Illinois General Assembly - Full Text of SB1739
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Full Text of SB1739  101st General Assembly




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1    AN ACT concerning State government.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Illinois Health Facilities Planning Act is
5amended by changing Sections 6, 8.5, 12, and 12.2 and by adding
6Section 8.7 as follows:
7    (20 ILCS 3960/6)  (from Ch. 111 1/2, par. 1156)
8    (Section scheduled to be repealed on December 31, 2029)
9    Sec. 6. Application for permit or exemption; exemption
11    (a) An application for a permit or exemption shall be made
12to the State Board upon forms provided by the State Board. This
13application shall contain such information as the State Board
14deems necessary. The State Board shall not require an applicant
15to file a Letter of Intent before an application is filed. Such
16application shall include affirmative evidence on which the
17State Board or Chairman may make its decision on the approval
18or denial of the permit or exemption.
19    (b) The State Board shall establish by regulation the
20procedures and requirements regarding issuance of exemptions.
21An exemption shall be approved when information required by the
22Board by rule is submitted. Projects eligible for an exemption,
23rather than a permit, include, but are not limited to, change



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1of ownership of a health care facility and discontinuation of a
2category of service , discontinuation of a category of service,
3and discontinuation of a health care facility, other than a
4health care facility maintained by the State or any agency or
5department thereof or a nursing home maintained by a county.
6The Board may accept an application for an exemption for the
7discontinuation of a category of service at a health care
8facility only once in a 6-month period following (1) the
9previous application for exemption at the same health care
10facility or (2) the final decision of the Board regarding the
11discontinuation of a category of service at the same health
12care facility, whichever occurs later. A discontinuation of a
13category of service shall otherwise require an application for
14a permit if an application for an exemption has already been
15accepted within the 6-month period. For a change of ownership
16among related persons of a health care facility, the State
17Board shall provide by rule for an expedited process for
18obtaining an exemption in accordance with Section 8.5 of this
19Act. For the purposes of this Section, "change of ownership
20among related persons" means a transaction in which the parties
21to the transaction are under common control or ownership before
22and after the transaction is complete.
23    (c) All applications shall be signed by the applicant and
24shall be verified by any 2 officers thereof.
25    (c-5) Any written review or findings of the Board staff set
26forth in the State Board Staff Report concerning an application



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1for a permit must be made available to the public and the
2applicant at least 14 calendar days before the meeting of the
3State Board at which the review or findings are considered. The
4applicant and members of the public may submit, to the State
5Board, written responses regarding the facts set forth in the
6review or findings of the Board staff. Members of the public
7and the applicant shall have until 10 days before the meeting
8of the State Board to submit any written response concerning
9the Board staff's written review or findings. The Board staff
10may revise any findings to address corrections of factual
11errors cited in the public response. At the meeting, the State
12Board may, in its discretion, permit the submission of other
13additional written materials.
14    (d) Upon receipt of an application for a permit, the State
15Board shall approve and authorize the issuance of a permit if
16it finds (1) that the applicant is fit, willing, and able to
17provide a proper standard of health care service for the
18community with particular regard to the qualification,
19background and character of the applicant, (2) that economic
20feasibility is demonstrated in terms of effect on the existing
21and projected operating budget of the applicant and of the
22health care facility; in terms of the applicant's ability to
23establish and operate such facility in accordance with
24licensure regulations promulgated under pertinent state laws;
25and in terms of the projected impact on the total health care
26expenditures in the facility and community, (3) that safeguards



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1are provided that assure that the establishment, construction
2or modification of the health care facility or acquisition of
3major medical equipment is consistent with the public interest,
4and (4) that the proposed project is consistent with the
5orderly and economic development of such facilities and
6equipment and is in accord with standards, criteria, or plans
7of need adopted and approved pursuant to the provisions of
8Section 12 of this Act.
9(Source: P.A. 99-154, eff. 7-28-15; 100-518, eff. 6-1-18;
10100-681, eff. 8-3-18.)
11    (20 ILCS 3960/8.5)
12    (Section scheduled to be repealed on December 31, 2029)
13    Sec. 8.5. Certificate of exemption for change of ownership
14of a health care facility; discontinuation of a health care
15facility or category of service; public notice and public
17    (a) Upon a finding that an application for a change of
18ownership is complete, the State Board shall publish a legal
19notice on 3 consecutive days one day in a newspaper of general
20circulation in the area or community to be affected and afford
21the public an opportunity to request a hearing. If the
22application is for a facility located in a Metropolitan
23Statistical Area, an additional legal notice shall be published
24in a newspaper of limited circulation, if one exists, in the
25area in which the facility is located. If the newspaper of



