Rep. William Davis

Filed: 3/17/2017

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 763

2    AMENDMENT NO. ______. Amend House Bill 763 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Illinois Health Facilities Planning Act is
5amended by changing Sections 3, 4.2, 5, 5.4, 6, and 12 as
6follows:
 
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8    (Section scheduled to be repealed on December 31, 2019)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

 

 

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1    Act.
2        (3) Skilled and intermediate long term care facilities
3    licensed under the Nursing Home Care Act.
4            (A) If a demonstration project under the Nursing
5        Home Care Act applies for a certificate of need to
6        convert to a nursing facility, it shall meet the
7        licensure and certificate of need requirements in
8        effect as of the date of application.
9            (B) Except as provided in item (A) of this
10        subsection, this Act does not apply to facilities
11        granted waivers under Section 3-102.2 of the Nursing
12        Home Care Act.
13        (3.5) Skilled and intermediate care facilities
14    licensed under the ID/DD Community Care Act or the MC/DD
15    Act. No permit or exemption is required for a facility
16    licensed under the ID/DD Community Care Act or the MC/DD
17    Act prior to the reduction of the number of beds at a
18    facility. If there is a total reduction of beds at a
19    facility licensed under the ID/DD Community Care Act or the
20    MC/DD Act, this is a discontinuation or closure of the
21    facility. If a facility licensed under the ID/DD Community
22    Care Act or the MC/DD Act reduces the number of beds or
23    discontinues the facility, that facility must notify the
24    Board as provided in Section 14.1 of this Act.
25        (3.7) Facilities licensed under the Specialized Mental
26    Health Rehabilitation Act of 2013.

 

 

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

 

 

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1        (7) An institution, place, building, or room used for
2    provision of a health care category of service, including,
3    but not limited to, cardiac catheterization and open heart
4    surgery.
5        (8) An institution, place, building, or room housing
6    major medical equipment used in the direct clinical
7    diagnosis or treatment of patients, and whose project cost
8    is in excess of the capital expenditure minimum.
9    "Health care facilities" does not include the following
10entities or facility transactions:
11        (1) Federally-owned facilities.
12        (2) Facilities used solely for healing by prayer or
13    spiritual means.
14        (3) An existing facility located on any campus facility
15    as defined in Section 5-5.8b of the Illinois Public Aid
16    Code, provided that the campus facility encompasses 30 or
17    more contiguous acres and that the new or renovated
18    facility is intended for use by a licensed residential
19    facility.
20        (4) Facilities licensed under the Supportive
21    Residences Licensing Act or the Assisted Living and Shared
22    Housing Act.
23        (5) Facilities designated as supportive living
24    facilities that are in good standing with the program
25    established under Section 5-5.01a of the Illinois Public
26    Aid Code.

 

 

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

 

 

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1    the Nursing Home Care Act.
2    With the exception of those health care facilities
3specifically included in this Section, nothing in this Act
4shall be intended to include facilities operated as a part of
5the practice of a physician or other licensed health care
6professional, whether practicing in his individual capacity or
7within the legal structure of any partnership, medical or
8professional corporation, or unincorporated medical or
9professional group. Further, this Act shall not apply to
10physicians or other licensed health care professional's
11practices where such practices are carried out in a portion of
12a health care facility under contract with such health care
13facility by a physician or by other licensed health care
14professionals, whether practicing in his individual capacity
15or within the legal structure of any partnership, medical or
16professional corporation, or unincorporated medical or
17professional groups, unless the entity constructs, modifies,
18or establishes a health care facility as specifically defined
19in this Section. This Act shall apply to construction or
20modification and to establishment by such health care facility
21of such contracted portion which is subject to facility
22licensing requirements, irrespective of the party responsible
23for such action or attendant financial obligation.
24    "Person" means any one or more natural persons, legal
25entities, governmental bodies other than federal, or any
26combination thereof.

 

 

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1    "Consumer" means any person other than a person (a) whose
2major occupation currently involves or whose official capacity
3within the last 12 months has involved the providing,
4administering or financing of any type of health care facility,
5(b) who is engaged in health research or the teaching of
6health, (c) who has a material financial interest in any
7activity which involves the providing, administering or
8financing of any type of health care facility, or (d) who is or
9ever has been a member of the immediate family of the person
10defined by (a), (b), or (c).
11    "State Board" or "Board" means the Health Facilities and
12Services Review Board.
13    "Construction or modification" means the establishment,
14erection, building, alteration, reconstruction, modernization,
15improvement, extension, discontinuation, change of ownership,
16of or by a health care facility, or the purchase or acquisition
17by or through a health care facility of equipment or service
18for diagnostic or therapeutic purposes or for facility
19administration or operation, or any capital expenditure made by
20or on behalf of a health care facility which exceeds the
21capital expenditure minimum; however, any capital expenditure
22made by or on behalf of a health care facility for (i) the
23construction or modification of a facility licensed under the
24Assisted Living and Shared Housing Act or (ii) a conversion
25project undertaken in accordance with Section 30 of the Older
26Adult Services Act shall be excluded from any obligations under

