HB5188 104TH GENERAL ASSEMBLY

LRB104 18401 BDA 31843 b

104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB5188

Introduced 2/10/2026, by Rep. Lilian Jiménez

SYNOPSIS AS INTRODUCED:

20 ILCS 2310/2310-715

Amends Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. In provisions regarding a Safety-Net Hospital Health Equity and Access Leadership (HEAL) Grant Program, changes references to safety-net hospitals to references to community safety-net hospitals. Updates references to dates in those provisions. Defines "community safety-net hospital", "health system", and "medically underserved area". Makes changes to required provisions in the report to the General Assembly regarding criteria for a community safety-net hospital to be eligible for the program, deletes required provisions in the report to the General Assembly regarding potential projects eligible for grant funds, and adds required provisions in the report to the General Assembly regarding an application process and criteria, as well as policies, standards, and procedures to administer the program and ensure accountability.

A BILL FOR

AN ACT concerning State government.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois is amended by changing Section 2310-715 as follows:

(20 ILCS 2310/2310-715)

Sec. 2310-715. Community Safety-Net Hospital Health Equity and Access Leadership (HEAL) Grant Program.

(a) Findings. The General Assembly finds that there are communities in Illinois that experience significant health care disparities, as recently emphasized by the COVID-19 pandemic, aggravated by social determinants of health and a lack of sufficient access to high quality health care resources, particularly community-based services, preventive care, obstetric care, chronic disease management, and specialty care. Community safety-net Safety-net hospitals, as defined under the this Section Illinois Public Aid Code, serve as the anchors of the health care system for many of these communities. These Safety-net hospitals not only care for their patients, they also are rooted in their communities and provide by providing jobs and partner partnering with local organizations to help address the social determinants of health, such as food, housing, and transportation needs.

However, community safety-net hospitals serve a significant number of Medicare, Medicaid, and uninsured patients, and therefore, are heavily dependent on underfunded government payers, and are heavily burdened by uncompensated care. At the same time, the overall cost of providing care has increased substantially in recent years, driven by increasing costs for staffing, prescription drugs, technology, and infrastructure.

For all of these reasons, the General Assembly finds that the long-term sustainability of community safety-net hospitals is threatened. While the General Assembly has provided is providing funding to the Department to be paid to support the expenses of specific community safety-net hospitals in previous fiscal years State Fiscal Year 2023, such annual, ad hoc funding is not a reliable and stable source of funding that will enable community safety-net hospitals to develop strategies to achieve long term sustainability. Such annual, ad hoc funding also does not provide the State with transparency and accountability to ensure that such funding is being used effectively and efficiently to maximize the benefit to members of the community.

Therefore, it is the intent of the General Assembly that the Department of Public Health and the Department of Healthcare and Family Services jointly create provide options and recommendations to the General Assembly by February 1, 2023, for the establishment of a permanent Community Safety-Net Hospital Health Equity and Access Leadership (HEAL) Grant Program, in accordance with this Section. It is the intention of the General Assembly that, beginning in fiscal year 2027 during State fiscal years 2024 through 2029, the Community Safety-Net Safety-Net Hospital Health Equity and Access Leadership (HEAL) Grant Program shall be supported by an annual funding pool of at least up to $100,000,000, subject to appropriation.

(a-5) Definitions. As used in this Section:

"Community safety-net hospital" means a hospital that satisfies the criteria under Section 5-5e.1 of the Illinois Public Aid Code and that is not part of a health system with more than $1,000,000,000 in assets.

"Health system" means a group of hospitals that are owned and operated by the same entity.

"Medically underserved area" means a geographic area with a shortage of primary health care services for residents.

(b) By February 1, 2027 2023, the Department of Public Health and the Department of Healthcare and Family Services shall provide a joint report to the General Assembly on options and recommendations for the establishment of a permanent Community Safety-Net Hospital Health Equity and Access Leadership (HEAL) Grant Program to be administered by the State. For this report, "safety-net hospital" means a hospital identified by the Department of Healthcare and Family Services under Section 5-5e.1 of the Illinois Public Aid Code. The Departments of Public Health and Healthcare and Family Services may consult with the statewide association representing a majority of hospitals and community safety-net hospitals on the report. The report may include, but need not be limited to:

(1) Criteria for a community safety-net hospital to be eligible for the program, such as:

(A) The hospital is a community safety-net hospital as defined in this Section participating provider in at least one Medicaid managed care plan.

(B) The hospital is located in a medically underserved area.

(C) The hospital's Medicaid utilization rate (for both inpatient and outpatient services).

(D) The hospital's Medicare utilization rate (for both inpatient and outpatient services).

(E) The hospital's uncompensated care percentage.

(C) (F) The hospital is demonstrably working to expand hospital's role in providing access to services, reducing health disparities, and improving health equity in its service area.

(G) The hospital's performance on quality indicators.

(2) Information regarding additional requirements for the Community Safety-Net Hospital Health Equity and Access Leadership (HEAL) Grant Program, such as:

(A) an application process and criteria to determine which applications should receive funding, established by the Department of Healthcare and Family Services and the Department of Public Health, with formal input from stakeholders; and

(B) policies, standards, and procedures developed by the Department of Healthcare and Family Services and the Department of Public Health, with formal input from stakeholders, to both administer the program and ensure accountability, that include, at a minimum:

(i) transparency: participant hospitals must open all governing board meetings to the public and include space and time for public comment;

(ii) stakeholder oversight or codetermination: participant hospitals must:

(I) have governing boards comprised of, at a minimum, 51% community members, frontline hospital workers, and patients; and

(II) create an advocacy council comprised of community members, frontline hospital workers, patients, and other key stakeholders that has meaningful input into hospital management and strategic decision making that meets at least quarterly and upon its own initiative; and

(iii) wage and labor standards: participant hospitals must:

(I) pay workers a living wage;

(II) permit workers to form or join a labor organization of their choice without interference from management; and

(III) staff adequately and negotiate a process for resolving formal objections to unsafe staffing.

Potential projects eligible for grant funds which may include projects to reduce health disparities, advance health equity, or improve access to or the quality of health care services.

(3) Potential policies, standards, and procedures to ensure accountability for the use of grant funds.

(4) Potential strategies to generate federal Medicaid matching funds for expenditures under the program.

(5) Potential policies, processes, and procedures for the administration of the program.

(Source: P.A. 102-886, eff. 5-17-22; 103-154, eff. 6-30-23.)