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91_HB4286
LRB9111866JMmb
1 AN ACT to amend the Health Facilities Planning Act.
2 WHEREAS, the General Assembly finds and declares that:
3 The regulatory structure for the State's health care
4 delivery system put in place in the 1970's was an outgrowth
5 of federal legislation predicated on the idea that the most
6 satisfactory means of controlling health care costs was the
7 allocation of health care resources by government through a
8 highly centralized health planning mechanism; and
9 For two decades, the State established strong controls
10 over the health care delivery system through the certificate
11 of need program, which allocated the provision of services
12 among providers, regulated hospital expansion, and regulated
13 the purchase of equipment and the use of medical technology;
14 and
15 The evolution of market-based means of controlling costs,
16 most notably the growth of managed care, and the rapid
17 development of new medical techniques and innovations in
18 medical technology exposed the inefficiencies inherent in
19 centralized health care planning, which was unable to respond
20 quickly to the changing needs of the health care system; and
21 The certificate of need program is a relic of the highly
22 regulated environment, and its original purpose, which was to
23 control costs by limiting the proliferation of health care
24 services through State control of those services, has been
25 undermined by the significant changes in the economics of the
26 health care system that have taken place since its inception;
27 and
28 Decisions as to health care services, the acquisition of
29 medical technology, and the expansion of facilities can best
30 be made by the health care provider, based on his or her own
31 expertise in delivering health care services to the community
32 he or she serves; and
33 The appropriate role of the State with respect to
34 services no longer subject to certificate of need is that of
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1 licensure of facilities and services, to ensure the quality
2 of care; and
3 For reasons of maintaining the quality of certain health
4 care services, a limitation of the proliferation of those
5 services may continue to be essential to protect the
6 viability of the services as well as the providers now
7 rendering them, to protect the role of institutions such as
8 urban hospitals, whose importance to the Statewide health
9 care system is indisputable, and to guard against the closing
10 of important facilities and the transfer of services from
11 facilities in a manner which is harmful to the public
12 interest; and
13 It is essential, in order to promote greater efficiency
14 in the State's health care delivery system, to eliminate the
15 certificate of need requirement for many services
16 immediately, to eliminate the requirement for other services
17 over a more extended period, and to create a commission to
18 consider whether certain remaining health care services
19 should continue to be subject to a certificate of need
20 requirement in the interest of the well-being of the public
21 and to ensure the maintenance of quality health care
22 throughout the State; therefore
23 Be it enacted by the People of the State of Illinois,
24 represented in the General Assembly:
25 Section 5. The Illinois Health Facilities Planning Act
26 is amended by changing Section 5 and adding Sections 5.2,
27 5.3, and 12.3 as follows:
28 (20 ILCS 3960/5) (from Ch. 111 1/2, par. 1155)
29 Sec. 5. Construction, modification, or establishment of
30 health care facilities or acquisition of major medical
31 equipment; permits or exemptions. After effective dates set
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1 by the State Board, and subject to Sections 5.2 and 5.3, no
2 person shall construct, modify or establish a health care
3 facility or acquire major medical equipment without first
4 obtaining a permit or exemption from the State Board. The
5 State Board shall not delegate to the Executive Secretary of
6 the State Board or any other person or entity the authority
7 to grant permits or exemptions whenever the Executive
8 Secretary or other person or entity would be required to
9 exercise any discretion affecting the decision to grant a
10 permit or exemption. The State Board shall set effective
11 dates applicable to all or to each classification or category
12 of health care facilities and applicable to all or each type
13 of transaction for which a permit is required. Varying
14 effective dates may be set, providing the date or dates so
15 set shall apply uniformly statewide.
16 Notwithstanding any effective dates established by this
17 Act or by the State Board, no person shall be required to
18 obtain a permit for any purpose under this Act until the
19 State health facilities plan referred to in paragraph (4) of
20 Section 12 of this Act has been approved and adopted by the
21 State Board subsequent to public hearings having been held
22 thereon.
23 Subject to Sections 5.2 and 5.3, a permit or exemption
24 shall be obtained prior to the acquisition of major medical
25 equipment or to the construction or modification of a health
26 care facility which:
27 (a) requires a total capital expenditure in excess
28 of the capital expenditure minimum; or
29 (b) substantially changes the scope or changes the
30 functional operation of the facility; or
31 (c) changes the bed capacity of a health care
32 facility by increasing the total number of beds or by
33 distributing beds among various categories of service or
34 by relocating beds from one physical facility or site to
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1 another by more than 10 beds or more than 10% of total
2 bed capacity as defined by the State Board, whichever is
3 less, over a 2 year period.
4 A permit shall be valid only for the defined construction
5 or modifications, site, amount and person named in the
6 application for such permit and shall not be transferable or
7 assignable. A permit shall be valid until such time as the
8 project has been completed, provided that (a) obligation of
9 the project occurs within 12 months following issuance of the
10 permit except for major construction projects such obligation
11 must occur within 18 months following issuance of the permit;
12 and (b) the project commences and proceeds to completion with
13 due diligence. Major construction projects, for the purposes
14 of this Act, shall include but are not limited to: projects
15 for the construction of new buildings; additions to existing
16 facilities; modernization projects whose cost is in excess of
17 $1,000,000 or 10% of the facilities' operating revenue,
18 whichever is less; and such other projects as the State Board
19 shall define and prescribe pursuant to this Act. The State
20 Board may extend the obligation period upon a showing of good
21 cause by the permit holder. Permits for projects that have
22 not been obligated within the prescribed obligation period
23 shall expire on the last day of that period.