 

 

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1this Act.
2    "Establish" means the construction of a health care
3facility or the replacement of an existing facility on another
4site or the initiation of a category of service.
5    "Major medical equipment" means medical equipment which is
6used for the provision of medical and other health services and
7which costs in excess of the capital expenditure minimum,
8except that such term does not include medical equipment
9acquired by or on behalf of a clinical laboratory to provide
10clinical laboratory services if the clinical laboratory is
11independent of a physician's office and a hospital and it has
12been determined under Title XVIII of the Social Security Act to
13meet the requirements of paragraphs (10) and (11) of Section
141861(s) of such Act. In determining whether medical equipment
15has a value in excess of the capital expenditure minimum, the
16value of studies, surveys, designs, plans, working drawings,
17specifications, and other activities essential to the
18acquisition of such equipment shall be included.
19    "Capital Expenditure" means an expenditure: (A) made by or
20on behalf of a health care facility (as such a facility is
21defined in this Act); and (B) which under generally accepted
22accounting principles is not properly chargeable as an expense
23of operation and maintenance, or is made to obtain by lease or
24comparable arrangement any facility or part thereof or any
25equipment for a facility or part; and which exceeds the capital
26expenditure minimum.

 

 

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1    For the purpose of this paragraph, the cost of any studies,
2surveys, designs, plans, working drawings, specifications, and
3other activities essential to the acquisition, improvement,
4expansion, or replacement of any plant or equipment with
5respect to which an expenditure is made shall be included in
6determining if such expenditure exceeds the capital
7expenditures minimum. Unless otherwise interdependent, or
8submitted as one project by the applicant, components of
9construction or modification undertaken by means of a single
10construction contract or financed through the issuance of a
11single debt instrument shall not be grouped together as one
12project. Donations of equipment or facilities to a health care
13facility which if acquired directly by such facility would be
14subject to review under this Act shall be considered capital
15expenditures, and a transfer of equipment or facilities for
16less than fair market value shall be considered a capital
17expenditure for purposes of this Act if a transfer of the
18equipment or facilities at fair market value would be subject
19to review.
20    "Capital expenditure minimum" means $11,500,000 for
21projects by hospital applicants, $6,500,000 for applicants for
22projects related to skilled and intermediate care long-term
23care facilities licensed under the Nursing Home Care Act, and
24$3,000,000 for projects by all other applicants, which shall be
25annually adjusted to reflect the increase in construction costs
26due to inflation, for major medical equipment and for all other

 

 

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1capital expenditures.
2    "Financial Commitment" means the commitment of at least 33%
3of total funds assigned to cover total project cost, which
4occurs by the actual expenditure of 33% or more of the total
5project cost or the commitment to expend 33% or more of the
6total project cost by signed contracts or other legal means.
7    "Non-clinical service area" means an area (i) for the
8benefit of the patients, visitors, staff, or employees of a
9health care facility and (ii) not directly related to the
10diagnosis, treatment, or rehabilitation of persons receiving
11services from the health care facility. "Non-clinical service
12areas" include, but are not limited to, chapels; gift shops;
13news stands; computer systems; tunnels, walkways, and
14elevators; telephone systems; projects to comply with life
15safety codes; educational facilities; student housing;
16patient, employee, staff, and visitor dining areas;
17administration and volunteer offices; modernization of
18structural components (such as roof replacement and masonry
19work); boiler repair or replacement; vehicle maintenance and
20storage facilities; parking facilities; mechanical systems for
21heating, ventilation, and air conditioning; loading docks; and
22repair or replacement of carpeting, tile, wall coverings,
23window coverings or treatments, or furniture. Solely for the
24purpose of this definition, "non-clinical service area" does
25not include health and fitness centers.
26    "Areawide" means a major area of the State delineated on a

 

 

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1geographic, demographic, and functional basis for health
2planning and for health service and having within it one or
3more local areas for health planning and health service. The
4term "region", as contrasted with the term "subregion", and the
5word "area" may be used synonymously with the term "areawide".
6    "Local" means a subarea of a delineated major area that on
7a geographic, demographic, and functional basis may be
8considered to be part of such major area. The term "subregion"
9may be used synonymously with the term "local".
10    "Physician" means a person licensed to practice in
11accordance with the Medical Practice Act of 1987, as amended.
12    "Licensed health care professional" means a person
13licensed to practice a health profession under pertinent
14licensing statutes of the State of Illinois.
15    "Director" means the Director of the Illinois Department of
16Public Health.
17    "Agency" or "Department" means the Illinois Department of
18Public Health.
19    "Alternative health care model" means a facility or program
20authorized under the Alternative Health Care Delivery Act.
21    "Out-of-state facility" means a person that is both (i)
22licensed as a hospital or as an ambulatory surgery center under
23the laws of another state or that qualifies as a hospital or an
24ambulatory surgery center under regulations adopted pursuant
25to the Social Security Act and (ii) not licensed under the
26Ambulatory Surgical Treatment Center Act, the Hospital

