Bill Text: IL HB3651 | 2009-2010 | 96th General Assembly | Introduced

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Bill Title: Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Creates the Center for Comprehensive Health Planning to promote the distribution of health care services and improve the healthcare delivery system in Illinois by establishing a statewide Comprehensive Health Plan and ensuring a predictable, transparent, and efficient Certificate of Need process under the Illinois Health Facilities Planning Act. Amends the Illinois Health Facilities Planning Act. Replaces the 5-member Health Facilities Planning Board with a 9-member Health Facilities and Services Review Board. Makes changes in provisions concerning the purposes of the Act; definitions; ex parte communication; construction, modification, or establishment of health care facilities or acquisition of major medical equipment; application for permits or exemption from application; powers and duties of the State Board and its staff; revision of criteria, standards, and rules; penalties; and an audit by the Auditor General. Adds provisions concerning Safety Net Impact Statements and creating the Nomination Panel, which provides a list of candidates to the Governor for appointment to Illinois Health Facilities and Services Review Board, the position of Chairman of the Board, and the Comprehensive Health Planner. Extends the repeal of the Act from July 1, 2009 to December 31, 2019. Repeals provisions concerning areawide health planning organizations, certificates of recognition, and the Task Force on Health Planning Reform. Makes related changes in other Acts. Effective immediately.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced - Dead) 2009-03-13 - Rule 19(a) / Re-referred to Rules Committee [HB3651 Detail]

Download: Illinois-2009-HB3651-Introduced.html

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96TH GENERAL ASSEMBLY State of Illinois 2009 and 2010 HB3651 Introduced 2/24/2009, by Rep. Lisa M. Dugan - Lou Lang SYNOPSIS AS INTRODUCED:
See Index
Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Creates the Center for Comprehensive Health Planning to promote the distribution of health care services and improve the healthcare delivery system in Illinois by establishing a statewide Comprehensive Health Plan and ensuring a predictable, transparent, and efficient Certificate of Need process under the Illinois Health Facilities Planning Act. Amends the Illinois Health Facilities Planning Act. Replaces the 5-member Health Facilities Planning Board with a 9-member Health Facilities and Services Review Board. Makes changes in provisions concerning the purposes of the Act; definitions; ex parte communication; construction, modification, or establishment of health care facilities or acquisition of major medical equipment; application for permits or exemption from application; powers and duties of the State Board and its staff; revision of criteria, standards, and rules; penalties; and an audit by the Auditor General. Adds provisions concerning Safety Net Impact Statements and creating the Nomination Panel, which provides a list of candidates to the Governor for appointment to Illinois Health Facilities and Services Review Board, the position of Chairman of the Board, and the Comprehensive Health Planner. Extends the repeal of the Act from July 1, 2009 to December 31, 2019. Repeals provisions concerning areawide health planning organizations, certificates of recognition, and the Task Force on Health Planning Reform. Makes related changes in other Acts. Effective immediately, except that certain provisions are effective July 1, 2009.
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FISCAL NOTE ACT MAY APPLY
A BILL FOR
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AN ACT concerning public health.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Open Meetings Act is amended by changing
Section 1.02 as follows:
(5 ILCS 120/1.02) (from Ch. 102, par. 41.02)
Sec. 1.02. For the purposes of this Act:
"Meeting" means any gathering, whether in person or by
video or audio conference, telephone call, electronic means
(such as, without limitation, electronic mail, electronic
chat, and instant messaging), or other means of contemporaneous
interactive communication, of a majority of a quorum of the
members of a public body held for the purpose of discussing
public business or, for a 5-member public body, a quorum of the
members of a public body held for the purpose of discussing
public business.
Accordingly, for a 5-member public body, 3 members of the
body constitute a quorum and the affirmative vote of 3 members
is necessary to adopt any motion, resolution, or ordinance,
unless a greater number is otherwise required.
"Public body" includes all legislative, executive,
administrative or advisory bodies of the State, counties,
townships, cities, villages, incorporated towns, school

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districts and all other municipal corporations, boards,
bureaus, committees or commissions of this State, and any
subsidiary bodies of any of the foregoing including but not
limited to committees and subcommittees which are supported in
whole or in part by tax revenue, or which expend tax revenue,
except the General Assembly and committees or commissions
thereof. "Public body" includes tourism boards and convention
or civic center boards located in counties that are contiguous
to the Mississippi River with populations of more than 250,000
but less than 300,000. "Public body" includes the Health
Facilities and Services Review Board Health Facilities
Planning Board. "Public body" does not include a child death
review team or the Illinois Child Death Review Teams Executive
Council established under the Child Death Review Team Act or an
ethics commission acting under the State Officials and
Employees Ethics Act.
(Source: P.A. 94-1058, eff. 1-1-07; 95-245, eff. 8-17-07.)
Section 10. The State Officials and Employees Ethics Act is
amended by changing Section 5-50 as follows:
(5 ILCS 430/5-50)
Sec. 5-50. Ex parte communications; special government
agents.
(a) This Section applies to ex parte communications made to
any agency listed in subsection (e).

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(b) "Ex parte communication" means any written or oral
communication by any person that imparts or requests material
information or makes a material argument regarding potential
action concerning regulatory, quasi-adjudicatory, investment,
or licensing matters pending before or under consideration by
the agency. "Ex parte communication" does not include the
following: (i) statements by a person publicly made in a public
forum; (ii) statements regarding matters of procedure and
practice, such as format, the number of copies required, the
manner of filing, and the status of a matter; and (iii)
statements made by a State employee of the agency to the agency
head or other employees of that agency.
(b-5) An ex parte communication received by an agency,
agency head, or other agency employee from an interested party
or his or her official representative or attorney shall
promptly be memorialized and made a part of the record.
(c) An ex parte communication received by any agency,
agency head, or other agency employee, other than an ex parte
communication described in subsection (b-5), shall immediately
be reported to that agency's ethics officer by the recipient of
the communication and by any other employee of that agency who
responds to the communication. The ethics officer shall require
that the ex parte communication be promptly made a part of the
record. The ethics officer shall promptly file the ex parte
communication with the Executive Ethics Commission, including
all written communications, all written responses to the

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communications, and a memorandum prepared by the ethics officer
stating the nature and substance of all oral communications,
the identity and job title of the person to whom each
communication was made, all responses made, the identity and
job title of the person making each response, the identity of
each person from whom the written or oral ex parte
communication was received, the individual or entity
represented by that person, any action the person requested or
recommended, and any other pertinent information. The
disclosure shall also contain the date of any ex parte
communication.
(d) "Interested party" means a person or entity whose
rights, privileges, or interests are the subject of or are
directly affected by a regulatory, quasi-adjudicatory,
investment, or licensing matter.
(e) This Section applies to the following agencies:
Executive Ethics Commission
Illinois Commerce Commission
Educational Labor Relations Board
State Board of Elections
Illinois Gaming Board
Health Facilities and Services Review Board
Health Facilities Planning Board
Illinois Workers' Compensation Commission
Illinois Labor Relations Board
Illinois Liquor Control Commission

