Bill Amendment: IL HB0763 | 2017-2018 | 100th General Assembly

NOTE: For additional amemendments please see the Bill Drafting List

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Bill Title: HEALTH FACILITIES-STATE BOARD

Status: 2017-09-22 - Public Act . . . . . . . . . 100-0518 [HB0763 Detail]

Download: Illinois-2017-HB0763-House_Amendment_001.html

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Rep. William Davis

Filed: 3/7/2017

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AMENDMENT TO HOUSE BILL 763
AMENDMENT NO. ______. Amend House Bill 763 by replacing
everything after the enacting clause with the following:
"Section 5. The Illinois Health Facilities Planning Act is
amended by changing Sections 3, 4.2, 5, 5.4, 6, and 12 as
follows:
(20 ILCS 3960/3) (from Ch. 111 1/2, par. 1153)
(Section scheduled to be repealed on December 31, 2019)
Sec. 3. Definitions. As used in this Act:
"Health care facilities" means and includes the following
facilities, organizations, and related persons:
(1) An ambulatory surgical treatment center required
to be licensed pursuant to the Ambulatory Surgical
Treatment Center Act.
(2) An institution, place, building, or agency
required to be licensed pursuant to the Hospital Licensing

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Act.
(3) Skilled and intermediate long term care facilities
licensed under the Nursing Home Care Act.
(A) If a demonstration project under the Nursing
Home Care Act applies for a certificate of need to
convert to a nursing facility, it shall meet the
licensure and certificate of need requirements in
effect as of the date of application.
(B) Except as provided in item (A) of this
subsection, this Act does not apply to facilities
granted waivers under Section 3-102.2 of the Nursing
Home Care Act.
(3.5) Skilled and intermediate care facilities
licensed under the ID/DD Community Care Act or the MC/DD
Act. No permit or exemption is required for a facility
licensed under the ID/DD Community Care Act or the MC/DD
Act prior to the reduction of the number of beds at a
facility. If there is a total reduction of beds at a
facility licensed under the ID/DD Community Care Act or the
MC/DD Act, this is a discontinuation or closure of the
facility. If a facility licensed under the ID/DD Community
Care Act or the MC/DD Act reduces the number of beds or
discontinues the facility, that facility must notify the
Board as provided in Section 14.1 of this Act.
(3.7) Facilities licensed under the Specialized Mental
Health Rehabilitation Act of 2013.

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(4) Hospitals, nursing homes, ambulatory surgical
treatment centers, or kidney disease treatment centers
maintained by the State or any department or agency
thereof.
(5) Kidney disease treatment centers, including a
free-standing hemodialysis unit required to be licensed
under the End Stage Renal Disease Facility Act.
(A) This Act does not apply to a dialysis facility
that provides only dialysis training, support, and
related services to individuals with end stage renal
disease who have elected to receive home dialysis.
(B) This Act does not apply to a dialysis unit
located in a licensed nursing home that offers or
provides dialysis-related services to residents with
end stage renal disease who have elected to receive
home dialysis within the nursing home.
(C) The Board, however, may require dialysis
facilities and licensed nursing homes under items (A)
and (B) of this subsection to report statistical
information on a quarterly basis to the Board to be
used by the Board to conduct analyses on the need for
proposed kidney disease treatment centers.
(6) An institution, place, building, or room used for
the performance of outpatient surgical procedures that is
leased, owned, or operated by or on behalf of an
out-of-state facility.

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(7) An institution, place, building, or room used for
provision of a health care category of service, including,
but not limited to, cardiac catheterization and open heart
surgery.
(8) An institution, place, building, or room housing
major medical equipment used in the direct clinical
diagnosis or treatment of patients, and whose project cost
is in excess of the capital expenditure minimum.
"Health care facilities" does not include the following
entities or facility transactions:
(1) Federally-owned facilities.
(2) Facilities used solely for healing by prayer or
spiritual means.
(3) An existing facility located on any campus facility
as defined in Section 5-5.8b of the Illinois Public Aid
Code, provided that the campus facility encompasses 30 or
more contiguous acres and that the new or renovated
facility is intended for use by a licensed residential
facility.
(4) Facilities licensed under the Supportive
Residences Licensing Act or the Assisted Living and Shared
Housing Act.
(5) Facilities designated as supportive living
facilities that are in good standing with the program
established under Section 5-5.01a of the Illinois Public
Aid Code.