 

 

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1Licensing Act, or the Nursing Home Care Act. Affiliates of
2out-of-state facilities shall be considered out-of-state
3facilities. Affiliates of Illinois licensed health care
4facilities 100% owned by an Illinois licensed health care
5facility, its parent, or Illinois physicians licensed to
6practice medicine in all its branches shall not be considered
7out-of-state facilities. Nothing in this definition shall be
8construed to include an office or any part of an office of a
9physician licensed to practice medicine in all its branches in
10Illinois that is not required to be licensed under the
11Ambulatory Surgical Treatment Center Act.
12    "Change of ownership of a health care facility" means a
13change in the person who has ownership or control of a health
14care facility's physical plant and capital assets. A change in
15ownership is indicated by the following transactions: sale,
16transfer, acquisition, lease, change of sponsorship, or other
17means of transferring control.
18    "Related person" means any person that: (i) is at least 50%
19owned, directly or indirectly, by either the health care
20facility or a person owning, directly or indirectly, at least
2150% of the health care facility; or (ii) owns, directly or
22indirectly, at least 50% of the health care facility.
23    "Charity care" means care provided by a health care
24facility for which the provider does not expect to receive
25payment from the patient or a third-party payer.
26    "Freestanding emergency center" means a facility subject

 

 

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1to licensure under Section 32.5 of the Emergency Medical
2Services (EMS) Systems Act.
3    "Category of service" means a grouping by generic class of
4various types or levels of support functions, equipment, care,
5or treatment provided to patients or residents, including, but
6not limited to, classes such as medical-surgical, pediatrics,
7or cardiac catheterization. A category of service may include
8subcategories or levels of care that identify a particular
9degree or type of care within the category of service. Nothing
10in this definition shall be construed to include the practice
11of a physician or other licensed health care professional while
12functioning in an office providing for the care, diagnosis, or
13treatment of patients. A category of service that is subject to
14the Board's jurisdiction must be designated in rules adopted by
15the Board.
16    "State Board Staff Report" means the document that sets
17forth the review and findings of the State Board staff, as
18prescribed by the State Board, regarding applications subject
19to Board jurisdiction.
20(Source: P.A. 98-414, eff. 1-1-14; 98-629, eff. 1-1-15; 98-651,
21eff. 6-16-14; 98-1086, eff. 8-26-14; 99-78, eff. 7-20-15;
2299-180, eff. 7-29-15; 99-527, eff. 1-1-17.)
 
23    (20 ILCS 3960/4.2)
24    (Section scheduled to be repealed on December 31, 2019)
25    Sec. 4.2. Ex parte communications.

 

 

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1    (a) Except in the disposition of matters that agencies are
2authorized by law to entertain or dispose of on an ex parte
3basis including, but not limited to rule making, the State
4Board, any State Board member, employee, or a hearing officer
5shall not engage in ex parte communication in connection with
6the substance of any formally filed application for a permit
7with any person or party or the representative of any party.
8This subsection (a) applies when the Board, member, employee,
9or hearing officer knows, or should know upon reasonable
10inquiry, that the application or exemption has been formally
11filed with the Board. Nothing in this Section shall prohibit
12staff members from providing technical assistance to
13applicants. Nothing in this Section shall prohibit staff from
14verifying or clarifying an applicant's information as it
15prepares the State Board Staff Report staff report. Once an
16application or exemption is filed and deemed complete, a
17written record of any communication between staff and an
18applicant shall be prepared by staff and made part of the
19public record, using a prescribed, standardized format, and
20shall be included in the application file.
21    (b) A State Board member or employee may communicate with
22other members or employees and any State Board member or
23hearing officer may have the aid and advice of one or more
24personal assistants.
25    (c) An ex parte communication received by the State Board,
26any State Board member, employee, or a hearing officer shall be

 

 

