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

Bill Title: Amends the Illinois Health Facilities Planning Act. Provides for specified financial commitment reporting requirements for completion of projects under the Act. Removes reviewing organizations other than State Board staff from the requirement of making any written review or findings concerning an application for a permit available to the public at least 14 calendar days before the meeting of the State Board at which the review or findings are considered. Provides that substantive projects under the Act, in addition to other specified substantive projects, shall include discontinuation of a State-owned healthcare facility (currently, discontinuation of service within an existing healthcare facility) and relocation of an end stage renal facility. Provides that a State Board Staff Report shall pertain to applications for extension of the financial commitment period (currently, obligation period), in addition to other specified applications. Defines "financial commitment". Makes other technical changes.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Engrossed) 2017-04-20 - Referred to Assignments [HB0763 Detail]

Download: Illinois-2017-HB0763-Engrossed.html

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1 AN ACT concerning State government.
2 Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4 Section 5. The Illinois Health Facilities Planning Act is
5amended by changing Sections 3, 4.2, 5, 5.4, 6, and 12 as
7 (20 ILCS 3960/3) (from Ch. 111 1/2, par. 1153)
8 (Section scheduled to be repealed on December 31, 2019)
9 Sec. 3. Definitions. As used in this Act:
10 "Health care facilities" means and includes the following
11facilities, organizations, and related persons:
12 (1) An ambulatory surgical treatment center required
13 to be licensed pursuant to the Ambulatory Surgical
14 Treatment Center Act.
15 (2) An institution, place, building, or agency
16 required to be licensed pursuant to the Hospital Licensing
17 Act.
18 (3) Skilled and intermediate long term care facilities
19 licensed under the Nursing Home Care Act.
20 (A) If a demonstration project under the Nursing
21 Home Care Act applies for a certificate of need to
22 convert to a nursing facility, it shall meet the
23 licensure and certificate of need requirements in

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1 effect as of the date of application.
2 (B) Except as provided in item (A) of this
3 subsection, this Act does not apply to facilities
4 granted waivers under Section 3-102.2 of the Nursing
5 Home Care Act.
6 (3.5) Skilled and intermediate care facilities
7 licensed under the ID/DD Community Care Act or the MC/DD
8 Act. No permit or exemption is required for a facility
9 licensed under the ID/DD Community Care Act or the MC/DD
10 Act prior to the reduction of the number of beds at a
11 facility. If there is a total reduction of beds at a
12 facility licensed under the ID/DD Community Care Act or the
13 MC/DD Act, this is a discontinuation or closure of the
14 facility. If a facility licensed under the ID/DD Community
15 Care Act or the MC/DD Act reduces the number of beds or
16 discontinues the facility, that facility must notify the
17 Board as provided in Section 14.1 of this Act.
18 (3.7) Facilities licensed under the Specialized Mental
19 Health Rehabilitation Act of 2013.
20 (4) Hospitals, nursing homes, ambulatory surgical
21 treatment centers, or kidney disease treatment centers
22 maintained by the State or any department or agency
23 thereof.
24 (5) Kidney disease treatment centers, including a
25 free-standing hemodialysis unit required to be licensed
26 under the End Stage Renal Disease Facility Act.

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1 (A) This Act does not apply to a dialysis facility
2 that provides only dialysis training, support, and
3 related services to individuals with end stage renal
4 disease who have elected to receive home dialysis.
5 (B) This Act does not apply to a dialysis unit
6 located in a licensed nursing home that offers or
7 provides dialysis-related services to residents with
8 end stage renal disease who have elected to receive
9 home dialysis within the nursing home.
10 (C) The Board, however, may require dialysis
11 facilities and licensed nursing homes under items (A)
12 and (B) of this subsection to report statistical
13 information on a quarterly basis to the Board to be
14 used by the Board to conduct analyses on the need for
15 proposed kidney disease treatment centers.
16 (6) An institution, place, building, or room used for
17 the performance of outpatient surgical procedures that is
18 leased, owned, or operated by or on behalf of an
19 out-of-state facility.
20 (7) An institution, place, building, or room used for
21 provision of a health care category of service, including,
22 but not limited to, cardiac catheterization and open heart
23 surgery.
24 (8) An institution, place, building, or room housing
25 major medical equipment used in the direct clinical
26 diagnosis or treatment of patients, and whose project cost

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1 is in excess of the capital expenditure minimum.
2 "Health care facilities" does not include the following
3entities or facility transactions:
4 (1) Federally-owned facilities.
5 (2) Facilities used solely for healing by prayer or
6 spiritual means.
7 (3) An existing facility located on any campus facility
8 as defined in Section 5-5.8b of the Illinois Public Aid
9 Code, provided that the campus facility encompasses 30 or
10 more contiguous acres and that the new or renovated
11 facility is intended for use by a licensed residential
12 facility.
13 (4) Facilities licensed under the Supportive
14 Residences Licensing Act or the Assisted Living and Shared
15 Housing Act.
16 (5) Facilities designated as supportive living
17 facilities that are in good standing with the program
18 established under Section 5-5.01a of the Illinois Public
19 Aid Code.
20 (6) Facilities established and operating under the
21 Alternative Health Care Delivery Act as a children's
22 community-based health care center alternative health care
23 model demonstration program or as an Alzheimer's Disease
24 Management Center alternative health care model
25 demonstration program.
26 (7) The closure of an entity or a portion of an entity