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Pollution Control Board
Property Tax Appeal Board
Illinois Racing Board
Illinois Purchased Care Review Board
Department of State Police Merit Board
Motor Vehicle Review Board
Prisoner Review Board
Civil Service Commission
Personnel Review Board for the Treasurer
Merit Commission for the Secretary of State
Merit Commission for the Office of the Comptroller
Court of Claims
Board of Review of the Department of Employment Security
Department of Insurance
Department of Professional Regulation and licensing boards
under the Department
Department of Public Health and licensing boards under the
Department
Office of Banks and Real Estate and licensing boards under
the Office
State Employees Retirement System Board of Trustees
Judges Retirement System Board of Trustees
General Assembly Retirement System Board of Trustees
Illinois Board of Investment
State Universities Retirement System Board of Trustees
Teachers Retirement System Officers Board of Trustees

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(f) Any person who fails to (i) report an ex parte
communication to an ethics officer, (ii) make information part
of the record, or (iii) make a filing with the Executive Ethics
Commission as required by this Section or as required by
Section 5-165 of the Illinois Administrative Procedure Act
violates this Act.
(Source: P.A. 95-331, eff. 8-21-07.)
Section 12. The Civil Administrative Code of Illinois is
amended by changing Section 5-565 as follows:
(20 ILCS 5/5-565) (was 20 ILCS 5/6.06)
Sec. 5-565. In the Department of Public Health.
(a) The General Assembly declares it to be the public
policy of this State that all citizens of Illinois are entitled
to lead healthy lives. Governmental public health has a
specific responsibility to ensure that a system is in place to
allow the public health mission to be achieved. To develop a
system requires certain core functions to be performed by
government. The State Board of Health is to assume the
leadership role in advising the Director in meeting the
following functions:
(1) Needs assessment.
(2) Statewide health objectives.
(3) Policy development.
(4) Assurance of access to necessary services.

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There shall be a State Board of Health composed of 17
persons, all of whom shall be appointed by the Governor, with
the advice and consent of the Senate for those appointed by the
Governor on and after June 30, 1998, and one of whom shall be a
senior citizen age 60 or over. Five members shall be physicians
licensed to practice medicine in all its branches, one
representing a medical school faculty, one who is board
certified in preventive medicine, and one who is engaged in
private practice. One member shall be a dentist; one an
environmental health practitioner; one a local public health
administrator; one a local board of health member; one a
registered nurse; one a veterinarian; one a public health
academician; one a health care industry representative; one a
representative of the business community; one a representative
of the non-profit public interest community; and 2 shall be
citizens at large.
The terms of Board of Health members shall be 3 years,
except that members shall continue to serve on the Board of
Health until a replacement is appointed. Upon the effective
date of this amendatory Act of the 93rd General Assembly, in
the appointment of the Board of Health members appointed to
vacancies or positions with terms expiring on or before
December 31, 2004, the Governor shall appoint up to 6 members
to serve for terms of 3 years; up to 6 members to serve for
terms of 2 years; and up to 5 members to serve for a term of one
year, so that the term of no more than 6 members expire in the

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same year. All members shall be legal residents of the State of
Illinois. The duties of the Board shall include, but not be
limited to, the following:
(1) To advise the Department of ways to encourage
public understanding and support of the Department's
programs.
(2) To evaluate all boards, councils, committees,
authorities, and bodies advisory to, or an adjunct of, the
Department of Public Health or its Director for the purpose
of recommending to the Director one or more of the
following:
(i) The elimination of bodies whose activities are
not consistent with goals and objectives of the
Department.
(ii) The consolidation of bodies whose activities
encompass compatible programmatic subjects.
(iii) The restructuring of the relationship
between the various bodies and their integration
within the organizational structure of the Department.
(iv) The establishment of new bodies deemed
essential to the functioning of the Department.
(3) To serve as an advisory group to the Director for
public health emergencies and control of health hazards.
(4) To advise the Director regarding public health
policy, and to make health policy recommendations
regarding priorities to the Governor through the Director.

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(5) To present public health issues to the Director and
to make recommendations for the resolution of those issues.
(6) To recommend studies to delineate public health
problems.
(7) To make recommendations to the Governor through the
Director regarding the coordination of State public health
activities with other State and local public health
agencies and organizations.
(8) To report on or before February 1 of each year on
the health of the residents of Illinois to the Governor,
the General Assembly, and the public.
(9) To review the final draft of all proposed
administrative rules, other than emergency or preemptory
rules and those rules that another advisory body must
approve or review within a statutorily defined time period,
of the Department after September 19, 1991 (the effective
date of Public Act 87-633). The Board shall review the
proposed rules within 90 days of submission by the
Department. The Department shall take into consideration
any comments and recommendations of the Board regarding the
proposed rules prior to submission to the Secretary of
State for initial publication. If the Department disagrees
with the recommendations of the Board, it shall submit a
written response outlining the reasons for not accepting
the recommendations.
In the case of proposed administrative rules or

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amendments to administrative rules regarding immunization
of children against preventable communicable diseases
designated by the Director under the Communicable Disease
Prevention Act, after the Immunization Advisory Committee
has made its recommendations, the Board shall conduct 3
public hearings, geographically distributed throughout the
State. At the conclusion of the hearings, the State Board
of Health shall issue a report, including its
recommendations, to the Director. The Director shall take
into consideration any comments or recommendations made by
the Board based on these hearings.
(10) To deliver to the Governor for presentation to the
General Assembly a State Health Improvement Plan. The first
and second such plans shall be delivered to the Governor on
January 1, 2006 and on January 1, 2009 respectively, and
then every 4 years thereafter.
The Plan shall recommend priorities and strategies to
improve the public health system and the health status of
Illinois residents, taking into consideration national
health objectives and system standards as frameworks for
assessment.
The Plan shall also take into consideration priorities
and strategies developed at the community level through the
Illinois Project for Local Assessment of Needs (IPLAN) and
any regional health improvement plans that may be
developed. The Plan shall focus on prevention as a key

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strategy for long-term health improvement in Illinois.
The Plan shall examine and make recommendations on the
contributions and strategies of the public and private
sectors for improving health status and the public health
system in the State. In addition to recommendations on
health status improvement priorities and strategies for
the population of the State as a whole, the Plan shall make
recommendations regarding priorities and strategies for
reducing and eliminating health disparities in Illinois;
including racial, ethnic, gender, age, socio-economic and
geographic disparities.
The Director of the Illinois Department of Public
Health shall appoint a Planning Team that includes a range
of public, private, and voluntary sector stakeholders and
participants in the public health system. This Team shall
include: the directors of State agencies with public health
responsibilities (or their designees), including but not
limited to the Illinois Departments of Public Health and
Department of Human Services, representatives of local
health departments, representatives of local community
health partnerships, and individuals with expertise who
represent an array of organizations and constituencies
engaged in public health improvement and prevention.
The State Board of Health shall hold at least 3 public
hearings addressing drafts of the Plan in representative
geographic areas of the State. Members of the Planning Team

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shall receive no compensation for their services, but may
be reimbursed for their necessary expenses.
(11) Upon the request of the Governor, to recommend to
the Governor candidates for Director of Public Health when
vacancies occur in the position.
(12) To adopt bylaws for the conduct of its own
business, including the authority to establish ad hoc
committees to address specific public health programs
requiring resolution.
(13) To review and comment upon the Comprehensive
Health Plan submitted by the Center for Comprehensive
Health Planning as provided under Section 2310-217 of the
Department of Public Health Powers and Duties Law of the
Civil Administrative Code of Illinois.
Upon appointment, the Board shall elect a chairperson from
among its members.
Members of the Board shall receive compensation for their
services at the rate of $150 per day, not to exceed $10,000 per
year, as designated by the Director for each day required for
transacting the business of the Board and shall be reimbursed
for necessary expenses incurred in the performance of their
duties. The Board shall meet from time to time at the call of
the Department, at the call of the chairperson, or upon the
request of 3 of its members, but shall not meet less than 4
times per year.
(b) (Blank).

