Full Text of HB3657 102nd General Assembly
HB3657eng 102ND GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning State government.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Department of Public Health Powers and | 5 | | Duties Law of the
Civil Administrative Code of Illinois is | 6 | | amended by renumbering Section 2310-223 as follows: | 7 | | (20 ILCS 2310/2310-222) | 8 | | Sec. 2310-222 2310-223 . Obstetric hemorrhage and | 9 | | hypertension training. | 10 | | (a) As used in this Section, "birthing facility" means (1) | 11 | | a hospital, as defined in the Hospital Licensing Act, with | 12 | | more than one licensed obstetric bed or a neonatal intensive | 13 | | care unit; (2) a hospital operated by a State university; or | 14 | | (3) a birth center, as defined in the Alternative Health Care | 15 | | Delivery Act. | 16 | | (b) The Department shall ensure that all birthing | 17 | | facilities conduct continuing education yearly for providers | 18 | | and staff of obstetric medicine and of the emergency | 19 | | department and other staff that may care for pregnant or | 20 | | postpartum women. The continuing education shall include | 21 | | yearly educational modules regarding management of severe | 22 | | maternal hypertension and obstetric hemorrhage for units that | 23 | | care for pregnant or postpartum women. Birthing facilities |
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| 1 | | must demonstrate compliance with these education and training | 2 | | requirements. | 3 | | (c) The Department shall collaborate with the Illinois | 4 | | Perinatal Quality Collaborative or its successor organization | 5 | | to develop an initiative to improve birth equity and reduce | 6 | | peripartum racial and ethnic disparities. The Department shall | 7 | | ensure that the initiative includes the development of best | 8 | | practices for implicit bias training and education in cultural | 9 | | competency to be used by birthing facilities in interactions | 10 | | between patients and providers. In developing the initiative, | 11 | | the Illinois Perinatal Quality Collaborative or its successor | 12 | | organization shall consider existing programs, such as the | 13 | | Alliance for Innovation on Maternal Health and the California | 14 | | Maternal Quality Collaborative's pilot work on improving birth | 15 | | equity. The Department shall support the initiation of a | 16 | | statewide perinatal quality improvement initiative in | 17 | | collaboration with birthing facilities to implement strategies | 18 | | to reduce peripartum racial and ethnic disparities and to | 19 | | address implicit bias in the health care system. | 20 | | (d) The Department, in consultation with the Maternal | 21 | | Mortality Review Committee, shall make available to all | 22 | | birthing facilities best practices for timely identification | 23 | | of all pregnant and postpartum women in the emergency | 24 | | department and for appropriate and timely consultation of an | 25 | | obstetric provider to provide input on management and | 26 | | follow-up. Birthing facilities may use telemedicine for the |
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| 1 | | consultation. | 2 | | (e) The Department may adopt rules for the purpose of | 3 | | implementing this Section.
| 4 | | (Source: P.A. 101-390, eff. 1-1-20; revised 10-7-19.) | 5 | | Section 10. The Illinois Health Facilities Planning Act is | 6 | | amended by changing Sections 2, 3, 5, 5.4, 6, 6.2, 8.5, 8.7, | 7 | | 12, 12.3, 12.4, 13.1, 14, and 14.1 and by adding Sections 5.5, | 8 | | 5.6, 6.05, and 14.05 as follows:
| 9 | | (20 ILCS 3960/2) (from Ch. 111 1/2, par. 1152)
| 10 | | (Section scheduled to be repealed on December 31, 2029)
| 11 | | Sec. 2. Purpose of the Act. This Act shall establish a | 12 | | procedure (1) which requires a person
establishing, | 13 | | constructing or modifying a health care facility, as
herein | 14 | | defined, to have the qualifications, background, character and
| 15 | | financial resources to adequately provide a proper service for | 16 | | the
community; (2) that promotes the orderly and
economic | 17 | | development of health care facilities in the State of Illinois
| 18 | | that avoids unnecessary duplication of such facilities; (3) | 19 | | that promotes health equity including equitable access to | 20 | | quality health care through the development and preservation | 21 | | of safety net services; and (4) (3) that
promotes planning for | 22 | | and development of health care facilities needed
for | 23 | | comprehensive health care especially in areas where the health
| 24 | | planning process has identified unmet needs.
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| 1 | | The changes made to this Act by this amendatory Act of the | 2 | | 96th General Assembly are intended to accomplish the following | 3 | | objectives: to improve the financial ability of the public to | 4 | | obtain necessary health services; to establish an orderly and | 5 | | comprehensive health care delivery system that will guarantee | 6 | | the availability of quality health care to the general public; | 7 | | to maintain and improve the provision of essential health care | 8 | | services and increase the accessibility of those services to | 9 | | the medically underserved and indigent; to assure that the | 10 | | reduction and closure of health care services or facilities is | 11 | | performed in an orderly and timely manner, and that these | 12 | | actions are deemed to be in the best interests of the public; | 13 | | and to assess the financial burden to patients caused by | 14 | | unnecessary health care construction and modification. | 15 | | Evidence-based assessments, projections and decisions will be | 16 | | applied regarding capacity, quality, value and equity in the | 17 | | delivery of health care services in Illinois. The integrity of | 18 | | the Certificate of Need process is ensured through revised | 19 | | ethics and communications procedures. Cost containment and | 20 | | support for safety net services must continue to be central | 21 | | tenets of the Certificate of Need process. | 22 | | The changes made to this Act by this amendatory Act of the | 23 | | 102nd General Assembly recognize a persistent problem of | 24 | | hospital service cuts and facility closures. These harm the | 25 | | health care safety net in Illinois and have negatively | 26 | | impacted access to hospital services in communities of color |
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| 1 | | in particular. The changes are intended to accomplish the | 2 | | objective of protecting the public interest in equitable | 3 | | access to health care services. | 4 | | (Source: P.A. 99-527, eff. 1-1-17 .)
| 5 | | (20 ILCS 3960/3) (from Ch. 111 1/2, par. 1153)
| 6 | | (Section scheduled to be repealed on December 31, 2029) | 7 | | Sec. 3. Definitions. As used in this Act:
| 8 | | "Health care facilities" means and includes
the following | 9 | | facilities, organizations, and related persons:
| 10 | | (1) An ambulatory surgical treatment center required | 11 | | to be licensed
pursuant to the Ambulatory Surgical | 12 | | Treatment Center Act.
| 13 | | (2) An institution, place, building, or agency | 14 | | required to be licensed
pursuant to the Hospital Licensing | 15 | | Act.
| 16 | | (3) Skilled and intermediate long term care facilities | 17 | | licensed under the
Nursing
Home Care Act. | 18 | | (A) If a demonstration project under the Nursing | 19 | | Home Care Act applies for a certificate of need to | 20 | | convert to a nursing facility, it shall meet the | 21 | | licensure and certificate of need requirements in | 22 | | effect as of the date of application. | 23 | | (B) Except as provided in item (A) of this | 24 | | subsection, this Act does not apply to facilities | 25 | | granted waivers under Section 3-102.2 of the Nursing |
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| 1 | | Home Care Act.
| 2 | | (3.5) Skilled and intermediate care facilities | 3 | | licensed under the ID/DD Community Care Act or the MC/DD | 4 | | Act. No permit or exemption is required for a facility | 5 | | licensed under the ID/DD Community Care Act or the MC/DD | 6 | | Act prior to the reduction of the number of beds at a | 7 | | facility. If there is a total reduction of beds at a | 8 | | facility licensed under the ID/DD Community Care Act or | 9 | | the MC/DD Act, this is a discontinuation or closure of the | 10 | | facility. If a facility licensed under the ID/DD Community | 11 | | Care Act or the MC/DD Act reduces the number of beds or | 12 | | discontinues the facility, that facility must notify the | 13 | | Board as provided in Section 14.1 of this Act. | 14 | | (3.7) Facilities licensed under the Specialized Mental | 15 | | Health Rehabilitation Act of 2013. | 16 | | (4) Hospitals, nursing homes, ambulatory surgical | 17 | | treatment centers, or
kidney disease treatment centers
| 18 | | maintained by the State or any department or agency | 19 | | thereof.
| 20 | | (5) Kidney disease treatment centers, including a | 21 | | free-standing
hemodialysis unit required to meet the | 22 | | requirements of 42 CFR 494 in order to be certified for | 23 | | participation in Medicare and Medicaid under Titles XVIII | 24 | | and XIX of the federal Social Security Act.
| 25 | | (A) This Act does not apply to a dialysis facility | 26 | | that provides only dialysis training, support, and |
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| 1 | | related services to individuals with end stage renal | 2 | | disease who have elected to receive home dialysis. | 3 | | (B) This Act does not apply to a dialysis unit | 4 | | located in a licensed nursing home that offers or | 5 | | provides dialysis-related services to residents with | 6 | | end stage renal disease who have elected to receive | 7 | | home dialysis within the nursing home. | 8 | | (C) The Board, however, may require dialysis | 9 | | facilities and licensed nursing homes under items (A) | 10 | | and (B) of this subsection to report statistical | 11 | | information on a quarterly basis to the Board to be | 12 | | used by the Board to conduct analyses on the need for | 13 | | proposed kidney disease treatment centers. | 14 | | (6) An institution, place, building, or room used for | 15 | | the performance of
outpatient surgical procedures that is | 16 | | leased, owned, or operated by or on
behalf of an | 17 | | out-of-state facility.
| 18 | | (7) An institution, place, building, or room used for | 19 | | provision of a health care category of service, including, | 20 | | but not limited to, cardiac catheterization and open heart | 21 | | surgery. | 22 | | (8) An institution, place, building, or room housing | 23 | | major medical equipment used in the direct clinical | 24 | | diagnosis or treatment of patients, and whose project cost | 25 | | is in excess of the capital expenditure minimum. | 26 | | "Health care facilities" does not include the following |
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| 1 | | entities or facility transactions: | 2 | | (1) Federally-owned facilities. | 3 | | (2) Facilities used solely for healing by prayer or | 4 | | spiritual means. | 5 | | (3) An existing facility located on any campus | 6 | | facility as defined in Section 5-5.8b of the Illinois | 7 | | Public Aid Code, provided that the campus facility | 8 | | encompasses 30 or more contiguous acres and that the new | 9 | | or renovated facility is intended for use by a licensed | 10 | | residential facility. | 11 | | (4) Facilities licensed under the Supportive | 12 | | Residences Licensing Act or the Assisted Living and Shared | 13 | | Housing Act. | 14 | | (5) Facilities designated as supportive living | 15 | | facilities that are in good standing with the program | 16 | | established under Section 5-5.01a of the Illinois Public | 17 | | Aid Code. | 18 | | (6) Facilities established and operating under the | 19 | | Alternative Health Care Delivery Act as a children's | 20 | | community-based health care center alternative health care | 21 | | model demonstration program or as an Alzheimer's Disease | 22 | | Management Center alternative health care model | 23 | | demonstration program. | 24 | | (7) The closure of an entity or a portion of an entity | 25 | | licensed under the Nursing Home Care Act, the Specialized | 26 | | Mental Health Rehabilitation Act of 2013, the ID/DD |
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| 1 | | Community Care Act, or the MC/DD Act, with the exception | 2 | | of facilities operated by a county or Illinois Veterans | 3 | | Homes, that elect to convert, in whole or in part, to an | 4 | | assisted living or shared housing establishment licensed | 5 | | under the Assisted Living and Shared Housing Act and with | 6 | | the exception of a facility licensed under the Specialized | 7 | | Mental Health Rehabilitation Act of 2013 in connection | 8 | | with a proposal to close a facility and re-establish the | 9 | | facility in another location. | 10 | | (8) Any change of ownership of a health care facility | 11 | | that is licensed under the Nursing Home Care Act, the | 12 | | Specialized Mental Health Rehabilitation Act of 2013, the | 13 | | ID/DD Community Care Act, or the MC/DD Act, with the | 14 | | exception of facilities operated by a county or Illinois | 15 | | Veterans Homes. Changes of ownership of facilities | 16 | | licensed under the Nursing Home Care Act must meet the | 17 | | requirements set forth in Sections 3-101 through 3-119 of | 18 | | the Nursing Home Care Act.
