to each Qualifying Ground
Ambulance Service Provider for the purpose of providing
premium pay to eligible workers.
(1) Financial assistance pursuant to this paragraph
(d) shall be scaled based on a process determined by the
Department. The amount awarded to each Qualifying Ground
Ambulance Service Provider shall be up to $13 per hour for
each eligible worker employed.
(2) The financial assistance awarded shall only be
expended for premium pay for eligible workers, which must
be in addition to any wages or remuneration the eligible
worker has already received and shall be subject to the
other requirements and limitations set forth in the ARPA
and related federal guidance.
(3) Upon receipt of funds, the Qualifying Ground
Ambulance Service Provider shall distribute funds such
that an eligible worker receives an amount up to $13 per

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hour but no more than $25,000 for the duration of the
program. The Qualifying Ground Ambulance Service Provider
shall provide a written certification to the Department
acknowledging compliance with this paragraph (d).
(4) No portion of these funds shall be spent on
volunteer staff.
(5) These funds shall not be used to make retroactive
premium payments prior to the effective date of this
amendatory Act of the 102nd General Assembly.
(6) The Department shall require each Qualifying
Ground Ambulance Service Provider that receives funds
under this paragraph (d) to submit appropriate
documentation acknowledging compliance with State and
federal law on an annual basis.
(e) COVID-19 Response Support Initiative. Subject to
paragraph (c) of this Section and based on an application
filed by a Qualifying Ground Ambulance Service Provider, the
Department shall establish the Ground Ambulance COVID-19
Response Support Initiative. The purpose of the award shall be
to reimburse Qualifying Ground Ambulance Service Providers for
eligible expenses under Section 9901 of the ARPA related to
the public health impacts of the COVID-19 public health
emergency, including, but not limited to: (i) costs incurred
due to the COVID-19 public health emergency; (ii) costs
related to vaccination programs, including vaccine incentives;
(iii) costs related to COVID-19 testing; (iv) costs related to

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COVID-19 prevention and treatment equipment; (v) expenses for
medical supplies; (vi) expenses for personal protective
equipment; (vii) costs related to isolation and quarantine;
(viii) costs for ventilation system installation and
improvement; (ix) costs related to other emergency response
equipment, such as ground ambulances, ventilators, cardiac
monitoring equipment, defibrillation equipment, pacing
equipment, ambulance stretchers, and radio equipment; and (x)
other emergency medical response expenses. costs related to
COVID-19 testing for patients, COVID-19 prevention and
treatment equipment, medical supplies, personal protective
equipment, and other emergency medical response treatments.
(1) The award shall be for eligible obligated
expenditures incurred no earlier than May 1, 2022 and no
later than June 30, 2024 2023. Expenditures under this
paragraph must be incurred by June 30, 2025.
(2) Funds awarded under this paragraph (e) shall not
be expended for premium pay to eligible workers.
(3) The Department shall require each Qualifying
Ground Ambulance Service Provider that receives funds
under this paragraph (e) to submit appropriate
documentation acknowledging compliance with State and
federal law on an annual basis. For purchases of medical
equipment or other capital expenditures, the Qualifying
Ground Ambulance Service Provider shall include
documentation that describes the harm or need to be

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addressed by the expenditures and how that capital
expenditure is appropriate to address that identified harm
or need.
(f) Ambulance Industry Recovery Program. If the Department
designates the Ambulance Services Industry as an "impacted
industry", as defined by the ARPA and related federal
guidance, the Department shall establish the Ambulance
Industry Recovery Grant Program, to provide aid to Qualifying
Ground Ambulance Service Providers that experienced staffing
losses due to the COVID-19 public health emergency.
(1) Funds awarded under this paragraph (f) shall not
be expended for premium pay to eligible workers.
(2) Each Qualifying Ground Ambulance Service Provider
that receives funds under this paragraph (f) shall comply
with paragraph (c) of this Section.
(3) The Department shall require each Qualifying
Ground Ambulance Service Provider that receives funds
under this paragraph (f) to submit appropriate
documentation acknowledging compliance with State and
federal law on an annual basis.
(Source: P.A. 102-699, eff. 4-19-22.)
(305 ILCS 5/5B-2) (from Ch. 23, par. 5B-2)
Sec. 5B-2. Assessment; no local authorization to tax.
(a) For the privilege of engaging in the occupation of
long-term care provider, beginning July 1, 2011 through June