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1limited circulation is published on a daily basis, the
2additional legal notice shall be published on 3 consecutive
3days one day. The applicant shall pay the cost incurred by the
4Board in publishing the change of ownership notice in
5newspapers as required under this subsection. The legal notice
6shall also be posted on the Health Facilities and Services
7Review Board's web site and sent to the State Representative
8and State Senator of the district in which the health care
9facility is located. An application for change of ownership of
10a hospital shall not be deemed complete without a signed
11certification that for a period of 2 years after the change of
12ownership transaction is effective, the hospital will not adopt
13a charity care policy that is more restrictive than the policy
14in effect during the year prior to the transaction. An
15application for a change of ownership need not contain signed
16transaction documents so long as it includes the following key
17terms of the transaction: names and background of the parties;
18structure of the transaction; the person who will be the
19licensed or certified entity after the transaction; the
20ownership or membership interests in such licensed or certified
21entity both prior to and after the transaction; fair market
22value of assets to be transferred; and the purchase price or
23other form of consideration to be provided for those assets.
24The issuance of the certificate of exemption shall be
25contingent upon the applicant submitting a statement to the
26Board within 90 days after the closing date of the transaction,



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1or such longer period as provided by the Board, certifying that
2the change of ownership has been completed in accordance with
3the key terms contained in the application. If such key terms
4of the transaction change, a new application shall be required.
5    Where a change of ownership is among related persons, and
6there are no other changes being proposed at the health care
7facility that would otherwise require a permit or exemption
8under this Act, the applicant shall submit an application
9consisting of a standard notice in a form set forth by the
10Board briefly explaining the reasons for the proposed change of
11ownership. Once such an application is submitted to the Board
12and reviewed by the Board staff, the Board Chair shall take
13action on an application for an exemption for a change of
14ownership among related persons within 45 days after the
15application has been deemed complete, provided the application
16meets the applicable standards under this Section. If the Board
17Chair has a conflict of interest or for other good cause, the
18Chair may request review by the Board. Notwithstanding any
19other provision of this Act, for purposes of this Section, a
20change of ownership among related persons means a transaction
21where the parties to the transaction are under common control
22or ownership before and after the transaction is completed.
23    Nothing in this Act shall be construed as authorizing the
24Board to impose any conditions, obligations, or limitations,
25other than those required by this Section, with respect to the
26issuance of an exemption for a change of ownership, including,



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1but not limited to, the time period before which a subsequent
2change of ownership of the health care facility could be
3sought, or the commitment to continue to offer for a specified
4time period any services currently offered by the health care
6    (a-3) (Blank). Upon a finding that an application to close
7a health care facility is complete, the State Board shall
8publish a legal notice on 3 consecutive days in a newspaper of
9general circulation in the area or community to be affected and
10afford the public an opportunity to request a hearing. If the
11application is for a facility located in a Metropolitan
12Statistical Area, an additional legal notice shall be published
13in a newspaper of limited circulation, if one exists, in the
14area in which the facility is located. If the newspaper of
15limited circulation is published on a daily basis, the
16additional legal notice shall be published on 3 consecutive
17days. The legal notice shall also be posted on the Health
18Facilities and Services Review Board's web site and sent to the
19State Representative and State Senator of the district in which
20the health care facility is located. In addition, the health
21care facility shall provide notice of closure to the local
22media that the health care facility would routinely notify
23about facility events. No later than 90 days after a
24discontinuation of a health facility, the applicant must submit
25a statement to the State Board certifying that the
26discontinuation is complete.



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1    (a-5) Upon a finding that an application to discontinue a
2category of service is complete and provides the requested
3information, as specified by the State Board, an exemption
4shall be issued. No later than 30 days after the issuance of
5the exemption, the health care facility must give written
6notice of the discontinuation of the category of service to the
7State Senator and State Representative serving the legislative
8district in which the health care facility is located. No later
9than 90 days after a discontinuation of a category of service,
10the applicant must submit a statement to the State Board
11certifying that the discontinuation is complete.
12    (b) If a public hearing is requested, it shall be held at
13least 15 days but no more than 30 days after the date of
14publication of the legal notice in the community in which the
15facility is located. The hearing shall be held in the affected
16area or community in a place of reasonable size and
17accessibility and a full and complete written transcript of the
18proceedings shall be made. All interested persons attending the
19hearing shall be given a reasonable opportunity to present
20their positions in writing or orally. The applicant shall
21provide a summary or describe the proposed change of ownership
22of the proposal for distribution at the public hearing.
23    (c) For the purposes of this Section "newspaper of limited
24circulation" means a newspaper intended to serve a particular
25or defined population of a specific geographic area within a
26Metropolitan Statistical Area such as a municipality, town,