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1made a part of the record of the matter, including all written
2communications, all written responses to the communications,
3and a memorandum stating the substance of all oral
4communications and all responses made and the identity of each
5person from whom the ex parte communication was received.
6    (d) "Ex parte communication" means a communication between
7a person who is not a State Board member or employee and a
8State Board member or employee that reflects on the substance
9of a pending or impending State Board proceeding and that takes
10place outside the record of the proceeding. Communications
11regarding matters of procedure and practice, such as the format
12of pleading, number of copies required, manner of service, and
13status of proceedings, are not considered ex parte
14communications. Technical assistance with respect to an
15application, not intended to influence any decision on the
16application, may be provided by employees to the applicant. Any
17assistance shall be documented in writing by the applicant and
18employees within 10 business days after the assistance is
19provided.
20    (e) For purposes of this Section, "employee" means a person
21the State Board or the Agency employs on a full-time,
22part-time, contract, or intern basis.
23    (f) The State Board, State Board member, or hearing
24examiner presiding over the proceeding, in the event of a
25violation of this Section, must take whatever action is
26necessary to ensure that the violation does not prejudice any

 

 

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1party or adversely affect the fairness of the proceedings.
2    (g) Nothing in this Section shall be construed to prevent
3the State Board or any member of the State Board from
4consulting with the attorney for the State Board.
5(Source: P.A. 96-31, eff. 6-30-09.)
 
6    (20 ILCS 3960/5)  (from Ch. 111 1/2, par. 1155)
7    (Section scheduled to be repealed on December 31, 2019)
8    Sec. 5. Construction, modification, or establishment of
9health care facilities or acquisition of major medical
10equipment; permits or exemptions. No person shall construct,
11modify or establish a health care facility or acquire major
12medical equipment without first obtaining a permit or exemption
13from the State Board. The State Board shall not delegate to the
14staff of the State Board or any other person or entity the
15authority to grant permits or exemptions whenever the staff or
16other person or entity would be required to exercise any
17discretion affecting the decision to grant a permit or
18exemption. The State Board may, by rule, delegate authority to
19the Chairman to grant permits or exemptions when applications
20meet all of the State Board's review criteria and are
21unopposed.
22    A permit or exemption shall be obtained prior to the
23acquisition of major medical equipment or to the construction
24or modification of a health care facility which:
25        (a) requires a total capital expenditure in excess of

 

 

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1    the capital expenditure minimum; or
2        (b) substantially changes the scope or changes the
3    functional operation of the facility; or
4        (c) changes the bed capacity of a health care facility
5    by increasing the total number of beds or by distributing
6    beds among various categories of service or by relocating
7    beds from one physical facility or site to another by more
8    than 20 beds or more than 10% of total bed capacity as
9    defined by the State Board, whichever is less, over a 2
10    year period.
11    A permit shall be valid only for the defined construction
12or modifications, site, amount and person named in the
13application for such permit and shall not be transferable or
14assignable. A permit shall be valid until such time as the
15project has been completed, provided that the project commences
16and proceeds to completion with due diligence by the completion
17date or extension date approved by the Board.
18    A permit holder must do the following: (i) submit the final
19completion and cost report for the project within 90 days after
20the approved project completion date or extension date and (ii)
21submit annual progress reports no earlier than 30 days before
22and no later than 30 days after each anniversary date of the
23Board's approval of the permit until the project is completed.
24To maintain a valid permit and to monitor progress toward
25project commencement and completion, routine post-permit
26reports shall be limited to annual progress reports and the

 

 

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1final completion and cost report. Annual progress reports shall
2include information regarding the committed funds expended
3toward the approved project. For projects to be completed in 12
4months or less, the permit holder shall report financial
5commitment in the final completion and cost report. For
6projects to be completed between 12 to 24 months, the permit
7holder shall report financial commitment in the first annual
8report. For projects to be completed in more than 24 months,
9the permit holder shall report financial commitment in the
10second annual progress report. The If the project is not
11completed in one year, then, by the second annual report, the
12permit holder shall expend 33% or more of the total project
13cost or shall make a commitment to expend 33% or more of the
14total project cost by signed contracts or other legal means,
15and the report shall contain information regarding financial
16commitment those expenditures or commitments. If the project is
17to be completed in one year, then the first annual report shall
18contain the expenditure commitment information for the total
19project cost. The State Board may extend the financial
20expenditure commitment period after considering a permit
21holder's showing of good cause and request for additional time
22to complete the project.
23    The Certificate of Need process required under this Act is
24designed to restrain rising health care costs by preventing
25unnecessary construction or modification of health care
26facilities. The Board must assure that the establishment,

 

 

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1construction, or modification of a health care facility or the
2acquisition of major medical equipment is consistent with the
3public interest and that the proposed project is consistent
4with the orderly and economic development or acquisition of
5those facilities and equipment and is in accord with the
6standards, criteria, or plans of need adopted and approved by
7the Board. Board decisions regarding the construction of health
8care facilities must consider capacity, quality, value, and
9equity. Projects may deviate from the costs, fees, and expenses
10provided in their project cost information for the project's
11cost components, provided that the final total project cost
12does not exceed the approved permit amount. Project alterations
13shall not increase the total approved permit amount by more
14than the limit set forth under the Board's rules.
15    Major construction projects, for the purposes of this Act,
16shall include but are not limited to: projects for the
17construction of new buildings; additions to existing
18facilities; modernization projects whose cost is in excess of
19$1,000,000 or 10% of the facilities' operating revenue,
20whichever is less; and such other projects as the State Board
21shall define and prescribe pursuant to this Act.
22    The acquisition by any person of major medical equipment
23that will not be owned by or located in a health care facility
24and that will not be used to provide services to inpatients of
25a health care facility shall be exempt from review provided
26that a notice is filed in accordance with exemption

