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

HB3657ham001 102ND GENERAL ASSEMBLY

Rep. Lamont J. Robinson, Jr.

Filed: 4/16/2021

 

 


 

 


 
10200HB3657ham001LRB102 13678 RJF 25305 a

1
AMENDMENT TO HOUSE BILL 3657

2    AMENDMENT NO. ______. Amend House Bill 3657 by replacing
3everything after the enacting clause with the following:
 
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

 

 

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1facilities conduct continuing education yearly for providers
2and staff of obstetric medicine and of the emergency
3department and other staff that may care for pregnant or
4postpartum women. The continuing education shall include
5yearly educational modules regarding management of severe
6maternal hypertension and obstetric hemorrhage for units that
7care for pregnant or postpartum women. Birthing facilities
8must demonstrate compliance with these education and training
9requirements.
10    (c) The Department shall collaborate with the Illinois
11Perinatal Quality Collaborative or its successor organization
12to develop an initiative to improve birth equity and reduce
13peripartum racial and ethnic disparities. The Department shall
14ensure that the initiative includes the development of best
15practices for implicit bias training and education in cultural
16competency to be used by birthing facilities in interactions
17between patients and providers. In developing the initiative,
18the Illinois Perinatal Quality Collaborative or its successor
19organization shall consider existing programs, such as the
20Alliance for Innovation on Maternal Health and the California
21Maternal Quality Collaborative's pilot work on improving birth
22equity. The Department shall support the initiation of a
23statewide perinatal quality improvement initiative in
24collaboration with birthing facilities to implement strategies
25to reduce peripartum racial and ethnic disparities and to
26address implicit bias in the health care system.

 

 

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1    (d) The Department, in consultation with the Maternal
2Mortality Review Committee, shall make available to all
3birthing facilities best practices for timely identification
4of all pregnant and postpartum women in the emergency
5department and for appropriate and timely consultation of an
6obstetric provider to provide input on management and
7follow-up. Birthing facilities may use telemedicine for the
8consultation.
9    (e) The Department may adopt rules for the purpose of
10implementing this Section.
11(Source: P.A. 101-390, eff. 1-1-20; revised 10-7-19.)
 
12    Section 10. The Illinois Health Facilities Planning Act is
13amended by changing Sections 2, 3, 5, 5.4, 6, 6.2, 8.5, 8.7,
1412, 12.3, 12.4, 13.1, 14, and 14.1 and by adding Sections 5.5,
155.6, 6.05, and 14.05 as follows:
 
16    (20 ILCS 3960/2)  (from Ch. 111 1/2, par. 1152)
17    (Section scheduled to be repealed on December 31, 2029)
18    Sec. 2. Purpose of the Act. This Act shall establish a
19procedure (1) which requires a person establishing,
20constructing or modifying a health care facility, as herein
21defined, to have the qualifications, background, character and
22financial resources to adequately provide a proper service for
23the community; (2) that promotes the orderly and economic
24development of health care facilities in the State of Illinois

 

 

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1that avoids unnecessary duplication of such facilities; (3)
2that promotes health equity including equitable access to
3quality health care through the development and preservation
4of safety net services; and (4) (3) that promotes planning for
5and development of health care facilities needed for
6comprehensive health care especially in areas where the health
7planning process has identified unmet needs.
8    The changes made to this Act by this amendatory Act of the
996th General Assembly are intended to accomplish the following
10objectives: to improve the financial ability of the public to
11obtain necessary health services; to establish an orderly and
12comprehensive health care delivery system that will guarantee
13the availability of quality health care to the general public;
14to maintain and improve the provision of essential health care
15services and increase the accessibility of those services to
16the medically underserved and indigent; to assure that the
17reduction and closure of health care services or facilities is
18performed in an orderly and timely manner, and that these
19actions are deemed to be in the best interests of the public;
20and to assess the financial burden to patients caused by
21unnecessary health care construction and modification.
22Evidence-based assessments, projections and decisions will be
23applied regarding capacity, quality, value and equity in the
24delivery of health care services in Illinois. The integrity of
25the Certificate of Need process is ensured through revised
26ethics and communications procedures. Cost containment and

 

 

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1support for safety net services must continue to be central
2tenets of the Certificate of Need process.
3    The changes made to this Act by this amendatory Act of the
4102nd General Assembly recognize a persistent problem of
5hospital service cuts and facility closures. These harm the
6health care safety net in Illinois and have negatively
7impacted access to hospital services in communities of color
8in particular. The changes are intended to accomplish the
9objective of protecting the public interest in equitable
10access to health care services.
11(Source: P.A. 99-527, eff. 1-1-17.)
 
12    (20 ILCS 3960/3)  (from Ch. 111 1/2, par. 1153)
13    (Section scheduled to be repealed on December 31, 2029)
14    Sec. 3. Definitions. As used in this Act:
15    "Health care facilities" means and includes the following
16facilities, organizations, and related persons:
17        (1) An ambulatory surgical treatment center required
18    to be licensed pursuant to the Ambulatory Surgical
19    Treatment Center Act.
20        (2) An institution, place, building, or agency
21    required to be licensed pursuant to the Hospital Licensing
22    Act.
23        (3) Skilled and intermediate long term care facilities
24    licensed under the Nursing Home Care Act.
25            (A) If a demonstration project under the Nursing

 

 

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1        Home Care Act applies for a certificate of need to
2        convert to a nursing facility, it shall meet the
3        licensure and certificate of need requirements in
4        effect as of the date of application.
5            (B) Except as provided in item (A) of this
6        subsection, this Act does not apply to facilities
7        granted waivers under Section 3-102.2 of the Nursing
8        Home Care Act.
9        (3.5) Skilled and intermediate care facilities
10    licensed under the ID/DD Community Care Act or the MC/DD
11    Act. No permit or exemption is required for a facility
12    licensed under the ID/DD Community Care Act or the MC/DD
13    Act prior to the reduction of the number of beds at a
14    facility. If there is a total reduction of beds at a
15    facility licensed under the ID/DD Community Care Act or
16    the MC/DD Act, this is a discontinuation or closure of the
17    facility. If a facility licensed under the ID/DD Community
18    Care Act or the MC/DD Act reduces the number of beds or
19    discontinues the facility, that facility must notify the
20    Board as provided in Section 14.1 of this Act.
21        (3.7) Facilities licensed under the Specialized Mental
22    Health Rehabilitation Act of 2013.
23        (4) Hospitals, nursing homes, ambulatory surgical
24    treatment centers, or kidney disease treatment centers
25    maintained by the State or any department or agency
26    thereof.

 

 

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1        (5) Kidney disease treatment centers, including a
2    free-standing hemodialysis unit required to meet the
3    requirements of 42 CFR 494 in order to be certified for
4    participation in Medicare and Medicaid under Titles XVIII
5    and XIX of the federal Social Security Act.
6            (A) This Act does not apply to a dialysis facility
7        that provides only dialysis training, support, and
8        related services to individuals with end stage renal
9        disease who have elected to receive home dialysis.
10            (B) This Act does not apply to a dialysis unit
11        located in a licensed nursing home that offers or
12        provides dialysis-related services to residents with
13        end stage renal disease who have elected to receive
14        home dialysis within the nursing home.
15            (C) The Board, however, may require dialysis
16        facilities and licensed nursing homes under items (A)
17        and (B) of this subsection to report statistical
18        information on a quarterly basis to the Board to be
19        used by the Board to conduct analyses on the need for
20        proposed kidney disease treatment centers.
21        (6) An institution, place, building, or room used for
22    the performance of outpatient surgical procedures that is
23    leased, owned, or operated by or on behalf of an
24    out-of-state facility.
25        (7) An institution, place, building, or room used for
26    provision of a health care category of service, including,

 

 

