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


Rep. Kathleen Willis

Filed: 5/23/2019





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2    AMENDMENT NO. ______. Amend Senate Bill 1739 by replacing
3everything after the enacting clause with the following:
4    "Section 5. The Illinois Health Facilities Planning Act is
5amended by changing Sections 6, 8.5, 12, and 12.2 and by adding
6Section 8.7 as follows:
7    (20 ILCS 3960/6)  (from Ch. 111 1/2, par. 1156)
8    (Section scheduled to be repealed on December 31, 2029)
9    Sec. 6. Application for permit or exemption; exemption
11    (a) An application for a permit or exemption shall be made
12to the State Board upon forms provided by the State Board. This
13application shall contain such information as the State Board
14deems necessary. The State Board shall not require an applicant
15to file a Letter of Intent before an application is filed. Such
16application shall include affirmative evidence on which the



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1State Board or Chairman may make its decision on the approval
2or denial of the permit or exemption.
3    (b) The State Board shall establish by regulation the
4procedures and requirements regarding issuance of exemptions.
5An exemption shall be approved when information required by the
6Board by rule is submitted. Projects eligible for an exemption,
7rather than a permit, include, but are not limited to, change
8of ownership of a health care facility and discontinuation of a
9category of service , discontinuation of a category of service,
10and discontinuation of a health care facility, other than a
11health care facility maintained by the State or any agency or
12department thereof or a nursing home maintained by a county.
13The Board may accept an application for an exemption for the
14discontinuation of a category of service at a health care
15facility only once in a 6-month period following (1) the
16previous application for exemption at the same health care
17facility or (2) the final decision of the Board regarding the
18discontinuation of a category service at the same health care
19facility, whichever occurs later. A discontinuation of a
20category of service shall otherwise require an application for
21a permit if an application for an exemption has already been
22accepted within the 6-month period. For a change of ownership
23among related persons of a health care facility, the State
24Board shall provide by rule for an expedited process for
25obtaining an exemption in accordance with Section 8.5 of this
26Act. For the purposes of this Section, "change of ownership



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1among related persons" means a transaction in which the parties
2to the transaction are under common control or ownership before
3and after the transaction is complete.
4    (c) All applications shall be signed by the applicant and
5shall be verified by any 2 officers thereof.
6    (c-5) Any written review or findings of the Board staff set
7forth in the State Board Staff Report concerning an application
8for a permit must be made available to the public and the
9applicant at least 14 calendar days before the meeting of the
10State Board at which the review or findings are considered. The
11applicant and members of the public may submit, to the State
12Board, written responses regarding the facts set forth in the
13review or findings of the Board staff. Members of the public
14and the applicant shall have until 10 days before the meeting
15of the State Board to submit any written response concerning
16the Board staff's written review or findings. The Board staff
17may revise any findings to address corrections of factual
18errors cited in the public response. At the meeting, the State
19Board may, in its discretion, permit the submission of other
20additional written materials.
21    (d) Upon receipt of an application for a permit, the State
22Board shall approve and authorize the issuance of a permit if
23it finds (1) that the applicant is fit, willing, and able to
24provide a proper standard of health care service for the
25community with particular regard to the qualification,
26background and character of the applicant, (2) that economic



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1feasibility is demonstrated in terms of effect on the existing
2and projected operating budget of the applicant and of the
3health care facility; in terms of the applicant's ability to
4establish and operate such facility in accordance with
5licensure regulations promulgated under pertinent state laws;
6and in terms of the projected impact on the total health care
7expenditures in the facility and community, (3) that safeguards
8are provided that assure that the establishment, construction
9or modification of the health care facility or acquisition of
10major medical equipment is consistent with the public interest,
11and (4) that the proposed project is consistent with the
12orderly and economic development of such facilities and
13equipment and is in accord with standards, criteria, or plans
14of need adopted and approved pursuant to the provisions of
15Section 12 of this Act.
16(Source: P.A. 99-154, eff. 7-28-15; 100-518, eff. 6-1-18;
17100-681, eff. 8-3-18.)
18    (20 ILCS 3960/8.5)
19    (Section scheduled to be repealed on December 31, 2029)
20    Sec. 8.5. Certificate of exemption for change of ownership
21of a health care facility; discontinuation of a health care
22facility or category of service; public notice and public
24    (a) Upon a finding that an application for a change of
25ownership is complete, the State Board shall publish a legal



