Illinois General Assembly - Full Text of HB3657
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Full Text of HB3657  102nd General Assembly

HB3657eng 102ND GENERAL ASSEMBLY

  
  
  

 


 
HB3657 EngrossedLRB102 13678 RJF 19028 b

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 Department of Public Health Powers and
5Duties Law of the Civil Administrative Code of Illinois is
6amended by renumbering Section 2310-223 as follows:
 
7    (20 ILCS 2310/2310-222)
8    Sec. 2310-222 2310-223. Obstetric hemorrhage and
9hypertension training.
10    (a) As used in this Section, "birthing facility" means (1)
11a hospital, as defined in the Hospital Licensing Act, with
12more than one licensed obstetric bed or a neonatal intensive
13care unit; (2) a hospital operated by a State university; or
14(3) a birth center, as defined in the Alternative Health Care
15Delivery Act.
16    (b) The Department shall ensure that all birthing
17facilities conduct continuing education yearly for providers
18and staff of obstetric medicine and of the emergency
19department and other staff that may care for pregnant or
20postpartum women. The continuing education shall include
21yearly educational modules regarding management of severe
22maternal hypertension and obstetric hemorrhage for units that
23care for pregnant or postpartum women. Birthing facilities

 

 

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1must demonstrate compliance with these education and training
2requirements.
3    (c) The Department shall collaborate with the Illinois
4Perinatal Quality Collaborative or its successor organization
5to develop an initiative to improve birth equity and reduce
6peripartum racial and ethnic disparities. The Department shall
7ensure that the initiative includes the development of best
8practices for implicit bias training and education in cultural
9competency to be used by birthing facilities in interactions
10between patients and providers. In developing the initiative,
11the Illinois Perinatal Quality Collaborative or its successor
12organization shall consider existing programs, such as the
13Alliance for Innovation on Maternal Health and the California
14Maternal Quality Collaborative's pilot work on improving birth
15equity. The Department shall support the initiation of a
16statewide perinatal quality improvement initiative in
17collaboration with birthing facilities to implement strategies
18to reduce peripartum racial and ethnic disparities and to
19address implicit bias in the health care system.
20    (d) The Department, in consultation with the Maternal
21Mortality Review Committee, shall make available to all
22birthing facilities best practices for timely identification
23of all pregnant and postpartum women in the emergency
24department and for appropriate and timely consultation of an
25obstetric provider to provide input on management and
26follow-up. Birthing facilities may use telemedicine for the

 

 

HB3657 Engrossed- 3 -LRB102 13678 RJF 19028 b

1consultation.
2    (e) The Department may adopt rules for the purpose of
3implementing this Section.
4(Source: P.A. 101-390, eff. 1-1-20; revised 10-7-19.)
 
5    Section 10. The Illinois Health Facilities Planning Act is
6amended by changing Sections 2, 3, 5, 5.4, 6, 6.2, 8.5, 8.7,
712, 12.3, 12.4, 13.1, 14, and 14.1 and by adding Sections 5.5,
85.6, 6.05, and 14.05 as follows:
 
9    (20 ILCS 3960/2)  (from Ch. 111 1/2, par. 1152)
10    (Section scheduled to be repealed on December 31, 2029)
11    Sec. 2. Purpose of the Act. This Act shall establish a
12procedure (1) which requires a person establishing,
13constructing or modifying a health care facility, as herein
14defined, to have the qualifications, background, character and
15financial resources to adequately provide a proper service for
16the community; (2) that promotes the orderly and economic
17development of health care facilities in the State of Illinois
18that avoids unnecessary duplication of such facilities; (3)
19that promotes health equity including equitable access to
20quality health care through the development and preservation
21of safety net services; and (4) (3) that promotes planning for
22and development of health care facilities needed for
23comprehensive health care especially in areas where the health
24planning process has identified unmet needs.

 

 

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1    The changes made to this Act by this amendatory Act of the
296th General Assembly are intended to accomplish the following
3objectives: to improve the financial ability of the public to
4obtain necessary health services; to establish an orderly and
5comprehensive health care delivery system that will guarantee
6the availability of quality health care to the general public;
7to maintain and improve the provision of essential health care
8services and increase the accessibility of those services to
9the medically underserved and indigent; to assure that the
10reduction and closure of health care services or facilities is
11performed in an orderly and timely manner, and that these
12actions are deemed to be in the best interests of the public;
13and to assess the financial burden to patients caused by
14unnecessary health care construction and modification.
15Evidence-based assessments, projections and decisions will be
16applied regarding capacity, quality, value and equity in the
17delivery of health care services in Illinois. The integrity of
18the Certificate of Need process is ensured through revised
19ethics and communications procedures. Cost containment and
20support for safety net services must continue to be central
21tenets of the Certificate of Need process.
22    The changes made to this Act by this amendatory Act of the
23102nd General Assembly recognize a persistent problem of
24hospital service cuts and facility closures. These harm the
25health care safety net in Illinois and have negatively
26impacted access to hospital services in communities of color

 

 

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1in particular. The changes are intended to accomplish the
2objective of protecting the public interest in equitable
3access to health care services.
4(Source: P.A. 99-527, eff. 1-1-17.)
 
5    (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
6    (Section scheduled to be repealed on December 31, 2029)
7    Sec. 3. Definitions. As used in this Act:
8    "Health care facilities" means and includes the following
9facilities, organizations, and related persons:
10        (1) An ambulatory surgical treatment center required
11    to be licensed pursuant to the Ambulatory Surgical
12    Treatment Center Act.
13        (2) An institution, place, building, or agency
14    required to be licensed pursuant to the Hospital Licensing
15    Act.
16        (3) Skilled and intermediate long term care facilities
17    licensed under the Nursing Home Care Act.
18            (A) If a demonstration project under the Nursing
19        Home Care Act applies for a certificate of need to
20        convert to a nursing facility, it shall meet the
21        licensure and certificate of need requirements in
22        effect as of the date of application.
23            (B) Except as provided in item (A) of this
24        subsection, this Act does not apply to facilities
25        granted waivers under Section 3-102.2 of the Nursing

 

 

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1        Home Care Act.
2        (3.5) Skilled and intermediate care facilities
3    licensed under the ID/DD Community Care Act or the MC/DD
4    Act. No permit or exemption is required for a facility
5    licensed under the ID/DD Community Care Act or the MC/DD
6    Act prior to the reduction of the number of beds at a
7    facility. If there is a total reduction of beds at a
8    facility licensed under the ID/DD Community Care Act or
9    the MC/DD Act, this is a discontinuation or closure of the
10    facility. If a facility licensed under the ID/DD Community
11    Care Act or the MC/DD Act reduces the number of beds or
12    discontinues the facility, that facility must notify the
13    Board as provided in Section 14.1 of this Act.
14        (3.7) Facilities licensed under the Specialized Mental
15    Health Rehabilitation Act of 2013.
16        (4) Hospitals, nursing homes, ambulatory surgical
17    treatment centers, or kidney disease treatment centers
18    maintained by the State or any department or agency
19    thereof.
20        (5) Kidney disease treatment centers, including a
21    free-standing hemodialysis unit required to meet the
22    requirements of 42 CFR 494 in order to be certified for
23    participation in Medicare and Medicaid under Titles XVIII
24    and XIX of the federal Social Security Act.
25            (A) This Act does not apply to a dialysis facility
26        that provides only dialysis training, support, and

 

 

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1        related services to individuals with end stage renal
2        disease who have elected to receive home dialysis.
3            (B) This Act does not apply to a dialysis unit
4        located in a licensed nursing home that offers or
5        provides dialysis-related services to residents with
6        end stage renal disease who have elected to receive
7        home dialysis within the nursing home.
8            (C) The Board, however, may require dialysis
9        facilities and licensed nursing homes under items (A)
10        and (B) of this subsection to report statistical
11        information on a quarterly basis to the Board to be
12        used by the Board to conduct analyses on the need for
13        proposed kidney disease treatment centers.
14        (6) An institution, place, building, or room used for
15    the performance of outpatient surgical procedures that is
16    leased, owned, or operated by or on behalf of an
17    out-of-state facility.
18        (7) An institution, place, building, or room used for
19    provision of a health care category of service, including,
20    but not limited to, cardiac catheterization and open heart
21    surgery.
22        (8) An institution, place, building, or room housing
23    major medical equipment used in the direct clinical
24    diagnosis or treatment of patients, and whose project cost
25    is in excess of the capital expenditure minimum.
26    "Health care facilities" does not include the following

 

 

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1entities or facility transactions:
2        (1) Federally-owned facilities.
3        (2) Facilities used solely for healing by prayer or
4    spiritual means.
5        (3) An existing facility located on any campus
6    facility as defined in Section 5-5.8b of the Illinois
7    Public Aid Code, provided that the campus facility
8    encompasses 30 or more contiguous acres and that the new
9    or renovated facility is intended for use by a licensed
10    residential facility.
11        (4) Facilities licensed under the Supportive
12    Residences Licensing Act or the Assisted Living and Shared
13    Housing Act.
14        (5) Facilities designated as supportive living
15    facilities that are in good standing with the program
16    established under Section 5-5.01a of the Illinois Public
17    Aid Code.
18        (6) Facilities established and operating under the
19    Alternative Health Care Delivery Act as a children's
20    community-based health care center alternative health care
21    model demonstration program or as an Alzheimer's Disease
22    Management Center alternative health care model
23    demonstration program.
24        (7) The closure of an entity or a portion of an entity
25    licensed under the Nursing Home Care Act, the Specialized
26    Mental Health Rehabilitation Act of 2013, the ID/DD

 

 

