Public Act 101-0083
 
SB1739 EnrolledLRB101 09796 RJF 54897 b


  
    AN ACT concerning State government.
  
 
    Be it enacted by the People of the State of Illinois,
 
represented in the General Assembly:
  



 
 
    Section 5. The Illinois Health Facilities Planning Act is 
amended  by changing Sections 6, 8.5, 12, and 12.2 and by adding 
Section 8.7 as follows:
 


    (20 ILCS 3960/6)  (from Ch. 111 1/2, par. 1156)




    (Section scheduled to be repealed on December 31, 2029)

    Sec. 6. Application for permit or exemption; exemption 
regulations. 

    (a) An application for a permit or exemption shall be made 
to
the State Board upon forms provided by the State Board.  This 
application
shall contain such information
as the State Board 
deems necessary. The State Board shall not require an applicant 
to file a Letter of Intent before an application is filed. Such

application shall include affirmative evidence on which the 
State
Board or Chairman may make its decision on the approval 
or denial of the permit or
exemption.

    (b) The State Board shall establish by regulation the 
procedures and
requirements
regarding issuance of exemptions.

An exemption shall be approved when information required by the 
Board by rule
is submitted. Projects
eligible for an exemption, 
rather than a permit, include, but are not limited
to,
change 
of ownership of a health care facility and discontinuation of a 
category of service , discontinuation of a category of service, 
and discontinuation of a health care facility, other than a 
health care facility maintained by the State or any agency or 
department thereof or a nursing home maintained by a county. 
The Board may accept an application for an exemption for the 
discontinuation of a category of service at a health care 
facility only once in a 6-month period following (1) the 
previous application for exemption at the same health care 
facility or (2) the final decision of the Board regarding the 
discontinuation of a category of service at the same health 
care facility, whichever occurs later. A discontinuation of a 
category of service shall otherwise require an application for 
a permit if an application for an exemption has already been 
accepted within the 6-month period. For a change of
ownership 
among related persons of a health care
facility, the State 
Board shall provide by rule for an
expedited
process for 
obtaining an exemption in accordance with Section 8.5 of this 
Act. For the purposes of this Section, "change of ownership 
among related persons" means a transaction in which the parties 
to the transaction are under common control or ownership before 
and after the transaction is complete. 

    (c) All applications shall be signed by the applicant and 
shall be
verified by any 2 officers thereof.

    (c-5) Any written review or findings  of the Board staff set 
forth in the State Board Staff Report concerning an application 
for a permit must be made available to the public and the 
applicant at least 14 calendar days before the meeting of the 
State Board at which the review or findings are considered. The 
applicant and members of the public may submit, to the State 
Board, written responses regarding the facts set forth in the 
review or findings of the Board staff. Members of the public 
and the applicant shall have until 10 days before the meeting 
of the State Board to submit any written response concerning 
the Board staff's written review or findings. The Board staff 
may revise any findings to address corrections of factual 
errors cited in the public response. At the meeting, the State 
Board may, in its discretion, permit the submission of other 
additional written materials.

    (d) Upon receipt of an application for a permit, the State 
Board shall
approve and authorize the issuance of a permit if 
it finds (1) that the
applicant is fit, willing, and able to 
provide a proper standard of
health care service for the 
community with particular regard to the
qualification, 
background and character of the applicant, (2) that
economic 
feasibility is demonstrated in terms of effect on the existing

and projected operating budget of the applicant and of the 
health care
facility; in terms of the applicant's ability to 
establish and operate
such facility in accordance with 
licensure regulations promulgated under
pertinent state laws; 
and in terms of the projected impact on the total
health care 
expenditures in the facility and community, (3) that
safeguards 
are provided that assure that the establishment,
construction 
or modification of the health care facility or acquisition
of 
major medical equipment is consistent
with the public interest, 
and (4) that the proposed project is consistent
with the 
orderly and economic
development of such facilities and 
equipment and is in accord with standards,
criteria, or plans 
of need adopted and approved pursuant to the
provisions of 
Section 12 of this Act.

(Source: P.A. 99-154, eff. 7-28-15; 100-518, eff. 6-1-18; 
100-681, eff. 8-3-18.)