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1 licensed under the Nursing Home Care Act, the Specialized
2 Mental Health Rehabilitation Act of 2013, the ID/DD
3 Community Care Act, or the MC/DD Act, with the exception of
4 facilities operated by a county or Illinois Veterans Homes,
5 that elect to convert, in whole or in part, to an assisted
6 living or shared housing establishment licensed under the
7 Assisted Living and Shared Housing Act and with the
8 exception of a facility licensed under the Specialized
9 Mental Health Rehabilitation Act of 2013 in connection with
10 a proposal to close a facility and re-establish the
11 facility in another location.
12 (8) Any change of ownership of a health care facility
13 that is licensed under the Nursing Home Care Act, the
14 Specialized Mental Health Rehabilitation Act of 2013, the
15 ID/DD Community Care Act, or the MC/DD Act, with the
16 exception of facilities operated by a county or Illinois
17 Veterans Homes. Changes of ownership of facilities
18 licensed under the Nursing Home Care Act must meet the
19 requirements set forth in Sections 3-101 through 3-119 of
20 the Nursing Home Care Act.
21 With the exception of those health care facilities
22specifically included in this Section, nothing in this Act
23shall be intended to include facilities operated as a part of
24the practice of a physician or other licensed health care
25professional, whether practicing in his individual capacity or
26within the legal structure of any partnership, medical or

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1professional corporation, or unincorporated medical or
2professional group. Further, this Act shall not apply to
3physicians or other licensed health care professional's
4practices where such practices are carried out in a portion of
5a health care facility under contract with such health care
6facility by a physician or by other licensed health care
7professionals, whether practicing in his individual capacity
8or within the legal structure of any partnership, medical or
9professional corporation, or unincorporated medical or
10professional groups, unless the entity constructs, modifies,
11or establishes a health care facility as specifically defined
12in this Section. This Act shall apply to construction or
13modification and to establishment by such health care facility
14of such contracted portion which is subject to facility
15licensing requirements, irrespective of the party responsible
16for such action or attendant financial obligation.
17 "Person" means any one or more natural persons, legal
18entities, governmental bodies other than federal, or any
19combination thereof.
20 "Consumer" means any person other than a person (a) whose
21major occupation currently involves or whose official capacity
22within the last 12 months has involved the providing,
23administering or financing of any type of health care facility,
24(b) who is engaged in health research or the teaching of
25health, (c) who has a material financial interest in any
26activity which involves the providing, administering or

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1financing of any type of health care facility, or (d) who is or
2ever has been a member of the immediate family of the person
3defined by (a), (b), or (c).
4 "State Board" or "Board" means the Health Facilities and
5Services Review Board.
6 "Construction or modification" means the establishment,
7erection, building, alteration, reconstruction, modernization,
8improvement, extension, discontinuation, change of ownership,
9of or by a health care facility, or the purchase or acquisition
10by or through a health care facility of equipment or service
11for diagnostic or therapeutic purposes or for facility
12administration or operation, or any capital expenditure made by
13or on behalf of a health care facility which exceeds the
14capital expenditure minimum; however, any capital expenditure
15made by or on behalf of a health care facility for (i) the
16construction or modification of a facility licensed under the
17Assisted Living and Shared Housing Act or (ii) a conversion
18project undertaken in accordance with Section 30 of the Older
19Adult Services Act shall be excluded from any obligations under
20this Act.
21 "Establish" means the construction of a health care
22facility or the replacement of an existing facility on another
23site or the initiation of a category of service.
24 "Major medical equipment" means medical equipment which is
25used for the provision of medical and other health services and
26which costs in excess of the capital expenditure minimum,

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1except that such term does not include medical equipment
2acquired by or on behalf of a clinical laboratory to provide
3clinical laboratory services if the clinical laboratory is
4independent of a physician's office and a hospital and it has
5been determined under Title XVIII of the Social Security Act to
6meet the requirements of paragraphs (10) and (11) of Section
71861(s) of such Act. In determining whether medical equipment
8has a value in excess of the capital expenditure minimum, the
9value of studies, surveys, designs, plans, working drawings,
10specifications, and other activities essential to the
11acquisition of such equipment shall be included.
12 "Capital Expenditure" means an expenditure: (A) made by or
13on behalf of a health care facility (as such a facility is
14defined in this Act); and (B) which under generally accepted
15accounting principles is not properly chargeable as an expense
16of operation and maintenance, or is made to obtain by lease or
17comparable arrangement any facility or part thereof or any
18equipment for a facility or part; and which exceeds the capital
19expenditure minimum.
20 For the purpose of this paragraph, the cost of any studies,
21surveys, designs, plans, working drawings, specifications, and
22other activities essential to the acquisition, improvement,
23expansion, or replacement of any plant or equipment with
24respect to which an expenditure is made shall be included in
25determining if such expenditure exceeds the capital
26expenditures minimum. Unless otherwise interdependent, or