| 19 | | (9) (Blank). | 20 | | With the exception of those health care facilities | 21 | | specifically
included in this Section, nothing in this Act | 22 | | shall be intended to
include facilities operated as a part of | 23 | | the practice of a physician or
other licensed health care | 24 | | professional, whether practicing in his
individual capacity or | 25 | | within the legal structure of any partnership,
medical or | 26 | | professional corporation, or unincorporated medical or
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| 1 | | professional group. Further, this Act shall not apply to | 2 | | physicians or
other licensed health care professional's | 3 | | practices where such practices
are carried out in a portion of | 4 | | a health care facility under contract
with such health care | 5 | | facility by a physician or by other licensed
health care | 6 | | professionals, whether practicing in his individual capacity
| 7 | | or within the legal structure of any partnership, medical or
| 8 | | professional corporation, or unincorporated medical or | 9 | | professional
groups, unless the entity constructs, modifies, | 10 | | or establishes a health care facility as specifically defined | 11 | | in this Section. This Act shall apply to construction or
| 12 | | modification and to establishment by such health care facility | 13 | | of such
contracted portion which is subject to facility | 14 | | licensing requirements,
irrespective of the party responsible | 15 | | for such action or attendant
financial obligation.
| 16 | | "Person" means any one or more natural persons, legal | 17 | | entities,
governmental bodies other than federal, or any | 18 | | combination thereof.
| 19 | | "Consumer" means any person other than a person (a) whose | 20 | | major
occupation currently involves or whose official capacity | 21 | | within the last
12 months has involved the providing, | 22 | | administering or financing of any
type of health care | 23 | | facility, (b) who is engaged in health research or
the | 24 | | teaching of health, (c) who has a material financial interest | 25 | | in any
activity which involves the providing, administering or | 26 | | financing of any
type of health care facility, or (d) who is or |
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| 1 | | ever has been a member of
the immediate family of the person | 2 | | defined by item (a), (b), or (c).
| 3 | | "State Board" or "Board" means the Health Facilities and | 4 | | Services Review Board.
| 5 | | "Construction or modification" means the establishment, | 6 | | erection,
building, alteration, reconstruction, | 7 | | modernization, improvement,
extension, discontinuation, | 8 | | change of ownership, of or by a health care
facility, or the | 9 | | purchase or acquisition by or through a health care facility
| 10 | | of
equipment or service for diagnostic or therapeutic purposes | 11 | | or for
facility administration or operation, or any capital | 12 | | expenditure made by
or on behalf of a health care facility | 13 | | which
exceeds the capital expenditure minimum; however, any | 14 | | capital expenditure
made by or on behalf of a health care | 15 | | facility for (i) the construction or
modification of a | 16 | | facility licensed under the Assisted Living and Shared
Housing | 17 | | Act or (ii) a conversion project undertaken in accordance with | 18 | | Section 30 of the Older Adult Services Act shall be excluded | 19 | | from any obligations under this Act. For the purposes of this | 20 | | paragraph and Act, any temporary suspension of a category of | 21 | | service by a hospital for a time period exceeding 90 days shall | 22 | | be considered a discontinuation of a category of service.
| 23 | | "Establish" means the construction of a health care | 24 | | facility or the
replacement of an existing facility on another | 25 | | site or the initiation of a category of service.
| 26 | | "Major medical equipment" means medical equipment which is |
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| 1 | | used for the
provision of medical and other health services | 2 | | and which costs in excess
of the capital expenditure minimum, | 3 | | except that such term does not include
medical equipment | 4 | | acquired
by or on behalf of a clinical laboratory to provide | 5 | | clinical laboratory
services if the clinical laboratory is | 6 | | independent of a physician's office
and a hospital and it has | 7 | | been determined under Title XVIII of the Social
Security Act | 8 | | to meet the requirements of paragraphs (10) and (11) of | 9 | | Section
1861(s) of such Act. In determining whether medical | 10 | | equipment has a value
in excess of the capital expenditure | 11 | | minimum, the value of studies, surveys,
designs, plans, | 12 | | working drawings, specifications, and other activities
| 13 | | essential to the acquisition of such equipment shall be | 14 | | included.
| 15 | | "Capital expenditure" means an expenditure: (A) made by or | 16 | | on behalf of
a health care facility (as such a facility is | 17 | | defined in this Act); and
(B) which under generally accepted | 18 | | accounting principles is not properly
chargeable as an expense | 19 | | of operation and maintenance, or is made to obtain
by lease or | 20 | | comparable arrangement any facility or part thereof or any
| 21 | | equipment for a facility or part; and which exceeds the | 22 | | capital expenditure
minimum.
| 23 | | For the purpose of this paragraph, the cost of any | 24 | | studies, surveys, designs,
plans, working drawings, | 25 | | specifications, and other activities essential
to the | 26 | | acquisition, improvement, expansion, or replacement of any |
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| 1 | | plant
or equipment with respect to which an expenditure is | 2 | | made shall be included
in determining if such expenditure | 3 | | exceeds the capital expenditures minimum.
Unless otherwise | 4 | | interdependent, or submitted as one project by the applicant, | 5 | | components of construction or modification undertaken by means | 6 | | of a single construction contract or financed through the | 7 | | issuance of a single debt instrument shall not be grouped | 8 | | together as one project. Donations of equipment
or facilities | 9 | | to a health care facility which if acquired directly by such
| 10 | | facility would be subject to review under this Act shall be | 11 | | considered capital
expenditures, and a transfer of equipment | 12 | | or facilities for less than fair
market value shall be | 13 | | considered a capital expenditure for purposes of this
Act if a | 14 | | transfer of the equipment or facilities at fair market value | 15 | | would
be subject to review.
| 16 | | "Capital expenditure minimum" means $11,500,000 for | 17 | | projects by hospital applicants, $6,500,000 for applicants for | 18 | | projects related to skilled and intermediate care long-term | 19 | | care facilities licensed under the Nursing Home Care Act, and | 20 | | $3,000,000 for projects by all other applicants, which shall | 21 | | be annually
adjusted to reflect the increase in construction | 22 | | costs due to inflation, for major medical equipment and for | 23 | | all other
capital expenditures.
| 24 | | "Financial commitment" means the commitment of at least | 25 | | 33% of total funds assigned to cover total project cost, which | 26 | | occurs by the actual expenditure of 33% or more of the total |
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| 1 | | project cost or the commitment to expend 33% or more of the | 2 | | total project cost by signed contracts or other legal means. | 3 | | "Non-clinical service area" means an area (i) for the | 4 | | benefit of the
patients, visitors, staff, or employees of a | 5 | | health care facility and (ii) not
directly related to the | 6 | | diagnosis, treatment, or rehabilitation of persons
receiving | 7 | | services from the health care facility. "Non-clinical service | 8 | | areas"
include, but are not limited to, chapels; gift shops; | 9 | | news stands; computer
systems; tunnels, walkways, and | 10 | | elevators; telephone systems; projects to
comply with life | 11 | | safety codes; educational facilities; student housing;
| 12 | | patient, employee, staff, and visitor dining areas; | 13 | | administration and
volunteer offices; modernization of | 14 | | structural components (such as roof
replacement and masonry | 15 | | work); boiler repair or replacement; vehicle
maintenance and | 16 | | storage facilities; parking facilities; mechanical systems for
| 17 | | heating, ventilation, and air conditioning; loading docks; and | 18 | | repair or
replacement of carpeting, tile, wall coverings, | 19 | | window coverings or treatments,
or furniture. Solely for the | 20 | | purpose of this definition, "non-clinical service
area" does | 21 | | not include health and fitness centers.
| 22 | | "Areawide" means a major area of the State delineated on a
| 23 | | geographic, demographic, and functional basis for health | 24 | | planning and
for health service and having within it one or | 25 | | more local areas for
health planning and health service. The | 26 | | term "region", as contrasted
with the term "subregion", and |
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| 1 | | the word "area" may be used synonymously
with the term | 2 | | "areawide".
| 3 | | "Local" means a subarea of a delineated major area that on | 4 | | a
geographic, demographic, and functional basis may be | 5 | | considered to be
part of such major area. The term "subregion" | 6 | | may be used synonymously
with the term "local".
| 7 | | "Physician" means a person licensed to practice in | 8 | | accordance with
the Medical Practice Act of 1987, as amended.
| 9 | | "Licensed health care professional" means a person | 10 | | licensed to
practice a health profession under pertinent | 11 | | licensing statutes of the
State of Illinois.
| 12 | | "Director" means the Director of the Illinois Department | 13 | | of Public Health.
| 14 | | "Agency" or "Department" means the Illinois Department of | 15 | | Public Health.
| 16 | | "Alternative health care model" means a facility or | 17 | | program authorized
under the Alternative Health Care Delivery | 18 | | Act.
| 19 | | "Out-of-state facility" means a person that is both (i) | 20 | | licensed as a
hospital or as an ambulatory surgery center | 21 | | under the laws of another state
or that
qualifies as a hospital | 22 | | or an ambulatory surgery center under regulations
adopted | 23 | | pursuant to the Social Security Act and (ii) not licensed | 24 | | under the
Ambulatory Surgical Treatment Center Act, the | 25 | | Hospital Licensing Act, or the
Nursing Home Care Act. | 26 | | Affiliates of out-of-state facilities shall be
considered |
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| 1 | | out-of-state facilities. Affiliates of Illinois licensed | 2 | | health
care facilities 100% owned by an Illinois licensed | 3 | | health care facility, its
parent, or Illinois physicians | 4 | | licensed to practice medicine in all its
branches shall not be | 5 | | considered out-of-state facilities. Nothing in
this definition | 6 | | shall be
construed to include an office or any part of an | 7 | | office of a physician licensed
to practice medicine in all its | 8 | | branches in Illinois that is not required to be
licensed under | 9 | | the Ambulatory Surgical Treatment Center Act.
| 10 | | "Change of ownership of a health care facility" means a | 11 | | change in the
person
who has ownership or
control of a health | 12 | | care facility's physical plant and capital assets. A change
in | 13 | | ownership is indicated by
the following transactions: sale, | 14 | | transfer, acquisition, lease, change of
sponsorship, or other | 15 | | means of
transferring control.
| 16 | | "Related person" means any person that: (i) is at least | 17 | | 50% owned, directly
or indirectly, by
either the health care | 18 | | facility or a person owning, directly or indirectly, at
least | 19 | | 50% of the health
care facility; or (ii) owns, directly or | 20 | | indirectly, at least 50% of the
health care facility.
| 21 | | "Charity care" means care provided by a health care | 22 | | facility for which the provider does not expect to receive | 23 | | payment from the patient or a third-party payer. | 24 | | "Health disparities" means preventable differences in the | 25 | | burden of disease, injury, violence, or opportunities to | 26 | | achieve optimal health that are experienced by socially |
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| 1 | | disadvantaged populations. | 2 | | "Health equity" means a process of assurance of the | 3 | | conditions for optimal health for all people through focused | 4 | | and ongoing societal effort valuing all individuals and | 5 | | populations equally, recognizing and rectifying historical | 6 | | injustices, and providing resources according to need. | 7 | | "Safety net services" means services provided by health | 8 | | care providers or organizations that deliver health care | 9 | | services to persons with barriers to mainstream health care | 10 | | due to lack of insurance, inability to pay, special needs, | 11 | | ethnic or cultural characteristics, or geographic isolation, | 12 | | and those that deliver services to communities or populations | 13 | | suffering from health disparities including disparities in | 14 | | health status and outcomes due to differences in social, | 15 | | economic, environmental, or healthcare resources. Safety net | 16 | | service providers include, but are not limited to, hospitals | 17 | | and private practice physicians that provide charity care, | 18 | | school-based health centers, migrant health clinics, rural | 19 | | health clinics, federally qualified health centers, community | 20 | | health centers, public health departments, and community | 21 | | mental health centers. | 22 | | "Safety net hospital" has the meaning ascribed to it under | 23 | | Section 5-5e.1 of the Illinois Public Aid Code. | 24 | | "Emergency medical and trauma" means the emergency medical | 25 | | services, trauma services, and associated non-emergency | 26 | | medical services planned and coordinated in accordance with |
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| 1 | | the Emergency Medical Services (EMS) Systems Act. | 2 | | "Perinatal and maternal care" means obstetric and neonatal | 3 | | services under Subpart O of Hospital Licensing Requirements, | 4 | | 77 IAC 250; resources and services associated with hospital | 5 | | perinatal care level designations under the Developmental | 6 | | Disability Prevention Act; and maternal care resources and | 7 | | services developed or identified under Sections 2310-222 and | 8 | | 2310-223 of the Department of Public Health Powers and Duties | 9 | | Law. | 10 | | "Freestanding emergency center" means a facility subject | 11 | | to licensure under Section 32.5 of the Emergency Medical | 12 | | Services (EMS) Systems Act. | 13 | | "Category of service" means a grouping by generic class of | 14 | | various types or levels of support functions, equipment, care, | 15 | | or treatment provided to patients or residents . Categories of | 16 | | service shall include, but not be limited to, , including, but | 17 | | not limited to, classes such as medical-surgical, pediatrics, | 18 | | obstetrics, intensive care, neonatal intensive care, acute | 19 | | mental illness, comprehensive physical rehabilitation, | 20 | | long-term acute care, or cardiac catheterization , open heart | 21 | | surgery, kidney transplantation, general long term nursing | 22 | | care, long term care for the developmentally disabled (adult), | 23 | | long term care for the developmentally disabled (children), | 24 | | chronic mental illness care, in-center hemodialysis, and | 25 | | non-hospital ambulatory surgery . A category of service may | 26 | | include subcategories or levels of care that identify a |
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| 1 | | particular degree or type of care within the category of | 2 | | service. Nothing in this definition shall be construed to | 3 | | include the practice of a physician or other licensed health | 4 | | care professional while functioning in an office providing for | 5 | | the care, diagnosis, or treatment of patients. A category of | 6 | | service that is subject to the Board's jurisdiction must be | 7 | | designated in rules adopted by the Board. | 8 | | "State Board Staff Report" means the document that sets | 9 | | forth the review and findings of the State Board staff, as | 10 | | prescribed by the State Board, regarding applications subject | 11 | | to Board jurisdiction. | 12 | | (Source: P.A. 100-518, eff. 6-1-18; 100-581, eff. 3-12-18; | 13 | | 100-957, eff. 8-19-18; 101-81, eff. 7-12-19; 101-650, eff. | 14 | | 7-7-20.)