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(c) An Advisory Board on Necropsy Service to Coroners,
which shall counsel and advise with the Director on the
administration of the Autopsy Act. The Advisory Board shall
consist of 11 members, including a senior citizen age 60 or
over, appointed by the Governor, one of whom shall be
designated as chairman by a majority of the members of the
Board. In the appointment of the first Board the Governor shall
appoint 3 members to serve for terms of 1 year, 3 for terms of 2
years, and 3 for terms of 3 years. The members first appointed
under Public Act 83-1538 shall serve for a term of 3 years. All
members appointed thereafter shall be appointed for terms of 3
years, except that when an appointment is made to fill a
vacancy, the appointment shall be for the remaining term of the
position vacant. The members of the Board shall be citizens of
the State of Illinois. In the appointment of members of the
Advisory Board the Governor shall appoint 3 members who shall
be persons licensed to practice medicine and surgery in the
State of Illinois, at least 2 of whom shall have received
post-graduate training in the field of pathology; 3 members who
are duly elected coroners in this State; and 5 members who
shall have interest and abilities in the field of forensic
medicine but who shall be neither persons licensed to practice
any branch of medicine in this State nor coroners. In the
appointment of medical and coroner members of the Board, the
Governor shall invite nominations from recognized medical and
coroners organizations in this State respectively. Board

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members, while serving on business of the Board, shall receive
actual necessary travel and subsistence expenses while so
serving away from their places of residence.
(Source: P.A. 93-975, eff. 1-1-05.)
Section 15. The Department of Public Health Powers and
Duties Law of the Civil Administrative Code of Illinois is
amended by adding Section 2310-217 as follows:
(20 ILCS 2310/2310-217 new)
Sec. 2310-217. Center for Comprehensive Health Planning.
(a) The Center for Comprehensive Health Planning
("Center") is hereby created to promote the distribution of
health care services and improve the healthcare delivery system
in Illinois by establishing a statewide Comprehensive Health
Plan and ensuring a predictable, transparent, and efficient
Certificate of Need process under the Illinois Health
Facilities Planning Act. The objectives of the Comprehensive
Health Plan include: to assess existing community resources and
determine health care needs; to support safety net services for
uninsured and underinsured residents; to promote adequate
financing for health care services; and to recognize and
respond to changes in community health care needs, including
public health emergencies and natural disasters. The Center
shall comprehensively assess health and mental health
services; assess health needs with a special focus on the

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identification of health disparities; identify State-level and
regional needs; and make findings that identify the impact of
market forces on the access to high quality services for
uninsured and underinsured residents. The Center shall conduct
a biennial comprehensive assessment of health resources and
service needs, including, but not limited to, facilities,
clinical services, and workforce; conduct needs assessments
using key indicators of population health status and
determinations of potential benefits that could occur with
certain changes in the health care delivery system; collect and
analyze relevant, objective, and accurate data, including
health care utilization data; identify issues related to health
care financing such as revenue streams, federal opportunities,
better utilization of existing resources, development of
resources, and incentives for new resource development;
evaluate findings by the needs assessments; and annually report
to the General Assembly and the public.
The Illinois Department of Public Health shall establish a
Center for Comprehensive Health Planning to develop a
long-range Comprehensive Health Plan, which Plan shall guide
the development of clinical services, facilities, and
workforce that meet the health and mental health care needs of
this State.
(b) Center for Comprehensive Health Planning.
(1) Responsibilities and duties of the Center include:
(A) providing technical assistance to the Health

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Facilities Planning Board to permit the Planning Board
to apply relevant components of the Comprehensive
Health Plan in Planning Board deliberations;
(B) attempting to identify unmet health needs and
assist in any inter-agency State planning for health
resource development;
(C) considering health plans and other related
publications that have been developed in Illinois and
nationally;
(D) establishing priorities and recommend methods
for meeting identified health service, facilities, and
workforce needs. Plan recommendations shall be short
term, mid-term, and long-range;
(E) conducting an analysis regarding the
availability of long-term care resources throughout
the State, using data and plans developed under the
Illinois Older Adult Services Act, to adjust existing
bed need criteria and standards under the Health
Facilities Planning Act for changes in utilization of
institutional and non-institutional care options, with
special consideration of the availability of the
least-restrictive options in accordance with the needs
and preferences of persons requiring long-term care;
and
(F) considering and recognizing health resource
development projects or information on methods by

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which a community may receive benefit, that are
consistent with health resource needs identified
through the comprehensive health planning process.
(2) A Comprehensive Health Planner shall be appointed
by the Governor from a list of nominees selected by the
Special Nomination Panel established in Section 19.7 of the
Illinois Health Facilities Planning Act, with the advice
and consent of the Senate, to supervise the Center and its
staff for a paid 3-year term, subject to review and
re-approval every 3 years. The Planner shall receive an
annual salary of $120,000, or an amount set by the
Compensation Review Board, whichever is greater. The
Planner shall prepare a budget for review and approval by
the Illinois General Assembly, which shall become part of
the annual report available on the Department website.
(c) Comprehensive Health Plan.
(1) The Plan shall be developed with a 5 to 10 year
range, and updated every 2 years, or annually, if needed.
(2) Components of the Plan shall include:
(A) an inventory to map the State for growth,
population shifts, and utilization of available
healthcare resources, using both State-level and
regionally defined areas;
(B) an evaluation of health service needs,
addressing gaps in service, over-supply, and
continuity of care, including an assessment of

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existing safety net services;
(C) an inventory of health care facility
infrastructure, including regulated facilities and
services, and unregulated facilities and services, as
determined by the Agency;
(D) recommendations on ensuring access to care,
especially for safety net services, including rural
and medically underserved communities; and
(E) an integration between health planning for
clinical services, facilities and workforce under the
Illinois Health Facilities Planning Act and other
health planning laws and activities of the State.
(3) Components of the Plan may include recommendations
that will be integrated into any relevant certificate of
need review criteria, standards, and procedures.
(d) Within 60 days of receiving the Comprehensive Health
Plan, the State Board of Health shall review and comment upon
the Plan and any policy change recommendations. The first Plan
shall be submitted to the State Board of Health within one year
after hiring the Comprehensive Health Planner. The Plan shall
be submitted to the General Assembly by the following March 1.
The Center and State Board shall hold public hearings on the
Plan and its updates. The Center shall permit the public to
request the Plan to be updated more frequently to address
emerging population and demographic trends.
(e) Current comprehensive health planning data and