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



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1ownership or membership interests in such licensed or certified
2entity both prior to and after the transaction; fair market
3value of assets to be transferred; and the purchase price or
4other form of consideration to be provided for those assets.
5The issuance of the certificate of exemption shall be
6contingent upon the applicant submitting a statement to the
7Board within 90 days after the closing date of the transaction,
8or such longer period as provided by the Board, certifying that
9the change of ownership has been completed in accordance with
10the key terms contained in the application. If such key terms
11of the transaction change, a new application shall be required.
12    Where a change of ownership is among related persons, and
13there are no other changes being proposed at the health care
14facility that would otherwise require a permit or exemption
15under this Act, the applicant shall submit an application
16consisting of a standard notice in a form set forth by the
17Board briefly explaining the reasons for the proposed change of
18ownership. Once such an application is submitted to the Board
19and reviewed by the Board staff, the Board Chair shall take
20action on an application for an exemption for a change of
21ownership among related persons within 45 days after the
22application has been deemed complete, provided the application
23meets the applicable standards under this Section. If the Board
24Chair has a conflict of interest or for other good cause, the
25Chair may request review by the Board. Notwithstanding any
26other provision of this Act, for purposes of this Section, a



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1change of ownership among related persons means a transaction
2where the parties to the transaction are under common control
3or ownership before and after the transaction is completed.
4    Nothing in this Act shall be construed as authorizing the
5Board to impose any conditions, obligations, or limitations,
6other than those required by this Section, with respect to the
7issuance of an exemption for a change of ownership, including,
8but not limited to, the time period before which a subsequent
9change of ownership of the health care facility could be
10sought, or the commitment to continue to offer for a specified
11time period any services currently offered by the health care
13    (a-3) (Blank). Upon a finding that an application to close
14a health care facility is complete, the State Board shall
15publish a legal notice on 3 consecutive days in a newspaper of
16general circulation in the area or community to be affected and
17afford the public an opportunity to request a hearing. If the
18application is for a facility located in a Metropolitan
19Statistical Area, an additional legal notice shall be published
20in a newspaper of limited circulation, if one exists, in the
21area in which the facility is located. If the newspaper of
22limited circulation is published on a daily basis, the
23additional legal notice shall be published on 3 consecutive
24days. The legal notice shall also be posted on the Health
25Facilities and Services Review Board's web site and sent to the
26State Representative and State Senator of the district in which



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1the health care facility is located. In addition, the health
2care facility shall provide notice of closure to the local
3media that the health care facility would routinely notify
4about facility events. No later than 90 days after a
5discontinuation of a health facility, the applicant must submit
6a statement to the State Board certifying that the
7discontinuation is complete.
8    (a-5) Upon a finding that an application to discontinue a
9category of service is complete and provides the requested
10information, as specified by the State Board, an exemption
11shall be issued. No later than 30 days after the issuance of
12the exemption, the health care facility must give written
13notice of the discontinuation of the category of service to the
14State Senator and State Representative serving the legislative
15district in which the health care facility is located. No later
16than 90 days after a discontinuation of a category of service,
17the applicant must submit a statement to the State Board
18certifying that the discontinuation is complete.
19    (b) If a public hearing is requested, it shall be held at
20least 15 days but no more than 30 days after the date of
21publication of the legal notice in the community in which the
22facility is located. The hearing shall be held in the affected
23area or community in a place of reasonable size and
24accessibility and a full and complete written transcript of the
25proceedings shall be made. All interested persons attending the
26hearing shall be given a reasonable opportunity to present



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1their positions in writing or orally. The applicant shall
2provide a summary or describe the proposed change of ownership
3of the proposal for distribution at the public hearing.
4    (c) For the purposes of this Section "newspaper of limited
5circulation" means a newspaper intended to serve a particular
6or defined population of a specific geographic area within a
7Metropolitan Statistical Area such as a municipality, town,
8village, township, or community area, but does not include
9publications of professional and trade associations.
10    (d) The changes made to this Section by this amendatory Act
11of the 101st General Assembly shall apply to all applications
12submitted after the effective date of this amendatory Act of
13the 101st General Assembly.
14(Source: P.A. 99-154, eff. 7-28-15; 99-527, eff. 1-1-17;
1599-551, eff. 7-15-16; 100-201, eff. 8-18-17.)
16    (20 ILCS 3960/8.7 new)
17    Sec. 8.7. Application for permit for discontinuation of a
18health care facility or category of service; public notice and
19public hearing.
20    (a) Upon a finding that an application to close a health
21care facility or discontinue a category of service is complete,
22the State Board shall publish a legal notice on 3 consecutive
23days in a newspaper of general circulation in the area or
24community to be affected and afford the public an opportunity
25to request a hearing. If the application is for a facility