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(6) Facilities established and operating under the
Alternative Health Care Delivery Act as a children's
community-based health care center alternative health care
model demonstration program or as an Alzheimer's Disease
Management Center alternative health care model
demonstration program.
(7) The closure of an entity or a portion of an entity
licensed under the Nursing Home Care Act, the Specialized
Mental Health Rehabilitation Act of 2013, the ID/DD
Community Care Act, or the MC/DD Act, with the exception of
facilities operated by a county or Illinois Veterans Homes,
that elect to convert, in whole or in part, to an assisted
living or shared housing establishment licensed under the
Assisted Living and Shared Housing Act and with the
exception of a facility licensed under the Specialized
Mental Health Rehabilitation Act of 2013 in connection with
a proposal to close a facility and re-establish the
facility in another location.
(8) Any change of ownership of a health care facility
that is licensed under the Nursing Home Care Act, the
Specialized Mental Health Rehabilitation Act of 2013, the
ID/DD Community Care Act, or the MC/DD Act, with the
exception of facilities operated by a county or Illinois
Veterans Homes. Changes of ownership of facilities
licensed under the Nursing Home Care Act must meet the
requirements set forth in Sections 3-101 through 3-119 of

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the Nursing Home Care Act.
With the exception of those health care facilities
specifically included in this Section, nothing in this Act
shall be intended to include facilities operated as a part of
the practice of a physician or other licensed health care
professional, whether practicing in his individual capacity or
within the legal structure of any partnership, medical or
professional corporation, or unincorporated medical or
professional group. Further, this Act shall not apply to
physicians or other licensed health care professional's
practices where such practices are carried out in a portion of
a health care facility under contract with such health care
facility by a physician or by other licensed health care
professionals, whether practicing in his individual capacity
or within the legal structure of any partnership, medical or
professional corporation, or unincorporated medical or
professional groups, unless the entity constructs, modifies,
or establishes a health care facility as specifically defined
in this Section. This Act shall apply to construction or
modification and to establishment by such health care facility
of such contracted portion which is subject to facility
licensing requirements, irrespective of the party responsible
for such action or attendant financial obligation.
"Person" means any one or more natural persons, legal
entities, governmental bodies other than federal, or any
combination thereof.

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"Consumer" means any person other than a person (a) whose
major occupation currently involves or whose official capacity
within the last 12 months has involved the providing,
administering or financing of any type of health care facility,
(b) who is engaged in health research or the teaching of
health, (c) who has a material financial interest in any
activity which involves the providing, administering or
financing of any type of health care facility, or (d) who is or
ever has been a member of the immediate family of the person
defined by (a), (b), or (c).
"State Board" or "Board" means the Health Facilities and
Services Review Board.
"Construction or modification" means the establishment,
erection, building, alteration, reconstruction, modernization,
improvement, extension, discontinuation, change of ownership,
of or by a health care facility, or the purchase or acquisition
by or through a health care facility of equipment or service
for diagnostic or therapeutic purposes or for facility
administration or operation, or any capital expenditure made by
or on behalf of a health care facility which exceeds the
capital expenditure minimum; however, any capital expenditure
made by or on behalf of a health care facility for (i) the
construction or modification of a facility licensed under the
Assisted Living and Shared Housing Act or (ii) a conversion
project undertaken in accordance with Section 30 of the Older
Adult Services Act shall be excluded from any obligations under

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this Act.
"Establish" means the construction of a health care
facility or the replacement of an existing facility on another
site or the initiation of a category of service.
"Major medical equipment" means medical equipment which is
used for the provision of medical and other health services and
which costs in excess of the capital expenditure minimum,
except that such term does not include medical equipment
acquired by or on behalf of a clinical laboratory to provide
clinical laboratory services if the clinical laboratory is
independent of a physician's office and a hospital and it has
been determined under Title XVIII of the Social Security Act to
meet the requirements of paragraphs (10) and (11) of Section
1861(s) of such Act. In determining whether medical equipment
has a value in excess of the capital expenditure minimum, the
value of studies, surveys, designs, plans, working drawings,
specifications, and other activities essential to the
acquisition of such equipment shall be included.
"Capital Expenditure" means an expenditure: (A) made by or
on behalf of a health care facility (as such a facility is
defined in this Act); and (B) which under generally accepted
accounting principles is not properly chargeable as an expense
of operation and maintenance, or is made to obtain by lease or
comparable arrangement any facility or part thereof or any
equipment for a facility or part; and which exceeds the capital
expenditure minimum.

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For the purpose of this paragraph, the cost of any studies,
surveys, designs, plans, working drawings, specifications, and
other activities essential to the acquisition, improvement,
expansion, or replacement of any plant or equipment with
respect to which an expenditure is made shall be included in
determining if such expenditure exceeds the capital
expenditures minimum. Unless otherwise interdependent, or
submitted as one project by the applicant, components of
construction or modification undertaken by means of a single
construction contract or financed through the issuance of a
single debt instrument shall not be grouped together as one
project. Donations of equipment or facilities to a health care
facility which if acquired directly by such facility would be
subject to review under this Act shall be considered capital
expenditures, and a transfer of equipment or facilities for
less than fair market value shall be considered a capital
expenditure for purposes of this Act if a transfer of the
equipment or facilities at fair market value would be subject
to review.
"Capital expenditure minimum" means $11,500,000 for
projects by hospital applicants, $6,500,000 for applicants for
projects related to skilled and intermediate care long-term
care facilities licensed under the Nursing Home Care Act, and
$3,000,000 for projects by all other applicants, which shall be
annually adjusted to reflect the increase in construction costs
due to inflation, for major medical equipment and for all other

