HB5537 103RD GENERAL ASSEMBLY

LRB103 37655 AWJ 67782 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB5537

Introduced 2/9/2024, by Rep. Yolonda Morris

SYNOPSIS AS INTRODUCED:

20 ILCS 3960/5.4
55 ILCS 5/5-21001	from Ch. 34, par. 5-21001

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.

A BILL FOR

AN ACT concerning health.

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 5.4 as follows:

(20 ILCS 3960/5.4)

(Section scheduled to be repealed on December 31, 2029)

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, public health departments, and community mental health centers, and county-operated nursing homes.

(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, including the impact on racial and health care disparities 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 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. Facilities operated by a county shall also provide the number of the facility's Medicaid and Medicare certified beds for the 3 fiscal years prior to the application.

(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 shall include a statement as to whether a Safety Net Impact Statement was filed by the applicant and whether it included information on 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. If an application for a permit to discontinue or change ownership of a health care facility has been deemed substantially complete by the State Board staff, but the applicant was unable to describe the project impacts under subsections (c) and (d), the State Board Staff Report shall include a statement of findings regarding the project's safety net impact. The State Board staff's assessment shall be considered in determining whether the project fulfills the public interest requirements in paragraph (3) of subsection (d) of Section 6.

(Source: P.A. 102-4, eff. 4-27-21.)

Section 10. The Counties Code is amended by changing Section 5-21001 as follows:

(55 ILCS 5/5-21001) (from Ch. 34, par. 5-21001)

Sec. 5-21001. Establishment and maintenance of county home. In any county which establishes and maintains a county sheltered care home or a county nursing home for the care of infirm or chronically ill persons, as provided in Section 5-1005, the County Board shall have power:

1. To acquire in the name of the county by purchase, grant, gift, or legacy, a suitable tract or tracts of land upon which to erect and maintain the home, and in connection therewith a farm or acreage for the purpose of providing supplies for the home and employment for such patients as are able to work and benefit thereby.

The board shall expend not more than $20,000 for the purchase of any such land or the erection of buildings without a 2/3 vote of all its members in counties of 300,000 or more population, or a favorable vote of at least a majority of all its members in counties under 300,000 population.

2. To receive in the name of the county, gifts and legacies to aid in the erection or maintenance of the home.

3. To appoint a superintendent and all necessary employees for the management and control of the home and to prescribe their compensation and duties.

4. To arrange for physicians' or other health care professionals' services and other medical care for the patients in the home and prescribe the compensation and duties of physicians so designated.

5. To control the admission and discharge of patients in the home.

6. To fix the rate per day, week, or month which it will charge for care and maintenance of the patients. Rates so established may vary according to the amount of care required, but the rates shall be uniform for all persons or agencies purchasing care in the home except rates for persons who are able to purchase their own care may approximate actual cost.

7. To make all rules and regulations for the management of the home and of the patients therein.

8. To make appropriations from the county treasury for the purchase of land and the erection of buildings for the home, and to defray the expenses necessary for the care and maintenance of the home and for providing maintenance, personal care and nursing services to the patients therein, and to cause an amount sufficient for those purposes to be levied upon the taxable property of the counties and collected as other taxes and further providing that in counties with a population of not more than 1,000,000 to levy and collect annually a tax of not to exceed .1% of the value, as equalized or assessed by the Department of Revenue, of all the taxable property in the county for these purposes. The tax shall be in addition to all other taxes which the county is authorized to levy on the aggregate valuation of the property within the county and shall not be included in any limitation of the tax rate upon which taxes are required to be extended, but shall be excluded therefrom and in addition thereto. The tax shall be levied and collected in like manner as the general taxes of the county, and when collected, shall be paid into a special fund in the county treasury and used only as herein authorized. No such tax shall be levied or increased from a rate lower than the maximum rate in any such county until the question of levying such tax has first been submitted to the voters of such county at an election held in such county, and has been approved by a majority of such voters voting thereon. The corporate authorities shall certify the question of levying such tax to the proper election officials, who shall submit the question to the voters at an election held in accordance with the general election law.

The proposition shall be in substantially the following form:

--------------------------------------------------------

Shall ........ County be authorized to levy and collect a tax at a rate not YES to exceed .1% for the purpose of -------------------

........ (purchasing, maintaining) a NO county nursing home? -------------------------------------------------------------

If a majority of votes cast on the question are in favor, the county shall be authorized to levy the tax.

If the county has levied such tax at a rate lower than the maximum rate set forth in this Section, the county board may increase the rate of the tax, but not to exceed such maximum rate, by certifying the proposition of such increase to the proper election officials for submission to the voters of the county at a regular election in accordance with the general election law. The proposition shall be in substantially the following form:

----------------------------------------------

Shall the maximum rate of the tax levied by........ YES County for the purpose of....... (purchasing, maintaining) a ----------------------------

county nursing home be increased from........ to NO ........ (not to exceed .1%) -------------------------------------------------------------

If a majority of all the votes cast upon the proposition are in favor thereof, the county board may levy the tax at a rate not to exceed the rate set forth in this Section.

9. To Upon the vote of a 2/3 majority of all the members of the board, to sell, dispose of or lease for any term, any part of the home properties in such manner and upon such terms as it deems best for the interest of the county, and to make and execute all necessary conveyances thereof in the same manner as other conveyances of real estate may be made by a county. However, if the home was erected after referendum approval by the voters of the county, it shall not be sold or disposed of except after referendum approval thereof by a majority of the voters of the county voting thereon.

A referendum to sell the home shall be in substantially the following form: -------------------------------------------------------------

Shall........County sell (county home) to (entity name), an (entity type) located at (principal address), which was incorporated on (incorporation date), and whose managers and members are .... .... for (sale price)? --------------------------------------

Votes shall be recorded as "Yes" or "No".

A referendum to close the home shall be in substantially the following form: -------------------------------------------------------------

Shall........County close (county home), the county nursing home located at (address)? ---------------------------------------

Votes shall be recorded as "Yes" or "No".

The proposition to lease the home shall be in substantially the following form: -------------------------------------------------------------

Shall........County lease (county home) to (entity name), an (entity type) located at (principal address), which was incorporated on (incorporation date), and whose managers and members are ... .... for (lease amount) for a term of not more than (years)? --------------------------------------

Votes shall be recorded as "Yes" or "No".

If the home was erected after referendum approval by the voters of the county, the county nursing home may be leased upon the vote of a 3/5 majority of all the members of the board.

10. To operate a sheltered care home as a part of a county nursing home provided that a license to do so is obtained pursuant to the Nursing Home Care Act, as amended.

(Source: P.A. 99-581, eff. 1-1-17.)