Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 590 - UNDERSERVED HEALTH CARE PROVIDER WORKFORCE CODE › Subpart A - GENERAL PROVISIONS › Section 590.20 - Definitions

Current through Register Vol. 48, No. 28, July 12, 2024
When used in this Part, the following terms have the meanings
				  ascribed in this Section:
"Academic year" means September 1 in one year through August
				  31 of the next year, or as otherwise defined by the accredited school.
"Accredited family practice residency" means a training
				  program meeting the requirements of the Accreditation Council for Graduate
				  Medical Education of the American Medical Association, or the Committee on
				  Postdoctoral Training of the American Osteopathic Association.
"Accredited medical school" means a college or university at
				  which a Doctor of Medicine (M.D.) degree or a Doctor of Osteopathic Medicine
				  (D.O.) degree is earned. For an M.D., the college or university is accredited
				  by the Liaison Committee on Medical Education (
http://lcme.org/
). For a D.O., the college or
				  university is accredited by the Commission on Osteopathic College Accreditation
				  (
https://www.osteopathic.org/inside-aoa/accreditation/COM-accreditation/Pages/default.aspx
).
"Act" means the Underserved Health Care Provider Workforce
				  Act [110
				  ILCS 935 ].
"Administrative law judge" shall have the meaning ascribed in
				  77 Ill. Adm. Code 100 (Practice and Procedure in Administrative
				  Hearings).
"Advanced practice registered nurse" or "APRN" means
				  a person who has met the qualifications for a certified nurse midwife (CNM),
				  certified nurse practitioner (CNP); certified registered nurse anesthetist
				  (CRNA); or clinical nurse specialist (CNS) and has been licensed by the
				  Department of Financial and Professional Regulation. (Section 50-10 of the
				  Nurse Practice Act)
"Authorized representative" means a person who has authority
				  to act on behalf of the legal entity or person that is an applicant or grantee.
				  Authorized representatives are: for a corporation, any of its officers or
				  members of its board of directors; for a limited liability company, any of its
				  managers or members; for a partnership, any of its general partners; and for a
				  sole proprietor, the individual who is the sole proprietor.
"Board certified physician" means a physician who has passed
				  a medical specialty examination and who has maintained certification of that
				  specialty from a nationally recognized medical specialty board certification
				  body.
"Board eligible physician" means a physician who has
				  completed the requirements for admission to a medical specialty board
				  examination but has not yet taken and passed the examination.
"Breach of service obligation" means failure for any reason
				  to begin or complete all of a contractual service commitment.
"Business day" means Monday through Friday. It does not
				  include a federal or State government declared holiday, Saturday or
				  Sunday.
"Calendar day" means all days in a month or prescribed time
				  frame. It includes weekends and federal or State government declared
				  holidays.
"Center" means the Center for Rural Health of the Illinois
				  Department of Public Health.
"Certified Mail" means U.S. Mail for which proof of delivery
				  is obtained.
"Children's Health Insurance Program" or "CHIP" means health
				  coverage that is provided to eligible children, through the Illinois Department
				  of Healthcare and Family Services.
"Chiropractic physician" means a chiropractic
				  physician as defined in the Medical Practice Act of 1987.
(Section
				  3.11 of the Act)
"Commercial loans" means loans made by banks, credit unions,
				  savings and loan associations, insurance companies, and other licensed
				  financial institutions.
"Committee" means the Advisory Committee for
				  Residency Programs.
(Section
				  3.03 of the Act)
"Community-based organization" means a locally organized and
				  locally recognized group of individuals whose goals include efforts to lawfully
				  maintain or increase the availability of health care in their community.
"Construction" means the establishment of a new building
				  (including the installation of fixed equipment), or completion of shell space
				  in an existing building.
"Construction costs" or "Modernization costs" means expenses
				  from a construction contract.
"Continuous attendance" means enrollment in an accredited
				  medical school for an entire academic year and for the total duration of time
				  it takes the student to complete medical education, up to the maximum number of
				  years the recipient is eligible to receive the scholarship. Continuous
				  attendance shall be deemed to have been broken if the student goes more than 12
				  months without successfully completing a medical-related course from an
				  accredited medical school.
"Default" means failure to meet all legal obligations or
				  conditions of a loan.
"Deferment" means the temporary delay or postponement of a
				  scholarship recipient's continuous attendance or service obligation or an
				  educational loan repayment recipient's service obligation.
"Department" means the Illinois Department of Public
				  Health.
