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

HB3657 102ND GENERAL ASSEMBLY

  
  

 


 
102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB3657

 

Introduced 2/22/2021, by Rep. Lamont J. Robinson, Jr.

 

SYNOPSIS AS INTRODUCED:
 
See Index

    Amends the Health Facilities Planning Act. Modifies provisions concerning Safety Net Impact Statements. Provides for Emergency Medicine and Trauma Systems Impact Statements and Maternal and Child Health Impact Statements. Provides further requirements concerning the discontinuance of a hospital facility or a category of service. Provides requirements for hospital closure during a pandemic. Provides for a right of action under the Act. Specifies and modifies penalties for a violation of the Act. Allows a health facility to be placed under receivership. Specifies further powers and duties of the Health Facilities and Services Review Board under the Act. Amends the Illinois Public Aid Code. Requires a general acute care hospital that ceases to provide hospital services before January 1, 2022 to pay specified amounts. Provides further requirements concerning the payments. Defines terms. Makes conforming and other changes. Effective immediately.


LRB102 13678 RJF 19028 b

 

 

A BILL FOR

 

HB3657LRB102 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

 

 

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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, 4, 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, 14.05, and 14.2 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

 

 

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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- 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- 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 one month
22shall be considered a discontinuation of a category of
23service.
24    "Establish" means the construction of a health care
25facility or the replacement of an existing facility on another
26site or the initiation of a category of service.

 

 

HB3657- 12 -LRB102 13678 RJF 19028 b

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

 

 

HB3657- 13 -LRB102 13678 RJF 19028 b

1acquisition, improvement, expansion, or replacement of any
2plant or equipment with respect to which an expenditure is
3made shall be included in determining if such expenditure
4exceeds the capital expenditures minimum. Unless otherwise
5interdependent, or submitted as one project by the applicant,
6components of construction or modification undertaken by means
7of a single construction contract or financed through the
8issuance of a single debt instrument shall not be grouped
9together as one project. Donations of equipment or facilities
10to a health care facility which if acquired directly by such
11facility would be subject to review under this Act shall be
12considered capital expenditures, and a transfer of equipment
13or facilities for less than fair market value shall be
14considered a capital expenditure for purposes of this Act if a
15transfer of the equipment or facilities at fair market value
16would be subject to review.
17    "Capital expenditure minimum" means $11,500,000 for
18projects by hospital applicants, $6,500,000 for applicants for
19projects related to skilled and intermediate care long-term
20care facilities licensed under the Nursing Home Care Act, and
21$3,000,000 for projects by all other applicants, which shall
22be annually adjusted to reflect the increase in construction
23costs due to inflation, for major medical equipment and for
24all other capital expenditures.
25    "Financial commitment" means the commitment of at least
2633% of total funds assigned to cover total project cost, which

 

 

HB3657- 14 -LRB102 13678 RJF 19028 b

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

 

 

HB3657- 15 -LRB102 13678 RJF 19028 b

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

 

 

HB3657- 16 -LRB102 13678 RJF 19028 b

1Affiliates of out-of-state facilities shall be considered
2out-of-state facilities. Affiliates of Illinois licensed
3health care facilities 100% owned by an Illinois licensed
4health care facility, its parent, or Illinois physicians
5licensed to practice medicine in all its branches shall not be
6considered out-of-state facilities. Nothing in this definition
7shall be construed to include an office or any part of an
8office of a physician licensed to practice medicine in all its
9branches in Illinois that is not required to be licensed under
10the Ambulatory Surgical Treatment Center Act.
11    "Change of ownership of a health care facility" means a
12change in the person who has ownership or control of a health
13care facility's physical plant and capital assets. A change in
14ownership is indicated by the following transactions: sale,
15transfer, acquisition, lease, change of sponsorship, or other
16means of transferring control.
17    "Related person" means any person that: (i) is at least
1850% owned, directly or indirectly, by either the health care
19facility or a person owning, directly or indirectly, at least
2050% of the health care facility; or (ii) owns, directly or
21indirectly, at least 50% of the health care facility.
22    "Charity care" means care provided by a health care
23facility for which the provider does not expect to receive
24payment from the patient or a third-party payer.
25    "Health disparities" means preventable differences in the
26burden of disease, injury, violence, or opportunities to

 

 

HB3657- 17 -LRB102 13678 RJF 19028 b

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

 

 

HB3657- 18 -LRB102 13678 RJF 19028 b

1medical services planned and coordinated in accordance with
2the Emergency Medical Services (EMS) Systems Act.
3    "Perinatal and maternal care" means obstetric and neonatal
4services under Subpart O of Hospital Licensing Requirements,
577 IAC 250; resources and services associated with hospital
6perinatal care level designations under the Developmental
7Disability Prevention Act; and maternal care resources and
8services developed or identified under Sections 2310-222 and
92310-223 of the Department of Public Health Powers and Duties
10Law.
11    "Freestanding emergency center" means a facility subject
12to licensure under Section 32.5 of the Emergency Medical
13Services (EMS) Systems Act.
14    "Category of service" means a grouping by generic class of
15various types or levels of support functions, equipment, care,
16or treatment provided to patients or residents. Categories of
17service shall at minimum include , including, but not limited
18to, classes such as medical-surgical, pediatrics, obstetrics,
19intensive care, neonatal intensive care, acute mental illness,
20comprehensive physical rehabilitation, long-term acute care,
21or cardiac catheterization, open heart surgery, kidney
22transplantation, general long term nursing care, long term
23care for the developmentally disabled (adult), long term care
24for the developmentally disabled (children), chronic mental
25illness care, in-center hemodialysis, and non-hospital
26ambulatory surgery. A category of service may include

 

 

HB3657- 19 -LRB102 13678 RJF 19028 b

1subcategories or levels of care that identify a particular
2degree or type of care within the category of service. Nothing
3in this definition shall be construed to include the practice
4of a physician or other licensed health care professional
5while functioning in an office providing for the care,
6diagnosis, or treatment of patients. A category of service
7that is subject to the Board's jurisdiction must be designated
8in rules adopted by the Board.
9    "State Board Staff Report" means the document that sets
10forth the review and findings of the State Board staff, as
11prescribed by the State Board, regarding applications subject
12to Board jurisdiction.
13(Source: P.A. 100-518, eff. 6-1-18; 100-581, eff. 3-12-18;
14100-957, eff. 8-19-18; 101-81, eff. 7-12-19; 101-650, eff.
157-7-20.)
 
16    (20 ILCS 3960/4)  (from Ch. 111 1/2, par. 1154)
17    (Section scheduled to be repealed on December 31, 2029)
18    Sec. 4. Health Facilities and Services Review Board;
19membership; appointment; term; compensation; quorum.
20    (a) There is created the Health Facilities and Services
21Review Board, which shall perform the functions described in
22this Act. The Department shall provide operational support to
23the Board as necessary, including the provision of office
24space, supplies, and clerical, financial, and accounting
25services. The Board may contract for functions or operational

 

 

HB3657- 20 -LRB102 13678 RJF 19028 b

1support as needed. The Board may also contract with experts
2related to specific health services or facilities and create
3technical advisory panels to assist in the development of
4criteria, standards, and procedures used in the evaluation of
5applications for permit and exemption.
6    (b) The State Board shall consist of 9 voting members. All
7members shall be residents of Illinois and at least 3 4 shall
8reside outside the Chicago Metropolitan Statistical Area.
9Consideration shall be given to potential appointees who
10reflect the ethnic and cultural diversity of the State.
11Neither Board members nor Board staff shall be convicted
12felons or have pled guilty to a felony.
13    Each member shall have a reasonable knowledge of the
14practice, procedures and principles of the health care
15delivery system in Illinois, including at least 5 members who
16shall be knowledgeable about health care delivery systems,
17health systems planning, finance, or the management of health
18care facilities currently regulated under the Act. One member
19shall be a representative of a non-profit health care consumer
20advocacy organization and one member shall be representative
21of a trade or labor union representing health care workers. A
22spouse, parent, sibling, or child of a Board member cannot be
23an employee, agent, or under contract with services or
24facilities subject to the Act. Prior to appointment and in the
25course of service on the Board, members of the Board shall
26disclose the employment or other financial interest of any

 

 

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1other relative of the member, if known, in service or
2facilities subject to the Act. Members of the Board shall
3declare any conflict of interest that may exist with respect
4to the status of those relatives and recuse themselves from
5voting on any issue for which a conflict of interest is
6declared. No person shall be appointed or continue to serve as
7a member of the State Board who is, or whose spouse, parent,
8sibling, or child is, a member of the Board of Directors of,
9has a financial interest in, or has a business relationship
10with a health care facility.
11    Notwithstanding any provision of this Section to the
12contrary, the term of office of each member of the State Board
13serving on the day before the effective date of this
14amendatory Act of the 96th General Assembly is abolished on
15the date upon which members of the 9-member Board, as
16established by this amendatory Act of the 96th General
17Assembly, have been appointed and can begin to take action as a
18Board.
19    (c) The State Board shall be appointed by the Governor,
20with the advice and consent of the Senate. Not more than 5 of
21the appointments shall be of the same political party at the
22time of the appointment.
23    The Secretary of Human Services, the Director of
24Healthcare and Family Services, and the Director of Public
25Health, or their designated representatives, shall serve as
26ex-officio, non-voting members of the State Board.