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capital expenditures.
"Financial Commitment" means the commitment of at least 33%
of total funds assigned to cover total project cost, which
occurs by the actual expenditure of 33% or more of the total
project cost or the commitment to expend 33% or more of the
total project cost by signed contracts or other legal means.
"Non-clinical service area" means an area (i) for the
benefit of the patients, visitors, staff, or employees of a
health care facility and (ii) not directly related to the
diagnosis, treatment, or rehabilitation of persons receiving
services from the health care facility. "Non-clinical service
areas" include, but are not limited to, chapels; gift shops;
news stands; computer systems; tunnels, walkways, and
elevators; telephone systems; projects to comply with life
safety codes; educational facilities; student housing;
patient, employee, staff, and visitor dining areas;
administration and volunteer offices; modernization of
structural components (such as roof replacement and masonry
work); boiler repair or replacement; vehicle maintenance and
storage facilities; parking facilities; mechanical systems for
heating, ventilation, and air conditioning; loading docks; and
repair or replacement of carpeting, tile, wall coverings,
window coverings or treatments, or furniture. Solely for the
purpose of this definition, "non-clinical service area" does
not include health and fitness centers.
"Areawide" means a major area of the State delineated on a

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geographic, demographic, and functional basis for health
planning and for health service and having within it one or
more local areas for health planning and health service. The
term "region", as contrasted with the term "subregion", and the
word "area" may be used synonymously with the term "areawide".
"Local" means a subarea of a delineated major area that on
a geographic, demographic, and functional basis may be
considered to be part of such major area. The term "subregion"
may be used synonymously with the term "local".
"Physician" means a person licensed to practice in
accordance with the Medical Practice Act of 1987, as amended.
"Licensed health care professional" means a person
licensed to practice a health profession under pertinent
licensing statutes of the State of Illinois.
"Director" means the Director of the Illinois Department of
Public Health.
"Agency" or "Department" means the Illinois Department of
Public Health.
"Alternative health care model" means a facility or program
authorized under the Alternative Health Care Delivery Act.
"Out-of-state facility" means a person that is both (i)
licensed as a hospital or as an ambulatory surgery center under
the laws of another state or that qualifies as a hospital or an
ambulatory surgery center under regulations adopted pursuant
to the Social Security Act and (ii) not licensed under the
Ambulatory Surgical Treatment Center Act, the Hospital

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Licensing Act, or the Nursing Home Care Act. Affiliates of
out-of-state facilities shall be considered out-of-state
facilities. Affiliates of Illinois licensed health care
facilities 100% owned by an Illinois licensed health care
facility, its parent, or Illinois physicians licensed to
practice medicine in all its branches shall not be considered
out-of-state facilities. Nothing in this definition shall be
construed to include an office or any part of an office of a
physician licensed to practice medicine in all its branches in
Illinois that is not required to be licensed under the
Ambulatory Surgical Treatment Center Act.
"Change of ownership of a health care facility" means a
change in the person who has ownership or control of a health
care facility's physical plant and capital assets. A change in
ownership is indicated by the following transactions: sale,
transfer, acquisition, lease, change of sponsorship, or other
means of transferring control.
"Related person" means any person that: (i) is at least 50%
owned, directly or indirectly, by either the health care
facility or a person owning, directly or indirectly, at least
50% of the health care facility; or (ii) owns, directly or
indirectly, at least 50% of the health care facility.
"Charity care" means care provided by a health care
facility for which the provider does not expect to receive
payment from the patient or a third-party payer.
"Freestanding emergency center" means a facility subject

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to licensure under Section 32.5 of the Emergency Medical
Services (EMS) Systems Act.
"Category of service" means a grouping by generic class of
various types or levels of support functions, equipment, care,
or treatment provided to patients or residents, including, but
not limited to, classes such as medical-surgical, pediatrics,
or cardiac catheterization. A category of service may include
subcategories or levels of care that identify a particular
degree or type of care within the category of service. Nothing
in this definition shall be construed to include the practice
of a physician or other licensed health care professional while
functioning in an office providing for the care, diagnosis, or
treatment of patients. A category of service that is subject to
the Board's jurisdiction must be designated in rules adopted by
the Board.
"State Board Staff Report" means the document that sets
forth the review and findings of the State Board staff, as
prescribed by the State Board, regarding applications subject
to Board jurisdiction.
(Source: P.A. 98-414, eff. 1-1-14; 98-629, eff. 1-1-15; 98-651,
eff. 6-16-14; 98-1086, eff. 8-26-14; 99-78, eff. 7-20-15;
99-180, eff. 7-29-15; 99-527, eff. 1-1-17.)
(20 ILCS 3960/4.2)
(Section scheduled to be repealed on December 31, 2019)
Sec. 4.2. Ex parte communications.