HB3657 Engrossed- 9 -LRB102 13678 RJF 19028 b

1    Community Care Act, or the MC/DD Act, with the exception
2    of facilities operated by a county or Illinois Veterans
3    Homes, that elect to convert, in whole or in part, to an
4    assisted living or shared housing establishment licensed
5    under the Assisted Living and Shared Housing Act and with
6    the exception of a facility licensed under the Specialized
7    Mental Health Rehabilitation Act of 2013 in connection
8    with a proposal to close a facility and re-establish the
9    facility in another location.
10        (8) Any change of ownership of a health care facility
11    that is licensed under the Nursing Home Care Act, the
12    Specialized Mental Health Rehabilitation Act of 2013, the
13    ID/DD Community Care Act, or the MC/DD Act, with the
14    exception of facilities operated by a county or Illinois
15    Veterans Homes. Changes of ownership of facilities
16    licensed under the Nursing Home Care Act must meet the
17    requirements set forth in Sections 3-101 through 3-119 of
18    the Nursing Home Care Act.
19        (9) (Blank).
20    With the exception of those health care facilities
21specifically included in this Section, nothing in this Act
22shall be intended to include facilities operated as a part of
23the practice of a physician or other licensed health care
24professional, whether practicing in his individual capacity or
25within the legal structure of any partnership, medical or
26professional corporation, or unincorporated medical or

 

 

HB3657 Engrossed- 10 -LRB102 13678 RJF 19028 b

1professional group. Further, this Act shall not apply to
2physicians or other licensed health care professional's
3practices where such practices are carried out in a portion of
4a health care facility under contract with such health care
5facility by a physician or by other licensed health care
6professionals, whether practicing in his individual capacity
7or within the legal structure of any partnership, medical or
8professional corporation, or unincorporated medical or
9professional groups, unless the entity constructs, modifies,
10or establishes a health care facility as specifically defined
11in this Section. This Act shall apply to construction or
12modification and to establishment by such health care facility
13of such contracted portion which is subject to facility
14licensing requirements, irrespective of the party responsible
15for such action or attendant financial obligation.
16    "Person" means any one or more natural persons, legal
17entities, governmental bodies other than federal, or any
18combination thereof.
19    "Consumer" means any person other than a person (a) whose
20major occupation currently involves or whose official capacity
21within the last 12 months has involved the providing,
22administering or financing of any type of health care
23facility, (b) who is engaged in health research or the
24teaching of health, (c) who has a material financial interest
25in any activity which involves the providing, administering or
26financing of any type of health care facility, or (d) who is or

 

 

HB3657 Engrossed- 11 -LRB102 13678 RJF 19028 b

1ever has been a member of the immediate family of the person
2defined by item (a), (b), or (c).
3    "State Board" or "Board" means the Health Facilities and
4Services Review Board.
5    "Construction or modification" means the establishment,
6erection, building, alteration, reconstruction,
7modernization, improvement, extension, discontinuation,
8change of ownership, of or by a health care facility, or the
9purchase or acquisition by or through a health care facility
10of equipment or service for diagnostic or therapeutic purposes
11or for facility administration or operation, or any capital
12expenditure made by or on behalf of a health care facility
13which exceeds the capital expenditure minimum; however, any
14capital expenditure made by or on behalf of a health care
15facility for (i) the construction or modification of a
16facility licensed under the Assisted Living and Shared Housing
17Act or (ii) a conversion project undertaken in accordance with
18Section 30 of the Older Adult Services Act shall be excluded
19from any obligations under this Act. For the purposes of this
20paragraph and Act, any temporary suspension of a category of
21service by a hospital for a time period exceeding 90 days shall
22be considered a discontinuation of a category of service.
23    "Establish" means the construction of a health care
24facility or the replacement of an existing facility on another
25site or the initiation of a category of service.
26    "Major medical equipment" means medical equipment which is

 

 

HB3657 Engrossed- 12 -LRB102 13678 RJF 19028 b

1used for the provision of medical and other health services
2and which costs in excess of the capital expenditure minimum,
3except that such term does not include medical equipment
4acquired by or on behalf of a clinical laboratory to provide
5clinical laboratory services if the clinical laboratory is
6independent of a physician's office and a hospital and it has
7been determined under Title XVIII of the Social Security Act
8to meet the requirements of paragraphs (10) and (11) of
9Section 1861(s) of such Act. In determining whether medical
10equipment has a value in excess of the capital expenditure
11minimum, the value of studies, surveys, designs, plans,
12working drawings, specifications, and other activities
13essential to the acquisition of such equipment shall be
14included.
15    "Capital expenditure" means an expenditure: (A) made by or
16on behalf of a health care facility (as such a facility is
17defined in this Act); and (B) which under generally accepted
18accounting principles is not properly chargeable as an expense
19of operation and maintenance, or is made to obtain by lease or
20comparable arrangement any facility or part thereof or any
21equipment for a facility or part; and which exceeds the
22capital expenditure minimum.
23    For the purpose of this paragraph, the cost of any
24studies, surveys, designs, plans, working drawings,
25specifications, and other activities essential to the
26acquisition, improvement, expansion, or replacement of any

 

 

HB3657 Engrossed- 13 -LRB102 13678 RJF 19028 b

1plant or equipment with respect to which an expenditure is
2made shall be included in determining if such expenditure
3exceeds the capital expenditures minimum. Unless otherwise
4interdependent, or submitted as one project by the applicant,
5components of construction or modification undertaken by means
6of a single construction contract or financed through the
7issuance of a single debt instrument shall not be grouped
8together as one project. Donations of equipment or facilities
9to a health care facility which if acquired directly by such
10facility would be subject to review under this Act shall be
11considered capital expenditures, and a transfer of equipment
12or facilities for less than fair market value shall be
13considered a capital expenditure for purposes of this Act if a
14transfer of the equipment or facilities at fair market value
15would be subject to review.
16    "Capital expenditure minimum" means $11,500,000 for
17projects by hospital applicants, $6,500,000 for applicants for
18projects related to skilled and intermediate care long-term
19care facilities licensed under the Nursing Home Care Act, and
20$3,000,000 for projects by all other applicants, which shall
21be annually adjusted to reflect the increase in construction
22costs due to inflation, for major medical equipment and for
23all other capital expenditures.
24    "Financial commitment" means the commitment of at least
2533% of total funds assigned to cover total project cost, which
26occurs by the actual expenditure of 33% or more of the total

 

 

HB3657 Engrossed- 14 -LRB102 13678 RJF 19028 b

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

 

 

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

 

 

HB3657 Engrossed- 16 -LRB102 13678 RJF 19028 b

1out-of-state facilities. Affiliates of Illinois licensed
2health care facilities 100% owned by an Illinois licensed
3health care facility, its parent, or Illinois physicians
4licensed to practice medicine in all its branches shall not be
5considered out-of-state facilities. Nothing in this definition
6shall be construed to include an office or any part of an
7office of a physician licensed to practice medicine in all its
8branches in Illinois that is not required to be licensed under
9the Ambulatory Surgical Treatment Center Act.
10    "Change of ownership of a health care facility" means a
11change in the person who has ownership or control of a health
12care facility's physical plant and capital assets. A change in
13ownership is indicated by the following transactions: sale,
14transfer, acquisition, lease, change of sponsorship, or other
15means of transferring control.
16    "Related person" means any person that: (i) is at least
1750% owned, directly or indirectly, by either the health care
18facility or a person owning, directly or indirectly, at least
1950% of the health care facility; or (ii) owns, directly or
20indirectly, at least 50% of the health care facility.
21    "Charity care" means care provided by a health care
22facility for which the provider does not expect to receive
23payment from the patient or a third-party payer.
24    "Health disparities" means preventable differences in the
25burden of disease, injury, violence, or opportunities to
26achieve optimal health that are experienced by socially

 

 

HB3657 Engrossed- 17 -LRB102 13678 RJF 19028 b

1disadvantaged populations.
2    "Health equity" means a process of assurance of the
3conditions for optimal health for all people through focused
4and ongoing societal effort valuing all individuals and
5populations equally, recognizing and rectifying historical
6injustices, and providing resources according to need.
7    "Safety net services" means services provided by health
8care providers or organizations that deliver health care
9services to persons with barriers to mainstream health care
10due to lack of insurance, inability to pay, special needs,
11ethnic or cultural characteristics, or geographic isolation,
12and those that deliver services to communities or populations
13suffering from health disparities including disparities in
14health status and outcomes due to differences in social,
15economic, environmental, or healthcare resources. Safety net
16service providers include, but are not limited to, hospitals
17and private practice physicians that provide charity care,
18school-based health centers, migrant health clinics, rural
19health clinics, federally qualified health centers, community
20health centers, public health departments, and community
21mental health centers.
22    "Safety net hospital" has the meaning ascribed to it under
23Section 5-5e.1 of the Illinois Public Aid Code.
24    "Emergency medical and trauma" means the emergency medical
25services, trauma services, and associated non-emergency
26medical services planned and coordinated in accordance with

 

 

HB3657 Engrossed- 18 -LRB102 13678 RJF 19028 b

1the Emergency Medical Services (EMS) Systems Act.
2    "Perinatal and maternal care" means obstetric and neonatal
3services under Subpart O of Hospital Licensing Requirements,
477 IAC 250; resources and services associated with hospital
5perinatal care level designations under the Developmental
6Disability Prevention Act; and maternal care resources and
7services developed or identified under Sections 2310-222 and
82310-223 of the Department of Public Health Powers and Duties
9Law.
10    "Freestanding emergency center" means a facility subject
11to licensure under Section 32.5 of the Emergency Medical
12Services (EMS) Systems Act.
13    "Category of service" means a grouping by generic class of
14various types or levels of support functions, equipment, care,
15or treatment provided to patients or residents. Categories of
16service shall include, but not be limited to, , including, but
17not limited to, classes such as medical-surgical, pediatrics,
18obstetrics, intensive care, neonatal intensive care, acute
19mental illness, comprehensive physical rehabilitation,
20long-term acute care, or cardiac catheterization, open heart
21surgery, kidney transplantation, general long term nursing
22care, long term care for the developmentally disabled (adult),
23long term care for the developmentally disabled (children),
24chronic mental illness care, in-center hemodialysis, and
25non-hospital ambulatory surgery. A category of service may
26include subcategories or levels of care that identify a

 

 

HB3657 Engrossed- 19 -LRB102 13678 RJF 19028 b

1particular degree or type of care within the category of
2service. Nothing in this definition shall be construed to
3include the practice of a physician or other licensed health
4care professional while functioning in an office providing for
5the care, diagnosis, or treatment of patients. A category of
6service that is subject to the Board's jurisdiction must be
7designated in rules adopted by the Board.
8    "State Board Staff Report" means the document that sets
9forth the review and findings of the State Board staff, as
10prescribed by the State Board, regarding applications subject
11to Board jurisdiction.
12(Source: P.A. 100-518, eff. 6-1-18; 100-581, eff. 3-12-18;
13100-957, eff. 8-19-18; 101-81, eff. 7-12-19; 101-650, eff.
147-7-20.)
 