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information about Center funding shall be available to the
public on the Department website.
(f) The Department shall submit to a performance audit of
the Center by the Auditor General in order to assess whether
progress is being made to develop a Comprehensive Health Plan
and whether resources are sufficient to meet the goals of the
Center for Comprehensive Health Planning.
Section 20. The Illinois Health Facilities Planning Act is
amended by changing Sections 2, 3, 4, 4.2, 5, 6, 8.5, 12, 12.2,
12.3, 15.1, 19.5, and 19.6 and by adding Sections 5.4 and 19.7
as follows:
(20 ILCS 3960/2) (from Ch. 111 1/2, par. 1152)
(Section scheduled to be repealed on July 1, 2009)
Sec. 2. Purpose of the Act. The purpose of this Act is to
establish a procedure designed to reverse the trends of
increasing costs of health care resulting from unnecessary
construction or modification of health care facilities. Such
procedure shall represent an attempt by the State of Illinois
to improve the financial ability of the public to obtain
necessary health services, and to establish an orderly and
comprehensive health care delivery system which will guarantee
the availability of quality health care to the general public.
This Act shall establish a procedure (1) which requires a
person establishing, constructing or modifying a health care

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facility, as herein defined, to have the qualifications,
background, character and financial resources to adequately
provide a proper service for the community; (2) that promotes,
through the process of comprehensive health planning
recognized local and areawide health facilities planning, the
orderly and economic development of health care facilities in
the State of Illinois that avoids unnecessary duplication of
such facilities; (3) that promotes planning for and development
of health care facilities needed for comprehensive health care
especially in areas where the health planning process has
identified unmet needs; and (4) that carries out these purposes
in coordination with the Center for Comprehensive Health
Planning Agency and the Comprehensive Health Plan
comprehensive State health plan developed by that Center
Agency.
The changes made to this Act by this amendatory Act of the
96th General Assembly are intended to accomplish the following
objectives: to improve the financial ability of the public to
obtain necessary health services; to establish an orderly and
comprehensive health care delivery system that will guarantee
the availability of quality health care to the general public;
to maintain and improve the provision of essential health care
services and increase the accessibility of those services to
the medically underserved and indigent; to assure that the
reduction and closure of health care services or facilities is
performed in an orderly and timely manner, and that these

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actions are deemed to be in the best interests of the public;
and to assess the financial burden to patients caused by
unnecessary health care construction and modification. The
Health Facilities and Services Review Board must apply the
findings from the Comprehensive Health Plan to update review
standards and criteria, as well as better identify needs and
evaluate applications, and establish mechanisms to support
adequate financing of the health care delivery system in
Illinois, for the development and preservation of safety net
services. The Board must provide written and consistent
decisions that are based on the findings from the Comprehensive
Health Plan, as well as other issue or subject specific plans,
recommended by the Center for Comprehensive Health Planning.
Policies and procedures must include criteria and standards for
plan variations and deviations that must be updated.
Evidence-based assessments, projections and decisions will be
applied regarding capacity, quality, value and equity in the
delivery of health care services in Illinois. The integrity of
the Certificate of Need process is ensured through
implementation of a special panel for nominations of the
Certificate of Need Board, as well as revised ethics and
communications procedures. Cost containment and support for
safety net services must continue to be central tenets of the
Certificate of Need process.
(Source: P.A. 80-941.)

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(20 ILCS 3960/3) (from Ch. 111 1/2, par. 1153)
(Section scheduled to be repealed on July 1, 2009)
Sec. 3. Definitions. As used in this Act:
"Health care facilities" means and includes the following
facilities and organizations:
1. An ambulatory surgical treatment center required to
be licensed pursuant to the Ambulatory Surgical Treatment
Center Act;
2. An institution, place, building, or agency required
to be licensed pursuant to the Hospital Licensing Act;
3. Skilled and intermediate long term care facilities
licensed under the Nursing Home Care Act;
4. Hospitals, nursing homes, ambulatory surgical
treatment centers, or kidney disease treatment centers
maintained by the State or any department or agency
thereof;
5. Kidney disease treatment centers, including a
free-standing hemodialysis unit required to be licensed
under the End Stage Renal Disease Facility Act; and
6. An institution, place, building, or room used for
the performance of outpatient surgical procedures that is
leased, owned, or operated by or on behalf of an
out-of-state facility; .
7. An institution, place, building, or room used for
provision of a health care category of service as defined
by the Board, including, but not limited to, cardiac

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catheterization and open heart surgery; and
8. An institution, place, building, or room used for
provision of major medical equipment used in the direct
clinical diagnosis or treatment of patients, and whose
project cost is in excess of the capital expenditure
minimum.
This Act shall not apply to the construction of any new
facility or the renovation of any existing facility located on
any campus facility as defined in Section 5-5.8b of the
Illinois Public Aid Code, provided that the campus facility
encompasses 30 or more contiguous acres and that the new or
renovated facility is intended for use by a licensed
residential facility.
No federally owned facility shall be subject to the
provisions of this Act, nor facilities used solely for healing
by prayer or spiritual means.
No facility licensed under the Supportive Residences
Licensing Act or the Assisted Living and Shared Housing Act
shall be subject to the provisions of this Act.
No facility established and operating under the
Alternative Health Care Delivery Act as a community-based
residential rehabilitation center alternative health care
model demonstration program or as an Alzheimer's Disease
Management Center alternative health care model demonstration
program shall be subject to the provisions of this Act.
A facility designated as a supportive living facility that

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is in good standing with the program established under Section
5-5.01a of the Illinois Public Aid Code shall not be subject to
the provisions of this Act.
This Act does not apply to facilities granted waivers under
Section 3-102.2 of the Nursing Home Care Act. However, if a
demonstration project under that Act applies for a certificate
of need to convert to a nursing facility, it shall meet the
licensure and certificate of need requirements in effect as of
the date of application.
This Act does not apply to a dialysis facility that
provides only dialysis training, support, and related services
to individuals with end stage renal disease who have elected to
receive home dialysis. This Act does not apply to a dialysis
unit located in a licensed nursing home that offers or provides
dialysis-related services to residents with end stage renal
disease who have elected to receive home dialysis within the
nursing home. The Board, however, may require these dialysis
facilities and licensed nursing homes to report statistical
information on a quarterly basis to the Board to be used by the
Board to conduct analyses on the need for proposed kidney
disease treatment centers.
This Act shall not apply to the closure of an entity or a
portion of an entity licensed under the Nursing Home Care Act,
with the exceptions of facilities operated by a county or
Illinois Veterans Homes, that elects to convert, in whole or in
part, to an assisted living or shared housing establishment