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1located in a Metropolitan Statistical Area, an additional legal
2notice shall be published in a newspaper of limited
3circulation, if one exists, in the area in which the facility
4is located. If the newspaper of limited circulation is
5published on a daily basis, the additional legal notice shall
6be published on 3 consecutive days. The legal notice shall also
7be posted on the Health Facilities and Services Review Board's
8website and sent to the State Representative and State Senator
9of the district in which the health care facility is located.
10In addition, the health care facility shall provide notice of
11closure to the local media that the health care facility would
12routinely notify about facility events.
13    (b) No later than 30 days after issuance of a permit to
14close a health care facility or discontinue a category of
15service, the permit holder shall give written notice of the
16closure or discontinuation to the State Senator and State
17Representative serving the legislative district in which the
18health care facility is located.
19    (c) If there is a pending lawsuit that challenges an
20application to discontinue a health care facility that either
21names the Board as a party or alleges fraud in the filing of
22the application, the Board may defer action on the application
23for up to 6 months after the date of the initial deferral of
24the application.
25    (d) The changes made to this Section by this amendatory Act
26of the 101st General Assembly shall apply to all applications



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1submitted after the effective date of this amendatory Act of
2the 101st General Assembly.
3    (20 ILCS 3960/12)  (from Ch. 111 1/2, par. 1162)
4    (Section scheduled to be repealed on December 31, 2029)
5    Sec. 12. Powers and duties of State Board. For purposes of
6this Act, the State Board shall exercise the following powers
7and duties:
8    (1) Prescribe rules, regulations, standards, criteria,
9procedures or reviews which may vary according to the purpose
10for which a particular review is being conducted or the type of
11project reviewed and which are required to carry out the
12provisions and purposes of this Act. Policies and procedures of
13the State Board shall take into consideration the priorities
14and needs of medically underserved areas and other health care
15services, giving special consideration to the impact of
16projects on access to safety net services.
17    (2) Adopt procedures for public notice and hearing on all
18proposed rules, regulations, standards, criteria, and plans
19required to carry out the provisions of this Act.
20    (3) (Blank).
21    (4) Develop criteria and standards for health care
22facilities planning, conduct statewide inventories of health
23care facilities, maintain an updated inventory on the Board's
24web site reflecting the most recent bed and service changes and
25updated need determinations when new census data become



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



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1    operation of the facility;
2        (f) Multi-institutional planning and the establishment
3    of multi-institutional systems where feasible;
4        (g) The financial and economic feasibility of proposed
5    construction or modification; and
6        (h) In the case of health care facilities established
7    by a religious body or denomination, the needs of the
8    members of such religious body or denomination may be
9    considered to be public need.
10    The health care facility plans which are developed and
11adopted in accordance with this Section shall form the basis
12for the plan of the State to deal most effectively with
13statewide health needs in regard to health care facilities.
14    (5) Coordinate with other state agencies having
15responsibilities affecting health care facilities, including
16those of licensure and cost reporting.
17    (6) Solicit, accept, hold and administer on behalf of the
18State any grants or bequests of money, securities or property
19for use by the State Board in the administration of this Act;
20and enter into contracts consistent with the appropriations for
21purposes enumerated in this Act.
22    (7) (Blank).
23    (8) Prescribe rules, regulations, standards, and criteria
24for the conduct of an expeditious review of applications for
25permits for projects of construction or modification of a
26health care facility, which projects are classified as