| 15 | | (20 ILCS 3960/5) (from Ch. 111 1/2, par. 1155)
| 16 | | (Section scheduled to be repealed on December 31, 2029)
| 17 | | Sec. 5. Construction, modification, or establishment of | 18 | | health care facilities or acquisition of major medical | 19 | | equipment; permits or exemptions. No person shall construct, | 20 | | modify or establish a
health care facility or acquire major | 21 | | medical equipment without first
obtaining a permit or | 22 | | exemption from the State
Board. The State Board shall not | 23 | | delegate to the staff of
the State Board or any other person or | 24 | | entity the authority to grant
permits or exemptions whenever | 25 | | the staff or other person or
entity would be required to |
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| 1 | | exercise any discretion affecting the decision
to grant a | 2 | | permit or exemption. The State Board may, by rule, delegate | 3 | | authority to the Chairman to grant permits or exemptions when | 4 | | applications meet all of the State Board's review criteria and | 5 | | are unopposed.
| 6 | | A permit or exemption shall be obtained prior to the | 7 | | acquisition
of major medical equipment or to the construction | 8 | | or modification of a
health care facility which:
| 9 | | (a) requires a total capital expenditure in excess of | 10 | | the capital
expenditure
minimum; or
| 11 | | (b) substantially changes the scope or changes the | 12 | | functional operation
of the facility; or
| 13 | | (c) changes the bed capacity of a health care facility | 14 | | by increasing the
total number of beds or by distributing | 15 | | beds among
various categories of service or by relocating | 16 | | beds from one physical facility
or site to another by more | 17 | | than 20 beds or more than 10% of total bed
capacity as | 18 | | defined by the
State Board, whichever is less, over a | 19 | | 2-year period.
| 20 | | A permit shall be valid only for the defined construction | 21 | | or modifications,
site, amount and person named in the | 22 | | application for such permit. The State Board may approve the | 23 | | transfer of an existing permit without regard to whether the | 24 | | permit to be transferred has yet been financially committed, | 25 | | except for permits to establish a new facility or category of | 26 | | service. A permit shall be valid until such
time as the project |
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| 1 | | has been completed,
provided that the project
commences and | 2 | | proceeds to completion with due diligence by the completion | 3 | | date or extension date approved by the Board. | 4 | | A permit holder must do the following: (i) submit the | 5 | | final completion and cost report for the project within 90 | 6 | | days after the approved project completion date or extension | 7 | | date and (ii) submit annual progress reports no earlier than | 8 | | 30 days before and no later than 30 days after each anniversary | 9 | | date of the Board's approval of the permit until the project is | 10 | | completed. To maintain a valid permit and to monitor progress | 11 | | toward project commencement and completion, routine | 12 | | post-permit reports shall be limited to annual progress | 13 | | reports and the final completion and cost report. Annual | 14 | | progress reports shall include information regarding the | 15 | | committed funds expended toward the approved project. For | 16 | | projects to be completed in 12 months or less, the permit | 17 | | holder shall report financial commitment in the final | 18 | | completion and cost report. For projects to be completed | 19 | | between 12 to 24 months, the permit holder shall report | 20 | | financial commitment in the first annual report. For projects | 21 | | to be completed in more than 24 months, the permit holder shall | 22 | | report financial commitment in the second annual progress | 23 | | report. The report shall contain information regarding | 24 | | expenditures and financial commitments. The State Board may | 25 | | extend the financial commitment period after considering a | 26 | | permit holder's showing of good cause and request for |
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| 1 | | additional time to complete the project. | 2 | | The Certificate of Need process required under this Act is | 3 | | designed to support equitable access to health care services, | 4 | | develop and protect safety net services, and restrain rising | 5 | | health care costs by preventing unnecessary construction or | 6 | | modification of health care facilities. The Board must assure | 7 | | that the establishment, construction, or modification of a | 8 | | health care facility or the acquisition of major medical | 9 | | equipment is consistent with the public interest and that the | 10 | | proposed project is consistent with the orderly and economic | 11 | | development or acquisition of those facilities and equipment | 12 | | and is in accord with the standards, criteria, or plans of need | 13 | | adopted and approved by the Board. The Board must assure | 14 | | decisions regarding hospital facility or service | 15 | | discontinuations are consistent with the health equity | 16 | | purposes of the Act and weigh whether or not such facility or | 17 | | service discontinuations will worsen health disparities. Board | 18 | | decisions regarding the construction of health care facilities | 19 | | must consider capacity, quality, value, and equity. Projects | 20 | | may deviate from the costs, fees, and expenses provided in | 21 | | their project cost information for the project's cost | 22 | | components, provided that the final total project cost does | 23 | | not exceed the approved permit amount. Project alterations | 24 | | shall not increase the total approved permit amount by more | 25 | | than the limit set forth under the Board's rules.
| 26 | | The acquisition by any person of major medical equipment |
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| 1 | | that will not
be owned by or located in a health care facility | 2 | | and that will not be used
to provide services to inpatients of | 3 | | a health care facility shall be exempt
from review provided | 4 | | that a notice is filed in accordance with exemption
| 5 | | requirements.
| 6 | | Notwithstanding any other provision of this Act, no permit | 7 | | or exemption is
required for the construction or modification | 8 | | of a non-clinical service area
of a health care facility.
| 9 | | (Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18 .)
| 10 | | (20 ILCS 3960/5.4) | 11 | | (Section scheduled to be repealed on December 31, 2029) | 12 | | Sec. 5.4. Safety Net Impact Statement. | 13 | | (a) General review criteria shall include a requirement | 14 | | that all health care facilities, with the exception of skilled | 15 | | and intermediate long-term care facilities licensed under the | 16 | | Nursing Home Care Act, provide a Safety Net Impact Statement, | 17 | | which shall be filed with an application for a substantive | 18 | | project or when the application proposes to discontinue a | 19 | | category of service. | 20 | | (b) (Blank). For the purposes of this Section, "safety net | 21 | | services" are services provided by health care providers or | 22 | | organizations that deliver health care services to persons | 23 | | with barriers to mainstream health care due to lack of | 24 | | insurance, inability to pay, special needs, ethnic or cultural | 25 | | characteristics, or geographic isolation. Safety net service |
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| 1 | | providers include, but are not limited to, hospitals and | 2 | | private practice physicians that provide charity care, | 3 | | school-based health centers, migrant health clinics, rural | 4 | | health clinics, federally qualified health centers, community | 5 | | health centers, public health departments, and community | 6 | | mental health centers. | 7 | | (c) As developed by the applicant, a Safety Net Impact | 8 | | Statement shall describe all of the following: | 9 | | (1) The project's material impact, if any, on | 10 | | essential safety net services in the community, including | 11 | | safety net hospitals and critical access hospitals, to the | 12 | | extent that it is feasible for an applicant to have such | 13 | | knowledge. | 14 | | (2) The project's impact on the ability of another | 15 | | provider or health care system to cross-subsidize safety | 16 | | net services , to the extent that it is feasible for an | 17 | | applicant to have such knowledge , if reasonably known to | 18 | | the applicant . | 19 | | (3) How the discontinuation of a facility or service | 20 | | will might impact other the remaining safety net | 21 | | providers , to the extent that it is feasible for an | 22 | | applicant to have such knowledge in a given community, if | 23 | | reasonably known by the applicant . | 24 | | (4) How the discontinuation of a facility or service | 25 | | will impact the Medicaid population. | 26 | | (5) How the discontinuation of a facility or service |
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| 1 | | will impact the health status and outcomes of populations | 2 | | suffering from health disparities. This should include | 3 | | consideration of disparities in healthcare access and | 4 | | outcomes by income, race and ethnic identity, and | 5 | | preferred language. | 6 | | (d) Safety Net Impact Statements shall also include all of | 7 | | the following: | 8 | | (1) For the 3 fiscal years prior to the application, a | 9 | | certification describing the amount of charity care | 10 | | provided by the applicant. The amount calculated by | 11 | | hospital applicants shall be in accordance with the | 12 | | reporting requirements for charity care reporting in the | 13 | | Illinois Community Benefits Act. Non-hospital applicants | 14 | | shall report charity care, at cost, in accordance with an | 15 | | appropriate methodology specified by the Board. | 16 | | (2) For the 3 fiscal years prior to the application, a | 17 | | certification of the amount of care provided to Medicaid | 18 | | patients. Hospital and non-hospital applicants shall | 19 | | provide Medicaid information in a manner consistent with | 20 | | the information reported each year to the State Board | 21 | | regarding "Inpatients and Outpatients Served by Payor | 22 | | Source" and "Inpatient and Outpatient Net Revenue by Payor | 23 | | Source" as required by the Board under Section 13 of this | 24 | | Act and published in the Annual Hospital Profile. | 25 | | (3) Any information the applicant believes is directly | 26 | | relevant to safety net services, including information |
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| 1 | | regarding teaching, research, and any other service. | 2 | | (e) The Board staff shall publish a notice, that an | 3 | | application accompanied by a Safety Net Impact Statement has | 4 | | been filed, in a newspaper having general circulation within | 5 | | the area affected by the application. If no newspaper has a | 6 | | general circulation within the county, the Board shall post | 7 | | the notice in 5 conspicuous places within the proposed area. | 8 | | (f) Any person, community organization, provider, or | 9 | | health system or other entity wishing to comment upon or | 10 | | oppose the application may file a Safety Net Impact Statement | 11 | | Response with the Board, which shall provide additional | 12 | | information concerning a project's impact on safety net | 13 | | services in the community. | 14 | | (g) Applicants shall be provided an opportunity to submit | 15 | | a reply to any Safety Net Impact Statement Response. | 16 | | (h) The State Board Staff Report shall include a statement | 17 | | as to whether a Safety Net Impact Statement was filed by the | 18 | | applicant and whether it included information on charity care, | 19 | | the amount of care provided to Medicaid patients, and | 20 | | information on teaching, research, or any other service | 21 | | provided by the applicant directly relevant to safety net | 22 | | services. The report shall also indicate the names of the | 23 | | parties submitting responses and the number of responses and | 24 | | replies, if any, that were filed.