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1    but not limited to, cardiac catheterization and open heart
2    surgery.
3        (8) An institution, place, building, or room housing
4    major medical equipment used in the direct clinical
5    diagnosis or treatment of patients, and whose project cost
6    is in excess of the capital expenditure minimum.
7    "Health care facilities" does not include the following
8entities or facility transactions:
9        (1) Federally-owned facilities.
10        (2) Facilities used solely for healing by prayer or
11    spiritual means.
12        (3) An existing facility located on any campus
13    facility as defined in Section 5-5.8b of the Illinois
14    Public Aid Code, provided that the campus facility
15    encompasses 30 or more contiguous acres and that the new
16    or renovated facility is intended for use by a licensed
17    residential facility.
18        (4) Facilities licensed under the Supportive
19    Residences Licensing Act or the Assisted Living and Shared
20    Housing Act.
21        (5) Facilities designated as supportive living
22    facilities that are in good standing with the program
23    established under Section 5-5.01a of the Illinois Public
24    Aid Code.
25        (6) Facilities established and operating under the
26    Alternative Health Care Delivery Act as a children's

 

 

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1    community-based health care center alternative health care
2    model demonstration program or as an Alzheimer's Disease
3    Management Center alternative health care model
4    demonstration program.
5        (7) The closure of an entity or a portion of an entity
6    licensed under the Nursing Home Care Act, the Specialized
7    Mental Health Rehabilitation Act of 2013, the ID/DD
8    Community Care Act, or the MC/DD Act, with the exception
9    of facilities operated by a county or Illinois Veterans
10    Homes, that elect to convert, in whole or in part, to an
11    assisted living or shared housing establishment licensed
12    under the Assisted Living and Shared Housing Act and with
13    the exception of a facility licensed under the Specialized
14    Mental Health Rehabilitation Act of 2013 in connection
15    with a proposal to close a facility and re-establish the
16    facility in another location.
17        (8) Any change of ownership of a health care facility
18    that is licensed under the Nursing Home Care Act, the
19    Specialized Mental Health Rehabilitation Act of 2013, the
20    ID/DD Community Care Act, or the MC/DD Act, with the
21    exception of facilities operated by a county or Illinois
22    Veterans Homes. Changes of ownership of facilities
23    licensed under the Nursing Home Care Act must meet the
24    requirements set forth in Sections 3-101 through 3-119 of
25    the Nursing Home Care Act.
26        (9) (Blank).

 

 

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1    With the exception of those health care facilities
2specifically included in this Section, nothing in this Act
3shall be intended to include facilities operated as a part of
4the practice of a physician or other licensed health care
5professional, whether practicing in his individual capacity or
6within the legal structure of any partnership, medical or
7professional corporation, or unincorporated medical or
8professional group. Further, this Act shall not apply to
9physicians or other licensed health care professional's
10practices where such practices are carried out in a portion of
11a health care facility under contract with such health care
12facility by a physician or by other licensed health care
13professionals, whether practicing in his individual capacity
14or within the legal structure of any partnership, medical or
15professional corporation, or unincorporated medical or
16professional groups, unless the entity constructs, modifies,
17or establishes a health care facility as specifically defined
18in this Section. This Act shall apply to construction or
19modification and to establishment by such health care facility
20of such contracted portion which is subject to facility
21licensing requirements, irrespective of the party responsible
22for such action or attendant financial obligation.
23    "Person" means any one or more natural persons, legal
24entities, governmental bodies other than federal, or any
25combination thereof.
26    "Consumer" means any person other than a person (a) whose

 

 

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1major occupation currently involves or whose official capacity
2within the last 12 months has involved the providing,
3administering or financing of any type of health care
4facility, (b) who is engaged in health research or the
5teaching of health, (c) who has a material financial interest
6in any activity which involves the providing, administering or
7financing of any type of health care facility, or (d) who is or
8ever has been a member of the immediate family of the person
9defined by item (a), (b), or (c).
10    "State Board" or "Board" means the Health Facilities and
11Services Review Board.
12    "Construction or modification" means the establishment,
13erection, building, alteration, reconstruction,
14modernization, improvement, extension, discontinuation,
15change of ownership, of or by a health care facility, or the
16purchase or acquisition by or through a health care facility
17of equipment or service for diagnostic or therapeutic purposes
18or for facility administration or operation, or any capital
19expenditure made by or on behalf of a health care facility
20which exceeds the capital expenditure minimum; however, any
21capital expenditure made by or on behalf of a health care
22facility for (i) the construction or modification of a
23facility licensed under the Assisted Living and Shared Housing
24Act or (ii) a conversion project undertaken in accordance with
25Section 30 of the Older Adult Services Act shall be excluded
26from any obligations under this Act. For the purposes of this

 

 

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1paragraph and Act, any temporary suspension of a category of
2service by a hospital for a time period exceeding 90 days shall
3be considered a discontinuation of a category of service.
4    "Establish" means the construction of a health care
5facility or the replacement of an existing facility on another
6site or the initiation of a category of service.
7    "Major medical equipment" means medical equipment which is
8used for the provision of medical and other health services
9and which costs in excess of the capital expenditure minimum,
10except that such term does not include medical equipment
11acquired by or on behalf of a clinical laboratory to provide
12clinical laboratory services if the clinical laboratory is
13independent of a physician's office and a hospital and it has
14been determined under Title XVIII of the Social Security Act
15to meet the requirements of paragraphs (10) and (11) of
16Section 1861(s) of such Act. In determining whether medical
17equipment has a value in excess of the capital expenditure
18minimum, the value of studies, surveys, designs, plans,
19working drawings, specifications, and other activities
20essential to the acquisition of such equipment shall be
21included.
22    "Capital expenditure" means an expenditure: (A) made by or
23on behalf of a health care facility (as such a facility is
24defined in this Act); and (B) which under generally accepted
25accounting principles is not properly chargeable as an expense
26of operation and maintenance, or is made to obtain by lease or

 

 

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1comparable arrangement any facility or part thereof or any
2equipment for a facility or part; and which exceeds the
3capital expenditure minimum.
4    For the purpose of this paragraph, the cost of any
5studies, surveys, designs, plans, working drawings,
6specifications, and other activities essential to the
7acquisition, improvement, expansion, or replacement of any
8plant or equipment with respect to which an expenditure is
9made shall be included in determining if such expenditure
10exceeds the capital expenditures minimum. Unless otherwise
11interdependent, or submitted as one project by the applicant,
12components of construction or modification undertaken by means
13of a single construction contract or financed through the
14issuance of a single debt instrument shall not be grouped
15together as one project. Donations of equipment or facilities
16to a health care facility which if acquired directly by such
17facility would be subject to review under this Act shall be
18considered capital expenditures, and a transfer of equipment
19or facilities for less than fair market value shall be
20considered a capital expenditure for purposes of this Act if a
21transfer of the equipment or facilities at fair market value
22would be subject to review.
23    "Capital expenditure minimum" means $11,500,000 for
24projects by hospital applicants, $6,500,000 for applicants for
25projects related to skilled and intermediate care long-term
26care facilities licensed under the Nursing Home Care Act, and

 

 

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1$3,000,000 for projects by all other applicants, which shall
2be annually adjusted to reflect the increase in construction
3costs due to inflation, for major medical equipment and for
4all other capital expenditures.
5    "Financial commitment" means the commitment of at least
633% of total funds assigned to cover total project cost, which
7occurs by the actual expenditure of 33% or more of the total
8project cost or the commitment to expend 33% or more of the
9total project cost by signed contracts or other legal means.
10    "Non-clinical service area" means an area (i) for the
11benefit of the patients, visitors, staff, or employees of a
12health care facility and (ii) not directly related to the
13diagnosis, treatment, or rehabilitation of persons receiving
14services from the health care facility. "Non-clinical service
15areas" include, but are not limited to, chapels; gift shops;
16news stands; computer systems; tunnels, walkways, and
17elevators; telephone systems; projects to comply with life
18safety codes; educational facilities; student housing;
19patient, employee, staff, and visitor dining areas;
20administration and volunteer offices; modernization of
21structural components (such as roof replacement and masonry
22work); boiler repair or replacement; vehicle maintenance and
23storage facilities; parking facilities; mechanical systems for
24heating, ventilation, and air conditioning; loading docks; and
25repair or replacement of carpeting, tile, wall coverings,
26window coverings or treatments, or furniture. Solely for the