 

 

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1    (d) Of those 9 members initially appointed by the Governor
2following the effective date of this amendatory Act of the
396th General Assembly, 3 shall serve for terms expiring July
41, 2011, 3 shall serve for terms expiring July 1, 2012, and 3
5shall serve for terms expiring July 1, 2013. Thereafter, each
6appointed member shall hold office for a term of 3 years,
7provided that any member appointed to fill a vacancy occurring
8prior to the expiration of the term for which his or her
9predecessor was appointed shall be appointed for the remainder
10of such term and the term of office of each successor shall
11commence on July 1 of the year in which his predecessor's term
12expires. Each member shall hold office until his or her
13successor is appointed and qualified. The Governor may
14reappoint a member for additional terms, but no member shall
15serve more than 3 terms, subject to review and re-approval
16every 3 years.
17    (e) State Board members, while serving on business of the
18State Board, shall receive actual and necessary travel and
19subsistence expenses while so serving away from their places
20of residence. Until March 1, 2010, a member of the State Board
21who experiences a significant financial hardship due to the
22loss of income on days of attendance at meetings or while
23otherwise engaged in the business of the State Board may be
24paid a hardship allowance, as determined by and subject to the
25approval of the Governor's Travel Control Board.
26    (f) The Governor shall designate one of the members to

 

 

HB3657- 23 -LRB102 13678 RJF 19028 b

1serve as the Chairman of the Board, who shall be a person with
2expertise in health care delivery system planning, finance or
3management of health care facilities that are regulated under
4the Act. The Chairman shall annually review Board member
5performance and shall report the attendance record of each
6Board member to the General Assembly.
7    (g) The State Board, through the Chairman, shall prepare a
8separate and distinct budget approved by the General Assembly
9and shall hire and supervise its own professional staff
10responsible for carrying out the responsibilities of the
11Board.
12    (h) The State Board shall meet at least every 45 days, or
13as often as the Chairman of the State Board deems necessary, or
14upon the request of a majority of the members.
15    (i) Five members of the State Board shall constitute a
16quorum. The affirmative vote of 5 of the members of the State
17Board shall be necessary for any action requiring a vote to be
18taken by the State Board. A vacancy in the membership of the
19State Board shall not impair the right of a quorum to exercise
20all the rights and perform all the duties of the State Board as
21provided by this Act.
22    (j) A State Board member shall disqualify himself or
23herself from the consideration of any application for a permit
24or exemption in which the State Board member or the State Board
25member's spouse, parent, sibling, or child: (i) has an
26economic interest in the matter; or (ii) is employed by,

 

 

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1serves as a consultant for, or is a member of the governing
2board of the applicant or a party opposing the application.
3    (k) The Chairman, Board members, and Board staff must
4comply with the Illinois Governmental Ethics Act.
5(Source: P.A. 99-527, eff. 1-1-17; 100-681, eff. 8-3-18.)
 
6    (20 ILCS 3960/5)  (from Ch. 111 1/2, par. 1155)
7    (Section scheduled to be repealed on December 31, 2029)
8    Sec. 5. Construction, modification, or establishment of
9health care facilities or acquisition of major medical
10equipment; permits or exemptions. No person shall construct,
11modify or establish a health care facility or acquire major
12medical equipment without first obtaining a permit or
13exemption from the State Board. The State Board shall not
14delegate to the staff of the State Board or any other person or
15entity the authority to grant permits or exemptions whenever
16the staff or other person or entity would be required to
17exercise any discretion affecting the decision to grant a
18permit or exemption. The State Board may, by rule, delegate
19authority to the Chairman to grant permits or exemptions when
20applications meet all of the State Board's review criteria and
21are unopposed.
22    A permit or exemption shall be obtained prior to the
23acquisition of major medical equipment or to the construction
24or modification of a health care facility which:
25        (a) requires a total capital expenditure in excess of

 

 

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1    the capital expenditure minimum; or
2        (b) substantially changes the scope or changes the
3    functional operation of the facility; or
4        (c) changes the bed capacity of a health care facility
5    by increasing the total number of beds or by distributing
6    beds among various categories of service or by relocating
7    beds from one physical facility or site to another by more
8    than 20 beds or more than 10% of total bed capacity as
9    defined by the State Board, whichever is less, over a
10    2-year period.
11    A permit shall be valid only for the defined construction
12or modifications, site, amount and person named in the
13application for such permit. The State Board may approve the
14transfer of an existing permit without regard to whether the
15permit to be transferred has yet been financially committed,
16except for permits to establish a new facility or category of
17service. A permit shall be valid until such time as the project
18has been completed, provided that the project commences and
19proceeds to completion with due diligence by the completion
20date or extension date approved by the Board.
21    A permit holder must do the following: (i) submit the
22final completion and cost report for the project within 90
23days after the approved project completion date or extension
24date and (ii) submit annual progress reports no earlier than
2530 days before and no later than 30 days after each anniversary
26date of the Board's approval of the permit until the project is

 

 

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1completed. To maintain a valid permit and to monitor progress
2toward project commencement and completion, routine
3post-permit reports shall be limited to annual progress
4reports and the final completion and cost report. Annual
5progress reports shall include information regarding the
6committed funds expended toward the approved project. For
7projects to be completed in 12 months or less, the permit
8holder shall report financial commitment in the final
9completion and cost report. For projects to be completed
10between 12 to 24 months, the permit holder shall report
11financial commitment in the first annual report. For projects
12to be completed in more than 24 months, the permit holder shall
13report financial commitment in the second annual progress
14report. The report shall contain information regarding
15expenditures and financial commitments. The State Board may
16extend the financial commitment period after considering a
17permit holder's showing of good cause and request for
18additional time to complete the project.
19    The Certificate of Need process required under this Act is
20designed to support equitable access to health care services,
21develop and protect safety net services, and restrain rising
22health care costs by preventing unnecessary construction or
23modification of health care facilities. The Board must assure
24that the establishment, construction, or modification of a
25health care facility or the acquisition of major medical
26equipment is consistent with the public interest and that the

 

 

HB3657- 27 -LRB102 13678 RJF 19028 b

1proposed project is consistent with the orderly and economic
2development or acquisition of those facilities and equipment
3and is in accord with the standards, criteria, or plans of need
4adopted and approved by the Board. The Board must assure
5decisions regarding hospital facility or service
6discontinuations are consistent with the health equity
7purposes of the Act and consider whether or not such facility
8or service discontinuations will worsen health disparities.
9Board decisions regarding the construction of health care
10facilities must consider capacity, quality, value, and equity.
11Projects may deviate from the costs, fees, and expenses
12provided in their project cost information for the project's
13cost components, provided that the final total project cost
14does not exceed the approved permit amount. Project
15alterations shall not increase the total approved permit
16amount by more than the limit set forth under the Board's
17rules.
18    The acquisition by any person of major medical equipment
19that will not be owned by or located in a health care facility
20and that will not be used to provide services to inpatients of
21a health care facility shall be exempt from review provided
22that a notice is filed in accordance with exemption
23requirements.
24    Notwithstanding any other provision of this Act, no permit
25or exemption is required for the construction or modification
26of a non-clinical service area of a health care facility.

 

 

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1(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18.)
 
2    (20 ILCS 3960/5.4)
3    (Section scheduled to be repealed on December 31, 2029)
4    Sec. 5.4. Safety Net Impact Statement.
5    (a) General review criteria shall include a requirement
6that all health care facilities, with the exception of skilled
7and intermediate long-term care facilities licensed under the
8Nursing Home Care Act, provide a Safety Net Impact Statement,
9which shall be filed with an application for a substantive
10project or when the application proposes to discontinue a
11category of service.
12    (b) (Blank). For the purposes of this Section, "safety net
13services" are services provided by health care providers or
14organizations that deliver health care services to persons
15with barriers to mainstream health care due to lack of
16insurance, inability to pay, special needs, ethnic or cultural
17characteristics, or geographic isolation. Safety net service
18providers include, but are not limited to, hospitals and
19private practice physicians that provide charity care,
20school-based health centers, migrant health clinics, rural
21health clinics, federally qualified health centers, community
22health centers, public health departments, and community
23mental health centers.
24    (c) As developed by the applicant, a Safety Net Impact
25Statement shall describe all of the following:

 

 