| 25 | | (Source: P.A. 100-518, eff. 6-1-18 .) |
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| 1 | | (20 ILCS 3960/5.5 new) | 2 | | Sec. 5.5. Emergency Medicine and Trauma Systems Impact | 3 | | Statement. | 4 | | (a) Review criteria shall include a requirement that all | 5 | | general acute hospitals applying to discontinue a facility, | 6 | | intensive care services, or another category of service | 7 | | relevant to emergency medical service and trauma systems | 8 | | identified by rule by the Board include in its application an | 9 | | Emergency Medicine and Trauma Systems Impact Statement. | 10 | | (b) As developed by the applicant, an Emergency Medicine | 11 | | and Trauma Systems Impact Statement shall describe all of the | 12 | | following: | 13 | | (1) How the discontinuation of the facility or service | 14 | | will impact the availability of emergency medical and | 15 | | trauma services for area populations, specifically | 16 | | including those that experience difficulty accessing | 17 | | health services or experience health disparities. | 18 | | (2) How the discontinuation of the facility or service | 19 | | might impact the remaining providers of emergency medical | 20 | | and trauma services in the area, to the extent known by the | 21 | | applicant. | 22 | | (c) Emergency Medicine and Trauma Systems Impact | 23 | | Statements shall also include all of the following: | 24 | | (1) A list of each resource identified in any | 25 | | emergency medical service system program plan that will | 26 | | cease to exist as a result of the facility or service |
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| 1 | | discontinuation, with a description of its utilization in | 2 | | the most recent 2 years for which data is available. | 3 | | (2) A list of each resource identified in any trauma | 4 | | or stroke center designation that will cease to exist as a | 5 | | result of the facility or service discontinuation, with a | 6 | | description of its utilization in the most recent 2 years | 7 | | for which data is available. | 8 | | (3) If any resource listed pursuant to paragraphs (1) | 9 | | or (2) above was on diversion or bypass status or | 10 | | otherwise not available during the 2 years, the statement | 11 | | must list the times and reasons it was on bypass. | 12 | | (d) The Board staff shall publish a notice, that an | 13 | | application accompanied by an Emergency Medicine and Trauma | 14 | | Systems Impact Statement has been filed, in a newspaper having | 15 | | general circulation within the area affected by the | 16 | | application. If no newspaper has a general circulation within | 17 | | the county, the Board shall post the notice in 5 conspicuous | 18 | | places within the proposed area. The public notice required by | 19 | | this subsection may be provided in conjunction with the notice | 20 | | required for a safety net impact statement pursuant to | 21 | | subsection (e) of Section 5.4. | 22 | | (e) Any person, community organization, provider, or | 23 | | health system or other entity wishing to comment upon or | 24 | | oppose the application may file an Emergency Medical and | 25 | | Trauma Systems Impact Statement Response with the Board, which | 26 | | shall provide additional information concerning a project's |
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| 1 | | impact on emergency medical and trauma services in the | 2 | | community. | 3 | | (f) Applicants shall be provided an opportunity to submit | 4 | | a reply to any Emergency Medical and Trauma Systems Impact | 5 | | Statement Response. | 6 | | (g) The State Board Staff Report shall include a statement | 7 | | as to whether an Emergency Medical and Trauma Systems Impact | 8 | | Statement was filed by the applicant and whether it included | 9 | | each item of information described in the lists of subsections | 10 | | (b) and (c) above. The report shall also indicate the names of | 11 | | the parties submitting responses and the number of responses | 12 | | and replies, if any, that were filed. | 13 | | (20 ILCS 3960/5.6 new) | 14 | | Sec. 5.6. Maternal and Child Health Impact Statement. | 15 | | (a) Review criteria shall include a requirement that all | 16 | | general acute hospitals applying to discontinue a facility, | 17 | | obstetric services, pediatric services, neonatal intensive | 18 | | care services, or any other category of service relevant to | 19 | | maternal and child health identified by rule by the Board | 20 | | include in its application an Maternal and Child Health Impact | 21 | | Statement. | 22 | | (b) As developed by the applicant, a Maternal and Child | 23 | | Health Impact Statement shall describe all of the following: | 24 | | (1) How the discontinuation of the facility or service | 25 | | will impact the availability of perinatal and maternal |
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| 1 | | care services for area populations, specifically including | 2 | | those that experience difficulty accessing health services | 3 | | or experience health disparities. | 4 | | (2) How the discontinuation of the facility or service | 5 | | might impact the remaining providers of perinatal and | 6 | | maternal care services in the area, to the extent known by | 7 | | the applicant. | 8 | | (c) Maternal and Child Health Impact Statements shall also | 9 | | include all of the following: | 10 | | (1) A list of each resource identified in any | 11 | | obstetric and neonatal service plan, hospital perinatal | 12 | | care level designation, or maternal care level designation | 13 | | that will cease to exist as a result of the facility or | 14 | | service discontinuation, with a description of its | 15 | | utilization in the most recent 2 years for which data is | 16 | | available. | 17 | | (2) A list of any resource that was developed through | 18 | | initiatives set forth in Section 2310-222 of the | 19 | | Department of Public Health Powers and Duties Law to | 20 | | improve birth equity and reduce postpartum racial and | 21 | | ethnic disparities, or that serves similar purposes that | 22 | | will cease to exist as a result of the facility or service | 23 | | discontinuation. | 24 | | (d) The Board staff shall publish a notice, that an | 25 | | application accompanied by a Maternal and Child Health Impact | 26 | | Statement has been filed, in a newspaper having general |
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| 1 | | circulation within the area affected by the application. If no | 2 | | newspaper has a general circulation within the county, the | 3 | | Board shall post the notice in 5 conspicuous places within the | 4 | | proposed area. The public notice required by this subsection | 5 | | may be provided in conjunction with the notice required for a | 6 | | safety net impact statement pursuant to subsection (e) of | 7 | | Section 5.4. | 8 | | (e) Any person, community organization, provider, or | 9 | | health system or other entity wishing to comment upon or | 10 | | oppose the application may file a Maternal and Child Health | 11 | | Impact Statement Response with the Board, which shall provide | 12 | | additional information concerning a project's impact on | 13 | | maternal and child health services in the community. | 14 | | (f) Applicants shall be provided an opportunity to submit | 15 | | a reply to any Maternal and Child Health Impact Statement | 16 | | Response. | 17 | | (g) The State Board Staff Report shall include a statement | 18 | | as to whether a Maternal and Child Health Impact Statement was | 19 | | filed by the applicant and whether it included each item of | 20 | | information described in the lists of subsections (b) and (c) | 21 | | above. The report shall also indicate the names of the parties | 22 | | submitting responses and the number of responses and replies, | 23 | | if any, that were filed.
| 24 | | (20 ILCS 3960/6) (from Ch. 111 1/2, par. 1156)
| 25 | | (Section scheduled to be repealed on December 31, 2029)
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| 1 | | Sec. 6. Application for permit or exemption; exemption | 2 | | regulations.
| 3 | | (a) An application for a permit or exemption shall be made | 4 | | to
the State Board upon forms provided by the State Board. This | 5 | | application
shall contain such information
as the State Board | 6 | | deems necessary. The State Board shall not require an | 7 | | applicant to file a Letter of Intent before an application is | 8 | | filed. Such
application shall include affirmative evidence on | 9 | | which the State
Board or Chairman may make its decision on the | 10 | | approval or denial of the permit or
exemption.
| 11 | | (b) The State Board shall establish by regulation the | 12 | | procedures and
requirements
regarding issuance of exemptions.
| 13 | | An exemption shall be approved when information required by | 14 | | the Board by rule
is submitted. Projects
eligible for an | 15 | | exemption, rather than a permit, shall be include, but are not | 16 | | limited
to ,
change of ownership of a health care facility , | 17 | | establishment or expansion of a neonatal intensive care | 18 | | category of service, and discontinuation of a category of | 19 | | service, other than at a hospital, or a health care facility | 20 | | maintained by the State or any agency or department thereof or | 21 | | a nursing home maintained by a county. The Board may accept an | 22 | | application for an exemption for the discontinuation of a | 23 | | category of service at any other a health care facility only | 24 | | once in a 6-month period following (1) the previous | 25 | | application for exemption at the same health care facility or | 26 | | (2) the final decision of the Board regarding the |
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| 1 | | discontinuation of a category of service at the same health | 2 | | care facility, whichever occurs later. A discontinuation of a | 3 | | category of service shall otherwise require an application for | 4 | | a permit if an application for an exemption has already been | 5 | | accepted within the 6-month period. For a change of
ownership | 6 | | among related persons of a health care
facility, the State | 7 | | Board shall provide by rule for an
expedited
process for | 8 | | obtaining an exemption. For the purposes of this Section, | 9 | | "change of ownership among related persons" means a | 10 | | transaction in which the parties to the transaction are under | 11 | | common control or ownership before and after the transaction | 12 | | is complete.
| 13 | | (c) All applications shall be signed by the applicant and | 14 | | shall be
verified by any 2 officers thereof.
| 15 | | (c-5) Any written review or findings of the Board staff | 16 | | set forth in the State Board Staff Report concerning an | 17 | | application for a permit must be made available to the public | 18 | | and the applicant at least 14 calendar days before the meeting | 19 | | of the State Board at which the review or findings are | 20 | | considered. The applicant and members of the public may | 21 | | submit, to the State Board, written responses regarding the | 22 | | facts set forth in the review or findings of the Board staff. | 23 | | Members of the public and the applicant shall have until 10 | 24 | | days before the meeting of the State Board to submit any | 25 | | written response concerning the Board staff's written review | 26 | | or findings. The Board staff may revise any findings to |
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| 1 | | address corrections of factual errors cited in the public | 2 | | response. At the meeting, the State Board may, in its | 3 | | discretion, permit the submission of other additional written | 4 | | materials.
| 5 | | (d) Upon receipt of an application for a permit, the State | 6 | | Board shall
approve and authorize the issuance of a permit if | 7 | | it finds (1) that the
applicant is fit, willing, and able to | 8 | | provide a proper standard of
health care service for the | 9 | | community with particular regard to the
qualification, | 10 | | background and character of the applicant, (2) that
economic | 11 | | feasibility is demonstrated in terms of effect on the existing
| 12 | | and projected operating budget of the applicant and of the | 13 | | health care
facility; in terms of the applicant's ability to | 14 | | establish and operate
such facility in accordance with | 15 | | licensure regulations promulgated under
pertinent state laws; | 16 | | and in terms of the projected impact on the total
health care | 17 | | expenditures in the facility and community, (3) that
| 18 | | safeguards are provided that assure that the establishment,
| 19 | | construction or modification of the health care facility or | 20 | | acquisition
of major medical equipment is consistent
with the | 21 | | public interest, and (4) that the proposed project is | 22 | | consistent
with the orderly and economic
development of such | 23 | | facilities and equipment and is in accord with standards,
| 24 | | criteria, or plans of need adopted and approved pursuant to | 25 | | the
provisions of Section 12 of this Act. Notwithstanding the | 26 | | foregoing or any other provision of this Act, the State Board |
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| 1 | | may deny issuance of a permit if it finds the project will | 2 | | plausibly increase health disparities.
| 3 | | (d-5) For an application for a permit to discontinue a | 4 | | hospital facility or service, the State Board shall consider: | 5 | | (1) how the discontinuation of the facility or service | 6 | | will impact safety net services; | 7 | | (2) the emergency medical and trauma system impact, if | 8 | | applicable; | 9 | | (3) the maternal and child health impact, if | 10 | | applicable; and | 11 | | (4) the economic feasibility, based on the resources | 12 | | of the applicant and related persons, of continued | 13 | | operation as an alternative. | 14 | | (e) The State Board may attach conditions to issuance of a | 15 | | permit requiring that certain disclosed support or subsidies | 16 | | received by the hospital must be repaid. | 17 | | (Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18; | 18 | | 101-83, eff. 7-15-19.)
| 19 | | (20 ILCS 3960/6.05 new) | 20 | | Sec. 6.05. Hospital closure during a pandemic. The State | 21 | | Board shall not issue a permit or take any other action that | 22 | | would allow closure of a general acute care hospital to | 23 | | proceed during a public health emergency declared pursuant to | 24 | | the Illinois Emergency Management Act as the result of an | 25 | | infectious disease pandemic. |
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| 1 | | (20 ILCS 3960/6.2) | 2 | | (Section scheduled to be repealed on December 31, 2029) | 3 | | Sec. 6.2. Review of permits; State Board Staff Reports. | 4 | | Upon receipt of an application for a permit to establish,
| 5 | | construct, or modify a health care facility, the State Board | 6 | | staff
shall notify the applicant in writing within 10
working | 7 | | days either that the application is or is not substantially | 8 | | complete. If the
application is substantially complete, the | 9 | | State Board staff shall
notify the applicant of the beginning | 10 | | of the review process. If the application is not substantially | 11 | | complete, the Board staff shall explain within the 10-day | 12 | | period why the application is incomplete. | 13 | | The State Board staff shall afford a reasonable amount of | 14 | | time as
established by the State Board, but not to exceed 180 | 15 | | 120 days,
for the review of the application. The 180-day | 16 | | 120-day period
begins on the day the application is found to be
| 17 | | substantially complete, as that term is defined by the State
| 18 | | Board. During the 180-day 120-day period, the applicant may | 19 | | request
an extension. An applicant may modify the application | 20 | | at any
time before a final administrative decision has been | 21 | | made on the
application.
