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1     AN ACT concerning State government.
 
2     WHEREAS, The 94th General Assembly funded a study by the
3 Lewin Group, "An Evaluation of Illinois' 'Certificate of Need'
4 Program", which recommended that "... the Illinois legislature
5 move forward to continue the 'Certificate-of-Need' program
6 with an abundance of caution...". Given the potential for harm
7 to specific critical elements of the health care system,
8 non-traditional arguments for maintaining
9 "Certificate-of-Need" laws deserve consideration, until the
10 evidence on the impact that specialty providers and ambulatory
11 surgery centers may have on safety-net providers and services
12 can be better quantified. In response to the Lewin analysis and
13 additional concerns regarding health planning in Illinois, the
14 95th General Assembly enacted Senate Bill 611 (Public Act
15 95-0001) that extended the "sunset" date of the Illinois Health
16 Facilities Planning Act from April 1, 2007 to May 31, 2007 so
17 that interested parties could agree on a strategy to further
18 extend the "sunset" date, and develop a more comprehensive
19 reform agenda; therefore
 
20     Be it enacted by the People of the State of Illinois,
21 represented in the General Assembly:
 
22     Section 5. The Illinois Health Facilities Planning Act is
23 amended by changing Section 19.6 and by adding Sections 12.5

 

 

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1 and 15.5 as follows:
 
2     (20 ILCS 3960/12.5 new)
3     Sec. 12.5. Update existing bed inventory and associated bed
4 need projections. While the Task Force on Health Planning
5 Reform will make long-term recommendations related to the
6 method and formula for calculating the bed inventory and
7 associated bed need projections, there is a current need for
8 the bed inventory to be updated prior to the issuance of the
9 recommendations of the Task Force. Therefore, the State Agency
10 shall immediately update the existing bed inventory and
11 associated bed need projections required by Sections 12 and
12 12.3 of this Act, using the most recently published historical
13 utilization data, 10-year population projections, and an
14 appropriate migration factor for the medical-surgical and
15 pediatric category of service which shall be no less than 50%.
16 The State Agency shall provide written documentation providing
17 the methodology and rationale used to determine the appropriate
18 migration factor.
 
19     (20 ILCS 3960/15.5 new)
20     Sec. 15.5. Task Force on Health Planning Reform.
21     (a) The Task Force on Health Planning Reform is created.
22     (b) The Task Force shall consist of 19 voting members, as
23 follows: 6 persons, who are not currently employed by a State
24 agency, appointed by the Director of Public Health, 3 of whom

 

 

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1 shall be persons with knowledge and experience in the delivery
2 of health care services, including at least one person
3 representing organized health service workers, 2 of whom shall
4 be persons with professional experience in the administration
5 or management of health care facilities, and one of whom shall
6 be a person with experience in health planning; 2 members of
7 the Illinois Senate appointed by the President of the Senate,
8 one of whom shall be a co-chair to the Task Force; 2 members of
9 the Illinois Senate appointed by the Senate Minority Leader; 2
10 members of the Illinois House of Representatives appointed by
11 the Speaker of the House of Representatives, one of whom shall
12 be a co-chair to the Task Force; 2 members of the Illinois
13 House of Representatives appointed by the House Minority
14 Leader; the Attorney General, or his or her designee; and 4
15 members of the general public, representing health care
16 consumers, appointed by the Attorney General of Illinois.
17     The following persons, or their designees, shall serve, ex
18 officio, as nonvoting members of the Task Force: the Director
19 of Public Health, the Secretary of the Illinois Health
20 Facilities Planning Board, the Director of Healthcare and
21 Family Services, the Secretary of Human Services, and the
22 Director of the Governor's Office of Management and Budget.
23     Members shall serve without compensation, but may be
24 reimbursed for their expenses in relation to duties on the Task
25 Force.
26     A vote of 12 members appointed to the Task Force is

 

 