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1submitted as one project by the applicant, components of
2construction or modification undertaken by means of a single
3construction contract or financed through the issuance of a
4single debt instrument shall not be grouped together as one
5project. Donations of equipment or facilities to a health care
6facility which if acquired directly by such facility would be
7subject to review under this Act shall be considered capital
8expenditures, and a transfer of equipment or facilities for
9less than fair market value shall be considered a capital
10expenditure for purposes of this Act if a transfer of the
11equipment or facilities at fair market value would be subject
12to review.
13 "Capital expenditure minimum" means $11,500,000 for
14projects by hospital applicants, $6,500,000 for applicants for
15projects related to skilled and intermediate care long-term
16care facilities licensed under the Nursing Home Care Act, and
17$3,000,000 for projects by all other applicants, which shall be
18annually adjusted to reflect the increase in construction costs
19due to inflation, for major medical equipment and for all other
20capital expenditures.
21 "Financial Commitment" means the commitment of at least 33%
22of total funds assigned to cover total project cost, which
23occurs by the actual expenditure of 33% or more of the total
24project cost or the commitment to expend 33% or more of the
25total project cost by signed contracts or other legal means.
26 "Non-clinical service area" means an area (i) for the

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1benefit of the patients, visitors, staff, or employees of a
2health care facility and (ii) not directly related to the
3diagnosis, treatment, or rehabilitation of persons receiving
4services from the health care facility. "Non-clinical service
5areas" include, but are not limited to, chapels; gift shops;
6news stands; computer systems; tunnels, walkways, and
7elevators; telephone systems; projects to comply with life
8safety codes; educational facilities; student housing;
9patient, employee, staff, and visitor dining areas;
10administration and volunteer offices; modernization of
11structural components (such as roof replacement and masonry
12work); boiler repair or replacement; vehicle maintenance and
13storage facilities; parking facilities; mechanical systems for
14heating, ventilation, and air conditioning; loading docks; and
15repair or replacement of carpeting, tile, wall coverings,
16window coverings or treatments, or furniture. Solely for the
17purpose of this definition, "non-clinical service area" does
18not include health and fitness centers.
19 "Areawide" means a major area of the State delineated on a
20geographic, demographic, and functional basis for health
21planning and for health service and having within it one or
22more local areas for health planning and health service. The
23term "region", as contrasted with the term "subregion", and the
24word "area" may be used synonymously with the term "areawide".
25 "Local" means a subarea of a delineated major area that on
26a geographic, demographic, and functional basis may be

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1considered to be part of such major area. The term "subregion"
2may be used synonymously with the term "local".
3 "Physician" means a person licensed to practice in
4accordance with the Medical Practice Act of 1987, as amended.
5 "Licensed health care professional" means a person
6licensed to practice a health profession under pertinent
7licensing statutes of the State of Illinois.
8 "Director" means the Director of the Illinois Department of
9Public Health.
10 "Agency" or "Department" means the Illinois Department of
11Public Health.
12 "Alternative health care model" means a facility or program
13authorized under the Alternative Health Care Delivery Act.
14 "Out-of-state facility" means a person that is both (i)
15licensed as a hospital or as an ambulatory surgery center under
16the laws of another state or that qualifies as a hospital or an
17ambulatory surgery center under regulations adopted pursuant
18to the Social Security Act and (ii) not licensed under the
19Ambulatory Surgical Treatment Center Act, the Hospital
20Licensing Act, or the Nursing Home Care Act. Affiliates of
21out-of-state facilities shall be considered out-of-state
22facilities. Affiliates of Illinois licensed health care
23facilities 100% owned by an Illinois licensed health care
24facility, its parent, or Illinois physicians licensed to
25practice medicine in all its branches shall not be considered
26out-of-state facilities. Nothing in this definition shall be

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1construed to include an office or any part of an office of a
2physician licensed to practice medicine in all its branches in
3Illinois that is not required to be licensed under the
4Ambulatory Surgical Treatment Center Act.
5 "Change of ownership of a health care facility" means a
6change in the person who has ownership or control of a health
7care facility's physical plant and capital assets. A change in
8ownership is indicated by the following transactions: sale,
9transfer, acquisition, lease, change of sponsorship, or other
10means of transferring control.
11 "Related person" means any person that: (i) is at least 50%
12owned, directly or indirectly, by either the health care
13facility or a person owning, directly or indirectly, at least
1450% of the health care facility; or (ii) owns, directly or
15indirectly, at least 50% of the health care facility.
16 "Charity care" means care provided by a health care
17facility for which the provider does not expect to receive
18payment from the patient or a third-party payer.
19 "Freestanding emergency center" means a facility subject
20to licensure under Section 32.5 of the Emergency Medical
21Services (EMS) Systems Act.
22 "Category of service" means a grouping by generic class of
23various types or levels of support functions, equipment, care,
24or treatment provided to patients or residents, including, but
25not limited to, classes such as medical-surgical, pediatrics,
26or cardiac catheterization. A category of service may include