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licensed under the Assisted Living and Shared Housing Act.
This Act does not apply to any change of ownership of a
healthcare facility that is licensed under the Nursing Home
Care Act, with the exceptions of facilities operated by a
county or Illinois Veterans Homes. Changes of ownership of
facilities licensed under the Nursing Home Care Act must meet
the requirements set forth in Sections 3-101 through 3-119 of
the Nursing Home Care Act.
With the exception of those health care facilities
specifically included in this Section, nothing in this Act
shall be intended to include facilities operated as a part of
the practice of a physician or other licensed health care
professional, whether practicing in his individual capacity or
within the legal structure of any partnership, medical or
professional corporation, or unincorporated medical or
professional group. Further, this Act shall not apply to
physicians or other licensed health care professional's
practices where such practices are carried out in a portion of
a health care facility under contract with such health care
facility by a physician or by other licensed health care
professionals, whether practicing in his individual capacity
or within the legal structure of any partnership, medical or
professional corporation, or unincorporated medical or
professional groups. This Act shall apply to construction or
modification and to establishment by such health care facility
of such contracted portion which is subject to facility

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licensing requirements, irrespective of the party responsible
for such action or attendant financial obligation.
"Person" means any one or more natural persons, legal
entities, governmental bodies other than federal, or any
combination thereof.
"Consumer" means any person other than a person (a) whose
major occupation currently involves or whose official capacity
within the last 12 months has involved the providing,
administering or financing of any type of health care facility,
(b) who is engaged in health research or the teaching of
health, (c) who has a material financial interest in any
activity which involves the providing, administering or
financing of any type of health care facility, or (d) who is or
ever has been a member of the immediate family of the person
defined by (a), (b), or (c).
"State Board" or "Board" means the Health Facilities and
Services Review Planning Board.
"Construction or modification" means the establishment,
erection, building, alteration, reconstruction, modernization,
improvement, extension, discontinuation, change of ownership,
of or by a health care facility, or the purchase or acquisition
by or through a health care facility of equipment or service
for diagnostic or therapeutic purposes or for facility
administration or operation, or any capital expenditure made by
or on behalf of a health care facility which exceeds the
capital expenditure minimum; however, any capital expenditure

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made by or on behalf of a health care facility for (i) the
construction or modification of a facility licensed under the
Assisted Living and Shared Housing Act or (ii) a conversion
project undertaken in accordance with Section 30 of the Older
Adult Services Act shall be excluded from any obligations under
this Act.
"Establish" means the construction of a health care
facility or the replacement of an existing facility on another
site or the initiation of a category of service as defined by
the Board.
"Major medical equipment" means medical equipment which is
used for the provision of medical and other health services and
which costs in excess of the capital expenditure minimum,
except that such term does not include medical equipment
acquired by or on behalf of a clinical laboratory to provide
clinical laboratory services if the clinical laboratory is
independent of a physician's office and a hospital and it has
been determined under Title XVIII of the Social Security Act to
meet the requirements of paragraphs (10) and (11) of Section
1861(s) of such Act. In determining whether medical equipment
has a value in excess of the capital expenditure minimum, the
value of studies, surveys, designs, plans, working drawings,
specifications, and other activities essential to the
acquisition of such equipment shall be included.
"Capital Expenditure" means an expenditure: (A) made by or
on behalf of a health care facility (as such a facility is

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defined in this Act); and (B) which under generally accepted
accounting principles is not properly chargeable as an expense
of operation and maintenance, or is made to obtain by lease or
comparable arrangement any facility or part thereof or any
equipment for a facility or part; and which exceeds the capital
expenditure minimum.
For the purpose of this paragraph, the cost of any studies,
surveys, designs, plans, working drawings, specifications, and
other activities essential to the acquisition, improvement,
expansion, or replacement of any plant or equipment with
respect to which an expenditure is made shall be included in
determining if such expenditure exceeds the capital
expenditures minimum. Unless otherwise interdependent, or
submitted as one project by the applicant, components of
construction or modification undertaken by means of a single
construction contract or financed through the issuance of a
single debt instrument shall not be grouped together as one
project. Donations of equipment or facilities to a health care
facility which if acquired directly by such facility would be
subject to review under this Act shall be considered capital
expenditures, and a transfer of equipment or facilities for
less than fair market value shall be considered a capital
expenditure for purposes of this Act if a transfer of the
equipment or facilities at fair market value would be subject
to review.
"Capital expenditure minimum" means $11,500,000 for

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projects by hospital applicants and $3,000,000 for projects by
all other applicants $6,000,000, which shall be annually
adjusted to reflect the increase in construction costs due to
inflation, for major medical equipment and for all other
capital expenditures; provided, however, that when a capital
expenditure is for the construction or modification of a health
and fitness center, "capital expenditure minimum" means the
capital expenditure minimum for all other capital expenditures
in effect on March 1, 2000, which shall be annually adjusted to
reflect the increase in construction costs due to inflation.
"Non-clinical service area" means an area (i) for the
benefit of the patients, visitors, staff, or employees of a
health care facility and (ii) not directly related to the
diagnosis, treatment, or rehabilitation of persons receiving
services from the health care facility. "Non-clinical service
areas" include, but are not limited to, chapels; gift shops;
news stands; computer systems; tunnels, walkways, and
elevators; telephone systems; projects to comply with life
safety codes; educational facilities; student housing;
patient, employee, staff, and visitor dining areas;
administration and volunteer offices; modernization of
structural components (such as roof replacement and masonry
work); boiler repair or replacement; vehicle maintenance and
storage facilities; parking facilities; mechanical systems for
heating, ventilation, and air conditioning; loading docks; and
repair or replacement of carpeting, tile, wall coverings,

HB3651 - 30 - LRB096 11637 RPM 22183 b
window coverings or treatments, or furniture. Solely for the
purpose of this definition, "non-clinical service area" does
not include health and fitness centers.
"Areawide" means a major area of the State delineated on a
geographic, demographic, and functional basis for health
planning and for health service and having within it one or
more local areas for health planning and health service. The
term "region", as contrasted with the term "subregion", and the
word "area" may be used synonymously with the term "areawide".
"Local" means a subarea of a delineated major area that on
a geographic, demographic, and functional basis may be
considered to be part of such major area. The term "subregion"
may be used synonymously with the term "local".
"Areawide health planning organization" or "Comprehensive
health planning organization" means the health systems agency
designated by the Secretary, Department of Health and Human
Services or any successor agency.
"Local health planning organization" means those local
health planning organizations that are designated as such by
the areawide health planning organization of the appropriate
area.
"Physician" means a person licensed to practice in
accordance with the Medical Practice Act of 1987, as amended.
"Licensed health care professional" means a person
licensed to practice a health profession under pertinent
licensing statutes of the State of Illinois.