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30, 2022, or upon federal approval by the Centers for Medicare
and Medicaid Services of the long-term care provider
assessment described in subsection (a-1), whichever is later,
an assessment is imposed upon each long-term care provider in
an amount equal to $6.07 times the number of occupied bed days
due and payable each month. Notwithstanding any provision of
any other Act to the contrary, this assessment shall be
construed as a tax, but shall not be billed or passed on to any
resident of a nursing home operated by the nursing home
provider.
(a-1) For the privilege of engaging in the occupation of
long-term care provider for each occupied non-Medicare bed
day, beginning July 1, 2022, an assessment is imposed upon
each long-term care provider in an amount varying with the
number of paid Medicaid resident days per annum in the
facility with the following schedule of occupied bed tax
amounts. This assessment is due and payable each month. The
tax shall follow the schedule below and be rebased by the
Department on an annual basis. The Department shall publish
each facility's rebased tax rate according to the schedule in
this Section 30 days prior to the beginning of the 6-month
period beginning July 1, 2022 and thereafter 30 days prior to
the beginning of each calendar year which shall incorporate
the number of paid Medicaid days used to determine each
facility's rebased tax rate.
(1) 0-5,000 paid Medicaid resident days per annum,

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$10.67.
(2) 5,001-15,000 paid Medicaid resident days per
annum, $19.20.
(3) 15,001-35,000 paid Medicaid resident days per
annum, $22.40.
(4) 35,001-55,000 paid Medicaid resident days per
annum, $19.20.
(5) 55,001-65,000 paid Medicaid resident days per
annum, $13.86.
(6) 65,001+ paid Medicaid resident days per annum,
$10.67.
(7) Any non-profit nursing facilities without
Medicaid-certified beds or any nursing facility owned and
operated by a county government, $7 per occupied bed day.
The changes made by this amendatory Act of the 102nd
General Assembly to this paragraph (7) shall be
implemented only upon federal approval.
Notwithstanding any provision of any other Act to the
contrary, this assessment shall be construed as a tax but
shall not be billed or passed on to any resident of a nursing
home operated by the nursing home provider.
For each new calendar year and for the 6-month period
beginning July 1, 2022, a facility's paid Medicaid resident
days per annum shall be determined using the Department's
Medicaid Management Information System to include Medicaid
resident days for the year ending 9 months earlier.

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(b) Nothing in this amendatory Act of 1992 shall be
construed to authorize any home rule unit or other unit of
local government to license for revenue or impose a tax or
assessment upon long-term care providers or the occupation of
long-term care provider, or a tax or assessment measured by
the income or earnings or occupied bed days of a long-term care
provider.
(c) The assessment imposed by this Section shall not be
due and payable, however, until after the Department notifies
the long-term care providers, in writing, that the payment
methodologies to long-term care providers required under
Section 5-5.2 of this Code have been approved by the Centers
for Medicare and Medicaid Services of the U.S. Department of
Health and Human Services and that the waivers under 42 CFR
433.68 for the assessment imposed by this Section, if
necessary, have been granted by the Centers for Medicare and
Medicaid Services of the U.S. Department of Health and Human
Services.
(Source: P.A. 102-1035, eff. 5-31-22.)
Section 40. The Rebuild Illinois Mental Health Workforce
Act is amended by changing Sections 20-10 and 20-20 as
follows:
(305 ILCS 66/20-10)
Sec. 20-10. Medicaid funding for community mental health

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services. Medicaid funding for the specific community mental
health services listed in this Act shall be adjusted and paid
as set forth in this Act. Such payments shall be paid in
addition to the base Medicaid reimbursement rate and add-on
payment rates per service unit.
(a) The payment adjustments shall begin on July 1, 2022
for State Fiscal Year 2023 and shall continue for every State
fiscal year thereafter.
(1) Individual Therapy Medicaid Payment rate for
services provided under the H0004 Code:
(A) The Medicaid total payment rate for individual
therapy provided by a qualified mental health
professional shall be increased by no less than $9 per
service unit.
(B) The Medicaid total payment rate for individual
therapy provided by a mental health professional shall
be increased by no less then $9 per service unit.
(2) Community Support - Individual Medicaid Payment
rate for services provided under the H2015 Code: All
community support - individual services shall be increased
by no less than $15 per service unit.
(3) Case Management Medicaid Add-on Payment for
services provided under the T1016 code: All case
management services rates shall be increased by no less
than $15 per service unit.
(4) Assertive Community Treatment Medicaid Add-on