15    (20 ILCS 3960/5)  (from Ch. 111 1/2, par. 1155)
16    (Section scheduled to be repealed on December 31, 2029)
17    Sec. 5. Construction, modification, or establishment of
18health care facilities or acquisition of major medical
19equipment; permits or exemptions. No person shall construct,
20modify or establish a health care facility or acquire major
21medical equipment without first obtaining a permit or
22exemption from the State Board. The State Board shall not
23delegate to the staff of the State Board or any other person or
24entity the authority to grant permits or exemptions whenever
25the staff or other person or entity would be required to

 

 

HB3657 Engrossed- 20 -LRB102 13678 RJF 19028 b

1exercise any discretion affecting the decision to grant a
2permit or exemption. The State Board may, by rule, delegate
3authority to the Chairman to grant permits or exemptions when
4applications meet all of the State Board's review criteria and
5are unopposed.
6    A permit or exemption shall be obtained prior to the
7acquisition of major medical equipment or to the construction
8or modification of a health care facility which:
9        (a) requires a total capital expenditure in excess of
10    the capital expenditure minimum; or
11        (b) substantially changes the scope or changes the
12    functional operation of the facility; or
13        (c) changes the bed capacity of a health care facility
14    by increasing the total number of beds or by distributing
15    beds among various categories of service or by relocating
16    beds from one physical facility or site to another by more
17    than 20 beds or more than 10% of total bed capacity as
18    defined by the State Board, whichever is less, over a
19    2-year period.
20    A permit shall be valid only for the defined construction
21or modifications, site, amount and person named in the
22application for such permit. The State Board may approve the
23transfer of an existing permit without regard to whether the
24permit to be transferred has yet been financially committed,
25except for permits to establish a new facility or category of
26service. A permit shall be valid until such time as the project

 

 

HB3657 Engrossed- 21 -LRB102 13678 RJF 19028 b

1has been completed, provided that the project commences and
2proceeds to completion with due diligence by the completion
3date or extension date approved by the Board.
4    A permit holder must do the following: (i) submit the
5final completion and cost report for the project within 90
6days after the approved project completion date or extension
7date and (ii) submit annual progress reports no earlier than
830 days before and no later than 30 days after each anniversary
9date of the Board's approval of the permit until the project is
10completed. To maintain a valid permit and to monitor progress
11toward project commencement and completion, routine
12post-permit reports shall be limited to annual progress
13reports and the final completion and cost report. Annual
14progress reports shall include information regarding the
15committed funds expended toward the approved project. For
16projects to be completed in 12 months or less, the permit
17holder shall report financial commitment in the final
18completion and cost report. For projects to be completed
19between 12 to 24 months, the permit holder shall report
20financial commitment in the first annual report. For projects
21to be completed in more than 24 months, the permit holder shall
22report financial commitment in the second annual progress
23report. The report shall contain information regarding
24expenditures and financial commitments. The State Board may
25extend the financial commitment period after considering a
26permit holder's showing of good cause and request for

 

 

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1additional time to complete the project.
2    The Certificate of Need process required under this Act is
3designed to support equitable access to health care services,
4develop and protect safety net services, and restrain rising
5health care costs by preventing unnecessary construction or
6modification of health care facilities. The Board must assure
7that the establishment, construction, or modification of a
8health care facility or the acquisition of major medical
9equipment is consistent with the public interest and that the
10proposed project is consistent with the orderly and economic
11development or acquisition of those facilities and equipment
12and is in accord with the standards, criteria, or plans of need
13adopted and approved by the Board. The Board must assure
14decisions regarding hospital facility or service
15discontinuations are consistent with the health equity
16purposes of the Act and weigh whether or not such facility or
17service discontinuations will worsen health disparities. Board
18decisions regarding the construction of health care facilities
19must consider capacity, quality, value, and equity. Projects
20may deviate from the costs, fees, and expenses provided in
21their project cost information for the project's cost
22components, provided that the final total project cost does
23not exceed the approved permit amount. Project alterations
24shall not increase the total approved permit amount by more
25than the limit set forth under the Board's rules.
26    The acquisition by any person of major medical equipment

 

 

HB3657 Engrossed- 23 -LRB102 13678 RJF 19028 b

1that will not be owned by or located in a health care facility
2and that will not be used to provide services to inpatients of
3a health care facility shall be exempt from review provided
4that a notice is filed in accordance with exemption
5requirements.
6    Notwithstanding any other provision of this Act, no permit
7or exemption is required for the construction or modification
8of a non-clinical service area of a health care facility.
9(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18.)
 
10    (20 ILCS 3960/5.4)
11    (Section scheduled to be repealed on December 31, 2029)
12    Sec. 5.4. Safety Net Impact Statement.
13    (a) General review criteria shall include a requirement
14that all health care facilities, with the exception of skilled
15and intermediate long-term care facilities licensed under the
16Nursing Home Care Act, provide a Safety Net Impact Statement,
17which shall be filed with an application for a substantive
18project or when the application proposes to discontinue a
19category of service.
20    (b) (Blank). For the purposes of this Section, "safety net
21services" are services provided by health care providers or
22organizations that deliver health care services to persons
23with barriers to mainstream health care due to lack of
24insurance, inability to pay, special needs, ethnic or cultural
25characteristics, or geographic isolation. Safety net service

 

 

HB3657 Engrossed- 24 -LRB102 13678 RJF 19028 b

1providers include, but are not limited to, hospitals and
2private practice physicians that provide charity care,
3school-based health centers, migrant health clinics, rural
4health clinics, federally qualified health centers, community
5health centers, public health departments, and community
6mental health centers.
7    (c) As developed by the applicant, a Safety Net Impact
8Statement shall describe all of the following:
9        (1) The project's material impact, if any, on
10    essential safety net services in the community, including
11    safety net hospitals and critical access hospitals, to the
12    extent that it is feasible for an applicant to have such
13    knowledge.
14        (2) The project's impact on the ability of another
15    provider or health care system to cross-subsidize safety
16    net services, to the extent that it is feasible for an
17    applicant to have such knowledge , if reasonably known to
18    the applicant.
19        (3) How the discontinuation of a facility or service
20    will might impact other the remaining safety net
21    providers, to the extent that it is feasible for an
22    applicant to have such knowledge in a given community, if
23    reasonably known by the applicant.
24        (4) How the discontinuation of a facility or service
25    will impact the Medicaid population.
26        (5) How the discontinuation of a facility or service

 

 

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1    will impact the health status and outcomes of populations
2    suffering from health disparities. This should include
3    consideration of disparities in healthcare access and
4    outcomes by income, race and ethnic identity, and
5    preferred language.
6    (d) Safety Net Impact Statements shall also include all of
7the following:
8        (1) For the 3 fiscal years prior to the application, a
9    certification describing the amount of charity care
10    provided by the applicant. The amount calculated by
11    hospital applicants shall be in accordance with the
12    reporting requirements for charity care reporting in the
13    Illinois Community Benefits Act. Non-hospital applicants
14    shall report charity care, at cost, in accordance with an
15    appropriate methodology specified by the Board.
16        (2) For the 3 fiscal years prior to the application, a
17    certification of the amount of care provided to Medicaid
18    patients. Hospital and non-hospital applicants shall
19    provide Medicaid information in a manner consistent with
20    the information reported each year to the State Board
21    regarding "Inpatients and Outpatients Served by Payor
22    Source" and "Inpatient and Outpatient Net Revenue by Payor
23    Source" as required by the Board under Section 13 of this
24    Act and published in the Annual Hospital Profile.
25        (3) Any information the applicant believes is directly
26    relevant to safety net services, including information

 

 

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1    regarding teaching, research, and any other service.
2    (e) The Board staff shall publish a notice, that an
3application accompanied by a Safety Net Impact Statement has
4been filed, in a newspaper having general circulation within
5the area affected by the application. If no newspaper has a
6general circulation within the county, the Board shall post
7the notice in 5 conspicuous places within the proposed area.
8    (f) Any person, community organization, provider, or
9health system or other entity wishing to comment upon or
10oppose the application may file a Safety Net Impact Statement
11Response with the Board, which shall provide additional
12information concerning a project's impact on safety net
13services in the community.
14    (g) Applicants shall be provided an opportunity to submit
15a reply to any Safety Net Impact Statement Response.
16    (h) The State Board Staff Report shall include a statement
17as to whether a Safety Net Impact Statement was filed by the
18applicant and whether it included information on charity care,
19the amount of care provided to Medicaid patients, and
20information on teaching, research, or any other service
21provided by the applicant directly relevant to safety net
22services. The report shall also indicate the names of the
23parties submitting responses and the number of responses and
24replies, if any, that were filed.
25(Source: P.A. 100-518, eff. 6-1-18.)
 