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(a) Except in the disposition of matters that agencies are
authorized by law to entertain or dispose of on an ex parte
basis including, but not limited to rule making, the State
Board, any State Board member, employee, or a hearing officer
shall not engage in ex parte communication in connection with
the substance of any formally filed application for a permit
with any person or party or the representative of any party.
This subsection (a) applies when the Board, member, employee,
or hearing officer knows, or should know upon reasonable
inquiry, that the application or exemption has been formally
filed with the Board. Nothing in this Section shall prohibit
staff members from providing technical assistance to
applicants. Nothing in this Section shall prohibit staff from
verifying or clarifying an applicant's information as it
prepares the State Board Staff Report staff report. Once an
application or exemption is filed and deemed complete, a
written record of any communication between staff and an
applicant shall be prepared by staff and made part of the
public record, using a prescribed, standardized format, and
shall be included in the application file.
(b) A State Board member or employee may communicate with
other members or employees and any State Board member or
hearing officer may have the aid and advice of one or more
personal assistants.
(c) An ex parte communication received by the State Board,
any State Board member, employee, or a hearing officer shall be

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made a part of the record of the matter, including all written
communications, all written responses to the communications,
and a memorandum stating the substance of all oral
communications and all responses made and the identity of each
person from whom the ex parte communication was received.
(d) "Ex parte communication" means a communication between
a person who is not a State Board member or employee and a
State Board member or employee that reflects on the substance
of a pending or impending State Board proceeding and that takes
place outside the record of the proceeding. Communications
regarding matters of procedure and practice, such as the format
of pleading, number of copies required, manner of service, and
status of proceedings, are not considered ex parte
communications. Technical assistance with respect to an
application, not intended to influence any decision on the
application, may be provided by employees to the applicant. Any
assistance shall be documented in writing by the applicant and
employees within 10 business days after the assistance is
provided.
(e) For purposes of this Section, "employee" means a person
the State Board or the Agency employs on a full-time,
part-time, contract, or intern basis.
(f) The State Board, State Board member, or hearing
examiner presiding over the proceeding, in the event of a
violation of this Section, must take whatever action is
necessary to ensure that the violation does not prejudice any

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party or adversely affect the fairness of the proceedings.
(g) Nothing in this Section shall be construed to prevent
the State Board or any member of the State Board from
consulting with the attorney for the State Board.
(Source: P.A. 96-31, eff. 6-30-09.)
(20 ILCS 3960/5) (from Ch. 111 1/2, par. 1155)
(Section scheduled to be repealed on December 31, 2019)
Sec. 5. Construction, modification, or establishment of
health care facilities or acquisition of major medical
equipment; permits or exemptions. No person shall construct,
modify or establish a health care facility or acquire major
medical equipment without first obtaining a permit or exemption
from the State Board. The State Board shall not delegate to the
staff of the State Board or any other person or entity the
authority to grant permits or exemptions whenever the staff or
other person or entity would be required to exercise any
discretion affecting the decision to grant a permit or
exemption. The State Board may, by rule, delegate authority to
the Chairman to grant permits or exemptions when applications
meet all of the State Board's review criteria and are
unopposed.
A permit or exemption shall be obtained prior to the
acquisition of major medical equipment or to the construction
or modification of a health care facility which:
(a) requires a total capital expenditure in excess of

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the capital expenditure minimum; or
(b) substantially changes the scope or changes the
functional operation of the facility; or
(c) changes the bed capacity of a health care facility
by increasing the total number of beds or by distributing
beds among various categories of service or by relocating
beds from one physical facility or site to another by more
than 20 beds or more than 10% of total bed capacity as
defined by the State Board, whichever is less, over a 2
year period.
A permit shall be valid only for the defined construction
or modifications, site, amount and person named in the
application for such permit and shall not be transferable or
assignable. A permit shall be valid until such time as the
project has been completed, provided that the project commences
and proceeds to completion with due diligence by the completion
date or extension date approved by the Board.
A permit holder must do the following: (i) submit the final
completion and cost report for the project within 90 days after
the approved project completion date or extension date and (ii)
submit annual progress reports no earlier than 30 days before
and no later than 30 days after each anniversary date of the
Board's approval of the permit until the project is completed.
To maintain a valid permit and to monitor progress toward
project commencement and completion, routine post-permit
reports shall be limited to annual progress reports and the

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final completion and cost report. Annual progress reports shall
include information regarding the committed funds expended
toward the approved project. For projects to be completed in 12
months or less, the permit holder shall report financial
commitment in the final completion and cost report. For
projects to be completed between 12 to 24 months, the permit
holder shall report financial commitment in the first annual
report. For projects to be completed in more than 24 months,
the permit holder shall report financial commitment in the
second annual progress report. The If the project is not
completed in one year, then, by the second annual report, the
permit holder shall expend 33% or more of the total project
cost or shall make a commitment to expend 33% or more of the
total project cost by signed contracts or other legal means,
and the report shall contain information regarding financial
commitment those expenditures or commitments. If the project is
to be completed in one year, then the first annual report shall
contain the expenditure commitment information for the total
project cost. The State Board may extend the financial
expenditure commitment period after considering a permit
holder's showing of good cause and request for additional time
to complete the project.
The Certificate of Need process required under this Act is
designed to restrain rising health care costs by preventing
unnecessary construction or modification of health care
facilities. The Board must assure that the establishment,