HB3651 - 31 - LRB096 11637 RPM 22183 b
"Director" means the Director of the Illinois Department of
Public Health.
"Agency" means the Illinois Department of Public Health.
"Comprehensive health planning" means health planning
concerned with the total population and all health and
associated problems that affect the well-being of people and
that encompasses health services, health manpower, and health
facilities; and the coordination among these and with those
social, economic, and environmental factors that affect
health.
"Alternative health care model" means a facility or program
authorized under the Alternative Health Care Delivery Act.
"Out-of-state facility" means a person that is both (i)
licensed as a hospital or as an ambulatory surgery center under
the laws of another state or that qualifies as a hospital or an
ambulatory surgery center under regulations adopted pursuant
to the Social Security Act and (ii) not licensed under the
Ambulatory Surgical Treatment Center Act, the Hospital
Licensing Act, or the Nursing Home Care Act. Affiliates of
out-of-state facilities shall be considered out-of-state
facilities. Affiliates of Illinois licensed health care
facilities 100% owned by an Illinois licensed health care
facility, its parent, or Illinois physicians licensed to
practice medicine in all its branches shall not be considered
out-of-state facilities. Nothing in this definition shall be
construed to include an office or any part of an office of a

HB3651 - 32 - LRB096 11637 RPM 22183 b
physician licensed to practice medicine in all its branches in
Illinois that is not required to be licensed under the
Ambulatory Surgical Treatment Center Act.
"Change of ownership of a health care facility" means a
change in the person who has ownership or control of a health
care facility's physical plant and capital assets. A change in
ownership is indicated by the following transactions: sale,
transfer, acquisition, lease, change of sponsorship, or other
means of transferring control.
"Related person" means any person that: (i) is at least 50%
owned, directly or indirectly, by either the health care
facility or a person owning, directly or indirectly, at least
50% of the health care facility; or (ii) owns, directly or
indirectly, at least 50% of the health care facility.
"Charity care" means care provided by a health care
facility for which the provider does not expect to receive
payment from the patient or a third-party payer.
"Freestanding emergency center" means a facility subject
to licensure under Section 32.5 of the Emergency Medical
Services (EMS) Systems Act.
"Special Nomination Panel" means the Special Nomination
Panel created in Section 19.7 of this Act.
(Source: P.A. 94-342, eff. 7-26-05; 95-331, eff. 8-21-07;
95-543, eff. 8-28-07; 95-584, eff. 8-31-07; 95-727, eff.
6-30-08; 95-876, eff. 8-21-08.)

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(20 ILCS 3960/4) (from Ch. 111 1/2, par. 1154)
(Section scheduled to be repealed on July 1, 2009)
Sec. 4. Health Facilities and Services Review Planning
Board; membership; appointment; term; compensation; quorum.
Notwithstanding any other provision in this Section, members of
the State Board holding office on the day before the effective
date of this Amendatory Act of the 96th General Assembly shall
retain their authority.
(a) There is created the Health Facilities and Services
Review Planning Board, which shall perform the functions
described in this Act. The Department shall provide operational
support to the Board, including the provision of office space,
supplies, and clerical, financial, and accounting services.
The Board may contract with experts related to specific health
services or facilities and create technical advisory panels to
assist in the development of criteria, standards, and
procedures used in the evaluation of applications for permit
and exemption.
(b) Beginning March 1, 2010, the The State Board shall
consist of 9 5 voting members. The members shall include a
paid, full-time chairman, and 8 paid part-time members. Each
Board member shall receive an annual salary of $65,000, or such
amount as set by the Compensation Review Board, whichever is
greater. The chairman of the Board shall receive, in addition
to his or her salary, an additional sum of $25,000 per year, or
an amount set by the Compensation Review Board, whichever is

HB3651 - 34 - LRB096 11637 RPM 22183 b
greater, during such time as he or she shall serve as chairman.
All members shall be residents of Illinois and at least 4 shall
reside outside the Chicago Metropolitan Statistical Area.
Consideration shall be given to potential appointees who
reflect the ethnic and cultural diversity of the State. Neither
Board members nor Board staff shall be convicted felons or have
pled guilty to a felony.
Each member shall have a reasonable knowledge of the
practice, procedures and principles of the health care delivery
system in Illinois, including at least 5 members who shall be
knowledgeable about health care delivery systems, health
systems planning, finance, or the management of health care
facilities currently regulated under the Act. One member shall
be a representative of a non-profit health care consumer
advocacy organization health planning, health finance, or
health care at the time of his or her appointment. Spouses or
other members of the immediate family of the Board cannot be an
employee, agent, or under contract with services or facilities
subject to the Act. Prior to appointment and in the course of
service on the Board, members of the Board shall disclose the
employment or other financial interest of any other relative of
the member, if known, in service or facilities subject to the
Act. Members of the Board shall declare any
conflict-of-interest that may exist with respect to the status
of those relatives and recuse themselves from voting on any
issue for which a conflict-of-interest is declared. No person

HB3651 - 35 - LRB096 11637 RPM 22183 b
shall be appointed or continue to serve as a member of the
State Board who is, or whose spouse, parent, or child is, a
member of the Board of Directors of, has a financial interest
in, or has a business relationship with a health care facility.
Notwithstanding any provision of this Section to the
contrary, the term of office of each member of the State Board
serving on the day before the effective date of this amendatory
Act of the 96th General Assembly is abolished on the date upon
which members of the 9-member Board, as established by this
amendatory Act of the 96th General Assembly, have been
appointed and can begin to take action as a Board. Members of
the State Board serving on the day before the effective date of
this amendatory Act of the 96th General Assembly may be
reappointed to the 9-member Board. effective date of this
amendatory Act of the 93rd General Assembly and those members
no longer hold office.
(c) The State Board shall be appointed by the Governor from
a list of nominees selected by the Special Nomination Panel,
with the advice and consent of the Senate. Not more than 5 3 of
the appointments shall be of the same political party at the
time of the appointment. No person shall be appointed as a
State Board member if that person has served, after the
effective date of Public Act 93-41, 2 3-year terms as a State
Board member, except for ex officio non-voting members.
The Secretary of Human Services, the Director of Healthcare
and Family Services, and the Director of Public Health, or

HB3651 - 36 - LRB096 11637 RPM 22183 b
their designated representatives, shall serve as ex-officio,
non-voting members of the State Board.
(d) Of those 9 members initially appointed by the Governor
following the effective date of under this amendatory Act of
the 96th 93rd General Assembly, 3 2 shall serve for terms
expiring July 1, 2011 2005, 3 2 shall serve for terms expiring
July 1, 2012 2006, and 3 1 shall serve for terms a term
expiring July 1, 2013 2007. Thereafter, each appointed member
shall hold office for a term of 3 years, provided that any
member appointed to fill a vacancy occurring prior to the
expiration of the term for which his or her predecessor was
appointed shall be appointed for the remainder of such term and
the term of office of each successor shall commence on July 1
of the year in which his predecessor's term expires. Each
member appointed after the effective date of this amendatory
Act of the 96th 93rd General Assembly shall hold office until
his or her successor is appointed and qualified. No member
shall serve more than 3 terms.
(e) State Board members, while serving on business of the
State Board, shall receive actual and necessary travel and
subsistence expenses while so serving away from their places of
residence. Until March 1, 2010, a A member of the State Board
who experiences a significant financial hardship due to the
loss of income on days of attendance at meetings or while
otherwise engaged in the business of the State Board may be
paid a hardship allowance, as determined by and subject to the