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1village, township, or community area, but does not include
2publications of professional and trade associations.
3    (d) The changes made to this Section by this amendatory Act
4of the 101st General Assembly shall apply to all applications
5submitted after the effective date of this amendatory Act of
6the 101st General Assembly.
7(Source: P.A. 99-154, eff. 7-28-15; 99-527, eff. 1-1-17;
899-551, eff. 7-15-16; 100-201, eff. 8-18-17.)
9    (20 ILCS 3960/8.7 new)
10    Sec. 8.7. Application for permit for discontinuation of a
11health care facility or category of service; public notice and
12public hearing.
13    (a) Upon a finding that an application to close a health
14care facility or discontinue a category of service is complete,
15the State Board shall publish a legal notice on 3 consecutive
16days in a newspaper of general circulation in the area or
17community to be affected and afford the public an opportunity
18to request a hearing. If the application is for a facility
19located in a Metropolitan Statistical Area, an additional legal
20notice shall be published in a newspaper of limited
21circulation, if one exists, in the area in which the facility
22is located. If the newspaper of limited circulation is
23published on a daily basis, the additional legal notice shall
24be published on 3 consecutive days. The legal notice shall also
25be posted on the Health Facilities and Services Review Board's



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1website and sent to the State Representative and State Senator
2of the district in which the health care facility is located.
3In addition, the health care facility shall provide notice of
4closure to the local media that the health care facility would
5routinely notify about facility events.
6    (b) No later than 30 days after issuance of a permit to
7close a health care facility or discontinue a category of
8service, the permit holder shall give written notice of the
9closure or discontinuation to the State Senator and State
10Representative serving the legislative district in which the
11health care facility is located.
12    (c) If there is a pending lawsuit that challenges an
13application to discontinue a health care facility that either
14names the Board as a party or alleges fraud in the filing of
15the application, the Board may defer action on the application
16for up to 6 months after the date of the initial deferral of
17the application.
18    (d) The changes made to this Section by this amendatory Act
19of the 101st General Assembly shall apply to all applications
20submitted after the effective date of this amendatory Act of
21the 101st General Assembly.
22    (20 ILCS 3960/12)  (from Ch. 111 1/2, par. 1162)
23    (Section scheduled to be repealed on December 31, 2029)
24    Sec. 12. Powers and duties of State Board. For purposes of
25this Act, the State Board shall exercise the following powers



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



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



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1    members of such religious body or denomination may be
2    considered to be public need.
3    The health care facility plans which are developed and
4adopted in accordance with this Section shall form the basis
5for the plan of the State to deal most effectively with
6statewide health needs in regard to health care facilities.
7    (5) Coordinate with other state agencies having
8responsibilities affecting health care facilities, including
9those of licensure and cost reporting.
10    (6) Solicit, accept, hold and administer on behalf of the
11State any grants or bequests of money, securities or property
12for use by the State Board in the administration of this Act;
13and enter into contracts consistent with the appropriations for
14purposes enumerated in this Act.
15    (7) (Blank).
16    (8) Prescribe rules, regulations, standards, and criteria
17for the conduct of an expeditious review of applications for
18permits for projects of construction or modification of a
19health care facility, which projects are classified as
20emergency, substantive, or non-substantive in nature.
21    Substantive projects shall include no more than the
23        (a) Projects to construct (1) a new or replacement
24    facility located on a new site or (2) a replacement
25    facility located on the same site as the original facility
26    and the cost of the replacement facility exceeds the



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1    capital expenditure minimum, which shall be reviewed by the
2    Board within 120 days;
3        (b) Projects proposing a (1) new service within an
4    existing healthcare facility or (2) discontinuation of a
5    service within an existing healthcare facility, which
6    shall be reviewed by the Board within 60 days; or
7        (c) Projects proposing a change in the bed capacity of
8    a health care facility by an increase in the total number
9    of beds or by a redistribution of beds among various
10    categories of service or by a relocation of beds from one
11    physical facility or site to another by more than 20 beds
12    or more than 10% of total bed capacity, as defined by the
13    State Board, whichever is less, over a 2-year period.
14    The Chairman may approve applications for exemption that
15meet the criteria set forth in rules or refer them to the full
16Board. The Chairman may approve any unopposed application that
17meets all of the review criteria or refer them to the full
19    Such rules shall not prevent the conduct of a public
20hearing upon the timely request of an interested party. Such
21reviews shall not exceed 60 days from the date the application
22is declared to be complete.
23    (9) Prescribe rules, regulations, standards, and criteria
24pertaining to the granting of permits for construction and
25modifications which are emergent in nature and must be
26undertaken immediately to prevent or correct structural