(Section
				  3.01 of the Act)
"Designated Shortage Area" means an area designated
				  by the Director as a physician shortage area, a medically underserved area, or
				  a critical health manpower shortage area as defined by the United States
				  Department of Health, Education and Welfare, or as further defined by the
				  Department to enable it to effectively fulfill the purpose stated in Section 2
				  of the Act. Such areas may include the following:
an urban or rural area which is a rational area for
				  the delivery of health services;
a population group;
a public or nonprofit private medical facility;
				  or
a government-owned, privately owned, independent, or
				  provider-based Rural Health Clinic or hospital that accepts Medicaid, Medicare,
				  the State's Children's Health Insurance Program, private insurance, and
				  self-pay.
(Section
				  3.04 of the Act)
"Direct patient care" means care of a patient provided by an
				  eligible health care provider. It may involve any aspect of the health care of
				  a patient, including diagnostic and treatment services; support services such
				  as laboratory, radiologic, and pharmacy; counseling; in-service for self-care;
				  patient education; and administration of medication.
"Director" means the Director of the Illinois
				  Department of Public Health.
(Section
				  3.02 of the Act)
"Disabled" shall have the meaning ascribed in Section
				  (2)(A)(2.1) of the Business Enterprise
				  for Minorities, Females and Persons with Disabilities Act.
"Disability" shall have the meaning ascribed in Section
				  1-103(I) of the Illinois Human Rights Act.
"Due diligence" means action taken toward the completion of a
				  project with the diligence and foresight that persons of ordinary prudence and
				  care would exercise under similar circumstances.
"Data Universal Numbering System" or "DUNS" is a system that
				  assigns a unique numeric identifier, referred to as a DUNS number, to a single
				  business entity.
"Educational loan repayment award" or "award" means the
				  amount of funding awarded to a recipient based upon reasonable educational
				  expenses, up to a maximum established by the program.
"Eligible health care provider" means a primary care
				  physician, general surgeon, emergency medicine physician, obstetrician,
				  anesthesiologist, chiropractic physician, advanced practice registered nurse,
				  or physician assistant who accepts Medicaid, Medicare, the State's Children's
				  Health Insurance Program, private insurance, and self-pay.
(Section
				  3.09 of the Act)
"Eligible medical student" means a person who meets
				  all of the following qualifications:
He or she is an Illinois resident at the time of
				  application for a scholarship;
He or she is studying medicine in
an
				  accredited
medical school located in Illinois or studying chiropractic
				  medicine in a chiropractic college or institution in Illinois;
He or she exhibits financial need as determined by
				  the Department; and
He or she agrees to practice full-time,
at
				  a Department approved site, located
in a Designated Shortage
				  Area
in Illinois
as a primary care physician, general surgeon,
				  emergency medicine physician, obstetrician, or chiropractic physician one year
				  for each year he or she is a scholarship recipient.
(Section
				  3.07 of the Act)
"Emergency medicine physician" means a physician licensed to
				  practice medicine in Illinois under the Medical Practice Act of 1987 with a
				  specialty dedicated to the care and treatment of acutely ill or injured
				  patients who need immediate medical attention.
"Equipment" means tangible personal property of a
				  non-consumable nature that may be acquired by a purchase, lease purchase, or
				  installment contract that has a value exceeding $100.
"Equipment costs" means the cost of movable capital equipment
				  that is not in a construction or renovation contract.
"Federally Qualified Health Center" or "FQHC" means a health
				  center funded under section 330 of the Public Health Service Act (42 U.S.C.
				  254b).
"Federally Qualified Health Center Look-Alike" or "FQHC
				  Look-Alike" means an organization that meets the requirements for receiving a
				  grant under section 330 of the Public Health Service Act but does not receive
				  federal grants under that authority.
"Federal poverty level as published in the Federal Register"
				  means the poverty level population figures published annually in the Federal
				  Register. The Federal Register may be found at the website:
https://www.federalregister.gov/
.
"Fellowship" means optional medical training, usually one
				  year, completed after residency training.
"Fiscal year" means the financial operating year of Illinois
				  State government. It begins on July 1 and ends on June 30 of the next calendar
				  year.
"Fixed equipment" means assets that are usually attached and
				  integral to the building's function.
"Forbearance" means the postponement of loan payments by a
				  lender for a temporary period to give the borrower time to make up overdue
				  payments.