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1 required with respect to the adoption of recommendations to the
2 Governor and General Assembly and the final report required by
3 this Section.
4     (c) The Task Force shall gather information and make
5 recommendations relating to at least the following topics in
6 relation to the Illinois Health Facilities Planning Act:
7         (1) The impact of health planning on the provision of
8     essential and accessible health care services; prevention
9     of unnecessary duplication of facilities and services;
10     improvement in the efficiency of the health care system;
11     maintenance of an environment in the health care system
12     that supports quality care; the most economic use of
13     available resources; and the effect of repealing this Act.
14         (2) Reform of the Illinois Health Facilities Planning
15     Board to enable it to undertake a more active role in
16     health planning to provide guidance in the development of
17     services to meet the health care needs of Illinois,
18     including identifying and recommending initiatives to meet
19     special needs.
20         (3) Reforms to ensure that health planning under the
21     Illinois Health Facilities Planning Act is coordinated
22     with other health planning laws and activities of the
23     State.
24         (4) Reforms that will enable the Illinois Health
25     Facilities Planning Board to focus most of its project
26     review efforts on "Certificate-of-Need" applications

 

 

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1     involving new facilities, discontinuation of services,
2     major expansions, and volume-sensitive services, and to
3     expedite review of other projects to the maximum extent
4     possible.
5         (5) Reforms that will enable the Illinois Health
6     Facilities Planning Board to determine how criteria,
7     standards, and procedures for evaluating project
8     applications involving specialty providers, ambulatory
9     surgical facilities, and other alternative health care
10     models should be amended to give special attention to the
11     impact of those projects on traditional community
12     hospitals to assure the availability and access to
13     essential quality medical care in those communities.
14         (6) Implementation of policies and procedures
15     necessary for the Illinois Health Facilities Planning
16     Board to give special consideration to the impact of the
17     projects it reviews on access to "safety net" services.
18         (7) Changes in policies and procedures to make the
19     Illinois health facilities planning process predictable,
20     transparent, and as efficient as possible; requiring the
21     State Agency (the Illinois Department of Public Health) and
22     the Illinois Health Facilities Planning Board to provide
23     timely and appropriate explanations of its decisions and
24     establish more effective procedures to enable public
25     review and comment on facts set forth in State Agency staff
26     analyses of project applications prior to the issuance of

 

 

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1     final decisions on each project.
2         (8) Reforms to ensure that patient access to new and
3     modernized services will not be delayed during a transition
4     period under any proposed system reform; and that the
5     transition should minimize disruption of the process for
6     current applicants.
7         (9) Identification of the resources necessary to
8     support the work of the Agency and the Board.
9     (d) The Task Force shall recommend reforms regarding the
10 following:
11         (1) The size and membership of current Illinois Health
12     Facilities Planning Board. Review and make recommendations
13     on the reorganization of the structure and function of the
14     Illinois Health Facilities Planning Board and the State
15     Agency responsible for health planning (the Illinois
16     Department of Public Health), giving consideration to
17     various options for reassigning the primary responsibility
18     for the review, approval, and denial of project
19     applications between the Board and the State Agency, so
20     that the "Certificate-of-Need" process is administered in
21     the most effective, efficient, and consistent manner
22     possible in accordance with the objectives referenced in
23     subsection (c) of this Section.
24         (2) Changes in policies and procedures that will charge
25     the Illinois Health Facilities Planning Board with
26     developing a long-range health facilities plan (10 years)

 

 

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1     to be updated at least every 2 years, so that it is a
2     rolling 10-year plan based upon data no older than 2 years.
3     The plan should incorporate an inventory of the State's
4     health facilities infrastructure including both facilities
5     and services regulated under this Act, as well as
6     facilities and services that are not currently regulated
7     under this Act, as determined by the Board. The planning
8     criteria and standards should be adjusted to take into
9     consideration services that are regulated under the Act,
10     but are also offered by non-regulated providers. The
11     Illinois Department of Public Health bed inventory should
12     be updated each year using the most recent utilization data
13     for both hospitals and long-term care facilities including
14     2003, 2004, 2005 and subsequent-year inpatient discharges
15     and days. This revised bed supply should be used as the bed
16     supply input for all Planning Area bed-need calculations.
17     Ten-year population projection data should be incorporated
18     into the plan. Plan updates may include redrawing planning
19     area boundaries to reflect population changes. The Task
20     Force shall consider whether the inventory formula should
21     use migration factors for the medical/surgical,
22     pediatrics, obstetrics, and other categories of service,
23     and if so, what those migration factors should be. The
24     Board should hold public hearings on the plan and its
25     updates. There should be a mechanism for the public to
26     request that the plan be updated more frequently to address

