Bill Text: IL HB5537 | 2023-2024 | 103rd General Assembly | Engrossed


Bill Title: Amends the Illinois Health Facilities Planning Act. Removes an exception for skilled and intermediate long-term care facilities licensed under the Nursing Home Care Act from providing a Safety Net Impact Statement as part of its general review criteria. Includes nursing homes operated by a county in a list of safety net service providers. Provides that facilities operated by a county shall provide in the facility's Safety Net Impact Statement the number of the facility's Medicaid and Medicare certified beds for the 3 fiscal years prior to the application. Requires the State Board Staff Report to include a statement of findings regarding the project's safety net impact under specified circumstances, and that the State Board Staff's assessment shall be considered in determining whether the project fulfills the public interest requirements. Amends the County Homes Division of the Counties Code. Removes a requirement that two-thirds of the county board is required sell, dispose of, or lease for any term, any part of the home properties, and requires a referendum before selling any home (rather than requiring a referendum only for homes that were erected after referendum approval by the voters of the county). Adds referendum language for the selling, disposition of, or lease of a home.

Spectrum: Partisan Bill (Democrat 14-0)

Status: (Engrossed) 2024-05-17 - Rule 3-9(a) / Re-referred to Assignments [HB5537 Detail]

Download: Illinois-2023-HB5537-Engrossed.html

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1 AN ACT concerning health.
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 Section 5.4 as follows:
6 (20 ILCS 3960/5.4)
7 (Section scheduled to be repealed on December 31, 2029)
8 Sec. 5.4. Safety Net Impact Statement.
9 (a) General review criteria shall include a requirement
10that all health care facilities, including nursing homes
11operated by a county, but otherwise with the exception of
12skilled and intermediate long-term care facilities licensed
13under the Nursing Home Care Act, provide a Safety Net Impact
14Statement, which shall be filed with an application for a
15substantive project or when the application proposes to
16discontinue a category of service. A Safety Net Impact
17Statement shall also be filed with an application to change
18ownership of a nursing home operated by a county.
19 (b) For the purposes of this Section, "safety net
20services" are services provided by health care providers or
21organizations that deliver health care services to persons
22with barriers to mainstream health care due to lack of
23insurance, inability to pay, special needs, ethnic or cultural

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1characteristics, or geographic isolation. Safety net service
2providers include, but are not limited to, hospitals and
3private practice physicians that provide charity care,
4school-based health centers, migrant health clinics, rural
5health clinics, federally qualified health centers, community
6health centers, public health departments, and community
7mental health centers, and nursing homes operated by a county.
8 (c) As developed by the applicant, a Safety Net Impact
9Statement shall describe all of the following:
10 (1) The project's material impact, if any, on
11 essential safety net services in the community, including
12 the impact on racial and health care disparities in the
13 community, to the extent that it is feasible for an
14 applicant to have such knowledge.
15 (2) The project's impact on the ability of another
16 provider or health care system to cross-subsidize safety
17 net services, if reasonably known to the applicant.
18 (3) How the discontinuation of a facility or service
19 might impact the remaining safety net providers in a given
20 community, if reasonably known by the applicant.
21 (d) Safety Net Impact Statements shall also include all of
22the following:
23 (1) For the 3 fiscal years prior to the application, a
24 certification describing the amount of charity care
25 provided by the applicant. The amount calculated by
26 hospital applicants shall be in accordance with the

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1 reporting requirements for charity care reporting in the
2 Illinois Community Benefits Act. Non-hospital applicants
3 shall report charity care, at cost, in accordance with an
4 appropriate methodology specified by the Board.
5 (2) For the 3 fiscal years prior to the application, a
6 certification of the amount of care provided to Medicaid
7 patients. Hospital and non-hospital applicants shall
8 provide Medicaid information in a manner consistent with
9 the information reported each year to the State Board
10 regarding "Inpatients and Outpatients Served by Payor
11 Source" and "Inpatient and Outpatient Net Revenue by Payor
12 Source" as required by the Board under Section 13 of this
13 Act and published in the Annual Hospital Profile. Nursing
14 homes operated by a county shall also provide the number
15 of the facility's Medicaid and Medicare certified beds for
16 the 3 fiscal years prior to the application.
17 (3) Any information the applicant believes is directly
18 relevant to safety net services, including information
19 regarding teaching, research, and any other service.
20 (e) The Board staff shall publish a notice, that an
21application accompanied by a Safety Net Impact Statement has
22been filed, in a newspaper having general circulation within
23the area affected by the application. If no newspaper has a
24general circulation within the county, the Board shall post
25the notice in 5 conspicuous places within the proposed area.
26 (f) Any person, community organization, provider, or

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1health system or other entity wishing to comment upon or
2oppose the application may file a Safety Net Impact Statement
3Response with the Board, which shall provide additional
4information concerning a project's impact on safety net
5services in the community.
6 (g) Applicants shall be provided an opportunity to submit
7a reply to any Safety Net Impact Statement Response.
8 (h) The State Board Staff Report shall include a statement
9as to whether a Safety Net Impact Statement was filed by the
10applicant and whether it included information on charity care,
11the amount of care provided to Medicaid patients, and
12information on teaching, research, or any other service
13provided by the applicant directly relevant to safety net
14services. The report shall also indicate the names of the
15parties submitting responses and the number of responses and
16replies, if any, that were filed.
17 The State Board Staff Report shall also include a
18statement of findings about an application's safety net impact
19when the application:
20 (1) proposes a substantive project at a nursing home
21 operated by a county;
22 (2) includes a change of ownership of a nursing home
23 currently operated by a county; or
24 (3) proposes to discontinue services at a nursing home
25 operated by a county.
26 The findings shall be considered when determining whether