 

 

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1requirements.
2    Notwithstanding any other provision of this Act, no permit
3or exemption is required for the construction or modification
4of a non-clinical service area of a health care facility.
5(Source: P.A. 97-1115, eff. 8-27-12; 98-414, eff. 1-1-14.)
 
6    (20 ILCS 3960/5.4)
7    (Section scheduled to be repealed on December 31, 2019)
8    Sec. 5.4. Safety Net Impact Statement.
9    (a) General review criteria shall include a requirement
10that all health care facilities, with the exception of skilled
11and intermediate long-term care facilities licensed under the
12Nursing Home Care Act, provide a Safety Net Impact Statement,
13which shall be filed with an application for a substantive
14project or when the application proposes to discontinue a
15category of service.
16    (b) For the purposes of this Section, "safety net services"
17are services provided by health care providers or organizations
18that deliver health care services to persons with barriers to
19mainstream health care due to lack of insurance, inability to
20pay, special needs, ethnic or cultural characteristics, or
21geographic isolation. Safety net service providers include,
22but are not limited to, hospitals and private practice
23physicians that provide charity care, school-based health
24centers, migrant health clinics, rural health clinics,
25federally qualified health centers, community health centers,

 

 

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1public health departments, and community mental health
2centers.
3    (c) As developed by the applicant, a Safety Net Impact
4Statement shall describe all of the following:
5        (1) The project's material impact, if any, on essential
6    safety net services in the community, to the extent that it
7    is feasible for an applicant to have such knowledge.
8        (2) The project's impact on the ability of another
9    provider or health care system to cross-subsidize safety
10    net services, if reasonably known to the applicant.
11        (3) How the discontinuation of a facility or service
12    might impact the remaining safety net providers in a given
13    community, if reasonably known by the applicant.
14    (d) Safety Net Impact Statements shall also include all of
15the following:
16        (1) For the 3 fiscal years prior to the application, a
17    certification describing the amount of charity care
18    provided by the applicant. The amount calculated by
19    hospital applicants shall be in accordance with the
20    reporting requirements for charity care reporting in the
21    Illinois Community Benefits Act. Non-hospital applicants
22    shall report charity care, at cost, in accordance with an
23    appropriate methodology specified by the Board.
24        (2) For the 3 fiscal years prior to the application, a
25    certification of the amount of care provided to Medicaid
26    patients. Hospital and non-hospital applicants shall

 

 

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1    provide Medicaid information in a manner consistent with
2    the information reported each year to the State Board
3    regarding "Inpatients and Outpatients Served by Payor
4    Source" and "Inpatient and Outpatient Net Revenue by Payor
5    Source" as required by the Board under Section 13 of this
6    Act and published in the Annual Hospital Profile.
7        (3) Any information the applicant believes is directly
8    relevant to safety net services, including information
9    regarding teaching, research, and any other service.
10    (e) The Board staff shall publish a notice, that an
11application accompanied by a Safety Net Impact Statement has
12been filed, in a newspaper having general circulation within
13the area affected by the application. If no newspaper has a
14general circulation within the county, the Board shall post the
15notice in 5 conspicuous places within the proposed area.
16    (f) Any person, community organization, provider, or
17health system or other entity wishing to comment upon or oppose
18the application may file a Safety Net Impact Statement Response
19with the Board, which shall provide additional information
20concerning a project's impact on safety net services in the
21community.
22    (g) Applicants shall be provided an opportunity to submit a
23reply to any Safety Net Impact Statement Response.
24    (h) The State Board Staff Report staff report shall include
25a statement as to whether a Safety Net Impact Statement was
26filed by the applicant and whether it included information on

 

 

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1charity care, the amount of care provided to Medicaid patients,
2and information on teaching, research, or any other service
3provided by the applicant directly relevant to safety net
4services. The report shall also indicate the names of the
5parties submitting responses and the number of responses and
6replies, if any, that were filed.
7(Source: P.A. 98-1086, eff. 8-26-14.)
 