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1deficiencies or hazardous conditions that may harm or injure
2persons using the facility, as defined in the rules and
3regulations of the State Board. This procedure is exempt from
4public hearing requirements of this Act.
5    (10) Prescribe rules, regulations, standards and criteria
6for the conduct of an expeditious review, not exceeding 60
7days, of applications for permits for projects to construct or
8modify health care facilities which are needed for the care and
9treatment of persons who have acquired immunodeficiency
10syndrome (AIDS) or related conditions.
11    (10.5) Provide its rationale when voting on an item before
12it at a State Board meeting in order to comply with subsection
13(b) of Section 3-108 of the Code of Civil Procedure.
14    (11) Issue written decisions upon request of the applicant
15or an adversely affected party to the Board. Requests for a
16written decision shall be made within 15 days after the Board
17meeting in which a final decision has been made. A "final
18decision" for purposes of this Act is the decision to approve
19or deny an application, or take other actions permitted under
20this Act, at the time and date of the meeting that such action
21is scheduled by the Board. The transcript of the State Board
22meeting shall be incorporated into the Board's final decision.
23The staff of the Board shall prepare a written copy of the
24final decision and the Board shall approve a final copy for
25inclusion in the formal record. The Board shall consider, for
26approval, the written draft of the final decision no later than



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1the next scheduled Board meeting. The written decision shall
2identify the applicable criteria and factors listed in this Act
3and the Board's regulations that were taken into consideration
4by the Board when coming to a final decision. If the Board
5denies or fails to approve an application for permit or
6exemption, the Board shall include in the final decision a
7detailed explanation as to why the application was denied and
8identify what specific criteria or standards the applicant did
9not fulfill.
10    (12) (Blank).
11    (13) Provide a mechanism for the public to comment on, and
12request changes to, draft rules and standards.
13    (14) Implement public information campaigns to regularly
14inform the general public about the opportunity for public
15hearings and public hearing procedures.
16    (15) Establish a separate set of rules and guidelines for
17long-term care that recognizes that nursing homes are a
18different business line and service model from other regulated
19facilities. An open and transparent process shall be developed
20that considers the following: how skilled nursing fits in the
21continuum of care with other care providers, modernization of
22nursing homes, establishment of more private rooms,
23development of alternative services, and current trends in
24long-term care services. The Chairman of the Board shall
25appoint a permanent Health Services Review Board Long-term Care
26Facility Advisory Subcommittee that shall develop and



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1recommend to the Board the rules to be established by the Board
2under this paragraph (15). The Subcommittee shall also provide
3continuous review and commentary on policies and procedures
4relative to long-term care and the review of related projects.
5The Subcommittee shall make recommendations to the Board no
6later than January 1, 2016 and every January thereafter
7pursuant to the Subcommittee's responsibility for the
8continuous review and commentary on policies and procedures
9relative to long-term care. In consultation with other experts
10from the health field of long-term care, the Board and the
11Subcommittee shall study new approaches to the current bed need
12formula and Health Service Area boundaries to encourage
13flexibility and innovation in design models reflective of the
14changing long-term care marketplace and consumer preferences
15and submit its recommendations to the Chairman of the Board no
16later than January 1, 2017. The Subcommittee shall evaluate,
17and make recommendations to the State Board regarding, the
18buying, selling, and exchange of beds between long-term care
19facilities within a specified geographic area or drive time.
20The Board shall file the proposed related administrative rules
21for the separate rules and guidelines for long-term care
22required by this paragraph (15) by no later than September 30,
232011. The Subcommittee shall be provided a reasonable and
24timely opportunity to review and comment on any review,
25revision, or updating of the criteria, standards, procedures,
26and rules used to evaluate project applications as provided



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1under Section 12.3 of this Act.
2    The Chairman of the Board shall appoint voting members of
3the Subcommittee, who shall serve for a period of 3 years, with
4one-third of the terms expiring each January, to be determined
5by lot. Appointees shall include, but not be limited to,
6recommendations from each of the 3 statewide long-term care
7associations, with an equal number to be appointed from each.
8Compliance with this provision shall be through the appointment
9and reappointment process. All appointees serving as of April
101, 2015 shall serve to the end of their term as determined by
11lot or until the appointee voluntarily resigns, whichever is
13    One representative from the Department of Public Health,
14the Department of Healthcare and Family Services, the
15Department on Aging, and the Department of Human Services may
16each serve as an ex-officio non-voting member of the
17Subcommittee. The Chairman of the Board shall select a
18Subcommittee Chair, who shall serve for a period of 3 years.
19    (16) Prescribe the format of the State Board Staff Report.
20A State Board Staff Report shall pertain to applications that
21include, but are not limited to, applications for permit or
22exemption, applications for permit renewal, applications for
23extension of the financial commitment period, applications
24requesting a declaratory ruling, or applications under the
25Health Care Worker Self-Referral Act. State Board Staff Reports
26shall compare applications to the relevant review criteria