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1        (1) The project's material impact, if any, on
2    essential safety net services in the community, including
3    safety net hospitals and critical access hospitals, to the
4    extent that it is feasible for an applicant to have such
5    knowledge.
6        (2) The project's impact on the ability of another
7    provider or health care system to cross-subsidize safety
8    net services, if reasonably known to the applicant.
9        (3) How the discontinuation of a facility or service
10    will might impact other the remaining safety net providers
11    in a given community, if reasonably known by the
12    applicant.
13        (4) How the discontinuation of a facility or service
14    will impact the Medicaid population.
15        (5) How the discontinuation of a facility or service
16    will impact the health status and outcomes of communities
17    or populations suffering from health disparities. This
18    should include consideration of disparities in healthcare
19    access and outcomes by income, race and ethnic identity,
20    and preferred language, if reasonably known to the
21    applicant.
22    (d) Safety Net Impact Statements shall also include all of
23the following:
24        (1) For the 3 fiscal years prior to the application, a
25    certification describing the amount of charity care
26    provided by the applicant. The amount calculated by

 

 

HB3657- 30 -LRB102 13678 RJF 19028 b

1    hospital applicants shall be in accordance with the
2    reporting requirements for charity care reporting in the
3    Illinois Community Benefits Act. Non-hospital applicants
4    shall report charity care, at cost, in accordance with an
5    appropriate methodology specified by the Board.
6        (2) For the 3 fiscal years prior to the application, a
7    certification of the amount of care provided to Medicaid
8    patients. Hospital and non-hospital applicants shall
9    provide Medicaid information in a manner consistent with
10    the information reported each year to the State Board
11    regarding "Inpatients and Outpatients Served by Payor
12    Source" and "Inpatient and Outpatient Net Revenue by Payor
13    Source" as required by the Board under Section 13 of this
14    Act and published in the Annual Hospital Profile.
15        (3) Any information the applicant believes is directly
16    relevant to safety net services, including information
17    regarding teaching, research, and any other service.
18    (e) The Board staff shall publish a notice, that an
19application accompanied by a Safety Net Impact Statement has
20been filed, in a newspaper having general circulation within
21the area affected by the application. If no newspaper has a
22general circulation within the county, the Board shall post
23the notice in 5 conspicuous places within the proposed area.
24    (f) Any person, community organization, provider, or
25health system or other entity wishing to comment upon or
26oppose the application may file a Safety Net Impact Statement

 

 

HB3657- 31 -LRB102 13678 RJF 19028 b

1Response with the Board, which shall provide additional
2information concerning a project's impact on safety net
3services in the community.
4    (g) Applicants shall be provided an opportunity to submit
5a reply to any Safety Net Impact Statement Response.
6    (h) The State Board Staff Report shall include a statement
7as to whether a Safety Net Impact Statement was filed by the
8applicant and whether it included information on charity care,
9the amount of care provided to Medicaid patients, and
10information on teaching, research, or any other service
11provided by the applicant directly relevant to safety net
12services. The report shall also indicate the names of the
13parties submitting responses and the number of responses and
14replies, if any, that were filed.
15(Source: P.A. 100-518, eff. 6-1-18.)
 
16    (20 ILCS 3960/5.5 new)
17    Sec. 5.5. Emergency Medicine and Trauma Systems Impact
18Statement.
19    (a) Review criteria shall include a requirement that all
20general acute hospitals applying to discontinue a facility,
21intensive care services, or another category of service
22relevant to emergency medical service and trauma systems
23identified by rule by the Board include in its application an
24Emergency Medicine and Trauma Systems Impact Statement.
25    (b) As developed by the applicant, an Emergency Medicine

 

 

HB3657- 32 -LRB102 13678 RJF 19028 b

1and Trauma Systems Impact Statement shall describe all of the
2following:
3        (1) How the discontinuation of the facility or service
4    will impact the availability of emergency medical and
5    trauma services for area populations, specifically
6    including those that experience difficulty accessing
7    health services or experience health disparities.
8        (2) How the discontinuation of the facility or service
9    might impact the remaining providers of emergency medical
10    and trauma services in the area, to the extent known by the
11    applicant.
12    (c) Emergency Medicine and Trauma Systems Impact
13Statements shall also include all of the following:
14        (1) A list of each resource identified in any
15    emergency medical service system program plan that will
16    cease to exist as a result of the facility or service
17    discontinuation, with a description of its utilization in
18    the most recent 2 years for which data is available.
19        (2) A list of each resource identified in any trauma
20    or stroke center designation that will cease to exist as a
21    result of the facility or service discontinuation, with a
22    description of its utilization in the most recent 2 years
23    for which data is available.
24        (3) If any resource listed pursuant to paragraphs (1)
25    or (2) above was on diversion or bypass status or
26    otherwise not available during the 2 years, the statement

 

 

HB3657- 33 -LRB102 13678 RJF 19028 b

1    must list the times and reasons it was on bypass.
2    (d) The Board staff shall publish a notice, that an
3application accompanied by an Emergency Medicine and Trauma
4Systems Impact Statement has been filed, in a newspaper having
5general circulation within the area affected by the
6application. If no newspaper has a general circulation within
7the county, the Board shall post the notice in 5 conspicuous
8places within the proposed area.
9    (e) Any person, community organization, provider, or
10health system or other entity wishing to comment upon or
11oppose the application may file an Emergency Medical and
12Trauma Systems Impact Statement Response with the Board, which
13shall provide additional information concerning a project's
14impact on emergency medical and trauma services in the
15community.
16    (f) Applicants shall be provided an opportunity to submit
17a reply to any Emergency Medical and Trauma Systems Impact
18Statement Response.
19    (g) The State Board Staff Report shall include a statement
20as to whether an Emergency Medical and Trauma Systems Impact
21Statement was filed by the applicant and whether it included
22information described in subsections (b) and (c) above. The
23report shall indicate whether the list of resources identified
24pursuant to subsection (c) is accurate and complete. The
25report shall also indicate the names of the parties submitting
26responses and the number of responses and replies, if any,

 

 

HB3657- 34 -LRB102 13678 RJF 19028 b

1that were filed.
 
2    (20 ILCS 3960/5.6 new)
3    Sec. 5.6. Maternal and Child Health Impact Statement.
4    (a) Review criteria shall include a requirement that all
5general acute hospitals applying to discontinue a facility,
6obstetric services, pediatric services, neonatal intensive
7care services, or any other category of service relevant to
8maternal and child health identified by rule by the Board
9include in its application an Emergency Medicine and Trauma
10Systems Impact Statement.
11    (b) As developed by the applicant, a Maternal and Child
12Health Impact Statement shall describe all of the following:
13        (1) How the discontinuation of the facility or service
14    will impact the availability of perinatal and maternal
15    care services for area populations, specifically including
16    those that experience difficulty accessing health services
17    or experience health disparities.
18        (2) How the discontinuation of the facility or service
19    might impact the remaining providers of perinatal and
20    maternal care services in the area, to the extent known by
21    the applicant.
22    (c) Maternal and Child Health Impact Statements shall also
23include all of the following:
24        (1) A list of each resource identified in any
25    obstetric and neonatal service plan, hospital perinatal

 

 

HB3657- 35 -LRB102 13678 RJF 19028 b

1    care level designation, or maternal care level designation
2    that will cease to exist as a result of the facility or
3    service discontinuation, with a description of its
4    utilization in the most recent 2 years for which data is
5    available.
6        (2) A list of any resource that was developed through
7    initiatives set forth in Section 2310-222 of the
8    Department of Public Health Powers and Duties Law to
9    improve birth equity and reduce postpartum racial and
10    ethnic disparities, or that serves similar purposes that
11    will cease to exist as a result of the facility or service
12    discontinuation.
13    (d) The Board staff shall publish a notice, that an
14application accompanied by a Maternal and Child Health Impact
15Statement has been filed, in a newspaper having general
16circulation within the area affected by the application. If no
17newspaper has a general circulation within the county, the
18Board shall post the notice in 5 conspicuous places within the
19proposed area.
20    (e) Any person, community organization, provider, or
21health system or other entity wishing to comment upon or
22oppose the application may file a Maternal and Child Health
23Impact Statement Response with the Board, which shall provide
24additional information concerning a project's impact on
25emergency medical and trauma services in the community.
26    (f) Applicants shall be provided an opportunity to submit

 

 

HB3657- 36 -LRB102 13678 RJF 19028 b

1a reply to any Maternal and Child Health Impact Statement
2Response.
3    (g) The State Board Staff Report shall include a statement
4as to whether a Maternal and Child Health Impact Statement was
5filed by the applicant and whether it included information
6described in paragraphs (b) and (c) above. The report shall
7indicate whether the list of resources identified pursuant to
8paragraph (c) is accurate and complete. The report shall also
9indicate the names of the parties submitting responses and the
10number of responses and replies, if any, that were filed.
 