| 22 | | The State Board staff shall submit its State Board Staff | 23 | | Report
to the State Board for its decision-making regarding | 24 | | approval or denial of the permit. | 25 | | When an application for a permit is initially reviewed by
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| 1 | | State Board staff, as provided in this Section, the State | 2 | | Board shall, upon request by the applicant or an interested | 3 | | person, afford an opportunity for a public hearing within a | 4 | | reasonable amount of time
after receipt of the complete | 5 | | application, but not to exceed
90 days after receipt of the | 6 | | complete application. Notice of the hearing shall be made | 7 | | promptly, not less than 10 days before the hearing, by
| 8 | | certified mail to the applicant and, not less than 10 days | 9 | | before the
hearing, by publication in a newspaper of general | 10 | | circulation
in the area or community to be affected. The | 11 | | hearing shall
be held in the area or community in which the | 12 | | proposed
project is to be located and shall be for the purpose | 13 | | of allowing
the applicant and any interested person to present | 14 | | public
testimony concerning the approval, denial, renewal, or
| 15 | | revocation of the permit. All interested persons attending
the | 16 | | hearing shall be given a reasonable opportunity to present
| 17 | | their views or arguments in writing or orally, and a record
of | 18 | | all of the testimony shall accompany any findings of the State
| 19 | | Board staff. The State Board shall adopt reasonable rules and | 20 | | regulations
governing the procedure and conduct of the | 21 | | hearings.
| 22 | | (Source: P.A. 99-114, eff. 7-23-15; 100-681, eff. 8-3-18 .) | 23 | | (20 ILCS 3960/8.5) | 24 | | (Section scheduled to be repealed on December 31, 2029) | 25 | | Sec. 8.5. Certificate of exemption for change of ownership |
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| 1 | | of a health care facility; discontinuation of a category of | 2 | | service; public notice and public hearing. | 3 | | (a) Upon a finding that an application for a change of | 4 | | ownership is complete, the State Board shall publish a legal | 5 | | notice on 3 consecutive days in a newspaper of general | 6 | | circulation in the area or community to be affected and afford | 7 | | the public an opportunity to request a hearing. If the | 8 | | application is for a facility located in a Metropolitan | 9 | | Statistical Area, an additional legal notice shall be | 10 | | published in a newspaper of limited circulation, if one | 11 | | exists, in the area in which the facility is located. If the | 12 | | newspaper of limited circulation is published on a daily | 13 | | basis, the additional legal notice shall be published on 3 | 14 | | consecutive days. The applicant shall pay the cost incurred by | 15 | | the Board in publishing the change of ownership notice in | 16 | | newspapers as required under this subsection. The legal notice | 17 | | shall also be posted on the Health Facilities and Services | 18 | | Review Board's web site and sent to the State Representative | 19 | | and State Senator of the district in which the health care | 20 | | facility is located. An application for change of ownership of | 21 | | a hospital shall not be deemed complete without a signed | 22 | | certification that for a period of 2 years after the change of | 23 | | ownership transaction is effective, the hospital will not | 24 | | adopt a charity care policy that is
more restrictive than the | 25 | | policy in effect during the year prior to the transaction. An | 26 | | application for change of ownership of a hospital shall not be |
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| 1 | | deemed complete without a signed certification that for a | 2 | | period of 18 months after the change of ownership transaction | 3 | | is effective, the hospital will not pursue facility closure, | 4 | | and for a period of 6 months after the change of ownership | 5 | | transaction is effective, the hospital will not pursue | 6 | | discontinuation of any category of service. An application for | 7 | | a change of ownership need not contain signed transaction | 8 | | documents so long as it includes the following key terms of the | 9 | | transaction: names and background of the parties; structure of | 10 | | the transaction; the person who will be the licensed or | 11 | | certified entity after the transaction; the ownership or | 12 | | membership interests in such licensed or certified entity both | 13 | | prior to and after the transaction; fair market value of | 14 | | assets to be transferred; and the purchase price or other form | 15 | | of consideration to be provided for those assets. The issuance | 16 | | of the certificate of exemption shall be contingent upon the | 17 | | applicant submitting a statement to the Board within 90 days | 18 | | after the closing date of the transaction, or such longer | 19 | | period as provided by the Board, certifying that the change of | 20 | | ownership has been completed in accordance with the key terms | 21 | | contained in the application. If such key terms of the | 22 | | transaction change, a new application shall be required. | 23 | | Where a change of ownership is among related persons, and | 24 | | there are no other changes being proposed at the health care | 25 | | facility that would otherwise require a permit or exemption | 26 | | under this Act, the applicant shall submit an application |
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| 1 | | consisting of a standard notice in a form set forth by the | 2 | | Board briefly explaining the reasons for the proposed change | 3 | | of ownership. Once such an application is submitted to the | 4 | | Board and reviewed by the Board staff, the Board Chair shall | 5 | | take action on an application for an exemption for a change of | 6 | | ownership among related persons within 45 days after the | 7 | | application has been deemed complete, provided the application | 8 | | meets the applicable standards under this Section. If the | 9 | | Board Chair has a conflict of interest or for other good cause, | 10 | | the Chair may request review by the Board. Notwithstanding any | 11 | | other provision of this Act, for purposes of this Section, a | 12 | | change of ownership among related persons means a transaction | 13 | | where the parties to the transaction are under common control | 14 | | or ownership before and after the transaction is completed. | 15 | | Nothing in this Act shall be construed as authorizing the | 16 | | Board to impose any conditions, obligations, or limitations, | 17 | | other than those required by this Section, with respect to the | 18 | | issuance of an exemption for a change of ownership, including, | 19 | | but not limited to, the time period before which a subsequent | 20 | | change of ownership of the health care facility could be | 21 | | sought, or the commitment to continue to offer for a specified | 22 | | time period any services currently offered by the health care | 23 | | facility. | 24 | | (a-3) (Blank). | 25 | | (a-5) Upon a finding that an application to discontinue a | 26 | | category of service is complete and provides the requested |
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| 1 | | information, as specified by the State Board, an exemption | 2 | | shall be issued. No later than 30 days after the issuance of | 3 | | the exemption, the health care facility must give written | 4 | | notice of the discontinuation of the category of service to | 5 | | the State Senator and State Representative serving the | 6 | | legislative district in which the health care facility is | 7 | | located. No later than 90 days after a discontinuation of a | 8 | | category of service, the applicant must submit a statement to | 9 | | the State Board certifying that the discontinuation is | 10 | | complete. | 11 | | (b) If a public hearing is requested, it shall be held at | 12 | | least 15 days but no more than 30 days after the date of | 13 | | publication of the legal notice in the community in which the | 14 | | facility is located. The hearing shall be held in the affected | 15 | | area or community in a place of reasonable size and | 16 | | accessibility and a full and complete written transcript of | 17 | | the proceedings shall be made. All interested persons | 18 | | attending the hearing shall be given a reasonable opportunity | 19 | | to present their positions in writing or orally. The applicant | 20 | | shall provide a summary or describe the proposed change of | 21 | | ownership at the public hearing.
| 22 | | (c) For the purposes of this Section "newspaper of limited | 23 | | circulation" means a newspaper intended to serve a particular | 24 | | or defined population of a specific geographic area within a | 25 | | Metropolitan Statistical Area such as a municipality, town, | 26 | | village, township, or community area, but does not include |
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| 1 | | publications of professional and trade associations. | 2 | | (d) The changes made to this Section by this amendatory | 3 | | Act of the 101st General Assembly shall apply to all | 4 | | applications submitted after the effective date of this | 5 | | amendatory Act of the 101st General Assembly. | 6 | | (Source: P.A. 100-201, eff. 8-18-17; 101-83, eff. 7-15-19.) | 7 | | (20 ILCS 3960/8.7) | 8 | | (Section scheduled to be repealed on December 31, 2029) | 9 | | Sec. 8.7. Application for permit for discontinuation of a | 10 | | health care facility or category of service; public notice and | 11 | | public hearing. | 12 | | (a) Upon a finding that an application to close a health | 13 | | care facility or discontinue a category of service is | 14 | | complete, the State Board shall publish a legal notice on 3 | 15 | | consecutive days in a newspaper of general circulation in the | 16 | | area or community to be affected and afford the public an | 17 | | opportunity to request a hearing. If the application is for a | 18 | | facility located in a Metropolitan Statistical Area, an | 19 | | additional legal notice shall be published in a newspaper of | 20 | | limited circulation, if one exists, in the area in which the | 21 | | facility is located. If the newspaper of limited circulation | 22 | | is published on a daily basis, the additional legal notice | 23 | | shall be published on 3 consecutive days. The legal notice | 24 | | shall also be posted on the Health Facilities and Services | 25 | | Review Board's website and sent to the State Representative |
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| 1 | | and State Senator of the district in which the health care | 2 | | facility is located. In addition, the health care facility | 3 | | shall provide notice of closure to the local media that the | 4 | | health care facility would routinely notify about facility | 5 | | events. | 6 | | An application to close a health care facility shall only | 7 | | be deemed complete if it includes evidence that the health | 8 | | care facility provided written notice at least 30 days prior | 9 | | to filing the application of its intent to do so to the | 10 | | municipality in which it is located, the State Representative | 11 | | and State Senator of the district in which the health care | 12 | | facility is located, the State Board, the Director of Public | 13 | | Health, and the Director of Healthcare and Family Services. | 14 | | The changes made to this subsection by this amendatory Act of | 15 | | the 101st General Assembly shall apply to all applications | 16 | | submitted after the effective date of this amendatory Act of | 17 | | the 101st General Assembly. | 18 | | (b) An application to close a hospital facility, or | 19 | | discontinue a hospital service if applicable, shall only be | 20 | | deemed complete when the applicant includes a list of public | 21 | | support or subsidies it has received without repaying or | 22 | | fulfilling obligations or any other public subsidies it has | 23 | | received in the past 5 years, including hospital assessment | 24 | | funded supplemental payments, capital development grants, | 25 | | public health grants, economic development grants and | 26 | | supports, and any other categories the Board may identify by |
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| 1 | | rule. In cases of service discontinuation, this requirement | 2 | | applies if the support or subsidy is specific to the service. | 3 | | (c) In cases of hospital facility or service | 4 | | discontinuation, a public response to a safety net impact | 5 | | statement under subsection (f) of Section 5.4, emergency | 6 | | medicine and trauma system impact statement under subsection | 7 | | (e) of Section 5.5, or maternal and child health impact | 8 | | statement under subsection (e) of Section 5.6 may request an | 9 | | investigative hearing by the full board under the procedures | 10 | | set forth in Section 13. The Board may grant at its discretion | 11 | | any such requests for an investigative hearing. In response to | 12 | | one or more requests from any of the following, the Board shall | 13 | | conduct at minimum one investigative hearing with a scope | 14 | | covering the subject matter of all impact statements subject | 15 | | to such requests: (i) an elected official representing a | 16 | | district containing the hospital; (ii) an organization | 17 | | representing employees at the hospital; (iii) a safety net | 18 | | hospital or critical access hospital plausibly affected by the | 19 | | application; or (iv) at least 50 community members residing in | 20 | | the area affected by the application. | 21 | | (d) No later than 30 days after issuance of a permit to | 22 | | close a health care facility or discontinue a category of | 23 | | service, the permit holder shall give written notice of the | 24 | | closure or discontinuation to the State Senator and State | 25 | | Representative serving the legislative district in which the | 26 | | health care facility is located. |
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| 1 | | (e) (c) If there is a pending lawsuit that challenges an | 2 | | application to discontinue a health care facility that either | 3 | | names the Board as a party or alleges fraud in the filing of | 4 | | the application, the Board may defer action on the application | 5 | | until there is no longer such a lawsuit pending for up to 6 | 6 | | months after the date of the initial deferral of the | 7 | | application . | 8 | | (f) (d) The changes made to this Section by this | 9 | | amendatory Act of the 101st General Assembly shall apply to | 10 | | all applications submitted after the effective date of this | 11 | | amendatory Act of the 101st General Assembly.