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1subcategories or levels of care that identify a particular
2degree or type of care within the category of service. Nothing
3in this definition shall be construed to include the practice
4of a physician or other licensed health care professional while
5functioning in an office providing for the care, diagnosis, or
6treatment of patients. A category of service that is subject to
7the Board's jurisdiction must be designated in rules adopted by
8the Board.
9 "State Board Staff Report" means the document that sets
10forth the review and findings of the State Board staff, as
11prescribed by the State Board, regarding applications subject
12to Board jurisdiction.
13(Source: P.A. 98-414, eff. 1-1-14; 98-629, eff. 1-1-15; 98-651,
14eff. 6-16-14; 98-1086, eff. 8-26-14; 99-78, eff. 7-20-15;
1599-180, eff. 7-29-15; 99-527, eff. 1-1-17.)
16 (20 ILCS 3960/4.2)
17 (Section scheduled to be repealed on December 31, 2019)
18 Sec. 4.2. Ex parte communications.
19 (a) Except in the disposition of matters that agencies are
20authorized by law to entertain or dispose of on an ex parte
21basis including, but not limited to rule making, the State
22Board, any State Board member, employee, or a hearing officer
23shall not engage in ex parte communication in connection with
24the substance of any formally filed application for a permit
25with any person or party or the representative of any party.

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1This subsection (a) applies when the Board, member, employee,
2or hearing officer knows, or should know upon reasonable
3inquiry, that the application or exemption has been formally
4filed with the Board. Nothing in this Section shall prohibit
5staff members from providing technical assistance to
6applicants. Nothing in this Section shall prohibit staff from
7verifying or clarifying an applicant's information as it
8prepares the State Board Staff Report staff report. Once an
9application or exemption is filed and deemed complete, a
10written record of any communication between staff and an
11applicant shall be prepared by staff and made part of the
12public record, using a prescribed, standardized format, and
13shall be included in the application file.
14 (b) A State Board member or employee may communicate with
15other members or employees and any State Board member or
16hearing officer may have the aid and advice of one or more
17personal assistants.
18 (c) An ex parte communication received by the State Board,
19any State Board member, employee, or a hearing officer shall be
20made a part of the record of the matter, including all written
21communications, all written responses to the communications,
22and a memorandum stating the substance of all oral
23communications and all responses made and the identity of each
24person from whom the ex parte communication was received.
25 (d) "Ex parte communication" means a communication between
26a person who is not a State Board member or employee and a

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1State Board member or employee that reflects on the substance
2of a pending or impending State Board proceeding and that takes
3place outside the record of the proceeding. Communications
4regarding matters of procedure and practice, such as the format
5of pleading, number of copies required, manner of service, and
6status of proceedings, are not considered ex parte
7communications. Technical assistance with respect to an
8application, not intended to influence any decision on the
9application, may be provided by employees to the applicant. Any
10assistance shall be documented in writing by the applicant and
11employees within 10 business days after the assistance is
13 (e) For purposes of this Section, "employee" means a person
14the State Board or the Agency employs on a full-time,
15part-time, contract, or intern basis.
16 (f) The State Board, State Board member, or hearing
17examiner presiding over the proceeding, in the event of a
18violation of this Section, must take whatever action is
19necessary to ensure that the violation does not prejudice any
20party or adversely affect the fairness of the proceedings.
21 (g) Nothing in this Section shall be construed to prevent
22the State Board or any member of the State Board from
23consulting with the attorney for the State Board.
24(Source: P.A. 96-31, eff. 6-30-09.)
25 (20 ILCS 3960/5) (from Ch. 111 1/2, par. 1155)

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1 (Section scheduled to be repealed on December 31, 2019)
2 Sec. 5. Construction, modification, or establishment of
3health care facilities or acquisition of major medical
4equipment; permits or exemptions. No person shall construct,
5modify or establish a health care facility or acquire major
6medical equipment without first obtaining a permit or exemption
7from the State Board. The State Board shall not delegate to the
8staff of the State Board or any other person or entity the
9authority to grant permits or exemptions whenever the staff or
10other person or entity would be required to exercise any
11discretion affecting the decision to grant a permit or
12exemption. The State Board may, by rule, delegate authority to
13the Chairman to grant permits or exemptions when applications
14meet all of the State Board's review criteria and are
16 A permit or exemption shall be obtained prior to the
17acquisition of major medical equipment or to the construction
18or modification of a health care facility which:
19 (a) requires a total capital expenditure in excess of
20 the capital expenditure minimum; or
21 (b) substantially changes the scope or changes the
22 functional operation of the facility; or
23 (c) changes the bed capacity of a health care facility
24 by increasing the total number of beds or by distributing
25 beds among various categories of service or by relocating
26 beds from one physical facility or site to another by more

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1 than 20 beds or more than 10% of total bed capacity as
2 defined by the State Board, whichever is less, over a 2
3 year period.
4 A permit shall be valid only for the defined construction
5or modifications, site, amount and person named in the
6application for such permit and shall not be transferable or
7assignable. A permit shall be valid until such time as the
8project has been completed, provided that the project commences
9and proceeds to completion with due diligence by the completion
10date or extension date approved by the Board.
11 A permit holder must do the following: (i) submit the final
12completion and cost report for the project within 90 days after
13the approved project completion date or extension date and (ii)
14submit annual progress reports no earlier than 30 days before
15and no later than 30 days after each anniversary date of the
16Board's approval of the permit until the project is completed.
17To maintain a valid permit and to monitor progress toward
18project commencement and completion, routine post-permit
19reports shall be limited to annual progress reports and the
20final completion and cost report. Annual progress reports shall
21include information regarding the committed funds expended
22toward the approved project. For projects to be completed in 12
23months or less, the permit holder shall report financial
24commitment in the final completion and cost report. For
25projects to be completed between 12 to 24 months, the permit
26holder shall report financial commitment in the first annual