HB3651 - 37 - LRB096 11637 RPM 22183 b
approval of the Governor's Travel Control Board.
The Governor shall separately appoint from a list of
nominees selected by the Special Nomination Panel the Chairman
of the Board, who shall be a person with expertise in health
care delivery system planning, finance or management of health
care facilities that are regulated under the Act. The Chairman
shall annually review Board member performance and shall report
the attendance record of each Board member to the General
Assembly.
(g) Board members appointed under this amendatory Act of
the 96th General Assembly with unexcused absences from meetings
of the full Board shall be fined $500 by way of salary
reductions, which may be pro-rated over 4 regularly scheduled
pay periods. The State Board, through the Chairman, shall
prepare a separate and distinct budget approved by the General
Assembly and shall hire and supervise its own professional
staff responsible for carrying out the responsibilities of the
Board. The Governor shall designate one of the members to serve
as Chairman and shall name as full-time Executive Secretary of
the State Board, a person qualified in health care facility
planning and in administration. The Agency shall provide
administrative and staff support for the State Board. The State
Board shall advise the Director of its budgetary and staff
support needs and consult with the Director on annual budget
preparation.
(h) The State Board shall meet at least every 45 days once

HB3651 - 38 - LRB096 11637 RPM 22183 b
each quarter, or as often as the Chairman of the State Board
deems necessary, or upon the request of a majority of the
members.
(i) Five Three members of the State Board shall constitute
a quorum. The affirmative vote of 5 3 of the members of the
State Board shall be necessary for any action requiring a vote
to be taken by the State Board. A vacancy in the membership of
the State Board shall not impair the right of a quorum to
exercise all the rights and perform all the duties of the State
Board as provided by this Act.
(j) A State Board member shall disqualify himself or
herself from the consideration of any application for a permit
or exemption in which the State Board member or the State Board
member's spouse, parent, or child: (i) has an economic interest
in the matter; or (ii) is employed by, serves as a consultant
for, or is a member of the governing board of the applicant or
a party opposing the application.
(k) The Chairman, Board members, and Board staff must
comply with the Illinois Governmental Ethics Act.
(Source: P.A. 95-331, eff. 8-21-07.)
(20 ILCS 3960/4.2)
(Section scheduled to be repealed on July 1, 2009)
Sec. 4.2. Ex parte communications.
(a) Except in the disposition of matters that agencies are
authorized by law to entertain or dispose of on an ex parte

HB3651 - 39 - LRB096 11637 RPM 22183 b
basis including, but not limited to rule making, the State
Board, any State Board member, employee, or a hearing officer
shall not engage in ex parte communication in connection with
the substance of any formally filed pending or impending
application for a permit with any person or party or the
representative of any party. This subsection (a) applies when
the Board, member, employee, or hearing officer knows, or
should know upon reasonable inquiry, that the application or
exemption has been formally filed with the Board. Nothing in
this Section shall prohibit staff members from providing
technical assistance to applicants. Nothing in this Section
shall prohibit staff from verifying or clarifying an
applicant's information as it prepares the State Agency Report.
Once an application or exemption is filed and deemed complete,
a written record of any communication between staff and an
applicant shall be prepared by staff and made part of the
public record. Communications that occur during the
administrative hearing process shall be made a part of the
formal public record using a prescribed, standardized format
and shall be included in the application file is pending or
impending.
(b) A State Board member or employee may communicate with
other members or employees and any State Board member or
hearing officer may have the aid and advice of one or more
personal assistants.
(c) An ex parte communication received by the State Board,

HB3651 - 40 - LRB096 11637 RPM 22183 b
any State Board member, employee, or a hearing officer shall be
made a part of the record of the matter, including all written
communications, all written responses to the communications,
and a memorandum stating the substance of all oral
communications and all responses made and the identity of each
person from whom the ex parte communication was received.
(d) "Ex parte communication" means a communication between
a person who is not a State Board member or employee and a
State Board member or employee that reflects on the substance
of a pending or impending State Board proceeding and that takes
place outside the record of the proceeding. Communications
regarding matters of procedure and practice, such as the format
of pleading, number of copies required, manner of service, and
status of proceedings, are not considered ex parte
communications. Technical assistance with respect to an
application, not intended to influence any decision on the
application, may be provided by employees to the applicant. Any
assistance shall be documented in writing by the applicant and
employees within 10 business days after the assistance is
provided.
(e) For purposes of this Section, "employee" means a person
the State Board or the Agency employs on a full-time,
part-time, contract, or intern basis.
(f) The State Board, State Board member, or hearing
examiner presiding over the proceeding, in the event of a
violation of this Section, must take whatever action is

HB3651 - 41 - LRB096 11637 RPM 22183 b
necessary to ensure that the violation does not prejudice any
party or adversely affect the fairness of the proceedings.
(g) Nothing in this Section shall be construed to prevent
the State Board or any member of the State Board from
consulting with the attorney for the State Board.
(Source: P.A. 93-889, eff. 8-9-04.)
(20 ILCS 3960/5) (from Ch. 111 1/2, par. 1155)
(Section scheduled to be repealed on July 1, 2009)
Sec. 5. Construction, modification, or establishment of
health care facilities or acquisition of major medical
equipment; permits or exemptions. No After effective dates set
by the State Board, no person shall construct, modify or
establish a health care facility or acquire major medical
equipment without first obtaining a permit or exemption from
the State Board. The State Board shall not delegate to the
staff Executive Secretary of the State Board or any other
person or entity the authority to grant permits or exemptions
whenever the staff Executive Secretary or other person or
entity would be required to exercise any discretion affecting
the decision to grant a permit or exemption. The State Board
may, by rule, delegate authority to the Chairman to grant
permits or exemptions when applications meet all of the State
Board's review criteria and are unopposed. The State Board
shall set effective dates applicable to all or to each
classification or category of health care facilities and

HB3651 - 42 - LRB096 11637 RPM 22183 b
applicable to all or each type of transaction for which a
permit is required. Varying effective dates may be set,
providing the date or dates so set shall apply uniformly
statewide.
Notwithstanding any effective dates established by this
Act or by the State Board, no person shall be required to
obtain a permit for any purpose under this Act until the State
health facilities plan referred to in paragraph (4) of Section
12 of this Act has been approved and adopted by the State Board
subsequent to public hearings having been held thereon.
A permit or exemption shall be obtained prior to the
acquisition of major medical equipment or to the construction
or modification of a health care facility which:
(a) requires a total capital expenditure in excess of
the capital expenditure minimum; or
(b) substantially changes the scope or changes the
functional operation of the facility; or
(c) changes the bed capacity of a health care facility
by increasing the total number of beds or by distributing
beds among various categories of service or by relocating
beds from one physical facility or site to another by more
than 20 10 beds or more than 10% of total bed capacity as
defined by the State Board, whichever is less, over a 2
year period.
A permit shall be valid only for the defined construction
or modifications, site, amount and person named in the