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1emergency, substantive, or non-substantive in nature.
2    Substantive projects shall include no more than the
4        (a) Projects to construct (1) a new or replacement
5    facility located on a new site or (2) a replacement
6    facility located on the same site as the original facility
7    and the cost of the replacement facility exceeds the
8    capital expenditure minimum, which shall be reviewed by the
9    Board within 120 days;
10        (b) Projects proposing a (1) new service within an
11    existing healthcare facility or (2) discontinuation of a
12    service within an existing healthcare facility, which
13    shall be reviewed by the Board within 60 days; or
14        (c) Projects proposing a change in the bed capacity of
15    a health care facility by an increase in the total number
16    of beds or by a redistribution of beds among various
17    categories of service or by a relocation of beds from one
18    physical facility or site to another by more than 20 beds
19    or more than 10% of total bed capacity, as defined by the
20    State Board, whichever is less, over a 2-year period.
21    The Chairman may approve applications for exemption that
22meet the criteria set forth in rules or refer them to the full
23Board. The Chairman may approve any unopposed application that
24meets all of the review criteria or refer them to the full
26    Such rules shall not prevent the conduct of a public



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



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1this Act, at the time and date of the meeting that such action
2is scheduled by the Board. The transcript of the State Board
3meeting shall be incorporated into the Board's final decision.
4The staff of the Board shall prepare a written copy of the
5final decision and the Board shall approve a final copy for
6inclusion in the formal record. The Board shall consider, for
7approval, the written draft of the final decision no later than
8the next scheduled Board meeting. The written decision shall
9identify the applicable criteria and factors listed in this Act
10and the Board's regulations that were taken into consideration
11by the Board when coming to a final decision. If the Board
12denies or fails to approve an application for permit or
13exemption, the Board shall include in the final decision a
14detailed explanation as to why the application was denied and
15identify what specific criteria or standards the applicant did
16not fulfill.
17    (12) (Blank).
18    (13) Provide a mechanism for the public to comment on, and
19request changes to, draft rules and standards.
20    (14) Implement public information campaigns to regularly
21inform the general public about the opportunity for public
22hearings and public hearing procedures.
23    (15) Establish a separate set of rules and guidelines for
24long-term care that recognizes that nursing homes are a
25different business line and service model from other regulated
26facilities. An open and transparent process shall be developed



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1that considers the following: how skilled nursing fits in the
2continuum of care with other care providers, modernization of
3nursing homes, establishment of more private rooms,
4development of alternative services, and current trends in
5long-term care services. The Chairman of the Board shall
6appoint a permanent Health Services Review Board Long-term Care
7Facility Advisory Subcommittee that shall develop and
8recommend to the Board the rules to be established by the Board
9under this paragraph (15). The Subcommittee shall also provide
10continuous review and commentary on policies and procedures
11relative to long-term care and the review of related projects.
12The Subcommittee shall make recommendations to the Board no
13later than January 1, 2016 and every January thereafter
14pursuant to the Subcommittee's responsibility for the
15continuous review and commentary on policies and procedures
16relative to long-term care. In consultation with other experts
17from the health field of long-term care, the Board and the
18Subcommittee shall study new approaches to the current bed need
19formula and Health Service Area boundaries to encourage
20flexibility and innovation in design models reflective of the
21changing long-term care marketplace and consumer preferences
22and submit its recommendations to the Chairman of the Board no
23later than January 1, 2017. The Subcommittee shall evaluate,
24and make recommendations to the State Board regarding, the
25buying, selling, and exchange of beds between long-term care
26facilities within a specified geographic area or drive time.



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1The Board shall file the proposed related administrative rules
2for the separate rules and guidelines for long-term care
3required by this paragraph (15) by no later than September 30,
42011. The Subcommittee shall be provided a reasonable and
5timely opportunity to review and comment on any review,
6revision, or updating of the criteria, standards, procedures,
7and rules used to evaluate project applications as provided
8under Section 12.3 of this Act.
9    The Chairman of the Board shall appoint voting members of
10the Subcommittee, who shall serve for a period of 3 years, with
11one-third of the terms expiring each January, to be determined
12by lot. Appointees shall include, but not be limited to,
13recommendations from each of the 3 statewide long-term care
14associations, with an equal number to be appointed from each.
15Compliance with this provision shall be through the appointment
16and reappointment process. All appointees serving as of April
171, 2015 shall serve to the end of their term as determined by
18lot or until the appointee voluntarily resigns, whichever is
20    One representative from the Department of Public Health,
21the Department of Healthcare and Family Services, the
22Department on Aging, and the Department of Human Services may
23each serve as an ex-officio non-voting member of the
24Subcommittee. The Chairman of the Board shall select a
25Subcommittee Chair, who shall serve for a period of 3 years.
26    (16) Prescribe the format of the State Board Staff Report.