 
    (20 ILCS 3960/8.5)
    (Section scheduled to be repealed on December 31, 2029)
    Sec. 8.5. Certificate of exemption for change of ownership 
of a health care facility; discontinuation of a health care 
facility or category of service; public notice and public 
hearing.
    (a) Upon a finding that an application for a change of 
ownership is complete, the State Board shall publish a legal 
notice on 3 consecutive days one day in a newspaper of general 
circulation in the area or community to be affected and afford 
the public an opportunity to request a hearing. If the 
application is for a facility located in a Metropolitan 
Statistical Area, an additional legal notice shall be published 
in a newspaper of limited circulation, if one exists, in the 
area in which the facility is located. If the newspaper of 
limited circulation is published on a daily basis, the 
additional legal notice shall be published on 3 consecutive 
days one day. The applicant shall pay the cost incurred by the 
Board in publishing the change of ownership notice in 
newspapers as required under this subsection. The legal notice 
shall also be posted on the Health Facilities and Services 
Review Board's web site and sent to the State Representative 
and State Senator of the district in which the health care 
facility is located. An application for change of ownership of 
a hospital shall not be deemed complete without a signed 
certification that for a period of 2 years after the change of 
ownership transaction is effective, the hospital will not adopt 
a charity care policy that is
more restrictive than the policy 
in effect during the year prior to the transaction. An 
application for a change of ownership need not contain signed 
transaction documents so long as it includes the following key 
terms of the transaction:  names and background of the parties; 
structure of the transaction; the person who will be the 
licensed or certified entity after the transaction; the 
ownership or membership interests in such licensed or certified 
entity both prior to and after the transaction; fair market 
value of assets to be transferred; and the purchase price or 
other form of consideration to be provided for those assets. 
The issuance of the certificate of exemption shall be 
contingent upon the applicant submitting a statement to the 
Board within 90 days after the closing date of the transaction, 
or such longer period as provided by the Board, certifying that 
the change of ownership has been completed in accordance with 
the key terms contained in the application.  If such key terms 
of the transaction change, a new application shall be required. 
    Where a change of ownership is among related persons, and 
there are no other changes being proposed at the health care 
facility that would otherwise require a permit or exemption 
under this Act, the applicant shall submit an application 
consisting of a standard notice in a form set forth by the 
Board briefly explaining the reasons for the proposed change of 
ownership. Once such an application is submitted to the Board 
and reviewed by the Board staff, the Board Chair shall take 
action on an application for an exemption for a change of 
ownership among related persons within 45 days after the 
application has been deemed complete, provided the application 
meets the applicable standards under this Section.  If the Board 
Chair has a conflict of interest or for other good cause, the 
Chair may request review by the Board. Notwithstanding  any 
other provision of this Act, for purposes of this Section, a 
change of ownership among related persons means a transaction 
where the parties to the transaction are under common control 
or ownership before and after the transaction is completed.
    Nothing in this Act shall be construed as authorizing the 
Board to impose any conditions, obligations, or limitations, 
other than those required by this Section, with respect to the 
issuance of an exemption for a change of ownership, including, 
but not limited to, the time period before which a subsequent 
change of ownership of the health care facility could be 
sought, or the commitment to continue to offer for a specified 
time period any services currently offered by the health care 
facility.
    (a-3) (Blank). Upon a finding that an application to close 
a health care facility is complete, the State Board shall 
publish a legal notice on 3 consecutive days in a newspaper of 
general circulation in the area or community to be affected and 
afford the public an opportunity to request a hearing. If the 
application is for a facility located in a Metropolitan 
Statistical Area, an additional legal notice shall be published 
in a newspaper of limited circulation, if one exists, in the 
area in which the facility is located. If the newspaper of 
limited circulation is published on a daily basis, the 
additional legal notice shall be published on 3 consecutive 
days. The legal notice shall also be posted on the Health 
Facilities and Services Review Board's web site and sent to the 
State Representative and State Senator of the district in which 
the health care facility is located.  In addition, the health 
care facility shall provide notice of closure to the local 
media that the health care facility would routinely notify 
about facility events. No later than 90 days after a 
discontinuation of a health facility, the applicant must submit 
a statement to the State Board certifying that the 
discontinuation is complete. 
    (a-5) Upon a finding that an application to discontinue a 
category of service is complete and provides the requested 
information, as specified by the State Board, an exemption 
shall be issued.  No later than 30 days after the issuance of 
the exemption, the health care facility must give written 
notice of the discontinuation of the category of service to the 
State Senator and State Representative serving the legislative 
district in which the health care facility is located. No later 
than 90 days after a discontinuation of a category of service, 
the applicant must submit a statement to the State Board 
certifying that the discontinuation is complete. 
    (b) If a public hearing is requested, it shall be held at 
least 15 days but no more than 30 days after the date of 
publication of the legal notice in the community in which the 
facility is located. The hearing shall be held in  the affected 
area or community in a place of reasonable size and 
accessibility and a full and complete written transcript of the 
proceedings shall be made. All interested persons attending the 
hearing shall be given a reasonable opportunity to present 
their positions in writing or orally. The applicant shall 
provide a summary or describe the proposed change of ownership 
of the proposal for distribution at the public hearing.