11    (20 ILCS 3960/6)  (from Ch. 111 1/2, par. 1156)
12    (Section scheduled to be repealed on December 31, 2029)
13    Sec. 6. Application for permit or exemption; exemption
14regulations.
15    (a) An application for a permit or exemption shall be made
16to the State Board upon forms provided by the State Board. This
17application shall contain such information as the State Board
18deems necessary. The State Board shall not require an
19applicant to file a Letter of Intent before an application is
20filed. Such application shall include affirmative evidence on
21which the State Board or Chairman may make its decision on the
22approval or denial of the permit or exemption.
23    (b) The State Board shall establish by regulation the
24procedures and requirements regarding issuance of exemptions.
25An exemption shall be approved when information required by

 

 

HB3657- 37 -LRB102 13678 RJF 19028 b

1the Board by rule is submitted. Projects eligible for an
2exemption, rather than a permit, shall be include, but are not
3limited to, change of ownership of a health care facility and
4discontinuation of a category of service, other than a
5hospital, or a health care facility maintained by the State or
6any agency or department thereof or a nursing home maintained
7by a county. The Board may accept an application for an
8exemption for the discontinuation of a category of service at
9any other a health care facility only once in a 6-month period
10following (1) the previous application for exemption at the
11same health care facility or (2) the final decision of the
12Board regarding the discontinuation of a category of service
13at the same health care facility, whichever occurs later. A
14discontinuation of a category of service shall otherwise
15require an application for a permit if an application for an
16exemption has already been accepted within the 6-month period.
17For a change of ownership among related persons of a health
18care facility, the State Board shall provide by rule for an
19expedited process for obtaining an exemption. For the purposes
20of this Section, "change of ownership among related persons"
21means a transaction in which the parties to the transaction
22are under common control or ownership before and after the
23transaction is complete.
24    (c) All applications shall be signed by the applicant and
25shall be verified by any 2 officers thereof.
26    (c-5) Any written review or findings of the Board staff

 

 

HB3657- 38 -LRB102 13678 RJF 19028 b

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

 

 

HB3657- 39 -LRB102 13678 RJF 19028 b

1and in terms of the projected impact on the total health care
2expenditures in the facility and community, (3) that
3safeguards are provided that assure that the establishment,
4construction or modification of the health care facility or
5acquisition of major medical equipment is consistent with the
6public interest, (4) that the project will not plausibly
7increase health disparities, and (5) (4) that the proposed
8project is consistent with the orderly and economic
9development of such facilities and equipment and is in accord
10with standards, criteria, or plans of need adopted and
11approved pursuant to the provisions of Section 12 of this Act.
12    (d-5) For an application for a permit to discontinue a
13hospital facility or service, the State Board shall consider:
14        (1) how the discontinuation of the facility or service
15    will impact safety net services;
16        (2) the emergency medical and trauma system impact, if
17    applicable;
18        (3) the maternal and child health impact, if
19    applicable; and
20        (4) the economic feasibility, based on the resources
21    of the applicant and related persons, of continued
22    operation as an alternative.
23    (e) The State Board may attach conditions to issuance of a
24permit. For a discontinuation of a hospital facility or
25service, the State Board is expressly permitted to attach
26conditions requiring that certain public support or subsidies

 

 

HB3657- 40 -LRB102 13678 RJF 19028 b

1received by the hospital must be repaid.
2(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18;
3101-83, eff. 7-15-19.)
 
4    (20 ILCS 3960/6.05 new)
5    Sec. 6.05. Hospital closure during a pandemic. The State
6Board shall not issue a permit or take any other action that
7would allow closure of a general acute care hospital to
8proceed during a public health emergency declared pursuant to
9the Illinois Emergency Management Act as the result of an
10infectious disease pandemic.
 
11    (20 ILCS 3960/6.2)
12    (Section scheduled to be repealed on December 31, 2029)
13    Sec. 6.2. Review of permits; State Board Staff Reports.
14Upon receipt of an application for a permit to establish,
15construct, or modify a health care facility, the State Board
16staff shall notify the applicant in writing within 10 working
17days either that the application is or is not substantially
18complete. If the application is substantially complete, the
19State Board staff shall notify the applicant of the beginning
20of the review process. If the application is not substantially
21complete, the Board staff shall explain within the 10-day
22period why the application is incomplete.
23    The State Board staff shall afford a reasonable amount of
24time as established by the State Board, but not to exceed 180

 

 

HB3657- 41 -LRB102 13678 RJF 19028 b

1120 days, for the review of the application. The 180-day
2120-day period begins on the day the application is found to be
3substantially complete, as that term is defined by the State
4Board. During the 180-day 120-day period, the applicant may
5request an extension. An applicant may modify the application
6at any time before a final administrative decision has been
7made on the application.
8    The State Board staff shall submit its State Board Staff
9Report to the State Board for its decision-making regarding
10approval or denial of the permit.
11    When an application for a permit is initially reviewed by
12State Board staff, as provided in this Section, the State
13Board shall, upon request by the applicant or an interested
14person, afford an opportunity for a public hearing within a
15reasonable amount of time after receipt of the complete
16application, but not to exceed 90 days after receipt of the
17complete application. Notice of the hearing shall be made
18promptly, not less than 10 days before the hearing, by
19certified mail to the applicant and, not less than 10 days
20before the hearing, by publication in a newspaper of general
21circulation in the area or community to be affected. The
22hearing shall be held in the area or community in which the
23proposed project is to be located and shall be for the purpose
24of allowing the applicant and any interested person to present
25public testimony concerning the approval, denial, renewal, or
26revocation of the permit. All interested persons attending the

 

 

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1hearing shall be given a reasonable opportunity to present
2their views or arguments in writing or orally, and a record of
3all of the testimony shall accompany any findings of the State
4Board staff. The State Board shall adopt reasonable rules and
5regulations governing the procedure and conduct of the
6hearings.
7(Source: P.A. 99-114, eff. 7-23-15; 100-681, eff. 8-3-18.)
 
8    (20 ILCS 3960/8.5)
9    (Section scheduled to be repealed on December 31, 2029)
10    Sec. 8.5. Certificate of exemption for change of ownership
11of a health care facility; discontinuation of a category of
12service; public notice and public hearing.
13    (a) Upon a finding that an application for a change of
14ownership is complete, the State Board shall publish a legal
15notice on 3 consecutive days in a newspaper of general
16circulation in the area or community to be affected and afford
17the 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
20published in a newspaper of limited circulation, if one
21exists, in the area in which the facility is located. If the
22newspaper of limited circulation is published on a daily
23basis, the additional legal notice shall be published on 3
24consecutive days. The applicant shall pay the cost incurred by
25the Board in publishing the change of ownership notice in

 

 

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

 

 

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

 

 

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1issuance of an exemption for a change of ownership, including,
2but not limited to, the time period before which a subsequent
3change of ownership of the health care facility could be
4sought, or the commitment to continue to offer for a specified
5time period any services currently offered by the health care
6facility.
7    (a-3) (Blank).
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
14the State Senator and State Representative serving the
15legislative district in which the health care facility is
16located. No later than 90 days after a discontinuation of a
17category of service, the applicant must submit a statement to
18the State Board certifying that the discontinuation is
19complete.
20    (b) If a public hearing is requested, it shall be held at
21least 15 days but no more than 30 days after the date of
22publication of the legal notice in the community in which the
23facility is located. The hearing shall be held in the affected
24area or community in a place of reasonable size and
25accessibility and a full and complete written transcript of
26the proceedings shall be made. All interested persons

 

 

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1attending the hearing shall be given a reasonable opportunity
2to present their positions in writing or orally. The applicant
3shall provide a summary or describe the proposed change of
4ownership at the public hearing.
5    (c) For the purposes of this Section "newspaper of limited
6circulation" means a newspaper intended to serve a particular
7or defined population of a specific geographic area within a
8Metropolitan Statistical Area such as a municipality, town,
9village, township, or community area, but does not include
10publications of professional and trade associations.
11    (d) The changes made to this Section by this amendatory
12Act of the 101st General Assembly shall apply to all
13applications submitted after the effective date of this
14amendatory Act of the 101st General Assembly.
15(Source: P.A. 100-201, eff. 8-18-17; 101-83, eff. 7-15-19.)
 
16    (20 ILCS 3960/8.7)
17    (Section scheduled to be repealed on December 31, 2029)
18    Sec. 8.7. Application for permit for discontinuation of a
19health care facility or category of service; public notice and
20public hearing.
21    (a) Upon a finding that an application to close a health
22care facility or discontinue a category of service is
23complete, the State Board shall publish a legal notice on 3
24consecutive days in a newspaper of general circulation in the
25area or community to be affected and afford the public an

 

 

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1opportunity to request a hearing. If the application is for a
2facility located in a Metropolitan Statistical Area, an
3additional legal notice shall be published in a newspaper of
4limited circulation, if one exists, in the area in which the
5facility is located. If the newspaper of limited circulation
6is published on a daily basis, the additional legal notice
7shall be published on 3 consecutive days. The legal notice
8shall also be posted on the Health Facilities and Services
9Review Board's website and sent to the State Representative
10and State Senator of the district in which the health care
11facility is located. In addition, the health care facility
12shall provide notice of closure to the local media that the
13health care facility would routinely notify about facility
14events.
15    An application to close a health care facility shall only
16be deemed complete if it includes evidence that the health
17care facility provided written notice at least 30 days prior
18to filing the application of its intent to do so to the
19municipality in which it is located, the State Representative
20and State Senator of the district in which the health care
21facility is located, the State Board, the Director of Public
22Health, and the Director of Healthcare and Family Services.
23The changes made to this subsection by this amendatory Act of
24the 101st General Assembly shall apply to all applications
25submitted after the effective date of this amendatory Act of
26the 101st General Assembly.