 

 

HB3657 Engrossed- 27 -LRB102 13678 RJF 19028 b

1    (20 ILCS 3960/5.5 new)
2    Sec. 5.5. Emergency Medicine and Trauma Systems Impact
3Statement.
4    (a) Review criteria shall include a requirement that all
5general acute hospitals applying to discontinue a facility,
6intensive care services, or another category of service
7relevant to emergency medical service and trauma systems
8identified by rule by the Board include in its application an
9Emergency Medicine and Trauma Systems Impact Statement.
10    (b) As developed by the applicant, an Emergency Medicine
11and Trauma Systems Impact Statement shall describe all of the
12following:
13        (1) How the discontinuation of the facility or service
14    will impact the availability of emergency medical and
15    trauma services for area populations, specifically
16    including those that experience difficulty accessing
17    health services or experience health disparities.
18        (2) How the discontinuation of the facility or service
19    might impact the remaining providers of emergency medical
20    and trauma services in the area, to the extent known by the
21    applicant.
22    (c) Emergency Medicine and Trauma Systems Impact
23Statements shall also include all of the following:
24        (1) A list of each resource identified in any
25    emergency medical service system program plan that will
26    cease to exist as a result of the facility or service

 

 

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1    discontinuation, with a description of its utilization in
2    the most recent 2 years for which data is available.
3        (2) A list of each resource identified in any trauma
4    or stroke center designation that will cease to exist as a
5    result of the facility or service discontinuation, with a
6    description of its utilization in the most recent 2 years
7    for which data is available.
8        (3) If any resource listed pursuant to paragraphs (1)
9    or (2) above was on diversion or bypass status or
10    otherwise not available during the 2 years, the statement
11    must list the times and reasons it was on bypass.
12    (d) The Board staff shall publish a notice, that an
13application accompanied by an Emergency Medicine and Trauma
14Systems Impact Statement has been filed, in a newspaper having
15general circulation within the area affected by the
16application. If no newspaper has a general circulation within
17the county, the Board shall post the notice in 5 conspicuous
18places within the proposed area. The public notice required by
19this subsection may be provided in conjunction with the notice
20required for a safety net impact statement pursuant to
21subsection (e) of Section 5.4.
22    (e) Any person, community organization, provider, or
23health system or other entity wishing to comment upon or
24oppose the application may file an Emergency Medical and
25Trauma Systems Impact Statement Response with the Board, which
26shall provide additional information concerning a project's

 

 

HB3657 Engrossed- 29 -LRB102 13678 RJF 19028 b

1impact on emergency medical and trauma services in the
2community.
3    (f) Applicants shall be provided an opportunity to submit
4a reply to any Emergency Medical and Trauma Systems Impact
5Statement Response.
6    (g) The State Board Staff Report shall include a statement
7as to whether an Emergency Medical and Trauma Systems Impact
8Statement was filed by the applicant and whether it included
9each item of information described in the lists of subsections
10(b) and (c) above. The report shall also indicate the names of
11the parties submitting responses and the number of responses
12and replies, if any, that were filed.
 
13    (20 ILCS 3960/5.6 new)
14    Sec. 5.6. Maternal and Child Health Impact Statement.
15    (a) Review criteria shall include a requirement that all
16general acute hospitals applying to discontinue a facility,
17obstetric services, pediatric services, neonatal intensive
18care services, or any other category of service relevant to
19maternal and child health identified by rule by the Board
20include in its application an Maternal and Child Health Impact
21Statement.
22    (b) As developed by the applicant, a Maternal and Child
23Health Impact Statement shall describe all of the following:
24        (1) How the discontinuation of the facility or service
25    will impact the availability of perinatal and maternal

 

 

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1    care services for area populations, specifically including
2    those that experience difficulty accessing health services
3    or experience health disparities.
4        (2) How the discontinuation of the facility or service
5    might impact the remaining providers of perinatal and
6    maternal care services in the area, to the extent known by
7    the applicant.
8    (c) Maternal and Child Health Impact Statements shall also
9include all of the following:
10        (1) A list of each resource identified in any
11    obstetric and neonatal service plan, hospital perinatal
12    care level designation, or maternal care level designation
13    that will cease to exist as a result of the facility or
14    service discontinuation, with a description of its
15    utilization in the most recent 2 years for which data is
16    available.
17        (2) A list of any resource that was developed through
18    initiatives set forth in Section 2310-222 of the
19    Department of Public Health Powers and Duties Law to
20    improve birth equity and reduce postpartum racial and
21    ethnic disparities, or that serves similar purposes that
22    will cease to exist as a result of the facility or service
23    discontinuation.
24    (d) The Board staff shall publish a notice, that an
25application accompanied by a Maternal and Child Health Impact
26Statement has been filed, in a newspaper having general

 

 

HB3657 Engrossed- 31 -LRB102 13678 RJF 19028 b

1circulation within the area affected by the application. If no
2newspaper has a general circulation within the county, the
3Board shall post the notice in 5 conspicuous places within the
4proposed area. The public notice required by this subsection
5may be provided in conjunction with the notice required for a
6safety net impact statement pursuant to subsection (e) of
7Section 5.4.
8    (e) Any person, community organization, provider, or
9health system or other entity wishing to comment upon or
10oppose the application may file a Maternal and Child Health
11Impact Statement Response with the Board, which shall provide
12additional information concerning a project's impact on
13maternal and child health services in the community.
14    (f) Applicants shall be provided an opportunity to submit
15a reply to any Maternal and Child Health Impact Statement
16Response.
17    (g) The State Board Staff Report shall include a statement
18as to whether a Maternal and Child Health Impact Statement was
19filed by the applicant and whether it included each item of
20information described in the lists of subsections (b) and (c)
21above. The report shall also indicate the names of the parties
22submitting responses and the number of responses and replies,
23if any, that were filed.
 
24    (20 ILCS 3960/6)  (from Ch. 111 1/2, par. 1156)
25    (Section scheduled to be repealed on December 31, 2029)

 

 

HB3657 Engrossed- 32 -LRB102 13678 RJF 19028 b

1    Sec. 6. Application for permit or exemption; exemption
2regulations.
3    (a) An application for a permit or exemption shall be made
4to the State Board upon forms provided by the State Board. This
5application shall contain such information as the State Board
6deems necessary. The State Board shall not require an
7applicant to file a Letter of Intent before an application is
8filed. Such application shall include affirmative evidence on
9which the State Board or Chairman may make its decision on the
10approval or denial of the permit or exemption.
11    (b) The State Board shall establish by regulation the
12procedures and requirements regarding issuance of exemptions.
13An exemption shall be approved when information required by
14the Board by rule is submitted. Projects eligible for an
15exemption, rather than a permit, shall be include, but are not
16limited to, change of ownership of a health care facility,
17establishment or expansion of a neonatal intensive care
18category of service, and discontinuation of a category of
19service, other than at a hospital, or a health care facility
20maintained by the State or any agency or department thereof or
21a nursing home maintained by a county. The Board may accept an
22application for an exemption for the discontinuation of a
23category of service at any other a health care facility only
24once in a 6-month period following (1) the previous
25application for exemption at the same health care facility or
26(2) the final decision of the Board regarding the

 

 

HB3657 Engrossed- 33 -LRB102 13678 RJF 19028 b

1discontinuation of a category of service at the same health
2care facility, whichever occurs later. A discontinuation of a
3category of service shall otherwise require an application for
4a permit if an application for an exemption has already been
5accepted within the 6-month period. For a change of ownership
6among related persons of a health care facility, the State
7Board shall provide by rule for an expedited process for
8obtaining an exemption. For the purposes of this Section,
9"change of ownership among related persons" means a
10transaction in which the parties to the transaction are under
11common control or ownership before and after the transaction
12is complete.
13    (c) All applications shall be signed by the applicant and
14shall be verified by any 2 officers thereof.
15    (c-5) Any written review or findings of the Board staff
16set forth in the State Board Staff Report concerning an
17application for a permit must be made available to the public
18and the applicant at least 14 calendar days before the meeting
19of the State Board at which the review or findings are
20considered. The applicant and members of the public may
21submit, to the State Board, written responses regarding the
22facts set forth in the review or findings of the Board staff.
23Members of the public and the applicant shall have until 10
24days before the meeting of the State Board to submit any
25written response concerning the Board staff's written review
26or findings. The Board staff may revise any findings to

 

 

HB3657 Engrossed- 34 -LRB102 13678 RJF 19028 b

1address corrections of factual errors cited in the public
2response. At the meeting, the State Board may, in its
3discretion, permit the submission of other additional written
4materials.
5    (d) Upon receipt of an application for a permit, the State
6Board shall approve and authorize the issuance of a permit if
7it finds (1) that the applicant is fit, willing, and able to
8provide a proper standard of health care service for the
9community with particular regard to the qualification,
10background and character of the applicant, (2) that economic
11feasibility is demonstrated in terms of effect on the existing
12and projected operating budget of the applicant and of the
13health care facility; in terms of the applicant's ability to
14establish and operate such facility in accordance with
15licensure regulations promulgated under pertinent state laws;
16and in terms of the projected impact on the total health care
17expenditures in the facility and community, (3) that
18safeguards are provided that assure that the establishment,
19construction or modification of the health care facility or
20acquisition of major medical equipment is consistent with the
21public interest, and (4) that the proposed project is
22consistent with the orderly and economic development of such
23facilities and equipment and is in accord with standards,
24criteria, or plans of need adopted and approved pursuant to
25the provisions of Section 12 of this Act. Notwithstanding the
26foregoing or any other provision of this Act, the State Board

 

 

HB3657 Engrossed- 35 -LRB102 13678 RJF 19028 b

1may deny issuance of a permit if it finds the project will
2plausibly increase health disparities.
3    (d-5) For an application for a permit to discontinue a
4hospital facility or service, the State Board shall consider:
5        (1) how the discontinuation of the facility or service
6    will impact safety net services;
7        (2) the emergency medical and trauma system impact, if
8    applicable;
9        (3) the maternal and child health impact, if
10    applicable; and
11        (4) the economic feasibility, based on the resources
12    of the applicant and related persons, of continued
13    operation as an alternative.
14    (e) The State Board may attach conditions to issuance of a
15permit requiring that certain disclosed support or subsidies
16received by the hospital must be repaid.
17(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18;
18101-83, eff. 7-15-19.)
 
19    (20 ILCS 3960/6.05 new)
20    Sec. 6.05. Hospital closure during a pandemic. The State
21Board shall not issue a permit or take any other action that
22would allow closure of a general acute care hospital to
23proceed during a public health emergency declared pursuant to
24the Illinois Emergency Management Act as the result of an
25infectious disease pandemic.
 