| 12 | | (Source: P.A. 101-83, eff. 7-15-19; 101-650, eff. 7-7-20.)
| 13 | | (20 ILCS 3960/12) (from Ch. 111 1/2, par. 1162)
| 14 | | (Section scheduled to be repealed on December 31, 2029) | 15 | | Sec. 12. Powers and duties of State Board. For purposes of | 16 | | this Act,
the State Board
shall
exercise the following powers | 17 | | and duties:
| 18 | | (1) Prescribe rules,
regulations, standards, criteria, | 19 | | procedures or reviews which may vary
according to the | 20 | | purpose for which a particular review is being conducted
| 21 | | or the type of project reviewed and which are required to | 22 | | carry out the
provisions and purposes of this Act. | 23 | | Policies and procedures of the State Board shall take into | 24 | | consideration the priorities and needs of medically | 25 | | underserved areas and other health care services, giving |
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| 1 | | special consideration to the impact of projects on access | 2 | | to safety net services.
| 3 | | (2) Adopt procedures for public
notice and hearing on | 4 | | all proposed rules, regulations, standards,
criteria, and | 5 | | plans required to carry out the provisions of this Act.
| 6 | | (3) (Blank).
| 7 | | (4) Develop criteria and standards for health care | 8 | | facilities planning,
conduct statewide inventories of | 9 | | health care facilities, maintain an updated
inventory on | 10 | | the Board's web site reflecting the
most recent bed and | 11 | | service
changes and updated need determinations when new | 12 | | census data become available
or new need formulae
are | 13 | | adopted,
and
develop health care facility plans which | 14 | | shall be utilized in the review of
applications for permit | 15 | | under
this Act. Such health facility plans shall be | 16 | | coordinated by the Board
with pertinent State Plans. | 17 | | Inventories pursuant to this Section of skilled or | 18 | | intermediate care facilities licensed under the Nursing | 19 | | Home Care Act, skilled or intermediate care facilities | 20 | | licensed under the ID/DD Community Care Act, skilled or | 21 | | intermediate care facilities licensed under the MC/DD Act, | 22 | | facilities licensed under the Specialized Mental Health | 23 | | Rehabilitation Act of 2013, or nursing homes licensed | 24 | | under the Hospital Licensing Act shall be conducted on an | 25 | | annual basis no later than July 1 of each year and shall | 26 | | include among the information requested a list of all |
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| 1 | | services provided by a facility to its residents and to | 2 | | the community at large and differentiate between active | 3 | | and inactive beds.
| 4 | | In developing health care facility plans, the State | 5 | | Board shall consider,
but shall not be limited to, the | 6 | | following:
| 7 | | (a) The size, composition and growth of the | 8 | | population of the area
to be served; | 9 | | (a-5) The incidence of diseases or health | 10 | | conditions that correlate with a need for services or | 11 | | facilities, determined either directly or through a | 12 | | comparison of the population characteristics of an | 13 | | area with those of a similar, larger, or encompassing | 14 | | reference area;
| 15 | | (b) The number of existing and planned facilities | 16 | | offering similar
programs;
| 17 | | (c) The extent of utilization of existing | 18 | | facilities; | 19 | | (c-5) Size, composition, and growth of the | 20 | | population covered by Medicaid relative to existing | 21 | | services;
| 22 | | (d) The availability of facilities which may serve | 23 | | as alternatives
or substitutes;
| 24 | | (e) The availability of personnel necessary to the | 25 | | operation of the
facility;
| 26 | | (f) Multi-institutional planning and the |
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| 1 | | establishment of
multi-institutional systems where | 2 | | feasible; | 3 | | (f-5) Impact on safety net services including | 4 | | safety net and critical access hospitals;
| 5 | | (g) The financial and economic feasibility of | 6 | | proposed construction
or modification; and
| 7 | | (h) In the case of health care facilities | 8 | | established by a religious
body or denomination, the | 9 | | needs of the members of such religious body or
| 10 | | denomination may be considered to be public need ; .
| 11 | | (i) The presence and severity of health | 12 | | disparities among the population to be served, | 13 | | including consideration of disparities in healthcare | 14 | | access and outcomes by income, race and ethnic | 15 | | identity, and preferred language; and | 16 | | (j) Beginning 2 years after the effective date of | 17 | | this amendatory Act of the 102nd General Assembly, | 18 | | need formulae shall be based on incidence of diseases | 19 | | or health conditions that correlate with the need for | 20 | | a service and shall adjust such incidence by | 21 | | disparities among the population described in | 22 | | paragraph (i) above. The Office of Policy, Planning, | 23 | | and Statistics; the Center for Minority Health | 24 | | Services; the Center for Rural Health; and, at the | 25 | | discretion of the Director, any other division of the | 26 | | Department shall provide support in the development of |
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| 1 | | new formulae, data, and planning policies if requested | 2 | | by the Board. The Board shall adopt rules to implement | 3 | | this paragraph (j). | 4 | | | 5 | | The health care facility plans which are developed and | 6 | | adopted in
accordance with this Section shall form the | 7 | | basis for the plan of the State
to deal most effectively | 8 | | with statewide health needs in regard to health
care | 9 | | facilities.
| 10 | | (5) Coordinate with other state agencies having | 11 | | responsibilities
affecting health care facilities, | 12 | | including those of licensure and cost
reporting.
| 13 | | (6) Solicit, accept, hold and administer on behalf of | 14 | | the State
any grants or bequests of money, securities or | 15 | | property for
use by the State Board in the administration | 16 | | of this Act; and enter into contracts
consistent with the | 17 | | appropriations for purposes enumerated in this Act.
| 18 | | (7) (Blank).
| 19 | | (7.5) Protect safety net services. | 20 | | (8) Prescribe rules, regulations,
standards, and | 21 | | criteria for the conduct of an expeditious review of
| 22 | | applications
for permits for projects of construction or | 23 | | modification of a health care
facility, which projects are | 24 | | classified as emergency, substantive, or non-substantive | 25 | | in nature. | 26 | | Substantive projects shall include no more than the |
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| 1 | | following: | 2 | | (a) Projects to construct (1) a new or replacement | 3 | | facility located on a new site or
(2) a replacement | 4 | | facility located on the same site as the original | 5 | | facility and the cost of the replacement facility | 6 | | exceeds the capital expenditure minimum, which shall | 7 | | be reviewed by the Board within 120 days; | 8 | | (b) Projects proposing a
(1) new service within an | 9 | | existing healthcare facility or
(2) discontinuation of | 10 | | a service within an existing healthcare facility, | 11 | | which shall be reviewed by the Board within 60 days; or | 12 | | (c) Projects proposing a change in the bed | 13 | | capacity of a health care facility by an increase in | 14 | | the total number of beds or by a redistribution of beds | 15 | | among various categories of service or by a relocation | 16 | | of beds from one physical facility or site to another | 17 | | by more than 20 beds or more than 10% of total bed | 18 | | capacity, as defined by the State Board, whichever is | 19 | | less, over a 2-year period. | 20 | | The Chairman may approve applications for exemption | 21 | | that meet the criteria set forth in rules or refer them to | 22 | | the full Board. The Chairman may approve any unopposed | 23 | | application that meets all of the review criteria or refer | 24 | | them to the full Board. | 25 | | Such rules shall
not prevent the conduct of a public | 26 | | hearing upon the timely request
of an interested party. |
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| 1 | | Such reviews shall not exceed 60 days from the
date the | 2 | | application is declared to be complete.
| 3 | | (9) Prescribe rules, regulations,
standards, and | 4 | | criteria pertaining to the granting of permits for
| 5 | | construction
and modifications which are emergent in | 6 | | nature and must be undertaken
immediately to prevent or | 7 | | correct structural deficiencies or hazardous
conditions | 8 | | that may harm or injure persons using the facility, as | 9 | | defined
in the rules and regulations of the State Board. | 10 | | This procedure is exempt
from public hearing requirements | 11 | | of this Act.
| 12 | | (10) Prescribe rules,
regulations, standards and | 13 | | criteria for the conduct of an expeditious
review, not | 14 | | exceeding 60 days, of applications for permits for | 15 | | projects to
construct or modify health care facilities | 16 | | which are needed for the care
and treatment of persons who | 17 | | have acquired immunodeficiency syndrome (AIDS)
or related | 18 | | conditions.
| 19 | | (10.5) Provide its rationale when voting on an item | 20 | | before it at a State Board meeting in order to comply with | 21 | | subsection (b) of Section 3-108 of the Code of Civil | 22 | | Procedure. | 23 | | (11) Issue written decisions upon request of the | 24 | | applicant or an adversely affected party to the Board. | 25 | | Requests for a written decision shall be made within 15 | 26 | | days after the Board meeting in which a final decision has |
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| 1 | | been made. A "final decision" for purposes of this Act is | 2 | | the decision to approve or deny an application, or take | 3 | | other actions permitted under this Act, at the time and | 4 | | date of the meeting that such action is scheduled by the | 5 | | Board. The transcript of the State Board meeting shall be | 6 | | incorporated into the Board's final decision. The staff of | 7 | | the Board shall prepare a written copy of the final | 8 | | decision and the Board shall approve a final copy for | 9 | | inclusion in the formal record. The Board shall consider, | 10 | | for approval, the written draft of the final decision no | 11 | | later than the next scheduled Board meeting. The written | 12 | | decision shall identify the applicable criteria and | 13 | | factors listed in this Act and the Board's regulations | 14 | | that were taken into consideration by the Board when | 15 | | coming to a final decision. If the Board denies or fails to | 16 | | approve an application for permit or exemption, the Board | 17 | | shall include in the final decision a detailed explanation | 18 | | as to why the application was denied and identify what | 19 | | specific criteria or standards the applicant did not | 20 | | fulfill. | 21 | | (12) (Blank). | 22 | | (13) Provide a mechanism for the public to comment on, | 23 | | and request changes to, draft rules and standards. | 24 | | (14) Implement public information campaigns to | 25 | | regularly inform the general public about the opportunity | 26 | | for public hearings and public hearing procedures. |
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| 1 | | (15) Establish a separate set of rules and guidelines | 2 | | for long-term care that recognizes that nursing homes are | 3 | | a different business line and service model from other | 4 | | regulated facilities. An open and transparent process | 5 | | shall be developed that considers the following: how | 6 | | skilled nursing fits in the continuum of care with other | 7 | | care providers, modernization of nursing homes, | 8 | | establishment of more private rooms, development of | 9 | | alternative services, and current trends in long-term care | 10 | | services.