"Full-time practice" means a recipient works a minimum of 40
				  hours per week, for a minimum of 45 weeks per year, at a medical facility
				  located in a designated shortage area in Illinois. For general surgeons and
				  emergency medicine physicians, full-time practice means working a minimum of 32
				  hours per week, for a minimum of 45 weeks per year, at a medical facility
				  located in a designated shortage area in Illinois.
"Funding period" means the time frame during which grant
				  funds are to be expended by the grantee (usually corresponding with the
				  Department's fiscal year).
"General surgeon" means a physician licensed to practice
				  medicine in Illinois under the Medical Practice Act of 1987 after successful
				  completion of an accredited surgical residency program, with a specialty in the
				  diagnosis, preoperative, operative, and postoperative surgical management of a
				  patient.
"Good academic standing" means a student is matriculating
				  with the rest of that student's class, as determined by the student's medical
				  school.
"Government loans" means loans made by federal, State, county
				  or city agencies authorized to make those loans.
"Grant" means funds awarded under the Act.
"Grantor agency"
means
any agency
				  of State government which dispenses grant funds.
(Section 2(a) of the
				  Illinois Grant Funds Recovery Act)
"Grant Agreement" or "agreement" means the agreement entered
				  into between the Department and the grantee setting forth the terms and
				  conditions of a scholarship or educational loan repayment award.
"Grant funds"
means
public funds
				  dispensed
by the Department
to any person or entity for
				  obligation, expenditure or use for a specific purpose.
(Section 2(b)
				  of the Illinois Grant Funds Recovery Act)
"Grantee" means a
person or entity which may use
				  grant funds.
(Section 2(c) of the Illinois Grant Funds Recovery
				  Act)
"Health Professional Shortage Area Score" or "HPSA score"
				  means the HPSA shortage severity score calculated by the U.S. Department of
				  Health and Human Services (HHS).
"Hospital" means a location defined in and licensed under the
				  Hospital Licensing Act [210 ILCS 85 ].
"Illinois resident" means a person who is a resident of
				  Illinois at the time of application for a Medical Student Scholarship or
				  educational loan repayment award and who is a citizen or national of the United
				  States.
"Legal holiday" means a holiday set by statute, during which
				  government working hours are suspended.
"Lender" means the commercial or government entity that made
				  the qualifying loan.
"Matriculation fees" means the actual educational expenses
				  charged to all students by the various medical schools. These fees are charged
				  to offset the expenses incurred by the school in areas such as the application
				  and enrollment processing, library use, mandatory health insurance, and student
				  activities.
"Medicaid" means a health insurance program for individuals
				  with limited income and limited financial assets. The Medicaid program is
				  jointly administered and funded by the federal and State government.
"Medical school" means any private or public nonprofit school
				  in Illinois that provides education leading to a doctor of medicine or doctor
				  of osteopathy degree, that is approved by the Illinois Department of Financial
				  and Professional Regulation, pursuant to the Medical Practice Act of 1987, and
				  that is accredited by the Liaison Committee on Medical Education (
http://lcme.org/
) or the Commission on
				  Osteopathic College Accreditation (
https://www.osteopathic.org/inside-aoa/accreditation/COM-accreditation/Pages/default.aspx
).
"Medical facility" means a facility for the delivery
				  of health services and includes a hospital, State mental health institution,
				  public health center, outpatient medical facility, rehabilitation facility,
				  long term care facility, community mental health center, migrant health center,
				  community health center,
rural health clinic,
or State
				  correctional institution.
(Section
				  3.08 of the Act)
"Medical student" means an individual studying medicine in an
				  accredited medical school located in Illinois or an individual studying
				  chiropractic medicine in a chiropractic college or institution in
				  Illinois.
"Medically underserved area" or "MUA" means a location
				  designated by the U.S. Department of Health and Human Services based on the
				  availability of primary care physicians, demographic characteristics, and
				  health status of the residents of a service area. The designation is used to
				  identify areas in need of additional health care services. MUAs can be found
				  at:
https://data.hrsa.gov/tools/shortage-area/mua-find
.
"Medically underserved population" or "MUP" means individuals
				  who:
reside in an HHS designated Health Professional Shortage Area
				  or a medically underserved area;
who are designated a medically underserved population by HHS;
				  or
who reside in an area designated by the Department as
				  underserved.
"Medicare" means the federal government's health insurance
				  program for: people who are 65 or older; certain younger people with
				  disabilities; and people with End-Stage Renal Disease (permanent kidney failure
				  requiring dialysis or a transplant, sometimes called ESRD).