    (c) For the purposes of this Section "newspaper of limited 
circulation" means a newspaper intended to serve a particular 
or defined population of a specific geographic area within a 
Metropolitan Statistical Area such as a municipality, town, 
village, township, or community area, but does not include 
publications of professional and trade associations. 
    (d) The changes made to this Section by this amendatory  Act 
of the 101st General Assembly shall apply to all applications 
submitted after the effective date of this amendatory Act of 
the  101st General Assembly. 
(Source: P.A. 99-154, eff. 7-28-15; 99-527, eff. 1-1-17; 
99-551, eff. 7-15-16; 100-201, eff. 8-18-17.)
 
    (20 ILCS 3960/8.7 new)
    Sec. 8.7. Application for permit for discontinuation of a 
health care facility or category of service; public notice and 
public hearing.
    (a) Upon a finding that an application to close a health 
care facility or discontinue a category of service is complete, 
the State Board shall publish a legal notice on 3 consecutive 
days in a newspaper of general circulation in the area or 
community to be affected and afford the public an opportunity 
to request a hearing.  If the application is for a facility 
located in a Metropolitan Statistical Area, an additional legal 
notice shall be published in a newspaper of limited 
circulation, if one exists, in the area in which the facility 
is located.  If the newspaper of limited circulation is 
published on a daily basis, the additional legal notice shall 
be published on 3 consecutive days.  The legal notice shall also 
be posted on the Health Facilities and Services Review Board's 
website and sent to the State Representative and State Senator 
of the district in which the health care facility is located.  
In addition, the health care facility shall provide notice of 
closure to the local media that the health care facility would 
routinely notify about facility events.
    (b) No later than 30 days after issuance of a permit to 
close a health care facility or discontinue a category of 
service, the permit holder shall give written notice of the 
closure or discontinuation to the State Senator and State 
Representative serving the legislative district in which the 
health care facility is located. 
    (c) If there is a pending lawsuit that challenges an 
application to discontinue a health care facility that either 
names the Board as a party or alleges fraud in the filing of 
the application, the Board may defer action on the application 
for up to 6 months after the date of the initial deferral of 
the application.
    (d) The changes made to this Section by this amendatory  Act 
of the 101st General Assembly shall apply to all applications 
submitted after the effective date of this amendatory Act of 
the  101st General Assembly. 
 

    (20 ILCS 3960/12)  (from Ch. 111 1/2, par. 1162)

  
    (Section scheduled to be repealed on December 31, 2029)
    Sec. 12. Powers and duties of State Board. For purposes of 
this Act,
the State Board
shall
exercise the following powers 
and duties:

    (1) Prescribe rules,
regulations, standards, criteria, 
procedures or reviews which may vary
according to the purpose 
for which a particular review is being conducted
or the type of 
project reviewed and which are required to carry out the

provisions and purposes of this Act. Policies and procedures of 
the State Board shall take into consideration the priorities 
and needs of medically underserved areas and other health care 
services, giving special consideration to the impact of 
projects on access to safety net services. 

    (2) Adopt procedures for public
notice and hearing on all 
proposed rules, regulations, standards,
criteria, and plans 
required to carry out the provisions of this Act.

    (3) (Blank).

