Public Act 095-0005
SB0244 Enrolled LRB095 08444 HLH 28621 b

    AN ACT concerning State government.
    WHEREAS, The 94th General Assembly funded a study by the
Lewin Group, "An Evaluation of Illinois' 'Certificate of Need'
Program", which recommended that "... the Illinois legislature
move forward to continue the 'Certificate-of-Need' program
with an abundance of caution...". Given the potential for harm
to specific critical elements of the health care system,
non-traditional arguments for maintaining
"Certificate-of-Need" laws deserve consideration, until the
evidence on the impact that specialty providers and ambulatory
surgery centers may have on safety-net providers and services
can be better quantified. In response to the Lewin analysis and
additional concerns regarding health planning in Illinois, the
95th General Assembly enacted Senate Bill 611 (Public Act
95-0001) that extended the "sunset" date of the Illinois Health
Facilities Planning Act from April 1, 2007 to May 31, 2007 so
that interested parties could agree on a strategy to further
extend the "sunset" date, and develop a more comprehensive
reform agenda; therefore
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
    Section 5. The Illinois Health Facilities Planning Act is
amended by changing Section 19.6 and by adding Sections 12.5
and 15.5 as follows:
    (20 ILCS 3960/12.5 new)
    Sec. 12.5. Update existing bed inventory and associated bed
need projections. While the Task Force on Health Planning
Reform will make long-term recommendations related to the
method and formula for calculating the bed inventory and
associated bed need projections, there is a current need for
the bed inventory to be updated prior to the issuance of the
recommendations of the Task Force. Therefore, the State Agency
shall immediately update the existing bed inventory and
associated bed need projections required by Sections 12 and
12.3 of this Act, using the most recently published historical
utilization data, 10-year population projections, and an
appropriate migration factor for the medical-surgical and
pediatric category of service which shall be no less than 50%.
The State Agency shall provide written documentation providing
the methodology and rationale used to determine the appropriate
migration factor.
    (20 ILCS 3960/15.5 new)
    Sec. 15.5. Task Force on Health Planning Reform.
    (a) The Task Force on Health Planning Reform is created.
    (b) The Task Force shall consist of 19 voting members, as
follows: 6 persons, who are not currently employed by a State
agency, appointed by the Director of Public Health, 3 of whom
shall be persons with knowledge and experience in the delivery
of health care services, including at least one person
representing organized health service workers, 2 of whom shall
be persons with professional experience in the administration
or management of health care facilities, and one of whom shall
be a person with experience in health planning; 2 members of
the Illinois Senate appointed by the President of the Senate,
one of whom shall be a co-chair to the Task Force; 2 members of
the Illinois Senate appointed by the Senate Minority Leader; 2
members of the Illinois House of Representatives appointed by
the Speaker of the House of Representatives, one of whom shall
be a co-chair to the Task Force; 2 members of the Illinois
House of Representatives appointed by the House Minority
Leader; the Attorney General, or his or her designee; and 4
members of the general public, representing health care
consumers, appointed by the Attorney General of Illinois.
    The following persons, or their designees, shall serve, ex
officio, as nonvoting members of the Task Force: the Director
of Public Health, the Secretary of the Illinois Health
Facilities Planning Board, the Director of Healthcare and
Family Services, the Secretary of Human Services, and the
Director of the Governor's Office of Management and Budget.
    Members shall serve without compensation, but may be
reimbursed for their expenses in relation to duties on the Task
    A vote of 12 members appointed to the Task Force is
required with respect to the adoption of recommendations to the
Governor and General Assembly and the final report required by
this Section.
    (c) The Task Force shall gather information and make
recommendations relating to at least the following topics in
relation to the Illinois Health Facilities Planning Act:
        (1) The impact of health planning on the provision of
    essential and accessible health care services; prevention
    of unnecessary duplication of facilities and services;
    improvement in the efficiency of the health care system;
    maintenance of an environment in the health care system
    that supports quality care; the most economic use of
    available resources; and the effect of repealing this Act.
        (2) Reform of the Illinois Health Facilities Planning
    Board to enable it to undertake a more active role in
    health planning to provide guidance in the development of
    services to meet the health care needs of Illinois,
    including identifying and recommending initiatives to meet
    special needs.
        (3) Reforms to ensure that health planning under the
    Illinois Health Facilities Planning Act is coordinated
    with other health planning laws and activities of the
        (4) Reforms that will enable the Illinois Health
    Facilities Planning Board to focus most of its project
    review efforts on "Certificate-of-Need" applications
    involving new facilities, discontinuation of services,
    major expansions, and volume-sensitive services, and to
    expedite review of other projects to the maximum extent
        (5) Reforms that will enable the Illinois Health
    Facilities Planning Board to determine how criteria,
    standards, and procedures for evaluating project
    applications involving specialty providers, ambulatory
    surgical facilities, and other alternative health care
    models should be amended to give special attention to the
    impact of those projects on traditional community
    hospitals to assure the availability and access to
    essential quality medical care in those communities.
        (6) Implementation of policies and procedures
    necessary for the Illinois Health Facilities Planning
    Board to give special consideration to the impact of the
    projects it reviews on access to "safety net" services.
        (7) Changes in policies and procedures to make the
    Illinois health facilities planning process predictable,
    transparent, and as efficient as possible; requiring the
    State Agency (the Illinois Department of Public Health) and
    the Illinois Health Facilities Planning Board to provide
    timely and appropriate explanations of its decisions and
    establish more effective procedures to enable public
    review and comment on facts set forth in State Agency staff
    analyses of project applications prior to the issuance of
    final decisions on each project.