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Payment for services provided under the H0039 code: The
Medicaid total payment rate for assertive community
treatment services shall increase by no less than $8 per
service unit.
(5) Medicaid user-based directed payments.
(A) For each State fiscal year, a monthly directed
payment shall be paid to a community mental health
provider of community support team services based on
the number of Medicaid users of community support team
services documented by Medicaid fee-for-service and
managed care encounter claims delivered by that
provider in the base year. The Department of
Healthcare and Family Services shall make the monthly
directed payment to each provider entitled to directed
payments under this Act by no later than the last day
of each month throughout each State fiscal year.
(i) The monthly directed payment for a
community support team provider shall be
calculated as follows: The sum total number of
individual Medicaid users of community support
team services delivered by that provider
throughout the base year, multiplied by $4,200 per
Medicaid user, divided into 12 equal monthly
payments for the State fiscal year.
(ii) As used in this subparagraph, "user"
means an individual who received at least 200

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units of community support team services (H2016)
during the base year.
(B) For each State fiscal year, a monthly directed
payment shall be paid to each community mental health
provider of assertive community treatment services
based on the number of Medicaid users of assertive
community treatment services documented by Medicaid
fee-for-service and managed care encounter claims
delivered by the provider in the base year.
(i) The monthly direct payment for an
assertive community treatment provider shall be
calculated as follows: The sum total number of
Medicaid users of assertive community treatment
services provided by that provider throughout the
base year, multiplied by $6,000 per Medicaid user,
divided into 12 equal monthly payments for that
State fiscal year.
(ii) As used in this subparagraph, "user"
means an individual that received at least 300
units of assertive community treatment services
during the base year.
(C) The base year for directed payments under this
Section shall be calendar year 2019 for State Fiscal
Year 2023 and State Fiscal Year 2024. For the State
fiscal year beginning on July 1, 2024, and for every
State fiscal year thereafter, the base year shall be

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the calendar year that ended 18 months prior to the
start of the State fiscal year in which payments are
made.
(b) Subject to federal approval, a one-time directed
payment must be made in calendar year 2023 for community
mental health services provided by community mental health
providers. The one-time directed payment shall be for an
amount appropriated for these purposes. The one-time directed
payment shall be for services for Integrated Assessment and
Treatment Planning and other intensive services, including,
but not limited to, services for Mobile Crisis Response,
crisis intervention, and medication monitoring. The amounts
and services used for designing and distributing these
one-time directed payments shall not be construed to require
any future rate or funding increases for the same or other
mental health services.
(Source: P.A. 102-699, eff. 4-19-22.)
(305 ILCS 66/20-20)
Sec. 20-20. Base Medicaid rates or add-on payments.
(a) For services under subsection (a) of Section 20-10. No
base Medicaid rate or Medicaid rate add-on payment or any
other payment for the provision of Medicaid community mental
health services in place on July 1, 2021 shall be diminished or
changed to make the reimbursement changes required by this
Act. Any payments required under this Act that are delayed due

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to implementation challenges or federal approval shall be made
retroactive to July 1, 2022 for the full amount required by
this Act regardless of the amount a provider bills Illinois'
Medical Assistance Program (via a Medicaid managed care
organization or the Department of Healthcare and Family
Services directly) for such services.
(b) For directed payments under subsection (b) of Section
20-10. No base Medicaid rate payment or any other payment for
the provision of Medicaid community mental health services in
place on January 1, 2023 shall be diminished or changed to make
the reimbursement changes required by this Act. The Department
of Healthcare and Family Services must pay the directed
payment in one installment within 60 days of receiving federal
approval.
(Source: P.A. 102-699, eff. 4-19-22.)
Section 45. The Code of Criminal Procedure of 1963 is
amended by changing Sections 104-17 and 104-23 as follows:
(725 ILCS 5/104-17) (from Ch. 38, par. 104-17)
Sec. 104-17. Commitment for treatment; treatment plan.
(a) If the defendant is eligible to be or has been released
on pretrial release or on his own recognizance, the court
shall select the least physically restrictive form of
treatment therapeutically appropriate and consistent with the
treatment plan. The placement may be ordered either on an