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1report. For projects to be completed in more than 24 months,
2the permit holder shall report financial commitment in the
3second annual progress report. The If the project is not
4completed in one year, then, by the second annual report, the
5permit holder shall expend 33% or more of the total project
6cost or shall make a commitment to expend 33% or more of the
7total project cost by signed contracts or other legal means,
8and the report shall contain information regarding financial
9commitment those expenditures or commitments. If the project is
10to be completed in one year, then the first annual report shall
11contain the expenditure commitment information for the total
12project cost. The State Board may extend the financial
13expenditure commitment period after considering a permit
14holder's showing of good cause and request for additional time
15to complete the project.
16 The Certificate of Need process required under this Act is
17designed to restrain rising health care costs by preventing
18unnecessary construction or modification of health care
19facilities. The Board must assure that the establishment,
20construction, or modification of a health care facility or the
21acquisition of major medical equipment is consistent with the
22public interest and that the proposed project is consistent
23with the orderly and economic development or acquisition of
24those facilities and equipment and is in accord with the
25standards, criteria, or plans of need adopted and approved by
26the Board. Board decisions regarding the construction of health

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1care facilities must consider capacity, quality, value, and
2equity. Projects may deviate from the costs, fees, and expenses
3provided in their project cost information for the project's
4cost components, provided that the final total project cost
5does not exceed the approved permit amount. Project alterations
6shall not increase the total approved permit amount by more
7than the limit set forth under the Board's rules.
8 Major construction projects, for the purposes of this Act,
9shall include but are not limited to: projects for the
10construction of new buildings; additions to existing
11facilities; modernization projects whose cost is in excess of
12$1,000,000 or 10% of the facilities' operating revenue,
13whichever is less; and such other projects as the State Board
14shall define and prescribe pursuant to this Act.
15 The acquisition by any person of major medical equipment
16that will not be owned by or located in a health care facility
17and that will not be used to provide services to inpatients of
18a health care facility shall be exempt from review provided
19that a notice is filed in accordance with exemption
21 Notwithstanding any other provision of this Act, no permit
22or exemption is required for the construction or modification
23of a non-clinical service area of a health care facility.
24(Source: P.A. 97-1115, eff. 8-27-12; 98-414, eff. 1-1-14.)
25 (20 ILCS 3960/5.4)

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1 (Section scheduled to be repealed on December 31, 2019)
2 Sec. 5.4. Safety Net Impact Statement.
3 (a) General review criteria shall include a requirement
4that all health care facilities, with the exception of skilled
5and intermediate long-term care facilities licensed under the
6Nursing Home Care Act, provide a Safety Net Impact Statement,
7which shall be filed with an application for a substantive
8project or when the application proposes to discontinue a
9category of service.
10 (b) For the purposes of this Section, "safety net services"
11are services provided by health care providers or organizations
12that deliver health care services to persons with barriers to
13mainstream health care due to lack of insurance, inability to
14pay, special needs, ethnic or cultural characteristics, or
15geographic isolation. Safety net service providers include,
16but are not limited to, hospitals and private practice
17physicians that provide charity care, school-based health
18centers, migrant health clinics, rural health clinics,
19federally qualified health centers, community health centers,
20public health departments, and community mental health
22 (c) As developed by the applicant, a Safety Net Impact
23Statement shall describe all of the following:
24 (1) The project's material impact, if any, on essential
25 safety net services in the community, to the extent that it
26 is feasible for an applicant to have such knowledge.

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1 (2) The project's impact on the ability of another
2 provider or health care system to cross-subsidize safety
3 net services, if reasonably known to the applicant.
4 (3) How the discontinuation of a facility or service
5 might impact the remaining safety net providers in a given
6 community, if reasonably known by the applicant.
7 (d) Safety Net Impact Statements shall also include all of
8the following:
9 (1) For the 3 fiscal years prior to the application, a
10 certification describing the amount of charity care
11 provided by the applicant. The amount calculated by
12 hospital applicants shall be in accordance with the
13 reporting requirements for charity care reporting in the
14 Illinois Community Benefits Act. Non-hospital applicants
15 shall report charity care, at cost, in accordance with an
16 appropriate methodology specified by the Board.
17 (2) For the 3 fiscal years prior to the application, a
18 certification of the amount of care provided to Medicaid
19 patients. Hospital and non-hospital applicants shall
20 provide Medicaid information in a manner consistent with
21 the information reported each year to the State Board
22 regarding "Inpatients and Outpatients Served by Payor
23 Source" and "Inpatient and Outpatient Net Revenue by Payor
24 Source" as required by the Board under Section 13 of this
25 Act and published in the Annual Hospital Profile.
26 (3) Any information the applicant believes is directly

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1 relevant to safety net services, including information
2 regarding teaching, research, and any other service.
3 (e) The Board staff shall publish a notice, that an
4application accompanied by a Safety Net Impact Statement has
5been filed, in a newspaper having general circulation within
6the area affected by the application. If no newspaper has a
7general circulation within the county, the Board shall post the
8notice in 5 conspicuous places within the proposed area.
9 (f) Any person, community organization, provider, or
10health system or other entity wishing to comment upon or oppose
11the application may file a Safety Net Impact Statement Response
12with the Board, which shall provide additional information
13concerning a project's impact on safety net services in the
15 (g) Applicants shall be provided an opportunity to submit a
16reply to any Safety Net Impact Statement Response.
17 (h) The State Board Staff Report staff report shall include
18a statement as to whether a Safety Net Impact Statement was
19filed by the applicant and whether it included information on
20charity care, the amount of care provided to Medicaid patients,
21and information on teaching, research, or any other service
22provided by the applicant directly relevant to safety net
23services. The report shall also indicate the names of the
24parties submitting responses and the number of responses and
25replies, if any, that were filed.
26(Source: P.A. 98-1086, eff. 8-26-14.)