 

 

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1    (b) An application to close a hospital facility, or
2discontinue a hospital service if applicable, shall only be
3deemed complete when the applicant includes a list of public
4support or subsidies it has received without repaying or
5fulfilling obligations or any other public subsidies it has
6received in the past 5 years, including hospital assessment
7funded supplemental payments, capital development grants,
8public health grants, economic development grants and
9supports, and any other categories the Board may identify by
10rule. In cases of service discontinuation, this requirement
11applies if the support or subsidy is specific to the service.
12    (c) In cases of hospital facility or service
13discontinuation, a public response to a safety net impact
14statement under subsection (f) of Section 5.4, emergency
15medicine and trauma system impact statement under subsection
16(e) of Section 5.5, or maternal and child health impact
17statement under subsection (e) of Section 5.6 may request an
18investigative hearing by the full board under the procedures
19set forth in Section 13. Such request shall be granted unless
20the Board finds the applicant has shown a likelihood there
21will be no impact on the services that are the subject of the
22request.
23    (d) No later than 30 days after issuance of a permit to
24close a health care facility or discontinue a category of
25service, the permit holder shall give written notice of the
26closure or discontinuation to the State Senator and State

 

 

HB3657- 49 -LRB102 13678 RJF 19028 b

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

 

 

HB3657- 50 -LRB102 13678 RJF 19028 b

1    consideration the priorities and needs of medically
2    underserved areas and other health care services, giving
3    special consideration to the impact of projects on access
4    to safety net services.
5        (2) Adopt procedures for public notice and hearing on
6    all proposed rules, regulations, standards, criteria, and
7    plans required to carry out the provisions of this Act.
8        (3) (Blank).
9        (4) Develop criteria and standards for health care
10    facilities planning, conduct statewide inventories of
11    health care facilities, maintain an updated inventory on
12    the Board's web site reflecting the most recent bed and
13    service changes and updated need determinations when new
14    census data become available or new need formulae are
15    adopted, and develop health care facility plans which
16    shall be utilized in the review of applications for permit
17    under this Act. Such health facility plans shall be
18    coordinated by the Board with pertinent State Plans.
19    Inventories pursuant to this Section of skilled or
20    intermediate care facilities licensed under the Nursing
21    Home Care Act, skilled or intermediate care facilities
22    licensed under the ID/DD Community Care Act, skilled or
23    intermediate care facilities licensed under the MC/DD Act,
24    facilities licensed under the Specialized Mental Health
25    Rehabilitation Act of 2013, or nursing homes licensed
26    under the Hospital Licensing Act shall be conducted on an

 

 

HB3657- 51 -LRB102 13678 RJF 19028 b

1    annual basis no later than July 1 of each year and shall
2    include among the information requested a list of all
3    services provided by a facility to its residents and to
4    the community at large and differentiate between active
5    and inactive beds.
6        In developing health care facility plans, the State
7    Board shall consider, but shall not be limited to, the
8    following:
9            (a) The size, composition and growth of the
10        population of the area to be served including Medicaid
11        population specifically;
12            (b) The number of existing and planned facilities
13        offering similar programs;
14            (c) The extent of utilization of existing
15        facilities including Medicaid utilization
16        specifically;
17            (d) The availability of facilities which may serve
18        as alternatives or substitutes;
19            (e) The availability of personnel necessary to the
20        operation of the facility;
21            (f) Multi-institutional planning and the
22        establishment of multi-institutional systems where
23        feasible;
24            (g) The financial and economic feasibility of
25        proposed construction or modification; and
26            (g-5) Impact on safety net services including

 

 

HB3657- 52 -LRB102 13678 RJF 19028 b

1        safety net and critical access hospitals;
2            (h) In the case of health care facilities
3        established by a religious body or denomination, the
4        needs of the members of such religious body or
5        denomination may be considered to be public need; and .
6            (i) The presence and severity of health
7        disparities in the area and among the population to be
8        served. This at minimum must include consideration of
9        disparities in healthcare access and outcomes by
10        income, race and ethnic identity, and preferred
11        language.
12        The health care facility plans which are developed and
13    adopted in accordance with this Section shall form the
14    basis for the plan of the State to deal most effectively
15    with statewide health needs in regard to health care
16    facilities.
17        (5) Coordinate with other state agencies having
18    responsibilities affecting health care facilities,
19    including those of licensure and cost reporting.
20        (6) Solicit, accept, hold and administer on behalf of
21    the State any grants or bequests of money, securities or
22    property for use by the State Board in the administration
23    of this Act; and enter into contracts consistent with the
24    appropriations for purposes enumerated in this Act.
25        (7) (Blank).
26        (7.5) Protect safety net services.

 

 

HB3657- 53 -LRB102 13678 RJF 19028 b

1        (8) Prescribe rules, regulations, standards, and
2    criteria for the conduct of an expeditious review of
3    applications for permits for projects of construction or
4    modification of a health care facility, which projects are
5    classified as emergency, substantive, or non-substantive
6    in nature.
7        Substantive projects shall include no more than the
8    following:
9            (a) Projects to construct (1) a new or replacement
10        facility located on a new site or (2) a replacement
11        facility located on the same site as the original
12        facility and the cost of the replacement facility
13        exceeds the capital expenditure minimum, which shall
14        be reviewed by the Board within 120 days;
15            (b) Projects proposing a (1) new service within an
16        existing healthcare facility or (2) discontinuation of
17        a service within an existing healthcare facility,
18        which shall be reviewed by the Board within 60 days; or
19            (c) Projects proposing a change in the bed
20        capacity of a health care facility by an increase in
21        the total number of beds or by a redistribution of beds
22        among various categories of service or by a relocation
23        of beds from one physical facility or site to another
24        by more than 20 beds or more than 10% of total bed
25        capacity, as defined by the State Board, whichever is
26        less, over a 2-year period.

 

 

HB3657- 54 -LRB102 13678 RJF 19028 b

1        The Chairman may approve applications for exemption
2    that meet the criteria set forth in rules or refer them to
3    the full Board. The Chairman may approve any unopposed
4    application that meets all of the review criteria or refer
5    them to the full Board.
6        Such rules shall not prevent the conduct of a public
7    hearing upon the timely request of an interested party.
8    Such reviews shall not exceed 60 days from the date the
9    application is declared to be complete.
10        (9) Prescribe rules, regulations, standards, and
11    criteria pertaining to the granting of permits for
12    construction and modifications which are emergent in
13    nature and must be undertaken immediately to prevent or
14    correct structural deficiencies or hazardous conditions
15    that may harm or injure persons using the facility, as
16    defined in the rules and regulations of the State Board.
17    This procedure is exempt from public hearing requirements
18    of this Act.
19        (10) Prescribe rules, regulations, standards and
20    criteria for the conduct of an expeditious review, not
21    exceeding 60 days, of applications for permits for
22    projects to construct or modify health care facilities
23    which are needed for the care and treatment of persons who
24    have acquired immunodeficiency syndrome (AIDS) or related
25    conditions.
26        (10.5) Provide its rationale when voting on an item

 

 

HB3657- 55 -LRB102 13678 RJF 19028 b

1    before it at a State Board meeting in order to comply with
2    subsection (b) of Section 3-108 of the Code of Civil
3    Procedure.
4        (11) Issue written decisions upon request of the
5    applicant or an adversely affected party to the Board.
6    Requests for a written decision shall be made within 15
7    days after the Board meeting in which a final decision has
8    been made. A "final decision" for purposes of this Act is
9    the decision to approve or deny an application, or take
10    other actions permitted under this Act, at the time and
11    date of the meeting that such action is scheduled by the
12    Board. The transcript of the State Board meeting shall be
13    incorporated into the Board's final decision. The staff of
14    the Board shall prepare a written copy of the final
15    decision and the Board shall approve a final copy for
16    inclusion in the formal record. The Board shall consider,
17    for approval, the written draft of the final decision no
18    later than the next scheduled Board meeting. The written
19    decision shall identify the applicable criteria and
20    factors listed in this Act and the Board's regulations
21    that were taken into consideration by the Board when
22    coming to a final decision. If the Board denies or fails to
23    approve an application for permit or exemption, the Board
24    shall include in the final decision a detailed explanation
25    as to why the application was denied and identify what
26    specific criteria or standards the applicant did not

 

 

HB3657- 56 -LRB102 13678 RJF 19028 b

1    fulfill.
2        (12) (Blank).
3        (13) Provide a mechanism for the public to comment on,
4    and request changes to, draft rules and standards.
5        (14) Implement public information campaigns to
6    regularly inform the general public about the opportunity
7    for public hearings and public hearing procedures.
8        (15) Establish a separate set of rules and guidelines
9    for long-term care that recognizes that nursing homes are
10    a different business line and service model from other
11    regulated facilities. An open and transparent process
12    shall be developed that considers the following: how
13    skilled nursing fits in the continuum of care with other
14    care providers, modernization of nursing homes,
15    establishment of more private rooms, development of
16    alternative services, and current trends in long-term care
17    services. The Chairman of the Board shall appoint a
18    permanent Health Services Review Board Long-term Care
19    Facility Advisory Subcommittee that shall develop and
20    recommend to the Board the rules to be established by the
21    Board under this paragraph (15). The Subcommittee shall
22    also provide continuous review and commentary on policies
23    and procedures relative to long-term care and the review
24    of related projects. The Subcommittee shall make
25    recommendations to the Board no later than January 1, 2016
26    and every January thereafter pursuant to the