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construction, or modification of a health care facility or the
acquisition of major medical equipment is consistent with the
public interest and that the proposed project is consistent
with the orderly and economic development or acquisition of
those facilities and equipment and is in accord with the
standards, criteria, or plans of need adopted and approved by
the Board. Board decisions regarding the construction of health
care facilities must consider capacity, quality, value, and
equity. Projects may deviate from the costs, fees, and expenses
provided in their project cost information for the project's
cost components, provided that the final total project cost
does not exceed the approved permit amount. Project alterations
shall not increase the total approved permit amount by more
than the limit set forth under the Board's rules.
Major construction projects, for the purposes of this Act,
shall include but are not limited to: projects for the
construction of new buildings; additions to existing
facilities; modernization projects whose cost is in excess of
$1,000,000 or 10% of the facilities' operating revenue,
whichever is less; and such other projects as the State Board
shall define and prescribe pursuant to this Act.
The acquisition by any person of major medical equipment
that will not be owned by or located in a health care facility
and that will not be used to provide services to inpatients of
a health care facility shall be exempt from review provided
that a notice is filed in accordance with exemption

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requirements.
Notwithstanding any other provision of this Act, no permit
or exemption is required for the construction or modification
of a non-clinical service area of a health care facility.
(Source: P.A. 97-1115, eff. 8-27-12; 98-414, eff. 1-1-14.)
(20 ILCS 3960/5.4)
(Section scheduled to be repealed on December 31, 2019)
Sec. 5.4. Safety Net Impact Statement.
(a) General review criteria shall include a requirement
that all health care facilities, with the exception of skilled
and intermediate long-term care facilities licensed under the
Nursing Home Care Act, provide a Safety Net Impact Statement,
which shall be filed with an application for a substantive
project or when the application proposes to discontinue a
category of service.
(b) For the purposes of this Section, "safety net services"
are services provided by health care providers or organizations
that deliver health care services to persons with barriers to
mainstream health care due to lack of insurance, inability to
pay, special needs, ethnic or cultural characteristics, or
geographic isolation. Safety net service providers include,
but are not limited to, hospitals and private practice
physicians that provide charity care, school-based health
centers, migrant health clinics, rural health clinics,
federally qualified health centers, community health centers,

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public health departments, and community mental health
centers.
(c) As developed by the applicant, a Safety Net Impact
Statement shall describe all of the following:
(1) The project's material impact, if any, on essential
safety net services in the community, to the extent that it
is feasible for an applicant to have such knowledge.
(2) The project's impact on the ability of another
provider or health care system to cross-subsidize safety
net services, if reasonably known to the applicant.
(3) How the discontinuation of a facility or service
might impact the remaining safety net providers in a given
community, if reasonably known by the applicant.
(d) Safety Net Impact Statements shall also include all of
the following:
(1) For the 3 fiscal years prior to the application, a
certification describing the amount of charity care
provided by the applicant. The amount calculated by
hospital applicants shall be in accordance with the
reporting requirements for charity care reporting in the
Illinois Community Benefits Act. Non-hospital applicants
shall report charity care, at cost, in accordance with an
appropriate methodology specified by the Board.
(2) For the 3 fiscal years prior to the application, a
certification of the amount of care provided to Medicaid
patients. Hospital and non-hospital applicants shall

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provide Medicaid information in a manner consistent with
the information reported each year to the State Board
regarding "Inpatients and Outpatients Served by Payor
Source" and "Inpatient and Outpatient Net Revenue by Payor
Source" as required by the Board under Section 13 of this
Act and published in the Annual Hospital Profile.
(3) Any information the applicant believes is directly
relevant to safety net services, including information
regarding teaching, research, and any other service.
(e) The Board staff shall publish a notice, that an
application accompanied by a Safety Net Impact Statement has
been filed, in a newspaper having general circulation within
the area affected by the application. If no newspaper has a
general circulation within the county, the Board shall post the
notice in 5 conspicuous places within the proposed area.
(f) Any person, community organization, provider, or
health system or other entity wishing to comment upon or oppose
the application may file a Safety Net Impact Statement Response
with the Board, which shall provide additional information
concerning a project's impact on safety net services in the
community.
(g) Applicants shall be provided an opportunity to submit a
reply to any Safety Net Impact Statement Response.
(h) The State Board Staff Report staff report shall include
a statement as to whether a Safety Net Impact Statement was
filed by the applicant and whether it included information on