The Chairman of the Board shall appoint a | 11 | | permanent Health Services Review Board Long-term Care | 12 | | Facility Advisory Subcommittee that shall develop and | 13 | | recommend to the Board the rules to be established by the | 14 | | Board under this paragraph (15). The Subcommittee shall | 15 | | also provide continuous review and commentary on policies | 16 | | and procedures relative to long-term care and the review | 17 | | of related projects. The Subcommittee shall make | 18 | | recommendations to the Board no later than January 1, 2016 | 19 | | and every January thereafter pursuant to the | 20 | | Subcommittee's responsibility for the continuous review | 21 | | and commentary on policies and procedures relative to | 22 | | long-term care. In consultation with other experts from | 23 | | the health field of long-term care, the Board and the | 24 | | Subcommittee shall study new approaches to the current bed | 25 | | need formula and Health Service Area boundaries to | 26 | | encourage flexibility and innovation in design models |
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| 1 | | reflective of the changing long-term care marketplace and | 2 | | consumer preferences and submit its recommendations to the | 3 | | Chairman of the Board no later than January 1, 2017. The | 4 | | Subcommittee shall evaluate, and make recommendations to | 5 | | the State Board regarding, the buying, selling, and | 6 | | exchange of beds between long-term care facilities within | 7 | | a specified geographic area or drive time. The Board shall | 8 | | file the proposed related administrative rules for the | 9 | | separate rules and guidelines for long-term care required | 10 | | by this paragraph (15) by no later than September 30, | 11 | | 2011. The Subcommittee shall be provided a reasonable and | 12 | | timely opportunity to review and comment on any review, | 13 | | revision, or updating of the criteria, standards, | 14 | | procedures, and rules used to evaluate project | 15 | | applications as provided under Section 12.3 of this Act. | 16 | | The Chairman of the Board shall appoint voting members | 17 | | of the Subcommittee, who shall serve for a period of 3 | 18 | | years, with one-third of the terms expiring each January, | 19 | | to be determined by lot. Appointees shall include, but not | 20 | | be limited to, recommendations from each of the 3 | 21 | | statewide long-term care associations, with an equal | 22 | | number to be appointed from each. Compliance with this | 23 | | provision shall be through the appointment and | 24 | | reappointment process. All appointees serving as of April | 25 | | 1, 2015 shall serve to the end of their term as determined | 26 | | by lot or until the appointee voluntarily resigns, |
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| 1 | | whichever is earlier. | 2 | | One representative from the Department of Public | 3 | | Health, the Department of Healthcare and Family Services, | 4 | | the Department on Aging, and the Department of Human | 5 | | Services may each serve as an ex-officio non-voting member | 6 | | of the Subcommittee. The Chairman of the Board shall | 7 | | select a Subcommittee Chair, who shall serve for a period | 8 | | of 3 years. | 9 | | (16) Prescribe the format of the State Board Staff | 10 | | Report. A State Board Staff Report shall pertain to | 11 | | applications that include, but are not limited to, | 12 | | applications for permit or exemption, applications for | 13 | | permit renewal, applications for extension of the | 14 | | financial commitment period, applications requesting a | 15 | | declaratory ruling, or applications under the Health Care | 16 | | Worker Self-Referral Act. State Board Staff Reports shall | 17 | | compare applications to the relevant review criteria under | 18 | | the Board's rules. | 19 | | (17) Establish a separate set of rules and guidelines | 20 | | for facilities licensed under the Specialized Mental | 21 | | Health Rehabilitation Act of 2013. An application for the | 22 | | re-establishment of a facility in connection with the | 23 | | relocation of the facility shall not be granted unless the | 24 | | applicant has a contractual relationship with at least one | 25 | | hospital to provide emergency and inpatient mental health | 26 | | services required by facility consumers, and at least one |
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| 1 | | community mental health agency to provide oversight and | 2 | | assistance to facility consumers while living in the | 3 | | facility, and appropriate services, including case | 4 | | management, to assist them to prepare for discharge and | 5 | | reside stably in the community thereafter. No new | 6 | | facilities licensed under the Specialized Mental Health | 7 | | Rehabilitation Act of 2013 shall be established after June | 8 | | 16, 2014 (the effective date of Public Act 98-651) except | 9 | | in connection with the relocation of an existing facility | 10 | | to a new location. An application for a new location shall | 11 | | not be approved unless there are adequate community | 12 | | services accessible to the consumers within a reasonable | 13 | | distance, or by use of public transportation, so as to | 14 | | facilitate the goal of achieving maximum individual | 15 | | self-care and independence. At no time shall the total | 16 | | number of authorized beds under this Act in facilities | 17 | | licensed under the Specialized Mental Health | 18 | | Rehabilitation Act of 2013 exceed the number of authorized | 19 | | beds on June 16, 2014 (the effective date of Public Act | 20 | | 98-651). | 21 | | (18) Elect a Vice Chairman to preside over State Board | 22 | | meetings and otherwise act in place of the Chairman when | 23 | | the Chairman is unavailable. | 24 | | (Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18; | 25 | | 101-83, eff. 7-15-19.)
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| 1 | | (20 ILCS 3960/12.3)
| 2 | | (Section scheduled to be repealed on December 31, 2029)
| 3 | | Sec. 12.3. Revision of criteria, standards, and rules. At | 4 | | least every 2 years, the State Board shall review, revise, and
| 5 | | update the
criteria, standards, and rules used to evaluate | 6 | | applications for permit and exemption. The Board may appoint | 7 | | temporary advisory committees made up of experts with | 8 | | professional competence in the subject matter of the proposed | 9 | | standards or criteria to assist in the development of | 10 | | revisions to requirements, standards, and criteria. In
| 11 | | particular, the review of
the criteria, standards, and rules | 12 | | shall consider:
| 13 | | (1) Whether the requirements, criteria, and standards | 14 | | reflect current industry standards
and
anticipated trends.
| 15 | | (2) Whether the criteria and standards can be reduced | 16 | | or eliminated.
| 17 | | (3) Whether requirements, criteria, and standards can | 18 | | be developed to authorize the
construction
of unfinished | 19 | | space for future use when the ultimate need for such space | 20 | | can be
reasonably
projected.
| 21 | | (4) Whether the criteria and standards take into | 22 | | account issues related to
population growth , and changing | 23 | | demographics , the population covered by Medicaid, and the | 24 | | presence and severity of health disparities in a | 25 | | community , which at minimum must include consideration of | 26 | | disparities in healthcare access and outcomes by income, |
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| 1 | | race and ethnic identity, and preferred language .
| 2 | | (5) Whether facility-defined service and planning | 3 | | areas should be
recognized.
| 4 | | (6) Whether categories of service that are subject to | 5 | | review should be re-evaluated, including provisions | 6 | | related to structural, functional, and operational | 7 | | differences between long-term care facilities and acute | 8 | | care facilities and that allow routine changes of | 9 | | ownership, facility sales, and closure requests to be | 10 | | processed on a more timely basis. | 11 | | (Source: P.A. 99-527, eff. 1-1-17; 100-681, eff. 8-3-18 .)
| 12 | | (20 ILCS 3960/12.4)
| 13 | | (Section scheduled to be repealed on December 31, 2029) | 14 | | Sec. 12.4. Hospital reduction in health care services; | 15 | | notice. If a hospital reduces any of the Categories of Service | 16 | | as outlined in Title 77, Chapter II, Part 1110 in the Illinois | 17 | | Administrative Code, or any other service as defined by rule | 18 | | by the State Board, by 50% or more according to rules adopted | 19 | | by the State Board, then within 30 days after reducing the | 20 | | service, the hospital must give written notice of the | 21 | | reduction in service to the State Board, the Department of | 22 | | Public Health, and the State Senator and State Representative | 23 | | serving the legislative district in which the hospital is | 24 | | located. The State Board shall publish the notice on its | 25 | | website. Any party receiving notice may request a safety net |
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| 1 | | impact statement, emergency medicine and trauma system impact | 2 | | statement, or maternal and child health impact statement, as | 3 | | described at: (i) subsections (c) and (d) of Section 5.4; (ii) | 4 | | subsections (b) and (c) of Section 5.5; and (iii) subsections | 5 | | (b) and (c) of Section 5.6, respectively, to be filed | 6 | | describing impact of the reduction in services. The State | 7 | | Board shall adopt rules to implement this Section, including | 8 | | rules that specify (i) how each health care service is | 9 | | defined, if not already defined in the State Board's rules, | 10 | | and (ii) what constitutes a reduction in service of 50% or | 11 | | more.
| 12 | | (Source: P.A. 100-681, eff. 8-3-18 .)
| 13 | | (20 ILCS 3960/13.1) (from Ch. 111 1/2, par. 1163.1)
| 14 | | (Section scheduled to be repealed on December 31, 2029)
| 15 | | Sec. 13.1.
Any person establishing, constructing, or | 16 | | modifying a
health care facility
or portion thereof without | 17 | | obtaining a required permit, or in violation of
the terms of | 18 | | the required permit, shall not be eligible
to apply for any | 19 | | necessary operating licenses or be eligible
for payment by any | 20 | | State agency for services rendered in that facility until
the | 21 | | required permit is obtained. In cases of any person | 22 | | discontinuing a hospital facility or category of service | 23 | | without obtaining a required permit, or in violation of the | 24 | | terms of the required permit, no related person shall be | 25 | | eligible to apply for any necessary operating licenses nor |
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| 1 | | shall any related person be eligible for payment by any State | 2 | | agency for services rendered until the required permit is | 3 | | obtained.
| 4 | | (Source: P.A. 88-18 .)
| 5 | | (20 ILCS 3960/14) (from Ch. 111 1/2, par. 1164)
| 6 | | (Section scheduled to be repealed on December 31, 2029)
| 7 | | Sec. 14.
Any person who has discontinued a hospital or a | 8 | | category of service at a hospital without a permit or | 9 | | exemption issued under this Act or in violation of the terms of | 10 | | such a permit or exemption is guilty of a business offense and | 11 | | may be fined up to $1,000,000. Any person otherwise acquiring | 12 | | major medical equipment or establishing,
constructing or | 13 | | modifying a health care facility without a permit issued
under | 14 | | this Act or in violation of the terms of such a permit is | 15 | | guilty of
a business offense and may be fined up to $100,000 | 16 | | $25,000 . The State's
Attorneys
of the several counties or the | 17 | | Attorney General shall represent the People
of the State of | 18 | | Illinois in proceedings under this Section. The State's | 19 | | Attorneys of the several counties or the Attorney General may | 20 | | additionally maintain an action in the name of the People of | 21 | | the State of Illinois for injunction or other process against | 22 | | any person or governmental unit to restrain or prevent the | 23 | | acquisition of major medical equipment, or the establishment, | 24 | | construction or modification of a health care facility without | 25 | | the required permit, or to restrain or prevent the occupancy |
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| 1 | | or utilization of the equipment acquired or facility which was | 2 | | constructed or modified without the required permit. | 3 | | Proceedings The prosecution
of an offense under this Section , | 4 | | including the prosecution of an offense, shall not prohibit | 5 | | the imposition of any other
sanction provided under this Act.
| 6 | | (Source: P.A. 88-18 .)
| 7 | | (20 ILCS 3960/14.05 new) | 8 | | Sec. 14.05. Right of action. Any person aggrieved by a | 9 | | violation of this Act, due to a negative impact on their access | 10 | | to health care or on their health due to diminished access to | 11 | | health care, involving the discontinuation of a hospital or a | 12 | | discontinuation of a category of service at a hospital without | 13 | | a permit or exemption as required by this Act shall have a | 14 | | right of action in a State circuit court or as a supplemental | 15 | | claim in federal district court against an offending party. A | 16 | | prevailing party may recover for each violation: (i) any | 17 | | actual damages; (ii) an injunction or other relief as the | 18 | | court may deem appropriate; and (iii) reasonable attorney's | 19 | | fees.
| 20 | | (20 ILCS 3960/14.1)
| 21 | | (Section scheduled to be repealed on December 31, 2029) | 22 | | Sec. 14.1. Denial of permit; other sanctions. | 23 | | (a) The State Board may deny an application for a permit or | 24 | | may revoke or
take other action as permitted by this Act with |
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| 1 | | regard to a permit as the State
Board deems appropriate, | 2 | | including the imposition of fines as set forth in this
| 3 | | Section, for any one or a combination of the following: | 4 | | (1) The acquisition of major medical equipment without | 5 | | a permit or in
violation of the terms of a permit. | 6 | | (2) The establishment, construction, modification, or | 7 | | change of ownership of a health care
facility without a | 8 | | permit or exemption or in violation of the terms of a | 9 | | permit. | 10 | | (3) The violation of any provision of this Act or any | 11 | | rule adopted
under this Act. | 12 | | (4) The failure, by any person subject to this Act, to | 13 | | provide information
requested by the State Board or Agency | 14 | | within 30 days after a formal written
request for the | 15 | | information. | 16 | | (5) The failure to pay any fine imposed under this | 17 | | Section within 30 days
of its imposition. | 18 | | (a-5) For facilities licensed under the ID/DD Community | 19 | | Care Act, no permit shall be denied on the basis of prior | 20 | | operator history, other than for actions specified under item | 21 | | (2), (4), or (5) of Section 3-117 of the ID/DD Community Care | 22 | | Act. For facilities licensed under the MC/DD Act, no permit | 23 | | shall be denied on the basis of prior operator history, other | 24 | | than for actions specified under item (2), (4), or (5) of | 25 | | Section 3-117 of the MC/DD Act. For facilities licensed under | 26 | | the Specialized Mental Health Rehabilitation Act of 2013, no |
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| 1 | | permit shall be denied on the basis of prior operator history, | 2 | | other than for actions specified under subsections (a) and (b) | 3 | | of Section 4-109 of the Specialized Mental Health | 4 | | Rehabilitation Act of 2013. For facilities licensed under the | 5 | | Nursing Home Care Act, no permit shall be denied on the basis | 6 | | of prior operator history, other than for: (i) actions | 7 | | specified under item (2), (3), (4), (5), or (6) of Section | 8 | | 3-117 of the Nursing Home Care Act; (ii) actions specified | 9 | | under item (a)(6) of Section 3-119 of the Nursing Home Care | 10 | | Act; or (iii) actions within the preceding 5 years | 11 | | constituting a substantial and repeated failure to comply with | 12 | | the Nursing Home Care Act or the rules and regulations adopted | 13 | | by the Department under that Act. The State Board shall not | 14 | | deny a permit on account of any action described in this | 15 | | subsection (a-5) without also considering all such actions in | 16 | | the light of all relevant information available to the State | 17 | | Board, including whether the permit is sought to substantially | 18 | | comply with a mandatory or voluntary plan of correction | 19 | | associated with any action described in this subsection (a-5).