 

 

HB3657 Engrossed- 36 -LRB102 13678 RJF 19028 b

1    (20 ILCS 3960/6.2)
2    (Section scheduled to be repealed on December 31, 2029)
3    Sec. 6.2. Review of permits; State Board Staff Reports.
4Upon receipt of an application for a permit to establish,
5construct, or modify a health care facility, the State Board
6staff shall notify the applicant in writing within 10 working
7days either that the application is or is not substantially
8complete. If the application is substantially complete, the
9State Board staff shall notify the applicant of the beginning
10of the review process. If the application is not substantially
11complete, the Board staff shall explain within the 10-day
12period why the application is incomplete.
13    The State Board staff shall afford a reasonable amount of
14time as established by the State Board, but not to exceed 180
15120 days, for the review of the application. The 180-day
16120-day period begins on the day the application is found to be
17substantially complete, as that term is defined by the State
18Board. During the 180-day 120-day period, the applicant may
19request an extension. An applicant may modify the application
20at any time before a final administrative decision has been
21made on the application.
22    The State Board staff shall submit its State Board Staff
23Report to the State Board for its decision-making regarding
24approval or denial of the permit.
25    When an application for a permit is initially reviewed by

 

 

HB3657 Engrossed- 37 -LRB102 13678 RJF 19028 b

1State Board staff, as provided in this Section, the State
2Board shall, upon request by the applicant or an interested
3person, afford an opportunity for a public hearing within a
4reasonable amount of time after receipt of the complete
5application, but not to exceed 90 days after receipt of the
6complete application. Notice of the hearing shall be made
7promptly, not less than 10 days before the hearing, by
8certified mail to the applicant and, not less than 10 days
9before the hearing, by publication in a newspaper of general
10circulation in the area or community to be affected. The
11hearing shall be held in the area or community in which the
12proposed project is to be located and shall be for the purpose
13of allowing the applicant and any interested person to present
14public testimony concerning the approval, denial, renewal, or
15revocation of the permit. All interested persons attending the
16hearing shall be given a reasonable opportunity to present
17their views or arguments in writing or orally, and a record of
18all of the testimony shall accompany any findings of the State
19Board staff. The State Board shall adopt reasonable rules and
20regulations governing the procedure and conduct of the
21hearings.
22(Source: P.A. 99-114, eff. 7-23-15; 100-681, eff. 8-3-18.)
 
23    (20 ILCS 3960/8.5)
24    (Section scheduled to be repealed on December 31, 2029)
25    Sec. 8.5. Certificate of exemption for change of ownership

 

 

HB3657 Engrossed- 38 -LRB102 13678 RJF 19028 b

1of a health care facility; discontinuation of a category of
2service; public notice and public hearing.
3    (a) Upon a finding that an application for a change of
4ownership is complete, the State Board shall publish a legal
5notice on 3 consecutive days in a newspaper of general
6circulation in the area or community to be affected and afford
7the public an opportunity to request a hearing. If the
8application is for a facility located in a Metropolitan
9Statistical Area, an additional legal notice shall be
10published in a newspaper of limited circulation, if one
11exists, in the area in which the facility is located. If the
12newspaper of limited circulation is published on a daily
13basis, the additional legal notice shall be published on 3
14consecutive days. The applicant shall pay the cost incurred by
15the Board in publishing the change of ownership notice in
16newspapers as required under this subsection. The legal notice
17shall also be posted on the Health Facilities and Services
18Review Board's web site and sent to the State Representative
19and State Senator of the district in which the health care
20facility is located. An application for change of ownership of
21a hospital shall not be deemed complete without a signed
22certification that for a period of 2 years after the change of
23ownership transaction is effective, the hospital will not
24adopt a charity care policy that is more restrictive than the
25policy in effect during the year prior to the transaction. An
26application for change of ownership of a hospital shall not be

 

 

HB3657 Engrossed- 39 -LRB102 13678 RJF 19028 b

1deemed complete without a signed certification that for a
2period of 18 months after the change of ownership transaction
3is effective, the hospital will not pursue facility closure,
4and for a period of 6 months after the change of ownership
5transaction is effective, the hospital will not pursue
6discontinuation of any category of service. An application for
7a change of ownership need not contain signed transaction
8documents so long as it includes the following key terms of the
9transaction: names and background of the parties; structure of
10the transaction; the person who will be the licensed or
11certified entity after the transaction; the ownership or
12membership interests in such licensed or certified entity both
13prior to and after the transaction; fair market value of
14assets to be transferred; and the purchase price or other form
15of consideration to be provided for those assets. The issuance
16of the certificate of exemption shall be contingent upon the
17applicant submitting a statement to the Board within 90 days
18after the closing date of the transaction, or such longer
19period as provided by the Board, certifying that the change of
20ownership has been completed in accordance with the key terms
21contained in the application. If such key terms of the
22transaction change, a new application shall be required.
23    Where a change of ownership is among related persons, and
24there are no other changes being proposed at the health care
25facility that would otherwise require a permit or exemption
26under this Act, the applicant shall submit an application

 

 

HB3657 Engrossed- 40 -LRB102 13678 RJF 19028 b

1consisting of a standard notice in a form set forth by the
2Board briefly explaining the reasons for the proposed change
3of ownership. Once such an application is submitted to the
4Board and reviewed by the Board staff, the Board Chair shall
5take action on an application for an exemption for a change of
6ownership among related persons within 45 days after the
7application has been deemed complete, provided the application
8meets the applicable standards under this Section. If the
9Board Chair has a conflict of interest or for other good cause,
10the Chair may request review by the Board. Notwithstanding any
11other provision of this Act, for purposes of this Section, a
12change of ownership among related persons means a transaction
13where the parties to the transaction are under common control
14or ownership before and after the transaction is completed.
15    Nothing in this Act shall be construed as authorizing the
16Board to impose any conditions, obligations, or limitations,
17other than those required by this Section, with respect to the
18issuance of an exemption for a change of ownership, including,
19but not limited to, the time period before which a subsequent
20change of ownership of the health care facility could be
21sought, or the commitment to continue to offer for a specified
22time period any services currently offered by the health care
23facility.
24    (a-3) (Blank).
25    (a-5) Upon a finding that an application to discontinue a
26category of service is complete and provides the requested

 

 

HB3657 Engrossed- 41 -LRB102 13678 RJF 19028 b

1information, as specified by the State Board, an exemption
2shall be issued. No later than 30 days after the issuance of
3the exemption, the health care facility must give written
4notice of the discontinuation of the category of service to
5the State Senator and State Representative serving the
6legislative district in which the health care facility is
7located. No later than 90 days after a discontinuation of a
8category of service, the applicant must submit a statement to
9the State Board certifying that the discontinuation is
10complete.
11    (b) If a public hearing is requested, it shall be held at
12least 15 days but no more than 30 days after the date of
13publication of the legal notice in the community in which the
14facility is located. The hearing shall be held in the affected
15area or community in a place of reasonable size and
16accessibility and a full and complete written transcript of
17the proceedings shall be made. All interested persons
18attending the hearing shall be given a reasonable opportunity
19to present their positions in writing or orally. The applicant
20shall provide a summary or describe the proposed change of
21ownership at the public hearing.
22    (c) For the purposes of this Section "newspaper of limited
23circulation" means a newspaper intended to serve a particular
24or defined population of a specific geographic area within a
25Metropolitan Statistical Area such as a municipality, town,
26village, township, or community area, but does not include

 

 

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1publications of professional and trade associations.
2    (d) The changes made to this Section by this amendatory
3Act of the 101st General Assembly shall apply to all
4applications submitted after the effective date of this
5amendatory Act of the 101st General Assembly.
6(Source: P.A. 100-201, eff. 8-18-17; 101-83, eff. 7-15-19.)
 
7    (20 ILCS 3960/8.7)
8    (Section scheduled to be repealed on December 31, 2029)
9    Sec. 8.7. Application for permit for discontinuation of a
10health care facility or category of service; public notice and
11public hearing.
12    (a) Upon a finding that an application to close a health
13care facility or discontinue a category of service is
14complete, the State Board shall publish a legal notice on 3
15consecutive days in a newspaper of general circulation in the
16area or community to be affected and afford the public an
17opportunity to request a hearing. If the application is for a
18facility located in a Metropolitan Statistical Area, an
19additional legal notice shall be published in a newspaper of
20limited circulation, if one exists, in the area in which the
21facility is located. If the newspaper of limited circulation
22is published on a daily basis, the additional legal notice
23shall be published on 3 consecutive days. The legal notice
24shall also be posted on the Health Facilities and Services
25Review Board's website and sent to the State Representative

 

 

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1and State Senator of the district in which the health care
2facility is located. In addition, the health care facility
3shall provide notice of closure to the local media that the
4health care facility would routinely notify about facility
5events.
6    An application to close a health care facility shall only
7be deemed complete if it includes evidence that the health
8care facility provided written notice at least 30 days prior
9to filing the application of its intent to do so to the
10municipality in which it is located, the State Representative
11and State Senator of the district in which the health care
12facility is located, the State Board, the Director of Public
13Health, and the Director of Healthcare and Family Services.
14The changes made to this subsection by this amendatory Act of
15the 101st General Assembly shall apply to all applications
16submitted after the effective date of this amendatory Act of
17the 101st General Assembly.
18    (b) An application to close a hospital facility, or
19discontinue a hospital service if applicable, shall only be
20deemed complete when the applicant includes a list of public
21support or subsidies it has received without repaying or
22fulfilling obligations or any other public subsidies it has
23received in the past 5 years, including hospital assessment
24funded supplemental payments, capital development grants,
25public health grants, economic development grants and
26supports, and any other categories the Board may identify by

 

 

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1rule. In cases of service discontinuation, this requirement
2applies if the support or subsidy is specific to the service.
3    (c) In cases of hospital facility or service
4discontinuation, a public response to a safety net impact
5statement under subsection (f) of Section 5.4, emergency
6medicine and trauma system impact statement under subsection
7(e) of Section 5.5, or maternal and child health impact
8statement under subsection (e) of Section 5.6 may request an
9investigative hearing by the full board under the procedures
10set forth in Section 13. The Board may grant at its discretion
11any such requests for an investigative hearing. In response to
12one or more requests from any of the following, the Board shall
13conduct at minimum one investigative hearing with a scope
14covering the subject matter of all impact statements subject
15to such requests: (i) an elected official representing a
16district containing the hospital; (ii) an organization
17representing employees at the hospital; (iii) a safety net
18hospital or critical access hospital plausibly affected by the
19application; or (iv) at least 50 community members residing in
20the area affected by the application.
21    (d) No later than 30 days after issuance of a permit to
22close a health care facility or discontinue a category of
23service, the permit holder shall give written notice of the
24closure or discontinuation to the State Senator and State
25Representative serving the legislative district in which the
26health care facility is located.