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inpatient or an outpatient basis.
(b) If the defendant's disability is mental, the court may
order him placed for secure treatment in the custody of the
Department of Human Services, or the court may order him
placed in the custody of any other appropriate public or
private mental health facility or treatment program which has
agreed to provide treatment to the defendant. If the most
serious charge faced by the defendant is a misdemeanor, the
court shall order outpatient treatment, unless the court finds
good cause on the record to order inpatient treatment. If the
court orders the defendant to inpatient treatment placed in
the custody of the Department of Human Services, the
Department shall evaluate the defendant to determine the most
appropriate to which secure facility to receive the defendant
shall be transported and, within 20 days of the transmittal by
the clerk of the circuit court of the court's placement court
order, notify the court of sheriff of the designated facility
to receive the defendant. The Department shall admit the
defendant to a secure facility within 60 days of the
transmittal of the court's placement order, unless the
Department can demonstrate good faith efforts at placement and
a lack of bed and placement availability. If placement cannot
be made within 60 days of the transmittal of the court's
placement order and the Department has demonstrated good faith
efforts at placement and a lack of bed and placement
availability, the Department shall provide an update to the

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ordering court every 30 days until the defendant is placed.
Once bed and placement availability is determined, the
Department shall notify Upon receipt of that notice, the
sheriff who shall promptly transport the defendant to the
designated facility. If the defendant is placed in the custody
of the Department of Human Services, the defendant shall be
placed in a secure setting. During the period of time required
to determine bed and placement availability at the designated
facility, the appropriate placement the defendant shall remain
in jail. If during the course of evaluating the defendant for
placement, the Department of Human Services determines that
the defendant is currently fit to stand trial, it shall
immediately notify the court and shall submit a written report
within 7 days. In that circumstance the placement shall be
held pending a court hearing on the Department's report.
Otherwise, upon completion of the placement process, including
identifying bed and placement availability, the sheriff shall
be notified and shall transport the defendant to the
designated facility. If, within 60 20 days of the transmittal
by the clerk of the circuit court of the court's placement
court order, the Department fails to provide notify the
sheriff with notice of bed and placement availability at the
designated facility, of the identity of the facility to which
the defendant shall be transported, the sheriff shall contact
a designated person within the Department to inquire about
when a placement will become available at the designated

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facility as well as bed and placement and bed availability at
other secure facilities. If, within 20 days of the transmittal
by the clerk of the circuit court of the placement court order,
the Department fails to notify the sheriff of the identity of
the facility to which the defendant shall be transported, the
sheriff shall notify the Department of its intent to transfer
the defendant to the nearest secure mental health facility
operated by the Department and inquire as to the status of the
placement evaluation and availability for admission to such
facility operated by the Department by contacting a designated
person within the Department. The Department shall respond to
the sheriff within 2 business days of the notice and inquiry by
the sheriff seeking the transfer and the Department shall
provide the sheriff with the status of the evaluation,
information on bed and placement availability, and an
estimated date of admission for the defendant and any changes
to that estimated date of admission. If the Department
notifies the sheriff during the 2 business day period of a
facility operated by the Department with placement
availability, the sheriff shall promptly transport the
defendant to that facility. The placement may be ordered
either on an inpatient or an outpatient basis.
(c) If the defendant's disability is physical, the court
may order him placed under the supervision of the Department
of Human Services which shall place and maintain the defendant
in a suitable treatment facility or program, or the court may