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charity care, the amount of care provided to Medicaid patients,
and information on teaching, research, or any other service
provided by the applicant directly relevant to safety net
services. The report shall also indicate the names of the
parties submitting responses and the number of responses and
replies, if any, that were filed.
(Source: P.A. 98-1086, eff. 8-26-14.)
(20 ILCS 3960/6) (from Ch. 111 1/2, par. 1156)
(Section scheduled to be repealed on December 31, 2019)
Sec. 6. Application for permit or exemption; exemption
regulations.
(a) An application for a permit or exemption shall be made
to the State Board upon forms provided by the State Board. This
application shall contain such information as the State Board
deems necessary. The State Board shall not require an applicant
to file a Letter of Intent before an application is filed. Such
application shall include affirmative evidence on which the
State Board or Chairman may make its decision on the approval
or denial of the permit or exemption.
(b) The State Board shall establish by regulation the
procedures and requirements regarding issuance of exemptions.
An exemption shall be approved when information required by the
Board by rule is submitted. Projects eligible for an exemption,
rather than a permit, include, but are not limited to, change
of ownership of a health care facility, discontinuation of a

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category of service, and discontinuation of a health care
facility, other than a health care facility maintained by the
State or any agency or department thereof or a nursing home
maintained by a county. For a change of ownership of a health
care facility, the State Board shall provide by rule for an
expedited process for obtaining an exemption in accordance with
Section 8.5 of this Act. In connection with a change of
ownership, the State Board may approve the transfer of an
existing permit without regard to whether the permit to be
transferred has yet been obligated, except for permits
establishing a new facility or a new category of service.
(c) All applications shall be signed by the applicant and
shall be verified by any 2 officers thereof.
(c-5) Any written review or findings of the Board staff or
any other reviewing organization under Section 8 concerning an
application for a permit must be made available to the public
at least 14 calendar days before the meeting of the State Board
at which the review or findings are considered. The applicant
and members of the public may submit, to the State Board,
written responses regarding the facts set forth in the review
or findings of the Board staff or reviewing organization.
Members of the public shall have until 10 days before the
meeting of the State Board to submit any written response
concerning the Board staff's written review or findings. The
Board staff may revise any findings to address corrections of
factual errors cited in the public response. At the meeting,

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the State Board may, in its discretion, permit the submission
of other additional written materials.
(d) Upon receipt of an application for a permit, the State
Board shall approve and authorize the issuance of a permit if
it finds (1) that the applicant is fit, willing, and able to
provide a proper standard of health care service for the
community with particular regard to the qualification,
background and character of the applicant, (2) that economic
feasibility is demonstrated in terms of effect on the existing
and projected operating budget of the applicant and of the
health care facility; in terms of the applicant's ability to
establish and operate such facility in accordance with
licensure regulations promulgated under pertinent state laws;
and in terms of the projected impact on the total health care
expenditures in the facility and community, (3) that safeguards
are provided which assure that the establishment, construction
or modification of the health care facility or acquisition of
major medical equipment is consistent with the public interest,
and (4) that the proposed project is consistent with the
orderly and economic development of such facilities and
equipment and is in accord with standards, criteria, or plans
of need adopted and approved pursuant to the provisions of
Section 12 of this Act.
(Source: P.A. 99-154, eff. 7-28-15.)
(20 ILCS 3960/12) (from Ch. 111 1/2, par. 1162)

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(Section scheduled to be repealed on December 31, 2019)
Sec. 12. Powers and duties of State Board. For purposes of
this Act, the State Board shall exercise the following powers
and duties:
(1) Prescribe rules, regulations, standards, criteria,
procedures or reviews which may vary according to the purpose
for which a particular review is being conducted or the type of
project reviewed and which are required to carry out the
provisions and purposes of this Act. Policies and procedures of
the State Board shall take into consideration the priorities
and needs of medically underserved areas and other health care
services, giving special consideration to the impact of
projects on access to safety net services.
(2) Adopt procedures for public notice and hearing on all
proposed rules, regulations, standards, criteria, and plans
required to carry out the provisions of this Act.
(3) (Blank).
(4) Develop criteria and standards for health care
facilities planning, conduct statewide inventories of health
care facilities, maintain an updated inventory on the Board's
web site reflecting the most recent bed and service changes and
updated need determinations when new census data become
available or new need formulae are adopted, and develop health
care facility plans which shall be utilized in the review of
applications for permit under this Act. Such health facility
plans shall be coordinated by the Board with pertinent State

10000HB0763ham001 - 27 - LRB100 03954 RJF 22698 a
Plans. Inventories pursuant to this Section of skilled or
intermediate care facilities licensed under the Nursing Home
Care Act, skilled or intermediate care facilities licensed
under the ID/DD Community Care Act, skilled or intermediate
care facilities licensed under the MC/DD Act, facilities
licensed under the Specialized Mental Health Rehabilitation
Act of 2013, or nursing homes licensed under the Hospital
Licensing Act shall be conducted on an annual basis no later
than July 1 of each year and shall include among the
information requested a list of all services provided by a
facility to its residents and to the community at large and
differentiate between active and inactive beds.
In developing health care facility plans, the State Board
shall consider, but shall not be limited to, the following:
(a) The size, composition and growth of the population
of the area to be served;
(b) The number of existing and planned facilities
offering similar programs;
(c) The extent of utilization of existing facilities;
(d) The availability of facilities which may serve as
alternatives or substitutes;
(e) The availability of personnel necessary to the
operation of the facility;
(f) Multi-institutional planning and the establishment
of multi-institutional systems where feasible;
(g) The financial and economic feasibility of proposed