24 Persons who otherwise would be required to obtain a
25 permit shall be exempt from such requirement if the State
26 Board finds that with respect to establishing a new facility
27 or construction of new buildings or additions or
28 modifications to an existing facility, final plans and
29 specifications for such work have prior to October 1, 1974,
30 been submitted to and approved by the Department of Public
31 Health in accordance with the requirements of applicable
32 laws. Such exemptions shall be null and void after December
33 31, 1979 unless binding construction contracts were signed
34 prior to December 1, 1979 and unless construction has
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1 commenced prior to December 31, 1979. Such exemptions shall
2 be valid until such time as the project has been completed
3 provided that the project proceeds to completion with due
4 diligence.
5 The acquisition by any person of major medical equipment
6 that will not be owned by or located in a health care
7 facility and that will not be used to provide services to
8 inpatients of a health care facility shall be exempt from
9 review provided that a notice is filed in accordance with
10 exemption requirements.
11 (Source: P.A. 88-18.)
12 (20 ILCS 3960/5.2 new)
13 Sec. 5.2. Services exempt from permit requirements.
14 Notwithstanding any provisions of Section 5 to the contrary,
15 the following services and facilities are exempt from any
16 permit requirements under this Act: outpatient and inpatient
17 drug and alcohol services; hospital-based medical
18 detoxification for drugs and alcohol; acute mental illness
19 services, including inpatient mental illness services; mental
20 health services which are non-bed related outpatient
21 services; capital improvements and renovations to health care
22 facilities; additions of medical, surgical, and adult
23 intensive care beds in hospitals; major medical equipment;
24 inpatient operating rooms; subacute care hospital services;
25 non-hospital based ambulatory surgery services and
26 facilities; comprehensive outpatient rehabilitation services;
27 transfer of ownership interests in licensed health care
28 facilities; magnetic resonance imaging; and chronic or acute
29 renal dialysis facilities and services.
30 (20 ILCS 3960/5.3 new)
31 Sec. 5.3. Additional services and facilities exempt from
32 permit requirements. Notwithstanding any provisions of
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1 Section 5 to the contrary, 24 months after the effective date
2 of this amendatory Act of the 91st General Assembly, the
3 following services and facilities shall be exempt from any
4 permit requirements pursuant to this Act: extracorporeal
5 shock wave lithotripsy services; positron emission tomography
6 scanning services; pediatric and obstetric services,
7 including the addition of inpatient pediatric and obstetric
8 beds in hospitals; therapeutic radiology services; and high
9 linear energy transfer services.
10 (20 ILCS 3960/12.3 new)
11 Sec. 12.3. Certificate of Need Study Commission.
12 (a) There is established a 12-member Certificate of Need
13 Study Commission. The members shall include: the Director of
14 Public Health, who shall serve ex officio, and 11 public
15 members. The public members shall be appointed as follows:
16 (1) Two persons to be appointed by the President of
17 the Senate, one of whom shall be appointed upon the
18 recommendation of the Minority Leader of the Senate, of
19 which 2 appointments one shall be a State licensed health
20 care professional and one shall be a representative of a
21 State licensed health care facility;
22 (2) Two persons to be appointed by the Speaker of
23 the House of Representatives, one of whom shall be
24 appointed upon the recommendation of the Minority Leader
25 of the House of Representatives, of which 2 appointments
26 one shall be a State licensed health care professional
27 and one shall be a representative of a State licensed
28 health care facility; and
29 (3) Seven persons to be appointed by the Governor,
30 of which 2 appointments shall be State licensed health
31 care professionals, of which 3 appointments shall be
32 representatives of State licensed health care facilities,
33 of which one appointment shall be a health economist, and
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1 of which one appointment shall be a consumer of health
2 care services who is knowledgeable about health care
3 financing issues and who is a resident of this State.
4 Vacancies in the membership of the Commission shall be
5 filled in the same manner provided for the original
6 appointments.
7 (b) The Director of Public Health shall serve as
8 chairman of the Commission. The Commission shall select a
9 vice-chairman from among the members. The Commission shall
10 organize as soon as practicable following the appointment of
11 its members.
12 (c) The Commission shall be entitled to call to its
13 assistance and avail itself of the services of the employees
14 of any State, county, or municipal department, board, bureau,
15 commission, or agency as it may require and as may be
16 available to it for its purposes. The Department of Public
17 Health shall provide staff support for the Commission.
18 (d) The Commission shall conduct a comprehensive study
19 to examine the impact that elimination of certificate of need
20 requirements would have on each of the following health care
21 services and facilities: long-term care facilities, both
22 general and specialized; comprehensive inpatient
23 rehabilitation services; new general acute care hospitals;
24 open-heart surgery and cardiac catheterization; organ
25 transplantation, including kidney transplantation; burn
26 services; specialized neonatal services; and any other health
27 care services and facilities subject to certificate of need
28 requirements that are not scheduled for exemption pursuant to
29 this Act. The Commission shall assess the impact that
30 deregulation of the services or facilities will have on:
31 (1) urban hospitals;
32 (2) access to care by residents in the State;
33 (3) quality of care;
34 (4) services that are delivered Statewide or on a
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1 regional basis; and
2 (5) the General Revenue Fund, including programs
3 such as Medicaid.
4 The Commission shall make recommendations about which
5 health care services or facilities, if any, should continue
6 to be subject to certificate of need requirements or another
7 type of State regulation, and which services or facilities
8 should be exempt from State regulation.
9 (e) Within 24 months of the effective date of this
10 amendatory Act of the 91st General Assembly, the Commission
11 shall report its findings and recommendations to the Governor
12 and General Assembly.
13 (f) The Commission shall expire upon the submission of
14 its report.
15 Section 99. Effective date. This Act takes effect
16 January 1, 2001.