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1A State Board Staff Report shall pertain to applications that
2include, but are not limited to, applications for permit or
3exemption, applications for permit renewal, applications for
4extension of the financial commitment period, applications
5requesting a declaratory ruling, or applications under the
6Health Care Worker Self-Referral Act. State Board Staff Reports
7shall compare applications to the relevant review criteria
8under the Board's rules.
9    (17) Establish a separate set of rules and guidelines for
10facilities licensed under the Specialized Mental Health
11Rehabilitation Act of 2013. An application for the
12re-establishment of a facility in connection with the
13relocation of the facility shall not be granted unless the
14applicant has a contractual relationship with at least one
15hospital to provide emergency and inpatient mental health
16services required by facility consumers, and at least one
17community mental health agency to provide oversight and
18assistance to facility consumers while living in the facility,
19and appropriate services, including case management, to assist
20them to prepare for discharge and reside stably in the
21community thereafter. No new facilities licensed under the
22Specialized Mental Health Rehabilitation Act of 2013 shall be
23established after June 16, 2014 (the effective date of Public
24Act 98-651) except in connection with the relocation of an
25existing facility to a new location. An application for a new
26location shall not be approved unless there are adequate



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1community services accessible to the consumers within a
2reasonable distance, or by use of public transportation, so as
3to facilitate the goal of achieving maximum individual
4self-care and independence. At no time shall the total number
5of authorized beds under this Act in facilities licensed under
6the Specialized Mental Health Rehabilitation Act of 2013 exceed
7the number of authorized beds on June 16, 2014 (the effective
8date of Public Act 98-651).
9    (18) Elect a Vice Chairman to preside over State Board
10meetings and otherwise act in place of the Chairman when the
11Chairman is unavailable.
12(Source: P.A. 99-78, eff. 7-20-15; 99-114, eff. 7-23-15;
1399-180, eff. 7-29-15; 99-277, eff. 8-5-15; 99-527, eff. 1-1-17;
1499-642, eff. 7-28-16; 100-518, eff. 6-1-18; 100-681, eff.
16    (20 ILCS 3960/12.2)
17    (Section scheduled to be repealed on December 31, 2029)
18    Sec. 12.2. Powers of the State Board staff. For purposes of
19this Act, the staff shall exercise the following powers and
21        (1) Review applications for permits and exemptions in
22    accordance with the standards, criteria, and plans of need
23    established by the State Board under this Act and certify
24    its finding to the State Board.
25        (1.5) Post the following on the Board's web site:



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1    relevant (i) rules, (ii) standards, (iii) criteria, (iv)
2    State norms, (v) references used by Board staff in making
3    determinations about whether application criteria are met,
4    and (vi) notices of project-related filings, including
5    notice of public comments related to the application.
6        (2) Charge and collect an amount determined by the
7    State Board and the staff to be reasonable fees for the
8    processing of applications by the State Board. The State
9    Board shall set the amounts by rule. Application fees for
10    continuing care retirement communities, and other health
11    care models that include regulated and unregulated
12    components, shall apply only to those components subject to
13    regulation under this Act. All fees and fines collected
14    under the provisions of this Act shall be deposited into
15    the Illinois Health Facilities Planning Fund to be used for
16    the expenses of administering this Act.
17        (2.1) Publish the following reports on the State Board
18    website:
19            (A) An annual accounting, aggregated by category
20        and with names of parties redacted, of fees, fines, and
21        other revenue collected as well as expenses incurred,
22        in the administration of this Act.
23            (B) An annual report, with names of the parties
24        redacted, that summarizes all settlement agreements
25        entered into with the State Board that resolve an
26        alleged instance of noncompliance with State Board



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1        requirements under this Act.
2            (C) (Blank).
3            (D) Board reports showing the degree to which an
4        application conforms to the review standards, a
5        summation of relevant public testimony, and any
6        additional information that staff wants to
7        communicate.
8        (3) Coordinate with other State agencies having
9    responsibilities affecting health care facilities,
10    including licensure and cost reporting agencies.
11        (4) Issue advisory opinions upon request. Staff
12    advisory opinions do not constitute determinations by the
13    State Board. Determinations by the State Board are made
14    through the declaratory ruling process.
15(Source: P.A. 99-527, eff. 1-1-17; 100-681, eff. 8-3-18.)
16    Section 99. Effective date. This Act takes effect upon
17becoming law.".