8    (20 ILCS 3960/6)  (from Ch. 111 1/2, par. 1156)
9    (Section scheduled to be repealed on December 31, 2019)
10    Sec. 6. Application for permit or exemption; exemption
11regulations.
12    (a) An application for a permit or exemption shall be made
13to the State Board upon forms provided by the State Board. This
14application shall contain such information as the State Board
15deems necessary. The State Board shall not require an applicant
16to file a Letter of Intent before an application is filed. Such
17application shall include affirmative evidence on which the
18State Board or Chairman may make its decision on the approval
19or denial of the permit or exemption.
20    (b) The State Board shall establish by regulation the
21procedures and requirements regarding issuance of exemptions.
22An exemption shall be approved when information required by the
23Board by rule is submitted. Projects eligible for an exemption,
24rather than a permit, include, but are not limited to, change
25of ownership of a health care facility, discontinuation of a

 

 

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1category of service, and discontinuation of a health care
2facility, other than a health care facility maintained by the
3State or any agency or department thereof or a nursing home
4maintained by a county. For a change of ownership of a health
5care facility, the State Board shall provide by rule for an
6expedited process for obtaining an exemption in accordance with
7Section 8.5 of this Act. In connection with a change of
8ownership, the State Board may approve the transfer of an
9existing permit without regard to whether the permit to be
10transferred has yet been obligated, except for permits
11establishing a new facility or a new category of service.
12    (c) All applications shall be signed by the applicant and
13shall be verified by any 2 officers thereof.
14    (c-5) Any written review or findings of the Board staff or
15any other reviewing organization under Section 8 concerning an
16application for a permit must be made available to the public
17at least 14 calendar days before the meeting of the State Board
18at which the review or findings are considered. The applicant
19and members of the public may submit, to the State Board,
20written responses regarding the facts set forth in the review
21or findings of the Board staff or reviewing organization.
22Members of the public shall have until 10 days before the
23meeting of the State Board to submit any written response
24concerning the Board staff's written review or findings. The
25Board staff may revise any findings to address corrections of
26factual errors cited in the public response. At the meeting,

 

 

10000HB0763ham002- 25 -LRB100 03954 RJF 23736 a

1the State Board may, in its discretion, permit the submission
2of other additional written materials.
3    (d) Upon receipt of an application for a permit, the State
4Board shall approve and authorize the issuance of a permit if
5it finds (1) that the applicant is fit, willing, and able to
6provide a proper standard of health care service for the
7community with particular regard to the qualification,
8background and character of the applicant, (2) that economic
9feasibility is demonstrated in terms of effect on the existing
10and projected operating budget of the applicant and of the
11health care facility; in terms of the applicant's ability to
12establish and operate such facility in accordance with
13licensure regulations promulgated under pertinent state laws;
14and in terms of the projected impact on the total health care
15expenditures in the facility and community, (3) that safeguards
16are provided which assure that the establishment, construction
17or modification of the health care facility or acquisition of
18major medical equipment is consistent with the public interest,
19and (4) that the proposed project is consistent with the
20orderly and economic development of such facilities and
21equipment and is in accord with standards, criteria, or plans
22of need adopted and approved pursuant to the provisions of
23Section 12 of this Act.
24(Source: P.A. 99-154, eff. 7-28-15.)
 
25    (20 ILCS 3960/12)  (from Ch. 111 1/2, par. 1162)

 

 

10000HB0763ham002- 26 -LRB100 03954 RJF 23736 a

1    (Section scheduled to be repealed on December 31, 2019)
2    Sec. 12. Powers and duties of State Board. For purposes of
3this Act, the State Board shall exercise the following powers
4and duties:
5    (1) Prescribe rules, regulations, standards, criteria,
6procedures or reviews which may vary according to the purpose
7for which a particular review is being conducted or the type of
8project reviewed and which are required to carry out the
9provisions and purposes of this Act. Policies and procedures of
10the State Board shall take into consideration the priorities
11and needs of medically underserved areas and other health care
12services, giving special consideration to the impact of
13projects on access to safety net services.
14    (2) Adopt procedures for public notice and hearing on all
15proposed rules, regulations, standards, criteria, and plans
16required to carry out the provisions of this Act.
17    (3) (Blank).
18    (4) Develop criteria and standards for health care
19facilities planning, conduct statewide inventories of health
20care facilities, maintain an updated inventory on the Board's
21web site reflecting the most recent bed and service changes and
22updated need determinations when new census data become
23available or new need formulae are adopted, and develop health
24care facility plans which shall be utilized in the review of
25applications for permit under this Act. Such health facility
26plans shall be coordinated by the Board with pertinent State

 

 

