Human Services Committee

Filed: 5/16/2007

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 244

2     AMENDMENT NO. ______. Amend Senate Bill 244 as follows:
 
3 immediately above the enacting clause, by inserting the
4 following:
 
5     "WHEREAS, The 94th General Assembly funded a study by the
6 Lewin Group, "An Evaluation of Illinois' 'Certificate of Need'
7 Program", which recommended that "... the Illinois legislature
8 move forward to continue the 'Certificate-of-Need' program
9 with an abundance of caution...". Given the potential for harm
10 to specific critical elements of the health care system,
11 non-traditional arguments for maintaining
12 "Certificate-of-Need" laws deserve consideration, until the
13 evidence on the impact that specialty providers and ambulatory
14 surgery centers may have on safety-net providers and services
15 can be better quantified. In response to the Lewin analysis and
16 additional concerns regarding health planning in Illinois, the

 

 

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1 95th General Assembly enacted Senate Bill 611 (Public Act
2 95-0001) that extended the "sunset" date of the Illinois Health
3 Facilities Planning Act from April 1, 2007 to May 31, 2007 so
4 that interested parties could agree on a strategy to further
5 extend the "sunset" date, and develop a more comprehensive
6 reform agenda; therefore"; and
 
7 by replacing everything after the enacting clause with the
8 following:
 
9     "Section 5. The Illinois Health Facilities Planning Act is
10 amended by changing Section 19.6 and by adding Sections 12.5
11 and 15.5 as follows:
 
12     (20 ILCS 3960/12.5 new)
13     Sec. 12.5. Update of existing bed inventory and associated
14 bed need projections. The State Agency shall immediately update
15 the existing bed inventory and associated bed need projections
16 required by Sections 12 and 12.3 of this Act, using the most
17 recently published historical utilization data, 10-year
18 population projections, and a consistent 85% migration factor
19 for each category of service.
 
20     (20 ILCS 3960/15.5 new)
21     Sec. 15.5. Task Force on Health Planning Reform.
22     (a) The Task Force on Health Planning Reform is created.

 

 

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1     (b) The Task Force shall consist of 15 voting members, as
2 follows: 6 persons, who are not currently employed by a State
3 agency, appointed by the Director of Public Health, 3 of whom
4 shall be persons with knowledge and experience in the delivery
5 of health care services, including at least 1 person
6 representing organized health service workers, 2 of whom shall
7 be persons with professional experience in the administration
8 or management of health care facilities, and 1 of whom shall be
9 a person with experience in health planning; 2 members of the
10 Illinois Senate appointed by the President of the Senate, one
11 of whom shall be designated a co-chair at the time of
12 appointment; 2 members of the Illinois Senate appointed by the
13 Senate Minority Leader; 2 members of the Illinois House of
14 Representatives appointed by the Speaker of the House of
15 Representatives, one of whom shall be designated a co-chair at
16 the time of appointment; 2 members of the Illinois House of
17 Representatives appointed by the House Minority Leader; and one
18 member, or a designee, appointed by the Attorney General of
19 Illinois.
20     The following persons, or their designees, shall serve, ex
21 officio, as nonvoting members of the Task Force: the Director
22 of Public Health, the Secretary of the Illinois Health
23 Facilities Planning Board, the Director of Healthcare and
24 Family Services, the Secretary of Human Services, and the
25 Director of the Governor's Office of Management and Budget.
26     Members shall serve without compensation, but may be

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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