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1an application fulfills the public interest requirements of
2this Act.
3(Source: P.A. 102-4, eff. 4-27-21.)
4 Section 10. The Counties Code is amended by changing
5Section 5-21001 as follows:
6 (55 ILCS 5/5-21001) (from Ch. 34, par. 5-21001)
7 Sec. 5-21001. Establishment and maintenance of county
8home. In any county which establishes and maintains a county
9sheltered care home or a county nursing home for the care of
10infirm or chronically ill persons, as provided in Section
115-1005, the County Board shall have power:
12 1. To acquire in the name of the county by purchase, grant,
13gift, or legacy, a suitable tract or tracts of land upon which
14to erect and maintain the home, and in connection therewith a
15farm or acreage for the purpose of providing supplies for the
16home and employment for such patients as are able to work and
17benefit thereby.
18 The board shall expend not more than $20,000 for the
19purchase of any such land or the erection of buildings without
20a 2/3 vote of all its members in counties of 300,000 or more
21population, or a favorable vote of at least a majority of all
22its members in counties under 300,000 population.
23 2. To receive in the name of the county, gifts and legacies
24to aid in the erection or maintenance of the home.

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1 3. To appoint a superintendent and all necessary employees
2for the management and control of the home and to prescribe
3their compensation and duties.
4 4. To arrange for physicians' or other health care
5professionals' services and other medical care for the
6patients in the home and prescribe the compensation and duties
7of physicians so designated.
8 5. To control the admission and discharge of patients in
9the home.
10 6. To fix the rate per day, week, or month which it will
11charge for care and maintenance of the patients. Rates so
12established may vary according to the amount of care required,
13but the rates shall be uniform for all persons or agencies
14purchasing care in the home except rates for persons who are
15able to purchase their own care may approximate actual cost.
16 7. To make all rules and regulations for the management of
17the home and of the patients therein.
18 8. To make appropriations from the county treasury for the
19purchase of land and the erection of buildings for the home,
20and to defray the expenses necessary for the care and
21maintenance of the home and for providing maintenance,
22personal care and nursing services to the patients therein,
23and to cause an amount sufficient for those purposes to be
24levied upon the taxable property of the counties and collected
25as other taxes and further providing that in counties with a
26population of not more than 1,000,000 to levy and collect

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1annually a tax of not to exceed .1% of the value, as equalized
2or assessed by the Department of Revenue, of all the taxable
3property in the county for these purposes. The tax shall be in
4addition to all other taxes which the county is authorized to
5levy on the aggregate valuation of the property within the
6county and shall not be included in any limitation of the tax
7rate upon which taxes are required to be extended, but shall be
8excluded therefrom and in addition thereto. The tax shall be
9levied and collected in like manner as the general taxes of the
10county, and when collected, shall be paid into a special fund
11in the county treasury and used only as herein authorized. No
12such tax shall be levied or increased from a rate lower than
13the maximum rate in any such county until the question of
14levying such tax has first been submitted to the voters of such
15county at an election held in such county, and has been
16approved by a majority of such voters voting thereon. The
17corporate authorities shall certify the question of levying
18such tax to the proper election officials, who shall submit
19the question to the voters at an election held in accordance
20with the general election law.
21 The proposition shall be in substantially the following
22form:
23--------------------------------------------------------
24 Shall ........ County be authorized
25to levy and collect a tax at a rate not YES
26to exceed .1% for the purpose of -------------------

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1 ........ (purchasing, maintaining) a NO
2 county nursing home?
3-------------------------------------------------------------
4 If a majority of votes cast on the question are in favor,
5the county shall be authorized to levy the tax.
6 If the county has levied such tax at a rate lower than the
7maximum rate set forth in this Section, the county board may
8increase the rate of the tax, but not to exceed such maximum
9rate, by certifying the proposition of such increase to the
10proper election officials for submission to the voters of the
11county at a regular election in accordance with the general
12election law. The proposition shall be in substantially the
13following form:
14----------------------------------------------
15 Shall the maximum rate
16of the tax levied by........ YES
17County for the purpose of.......
18(purchasing, maintaining) a ----------------------------
19county nursing home be
20increased from........ to NO
21........ (not to exceed .1%)
22-------------------------------------------------------------
23 If a majority of all the votes cast upon the proposition
24are in favor thereof, the county board may levy the tax at a
25rate not to exceed the rate set forth in this Section.
26 9. To Upon the vote of a 2/3 majority of all the members of

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1the board, to sell, dispose of or lease for any term, any part
2of the home properties in such manner and upon such terms as it
3deems best for the interest of the county, and to make and
4execute all necessary conveyances thereof in the same manner
5as other conveyances of real estate may be made by a county.
6However, if the home was erected after referendum approval by
7the voters of the county, it shall not be sold or disposed of
8except after referendum approval thereof by a majority of the
9voters of the county voting thereon.
10 A referendum to sell the home shall be in substantially
11the following form:
12-------------------------------------------------------------
13 Shall........County sell (county
14home) to (entity name), an (entity
15type) located at (principal address),
16which was incorporated on (incorporation date),
17and whose managers and members are ....
18.... for (sale price)?
19--------------------------------------
20 Votes shall be recorded as "Yes" or "No".
21 A referendum to close the home shall be in substantially
22the following form:
23-------------------------------------------------------------
24 Shall........County close
25(county home), the county nursing home
26located at (address)?

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1---------------------------------------
2 Votes shall be recorded as "Yes" or "No".
3 The proposition to lease the home shall be in
4substantially the following form:
5-------------------------------------------------------------
6 Shall........County lease (county
7home) to (entity name), an (entity
8type) located at (principal address),
9which was incorporated on (incorporation date),
10and whose managers and members are ...
11.... for (lease amount) for a term of
12not more than (years)?
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