 

 

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1    (e) (c) If there is a pending lawsuit that challenges an
2application to discontinue a health care facility that either
3names the Board as a party or alleges fraud in the filing of
4the application, the Board may defer action on the application
5until there is no longer such a lawsuit pending for up to 6
6months after the date of the initial deferral of the
7application.
8    (f) (d) The changes made to this Section by this
9amendatory Act of the 101st General Assembly shall apply to
10all applications submitted after the effective date of this
11amendatory Act of the 101st General Assembly.
12(Source: P.A. 101-83, eff. 7-15-19; 101-650, eff. 7-7-20.)
 
13    (20 ILCS 3960/12)  (from Ch. 111 1/2, par. 1162)
14    (Section scheduled to be repealed on December 31, 2029)
15    Sec. 12. Powers and duties of State Board. For purposes of
16this Act, the State Board shall exercise the following powers
17and duties:
18        (1) Prescribe rules, regulations, standards, criteria,
19    procedures or reviews which may vary according to the
20    purpose for which a particular review is being conducted
21    or the type of project reviewed and which are required to
22    carry out the provisions and purposes of this Act.
23    Policies and procedures of the State Board shall take into
24    consideration the priorities and needs of medically
25    underserved areas and other health care services, giving

 

 

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1    special consideration to the impact of projects on access
2    to safety net services.
3        (2) Adopt procedures for public notice and hearing on
4    all proposed rules, regulations, standards, criteria, and
5    plans required to carry out the provisions of this Act.
6        (3) (Blank).
7        (4) Develop criteria and standards for health care
8    facilities planning, conduct statewide inventories of
9    health care facilities, maintain an updated inventory on
10    the Board's web site reflecting the most recent bed and
11    service changes and updated need determinations when new
12    census data become available or new need formulae are
13    adopted, and develop health care facility plans which
14    shall be utilized in the review of applications for permit
15    under this Act. Such health facility plans shall be
16    coordinated by the Board with pertinent State Plans.
17    Inventories pursuant to this Section of skilled or
18    intermediate care facilities licensed under the Nursing
19    Home Care Act, skilled or intermediate care facilities
20    licensed under the ID/DD Community Care Act, skilled or
21    intermediate care facilities licensed under the MC/DD Act,
22    facilities licensed under the Specialized Mental Health
23    Rehabilitation Act of 2013, or nursing homes licensed
24    under the Hospital Licensing Act shall be conducted on an
25    annual basis no later than July 1 of each year and shall
26    include among the information requested a list of all

 

 

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1    services provided by a facility to its residents and to
2    the community at large and differentiate between active
3    and inactive beds.
4        In developing health care facility plans, the State
5    Board shall consider, but shall not be limited to, the
6    following:
7            (a) The size, composition and growth of the
8        population of the area to be served;
9            (a-5) The incidence of diseases or health
10        conditions that correlate with a need for services or
11        facilities, determined either directly or through a
12        comparison of the population characteristics of an
13        area with those of a similar, larger, or encompassing
14        reference area;
15            (b) The number of existing and planned facilities
16        offering similar programs;
17            (c) The extent of utilization of existing
18        facilities;
19            (c-5) Size, composition, and growth of the
20        population covered by Medicaid relative to existing
21        services;
22            (d) The availability of facilities which may serve
23        as alternatives or substitutes;
24            (e) The availability of personnel necessary to the
25        operation of the facility;
26            (f) Multi-institutional planning and the

 

 

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1        establishment of multi-institutional systems where
2        feasible;
3            (f-5) Impact on safety net services including
4        safety net and critical access hospitals;
5            (g) The financial and economic feasibility of
6        proposed construction or modification; and
7            (h) In the case of health care facilities
8        established by a religious body or denomination, the
9        needs of the members of such religious body or
10        denomination may be considered to be public need; .
11            (i) The presence and severity of health
12        disparities among the population to be served,
13        including consideration of disparities in healthcare
14        access and outcomes by income, race and ethnic
15        identity, and preferred language; and
16            (j) Beginning 2 years after the effective date of
17        this amendatory Act of the 102nd General Assembly,
18        need formulae shall be based on incidence of diseases
19        or health conditions that correlate with the need for
20        a service and shall adjust such incidence by
21        disparities among the population described in
22        paragraph (i) above. The Office of Policy, Planning,
23        and Statistics; the Center for Minority Health
24        Services; the Center for Rural Health; and, at the
25        discretion of the Director, any other division of the
26        Department shall provide support in the development of

 

 

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1        new formulae, data, and planning policies if requested
2        by the Board. The Board shall adopt rules to implement
3        this paragraph (j).
4            
5        The health care facility plans which are developed and
6    adopted in accordance with this Section shall form the
7    basis for the plan of the State to deal most effectively
8    with statewide health needs in regard to health care
9    facilities.
10        (5) Coordinate with other state agencies having
11    responsibilities affecting health care facilities,
12    including those of licensure and cost reporting.
13        (6) Solicit, accept, hold and administer on behalf of
14    the State any grants or bequests of money, securities or
15    property for use by the State Board in the administration
16    of this Act; and enter into contracts consistent with the
17    appropriations for purposes enumerated in this Act.
18        (7) (Blank).
19        (7.5) Protect safety net services.
20        (8) Prescribe rules, regulations, standards, and
21    criteria for the conduct of an expeditious review of
22    applications for permits for projects of construction or
23    modification of a health care facility, which projects are
24    classified as emergency, substantive, or non-substantive
25    in nature.
26        Substantive projects shall include no more than the

 

 

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1    following:
2            (a) Projects to construct (1) a new or replacement
3        facility located on a new site or (2) a replacement
4        facility located on the same site as the original
5        facility and the cost of the replacement facility
6        exceeds the capital expenditure minimum, which shall
7        be reviewed by the Board within 120 days;
8            (b) Projects proposing a (1) new service within an
9        existing healthcare facility or (2) discontinuation of
10        a service within an existing healthcare facility,
11        which shall be reviewed by the Board within 60 days; or
12            (c) Projects proposing a change in the bed
13        capacity of a health care facility by an increase in
14        the total number of beds or by a redistribution of beds
15        among various categories of service or by a relocation
16        of beds from one physical facility or site to another
17        by more than 20 beds or more than 10% of total bed
18        capacity, as defined by the State Board, whichever is
19        less, over a 2-year period.
20        The Chairman may approve applications for exemption
21    that meet the criteria set forth in rules or refer them to
22    the full Board. The Chairman may approve any unopposed
23    application that meets all of the review criteria or refer
24    them to the full Board.
25        Such rules shall not prevent the conduct of a public
26    hearing upon the timely request of an interested party.

 

 

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

 

 

HB3657 Engrossed- 52 -LRB102 13678 RJF 19028 b

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

 

 

HB3657 Engrossed- 53 -LRB102 13678 RJF 19028 b

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

 

 

HB3657 Engrossed- 54 -LRB102 13678 RJF 19028 b

1    reflective of the changing long-term care marketplace and
2    consumer preferences and submit its recommendations to the
3    Chairman of the Board no later than January 1, 2017. The
4    Subcommittee shall evaluate, and make recommendations to
5    the State Board regarding, the buying, selling, and
6    exchange of beds between long-term care facilities within
7    a specified geographic area or drive time. The Board shall
8    file the proposed related administrative rules for the
9    separate rules and guidelines for long-term care required
10    by this paragraph (15) by no later than September 30,
11    2011. The Subcommittee shall be provided a reasonable and
12    timely opportunity to review and comment on any review,
13    revision, or updating of the criteria, standards,
14    procedures, and rules used to evaluate project
15    applications as provided under Section 12.3 of this Act.
16        The Chairman of the Board shall appoint voting members
17    of the Subcommittee, who shall serve for a period of 3
18    years, with one-third of the terms expiring each January,
19    to be determined by lot. Appointees shall include, but not
20    be limited to, recommendations from each of the 3
21    statewide long-term care associations, with an equal
22    number to be appointed from each. Compliance with this
23    provision shall be through the appointment and
24    reappointment process. All appointees serving as of April
25    1, 2015 shall serve to the end of their term as determined
26    by lot or until the appointee voluntarily resigns,

 

 

HB3657 Engrossed- 55 -LRB102 13678 RJF 19028 b

1    whichever is earlier.
2        One representative from the Department of Public
3    Health, the Department of Healthcare and Family Services,
4    the Department on Aging, and the Department of Human
5    Services may each serve as an ex-officio non-voting member
6    of the Subcommittee. The Chairman of the Board shall
7    select a Subcommittee Chair, who shall serve for a period
8    of 3 years.
9        (16) Prescribe the format of the State Board Staff
10    Report. A State Board Staff Report shall pertain to
11    applications that include, but are not limited to,
12    applications for permit or exemption, applications for
13    permit renewal, applications for extension of the
14    financial commitment period, applications requesting a
15    declaratory ruling, or applications under the Health Care
16    Worker Self-Referral Act. State Board Staff Reports shall
17    compare applications to the relevant review criteria under
18    the Board's rules.
19        (17) Establish a separate set of rules and guidelines
20    for facilities licensed under the Specialized Mental
21    Health Rehabilitation Act of 2013. An application for the
22    re-establishment of a facility in connection with the
23    relocation of the facility shall not be granted unless the
24    applicant has a contractual relationship with at least one
25    hospital to provide emergency and inpatient mental health
26    services required by facility consumers, and at least one

 

 

HB3657 Engrossed- 56 -LRB102 13678 RJF 19028 b

1    community mental health agency to provide oversight and
2    assistance to facility consumers while living in the
3    facility, and appropriate services, including case
4    management, to assist them to prepare for discharge and
5    reside stably in the community thereafter. No new
6    facilities licensed under the Specialized Mental Health
7    Rehabilitation Act of 2013 shall be established after June
8    16, 2014 (the effective date of Public Act 98-651) except
9    in connection with the relocation of an existing facility
10    to a new location. An application for a new location shall
11    not be approved unless there are adequate community
12    services accessible to the consumers within a reasonable
13    distance, or by use of public transportation, so as to
14    facilitate the goal of achieving maximum individual
15    self-care and independence. At no time shall the total
16    number of authorized beds under this Act in facilities
17    licensed under the Specialized Mental Health
18    Rehabilitation Act of 2013 exceed the number of authorized
19    beds on June 16, 2014 (the effective date of Public Act
20    98-651).
21        (18) Elect a Vice Chairman to preside over State Board
22    meetings and otherwise act in place of the Chairman when
23    the Chairman is unavailable.
24(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18;
25101-83, eff. 7-15-19.)
 