 

 

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1purpose of this definition, "non-clinical service area" does
2not include health and fitness centers.
3    "Areawide" means a major area of the State delineated on a
4geographic, demographic, and functional basis for health
5planning and for health service and having within it one or
6more local areas for health planning and health service. The
7term "region", as contrasted with the term "subregion", and
8the word "area" may be used synonymously with the term
9"areawide".
10    "Local" means a subarea of a delineated major area that on
11a geographic, demographic, and functional basis may be
12considered to be part of such major area. The term "subregion"
13may be used synonymously with the term "local".
14    "Physician" means a person licensed to practice in
15accordance with the Medical Practice Act of 1987, as amended.
16    "Licensed health care professional" means a person
17licensed to practice a health profession under pertinent
18licensing statutes of the State of Illinois.
19    "Director" means the Director of the Illinois Department
20of Public Health.
21    "Agency" or "Department" means the Illinois Department of
22Public Health.
23    "Alternative health care model" means a facility or
24program authorized under the Alternative Health Care Delivery
25Act.
26    "Out-of-state facility" means a person that is both (i)

 

 

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1licensed as a hospital or as an ambulatory surgery center
2under the laws of another state or that qualifies as a hospital
3or an ambulatory surgery center under regulations adopted
4pursuant to the Social Security Act and (ii) not licensed
5under the Ambulatory Surgical Treatment Center Act, the
6Hospital Licensing Act, or the Nursing Home Care Act.
7Affiliates of out-of-state facilities shall be considered
8out-of-state facilities. Affiliates of Illinois licensed
9health care facilities 100% owned by an Illinois licensed
10health care facility, its parent, or Illinois physicians
11licensed to practice medicine in all its branches shall not be
12considered out-of-state facilities. Nothing in this definition
13shall be construed to include an office or any part of an
14office of a physician licensed to practice medicine in all its
15branches in Illinois that is not required to be licensed under
16the Ambulatory Surgical Treatment Center Act.
17    "Change of ownership of a health care facility" means a
18change in the person who has ownership or control of a health
19care facility's physical plant and capital assets. A change in
20ownership is indicated by the following transactions: sale,
21transfer, acquisition, lease, change of sponsorship, or other
22means of transferring control.
23    "Related person" means any person that: (i) is at least
2450% owned, directly or indirectly, by either the health care
25facility or a person owning, directly or indirectly, at least
2650% of the health care facility; or (ii) owns, directly or

 

 

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1indirectly, at least 50% of the health care facility.
2    "Charity care" means care provided by a health care
3facility for which the provider does not expect to receive
4payment from the patient or a third-party payer.
5    "Health disparities" means preventable differences in the
6burden of disease, injury, violence, or opportunities to
7achieve optimal health that are experienced by socially
8disadvantaged populations.
9    "Health equity" means a process of assurance of the
10conditions for optimal health for all people through focused
11and ongoing societal effort valuing all individuals and
12populations equally, recognizing and rectifying historical
13injustices, and providing resources according to need.
14    "Safety net services" means services provided by health
15care providers or organizations that deliver health care
16services to persons with barriers to mainstream health care
17due to lack of insurance, inability to pay, special needs,
18ethnic or cultural characteristics, or geographic isolation,
19and those that deliver services to communities or populations
20suffering from health disparities including disparities in
21health status and outcomes due to differences in social,
22economic, environmental, or healthcare resources. Safety net
23service providers include, but are not limited to, hospitals
24and private practice physicians that provide charity care,
25school-based health centers, migrant health clinics, rural
26health clinics, federally qualified health centers, community

 

 

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1health centers, public health departments, and community
2mental health centers.
3    "Safety net hospital" has the meaning ascribed to it under
4Section 5-5e.1 of the Illinois Public Aid Code.
5    "Emergency medical and trauma" means the emergency medical
6services, trauma services, and associated non-emergency
7medical services planned and coordinated in accordance with
8the Emergency Medical Services (EMS) Systems Act.
9    "Perinatal and maternal care" means obstetric and neonatal
10services under Subpart O of Hospital Licensing Requirements,
1177 IAC 250; resources and services associated with hospital
12perinatal care level designations under the Developmental
13Disability Prevention Act; and maternal care resources and
14services developed or identified under Sections 2310-222 and
152310-223 of the Department of Public Health Powers and Duties
16Law.
17    "Freestanding emergency center" means a facility subject
18to licensure under Section 32.5 of the Emergency Medical
19Services (EMS) Systems Act.
20    "Category of service" means a grouping by generic class of
21various types or levels of support functions, equipment, care,
22or treatment provided to patients or residents. Categories of
23service shall include, but not be limited to, , including, but
24not limited to, classes such as medical-surgical, pediatrics,
25obstetrics, intensive care, neonatal intensive care, acute
26mental illness, comprehensive physical rehabilitation,

 

 

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1long-term acute care, or cardiac catheterization, open heart
2surgery, kidney transplantation, general long term nursing
3care, long term care for the developmentally disabled (adult),
4long term care for the developmentally disabled (children),
5chronic mental illness care, in-center hemodialysis, and
6non-hospital ambulatory surgery. A category of service may
7include subcategories or levels of care that identify a
8particular degree or type of care within the category of
9service. Nothing in this definition shall be construed to
10include the practice of a physician or other licensed health
11care professional while functioning in an office providing for
12the care, diagnosis, or treatment of patients. A category of
13service that is subject to the Board's jurisdiction must be
14designated in rules adopted by the Board.
15    "State Board Staff Report" means the document that sets
16forth the review and findings of the State Board staff, as
17prescribed by the State Board, regarding applications subject
18to Board jurisdiction.
19(Source: P.A. 100-518, eff. 6-1-18; 100-581, eff. 3-12-18;
20100-957, eff. 8-19-18; 101-81, eff. 7-12-19; 101-650, eff.
217-7-20.)
 
22    (20 ILCS 3960/5)  (from Ch. 111 1/2, par. 1155)
23    (Section scheduled to be repealed on December 31, 2029)
24    Sec. 5. Construction, modification, or establishment of
25health care facilities or acquisition of major medical

 

 

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1equipment; permits or exemptions. No person shall construct,
2modify or establish a health care facility or acquire major
3medical equipment without first obtaining a permit or
4exemption from the State Board. The State Board shall not
5delegate to the staff of the State Board or any other person or
6entity the authority to grant permits or exemptions whenever
7the staff or other person or entity would be required to
8exercise any discretion affecting the decision to grant a
9permit or exemption. The State Board may, by rule, delegate
10authority to the Chairman to grant permits or exemptions when
11applications meet all of the State Board's review criteria and
12are unopposed.
13    A permit or exemption shall be obtained prior to the
14acquisition of major medical equipment or to the construction
15or modification of a health care facility which:
16        (a) requires a total capital expenditure in excess of
17    the capital expenditure minimum; or
18        (b) substantially changes the scope or changes the
19    functional operation of the facility; or
20        (c) changes the bed capacity of a health care facility
21    by increasing the total number of beds or by distributing
22    beds among various categories of service or by relocating
23    beds from one physical facility or site to another by more
24    than 20 beds or more than 10% of total bed capacity as
25    defined by the State Board, whichever is less, over a
26    2-year period.