10000HB0763ham002- 27 -LRB100 03954 RJF 23736 a

1Plans. Inventories pursuant to this Section of skilled or
2intermediate care facilities licensed under the Nursing Home
3Care Act, skilled or intermediate care facilities licensed
4under the ID/DD Community Care Act, skilled or intermediate
5care facilities licensed under the MC/DD Act, facilities
6licensed under the Specialized Mental Health Rehabilitation
7Act of 2013, or nursing homes licensed under the Hospital
8Licensing Act shall be conducted on an annual basis no later
9than July 1 of each year and shall include among the
10information requested a list of all services provided by a
11facility to its residents and to the community at large and
12differentiate between active and inactive beds.
13    In developing health care facility plans, the State Board
14shall consider, but shall not be limited to, the following:
15        (a) The size, composition and growth of the population
16    of the area to be served;
17        (b) The number of existing and planned facilities
18    offering similar programs;
19        (c) The extent of utilization of existing facilities;
20        (d) The availability of facilities which may serve as
21    alternatives or substitutes;
22        (e) The availability of personnel necessary to the
23    operation of the facility;
24        (f) Multi-institutional planning and the establishment
25    of multi-institutional systems where feasible;
26        (g) The financial and economic feasibility of proposed

 

 

10000HB0763ham002- 28 -LRB100 03954 RJF 23736 a

1    construction or modification; and
2        (h) In the case of health care facilities established
3    by a religious body or denomination, the needs of the
4    members of such religious body or denomination may be
5    considered to be public need.
6    The health care facility plans which are developed and
7adopted in accordance with this Section shall form the basis
8for the plan of the State to deal most effectively with
9statewide health needs in regard to health care facilities.
10    (5) Coordinate with other state agencies having
11responsibilities affecting health care facilities, including
12those of licensure and cost reporting.
13    (6) Solicit, accept, hold and administer on behalf of the
14State any grants or bequests of money, securities or property
15for use by the State Board in the administration of this Act;
16and enter into contracts consistent with the appropriations for
17purposes enumerated in this Act.
18    (7) The State Board shall prescribe procedures for review,
19standards, and criteria which shall be utilized to make
20periodic reviews and determinations of the appropriateness of
21any existing health services being rendered by health care
22facilities subject to the Act. The State Board shall consider
23recommendations of the Board in making its determinations.
24    (8) Prescribe rules, regulations, standards, and criteria
25for the conduct of an expeditious review of applications for
26permits for projects of construction or modification of a

 

 

10000HB0763ham002- 29 -LRB100 03954 RJF 23736 a

1health care facility, which projects are classified as
2emergency, substantive, or non-substantive in nature.
3    Six months after June 30, 2009 (the effective date of
4Public Act 96-31), substantive projects shall include no more
5than the following:
6        (a) Projects to construct (1) a new or replacement
7    facility located on a new site or (2) a replacement
8    facility located on the same site as the original facility
9    and the cost of the replacement facility exceeds the
10    capital expenditure minimum, which shall be reviewed by the
11    Board within 120 days;
12        (b) Projects proposing a (1) new service within an
13    existing healthcare facility or (2) discontinuation of a
14    service within an existing healthcare facility, which
15    shall be reviewed by the Board within 60 days; or
16        (c) Projects proposing a change in the bed capacity of
17    a health care facility by an increase in the total number
18    of beds or by a redistribution of beds among various
19    categories of service or by a relocation of beds from one
20    physical facility or site to another by more than 20 beds
21    or more than 10% of total bed capacity, as defined by the
22    State Board, whichever is less, over a 2-year period.
23    The Chairman may approve applications for exemption that
24meet the criteria set forth in rules or refer them to the full
25Board. The Chairman may approve any unopposed application that
26meets all of the review criteria or refer them to the full

 

 

10000HB0763ham002- 30 -LRB100 03954 RJF 23736 a

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

 

 

10000HB0763ham002- 31 -LRB100 03954 RJF 23736 a

1decision" for purposes of this Act is the decision to approve
2or deny an application, or take other actions permitted under
3this Act, at the time and date of the meeting that such action
4is scheduled by the Board. The transcript of the State Board
5meeting shall be incorporated into the Board's final decision.
6The staff of the Board shall prepare a written copy of the
7final decision and the Board shall approve a final copy for
8inclusion in the formal record. The Board shall consider, for
9approval, the written draft of the final decision no later than
10the next scheduled Board meeting. The written decision shall
11identify the applicable criteria and factors listed in this Act
12and the Board's regulations that were taken into consideration
13by the Board when coming to a final decision. If the Board
14denies or fails to approve an application for permit or
15exemption, the Board shall include in the final decision a
16detailed explanation as to why the application was denied and
17identify what specific criteria or standards the applicant did
18not fulfill.
19    (12) Require at least one of its members to participate in
20any public hearing, after the appointment of a majority of the
21members to the Board.
22    (13) Provide a mechanism for the public to comment on, and
23request changes to, draft rules and standards.
24    (14) Implement public information campaigns to regularly
25inform the general public about the opportunity for public
26hearings and public hearing procedures.