    (4) Develop criteria and standards for health care 
facilities planning,
conduct statewide inventories of health 
care facilities, maintain an updated
inventory on the Board's 
web site reflecting the
most recent bed and service
changes and 
updated need determinations when new census data become 
available
or new need formulae
are adopted,
and
develop health 
care facility plans which shall be utilized in the review of

applications for permit under
this Act.  Such health facility 
plans shall be coordinated by the Board
with pertinent State 
Plans. Inventories pursuant to this Section of skilled or 
intermediate care facilities licensed under the Nursing Home 
Care Act, skilled or intermediate care facilities licensed 
under the ID/DD Community Care Act, skilled or intermediate 
care facilities licensed under the MC/DD Act, facilities 
licensed under the Specialized Mental Health Rehabilitation 
Act of 2013, or nursing homes licensed under the Hospital 
Licensing Act shall be conducted on an annual basis no later 
than July 1 of each year and shall include among the 
information requested a list of all services provided by a 
facility to its residents and to the community at large and 
differentiate between active and inactive beds.


    In developing health care facility plans, the State Board 
shall consider,
but shall not be limited to, the following:

        (a) The size, composition and growth of the population 
    of the area
to be served;

        (b) The number of existing and planned facilities 
    offering similar
programs;

        (c) The extent of utilization of existing facilities;

        (d) The availability of facilities which may serve as 
    alternatives
or substitutes;

        (e) The availability of personnel necessary to the 
    operation of the
facility;

        (f) Multi-institutional planning and the establishment 
    of
multi-institutional systems where feasible;

        (g) The financial and economic feasibility of proposed 
    construction
or modification; and

        (h) In the case of health care facilities established 
    by a religious
body or denomination, the needs of the 
    members of such religious body or
denomination may be 
    considered to be public need.

    The health care facility plans which are developed and 
adopted in
accordance with this Section shall form the basis 
for the plan of the State
to deal most effectively with 
statewide health needs in regard to health
care facilities.

    (5) Coordinate with other state agencies having 
responsibilities
affecting health care facilities, including 
those of licensure and cost
reporting.

    (6) Solicit, accept, hold and administer on behalf of the 
State
any grants or bequests of money, securities or property 
for
use by the State Board in the administration of this Act; 
and enter into contracts
consistent with the appropriations for 
purposes enumerated in this Act.

    (7) (Blank).

    (8) Prescribe rules, regulations,
standards, and criteria 
for the conduct of an expeditious review of
applications
for 
permits for projects of construction or modification of a 
health care
facility, which projects are classified as 
emergency, substantive, or non-substantive in nature.  
    Substantive projects shall include no more than  the 
following:
        (a) Projects to construct (1) a new or replacement 
    facility located on a new site or
(2) a  replacement 
    facility located on the same site as the original facility 
    and the cost of  the replacement facility exceeds the 
    capital expenditure minimum, which shall be reviewed by the 
    Board within 120 days;
        (b) Projects proposing a
(1) new service within an 
    existing healthcare facility or
(2) discontinuation of a 
    service within an existing healthcare facility, which 
    shall be reviewed by the Board within 60 days; or
        (c) Projects proposing a change in the bed capacity of 
    a health care facility by an increase in the total number 
    of beds or by a redistribution of beds among various 
    categories of service or by a relocation of  beds from one 
    physical facility or site to another by more than 20 beds 
    or more than 10% of total bed capacity, as defined by the 
    State Board, whichever is less, over a 2-year period.
    The Chairman may approve applications for exemption that 
meet the criteria set forth in rules or refer them to the full 
Board.  The Chairman may approve any unopposed application that 
meets  all of the review criteria or refer them to the full 
Board. 
    Such rules shall
not prevent the conduct of a public 
hearing upon the timely request
of an interested party.  Such 
reviews shall not exceed 60 days from the
date the application 
is declared to be complete.

    (9) Prescribe rules, regulations,
standards, and criteria 
pertaining to the granting of permits for
construction
and 
modifications which are emergent in nature and must be 
undertaken
immediately to prevent or correct structural 
deficiencies or hazardous
conditions that may harm or injure 
persons using the facility, as defined
in the rules and 
regulations of the State Board. This procedure is exempt
from 
public hearing requirements of this Act.

    (10) Prescribe rules,
regulations, standards and criteria 
for the conduct of an expeditious
review, not exceeding 60 
days, of applications for permits for projects to
construct or 
modify health care facilities which are needed for the care
and 
treatment of persons who have acquired immunodeficiency 
syndrome (AIDS)
or related conditions.

