Public Act 095-0005
 		





SB0244 Enrolled
LRB095 08444 HLH 28621 b






    AN ACT concerning State government.

 
    WHEREAS, The 94th General Assembly funded a study by the 
Lewin Group, "An Evaluation of Illinois' 'Certificate of Need' 
Program", which recommended that "... the Illinois legislature 
move forward to continue the 'Certificate-of-Need' program 
with an abundance of caution...".  Given the potential for harm 
to specific critical elements of the health care system, 
non-traditional arguments for maintaining 
"Certificate-of-Need" laws deserve consideration, until the 
evidence on the impact that specialty providers and ambulatory 
surgery centers may have on safety-net providers and services 
can be better quantified. In response to the Lewin analysis and 
additional concerns regarding health planning in Illinois, the 
95th General Assembly enacted Senate Bill 611 (Public Act 
95-0001) that extended the "sunset" date of the Illinois Health 
Facilities Planning Act from April 1, 2007 to May 31, 2007 so 
that interested parties could agree on a strategy to further 
extend the "sunset" date, and develop a more comprehensive 
reform agenda; therefore
 
    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 Section 19.6 and by adding Sections 12.5 
and 15.5 as follows:
 
    (20 ILCS 3960/12.5 new)

    Sec. 12.5. Update existing bed inventory and associated bed 
need projections.  While the Task Force on Health Planning 
Reform will make long-term recommendations related to the 
method and formula for calculating the bed inventory and 
associated bed need projections, there is a current need for 
the bed inventory to be updated prior to the issuance of the 
recommendations of the Task Force.  Therefore, the State Agency 
shall immediately update the existing bed inventory and 
associated bed need projections required by Sections 12 and 
12.3 of this Act, using the most recently published historical 
utilization data, 10-year population projections, and an 
appropriate migration factor for the medical-surgical and 
pediatric category of service which shall be no less than 50%.  
The State Agency shall provide written documentation providing 
the methodology and rationale used to determine the appropriate 
migration factor.
 
    (20 ILCS 3960/15.5  new)
    Sec. 15.5. Task Force on Health Planning Reform.
    (a) The Task Force on Health Planning Reform is created.
    (b) The Task Force shall consist of 19 voting members, as 
follows: 6 persons, who are not currently employed by a State 
agency, appointed by the Director of Public Health, 3 of whom 
shall be persons with knowledge and experience in the delivery 
of health care services, including at least one person 
representing organized health service workers, 2 of whom shall 
be persons with professional experience in the administration 
or management of health care facilities, and one of whom shall 
be a person with experience in health planning; 2 members of 
the Illinois Senate appointed by the President of the Senate, 
one of  whom shall be a co-chair to the Task Force; 2 members of 
the Illinois Senate appointed by the Senate Minority Leader; 2 
members of the Illinois House of Representatives appointed by 
the Speaker of the House of Representatives, one of  whom shall 
be a co-chair to the Task Force; 2 members of the Illinois 
House of Representatives appointed by the House Minority 
Leader; the Attorney General, or his or her designee; and 4 
members of the general public, representing health care 
consumers, appointed by the Attorney General of Illinois.

    The following persons, or their designees, shall serve, ex 
officio, as nonvoting members of the Task Force: the Director 
of Public Health, the Secretary of the Illinois Health 
Facilities Planning Board, the Director of Healthcare and 
Family Services, the Secretary of Human Services, and the 
Director of the Governor's Office of Management and Budget.

    Members shall serve without compensation, but may be 
reimbursed for their expenses in relation to duties on the Task 
Force.

    A vote of 12 members appointed to the Task Force is 
required with respect to the adoption of recommendations to the 
Governor and General Assembly and the final report required by 
this Section.
    (c) The Task Force shall gather information and make 
recommendations relating to at least the following topics in 
relation to the Illinois Health Facilities Planning Act:

        (1) The impact of  health planning on the provision of  
    essential and accessible health care services; prevention 
    of unnecessary duplication of facilities and services; 
    improvement in the efficiency of the health care system; 
    maintenance of an environment in the health care system 
    that supports quality care; the most economic use of 
    available resources; and the effect of repealing this Act.
        (2) Reform of the Illinois Health Facilities Planning 
    Board to enable it to undertake a more active role in 
    health planning to provide guidance in the development of 
    services to meet the health care needs of Illinois, 
    including identifying and recommending initiatives to meet 
    special needs.
        (3) Reforms to ensure that health planning under the 
    Illinois Health Facilities Planning Act is coordinated 
    with other health planning laws and activities of the 
    State.
        (4) Reforms that will enable the Illinois Health 
    Facilities Planning Board to focus most of its project 
    review efforts on "Certificate-of-Need" applications 
    involving new facilities, discontinuation of services, 
    major expansions, and volume-sensitive services, and to 
    expedite review of other projects to the maximum extent 
    possible.
        (5) Reforms that will enable the Illinois Health 
    Facilities Planning Board to determine how criteria, 
    standards, and procedures for evaluating project 
    applications involving specialty providers, ambulatory 
    surgical facilities, and other alternative health care 
    models should be amended to give special attention to the 
    impact of those  projects on traditional community 
    hospitals to assure the availability and access to 
    essential quality medical care in those communities.
        (6) Implementation of policies and procedures 
    necessary for the Illinois Health Facilities Planning 
    Board to give special consideration to the impact of the 
    projects it reviews on access to "safety net" services.
        (7) Changes in policies and procedures to make the 
    Illinois health facilities planning process predictable, 
    transparent, and as efficient as possible;  requiring the 
    State Agency (the Illinois Department of Public Health) and 
    the Illinois Health Facilities Planning Board to provide 
    timely and appropriate explanations of its decisions and 
    establish more effective procedures to enable public 
    review and comment on facts set forth in State Agency staff 
    analyses of project applications prior to the issuance of 
    final decisions on each project.
        (8) Reforms to ensure that patient access to new and 
    modernized services will not be delayed during a transition 
    period under any proposed system reform; and that the 
    transition should minimize disruption of the process for 
    current applicants.
        (9) Identification of the resources necessary to 
    support the work of the Agency and the Board.