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1under the Board's rules.
2    (17) Establish a separate set of rules and guidelines for
3facilities licensed under the Specialized Mental Health
4Rehabilitation Act of 2013. An application for the
5re-establishment of a facility in connection with the
6relocation of the facility shall not be granted unless the
7applicant has a contractual relationship with at least one
8hospital to provide emergency and inpatient mental health
9services required by facility consumers, and at least one
10community mental health agency to provide oversight and
11assistance to facility consumers while living in the facility,
12and appropriate services, including case management, to assist
13them to prepare for discharge and reside stably in the
14community thereafter. No new facilities licensed under the
15Specialized Mental Health Rehabilitation Act of 2013 shall be
16established after June 16, 2014 (the effective date of Public
17Act 98-651) except in connection with the relocation of an
18existing facility to a new location. An application for a new
19location shall not be approved unless there are adequate
20community services accessible to the consumers within a
21reasonable distance, or by use of public transportation, so as
22to facilitate the goal of achieving maximum individual
23self-care and independence. At no time shall the total number
24of authorized beds under this Act in facilities licensed under
25the Specialized Mental Health Rehabilitation Act of 2013 exceed
26the number of authorized beds on June 16, 2014 (the effective



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1date of Public Act 98-651).
2    (18) Elect a Vice Chairman to preside over State Board
3meetings and otherwise act in place of the Chairman when the
4Chairman is unavailable.
5(Source: P.A. 99-78, eff. 7-20-15; 99-114, eff. 7-23-15;
699-180, eff. 7-29-15; 99-277, eff. 8-5-15; 99-527, eff. 1-1-17;
799-642, eff. 7-28-16; 100-518, eff. 6-1-18; 100-681, eff.
9    (20 ILCS 3960/12.2)
10    (Section scheduled to be repealed on December 31, 2029)
11    Sec. 12.2. Powers of the State Board staff. For purposes of
12this Act, the staff shall exercise the following powers and
14        (1) Review applications for permits and exemptions in
15    accordance with the standards, criteria, and plans of need
16    established by the State Board under this Act and certify
17    its finding to the State Board.
18        (1.5) Post the following on the Board's web site:
19    relevant (i) rules, (ii) standards, (iii) criteria, (iv)
20    State norms, (v) references used by Board staff in making
21    determinations about whether application criteria are met,
22    and (vi) notices of project-related filings, including
23    notice of public comments related to the application.
24        (2) Charge and collect an amount determined by the
25    State Board and the staff to be reasonable fees for the



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1    processing of applications by the State Board. The State
2    Board shall set the amounts by rule. Application fees for
3    continuing care retirement communities, and other health
4    care models that include regulated and unregulated
5    components, shall apply only to those components subject to
6    regulation under this Act. All fees and fines collected
7    under the provisions of this Act shall be deposited into
8    the Illinois Health Facilities Planning Fund to be used for
9    the expenses of administering this Act.
10        (2.1) Publish the following reports on the State Board
11    website:
12            (A) An annual accounting, aggregated by category
13        and with names of parties redacted, of fees, fines, and
14        other revenue collected as well as expenses incurred,
15        in the administration of this Act.
16            (B) An annual report, with names of the parties
17        redacted, that summarizes all settlement agreements
18        entered into with the State Board that resolve an
19        alleged instance of noncompliance with State Board
20        requirements under this Act.
21            (C) (Blank).
22            (D) Board reports showing the degree to which an
23        application conforms to the review standards, a
24        summation of relevant public testimony, and any
25        additional information that staff wants to
26        communicate.



SB1739 Enrolled- 22 -LRB101 09796 RJF 54897 b

1        (3) Coordinate with other State agencies having
2    responsibilities affecting health care facilities,
3    including licensure and cost reporting agencies.
4        (4) Issue advisory opinions upon request. Staff
5    advisory opinions do not constitute determinations by the
6    State Board. Determinations by the State Board are made
7    through the declaratory ruling process.
8(Source: P.A. 99-527, eff. 1-1-17; 100-681, eff. 8-3-18.)
9    Section 99. Effective date. This Act takes effect upon
10becoming law.