"Metropolitan Statistical Area" or "MSA" means one or more
				  adjacent counties that have at least one urban core area of at least 50,000
				  population, plus adjacent territory that has a high degree of social and
				  economic integration with the core, as measured by commuting ties.
"Modernization" means alteration, renovation, upgrading, or
				  improvement of an existing building.
"Null and void" means an application submitted to the
				  Department has no legal force and is invalid.
"Obligation" or "Obligated" means a requirement for a grantee
				  to make future payments from grant funds that result from financial
				  transactions that have occurred with vendors or other entities in relation to
				  the grantee's activities.
"Obstetrician" means a physician licensed to practice
				  medicine in Illinois under the Medical Practice Act of 1987 with a specialty
				  dedicated to pregnancy, childbirth and the postpartum period.
"Official transcript" means transcripts that have been
				  received directly from the institution or have been issued to the applicant or
				  recipient in a sealed envelope, which shall remain sealed until its arrival at
				  the Department. The transcript shall include the institution's official seal,
				  the date the transcript was issued, and the registrar's signature. The
				  transcript will be verifiable by the Department.
"Part-time practice" means a recipient works a minimum of 20
				  hours per week, but no more than 39 hours per week, for a minimum of 45 weeks
				  per year, at a medical facility located in a designated shortage area in
				  Illinois. For general surgeons and emergency medicine physicians, part-time
				  practice means working a minimum of 16 hours per week but no more than 24 hours
				  per week, for a minimum of 45 weeks per year, at a medical facility located in
				  a designated shortage area in Illinois.
"Physician assistant" means an individual licensed under the
				  Physician Assistant Practice Act of 1987 [225 ILCS 95
				  ].
"Practice location" means the physical location where the
				  eligible health care provider practices predominately. For full-time eligible
				  health care providers, this means working at least 21 hours per week at this
				  location. For general surgeons and emergency medicine physicians, this means
				  working at least 17 hours per week at this location. For part-time providers,
				  this means working at least 11 hours per week at this location. For part-time
				  providers who are general surgeons and emergency medicine physicians, this
				  means workings at least nine hours per week at this location.
"Primary care" means health care that encompasses prevention
				  services, basic diagnostic and treatment services, and support services,
				  including laboratory, radiologic, and pharmacy.
"Primary care physician" means a person licensed to
				  practice medicine in all of its branches under the Medical Practice Act of 1987
				  with a specialty in Family Practice, Internal Medicine, Obstetrics and
				  Gynecology, or Pediatrics as defined by recognized standards of professional
				  medical practice.
(Section
				  3.05 of the Act)
"Private insurance" means a health insurance plan sold by the
				  private health insurance industry. This involves employer-sponsored plans and
				  private coverage purchased outside of the workplace from the individual and
				  family health insurance marketplace.
"Project completion" means that the project has concluded
				  based on the project objectives and within the time frame requirements in the
				  Grant Agreement.
"Qualifying loan" means government or commercial loans used
				  for tuition and reasonable educational and living expenses related to the
				  medical degree that was obtained by the recipient prior to the recipient's
				  application for loan repayment. These loans shall be contemporaneous with the
				  education received.
"Rational area" means the geographic area surrounding a
				  physician's office, a hospital or a clinic, from which the residents of the
				  geographic area may be reasonably expected to seek health care from the
				  physician, hospital or clinic located within that geographic area.
"Real property" means lands, structures, buildings, and
				  anything that is affixed to them. Real property does not include items that can
				  be moved, including equipment and furniture.
"Reasonable educational expenses" means the actual costs for
				  education, exclusive of tuition. These costs include, but are not limited to,
				  matriculation fees, books, supplies, clinical travel, educational equipment,
				  materials, board certification, or licensing examinations. These costs shall
				  not exceed the estimated standard budget for expenses for the degree program
				  and for the years of enrollment.
"Reasonable living expenses" means room and board,
				  transportation and commuting costs. These expenses shall not exceed the
				  estimated standard budget for the recipient's degree program and for the years
				  of enrollment.
"Recipient" means a medical student receiving funds from the
				  Illinois Medical Student Scholarship Program or an eligible health care
				  provider receiving educational loan repayment funds.
"Residency matching process" means the U.S. National Resident
				  Matching Program that coordinates the matching of medical students with the
				  hospitals and residency training programs in the medical students' selected
				  specialty. The matching application process usually lasts from June through
				  September of one year, with match announcements made in March of the following
				  year.