 

 

HB3657 Engrossed- 57 -LRB102 13678 RJF 19028 b

1    (20 ILCS 3960/12.3)
2    (Section scheduled to be repealed on December 31, 2029)
3    Sec. 12.3. Revision of criteria, standards, and rules. At
4least every 2 years, the State Board shall review, revise, and
5update the criteria, standards, and rules used to evaluate
6applications for permit and exemption. The Board may appoint
7temporary advisory committees made up of experts with
8professional competence in the subject matter of the proposed
9standards or criteria to assist in the development of
10revisions to requirements, standards, and criteria. In
11particular, the review of the criteria, standards, and rules
12shall consider:
13        (1) Whether the requirements, criteria, and standards
14    reflect current industry standards and anticipated trends.
15        (2) Whether the criteria and standards can be reduced
16    or eliminated.
17        (3) Whether requirements, criteria, and standards can
18    be developed to authorize the construction of unfinished
19    space for future use when the ultimate need for such space
20    can be reasonably projected.
21        (4) Whether the criteria and standards take into
22    account issues related to population growth, and changing
23    demographics, the population covered by Medicaid, and the
24    presence and severity of health disparities in a
25    community, which at minimum must include consideration of
26    disparities in healthcare access and outcomes by income,

 

 

HB3657 Engrossed- 58 -LRB102 13678 RJF 19028 b

1    race and ethnic identity, and preferred language.
2        (5) Whether facility-defined service and planning
3    areas should be recognized.
4        (6) Whether categories of service that are subject to
5    review should be re-evaluated, including provisions
6    related to structural, functional, and operational
7    differences between long-term care facilities and acute
8    care facilities and that allow routine changes of
9    ownership, facility sales, and closure requests to be
10    processed on a more timely basis.
11(Source: P.A. 99-527, eff. 1-1-17; 100-681, eff. 8-3-18.)
 
12    (20 ILCS 3960/12.4)
13    (Section scheduled to be repealed on December 31, 2029)
14    Sec. 12.4. Hospital reduction in health care services;
15notice. If a hospital reduces any of the Categories of Service
16as outlined in Title 77, Chapter II, Part 1110 in the Illinois
17Administrative Code, or any other service as defined by rule
18by the State Board, by 50% or more according to rules adopted
19by the State Board, then within 30 days after reducing the
20service, the hospital must give written notice of the
21reduction in service to the State Board, the Department of
22Public Health, and the State Senator and State Representative
23serving the legislative district in which the hospital is
24located. The State Board shall publish the notice on its
25website. Any party receiving notice may request a safety net

 

 

HB3657 Engrossed- 59 -LRB102 13678 RJF 19028 b

1impact statement, emergency medicine and trauma system impact
2statement, or maternal and child health impact statement, as
3described at: (i) subsections (c) and (d) of Section 5.4; (ii)
4subsections (b) and (c) of Section 5.5; and (iii) subsections
5(b) and (c) of Section 5.6, respectively, to be filed
6describing impact of the reduction in services. The State
7Board shall adopt rules to implement this Section, including
8rules that specify (i) how each health care service is
9defined, if not already defined in the State Board's rules,
10and (ii) what constitutes a reduction in service of 50% or
11more.
12(Source: P.A. 100-681, eff. 8-3-18.)
 
13    (20 ILCS 3960/13.1)  (from Ch. 111 1/2, par. 1163.1)
14    (Section scheduled to be repealed on December 31, 2029)
15    Sec. 13.1. Any person establishing, constructing, or
16modifying a health care facility or portion thereof without
17obtaining a required permit, or in violation of the terms of
18the required permit, shall not be eligible to apply for any
19necessary operating licenses or be eligible for payment by any
20State agency for services rendered in that facility until the
21required permit is obtained. In cases of any person
22discontinuing a hospital facility or category of service
23without obtaining a required permit, or in violation of the
24terms of the required permit, no related person shall be
25eligible to apply for any necessary operating licenses nor

 

 

HB3657 Engrossed- 60 -LRB102 13678 RJF 19028 b

1shall any related person be eligible for payment by any State
2agency for services rendered until the required permit is
3obtained.
4(Source: P.A. 88-18.)
 
5    (20 ILCS 3960/14)  (from Ch. 111 1/2, par. 1164)
6    (Section scheduled to be repealed on December 31, 2029)
7    Sec. 14. Any person who has discontinued a hospital or a
8category of service at a hospital without a permit or
9exemption issued under this Act or in violation of the terms of
10such a permit or exemption is guilty of a business offense and
11may be fined up to $1,000,000. Any person otherwise acquiring
12major medical equipment or establishing, constructing or
13modifying a health care facility without a permit issued under
14this Act or in violation of the terms of such a permit is
15guilty of a business offense and may be fined up to $100,000
16$25,000. The State's Attorneys of the several counties or the
17Attorney General shall represent the People of the State of
18Illinois in proceedings under this Section. The State's
19Attorneys of the several counties or the Attorney General may
20additionally maintain an action in the name of the People of
21the State of Illinois for injunction or other process against
22any person or governmental unit to restrain or prevent the
23acquisition of major medical equipment, or the establishment,
24construction or modification of a health care facility without
25the required permit, or to restrain or prevent the occupancy

 

 

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1or utilization of the equipment acquired or facility which was
2constructed or modified without the required permit.
3Proceedings The prosecution of an offense under this Section,
4including the prosecution of an offense, shall not prohibit
5the imposition of any other sanction provided under this Act.
6(Source: P.A. 88-18.)
 
7    (20 ILCS 3960/14.05 new)
8    Sec. 14.05. Right of action. Any person aggrieved by a
9violation of this Act, due to a negative impact on their access
10to health care or on their health due to diminished access to
11health care, involving the discontinuation of a hospital or a
12discontinuation of a category of service at a hospital without
13a permit or exemption as required by this Act shall have a
14right of action in a State circuit court or as a supplemental
15claim in federal district court against an offending party. A
16prevailing party may recover for each violation: (i) any
17actual damages; (ii) an injunction or other relief as the
18court may deem appropriate; and (iii) reasonable attorney's
19fees.
 
20    (20 ILCS 3960/14.1)
21    (Section scheduled to be repealed on December 31, 2029)
22    Sec. 14.1. Denial of permit; other sanctions.
23    (a) The State Board may deny an application for a permit or
24may revoke or take other action as permitted by this Act with

 

 

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1regard to a permit as the State Board deems appropriate,
2including the imposition of fines as set forth in this
3Section, for any one or a combination of the following:
4        (1) The acquisition of major medical equipment without
5    a permit or in violation of the terms of a permit.
6        (2) The establishment, construction, modification, or
7    change of ownership of a health care facility without a
8    permit or exemption or in violation of the terms of a
9    permit.
10        (3) The violation of any provision of this Act or any
11    rule adopted under this Act.
12        (4) The failure, by any person subject to this Act, to
13    provide information requested by the State Board or Agency
14    within 30 days after a formal written request for the
15    information.
16        (5) The failure to pay any fine imposed under this
17    Section within 30 days of its imposition.
18    (a-5) For facilities licensed under the ID/DD Community
19Care Act, no permit shall be denied on the basis of prior
20operator history, other than for actions specified under item
21(2), (4), or (5) of Section 3-117 of the ID/DD Community Care
22Act. For facilities licensed under the MC/DD Act, no permit
23shall be denied on the basis of prior operator history, other
24than for actions specified under item (2), (4), or (5) of
25Section 3-117 of the MC/DD Act. For facilities licensed under
26the Specialized Mental Health Rehabilitation Act of 2013, no

 

 

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1permit shall be denied on the basis of prior operator history,
2other than for actions specified under subsections (a) and (b)
3of Section 4-109 of the Specialized Mental Health
4Rehabilitation Act of 2013. For facilities licensed under the
5Nursing Home Care Act, no permit shall be denied on the basis
6of prior operator history, other than for: (i) actions
7specified under item (2), (3), (4), (5), or (6) of Section
83-117 of the Nursing Home Care Act; (ii) actions specified
9under item (a)(6) of Section 3-119 of the Nursing Home Care
10Act; or (iii) actions within the preceding 5 years
11constituting a substantial and repeated failure to comply with
12the Nursing Home Care Act or the rules and regulations adopted
13by the Department under that Act. The State Board shall not
14deny a permit on account of any action described in this
15subsection (a-5) without also considering all such actions in
16the light of all relevant information available to the State
17Board, including whether the permit is sought to substantially
18comply with a mandatory or voluntary plan of correction
19associated with any action described in this subsection (a-5).
20    (b) Persons shall be subject to fines as provided in this
21subsection (b). The maximum fines imposed under this
22subsection (b) shall be annually adjusted and proportional
23with the increase in construction costs due to inflation, for
24major medical equipment and for all other capital
25expenditures. as follows:
26        (1) A permit holder who fails to comply with the