    (d) The Task Force shall recommend reforms regarding the 
following:

        (1) The size and membership of current Illinois Health 
    Facilities Planning Board.  Review and make recommendations 
    on the reorganization of the structure and function of the 
    Illinois Health Facilities Planning Board and the State 
    Agency responsible for health planning (the Illinois 
    Department of Public Health), giving consideration to 
    various options for reassigning the primary responsibility 
    for the review, approval, and denial of project 
    applications between the Board and the State Agency, so 
    that the "Certificate-of-Need" process is administered in 
    the most effective,  efficient, and consistent manner 
    possible in accordance with the objectives referenced in 
    subsection (c) of this Section.
        (2) Changes in policies and procedures that will charge 
    the Illinois Health Facilities Planning Board with 
    developing a long-range health facilities plan (10 years) 
    to be updated at least every 2 years, so that it is a 
    rolling 10-year plan based upon data no older than 2 years. 
    The plan should  incorporate an inventory of the State's 
    health facilities infrastructure including both facilities 
    and services regulated under this Act, as well as 
    facilities and services that are not currently regulated 
    under this Act, as determined by the Board.  The planning 
    criteria and standards should be adjusted to take into 
    consideration services that are regulated under the Act, 
    but are also offered by non-regulated providers. The 
    Illinois Department of Public Health bed inventory should  
    be updated each year using the most recent utilization data 
    for both hospitals and long-term care facilities including 
    2003, 2004, 2005 and subsequent-year inpatient discharges 
    and days.  This revised bed supply should be used as the bed 
    supply input for all Planning Area bed-need calculations.  
    Ten-year population projection data should be incorporated 
    into the plan. Plan updates may include redrawing planning 
    area boundaries to reflect population changes. The Task 
    Force shall consider whether the inventory formula should 
    use migration factors for the medical/surgical, 
    pediatrics, obstetrics, and other categories of service, 
    and if so, what those migration factors should be. The 
    Board should hold public hearings on the plan and its 
    updates. There should be a mechanism for the public to 
    request that the plan be updated more frequently to address 
    emerging population and demographic trends. In developing 
    the plan, the Board should consider health plans and other 
    related publications that have been developed both in 
    Illinois and nationally. In developing the plan, the need 
    to ensure access to care, especially for "safety net" 
    services, including rural and medically underserved 
    communities, should be included.
        (3) Changes in regulations that establish separate 
    criteria, standards, and procedures when necessary to 
    adjust for structural, functional, and operational 
    differences between long-term care facilities and acute 
    care facilities and that allow routine changes of 
    ownership, facility sales, and closure requests to be 
    processed on a timely basis.  Consider rules to allow 
    flexibility for facilities to modernize, expand, or 
    convert to alternative uses that are in accord with health 
    planning standards.
        (4) Changes in policies and procedures so that the 
    Illinois Health Facilities Planning Board updates the 
    standards and criteria on a regular basis and proposes new 
    standards to keep pace with the evolving health care 
    delivery system. Proton Therapy and Treatment is an example 
    of a new, cutting-edge procedure that may require the Board 
    to immediately develop criteria, standards, and procedures 
    for that type of facility.  Temporary advisory committees 
    may be appointed to assist in the development of revisions 
    to the Board's standards and criteria, including experts 
    with professional competence in the subject matter of the 
    proposed standards or criteria that are to be developed.
        (5) Changes in policies and procedures to expedite 
    project approval, particularly for less complex projects, 
    including standards for determining whether a project is in 
    "substantial compliance" with the Board's review 
    standards. The review standards must include a requirement 
    for applicants to include a "Safety Net" Impact Statement.  
    This Statement shall describe the project's impact on 
    safety net services in the community.  The State Agency 
    Report shall include an assessment of the Statement.
        (6)  Changes to enforcement processes and compliance 
    standards to ensure they are fair and consistent with the 
    severity of the violation.
        (7) Revisions in policies and procedures to prevent 
    conflicts of interest by members of the Illinois Health 
    Facilities Planning Board and State Agency staff, 
    including increasing the penalties for violations.

        (8) Other changes determined necessary to improve the 
    administration of this Act.

    (e) The State Agency, at the direction of the Task Force, 
may hire any necessary staff or consultants, enter into 
contracts, and make any expenditures necessary for carrying out 
the duties of the Task Force, all out of moneys appropriated 
for that purpose. Staff support services shall be provided to 
the Task Force by the State Agency from such appropriations.
    (f) The Task Force may establish any advisory committee to 
ensure maximum public participation in the Task Force's 
planning, organization, and implementation review process. If 
established, advisory committees shall (i) advise and assist 
the Task Force in its duties and (ii) help the Task Force to 
identify issues of public concern.
    (g) The Task Force shall submit findings and 
recommendations to the Governor and the General Assembly by 
March 1, 2008, including any necessary implementing 
legislation, and recommendations for changes to policies, 
rules, or procedures that are not incorporated in the 
implementing legislation.
    (h) The Task Force is abolished on August 1, 2008.

 



    (20 ILCS 3960/19.6)


    (Section scheduled to be repealed on May 31, 2007)

    Sec. 19.6. Repeal. This Act is repealed on August 31, 2008

May 31, 2007.

(Source: P.A. 94-983, eff. 6-30-06; 95-1, eff. 3-30-07.)

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