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1 (20 ILCS 3960/6) (from Ch. 111 1/2, par. 1156)
2 (Section scheduled to be repealed on December 31, 2019)
3 Sec. 6. Application for permit or exemption; exemption
5 (a) An application for a permit or exemption shall be made
6to the State Board upon forms provided by the State Board. This
7application shall contain such information as the State Board
8deems necessary. The State Board shall not require an applicant
9to file a Letter of Intent before an application is filed. Such
10application shall include affirmative evidence on which the
11State Board or Chairman may make its decision on the approval
12or denial of the permit or exemption.
13 (b) The State Board shall establish by regulation the
14procedures and requirements regarding issuance of exemptions.
15An exemption shall be approved when information required by the
16Board by rule is submitted. Projects eligible for an exemption,
17rather than a permit, include, but are not limited to, change
18of ownership of a health care facility, discontinuation of a
19category of service, and discontinuation of a health care
20facility, other than a health care facility maintained by the
21State or any agency or department thereof or a nursing home
22maintained by a county. For a change of ownership of a health
23care facility, the State Board shall provide by rule for an
24expedited process for obtaining an exemption in accordance with
25Section 8.5 of this Act. In connection with a change of

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1ownership, the State Board may approve the transfer of an
2existing permit without regard to whether the permit to be
3transferred has yet been obligated, except for permits
4establishing a new facility or a new category of service.
5 (c) All applications shall be signed by the applicant and
6shall be verified by any 2 officers thereof.
7 (c-5) Any written review or findings of the Board staff or
8any other reviewing organization under Section 8 concerning an
9application for a permit must be made available to the public
10at least 14 calendar days before the meeting of the State Board
11at which the review or findings are considered. The applicant
12and members of the public may submit, to the State Board,
13written responses regarding the facts set forth in the review
14or findings of the Board staff or reviewing organization.
15Members of the public shall have until 10 days before the
16meeting of the State Board to submit any written response
17concerning the Board staff's written review or findings. The
18Board staff may revise any findings to address corrections of
19factual errors cited in the public response. At the meeting,
20the State Board may, in its discretion, permit the submission
21of other additional written materials.
22 (d) Upon receipt of an application for a permit, the State
23Board shall approve and authorize the issuance of a permit if
24it finds (1) that the applicant is fit, willing, and able to
25provide a proper standard of health care service for the
26community with particular regard to the qualification,

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1background and character of the applicant, (2) that economic
2feasibility is demonstrated in terms of effect on the existing
3and projected operating budget of the applicant and of the
4health care facility; in terms of the applicant's ability to
5establish and operate such facility in accordance with
6licensure regulations promulgated under pertinent state laws;
7and in terms of the projected impact on the total health care
8expenditures in the facility and community, (3) that safeguards
9are provided which assure that the establishment, construction
10or modification of the health care facility or acquisition of
11major medical equipment is consistent with the public interest,
12and (4) that the proposed project is consistent with the
13orderly and economic development of such facilities and
14equipment and is in accord with standards, criteria, or plans
15of need adopted and approved pursuant to the provisions of
16Section 12 of this Act.
17(Source: P.A. 99-154, eff. 7-28-15.)
18 (20 ILCS 3960/12) (from Ch. 111 1/2, par. 1162)
19 (Section scheduled to be repealed on December 31, 2019)
20 Sec. 12. Powers and duties of State Board. For purposes of
21this Act, the State Board shall exercise the following powers
22and duties:
23 (1) Prescribe rules, regulations, standards, criteria,
24procedures or reviews which may vary according to the purpose
25for which a particular review is being conducted or the type of

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1project reviewed and which are required to carry out the
2provisions and purposes of this Act. Policies and procedures of
3the State Board shall take into consideration the priorities
4and needs of medically underserved areas and other health care
5services, giving special consideration to the impact of
6projects on access to safety net services.
7 (2) Adopt procedures for public notice and hearing on all
8proposed rules, regulations, standards, criteria, and plans
9required to carry out the provisions of this Act.
10 (3) (Blank).
11 (4) Develop criteria and standards for health care
12facilities planning, conduct statewide inventories of health
13care facilities, maintain an updated inventory on the Board's
14web site reflecting the most recent bed and service changes and
15updated need determinations when new census data become
16available or new need formulae are adopted, and develop health
17care facility plans which shall be utilized in the review of
18applications for permit under this Act. Such health facility
19plans shall be coordinated by the Board with pertinent State
20Plans. Inventories pursuant to this Section of skilled or
21intermediate care facilities licensed under the Nursing Home
22Care Act, skilled or intermediate care facilities licensed
23under the ID/DD Community Care Act, skilled or intermediate
24care facilities licensed under the MC/DD Act, facilities
25licensed under the Specialized Mental Health Rehabilitation
26Act of 2013, or nursing homes licensed under the Hospital