 

 

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1    A permit shall be valid only for the defined construction
2or modifications, site, amount and person named in the
3application for such permit. The State Board may approve the
4transfer of an existing permit without regard to whether the
5permit to be transferred has yet been financially committed,
6except for permits to establish a new facility or category of
7service. A permit shall be valid until such time as the project
8has been completed, provided that the project commences and
9proceeds to completion with due diligence by the completion
10date or extension date approved by the Board.
11    A permit holder must do the following: (i) submit the
12final completion and cost report for the project within 90
13days after the approved project completion date or extension
14date and (ii) submit annual progress reports no earlier than
1530 days before and no later than 30 days after each anniversary
16date of the Board's approval of the permit until the project is
17completed. To maintain a valid permit and to monitor progress
18toward project commencement and completion, routine
19post-permit reports shall be limited to annual progress
20reports and the final completion and cost report. Annual
21progress reports shall include information regarding the
22committed funds expended toward the approved project. For
23projects to be completed in 12 months or less, the permit
24holder shall report financial commitment in the final
25completion and cost report. For projects to be completed
26between 12 to 24 months, the permit holder shall report

 

 

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1financial commitment in the first annual report. For projects
2to be completed in more than 24 months, the permit holder shall
3report financial commitment in the second annual progress
4report. The report shall contain information regarding
5expenditures and financial commitments. The State Board may
6extend the financial commitment period after considering a
7permit holder's showing of good cause and request for
8additional time to complete the project.
9    The Certificate of Need process required under this Act is
10designed to support equitable access to health care services,
11develop and protect safety net services, and restrain rising
12health care costs by preventing unnecessary construction or
13modification of health care facilities. The Board must assure
14that the establishment, construction, or modification of a
15health care facility or the acquisition of major medical
16equipment is consistent with the public interest and that the
17proposed project is consistent with the orderly and economic
18development or acquisition of those facilities and equipment
19and is in accord with the standards, criteria, or plans of need
20adopted and approved by the Board. The Board must assure
21decisions regarding hospital facility or service
22discontinuations are consistent with the health equity
23purposes of the Act and weigh whether or not such facility or
24service discontinuations will worsen health disparities. Board
25decisions regarding the construction of health care facilities
26must consider capacity, quality, value, and equity. Projects

 

 

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1may deviate from the costs, fees, and expenses provided in
2their project cost information for the project's cost
3components, provided that the final total project cost does
4not exceed the approved permit amount. Project alterations
5shall not increase the total approved permit amount by more
6than the limit set forth under the Board's rules.
7    The acquisition by any person of major medical equipment
8that will not be owned by or located in a health care facility
9and that will not be used to provide services to inpatients of
10a health care facility shall be exempt from review provided
11that a notice is filed in accordance with exemption
12requirements.
13    Notwithstanding any other provision of this Act, no permit
14or exemption is required for the construction or modification
15of a non-clinical service area of a health care facility.
16(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18.)
 
17    (20 ILCS 3960/5.4)
18    (Section scheduled to be repealed on December 31, 2029)
19    Sec. 5.4. Safety Net Impact Statement.
20    (a) General review criteria shall include a requirement
21that all health care facilities, with the exception of skilled
22and intermediate long-term care facilities licensed under the
23Nursing Home Care Act, provide a Safety Net Impact Statement,
24which shall be filed with an application for a substantive
25project or when the application proposes to discontinue a

 

 

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1category of service.
2    (b) (Blank). For the purposes of this Section, "safety net
3services" are services provided by health care providers or
4organizations that deliver health care services to persons
5with barriers to mainstream health care due to lack of
6insurance, inability to pay, special needs, ethnic or cultural
7characteristics, or geographic isolation. Safety net service
8providers include, but are not limited to, hospitals and
9private practice physicians that provide charity care,
10school-based health centers, migrant health clinics, rural
11health clinics, federally qualified health centers, community
12health centers, public health departments, and community
13mental health centers.
14    (c) As developed by the applicant, a Safety Net Impact
15Statement shall describe all of the following:
16        (1) The project's material impact, if any, on
17    essential safety net services in the community, including
18    safety net hospitals and critical access hospitals, to the
19    extent that it is feasible for an applicant to have such
20    knowledge.
21        (2) The project's impact on the ability of another
22    provider or health care system to cross-subsidize safety
23    net services, to the extent that it is feasible for an
24    applicant to have such knowledge , if reasonably known to
25    the applicant.
26        (3) How the discontinuation of a facility or service

 

 

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1    will might impact other the remaining safety net
2    providers, to the extent that it is feasible for an
3    applicant to have such knowledge in a given community, if
4    reasonably known by the applicant.
5        (4) How the discontinuation of a facility or service
6    will impact the Medicaid population.
7        (5) How the discontinuation of a facility or service
8    will impact the health status and outcomes of populations
9    suffering from health disparities. This should include
10    consideration of disparities in healthcare access and
11    outcomes by income, race and ethnic identity, and
12    preferred language.
13    (d) Safety Net Impact Statements shall also include all of
14the following:
15        (1) For the 3 fiscal years prior to the application, a
16    certification describing the amount of charity care
17    provided by the applicant. The amount calculated by
18    hospital applicants shall be in accordance with the
19    reporting requirements for charity care reporting in the
20    Illinois Community Benefits Act. Non-hospital applicants
21    shall report charity care, at cost, in accordance with an
22    appropriate methodology specified by the Board.
23        (2) For the 3 fiscal years prior to the application, a
24    certification of the amount of care provided to Medicaid
25    patients. Hospital and non-hospital applicants shall
26    provide Medicaid information in a manner consistent with

 

 

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1    the information reported each year to the State Board
2    regarding "Inpatients and Outpatients Served by Payor
3    Source" and "Inpatient and Outpatient Net Revenue by Payor
4    Source" as required by the Board under Section 13 of this
5    Act and published in the Annual Hospital Profile.
6        (3) Any information the applicant believes is directly
7    relevant to safety net services, including information
8    regarding teaching, research, and any other service.
9    (e) The Board staff shall publish a notice, that an
10application accompanied by a Safety Net Impact Statement has
11been filed, in a newspaper having general circulation within
12the area affected by the application. If no newspaper has a
13general circulation within the county, the Board shall post
14the notice in 5 conspicuous places within the proposed area.
15    (f) Any person, community organization, provider, or
16health system or other entity wishing to comment upon or
17oppose the application may file a Safety Net Impact Statement
18Response with the Board, which shall provide additional
19information concerning a project's impact on safety net
20services in the community.
21    (g) Applicants shall be provided an opportunity to submit
22a reply to any Safety Net Impact Statement Response.
23    (h) The State Board Staff Report shall include a statement
24as to whether a Safety Net Impact Statement was filed by the
25applicant and whether it included information on charity care,
26the amount of care provided to Medicaid patients, and

 

 

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1information on teaching, research, or any other service
2provided by the applicant directly relevant to safety net
3services. The report shall also indicate the names of the
4parties submitting responses and the number of responses and
5replies, if any, that were filed.
6(Source: P.A. 100-518, eff. 6-1-18.)
 