 

 

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1    requirements of maintaining a valid permit shall be fined
2    an amount not to exceed 1% of the approved permit amount
3    plus an additional 1% of the approved permit amount for
4    each 30-day period, or fraction thereof, that the
5    violation continues.
6        (2) A permit holder who alters the scope of an
7    approved project or whose project costs exceed the
8    allowable permit amount without first obtaining approval
9    from the State Board shall be fined an amount not to exceed
10    the sum of (i) the lesser of $40,000 $25,000 or 2% of the
11    approved permit amount and (ii) in those cases where the
12    approved permit amount is exceeded by more than
13    $1,000,000, an additional $40,000 $20,000 for each
14    $1,000,000, or fraction thereof, in excess of the approved
15    permit amount.
16        (2.5) A permit or exemption holder who fails to comply
17    with the post-permit and reporting requirements set forth
18    in Sections 5 and 8.5 shall be fined an amount not to
19    exceed $18,000 $10,000 plus an additional $18,000 $10,000
20    for each 30-day period, or fraction thereof, that the
21    violation continues. The accrued fine is not waived by the
22    permit or exemption holder submitting the required
23    information and reports. Prior to any fine beginning to
24    accrue, the Board shall notify, in writing, a permit or
25    exemption holder of the due date for the post-permit and
26    reporting requirements no later than 30 days before the

 

 

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1    due date for the requirements. The exemption letter shall
2    serve as the notice for exemptions.
3        (3) A person who acquires major medical equipment or
4    who establishes a category of service without first
5    obtaining a permit or exemption, as the case may be, shall
6    be fined an amount not to exceed $18,000 $10,000 for each
7    such acquisition or category of service established plus
8    an additional $18,000 $10,000 for each 30-day period, or
9    fraction thereof, that the violation continues.
10        (4) A person who constructs, modifies, establishes, or
11    changes ownership of a health care facility without first
12    obtaining a permit or exemption shall be fined an amount
13    not to exceed $40,000 $25,000 plus an additional $40,000
14    $25,000 for each 30-day period, or fraction thereof, that
15    the violation continues.
16        (5) A person who discontinues a health care facility
17    other than a hospital or a category of service at a health
18    care facility other than a hospital without first
19    obtaining a permit or exemption shall be fined an amount
20    not to exceed $25,000 $10,000 plus an additional $25,000
21    $10,000 for each 30-day period, or fraction thereof, that
22    the violation continues. For purposes of this subparagraph
23    (5), facilities licensed under the Nursing Home Care Act,
24    the ID/DD Community Care Act, or the MC/DD Act, with the
25    exceptions of facilities operated by a county or Illinois
26    Veterans Homes, are exempt from this permit requirement.

 

 

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1    However, facilities licensed under the Nursing Home Care
2    Act, the ID/DD Community Care Act, or the MC/DD Act must
3    comply with Section 3-423 of the Nursing Home Care Act,
4    Section 3-423 of the ID/DD Community Care Act, or Section
5    3-423 of the MC/DD Act and must provide the Board and the
6    Department of Human Services with 30 days' written notice
7    of their intent to close. Facilities licensed under the
8    ID/DD Community Care Act or the MC/DD Act also must
9    provide the Board and the Department of Human Services
10    with 30 days' written notice of their intent to reduce the
11    number of beds for a facility.
12        (5.5) A person who discontinues a hospital facility or
13    category of service without first obtaining a permit or
14    exemption shall be fined an amount not to exceed $100,000
15    plus an additional $100,000 for each 30-day period, or
16    fraction thereof, that the violation continues.
17        (6) A person subject to this Act who fails to provide
18    information requested by the State Board or Agency within
19    30 days of a formal written request shall be fined an
20    amount not to exceed $2,000 $1,000 plus an additional
21    $2,000 $1,000 for each 30-day period, or fraction thereof,
22    that the information is not received by the State Board or
23    Agency.
24    (b-5) The State Board may accept in-kind services or
25donations instead of or in combination with the imposition of
26a fine. This authorization is limited to cases where the

 

 

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1non-compliant individual or entity has waived the right to an
2administrative hearing or opportunity to appear before the
3Board regarding the non-compliant matter.
4    (c) Before imposing any fine authorized under this
5Section, the State Board shall afford the person or permit
6holder, as the case may be, an appearance before the State
7Board and an opportunity for a hearing before a hearing
8officer appointed by the State Board. The hearing shall be
9conducted in accordance with Section 10. Requests for an
10appearance before the State Board must be made within 30 days
11after receiving notice that a fine will be imposed.
12    (d) All fines collected under this Act shall be
13transmitted to the State Treasurer, who shall deposit them
14into the Illinois Health Facilities Planning Fund.
15    (e) Fines imposed under this Section shall continue to
16accrue until: (i) the date that the matter is referred by the
17State Board to the Board's legal counsel; or (ii) the date that
18the health care facility becomes compliant with the Act,
19whichever is earlier.
20(Source: P.A. 99-114, eff. 7-23-15; 99-180, eff. 7-29-15;
2199-527, eff. 1-1-17; 99-642, eff. 6-28-16; 100-681, eff.
228-3-18.)
 
23    Section 15. The Illinois Public Aid Code is amended by
24changing Section 5A-17 as follows:
 

 

 

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1    (305 ILCS 5/5A-17)
2    Sec. 5A-17. Recovery of payments; liens.
3    (a) As a condition of receiving payments pursuant to
4subsections (d) and (k) of Section 5A-12.7 for State Fiscal
5Year 2021, a for-profit general acute care hospital that
6ceases to provide hospital services before July 1, 2021 and
7within 12 months of a change in the hospital's ownership
8status from not-for-profit to investor owned, shall be
9obligated to pay to the Department an amount equal to the
10payments received pursuant to subsections (d) and (k) of
11Section 5A-12.7 since the change in ownership status to the
12cessation of hospital services. The obligated amount shall be
13due immediately and must be paid to the Department within 10
14days of ceasing to provide services or pursuant to a payment
15plan approved by the Department unless the hospital requests a
16hearing under paragraph (d) of this Section. The obligation
17under this Section shall not apply to a hospital that ceases to
18provide services under circumstances that include:
19implementation of a transformation project approved by the
20Department under subsection (d-5) of Section 14-12;
21emergencies as declared by federal, State, or local
22government; actions approved or required by federal, State, or
23local government; actions taken in compliance with the
24Illinois Health Facilities Planning Act; or other
25circumstances beyond the control of the hospital provider or
26for the benefit of the community previously served by the

 

 

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1hospital, as determined on a case-by-case basis by the
2Department.
3    (a-5) As a condition of receiving payments pursuant to
4subsections (d) and (k) of Section 5A-12.7 for calendar year
52021, a general acute care hospital that ceases to provide
6hospital services before January 1, 2022 shall be obligated to
7pay to the Department an amount equal to the payments received
8pursuant to subsections (d) and (k) of Section 5A-12.7 up to
9the cessation of hospital services. The obligated amount shall
10be due immediately and must be paid to the Department within 30
11days of ceasing to provide services, or pursuant to a payment
12plan approved by the Department. The obligation under this
13Section shall not apply to a hospital that ceases to provide
14services under circumstances that include: (i) implementation
15of a transformation project approved under subsection (d-5) of
16Section 14-12; (ii) emergencies as declared by federal, State,
17or local government; (iii) actions approved or required by
18federal, State, or local government; (iv) actions taken in
19compliance with the Illinois Health Facilities Planning Act;
20or (v) other circumstances beyond the control of the hospital
21provider or for the benefit of the community previously served
22by the hospital, as determined on a case-by-case basis by the
23Department.
24    (b) The Illinois Department shall administer and enforce
25this Section and collect the obligations imposed under this
26Section using procedures employed in its administration of

 

 

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1this Code generally. The Illinois Department, its Director,
2and every hospital provider subject to this Section shall have
3the following powers, duties, and rights:
4        (1) The Illinois Department may initiate either
5    administrative or judicial proceedings, or both, to
6    enforce the provisions of this Section. Administrative
7    enforcement proceedings initiated hereunder shall be
8    governed by the Illinois Department's administrative
9    rules. Judicial enforcement proceedings initiated in
10    accordance with this Section shall be governed by the
11    rules of procedure applicable in the courts of this State.
12        (2) No proceedings for collection, refund, credit, or
13    other adjustment of an amount payable under this Section
14    shall be issued more than 3 years after the due date of the
15    obligation, except in the case of an extended period
16    agreed to in writing by the Illinois Department and the
17    hospital provider before the expiration of this limitation
18    period.
19        (3) Any unpaid obligation under this Section shall
20    become a lien upon the assets of the hospital. If any
21    hospital provider sells or transfers the major part of any
22    one or more of (i) the real property and improvements,
23    (ii) the machinery and equipment, or (iii) the furniture
24    or fixtures of any hospital that is subject to the
25    provisions of this Section, the seller or transferor shall
26    pay the Illinois Department the amount of any obligation

 

 

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1    due from it under this Section up to the date of the sale
2    or transfer. If the seller or transferor fails to pay any
3    amount due under this Section, the purchaser or transferee
4    of such asset shall be liable for the amount of the
5    obligation up to the amount of the reasonable value of the
6    property acquired by the purchaser or transferee. The
7    purchaser or transferee shall continue to be liable until
8    the purchaser or transferee pays the full amount of the
9    obligation up to the amount of the reasonable value of the
10    property acquired by the purchaser or transferee or until
11    the purchaser or transferee receives from the Illinois
12    Department a certificate showing that such assessment,
13    penalty, and interest have been paid or a certificate from
14    the Illinois Department showing that no amount is due from
15    the seller or transferor under this Section.
16    (c) In addition to any other remedy provided for, the
17Illinois Department may collect an unpaid obligation by
18withholding, as payment of the amount due, reimbursements or
19other amounts otherwise payable by the Illinois Department to
20the hospital provider.
21(Source: P.A. 101-650, eff. 7-7-20.)
 
22    Section 99. Effective date. This Act takes effect upon
23becoming law.