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1Licensing Act shall be conducted on an annual basis no later
2than July 1 of each year and shall include among the
3information requested a list of all services provided by a
4facility to its residents and to the community at large and
5differentiate between active and inactive beds.
6 In developing health care facility plans, the State Board
7shall consider, but shall not be limited to, the following:
8 (a) The size, composition and growth of the population
9 of the area to be served;
10 (b) The number of existing and planned facilities
11 offering similar programs;
12 (c) The extent of utilization of existing facilities;
13 (d) The availability of facilities which may serve as
14 alternatives or substitutes;
15 (e) The availability of personnel necessary to the
16 operation of the facility;
17 (f) Multi-institutional planning and the establishment
18 of multi-institutional systems where feasible;
19 (g) The financial and economic feasibility of proposed
20 construction or modification; and
21 (h) In the case of health care facilities established
22 by a religious body or denomination, the needs of the
23 members of such religious body or denomination may be
24 considered to be public need.
25 The health care facility plans which are developed and
26adopted in accordance with this Section shall form the basis

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1for the plan of the State to deal most effectively with
2statewide health needs in regard to health care facilities.
3 (5) Coordinate with other state agencies having
4responsibilities affecting health care facilities, including
5those of licensure and cost reporting.
6 (6) Solicit, accept, hold and administer on behalf of the
7State any grants or bequests of money, securities or property
8for use by the State Board in the administration of this Act;
9and enter into contracts consistent with the appropriations for
10purposes enumerated in this Act.
11 (7) The State Board shall prescribe procedures for review,
12standards, and criteria which shall be utilized to make
13periodic reviews and determinations of the appropriateness of
14any existing health services being rendered by health care
15facilities subject to the Act. The State Board shall consider
16recommendations of the Board in making its determinations.
17 (8) Prescribe rules, regulations, standards, and criteria
18for the conduct of an expeditious review of applications for
19permits for projects of construction or modification of a
20health care facility, which projects are classified as
21emergency, substantive, or non-substantive in nature.
22 Six months after June 30, 2009 (the effective date of
23Public Act 96-31), substantive projects shall include no more
24than the following:
25 (a) Projects to construct (1) a new or replacement
26 facility located on a new site or (2) a replacement

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1 facility located on the same site as the original facility
2 and the cost of the replacement facility exceeds the
3 capital expenditure minimum, which shall be reviewed by the
4 Board within 120 days;
5 (b) Projects proposing a (1) new service within an
6 existing healthcare facility or (2) discontinuation of a
7 service within an existing healthcare facility, which
8 shall be reviewed by the Board within 60 days; or
9 (c) Projects proposing a change in the bed capacity of
10 a health care facility by an increase in the total number
11 of beds or by a redistribution of beds among various
12 categories of service or by a relocation of beds from one
13 physical facility or site to another by more than 20 beds
14 or more than 10% of total bed capacity, as defined by the
15 State Board, whichever is less, over a 2-year period.
16 The Chairman may approve applications for exemption that
17meet the criteria set forth in rules or refer them to the full
18Board. The Chairman may approve any unopposed application that
19meets all of the review criteria or refer them to the full
21 Such rules shall not prevent the conduct of a public
22hearing upon the timely request of an interested party. Such
23reviews shall not exceed 60 days from the date the application
24is declared to be complete.
25 (9) Prescribe rules, regulations, standards, and criteria
26pertaining to the granting of permits for construction and

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1modifications which are emergent in nature and must be
2undertaken immediately to prevent or correct structural
3deficiencies or hazardous conditions that may harm or injure
4persons using the facility, as defined in the rules and
5regulations of the State Board. This procedure is exempt from
6public hearing requirements of this Act.
7 (10) Prescribe rules, regulations, standards and criteria
8for the conduct of an expeditious review, not exceeding 60
9days, of applications for permits for projects to construct or
10modify health care facilities which are needed for the care and
11treatment of persons who have acquired immunodeficiency
12syndrome (AIDS) or related conditions.
13 (10.5) Provide its rationale when voting on an item before
14it at a State Board meeting in order to comply with subsection
15(b) of Section 3-108 of the Code of Civil Procedure.
16 (11) Issue written decisions upon request of the applicant
17or an adversely affected party to the Board. Requests for a
18written decision shall be made within 15 days after the Board
19meeting in which a final decision has been made. A "final
20decision" for purposes of this Act is the decision to approve
21or deny an application, or take other actions permitted under
22this Act, at the time and date of the meeting that such action
23is scheduled by the Board. The transcript of the State Board
24meeting shall be incorporated into the Board's final decision.
25The staff of the Board shall prepare a written copy of the
26final decision and the Board shall approve a final copy for