    (10.5) Provide its rationale when voting on an item before 
it at a State Board meeting in order to comply with subsection 
(b) of Section 3-108 of the Code of Civil Procedure.
    (11)  Issue written decisions upon request of the applicant 
or an adversely affected party to the Board. Requests for a 
written decision shall be made within 15 days after the Board 
meeting in which a final decision has been made.  A "final 
decision" for purposes of this Act is the decision to approve 
or deny an application, or take other actions permitted under 
this Act, at the time and date of the meeting that such action 
is scheduled by the Board. The transcript of the State Board 
meeting shall be incorporated into the Board's final decision. 
The staff of the Board shall prepare a written copy of the 
final decision and the Board shall approve a final copy for 
inclusion in the formal record. The Board shall consider, for 
approval, the written draft of the final decision no later than 
the next scheduled Board meeting. The written decision shall 
identify the applicable criteria and factors listed in this Act 
and the Board's regulations that were taken into consideration 
by the Board when coming to a final decision. If the Board 
denies or fails to approve an application for permit or 
exemption, the Board shall include in the final decision a 
detailed explanation as to why the application was denied and 
identify what specific criteria or standards the applicant did 
not fulfill.
    (12) (Blank).
    (13)  Provide a mechanism for the public to comment on, and 
request changes to, draft rules and standards.
    (14)  Implement public information campaigns to regularly 
inform the general public about the opportunity for public 
hearings and public hearing procedures.
    (15) Establish a separate set of rules and guidelines for 
long-term care that recognizes that nursing homes are a 
different business line and service model from other regulated 
facilities. An open and transparent process shall be developed 
that considers the following: how skilled nursing fits in the 
continuum of care with other care providers, modernization of 
nursing homes, establishment of more private rooms, 
development of alternative services, and current trends in 
long-term care services.

The Chairman of the Board shall 
appoint a permanent Health Services Review Board Long-term Care 
Facility Advisory Subcommittee that shall develop and 
recommend to the Board the rules to be established by the Board 
under this paragraph (15). The Subcommittee shall also provide 
continuous review and commentary on policies and procedures 
relative to long-term care and the review of related projects. 
The Subcommittee shall make recommendations to the Board no 
later than January 1, 2016 and every January thereafter 
pursuant to the Subcommittee's responsibility for the 
continuous review and commentary on policies and procedures 
relative to long-term care. In consultation with other experts 
from the health field of long-term care, the Board and the 
Subcommittee shall study new approaches to the current bed need 
formula and Health Service Area boundaries to encourage 
flexibility and innovation in design models reflective of the 
changing long-term care marketplace and consumer preferences 
and submit its recommendations to the Chairman of the Board no 
later than January 1, 2017. The Subcommittee shall evaluate, 
and make recommendations to the State Board regarding, the 
buying, selling, and exchange of beds between long-term care 
facilities within a specified geographic area or drive time. 
The Board shall file the proposed related administrative rules 
for the separate rules and guidelines for long-term care 
required by this paragraph (15) by no later than September 30, 
2011.  The Subcommittee shall be provided a reasonable and 
timely opportunity to review and comment on any review, 
revision, or updating of the criteria, standards, procedures, 
and rules used to evaluate project applications as provided 
under Section 12.3 of this Act. 
    The Chairman of the Board shall appoint voting members of 
the Subcommittee, who shall serve for a period of 3 years, with 
one-third of the terms expiring each January, to be determined 
by lot. Appointees shall include, but  not be limited to, 
recommendations from each of the 3 statewide long-term care 
associations, with an equal number to be appointed from each. 
Compliance with this provision shall be through the appointment 
and reappointment process. All appointees serving as of April 
1, 2015 shall serve to the end of their term as determined by 
lot or until the appointee voluntarily resigns, whichever is 
earlier. 
    One representative from the Department of Public Health, 
the Department of Healthcare and Family Services, the 
Department on Aging, and the Department of Human Services may 
each serve as an ex-officio non-voting member of the 
Subcommittee. The Chairman of the Board shall select a 
Subcommittee Chair, who shall serve for a period of 3 years. 
    (16) Prescribe the format of the State Board Staff Report. 
A State Board Staff Report shall pertain to applications that 
include, but are not limited to, applications for permit or 
exemption, applications for permit renewal, applications for 
extension of the financial commitment period, applications 
requesting a declaratory ruling, or applications under the 
Health Care Worker Self-Referral Act.  State Board Staff Reports 
shall compare applications to the relevant review criteria 
under the Board's rules. 
    (17) Establish a separate set of rules and guidelines for 
facilities licensed under the Specialized Mental Health 
Rehabilitation Act of 2013.  An application for the 
re-establishment of a facility in connection with the 
relocation of the facility shall not be granted unless the 
applicant has a contractual relationship with at least one 
hospital to provide emergency and inpatient mental health 
services required by facility consumers, and at least one 
community mental health agency to provide oversight and 
assistance to facility consumers while living in the facility, 
and appropriate services, including case management, to assist 
them to prepare for discharge and  reside stably in the 
community thereafter.  No new facilities licensed under the 
Specialized Mental Health Rehabilitation Act of 2013 shall be 
established after June 16, 2014 (the effective date of Public 
Act 98-651) except in connection with the relocation of an 
existing facility to a new location. An application for a new 
location shall not be approved unless there are adequate 
community services accessible to the consumers within a 
reasonable distance, or by use of public transportation, so as 
to facilitate the goal of achieving maximum individual 
self-care and independence.  At no time shall the total number 
of authorized beds under this Act in facilities licensed under 
the Specialized Mental Health Rehabilitation Act of 2013 exceed 
the number of authorized beds on June 16, 2014 (the effective 
date of Public Act 98-651). 
    (18)   Elect a Vice Chairman to preside over State Board 
meetings and otherwise act in place of the Chairman when the 
Chairman is unavailable. 
(Source: P.A. 99-78, eff. 7-20-15; 99-114, eff. 7-23-15; 
99-180, eff. 7-29-15; 99-277, eff. 8-5-15; 99-527, eff. 1-1-17; 
99-642, eff. 7-28-16; 100-518, eff. 6-1-18; 100-681, eff. 
8-3-18.)
 