 

 

HB3657- 57 -LRB102 13678 RJF 19028 b

1    Subcommittee's responsibility for the continuous review
2    and commentary on policies and procedures relative to
3    long-term care. In consultation with other experts from
4    the health field of long-term care, the Board and the
5    Subcommittee shall study new approaches to the current bed
6    need formula and Health Service Area boundaries to
7    encourage flexibility and innovation in design models
8    reflective of the changing long-term care marketplace and
9    consumer preferences and submit its recommendations to the
10    Chairman of the Board no later than January 1, 2017. The
11    Subcommittee shall evaluate, and make recommendations to
12    the State Board regarding, the buying, selling, and
13    exchange of beds between long-term care facilities within
14    a specified geographic area or drive time. The Board shall
15    file the proposed related administrative rules for the
16    separate rules and guidelines for long-term care required
17    by this paragraph (15) by no later than September 30,
18    2011. The Subcommittee shall be provided a reasonable and
19    timely opportunity to review and comment on any review,
20    revision, or updating of the criteria, standards,
21    procedures, and rules used to evaluate project
22    applications as provided under Section 12.3 of this Act.
23        The Chairman of the Board shall appoint voting members
24    of the Subcommittee, who shall serve for a period of 3
25    years, with one-third of the terms expiring each January,
26    to be determined by lot. Appointees shall include, but not

 

 

HB3657- 58 -LRB102 13678 RJF 19028 b

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

 

 

HB3657- 59 -LRB102 13678 RJF 19028 b

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

 

 

HB3657- 60 -LRB102 13678 RJF 19028 b

1    98-651).
2        (18) Elect a Vice Chairman to preside over State Board
3    meetings and otherwise act in place of the Chairman when
4    the Chairman is unavailable.
5(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18;
6101-83, eff. 7-15-19.)
 
7    (20 ILCS 3960/12.3)
8    (Section scheduled to be repealed on December 31, 2029)
9    Sec. 12.3. Revision of criteria, standards, and rules. At
10least every 2 years, the State Board shall review, revise, and
11update the criteria, standards, and rules used to evaluate
12applications for permit and exemption. The Board may appoint
13temporary advisory committees made up of experts with
14professional competence in the subject matter of the proposed
15standards or criteria to assist in the development of
16revisions to requirements, standards, and criteria. In
17particular, the review of the criteria, standards, and rules
18shall consider:
19        (1) Whether the requirements, criteria, and standards
20    reflect current industry standards and anticipated trends.
21        (2) Whether the criteria and standards can be reduced
22    or eliminated.
23        (3) Whether requirements, criteria, and standards can
24    be developed to authorize the construction of unfinished
25    space for future use when the ultimate need for such space

 

 

HB3657- 61 -LRB102 13678 RJF 19028 b

1    can be reasonably projected.
2        (4) Whether the criteria and standards take into
3    account issues related to population growth, and changing
4    demographics, Medicaid utilization, and the presence and
5    severity of health disparities in a community, which at
6    minimum must include consideration of disparities in
7    healthcare access and outcomes by income, race and ethnic
8    identity, and preferred language.
9        (5) Whether facility-defined service and planning
10    areas should be recognized.
11        (6) Whether categories of service that are subject to
12    review should be re-evaluated, including provisions
13    related to structural, functional, and operational
14    differences between long-term care facilities and acute
15    care facilities and that allow routine changes of
16    ownership, facility sales, and closure requests to be
17    processed on a more timely basis.
18    As of July 1, 2021 and thereafter, the State Board may not
19utilize need formulae for lines of service that do not factor
20in disparities in incidence of health conditions or other
21demonstrated need for the service.
22(Source: P.A. 99-527, eff. 1-1-17; 100-681, eff. 8-3-18.)
 
23    (20 ILCS 3960/12.4)
24    (Section scheduled to be repealed on December 31, 2029)
25    Sec. 12.4. Hospital reduction in health care services;

 

 

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1notice. If a hospital reduces any of the Categories of Service
2as outlined in Title 77, Chapter II, Part 1110 in the Illinois
3Administrative Code, or any other service as defined by rule
4by the State Board, by 50% or more according to rules adopted
5by the State Board, then within 30 days after reducing the
6service, the hospital must give written notice of the
7reduction in service to the State Board, the Department of
8Public Health, and the State Senator and State Representative
9serving the legislative district in which the hospital is
10located. If the amount of the reduction is greater than or
11equal to 5% of service inventory in the region, the State Board
12shall cause the notice to be published in the publications and
13locations listed in subsection (a) of Section 8.7. Any party
14receiving notice may request a safety net impact statement,
15emergency medicine and trauma system impact statement, or
16maternal and child health impact statement, as described at:
17(i) subsections (c) and (d) of Section 5.4; (ii) subsections
18(b) and (c) of Section 5.5; and (iii) subsections (b) and (c)
19of Section 5.6, respectively, to be filed describing impact of
20the reduction in services. The State Board shall adopt rules
21to implement this Section, including rules that specify (i)
22how each health care service is defined, if not already
23defined in the State Board's rules, and (ii) what constitutes
24a reduction in service of 50% or more.
25(Source: P.A. 100-681, eff. 8-3-18.)
 

 

 

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1    (20 ILCS 3960/13.1)  (from Ch. 111 1/2, par. 1163.1)
2    (Section scheduled to be repealed on December 31, 2029)
3    Sec. 13.1. Any person establishing, constructing, or
4modifying a health care facility or portion thereof without
5obtaining a required permit, or in violation of the terms of
6the required permit, shall not be eligible to apply for any
7necessary operating licenses or be eligible for payment by any
8State agency for services rendered in that facility until the
9required permit is obtained. In cases of any person
10discontinuing a hospital facility or category of service
11without obtaining a required permit, or in violation of the
12terms of the required permit, no related person shall be
13eligible to apply for any necessary operating licenses nor
14shall any related person be eligible for payment by any State
15agency for services rendered until the required permit is
16obtained.
17(Source: P.A. 88-18.)
 
18    (20 ILCS 3960/14)  (from Ch. 111 1/2, par. 1164)
19    (Section scheduled to be repealed on December 31, 2029)
20    Sec. 14. Any person who has discontinued a hospital or a
21category of service at a hospital without a permit or
22exemption issued under this Act or in violation of the terms of
23such a permit or exemption is guilty of a business offense and
24may be fined up to $1,000,000. Any person otherwise acquiring
25major medical equipment or establishing, constructing or

 

 

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1modifying a health care facility without a permit issued under
2this Act or in violation of the terms of such a permit is
3guilty of a business offense and may be fined up to $100,000
4$25,000. The State's Attorneys of the several counties or the
5Attorney General shall represent the People of the State of
6Illinois in proceedings under this Section. The State's
7Attorneys of the several counties or the Attorney General may
8additionally maintain an action in the name of the People of
9the State of Illinois for injunction or other process against
10any person or governmental unit to restrain or prevent the
11acquisition of major medical equipment, or the establishment,
12construction or modification of a health care facility without
13the required permit, or to restrain or prevent the occupancy
14or utilization of the equipment acquired or facility which was
15constructed or modified without the required permit.
16Proceedings The prosecution of an offense under this Section,
17including the prosecution of an offense, shall not prohibit
18the imposition of any other sanction provided under this Act.
19(Source: P.A. 88-18.)
 
20    (20 ILCS 3960/14.05 new)
21    Sec. 14.05. Right of action. Any person aggrieved by a
22violation of this Act, due to a negative impact on their access
23to health care or on their health due to diminished access to
24health care, involving the discontinuation of a hospital or a
25discontinuation of a category of service at a hospital without

 

 

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1a permit or exemption as required by this Act shall have a
2right of action in a State circuit court or as a supplemental
3claim in federal district court against an offending party. A
4prevailing party may recover for each violation: (i) any
5actual damages; (ii) an injunction or other relief as the
6court may deem appropriate; and (iii) reasonable attorney's
7fees.
 