| 20 | | (b) Persons shall be subject to fines as provided in this | 21 | | subsection (b). The maximum fines imposed under this | 22 | | subsection (b) shall be annually adjusted and proportional | 23 | | with the increase in construction costs due to inflation, for | 24 | | major medical equipment and for all other capital | 25 | | expenditures. as follows: | 26 | | (1) A permit holder who fails to comply with the |
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| 1 | | requirements of
maintaining a valid permit shall be fined | 2 | | an amount not to exceed 1% of the
approved permit amount | 3 | | plus an additional 1% of the approved permit amount for
| 4 | | each 30-day period, or fraction thereof, that the | 5 | | violation continues. | 6 | | (2) A permit holder who alters the scope of an | 7 | | approved project or whose
project costs exceed the | 8 | | allowable permit amount without first obtaining
approval | 9 | | from the State Board shall be fined an amount not to exceed | 10 | | the sum of
(i) the lesser of $40,000 $25,000 or 2% of the | 11 | | approved permit amount and (ii) in those
cases where the | 12 | | approved permit amount is exceeded by more than | 13 | | $1,000,000, an
additional $40,000 $20,000 for each | 14 | | $1,000,000, or fraction thereof, in excess of the
approved | 15 | | permit amount. | 16 | | (2.5) A permit or exemption holder who fails to comply | 17 | | with the post-permit and reporting requirements set forth | 18 | | in Sections 5 and 8.5 shall be fined an amount not to | 19 | | exceed $18,000 $10,000 plus an additional $18,000 $10,000 | 20 | | for each 30-day period, or fraction thereof, that the | 21 | | violation continues. The accrued fine is not waived by the | 22 | | permit or exemption holder submitting the required | 23 | | information and reports. Prior to any fine beginning to | 24 | | accrue, the Board shall
notify, in writing, a permit or | 25 | | exemption holder of the due date
for the post-permit and | 26 | | reporting requirements no later than 30 days
before the |
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| 1 | | due date for the requirements. The exemption letter shall | 2 | | serve as the notice for exemptions. | 3 | | (3) A person who acquires major medical equipment or | 4 | | who establishes a
category of service without first | 5 | | obtaining a permit or exemption, as the case
may be, shall | 6 | | be fined an amount not to exceed $18,000 $10,000 for each | 7 | | such
acquisition or category of service established plus | 8 | | an additional $18,000 $10,000 for
each 30-day period, or | 9 | | fraction thereof, that the violation continues. | 10 | | (4) A person who constructs, modifies, establishes, or | 11 | | changes ownership of a health care
facility without first | 12 | | obtaining a permit or exemption shall be fined an amount | 13 | | not to
exceed $40,000 $25,000 plus an additional $40,000 | 14 | | $25,000 for each 30-day period, or fraction
thereof, that | 15 | | the violation continues. | 16 | | (5) A person who discontinues a health care facility | 17 | | other than a hospital or a category of
service at a health | 18 | | care facility other than a hospital without first | 19 | | obtaining a permit or exemption shall be fined an amount | 20 | | not to exceed $25,000
$10,000 plus an additional $25,000 | 21 | | $10,000 for each 30-day period, or fraction thereof,
that | 22 | | the violation continues. For purposes of this subparagraph | 23 | | (5), facilities licensed under the Nursing Home Care Act, | 24 | | the ID/DD Community Care Act, or the MC/DD Act, with the | 25 | | exceptions of facilities operated by a county or Illinois | 26 | | Veterans Homes, are exempt from this permit requirement. |
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| 1 | | However, facilities licensed under the Nursing Home Care | 2 | | Act, the ID/DD Community Care Act, or the MC/DD Act must | 3 | | comply with Section 3-423 of the Nursing Home Care Act, | 4 | | Section 3-423 of the ID/DD Community Care Act, or Section | 5 | | 3-423 of the MC/DD Act and must provide the Board and the | 6 | | Department of Human Services with 30 days' written notice | 7 | | of their intent to close.
Facilities licensed under the | 8 | | ID/DD Community Care Act or the MC/DD Act also must | 9 | | provide the Board and the Department of Human Services | 10 | | with 30 days' written notice of their intent to reduce the | 11 | | number of beds for a facility. | 12 | | (5.5) A person who discontinues a hospital facility or | 13 | | category of service without first obtaining a permit or | 14 | | exemption shall be fined an amount not to exceed $100,000 | 15 | | plus an additional $100,000 for each 30-day period, or | 16 | | fraction thereof, that the violation continues. | 17 | | (6) A person subject to this Act who fails to provide | 18 | | information
requested by the State Board or Agency within | 19 | | 30 days of a formal written
request shall be fined an | 20 | | amount not to exceed $2,000 $1,000 plus an additional | 21 | | $2,000 $1,000
for each 30-day period, or fraction thereof, | 22 | | that the information is not
received by the State Board or | 23 | | Agency. | 24 | | (b-5) The State Board may accept in-kind services or | 25 | | donations instead of or in combination with the imposition of | 26 | | a fine. This authorization is limited to cases where the |
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| 1 | | non-compliant individual or entity has waived the right to an | 2 | | administrative hearing or opportunity to appear before the | 3 | | Board regarding the non-compliant matter. | 4 | | (c) Before imposing any fine authorized under this | 5 | | Section, the State Board
shall afford the person or permit | 6 | | holder, as the case may be, an appearance
before the State | 7 | | Board and an opportunity for a hearing before a hearing
| 8 | | officer appointed by the State Board. The hearing shall be | 9 | | conducted in
accordance with Section 10. Requests for an | 10 | | appearance before the State Board must be made within 30 days | 11 | | after receiving notice that a fine will be imposed. | 12 | | (d) All fines collected under this Act shall be | 13 | | transmitted to the State
Treasurer, who shall deposit them | 14 | | into the Illinois Health Facilities Planning
Fund. | 15 | | (e) Fines imposed under this Section shall continue to | 16 | | accrue until: (i) the date that the matter is referred by the | 17 | | State Board to the Board's legal counsel; or (ii) the date that | 18 | | the health care facility becomes compliant with the Act, | 19 | | whichever is earlier. | 20 | | (Source: P.A. 99-114, eff. 7-23-15; 99-180, eff. 7-29-15; | 21 | | 99-527, eff. 1-1-17; 99-642, eff. 6-28-16; 100-681, eff. | 22 | | 8-3-18 .)
| 23 | | Section 15. The Illinois Public Aid Code is amended by | 24 | | changing Section 5A-17 as follows: |
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| 1 | | (305 ILCS 5/5A-17) | 2 | | Sec. 5A-17. Recovery of payments; liens. | 3 | | (a) As a condition of receiving payments pursuant to | 4 | | subsections (d) and (k) of Section 5A-12.7 for State Fiscal | 5 | | Year 2021, a for-profit general acute care hospital that | 6 | | ceases to provide hospital services before July 1, 2021 and | 7 | | within 12 months of a change in the hospital's ownership | 8 | | status from not-for-profit to investor owned, shall be | 9 | | obligated to pay to the Department an amount equal to the | 10 | | payments received pursuant to subsections (d) and (k) of | 11 | | Section 5A-12.7 since the change in ownership status to the | 12 | | cessation of hospital services. The obligated amount shall be | 13 | | due immediately and must be paid to the Department within 10 | 14 | | days of ceasing to provide services or pursuant to a payment | 15 | | plan approved by the Department unless the hospital requests a | 16 | | hearing under paragraph (d) of this Section. The obligation | 17 | | under this Section shall not apply to a hospital that ceases to | 18 | | provide services under circumstances that include: | 19 | | implementation of a transformation project approved by the | 20 | | Department under subsection (d-5) of Section 14-12; | 21 | | emergencies as declared by federal, State, or local | 22 | | government; actions approved or required by federal, State, or | 23 | | local government; actions taken in compliance with the | 24 | | Illinois Health Facilities Planning Act; or other | 25 | | circumstances beyond the control of the hospital provider or | 26 | | for the benefit of the community previously served by the |
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| 1 | | hospital, as determined on a case-by-case basis by the | 2 | | Department. | 3 | | (a-5) As a condition of receiving payments pursuant to | 4 | | subsections (d) and (k) of Section 5A-12.7 for calendar year | 5 | | 2021, a general acute care hospital that ceases to provide | 6 | | hospital services before January 1, 2022 shall be obligated to | 7 | | pay to the Department an amount equal to the payments received | 8 | | pursuant to subsections (d) and (k) of Section 5A-12.7 up to | 9 | | the cessation of hospital services. The obligated amount shall | 10 | | be due immediately and must be paid to the Department within 30 | 11 | | days of ceasing to provide services, or pursuant to a payment | 12 | | plan approved by the Department. The obligation under this | 13 | | Section shall not apply to a hospital that ceases to provide | 14 | | services under circumstances that include: (i) implementation | 15 | | of a transformation project approved under subsection (d-5) of | 16 | | Section 14-12; (ii) emergencies as declared by federal, State, | 17 | | or local government; (iii) actions approved or required by | 18 | | federal, State, or local government; (iv) actions taken in | 19 | | compliance with the Illinois Health Facilities Planning Act; | 20 | | or (v) other circumstances beyond the control of the hospital | 21 | | provider or for the benefit of the community previously served | 22 | | by the hospital, as determined on a case-by-case basis by the | 23 | | Department. | 24 | | (b) The Illinois Department shall administer and enforce | 25 | | this Section and collect the obligations imposed under this | 26 | | Section using procedures employed in its administration of |
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| 1 | | this Code generally. The Illinois Department, its Director, | 2 | | and every hospital provider subject to this Section shall have | 3 | | the following powers, duties, and rights: | 4 | | (1) The Illinois Department may initiate either | 5 | | administrative or judicial proceedings, or both, to | 6 | | enforce the provisions of this Section. Administrative | 7 | | enforcement proceedings initiated hereunder shall be | 8 | | governed by the Illinois Department's administrative | 9 | | rules. Judicial enforcement proceedings initiated in | 10 | | accordance with this Section shall be governed by the | 11 | | rules of procedure applicable in the courts of this State. | 12 | | (2) No proceedings for collection, refund, credit, or | 13 | | other adjustment of an amount payable under this Section | 14 | | shall be issued more than 3 years after the due date of the | 15 | | obligation, except in the case of an extended period | 16 | | agreed to in writing by the Illinois Department and the | 17 | | hospital provider before the expiration of this limitation | 18 | | period. | 19 | | (3) Any unpaid obligation under this Section shall | 20 | | become a lien upon the assets of the hospital. If any | 21 | | hospital provider sells or transfers the major part of any | 22 | | one or more of (i) the real property and improvements, | 23 | | (ii) the machinery and equipment, or (iii) the furniture | 24 | | or fixtures of any hospital that is subject to the | 25 | | provisions of this Section, the seller or transferor shall | 26 | | pay the Illinois Department the amount of any obligation |
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| 1 | | due from it under this Section up to the date of the sale | 2 | | or transfer. If the seller or transferor fails to pay any | 3 | | amount due under this Section, the purchaser or transferee | 4 | | of such asset shall be liable for the amount of the | 5 | | obligation up to the amount of the reasonable value of the | 6 | | property acquired by the purchaser or transferee. The | 7 | | purchaser or transferee shall continue to be liable until | 8 | | the purchaser or transferee pays the full amount of the | 9 | | obligation up to the amount of the reasonable value of the | 10 | | property acquired by the purchaser or transferee or until | 11 | | the purchaser or transferee receives from the Illinois | 12 | | Department a certificate showing that such assessment, | 13 | | penalty, and interest have been paid or a certificate from | 14 | | the Illinois Department showing that no amount is due from | 15 | | the seller or transferor under this Section. | 16 | | (c) In addition to any other remedy provided for, the | 17 | | Illinois Department may collect an unpaid obligation by | 18 | | withholding, as payment of the amount due, reimbursements or | 19 | | other amounts otherwise payable by the Illinois Department to | 20 | | the hospital provider.
| 21 | | (Source: P.A. 101-650, eff. 7-7-20.)
| 22 | | Section 99. Effective date. This Act takes effect upon | 23 | | becoming law.
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