10000HB0763ham001 - 28 - LRB100 03954 RJF 22698 a
construction or modification; and
(h) In the case of health care facilities established
by a religious body or denomination, the needs of the
members of such religious body or denomination may be
considered to be public need.
The health care facility plans which are developed and
adopted in accordance with this Section shall form the basis
for the plan of the State to deal most effectively with
statewide health needs in regard to health care facilities.
(5) Coordinate with other state agencies having
responsibilities affecting health care facilities, including
those of licensure and cost reporting.
(6) Solicit, accept, hold and administer on behalf of the
State any grants or bequests of money, securities or property
for use by the State Board in the administration of this Act;
and enter into contracts consistent with the appropriations for
purposes enumerated in this Act.
(7) The State Board shall prescribe procedures for review,
standards, and criteria which shall be utilized to make
periodic reviews and determinations of the appropriateness of
any existing health services being rendered by health care
facilities subject to the Act. The State Board shall consider
recommendations of the Board in making its determinations.
(8) Prescribe rules, regulations, standards, and criteria
for the conduct of an expeditious review of applications for
permits for projects of construction or modification of a

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health care facility, which projects are classified as
emergency, substantive, or non-substantive in nature.
Six months after June 30, 2009 (the effective date of
Public Act 96-31), substantive projects shall include no more
than the following:
(a) Projects to construct (1) a new or replacement
facility located on a new site or (2) a replacement
facility located on the same site as the original facility
and the cost of the replacement facility exceeds the
capital expenditure minimum, which shall be reviewed by the
Board within 120 days;
(b) Projects proposing a (1) new service within an
existing healthcare facility or (2) discontinuation of a
service within an existing healthcare facility, which
shall be reviewed by the Board within 60 days; or
(c) Projects proposing a change in the bed capacity of
a health care facility by an increase in the total number
of beds or by a redistribution of beds among various
categories of service or by a relocation of beds from one
physical facility or site to another by more than 20 beds
or more than 10% of total bed capacity, as defined by the
State Board, whichever is less, over a 2-year period.
The Chairman may approve applications for exemption that
meet the criteria set forth in rules or refer them to the full
Board. The Chairman may approve any unopposed application that
meets all of the review criteria or refer them to the full

10000HB0763ham001 - 30 - LRB100 03954 RJF 22698 a
Board.
Such rules shall not prevent the conduct of a public
hearing upon the timely request of an interested party. Such
reviews shall not exceed 60 days from the date the application
is declared to be complete.
(9) Prescribe rules, regulations, standards, and criteria
pertaining to the granting of permits for construction and
modifications which are emergent in nature and must be
undertaken immediately to prevent or correct structural
deficiencies or hazardous conditions that may harm or injure
persons using the facility, as defined in the rules and
regulations of the State Board. This procedure is exempt from
public hearing requirements of this Act.
(10) Prescribe rules, regulations, standards and criteria
for the conduct of an expeditious review, not exceeding 60
days, of applications for permits for projects to construct or
modify health care facilities which are needed for the care and
treatment of persons who have acquired immunodeficiency
syndrome (AIDS) or related conditions.
(10.5) Provide its rationale when voting on an item before
it at a State Board meeting in order to comply with subsection
(b) of Section 3-108 of the Code of Civil Procedure.
(11) Issue written decisions upon request of the applicant
or an adversely affected party to the Board. Requests for a
written decision shall be made within 15 days after the Board
meeting in which a final decision has been made. A "final

10000HB0763ham001 - 31 - LRB100 03954 RJF 22698 a
decision" for purposes of this Act is the decision to approve
or deny an application, or take other actions permitted under
this Act, at the time and date of the meeting that such action
is scheduled by the Board. The transcript of the State Board
meeting shall be incorporated into the Board's final decision.
The staff of the Board shall prepare a written copy of the
final decision and the Board shall approve a final copy for
inclusion in the formal record. The Board shall consider, for
approval, the written draft of the final decision no later than
the next scheduled Board meeting. The written decision shall
identify the applicable criteria and factors listed in this Act
and the Board's regulations that were taken into consideration
by the Board when coming to a final decision. If the Board
denies or fails to approve an application for permit or
exemption, the Board shall include in the final decision a
detailed explanation as to why the application was denied and
identify what specific criteria or standards the applicant did
not fulfill.
(12) Require at least one of its members to participate in
any public hearing, after the appointment of a majority of the
members to the Board.
(13) Provide a mechanism for the public to comment on, and
request changes to, draft rules and standards.
(14) Implement public information campaigns to regularly
inform the general public about the opportunity for public
hearings and public hearing procedures.