8    (20 ILCS 3960/14.1)
9    (Section scheduled to be repealed on December 31, 2029)
10    Sec. 14.1. Denial of permit; other sanctions.
11    (a) The State Board may deny an application for a permit or
12may revoke or take other action as permitted by this Act with
13regard to a permit as the State Board deems appropriate,
14including the imposition of fines as set forth in this
15Section, for any one or a combination of the following:
16        (1) The acquisition of major medical equipment without
17    a permit or in violation of the terms of a permit.
18        (2) The establishment, construction, modification, or
19    change of ownership of a health care facility without a
20    permit or exemption or in violation of the terms of a
21    permit.
22        (3) The violation of any provision of this Act or any
23    rule adopted under this Act.
24        (4) The failure, by any person subject to this Act, to
25    provide information requested by the State Board or Agency

 

 

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1    within 30 days after a formal written request for the
2    information.
3        (5) The failure to pay any fine imposed under this
4    Section within 30 days of its imposition.
5    (a-5) For facilities licensed under the ID/DD Community
6Care Act, no permit shall be denied on the basis of prior
7operator history, other than for actions specified under item
8(2), (4), or (5) of Section 3-117 of the ID/DD Community Care
9Act. For facilities licensed under the MC/DD Act, no permit
10shall be denied on the basis of prior operator history, other
11than for actions specified under item (2), (4), or (5) of
12Section 3-117 of the MC/DD Act. For facilities licensed under
13the Specialized Mental Health Rehabilitation Act of 2013, no
14permit shall be denied on the basis of prior operator history,
15other than for actions specified under subsections (a) and (b)
16of Section 4-109 of the Specialized Mental Health
17Rehabilitation Act of 2013. For facilities licensed under the
18Nursing Home Care Act, no permit shall be denied on the basis
19of prior operator history, other than for: (i) actions
20specified under item (2), (3), (4), (5), or (6) of Section
213-117 of the Nursing Home Care Act; (ii) actions specified
22under item (a)(6) of Section 3-119 of the Nursing Home Care
23Act; or (iii) actions within the preceding 5 years
24constituting a substantial and repeated failure to comply with
25the Nursing Home Care Act or the rules and regulations adopted
26by the Department under that Act. The State Board shall not

 

 

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1deny a permit on account of any action described in this
2subsection (a-5) without also considering all such actions in
3the light of all relevant information available to the State
4Board, including whether the permit is sought to substantially
5comply with a mandatory or voluntary plan of correction
6associated with any action described in this subsection (a-5).
7    (b) Persons shall be subject to fines as provided in this
8subsection (b). The maximum fines imposed under this
9subsection (b) shall be annually adjusted and proportional
10with the increase in construction costs due to inflation, for
11major medical equipment and for all other capital
12expenditures. as follows:
13        (1) A permit holder who fails to comply with the
14    requirements of maintaining a valid permit shall be fined
15    an amount not to exceed 1% of the approved permit amount
16    plus an additional 1% of the approved permit amount for
17    each 30-day period, or fraction thereof, that the
18    violation continues.
19        (2) A permit holder who alters the scope of an
20    approved project or whose project costs exceed the
21    allowable permit amount without first obtaining approval
22    from the State Board shall be fined an amount not to exceed
23    the sum of (i) the lesser of $40,000 $25,000 or 2% of the
24    approved permit amount and (ii) in those cases where the
25    approved permit amount is exceeded by more than
26    $1,000,000, an additional $40,000 $20,000 for each

 

 

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1    $1,000,000, or fraction thereof, in excess of the approved
2    permit amount.
3        (2.5) A permit or exemption holder who fails to comply
4    with the post-permit and reporting requirements set forth
5    in Sections 5 and 8.5 shall be fined an amount not to
6    exceed $18,000 $10,000 plus an additional $18,000 $10,000
7    for each 30-day period, or fraction thereof, that the
8    violation continues. The accrued fine is not waived by the
9    permit or exemption holder submitting the required
10    information and reports. Prior to any fine beginning to
11    accrue, the Board shall notify, in writing, a permit or
12    exemption holder of the due date for the post-permit and
13    reporting requirements no later than 30 days before the
14    due date for the requirements. The exemption letter shall
15    serve as the notice for exemptions.
16        (3) A person who acquires major medical equipment or
17    who establishes a category of service without first
18    obtaining a permit or exemption, as the case may be, shall
19    be fined an amount not to exceed $18,000 $10,000 for each
20    such acquisition or category of service established plus
21    an additional $18,000 $10,000 for each 30-day period, or
22    fraction thereof, that the violation continues.
23        (4) A person who constructs, modifies, establishes, or
24    changes ownership of a health care facility without first
25    obtaining a permit or exemption shall be fined an amount
26    not to exceed $40,000 $25,000 plus an additional $40,000

 

 

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1    $25,000 for each 30-day period, or fraction thereof, that
2    the violation continues.
3        (5) A person who discontinues a health care facility
4    other than a hospital or a category of service at a health
5    care facility other than a hospital without first
6    obtaining a permit or exemption shall be fined an amount
7    not to exceed $25,000 $10,000 plus an additional $25,000
8    $10,000 for each 30-day period, or fraction thereof, that
9    the violation continues. For purposes of this subparagraph
10    (5), facilities licensed under the Nursing Home Care Act,
11    the ID/DD Community Care Act, or the MC/DD Act, with the
12    exceptions of facilities operated by a county or Illinois
13    Veterans Homes, are exempt from this permit requirement.
14    However, facilities licensed under the Nursing Home Care
15    Act, the ID/DD Community Care Act, or the MC/DD Act must
16    comply with Section 3-423 of the Nursing Home Care Act,
17    Section 3-423 of the ID/DD Community Care Act, or Section
18    3-423 of the MC/DD Act and must provide the Board and the
19    Department of Human Services with 30 days' written notice
20    of their intent to close. Facilities licensed under the
21    ID/DD Community Care Act or the MC/DD Act also must
22    provide the Board and the Department of Human Services
23    with 30 days' written notice of their intent to reduce the
24    number of beds for a facility.
25        (5.5) A person who discontinues a hospital facility or
26    category of service without first obtaining a permit or

 

 

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1    exemption shall be fined an amount not to exceed $100,000
2    plus an additional $100,000 for each 30-day period, or
3    fraction thereof, that the violation continues.
4        (6) A person subject to this Act who fails to provide
5    information requested by the State Board or Agency within
6    30 days of a formal written request shall be fined an
7    amount not to exceed $2,000 $1,000 plus an additional
8    $2,000 $1,000 for each 30-day period, or fraction thereof,
9    that the information is not received by the State Board or
10    Agency.
11    (b-5) Notwithstanding any other provision of this Act, the
12State board may not accept in-kind services or donations
13instead of or in combination with any fine imposed on a person
14due to their discontinuation of a hospital or a category of
15service at a hospital. The State Board may accept in-kind
16services or donations instead of or in combination with the
17imposition of a fine. This authorization is limited to cases
18where the non-compliant individual or entity has waived the
19right to an administrative hearing or opportunity to appear
20before the Board regarding the non-compliant matter.
21    (c) Before imposing any fine authorized under this
22Section, the State Board shall afford the person or permit
23holder, as the case may be, an appearance before the State
24Board and an opportunity for a hearing before a hearing
25officer appointed by the State Board. The hearing shall be
26conducted in accordance with Section 10. Requests for an

 

 

HB3657- 71 -LRB102 13678 RJF 19028 b

1appearance before the State Board must be made within 30 days
2after receiving notice that a fine will be imposed.
3    (d) All fines collected under this Act shall be
4transmitted to the State Treasurer, who shall deposit them
5into the Illinois Health Facilities Planning Fund.
6    (e) Fines imposed under this Section shall continue to
7accrue until: (i) the date that the matter is referred by the
8State Board to the Board's legal counsel; or (ii) the date that
9the health care facility becomes compliant with the Act,
10whichever is earlier.
11(Source: P.A. 99-114, eff. 7-23-15; 99-180, eff. 7-29-15;
1299-527, eff. 1-1-17; 99-642, eff. 6-28-16; 100-681, eff.
138-3-18.)
 
14    (20 ILCS 3960/14.2 new)
15    Sec. 14.2. Receivership.
16    (a) Should a person attempt to discontinue a hospital
17facility or category of service without first obtaining a
18permit or exemption, the State Board may file a verified
19petition to the circuit court for the county in which the
20facility is located for an order placing the facility under
21the control of a receiver.
22    (b) The court shall hold a hearing within 5 days after the
23filing of the petition. The petition and notice of the hearing
24shall be served on the owner, administrator or designated
25agent of the facility as provided under the Civil Practice

 

 

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1Law, or the petition and notice of hearing shall be posted in a
2conspicuous place in the facility not later than 3 days before
3the time specified for the hearing, unless a different period
4is fixed by order of the court.
5    (c) The court may appoint any qualified person as
6receiver, except it shall not appoint any owner or related
7person of the facility which is in receivership as its
8receiver. The State Board shall maintain a list of such
9persons to operate facilities which the court may consider.
10    (d) The receiver shall make provisions for the continued
11health, safety, and welfare of all patients utilizing the
12facility.
13    (e) A receiver appointed under this Act:
14        (1) Shall exercise those powers and shall perform
15    those duties set out by the court.
16        (2) Shall operate the facility in such a manner as to
17    assure the safety and adequate health care for patients.
18        (3) Shall have the same rights to possession of the
19    building in which the facility is located and all goods
20    and fixtures in the building at the time the petition for
21    receivership is filed as the owner would have had if the
22    receiver had not been appointed, and of all assets of the
23    facility. The receiver shall take such action as
24    reasonably necessary to protect or conserve the assets or
25    property of which the receiver takes possession, or the
26    proceeds from any transfer thereof, and may use them only

 

 

HB3657- 73 -LRB102 13678 RJF 19028 b

1    in the performance of the powers and duties set forth in
2    this Section and by order of the court.
3        (4) May use the building, fixtures, furnishing and any
4    accompanying consumable goods in the provision of care and
5    services to patients receiving services from the facility.
6    The receiver shall collect payments for all goods and
7    services provided to patients during the period of the
8    receivership at the same rate of payment charged by the
9    operator at the time the petition for receivership was
10    filed.
11        (5) May let contracts and hire agents and employees to
12    carry out the powers and duties of the receiver under this
13    Section.
14        (6) Shall honor all leases, mortgages and secured
15    transactions governing the building in which the facility
16    is located and all goods and fixtures in the building of
17    which the receiver has taken possession, but only to the
18    extent of payment which, in the case of a purchase
19    agreement, come due during the period of receivership.
20        (7) Shall have full power to direct and manage and to
21    discharge employees of the facility, subject to any
22    contract rights they may have. The receiver shall pay
23    employees at minimum the same rate of compensation,
24    including benefits, that the employees would have received
25    from the obligation to employees not carried out by the
26    receiver.