 

 

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1     emerging population and demographic trends. In developing
2     the plan, the Board should consider health plans and other
3     related publications that have been developed both in
4     Illinois and nationally. In developing the plan, the need
5     to ensure access to care, especially for "safety net"
6     services, including rural and medically underserved
7     communities, should be included.
8         (3) Changes in regulations that establish separate
9     criteria, standards, and procedures when necessary to
10     adjust for structural, functional, and operational
11     differences between long-term care facilities and acute
12     care facilities and that allow routine changes of
13     ownership, facility sales, and closure requests to be
14     processed on a timely basis. Consider rules to allow
15     flexibility for facilities to modernize, expand, or
16     convert to alternative uses that are in accord with health
17     planning standards.
18         (4) Changes in policies and procedures so that the
19     Illinois Health Facilities Planning Board updates the
20     standards and criteria on a regular basis and proposes new
21     standards to keep pace with the evolving health care
22     delivery system. Proton Therapy and Treatment is an example
23     of a new, cutting-edge procedure that may require the Board
24     to immediately develop criteria, standards, and procedures
25     for that type of facility. Temporary advisory committees
26     may be appointed to assist in the development of revisions

 

 

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1     to the Board's standards and criteria, including experts
2     with professional competence in the subject matter of the
3     proposed standards or criteria that are to be developed.
4         (5) Changes in policies and procedures to expedite
5     project approval, particularly for less complex projects,
6     including standards for determining whether a project is in
7     "substantial compliance" with the Board's review
8     standards. The review standards must include a requirement
9     for applicants to include a "Safety Net" Impact Statement.
10     This Statement shall describe the project's impact on
11     safety net services in the community. The State Agency
12     Report shall include an assessment of the Statement.
13         (6) Changes to enforcement processes and compliance
14     standards to ensure they are fair and consistent with the
15     severity of the violation.
16         (7) Revisions in policies and procedures to prevent
17     conflicts of interest by members of the Illinois Health
18     Facilities Planning Board and State Agency staff,
19     including increasing the penalties for violations.
20         (8) Other changes determined necessary to improve the
21     administration of this Act.
22     (e) The State Agency, at the direction of the Task Force,
23 may hire any necessary staff or consultants, enter into
24 contracts, and make any expenditures necessary for carrying out
25 the duties of the Task Force, all out of moneys appropriated
26 for that purpose. Staff support services shall be provided to

 

 

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1 the Task Force by the State Agency from such appropriations.
2     (f) The Task Force may establish any advisory committee to
3 ensure maximum public participation in the Task Force's
4 planning, organization, and implementation review process. If
5 established, advisory committees shall (i) advise and assist
6 the Task Force in its duties and (ii) help the Task Force to
7 identify issues of public concern.
8     (g) The Task Force shall submit findings and
9 recommendations to the Governor and the General Assembly by
10 March 1, 2008, including any necessary implementing
11 legislation, and recommendations for changes to policies,
12 rules, or procedures that are not incorporated in the
13 implementing legislation.
14     (h) The Task Force is abolished on August 1, 2008.
 
15     (20 ILCS 3960/19.6)
16     (Section scheduled to be repealed on May 31, 2007)
17     Sec. 19.6. Repeal. This Act is repealed on August 31, 2008
18 May 31, 2007.
19 (Source: P.A. 94-983, eff. 6-30-06; 95-1, eff. 3-30-07.)
 
20     Section 99. Effective date. This Act takes effect upon
21 becoming law.