10000HB0763ham001 - 32 - LRB100 03954 RJF 22698 a
(15) Establish a separate set of rules and guidelines for
long-term care that recognizes that nursing homes are a
different business line and service model from other regulated
facilities. An open and transparent process shall be developed
that considers the following: how skilled nursing fits in the
continuum of care with other care providers, modernization of
nursing homes, establishment of more private rooms,
development of alternative services, and current trends in
long-term care services. The Chairman of the Board shall
appoint a permanent Health Services Review Board Long-term Care
Facility Advisory Subcommittee that shall develop and
recommend to the Board the rules to be established by the Board
under this paragraph (15). The Subcommittee shall also provide
continuous review and commentary on policies and procedures
relative to long-term care and the review of related projects.
The Subcommittee shall make recommendations to the Board no
later than January 1, 2016 and every January thereafter
pursuant to the Subcommittee's responsibility for the
continuous review and commentary on policies and procedures
relative to long-term care. In consultation with other experts
from the health field of long-term care, the Board and the
Subcommittee shall study new approaches to the current bed need
formula and Health Service Area boundaries to encourage
flexibility and innovation in design models reflective of the
changing long-term care marketplace and consumer preferences
and submit its recommendations to the Chairman of the Board no

10000HB0763ham001 - 33 - LRB100 03954 RJF 22698 a
later than January 1, 2017. The Subcommittee shall evaluate,
and make recommendations to the State Board regarding, the
buying, selling, and exchange of beds between long-term care
facilities within a specified geographic area or drive time.
The Board shall file the proposed related administrative rules
for the separate rules and guidelines for long-term care
required by this paragraph (15) by no later than September 30,
2011. The Subcommittee shall be provided a reasonable and
timely opportunity to review and comment on any review,
revision, or updating of the criteria, standards, procedures,
and rules used to evaluate project applications as provided
under Section 12.3 of this Act.
The Chairman of the Board shall appoint voting members of
the Subcommittee, who shall serve for a period of 3 years, with
one-third of the terms expiring each January, to be determined
by lot. Appointees shall include, but not be limited to,
recommendations from each of the 3 statewide long-term care
associations, with an equal number to be appointed from each.
Compliance with this provision shall be through the appointment
and reappointment process. All appointees serving as of April
1, 2015 shall serve to the end of their term as determined by
lot or until the appointee voluntarily resigns, whichever is
earlier.
One representative from the Department of Public Health,
the Department of Healthcare and Family Services, the
Department on Aging, and the Department of Human Services may

10000HB0763ham001 - 34 - LRB100 03954 RJF 22698 a
each serve as an ex-officio non-voting member of the
Subcommittee. The Chairman of the Board shall select a
Subcommittee Chair, who shall serve for a period of 3 years.
(16) Prescribe the format of the State Board Staff Report.
A State Board Staff Report shall pertain to applications that
include, but are not limited to, applications for permit or
exemption, applications for permit renewal, applications for
extension of the financial commitment obligation period,
applications requesting a declaratory ruling, or applications
under the Health Care Worker Self-Referral Act. State Board
Staff Reports shall compare applications to the relevant review
criteria under the Board's rules.
(17) Establish a separate set of rules and guidelines for
facilities licensed under the Specialized Mental Health
Rehabilitation Act of 2013. An application for the
re-establishment of a facility in connection with the
relocation of the facility shall not be granted unless the
applicant has a contractual relationship with at least one
hospital to provide emergency and inpatient mental health
services required by facility consumers, and at least one
community mental health agency to provide oversight and
assistance to facility consumers while living in the facility,
and appropriate services, including case management, to assist
them to prepare for discharge and reside stably in the
community thereafter. No new facilities licensed under the
Specialized Mental Health Rehabilitation Act of 2013 shall be

10000HB0763ham001 - 35 - LRB100 03954 RJF 22698 a
established after June 16, 2014 (the effective date of Public
Act 98-651) except in connection with the relocation of an
existing facility to a new location. An application for a new
location shall not be approved unless there are adequate
community services accessible to the consumers within a
reasonable distance, or by use of public transportation, so as
to facilitate the goal of achieving maximum individual
self-care and independence. At no time shall the total number
of authorized beds under this Act in facilities licensed under
the Specialized Mental Health Rehabilitation Act of 2013 exceed
the number of authorized beds on June 16, 2014 (the effective
date of Public Act 98-651).
(Source: P.A. 98-414, eff. 1-1-14; 98-463, eff. 8-16-13;
98-651, eff. 6-16-14; 98-1086, eff. 8-26-14; 99-78, eff.
7-20-15; 99-114, eff. 7-23-15; 99-180, eff. 7-29-15; 99-277,
eff. 8-5-15; 99-527, eff. 1-1-17; 99-642, eff. 7-28-16.)".