        (8) Reforms to ensure that patient access to new and
    modernized services will not be delayed during a transition
    period under any proposed system reform; and that the
    transition should minimize disruption of the process for
    current applicants.
        (9) Identification of the resources necessary to
    support the work of the Agency and the Board.
    (d) The Task Force shall recommend reforms regarding the
        (1) The size and membership of current Illinois Health
    Facilities Planning Board. Review and make recommendations
    on the reorganization of the structure and function of the
    Illinois Health Facilities Planning Board and the State
    Agency responsible for health planning (the Illinois
    Department of Public Health), giving consideration to
    various options for reassigning the primary responsibility
    for the review, approval, and denial of project
    applications between the Board and the State Agency, so
    that the "Certificate-of-Need" process is administered in
    the most effective, efficient, and consistent manner
    possible in accordance with the objectives referenced in
    subsection (c) of this Section.
        (2) Changes in policies and procedures that will charge
    the Illinois Health Facilities Planning Board with
    developing a long-range health facilities plan (10 years)
    to be updated at least every 2 years, so that it is a
    rolling 10-year plan based upon data no older than 2 years.
    The plan should incorporate an inventory of the State's
    health facilities infrastructure including both facilities
    and services regulated under this Act, as well as
    facilities and services that are not currently regulated
    under this Act, as determined by the Board. The planning
    criteria and standards should be adjusted to take into
    consideration services that are regulated under the Act,
    but are also offered by non-regulated providers. The
    Illinois Department of Public Health bed inventory should
    be updated each year using the most recent utilization data
    for both hospitals and long-term care facilities including
    2003, 2004, 2005 and subsequent-year inpatient discharges
    and days. This revised bed supply should be used as the bed
    supply input for all Planning Area bed-need calculations.
    Ten-year population projection data should be incorporated
    into the plan. Plan updates may include redrawing planning
    area boundaries to reflect population changes. The Task
    Force shall consider whether the inventory formula should
    use migration factors for the medical/surgical,
    pediatrics, obstetrics, and other categories of service,
    and if so, what those migration factors should be. The
    Board should hold public hearings on the plan and its
    updates. There should be a mechanism for the public to
    request that the plan be updated more frequently to address
    emerging population and demographic trends. In developing
    the plan, the Board should consider health plans and other
    related publications that have been developed both in
    Illinois and nationally. In developing the plan, the need
    to ensure access to care, especially for "safety net"
    services, including rural and medically underserved
    communities, should be included.
        (3) Changes in regulations that establish separate
    criteria, standards, and procedures when necessary to
    adjust for structural, functional, and operational
    differences between long-term care facilities and acute
    care facilities and that allow routine changes of
    ownership, facility sales, and closure requests to be
    processed on a timely basis. Consider rules to allow
    flexibility for facilities to modernize, expand, or
    convert to alternative uses that are in accord with health
    planning standards.
        (4) Changes in policies and procedures so that the
    Illinois Health Facilities Planning Board updates the
    standards and criteria on a regular basis and proposes new
    standards to keep pace with the evolving health care
    delivery system. Proton Therapy and Treatment is an example
    of a new, cutting-edge procedure that may require the Board
    to immediately develop criteria, standards, and procedures
    for that type of facility. Temporary advisory committees
    may be appointed to assist in the development of revisions
    to the Board's standards and criteria, including experts
    with professional competence in the subject matter of the
    proposed standards or criteria that are to be developed.
        (5) Changes in policies and procedures to expedite
    project approval, particularly for less complex projects,
    including standards for determining whether a project is in
    "substantial compliance" with the Board's review
    standards. The review standards must include a requirement
    for applicants to include a "Safety Net" Impact Statement.
    This Statement shall describe the project's impact on
    safety net services in the community. The State Agency
    Report shall include an assessment of the Statement.
        (6) Changes to enforcement processes and compliance
    standards to ensure they are fair and consistent with the
    severity of the violation.
        (7) Revisions in policies and procedures to prevent
    conflicts of interest by members of the Illinois Health
    Facilities Planning Board and State Agency staff,
    including increasing the penalties for violations.
        (8) Other changes determined necessary to improve the
    administration of this Act.
    (e) The State Agency, at the direction of the Task Force,
may hire any necessary staff or consultants, enter into
contracts, and make any expenditures necessary for carrying out
the duties of the Task Force, all out of moneys appropriated
for that purpose. Staff support services shall be provided to
the Task Force by the State Agency from such appropriations.
    (f) The Task Force may establish any advisory committee to
ensure maximum public participation in the Task Force's
planning, organization, and implementation review process. If
established, advisory committees shall (i) advise and assist
the Task Force in its duties and (ii) help the Task Force to
identify issues of public concern.
    (g) The Task Force shall submit findings and
recommendations to the Governor and the General Assembly by
March 1, 2008, including any necessary implementing
legislation, and recommendations for changes to policies,
rules, or procedures that are not incorporated in the
implementing legislation.
    (h) The Task Force is abolished on August 1, 2008.
    (20 ILCS 3960/19.6)
    (Section scheduled to be repealed on May 31, 2007)
    Sec. 19.6. Repeal. This Act is repealed on August 31, 2008
May 31, 2007.
(Source: P.A. 94-983, eff. 6-30-06; 95-1, eff. 3-30-07.)
    Section 99. Effective date. This Act takes effect upon
becoming law.