7    (20 ILCS 3960/5.5 new)
8    Sec. 5.5. Emergency Medicine and Trauma Systems Impact
9Statement.
10    (a) Review criteria shall include a requirement that all
11general acute hospitals applying to discontinue a facility,
12intensive care services, or another category of service
13relevant to emergency medical service and trauma systems
14identified by rule by the Board include in its application an
15Emergency Medicine and Trauma Systems Impact Statement.
16    (b) As developed by the applicant, an Emergency Medicine
17and Trauma Systems Impact Statement shall describe all of the
18following:
19        (1) How the discontinuation of the facility or service
20    will impact the availability of emergency medical and
21    trauma services for area populations, specifically
22    including those that experience difficulty accessing
23    health services or experience health disparities.
24        (2) How the discontinuation of the facility or service
25    might impact the remaining providers of emergency medical

 

 

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1    and trauma services in the area, to the extent known by the
2    applicant.
3    (c) Emergency Medicine and Trauma Systems Impact
4Statements shall also include all of the following:
5        (1) A list of each resource identified in any
6    emergency medical service system program plan that will
7    cease to exist as a result of the facility or service
8    discontinuation, with a description of its utilization in
9    the most recent 2 years for which data is available.
10        (2) A list of each resource identified in any trauma
11    or stroke center designation that will cease to exist as a
12    result of the facility or service discontinuation, with a
13    description of its utilization in the most recent 2 years
14    for which data is available.
15        (3) If any resource listed pursuant to paragraphs (1)
16    or (2) above was on diversion or bypass status or
17    otherwise not available during the 2 years, the statement
18    must list the times and reasons it was on bypass.
19    (d) The Board staff shall publish a notice, that an
20application accompanied by an Emergency Medicine and Trauma
21Systems Impact Statement has been filed, in a newspaper having
22general circulation within the area affected by the
23application. If no newspaper has a general circulation within
24the county, the Board shall post the notice in 5 conspicuous
25places within the proposed area. The public notice required by
26this subsection may be provided in conjunction with the notice

 

 

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1required for a safety net impact statement pursuant to
2subsection (e) of Section 5.4.
3    (e) Any person, community organization, provider, or
4health system or other entity wishing to comment upon or
5oppose the application may file an Emergency Medical and
6Trauma Systems Impact Statement Response with the Board, which
7shall provide additional information concerning a project's
8impact on emergency medical and trauma services in the
9community.
10    (f) Applicants shall be provided an opportunity to submit
11a reply to any Emergency Medical and Trauma Systems Impact
12Statement Response.
13    (g) The State Board Staff Report shall include a statement
14as to whether an Emergency Medical and Trauma Systems Impact
15Statement was filed by the applicant and whether it included
16each item of information described in the lists of subsections
17(b) and (c) above. The report shall also indicate the names of
18the parties submitting responses and the number of responses
19and replies, if any, that were filed.
 
20    (20 ILCS 3960/5.6 new)
21    Sec. 5.6. Maternal and Child Health Impact Statement.
22    (a) Review criteria shall include a requirement that all
23general acute hospitals applying to discontinue a facility,
24obstetric services, pediatric services, neonatal intensive
25care services, or any other category of service relevant to

 

 

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

 

 

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1    improve birth equity and reduce postpartum racial and
2    ethnic disparities, or that serves similar purposes that
3    will cease to exist as a result of the facility or service
4    discontinuation.
5    (d) The Board staff shall publish a notice, that an
6application accompanied by a Maternal and Child Health Impact
7Statement has been filed, in a newspaper having general
8circulation within the area affected by the application. If no
9newspaper has a general circulation within the county, the
10Board shall post the notice in 5 conspicuous places within the
11proposed area. The public notice required by this subsection
12may be provided in conjunction with the notice required for a
13safety net impact statement pursuant to subsection (e) of
14Section 5.4.
15    (e) Any person, community organization, provider, or
16health system or other entity wishing to comment upon or
17oppose the application may file a Maternal and Child Health
18Impact Statement Response with the Board, which shall provide
19additional information concerning a project's impact on
20maternal and child health services in the community.
21    (f) Applicants shall be provided an opportunity to submit
22a reply to any Maternal and Child Health Impact Statement
23Response.
24    (g) The State Board Staff Report shall include a statement
25as to whether a Maternal and Child Health Impact Statement was
26filed by the applicant and whether it included each item of

 

 

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1information described in the lists of subsections (b) and (c)
2above. The report shall also indicate the names of the parties
3submitting responses and the number of responses and replies,
4if any, that were filed.
 
5    (20 ILCS 3960/6)  (from Ch. 111 1/2, par. 1156)
6    (Section scheduled to be repealed on December 31, 2029)
7    Sec. 6. Application for permit or exemption; exemption
8regulations.
9    (a) An application for a permit or exemption shall be made
10to the State Board upon forms provided by the State Board. This
11application shall contain such information as the State Board
12deems necessary. The State Board shall not require an
13applicant to file a Letter of Intent before an application is
14filed. Such application shall include affirmative evidence on
15which the State Board or Chairman may make its decision on the
16approval or denial of the permit or exemption.
17    (b) The State Board shall establish by regulation the
18procedures and requirements regarding issuance of exemptions.
19An exemption shall be approved when information required by
20the Board by rule is submitted. Projects eligible for an
21exemption, rather than a permit, shall be include, but are not
22limited to, change of ownership of a health care facility,
23establishment or expansion of a neonatal intensive care
24category of service, and discontinuation of a category of
25service, other than at a hospital, or a health care facility

 

 

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

 

 

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

 

 

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1acquisition of major medical equipment is consistent with the
2public interest, and (4) that the proposed project is
3consistent with the orderly and economic development of such
4facilities and equipment and is in accord with standards,
5criteria, or plans of need adopted and approved pursuant to
6the provisions of Section 12 of this Act. Notwithstanding the
7foregoing or any other provision of this Act, the State Board
8may deny issuance of a permit if it finds the project will
9plausibly increase health disparities.
10    (d-5) For an application for a permit to discontinue a
11hospital facility or service, the State Board shall consider:
12        (1) how the discontinuation of the facility or service
13    will impact safety net services;
14        (2) the emergency medical and trauma system impact, if
15    applicable;
16        (3) the maternal and child health impact, if
17    applicable; and
18        (4) the economic feasibility, based on the resources
19    of the applicant and related persons, of continued
20    operation as an alternative.
21    (e) The State Board may attach conditions to issuance of a
22permit requiring that certain disclosed support or subsidies
23received by the hospital must be repaid.
24(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18;
25101-83, eff. 7-15-19.)
 

 

 

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1    (20 ILCS 3960/6.05 new)
2    Sec. 6.05. Hospital closure during a pandemic. The State
3Board shall not issue a permit or take any other action that
4would allow closure of a general acute care hospital to
5proceed during a public health emergency declared pursuant to
6the Illinois Emergency Management Act as the result of an
7infectious disease pandemic.
 
8    (20 ILCS 3960/6.2)
9    (Section scheduled to be repealed on December 31, 2029)
10    Sec. 6.2. Review of permits; State Board Staff Reports.
11Upon receipt of an application for a permit to establish,
12construct, or modify a health care facility, the State Board
13staff shall notify the applicant in writing within 10 working
14days either that the application is or is not substantially
15complete. If the application is substantially complete, the
16State Board staff shall notify the applicant of the beginning
17of the review process. If the application is not substantially
18complete, the Board staff shall explain within the 10-day
19period why the application is incomplete.
20    The State Board staff shall afford a reasonable amount of
21time as established by the State Board, but not to exceed 180
22120 days, for the review of the application. The 180-day
23120-day period begins on the day the application is found to be
24substantially complete, as that term is defined by the State
25Board. During the 180-day 120-day period, the applicant may

 

 

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1request an extension. An applicant may modify the application
2at any time before a final administrative decision has been
3made on the application.
4    The State Board staff shall submit its State Board Staff
5Report to the State Board for its decision-making regarding
6approval or denial of the permit.
7    When an application for a permit is initially reviewed by
8State Board staff, as provided in this Section, the State
9Board shall, upon request by the applicant or an interested
10person, afford an opportunity for a public hearing within a
11reasonable amount of time after receipt of the complete
12application, but not to exceed 90 days after receipt of the
13complete application. Notice of the hearing shall be made
14promptly, not less than 10 days before the hearing, by
15certified mail to the applicant and, not less than 10 days
16before the hearing, by publication in a newspaper of general
17circulation in the area or community to be affected. The
18hearing shall be held in the area or community in which the
19proposed project is to be located and shall be for the purpose
20of allowing the applicant and any interested person to present
21public testimony concerning the approval, denial, renewal, or
22revocation of the permit. All interested persons attending the
23hearing shall be given a reasonable opportunity to present
24their views or arguments in writing or orally, and a record of
25all of the testimony shall accompany any findings of the State
26Board staff. The State Board shall adopt reasonable rules and

 

 

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1regulations governing the procedure and conduct of the
2hearings.
3(Source: P.A. 99-114, eff. 7-23-15; 100-681, eff. 8-3-18.)
 