    (20 ILCS 3960/12.2)




    (Section scheduled to be repealed on December 31, 2029)

    Sec. 12.2. Powers of the State Board staff. For purposes of 
this Act,
the staff shall exercise the following powers and 
duties:

        (1) Review applications for permits and exemptions in 
    accordance with the
standards, criteria, and plans of need 
    established by the State Board under
this Act and certify 
    its finding to the State Board.

        (1.5) Post the following on the Board's web site: 
    relevant (i)
rules,
(ii)
standards, (iii)
criteria, (iv) 
    State norms, (v) references used by Board staff in making

    determinations about whether application criteria are met, 
    and (vi) notices of
project-related filings, including 
    notice of public comments related to the
application.

        (2) Charge and collect an amount determined by the 
    State Board and the staff to be
reasonable fees for the 
    processing of applications by the State Board.
The State 
    Board shall set the amounts by rule.  Application fees for 
    continuing care retirement communities, and other health 
    care models that include regulated and unregulated 
    components, shall apply only to those components subject to 
    regulation under this Act. All fees and fines
collected 
    under the provisions of this Act shall be deposited
into 
    the Illinois Health Facilities Planning Fund to be used for 
    the
expenses of administering this Act.

        (2.1) Publish the following reports on the State Board 
    website:
            (A) An annual accounting, aggregated by category 
        and with names of parties redacted, of fees, fines, and 
        other revenue collected as well as expenses incurred, 
        in the administration of this Act.
            (B) An annual report, with names of the parties 
        redacted, that summarizes all settlement agreements 
        entered into with the State Board that resolve an 
        alleged instance of noncompliance with State Board 
        requirements under this Act.
            (C) (Blank).
            (D) Board reports showing the degree to which an 
        application conforms to the review standards, a 
        summation of relevant public testimony, and any 
        additional information that staff wants to 
        communicate. 
        (3) Coordinate with other State agencies having 
    responsibilities
affecting
health care facilities, 
    including licensure and cost reporting agencies.

        (4)   Issue advisory opinions upon request. Staff 
    advisory opinions do not constitute determinations by the 
    State Board. Determinations by the State Board are made 
    through the declaratory ruling process. 
(Source: P.A. 99-527, eff. 1-1-17; 100-681, eff. 8-3-18.)

 
 
    Section 99. Effective date. This Act takes effect upon 
becoming law.