 

 

HB3657- 74 -LRB102 13678 RJF 19028 b

1        (8) Shall report to the court any actions they believe
2    should be continued when the receivership is terminated.
3    (f) A person who is served with notice of an order of the
4court appointing a receiver and of the receiver's name and
5address shall be liable to pay the receiver for any goods or
6services provided by the receiver after the date of the date of
7the order if the person would have been liable for the goods or
8services as supplied by the owner. The receiver shall give a
9receipt for each payment and shall keep a copy of each receipt
10on file. The receiver shall deposit amounts received in a
11separate account and shall use this account for all
12disbursements. The receiver may bring an action to enforce the
13liability created by this subsection.
14    (g) If there are insufficient fund on hand to meet the
15expenses of performing the powers and duties conferred on the
16receiver, the State Board may reimburse the receiver for those
17expenses from funds appropriated for its ordinary and
18contingent expenses by the General Assembly.
19    (h) In any action or special proceeding brought against a
20receiver in the receiver's official capacity for acts
21committed while carrying out powers and duties under this
22Section, the receiver shall be considered a public employee. A
23receiver may be held liable in a personal capacity only for the
24receivers own gross negligence, intentional acts, or breach of
25fiduciary duty.
26    (i) Other provisions of this Act notwithstanding, the

 

 

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1Department may issue a license to a facility placed in
2receivership. The duration of a license issued under this
3Section is limited to the duration of the receivership.
4    (j) The court may terminate a receivership at any time if
5it determines that the receivership is no longer necessary
6because the conditions which gave rise to the receivership no
7longer exist, either because the person attempting to
8discontinue the hospital facility or category of service
9without first obtaining a permit has obtained a permit
10allowing them to do so, or because the person attempting to
11discontinue the hospital facility or category of service
12without first obtaining a permit has ceased attempting to
13discontinue the hospital facility or category of service
14without first obtaining a permit.
 
15    Section 15. The Illinois Public Aid Code is amended by
16changing Section 5A-17 as follows:
 
17    (305 ILCS 5/5A-17)
18    Sec. 5A-17. Recovery of payments; liens.
19    (a) As a condition of receiving payments pursuant to
20subsections (d) and (k) of Section 5A-12.7 for State Fiscal
21Year 2021, a for-profit general acute care hospital that
22ceases to provide hospital services before July 1, 2021 and
23within 12 months of a change in the hospital's ownership
24status from not-for-profit to investor owned, shall be

 

 

HB3657- 76 -LRB102 13678 RJF 19028 b

1obligated to pay to the Department an amount equal to the
2payments received pursuant to subsections (d) and (k) of
3Section 5A-12.7 since the change in ownership status to the
4cessation of hospital services. The obligated amount shall be
5due immediately and must be paid to the Department within 10
6days of ceasing to provide services or pursuant to a payment
7plan approved by the Department unless the hospital requests a
8hearing under paragraph (d) of this Section. The obligation
9under this Section shall not apply to a hospital that ceases to
10provide services under circumstances that include:
11implementation of a transformation project approved by the
12Department under subsection (d-5) of Section 14-12;
13emergencies as declared by federal, State, or local
14government; actions approved or required by federal, State, or
15local government; actions taken in compliance with the
16Illinois Health Facilities Planning Act; or other
17circumstances beyond the control of the hospital provider or
18for the benefit of the community previously served by the
19hospital, as determined on a case-by-case basis by the
20Department.
21    (a-5) As a condition of receiving payments pursuant to
22subsections (d) and (k) of Section 5A-12.7 for calendar year
232021, a general acute care hospital that ceases to provide
24hospital services before January 1, 2022 shall be obligated to
25pay to the Department an amount equal to the payments received
26pursuant to subsections (d) and (k) of Section 5A-12.7 up to

 

 

HB3657- 77 -LRB102 13678 RJF 19028 b

1the cessation of hospital services. The obligated amount shall
2be due immediately and must be paid to the Department within 30
3days of ceasing to provide services, or pursuant to a payment
4plan approved by the Department. The obligation under this
5Section shall not apply to a hospital that ceases to provide
6services under circumstances that include: (i) implementation
7of a transformation project approved under subsection (d-5) of
8Section 14-12; (ii) emergencies as declared by federal, State,
9or local government; (iii) actions approved or required by
10federal, State, or local government; (iv) actions taken in
11compliance with the Illinois Health Facilities Planning Act;
12or (v) other circumstances beyond the control of the hospital
13provider or for the benefit of the community previously served
14by the hospital, as determined on a case-by-case basis by the
15Department.
16    (b) The Illinois Department shall administer and enforce
17this Section and collect the obligations imposed under this
18Section using procedures employed in its administration of
19this Code generally. The Illinois Department, its Director,
20and every hospital provider subject to this Section shall have
21the following powers, duties, and rights:
22        (1) The Illinois Department may initiate either
23    administrative or judicial proceedings, or both, to
24    enforce the provisions of this Section. Administrative
25    enforcement proceedings initiated hereunder shall be
26    governed by the Illinois Department's administrative

 

 

HB3657- 78 -LRB102 13678 RJF 19028 b

1    rules. Judicial enforcement proceedings initiated in
2    accordance with this Section shall be governed by the
3    rules of procedure applicable in the courts of this State.
4        (2) No proceedings for collection, refund, credit, or
5    other adjustment of an amount payable under this Section
6    shall be issued more than 3 years after the due date of the
7    obligation, except in the case of an extended period
8    agreed to in writing by the Illinois Department and the
9    hospital provider before the expiration of this limitation
10    period.
11        (3) Any unpaid obligation under this Section shall
12    become a lien upon the assets of the hospital. If any
13    hospital provider sells or transfers the major part of any
14    one or more of (i) the real property and improvements,
15    (ii) the machinery and equipment, or (iii) the furniture
16    or fixtures of any hospital that is subject to the
17    provisions of this Section, the seller or transferor shall
18    pay the Illinois Department the amount of any obligation
19    due from it under this Section up to the date of the sale
20    or transfer. If the seller or transferor fails to pay any
21    amount due under this Section, the purchaser or transferee
22    of such asset shall be liable for the amount of the
23    obligation up to the amount of the reasonable value of the
24    property acquired by the purchaser or transferee. The
25    purchaser or transferee shall continue to be liable until
26    the purchaser or transferee pays the full amount of the

 

 

HB3657- 79 -LRB102 13678 RJF 19028 b

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

 

 

HB3657- 80 -LRB102 13678 RJF 19028 b

1 INDEX
2 Statutes amended in order of appearance
3    20 ILCS 2310/2310-222
4    20 ILCS 3960/2from Ch. 111 1/2, par. 1152
5    20 ILCS 3960/3from Ch. 111 1/2, par. 1153
6    20 ILCS 3960/4from Ch. 111 1/2, par. 1154
7    20 ILCS 3960/5from Ch. 111 1/2, par. 1155
8    20 ILCS 3960/5.4
9    20 ILCS 3960/5.5 new
10    20 ILCS 3960/5.6 new
11    20 ILCS 3960/6from Ch. 111 1/2, par. 1156
12    20 ILCS 3960/6.05 new
13    20 ILCS 3960/6.2
14    20 ILCS 3960/8.5
15    20 ILCS 3960/8.7
16    20 ILCS 3960/12from Ch. 111 1/2, par. 1162
17    20 ILCS 3960/12.3
18    20 ILCS 3960/12.4
19    20 ILCS 3960/13.1from Ch. 111 1/2, par. 1163.1
20    20 ILCS 3960/14from Ch. 111 1/2, par. 1164
21    20 ILCS 3960/14.05 new
22    20 ILCS 3960/14.1
23    20 ILCS 3960/14.2 new
24    305 ILCS 5/5A-17