4    (20 ILCS 3960/8.5)
5    (Section scheduled to be repealed on December 31, 2029)
6    Sec. 8.5. Certificate of exemption for change of ownership
7of a health care facility; discontinuation of a category of
8service; public notice and public hearing.
9    (a) Upon a finding that an application for a change of
10ownership is complete, the State Board shall publish a legal
11notice on 3 consecutive days in a newspaper of general
12circulation in the area or community to be affected and afford
13the public an opportunity to request a hearing. If the
14application is for a facility located in a Metropolitan
15Statistical Area, an additional legal notice shall be
16published in a newspaper of limited circulation, if one
17exists, in the area in which the facility is located. If the
18newspaper of limited circulation is published on a daily
19basis, the additional legal notice shall be published on 3
20consecutive days. The applicant shall pay the cost incurred by
21the Board in publishing the change of ownership notice in
22newspapers as required under this subsection. The legal notice
23shall also be posted on the Health Facilities and Services
24Review Board's web site and sent to the State Representative
25and State Senator of the district in which the health care

 

 

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

 

 

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1ownership has been completed in accordance with the key terms
2contained in the application. If such key terms of the
3transaction change, a new application shall be required.
4    Where a change of ownership is among related persons, and
5there are no other changes being proposed at the health care
6facility that would otherwise require a permit or exemption
7under this Act, the applicant shall submit an application
8consisting of a standard notice in a form set forth by the
9Board briefly explaining the reasons for the proposed change
10of ownership. Once such an application is submitted to the
11Board and reviewed by the Board staff, the Board Chair shall
12take action on an application for an exemption for a change of
13ownership among related persons within 45 days after the
14application has been deemed complete, provided the application
15meets the applicable standards under this Section. If the
16Board Chair has a conflict of interest or for other good cause,
17the Chair may request review by the Board. Notwithstanding any
18other provision of this Act, for purposes of this Section, a
19change of ownership among related persons means a transaction
20where the parties to the transaction are under common control
21or ownership before and after the transaction is completed.
22    Nothing in this Act shall be construed as authorizing the
23Board to impose any conditions, obligations, or limitations,
24other than those required by this Section, with respect to the
25issuance of an exemption for a change of ownership, including,
26but not limited to, the time period before which a subsequent

 

 

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

 

 

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

 

 

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

 

 

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1deemed complete when the applicant includes a list of public
2support or subsidies it has received without repaying or
3fulfilling obligations or any other public subsidies it has
4received in the past 5 years, including hospital assessment
5funded supplemental payments, capital development grants,
6public health grants, economic development grants and
7supports, and any other categories the Board may identify by
8rule. In cases of service discontinuation, this requirement
9applies if the support or subsidy is specific to the service.
10    (c) In cases of hospital facility or service
11discontinuation, a public response to a safety net impact
12statement under subsection (f) of Section 5.4, emergency
13medicine and trauma system impact statement under subsection
14(e) of Section 5.5, or maternal and child health impact
15statement under subsection (e) of Section 5.6 may request an
16investigative hearing by the full board under the procedures
17set forth in Section 13. The Board may grant at its discretion
18any such requests for an investigative hearing. In response to
19one or more requests from any of the following, the Board shall
20conduct at minimum one investigative hearing with a scope
21covering the subject matter of all impact statements subject
22to such requests: (i) an elected official representing a
23district containing the hospital; (ii) an organization
24representing employees at the hospital; (iii) a safety net
25hospital or critical access hospital plausibly affected by the
26application; or (iv) at least 50 community members residing in

 

 

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1the area affected by the application.
2    (d) No later than 30 days after issuance of a permit to
3close a health care facility or discontinue a category of
4service, the permit holder shall give written notice of the
5closure or discontinuation to the State Senator and State
6Representative serving the legislative district in which the
7health care facility is located.
8    (e) (c) If there is a pending lawsuit that challenges an
9application to discontinue a health care facility that either
10names the Board as a party or alleges fraud in the filing of
11the application, the Board may defer action on the application
12until there is no longer such a lawsuit pending for up to 6
13months after the date of the initial deferral of the
14application.
15    (f) (d) The changes made to this Section by this
16amendatory Act of the 101st General Assembly shall apply to
17all applications submitted after the effective date of this
18amendatory Act of the 101st General Assembly.
19(Source: P.A. 101-83, eff. 7-15-19; 101-650, eff. 7-7-20.)
 
20    (20 ILCS 3960/12)  (from Ch. 111 1/2, par. 1162)
21    (Section scheduled to be repealed on December 31, 2029)
22    Sec. 12. Powers and duties of State Board. For purposes of
23this Act, the State Board shall exercise the following powers
24and duties:
25        (1) Prescribe rules, regulations, standards, criteria,

 

 

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

 

 

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1    licensed under the ID/DD Community Care Act, skilled or
2    intermediate care facilities licensed under the MC/DD Act,
3    facilities licensed under the Specialized Mental Health
4    Rehabilitation Act of 2013, or nursing homes licensed
5    under the Hospital Licensing Act shall be conducted on an
6    annual basis no later than July 1 of each year and shall
7    include among the information requested a list of all
8    services provided by a facility to its residents and to
9    the community at large and differentiate between active
10    and inactive beds.
11        In developing health care facility plans, the State
12    Board shall consider, but shall not be limited to, the
13    following:
14            (a) The size, composition and growth of the
15        population of the area to be served;
16            (a-5) The incidence of diseases or health
17        conditions that correlate with a need for services or
18        facilities, determined either directly or through a
19        comparison of the population characteristics of an
20        area with those of a similar, larger, or encompassing
21        reference area;
22            (b) The number of existing and planned facilities
23        offering similar programs;
24            (c) The extent of utilization of existing
25        facilities;
26            (c-5) Size, composition, and growth of the

 

 

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1        population covered by Medicaid relative to existing
2        services;
3            (d) The availability of facilities which may serve
4        as alternatives or substitutes;
5            (e) The availability of personnel necessary to the
6        operation of the facility;
7            (f) Multi-institutional planning and the
8        establishment of multi-institutional systems where
9        feasible;
10            (f-5) Impact on safety net services including
11        safety net and critical access hospitals;
12            (g) The financial and economic feasibility of
13        proposed construction or modification; and
14            (h) In the case of health care facilities
15        established by a religious body or denomination, the
16        needs of the members of such religious body or
17        denomination may be considered to be public need; .
18            (i) The presence and severity of health
19        disparities among the population to be served,
20        including consideration of disparities in healthcare
21        access and outcomes by income, race and ethnic
22        identity, and preferred language; and
23            (j) Beginning 2 years after the effective date of
24        this amendatory Act of the 102nd General Assembly,
25        need formulae shall be based on incidence of diseases
26        or health conditions that correlate with the need for

 

 

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1        a service and shall adjust such incidence by
2        disparities among the population described in
3        paragraph (i) above. The Office of Policy, Planning,
4        and Statistics; the Center for Minority Health
5        Services; the Center for Rural Health; and, at the
6        discretion of the Director, any other division of the
7        Department shall provide support in the development of
8        new formulae, data, and planning policies if requested
9        by the Board. The Board shall adopt rules to implement
10        this paragraph (j).
11            
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.

 

 

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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.

 

 

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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

 

 

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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

 

 

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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

 

 

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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

 

 

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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

 

 

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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

 

 

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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

 

 

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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, the population covered by Medicaid, and the
5    presence and severity of health disparities in a
6    community, which at minimum must include consideration of
7    disparities in healthcare access and outcomes by income,
8    race and ethnic 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(Source: P.A. 99-527, eff. 1-1-17; 100-681, eff. 8-3-18.)
 