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order him placed in an appropriate public or private facility
or treatment program which has agreed to provide treatment to
the defendant. The placement may be ordered either on an
inpatient or an outpatient basis.
(d) The clerk of the circuit court shall within 5 days of
the entry of the order transmit to the Department, agency or
institution, if any, to which the defendant is remanded for
treatment, the following:
(1) a certified copy of the order to undergo
treatment. Accompanying the certified copy of the order to
undergo treatment shall be the complete copy of any report
prepared under Section 104-15 of this Code or other report
prepared by a forensic examiner for the court;
(2) the county and municipality in which the offense
was committed;
(3) the county and municipality in which the arrest
took place;
(4) a copy of the arrest report, criminal charges,
arrest record; and
(5) all additional matters which the Court directs the
clerk to transmit.
(e) Within 30 days of admission to the designated facility
entry of an order to undergo treatment, the person supervising
the defendant's treatment shall file with the court, the
State, and the defense a report assessing the facility's or
program's capacity to provide appropriate treatment for the

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defendant and indicating his opinion as to the probability of
the defendant's attaining fitness within a period of time from
the date of the finding of unfitness. For a defendant charged
with a felony, the period of time shall be one year. For a
defendant charged with a misdemeanor, the period of time shall
be no longer than the sentence if convicted of the most serious
offense. If the report indicates that there is a substantial
probability that the defendant will attain fitness within the
time period, the treatment supervisor shall also file a
treatment plan which shall include:
(1) A diagnosis of the defendant's disability;
(2) A description of treatment goals with respect to
rendering the defendant fit, a specification of the
proposed treatment modalities, and an estimated timetable
for attainment of the goals;
(3) An identification of the person in charge of
supervising the defendant's treatment.
(Source: P.A. 100-27, eff. 1-1-18; 101-652, eff. 1-1-23.)
(725 ILCS 5/104-23) (from Ch. 38, par. 104-23)
Sec. 104-23. Unfit defendants. Cases involving an unfit
defendant who demands a discharge hearing or a defendant who
cannot become fit to stand trial and for whom no special
provisions or assistance can compensate for his disability and
render him fit shall proceed in the following manner:
(a) Upon a determination that there is not a substantial

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probability that the defendant will attain fitness within the
time period set in subsection (e) of Section 104-17 of this
Code from the original finding of unfitness, the court shall
hold a discharge hearing within 60 days, unless good cause is
shown for the delay. a defendant or the attorney for the
defendant may move for a discharge hearing pursuant to the
provisions of Section 104-25. The discharge hearing shall be
held within 120 days of the filing of a motion for a discharge
hearing, unless the delay is occasioned by the defendant.
(b) If at any time the court determines that there is not a
substantial probability that the defendant will become fit to
stand trial or to plead within the time period set in
subsection (e) of Section 104-17 of this Code from the date of
the original finding of unfitness, or if at the end of the time
period set in subsection (e) of Section 104-17 of this Code
from that date the court finds the defendant still unfit and
for whom no special provisions or assistance can compensate
for his disabilities and render him fit, the State shall
request the court:
(1) To set the matter for hearing pursuant to Section
104-25 unless a hearing has already been held pursuant to
paragraph (a) of this Section; or
(2) To release the defendant from custody and to
dismiss with prejudice the charges against him; or
(3) To remand the defendant to the custody of the
Department of Human Services and order a hearing to be

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conducted pursuant to the provisions of the Mental Health
and Developmental Disabilities Code, as now or hereafter
amended. The Department of Human Services shall have 7
days from the date it receives the defendant to prepare
and file the necessary petition and certificates that are
required for commitment under the Mental Health and
Developmental Disabilities Code. If the defendant is
committed to the Department of Human Services pursuant to
such hearing, the court having jurisdiction over the
criminal matter shall dismiss the charges against the
defendant, with the leave to reinstate. In such cases the
Department of Human Services shall notify the court, the
State's attorney and the defense attorney upon the
discharge of the defendant. A former defendant so
committed shall be treated in the same manner as any other
civilly committed patient for all purposes including
admission, selection of the place of treatment and the
treatment modalities, entitlement to rights and
privileges, transfer, and discharge. A defendant who is
not committed shall be remanded to the court having
jurisdiction of the criminal matter for disposition
pursuant to subparagraph (1) or (2) of paragraph (b) of
this Section.
(c) If the defendant is restored to fitness and the
original charges against him are reinstated, the speedy trial
provisions of Section 103-5 shall commence to run.

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(Source: P.A. 98-1025, eff. 8-22-14.)
Section 99. Effective date. This Act takes effect upon
becoming law.