 

 

10000HB0763ham002- 32 -LRB100 03954 RJF 23736 a

1    (15) Establish a separate set of rules and guidelines for
2long-term care that recognizes that nursing homes are a
3different business line and service model from other regulated
4facilities. An open and transparent process shall be developed
5that considers the following: how skilled nursing fits in the
6continuum of care with other care providers, modernization of
7nursing homes, establishment of more private rooms,
8development of alternative services, and current trends in
9long-term care services. The Chairman of the Board shall
10appoint a permanent Health Services Review Board Long-term Care
11Facility Advisory Subcommittee that shall develop and
12recommend to the Board the rules to be established by the Board
13under this paragraph (15). The Subcommittee shall also provide
14continuous review and commentary on policies and procedures
15relative to long-term care and the review of related projects.
16The Subcommittee shall make recommendations to the Board no
17later than January 1, 2016 and every January thereafter
18pursuant to the Subcommittee's responsibility for the
19continuous review and commentary on policies and procedures
20relative to long-term care. In consultation with other experts
21from the health field of long-term care, the Board and the
22Subcommittee shall study new approaches to the current bed need
23formula and Health Service Area boundaries to encourage
24flexibility and innovation in design models reflective of the
25changing long-term care marketplace and consumer preferences
26and submit its recommendations to the Chairman of the Board no

 

 

10000HB0763ham002- 33 -LRB100 03954 RJF 23736 a

1later than January 1, 2017. The Subcommittee shall evaluate,
2and make recommendations to the State Board regarding, the
3buying, selling, and exchange of beds between long-term care
4facilities within a specified geographic area or drive time.
5The Board shall file the proposed related administrative rules
6for the separate rules and guidelines for long-term care
7required by this paragraph (15) by no later than September 30,
82011. The Subcommittee shall be provided a reasonable and
9timely opportunity to review and comment on any review,
10revision, or updating of the criteria, standards, procedures,
11and rules used to evaluate project applications as provided
12under Section 12.3 of this Act.
13    The Chairman of the Board shall appoint voting members of
14the Subcommittee, who shall serve for a period of 3 years, with
15one-third of the terms expiring each January, to be determined
16by lot. Appointees shall include, but not be limited to,
17recommendations from each of the 3 statewide long-term care
18associations, with an equal number to be appointed from each.
19Compliance with this provision shall be through the appointment
20and reappointment process. All appointees serving as of April
211, 2015 shall serve to the end of their term as determined by
22lot or until the appointee voluntarily resigns, whichever is
23earlier.
24    One representative from the Department of Public Health,
25the Department of Healthcare and Family Services, the
26Department on Aging, and the Department of Human Services may

 

 

10000HB0763ham002- 34 -LRB100 03954 RJF 23736 a

1each serve as an ex-officio non-voting member of the
2Subcommittee. The Chairman of the Board shall select a
3Subcommittee Chair, who shall serve for a period of 3 years.
4    (16) Prescribe the format of the State Board Staff Report.
5A State Board Staff Report shall pertain to applications that
6include, but are not limited to, applications for permit or
7exemption, applications for permit renewal, applications for
8extension of the financial commitment obligation period,
9applications requesting a declaratory ruling, or applications
10under the Health Care Worker Self-Referral Act. State Board
11Staff Reports shall compare applications to the relevant review
12criteria under the Board's rules.
13    (17) Establish a separate set of rules and guidelines for
14facilities licensed under the Specialized Mental Health
15Rehabilitation Act of 2013. An application for the
16re-establishment of a facility in connection with the
17relocation of the facility shall not be granted unless the
18applicant has a contractual relationship with at least one
19hospital to provide emergency and inpatient mental health
20services required by facility consumers, and at least one
21community mental health agency to provide oversight and
22assistance to facility consumers while living in the facility,
23and appropriate services, including case management, to assist
24them to prepare for discharge and reside stably in the
25community thereafter. No new facilities licensed under the
26Specialized Mental Health Rehabilitation Act of 2013 shall be

 

 

10000HB0763ham002- 35 -LRB100 03954 RJF 23736 a

1established after June 16, 2014 (the effective date of Public
2Act 98-651) except in connection with the relocation of an
3existing facility to a new location. An application for a new
4location shall not be approved unless there are adequate
5community services accessible to the consumers within a
6reasonable distance, or by use of public transportation, so as
7to facilitate the goal of achieving maximum individual
8self-care and independence. At no time shall the total number
9of authorized beds under this Act in facilities licensed under
10the Specialized Mental Health Rehabilitation Act of 2013 exceed
11the number of authorized beds on June 16, 2014 (the effective
12date of Public Act 98-651).
13(Source: P.A. 98-414, eff. 1-1-14; 98-463, eff. 8-16-13;
1498-651, eff. 6-16-14; 98-1086, eff. 8-26-14; 99-78, eff.
157-20-15; 99-114, eff. 7-23-15; 99-180, eff. 7-29-15; 99-277,
16eff. 8-5-15; 99-527, eff. 1-1-17; 99-642, eff. 7-28-16.)".