19    (20 ILCS 3960/12.4)
20    (Section scheduled to be repealed on December 31, 2029)
21    Sec. 12.4. Hospital reduction in health care services;
22notice. If a hospital reduces any of the Categories of Service
23as outlined in Title 77, Chapter II, Part 1110 in the Illinois
24Administrative Code, or any other service as defined by rule
25by the State Board, by 50% or more according to rules adopted

 

 

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1by the State Board, then within 30 days after reducing the
2service, the hospital must give written notice of the
3reduction in service to the State Board, the Department of
4Public Health, and the State Senator and State Representative
5serving the legislative district in which the hospital is
6located. The State Board shall publish the notice on its
7website. Any party receiving notice may request a safety net
8impact statement, emergency medicine and trauma system impact
9statement, or maternal and child health impact statement, as
10described at: (i) subsections (c) and (d) of Section 5.4; (ii)
11subsections (b) and (c) of Section 5.5; and (iii) subsections
12(b) and (c) of Section 5.6, respectively, to be filed
13describing impact of the reduction in services. The State
14Board shall adopt rules to implement this Section, including
15rules that specify (i) how each health care service is
16defined, if not already defined in the State Board's rules,
17and (ii) what constitutes a reduction in service of 50% or
18more.
19(Source: P.A. 100-681, eff. 8-3-18.)
 
20    (20 ILCS 3960/13.1)  (from Ch. 111 1/2, par. 1163.1)
21    (Section scheduled to be repealed on December 31, 2029)
22    Sec. 13.1. Any person establishing, constructing, or
23modifying a health care facility or portion thereof without
24obtaining a required permit, or in violation of the terms of
25the required permit, shall not be eligible to apply for any

 

 

10200HB3657ham001- 60 -LRB102 13678 RJF 25305 a

1necessary operating licenses or be eligible for payment by any
2State agency for services rendered in that facility until the
3required permit is obtained. In cases of any person
4discontinuing a hospital facility or category of service
5without obtaining a required permit, or in violation of the
6terms of the required permit, no related person shall be
7eligible to apply for any necessary operating licenses nor
8shall any related person be eligible for payment by any State
9agency for services rendered until the required permit is
10obtained.
11(Source: P.A. 88-18.)
 
12    (20 ILCS 3960/14)  (from Ch. 111 1/2, par. 1164)
13    (Section scheduled to be repealed on December 31, 2029)
14    Sec. 14. Any person who has discontinued a hospital or a
15category of service at a hospital without a permit or
16exemption issued under this Act or in violation of the terms of
17such a permit or exemption is guilty of a business offense and
18may be fined up to $1,000,000. Any person otherwise acquiring
19major medical equipment or establishing, constructing or
20modifying a health care facility without a permit issued under
21this Act or in violation of the terms of such a permit is
22guilty of a business offense and may be fined up to $100,000
23$25,000. The State's Attorneys of the several counties or the
24Attorney General shall represent the People of the State of
25Illinois in proceedings under this Section. The State's

 

 

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1Attorneys of the several counties or the Attorney General may
2additionally maintain an action in the name of the People of
3the State of Illinois for injunction or other process against
4any person or governmental unit to restrain or prevent the
5acquisition of major medical equipment, or the establishment,
6construction or modification of a health care facility without
7the required permit, or to restrain or prevent the occupancy
8or utilization of the equipment acquired or facility which was
9constructed or modified without the required permit.
10Proceedings The prosecution of an offense under this Section,
11including the prosecution of an offense, shall not prohibit
12the imposition of any other sanction provided under this Act.
13(Source: P.A. 88-18.)
 
14    (20 ILCS 3960/14.05 new)
15    Sec. 14.05. Right of action. Any person aggrieved by a
16violation of this Act, due to a negative impact on their access
17to health care or on their health due to diminished access to
18health care, involving the discontinuation of a hospital or a
19discontinuation of a category of service at a hospital without
20a permit or exemption as required by this Act shall have a
21right of action in a State circuit court or as a supplemental
22claim in federal district court against an offending party. A
23prevailing party may recover for each violation: (i) any
24actual damages; (ii) an injunction or other relief as the
25court may deem appropriate; and (iii) reasonable attorney's

 

 

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1fees.
 
2    (20 ILCS 3960/14.1)
3    (Section scheduled to be repealed on December 31, 2029)
4    Sec. 14.1. Denial of permit; other sanctions.
5    (a) The State Board may deny an application for a permit or
6may revoke or take other action as permitted by this Act with
7regard to a permit as the State Board deems appropriate,
8including the imposition of fines as set forth in this
9Section, for any one or a combination of the following:
10        (1) The acquisition of major medical equipment without
11    a permit or in violation of the terms of a permit.
12        (2) The establishment, construction, modification, or
13    change of ownership of a health care facility without a
14    permit or exemption or in violation of the terms of a
15    permit.
16        (3) The violation of any provision of this Act or any
17    rule adopted under this Act.
18        (4) The failure, by any person subject to this Act, to
19    provide information requested by the State Board or Agency
20    within 30 days after a formal written request for the
21    information.
22        (5) The failure to pay any fine imposed under this
23    Section within 30 days of its imposition.
24    (a-5) For facilities licensed under the ID/DD Community
25Care Act, no permit shall be denied on the basis of prior

 

 

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1operator history, other than for actions specified under item
2(2), (4), or (5) of Section 3-117 of the ID/DD Community Care
3Act. For facilities licensed under the MC/DD Act, no permit
4shall be denied on the basis of prior operator history, other
5than for actions specified under item (2), (4), or (5) of
6Section 3-117 of the MC/DD Act. For facilities licensed under
7the Specialized Mental Health Rehabilitation Act of 2013, no
8permit shall be denied on the basis of prior operator history,
9other than for actions specified under subsections (a) and (b)
10of Section 4-109 of the Specialized Mental Health
11Rehabilitation Act of 2013. For facilities licensed under the
12Nursing Home Care Act, no permit shall be denied on the basis
13of prior operator history, other than for: (i) actions
14specified under item (2), (3), (4), (5), or (6) of Section
153-117 of the Nursing Home Care Act; (ii) actions specified
16under item (a)(6) of Section 3-119 of the Nursing Home Care
17Act; or (iii) actions within the preceding 5 years
18constituting a substantial and repeated failure to comply with
19the Nursing Home Care Act or the rules and regulations adopted
20by the Department under that Act. The State Board shall not
21deny a permit on account of any action described in this
22subsection (a-5) without also considering all such actions in
23the light of all relevant information available to the State
24Board, including whether the permit is sought to substantially
25comply with a mandatory or voluntary plan of correction
26associated with any action described in this subsection (a-5).

 

 

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1    (b) Persons shall be subject to fines as provided in this
2subsection (b). The maximum fines imposed under this
3subsection (b) shall be annually adjusted and proportional
4with the increase in construction costs due to inflation, for
5major medical equipment and for all other capital
6expenditures. as follows:
7        (1) A permit holder who fails to comply with the
8    requirements of maintaining a valid permit shall be fined
9    an amount not to exceed 1% of the approved permit amount
10    plus an additional 1% of the approved permit amount for
11    each 30-day period, or fraction thereof, that the
12    violation continues.
13        (2) A permit holder who alters the scope of an
14    approved project or whose project costs exceed the
15    allowable permit amount without first obtaining approval
16    from the State Board shall be fined an amount not to exceed
17    the sum of (i) the lesser of $40,000 $25,000 or 2% of the
18    approved permit amount and (ii) in those cases where the
19    approved permit amount is exceeded by more than
20    $1,000,000, an additional $40,000 $20,000 for each
21    $1,000,000, or fraction thereof, in excess of the approved
22    permit amount.
23        (2.5) A permit or exemption holder who fails to comply
24    with the post-permit and reporting requirements set forth
25    in Sections 5 and 8.5 shall be fined an amount not to
26    exceed $18,000 $10,000 plus an additional $18,000 $10,000