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1inclusion in the formal record. The Board shall consider, for
2approval, the written draft of the final decision no later than
3the next scheduled Board meeting. The written decision shall
4identify the applicable criteria and factors listed in this Act
5and the Board's regulations that were taken into consideration
6by the Board when coming to a final decision. If the Board
7denies or fails to approve an application for permit or
8exemption, the Board shall include in the final decision a
9detailed explanation as to why the application was denied and
10identify what specific criteria or standards the applicant did
11not fulfill.
12 (12) Require at least one of its members to participate in
13any public hearing, after the appointment of a majority of the
14members to the Board.
15 (13) Provide a mechanism for the public to comment on, and
16request changes to, draft rules and standards.
17 (14) Implement public information campaigns to regularly
18inform the general public about the opportunity for public
19hearings and public hearing procedures.
20 (15) Establish a separate set of rules and guidelines for
21long-term care that recognizes that nursing homes are a
22different business line and service model from other regulated
23facilities. An open and transparent process shall be developed
24that considers the following: how skilled nursing fits in the
25continuum of care with other care providers, modernization of
26nursing homes, establishment of more private rooms,

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1development of alternative services, and current trends in
2long-term care services. The Chairman of the Board shall
3appoint a permanent Health Services Review Board Long-term Care
4Facility Advisory Subcommittee that shall develop and
5recommend to the Board the rules to be established by the Board
6under this paragraph (15). The Subcommittee shall also provide
7continuous review and commentary on policies and procedures
8relative to long-term care and the review of related projects.
9The Subcommittee shall make recommendations to the Board no
10later than January 1, 2016 and every January thereafter
11pursuant to the Subcommittee's responsibility for the
12continuous review and commentary on policies and procedures
13relative to long-term care. In consultation with other experts
14from the health field of long-term care, the Board and the
15Subcommittee shall study new approaches to the current bed need
16formula and Health Service Area boundaries to encourage
17flexibility and innovation in design models reflective of the
18changing long-term care marketplace and consumer preferences
19and submit its recommendations to the Chairman of the Board no
20later than January 1, 2017. The Subcommittee shall evaluate,
21and make recommendations to the State Board regarding, the
22buying, selling, and exchange of beds between long-term care
23facilities within a specified geographic area or drive time.
24The Board shall file the proposed related administrative rules
25for the separate rules and guidelines for long-term care
26required by this paragraph (15) by no later than September 30,

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12011. The Subcommittee shall be provided a reasonable and
2timely opportunity to review and comment on any review,
3revision, or updating of the criteria, standards, procedures,
4and rules used to evaluate project applications as provided
5under Section 12.3 of this Act.
6 The Chairman of the Board shall appoint voting members of
7the Subcommittee, who shall serve for a period of 3 years, with
8one-third of the terms expiring each January, to be determined
9by lot. Appointees shall include, but not be limited to,
10recommendations from each of the 3 statewide long-term care
11associations, with an equal number to be appointed from each.
12Compliance with this provision shall be through the appointment
13and reappointment process. All appointees serving as of April
141, 2015 shall serve to the end of their term as determined by
15lot or until the appointee voluntarily resigns, whichever is
17 One representative from the Department of Public Health,
18the Department of Healthcare and Family Services, the
19Department on Aging, and the Department of Human Services may
20each serve as an ex-officio non-voting member of the
21Subcommittee. The Chairman of the Board shall select a
22Subcommittee Chair, who shall serve for a period of 3 years.
23 (16) Prescribe the format of the State Board Staff Report.
24A State Board Staff Report shall pertain to applications that
25include, but are not limited to, applications for permit or
26exemption, applications for permit renewal, applications for

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1extension of the financial commitment obligation period,
2applications requesting a declaratory ruling, or applications
3under the Health Care Worker Self-Referral Act. State Board
4Staff Reports shall compare applications to the relevant review
5criteria under the Board's rules.
6 (17) Establish a separate set of rules and guidelines for
7facilities licensed under the Specialized Mental Health
8Rehabilitation Act of 2013. An application for the
9re-establishment of a facility in connection with the
10relocation of the facility shall not be granted unless the
11applicant has a contractual relationship with at least one
12hospital to provide emergency and inpatient mental health
13services required by facility consumers, and at least one
14community mental health agency to provide oversight and
15assistance to facility consumers while living in the facility,
16and appropriate services, including case management, to assist
17them to prepare for discharge and reside stably in the
18community thereafter. No new facilities licensed under the
19Specialized Mental Health Rehabilitation Act of 2013 shall be
20established after June 16, 2014 (the effective date of Public
21Act 98-651) except in connection with the relocation of an
22existing facility to a new location. An application for a new
23location shall not be approved unless there are adequate
24community services accessible to the consumers within a
25reasonable distance, or by use of public transportation, so as
26to facilitate the goal of achieving maximum individual

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1self-care and independence. At no time shall the total number
2of authorized beds under this Act in facilities licensed under
3the Specialized Mental Health Rehabilitation Act of 2013 exceed
4the number of authorized beds on June 16, 2014 (the effective
5date of Public Act 98-651).
6(Source: P.A. 98-414, eff. 1-1-14; 98-463, eff. 8-16-13;
798-651, eff. 6-16-14; 98-1086, eff. 8-26-14; 99-78, eff.
87-20-15; 99-114, eff. 7-23-15; 99-180, eff. 7-29-15; 99-277,
9eff. 8-5-15; 99-527, eff. 1-1-17; 99-642, eff. 7-28-16.)