"Residency program" means a program accredited by
				  the Accreditation Council for Graduate Medical Education
(
http://www.acgme.org/
)
or the
				  Committee on Postdoctoral training of the American Osteopathic
				  Association
(
http://www.osteopathic.org/inside-aoa/accreditation/postdoctor-training-approval/Pages/default.aspx
)
.
(Section 3.06 of the Act)
"Residency training" means the years of graduate medical
				  education that follow medical school and that train the new physician in his or
				  her chosen specialty (e.g., family practice, pediatrics).
"Rural" means any geographic area not located in a U.S.
				  Bureau of the Census Metropolitan Statistical Area; or a county located within
				  a Metropolitan Statistical Area but having a population of 60,000 or less; or a
				  community located within a Metropolitan Statistical Area but having a
				  population of 2,500 or less.
"Rural Health Clinic" means a clinic that is located in a
				  rural area designated as a shortage area, is not a rehabilitation agency or a
				  facility primarily for the care and treatment of mental diseases and provides
				  primary care and routine laboratory services to medically underserved
				  populations.
"Self-pay" means a patient who pays for their health-related
				  service in absence of insurance to cover the medical or surgical procedure
				  performed.
"Service obligation" means an eligible health care provider
				  who practices full-time or part-time at a medical facility in a designated
				  shortage area in Illinois. For medical student scholarship recipients, the
				  physician must work
one year for each year he or she is a scholarship
				  recipient.
(Section
				  3.07(d) of the
				  Act) For educational loan repayment recipients, the eligible health care
				  provider must work full-time for two years or part-time for four years at a
				  medical facility in a designated shortage area in Illinois for the initial
				  grant term.
"Shell space" means space constructed to meet future needs.
				  It is space enclosed by an exterior building shell, but otherwise unfinished
				  inside.
"Submission of application" means that a complete grant,
				  scholarship or educational loan repayment application has been received by the
				  Department by the established deadline. Submission does not mean that the
				  application is postmarked by the established submission deadline but arrives at
				  the Department on a later date.
"Supplant" means to replace, to take the place of, or to
				  supersede. As used in this Part, grant funds cannot be used to replace or
				  supersede other sources of funding.
"Supplies" means a general purpose consumable item that
				  commonly has a shorter life span than equipment, and that is stocked for
				  recurring use.
"Supplies expense" means the actual costs incurred for
				  general purpose consumable items that have a shorter life span than equipment
				  and that are stocked for recurring use.
"Suspension" means an action by the Department to suspend a
				  recipient's participation in Department grant and loan repayment programs for a
				  specified period of time.
"Termination for cause" means termination of employment
				  caused by the eligible health care provider's personal dishonesty, willful
				  misconduct, breach of fiduciary duty, intentional failure to perform stated
				  duties, or the willful violation of any law, rule or regulation, any of which
				  results in material loss to the employer.
"Termination without cause" means termination of the eligible
				  health care provider's employment for the convenience of the employer.
"Toll" or "Tolling" means to pause, postpone or suspend the
				  running of a defined time period.
"Total and permanent disability" means a physical or mental
				  impairment, disease, or loss of a permanent nature that prevents employment
				  with or without reasonable accommodation.
"Travel" means the actual cost incurred by a grantee's
				  employees to travel to fulfill specific job requirements. These costs could
				  include air travel, local transportation, per diem, mileage allowance and
				  lodging.
"Tuition" means the established charges of a medical school
				  for instruction at that institution.
"United States citizen" means an individual born in the
				  United States; Puerto Rico (on or after April 11, 1899); the Canal Zone or the
				  Republic of Panama (on or after February 26, 1904); the Virgin Islands (on or
				  after January 17, 1917); Guam (after April 11, 1899); or the Commonwealth of
				  the Northern Mariana Islands (on or after November 4, 1986); foreign-born
				  children, under age 18, residing in the U.S. with their birth or adoptive
				  parents, at least one of whom is a U.S. citizen by birth or naturalization; and
				  individuals granted citizenship status by the U.S. Department of Homeland
				  Security, Customs and Immigration Service. (See
https://www.uscis.gov/policy-manual/volume-12-part-a-chapter-2#footnote-6
)
"Urban" means any geographic area that does not meet the
				  definition of "rural" in this Section.
"Waiver" means to permanently relieve a scholarship or
				  educational loan repayment recipient's continuous attendance or service
				  obligation, expressly put forth in writing.