 

 

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

 

 

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1    not to exceed $25,000 $10,000 plus an additional $25,000
2    $10,000 for each 30-day period, or fraction thereof, that
3    the violation continues. For purposes of this subparagraph
4    (5), facilities licensed under the Nursing Home Care Act,
5    the ID/DD Community Care Act, or the MC/DD Act, with the
6    exceptions of facilities operated by a county or Illinois
7    Veterans Homes, are exempt from this permit requirement.
8    However, facilities licensed under the Nursing Home Care
9    Act, the ID/DD Community Care Act, or the MC/DD Act must
10    comply with Section 3-423 of the Nursing Home Care Act,
11    Section 3-423 of the ID/DD Community Care Act, or Section
12    3-423 of the MC/DD Act and must provide the Board and the
13    Department of Human Services with 30 days' written notice
14    of their intent to close. Facilities licensed under the
15    ID/DD Community Care Act or the MC/DD Act also must
16    provide the Board and the Department of Human Services
17    with 30 days' written notice of their intent to reduce the
18    number of beds for a facility.
19        (5.5) A person who discontinues a hospital facility or
20    category of service without first obtaining a permit or
21    exemption shall be fined an amount not to exceed $100,000
22    plus an additional $100,000 for each 30-day period, or
23    fraction thereof, that the violation continues.
24        (6) A person subject to this Act who fails to provide
25    information requested by the State Board or Agency within
26    30 days of a formal written request shall be fined an

 

 

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1    amount not to exceed $2,000 $1,000 plus an additional
2    $2,000 $1,000 for each 30-day period, or fraction thereof,
3    that the information is not received by the State Board or
4    Agency.
5    (b-5) The State Board may accept in-kind services or
6donations instead of or in combination with the imposition of
7a fine. This authorization is limited to cases where the
8non-compliant individual or entity has waived the right to an
9administrative hearing or opportunity to appear before the
10Board regarding the non-compliant matter.
11    (c) Before imposing any fine authorized under this
12Section, the State Board shall afford the person or permit
13holder, as the case may be, an appearance before the State
14Board and an opportunity for a hearing before a hearing
15officer appointed by the State Board. The hearing shall be
16conducted in accordance with Section 10. Requests for an
17appearance before the State Board must be made within 30 days
18after receiving notice that a fine will be imposed.
19    (d) All fines collected under this Act shall be
20transmitted to the State Treasurer, who shall deposit them
21into the Illinois Health Facilities Planning Fund.
22    (e) Fines imposed under this Section shall continue to
23accrue until: (i) the date that the matter is referred by the
24State Board to the Board's legal counsel; or (ii) the date that
25the health care facility becomes compliant with the Act,
26whichever is earlier.

 

 

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1(Source: P.A. 99-114, eff. 7-23-15; 99-180, eff. 7-29-15;
299-527, eff. 1-1-17; 99-642, eff. 6-28-16; 100-681, eff.
38-3-18.)
 
4    Section 15. The Illinois Public Aid Code is amended by
5changing Section 5A-17 as follows:
 
6    (305 ILCS 5/5A-17)
7    Sec. 5A-17. Recovery of payments; liens.
8    (a) As a condition of receiving payments pursuant to
9subsections (d) and (k) of Section 5A-12.7 for State Fiscal
10Year 2021, a for-profit general acute care hospital that
11ceases to provide hospital services before July 1, 2021 and
12within 12 months of a change in the hospital's ownership
13status from not-for-profit to investor owned, shall be
14obligated to pay to the Department an amount equal to the
15payments received pursuant to subsections (d) and (k) of
16Section 5A-12.7 since the change in ownership status to the
17cessation of hospital services. The obligated amount shall be
18due immediately and must be paid to the Department within 10
19days of ceasing to provide services or pursuant to a payment
20plan approved by the Department unless the hospital requests a
21hearing under paragraph (d) of this Section. The obligation
22under this Section shall not apply to a hospital that ceases to
23provide services under circumstances that include:
24implementation of a transformation project approved by the

 

 

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1Department under subsection (d-5) of Section 14-12;
2emergencies as declared by federal, State, or local
3government; actions approved or required by federal, State, or
4local government; actions taken in compliance with the
5Illinois Health Facilities Planning Act; or other
6circumstances beyond the control of the hospital provider or
7for the benefit of the community previously served by the
8hospital, as determined on a case-by-case basis by the
9Department.
10    (a-5) As a condition of receiving payments pursuant to
11subsections (d) and (k) of Section 5A-12.7 for calendar year
122021, a general acute care hospital that ceases to provide
13hospital services before January 1, 2022 shall be obligated to
14pay to the Department an amount equal to the payments received
15pursuant to subsections (d) and (k) of Section 5A-12.7 up to
16the cessation of hospital services. The obligated amount shall
17be due immediately and must be paid to the Department within 30
18days of ceasing to provide services, or pursuant to a payment
19plan approved by the Department. The obligation under this
20Section shall not apply to a hospital that ceases to provide
21services under circumstances that include: (i) implementation
22of a transformation project approved under subsection (d-5) of
23Section 14-12; (ii) emergencies as declared by federal, State,
24or local government; (iii) actions approved or required by
25federal, State, or local government; (iv) actions taken in
26compliance with the Illinois Health Facilities Planning Act;

 

 

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1or (v) other circumstances beyond the control of the hospital
2provider or for the benefit of the community previously served
3by the hospital, as determined on a case-by-case basis by the
4Department.
5    (b) The Illinois Department shall administer and enforce
6this Section and collect the obligations imposed under this
7Section using procedures employed in its administration of
8this Code generally. The Illinois Department, its Director,
9and every hospital provider subject to this Section shall have
10the following powers, duties, and rights:
11        (1) The Illinois Department may initiate either
12    administrative or judicial proceedings, or both, to
13    enforce the provisions of this Section. Administrative
14    enforcement proceedings initiated hereunder shall be
15    governed by the Illinois Department's administrative
16    rules. Judicial enforcement proceedings initiated in
17    accordance with this Section shall be governed by the
18    rules of procedure applicable in the courts of this State.
19        (2) No proceedings for collection, refund, credit, or
20    other adjustment of an amount payable under this Section
21    shall be issued more than 3 years after the due date of the
22    obligation, except in the case of an extended period
23    agreed to in writing by the Illinois Department and the
24    hospital provider before the expiration of this limitation
25    period.
26        (3) Any unpaid obligation under this Section shall

 

 

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1    become a lien upon the assets of the hospital. If any
2    hospital provider sells or transfers the major part of any
3    one or more of (i) the real property and improvements,
4    (ii) the machinery and equipment, or (iii) the furniture
5    or fixtures of any hospital that is subject to the
6    provisions of this Section, the seller or transferor shall
7    pay the Illinois Department the amount of any obligation
8    due from it under this Section up to the date of the sale
9    or transfer. If the seller or transferor fails to pay any
10    amount due under this Section, the purchaser or transferee
11    of such asset shall be liable for the amount of the
12    obligation up to the amount of the reasonable value of the
13    property acquired by the purchaser or transferee. The
14    purchaser or transferee shall continue to be liable until
15    the purchaser or transferee pays the full amount of the
16    obligation up to the amount of the reasonable value of the
17    property acquired by the purchaser or transferee or until
18    the purchaser or transferee receives from the Illinois
19    Department a certificate showing that such assessment,
20    penalty, and interest have been paid or a certificate from
21    the Illinois Department showing that no amount is due from
22    the seller or transferor under this Section.
23    (c) In addition to any other remedy provided for, the
24Illinois Department may collect an unpaid obligation by
25withholding, as payment of the amount due, reimbursements or
26other amounts otherwise payable by the Illinois Department to

 

 

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1the hospital provider.
2(Source: P.A. 101-650, eff. 7-7-20.)
 
3    Section 99. Effective date. This Act takes effect upon
4becoming law.".