HB3651 - 43 - LRB096 11637 RPM 22183 b
application for such permit and shall not be transferable or
assignable. A permit shall be valid until such time as the
project has been completed, provided that (a) obligation of the
project occurs within 12 months following issuance of the
permit except for major construction projects such obligation
must occur within 18 months following issuance of the permit;
and (b) the project commences and proceeds to completion with
due diligence. To monitor progress toward project completion,
routine post-permit reports shall be limited to annual progress
reports and the final completion and cost report. Projects may
deviate from the costs, fees, and expenses provided in their
project cost information for the project's cost components,
provided that the final total project cost does not exceed the
approved permit amount. Major construction projects, for the
purposes of this Act, shall include but are not limited to:
projects for the construction of new buildings; additions to
existing facilities; modernization projects whose cost is in
excess of $1,000,000 or 10% of the facilities' operating
revenue, whichever is less; and such other projects as the
State Board shall define and prescribe pursuant to this Act.
The State Board may extend the obligation period upon a showing
of good cause by the permit holder. Permits for projects that
have not been obligated within the prescribed obligation period
shall expire on the last day of that period.
Persons who otherwise would be required to obtain a permit
shall be exempt from such requirement if the State Board finds

HB3651 - 44 - LRB096 11637 RPM 22183 b
that with respect to establishing a new facility or
construction of new buildings or additions or modifications to
an existing facility, final plans and specifications for such
work have prior to October 1, 1974, been submitted to and
approved by the Department of Public Health in accordance with
the requirements of applicable laws. Such exemptions shall be
null and void after December 31, 1979 unless binding
construction contracts were signed prior to December 1, 1979
and unless construction has commenced prior to December 31,
1979. Such exemptions shall be valid until such time as the
project has been completed provided that the project proceeds
to completion with due diligence.
The acquisition by any person of major medical equipment
that will not be owned by or located in a health care facility
and that will not be used to provide services to inpatients of
a health care facility shall be exempt from review provided
that a notice is filed in accordance with exemption
requirements.
Notwithstanding any other provision of this Act, no permit
or exemption is required for the construction or modification
of a non-clinical service area of a health care facility.
(Source: P.A. 91-782, eff. 6-9-00.)
(20 ILCS 3960/5.4 new)
Sec. 5.4. Safety Net Impact Statement.
(a) General review criteria shall include a requirement

HB3651 - 45 - LRB096 11637 RPM 22183 b
that all health care facilities, with the exception of skilled
and intermediate long-term care facilities licensed under the
Nursing Home Care Act, provide a Safety Net Impact Statement,
which shall be filed with an application for a substantive
project or when the application proposes to discontinue a
category of service.
(b) For the purposes of this Section, "safety net services"
are services provided by health care providers or organizations
that deliver health care services to persons with barriers to
mainstream health care due to lack of insurance, inability to
pay, special needs, ethnic or cultural characteristics, or
geographic isolation. Safety net service providers include,
but are not limited to, hospitals and private practice
physicians that provide charity care, school-based health
centers, migrant health clinics, rural health clinics,
federally qualified health centers, community health centers,
public health departments, and community mental health
centers.
(c) As developed by the applicant, a Safety Net Impact
Statement shall describe all of the following:
(1) The project's material impact, if any, on essential
safety net services in the community, to the extent that it
is feasible for an applicant to have such knowledge.
(2) The project's impact on the ability of another
provider or health care system to cross-subsidize safety
net services, if reasonably known to the applicant.

HB3651 - 46 - LRB096 11637 RPM 22183 b
(3) How the discontinuation of a facility or service
might impact the remaining safety net providers in a given
community, if reasonably known by the applicant.
(d) Safety Net Impact Statements shall also include all of
the following:
(1) For the 3 fiscal years prior to the application, a
certification describing the amount of charity care
provided by the applicant. The amount calculated by
hospital applicants shall be in accordance with the
reporting requirements for charity care reporting in the
Illinois Community Benefits Act. Non-hospital applicants
shall report charity care, at cost, in accordance with an
appropriate methodology specified by the Board.
(2) For the 3 fiscal years prior to the application, a
certification of the amount of care provided to Medicaid
patients. Hospital and non-hospital applicants shall
provide Medicaid information in a manner consistent with
the information reported each year to the Illinois
Department of Public Health regarding "Inpatients and
Outpatients Served by Payor Source" and "Inpatient and
Outpatient Net Revenue by Payor Source" as required by the
Board under Section 13 of this Act and published in the
Annual Hospital Profile.
(3) Any information the applicant believes is directly
relevant to safety net services, including information
regarding teaching, research, and any other service.

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(e) The Board staff shall publish a notice, that an
application accompanied by a Safety Net Impact Statement has
been filed, in a newspaper having general circulation within
the area affected by the application. If no newspaper has a
general circulation within the county, the Agency shall post
the notice in 5 conspicuous places within the proposed area.
(f) Any person, community organization, provider, or
health system or other entity wishing to comment upon or oppose
the application may file a Safety Net Impact Statement Response
with the Board, which shall provide additional information
concerning a project's impact on safety net services in the
community.
(g) Applicants shall be provided an opportunity to submit a
reply to any Safety Net Impact Statement Response.
(h) The State Agency Report shall include a statement as to
whether a Safety Net Impact Statement was filed by the
applicant and whether it included information on charity care,
the amount of care provided to Medicaid patients, and
information on teaching, research, or any other service
provided by the applicant directly relevant to safety net
services. The Report shall also indicate the names of the
parties submitting responses and the number of responses and
replies, if any, that were filed.
(20 ILCS 3960/6) (from Ch. 111 1/2, par. 1156)
(Section scheduled to be repealed on July 1, 2009)

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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
Director may make the findings required under this Section and
upon 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. For a change of
ownership of a health care facility between related persons,
the State Board shall provide by rule for an expedited process
for obtaining an exemption.
(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
Agency or any other reviewing organization under Section 8
concerning an application for a permit must be made available
to the public at least 14 calendar days before the meeting of

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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
support of or in opposition to the review or findings of the
Board staff Agency or reviewing organization. Members of the
public shall submit any written response at least 10 days
before the meeting of the State Board. The Board staff may
revise any findings to address corrections of factual errors
cited in the public response. A written response must be
submitted at least 2 business days before the meeting of the
State Board. 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

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are provided which 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. 95-237, eff. 1-1-08.)
(20 ILCS 3960/8.5)
(Section scheduled to be repealed on July 1, 2009)
Sec. 8.5. Certificate of exemption for change of ownership
of a health care facility; public notice and public hearing.
(a) Upon a finding by the Department of Public Health that
an application for a change of ownership is complete, the
Department of Public Health 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

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be posted on the Health Facilities and Services Review Board's
Illinois Health Facilities Planning Board's web site and sent
to the State Representative and State Senator of the district
in which the health care facility is located. The Department of
Public Health shall not find that an application for change of
ownership of a hospital is 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.
For the purposes of this subsection, "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.
(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 a place of
reasonable size and accessibility and a full and complete
written transcript of the proceedings shall be made. The
applicant shall provide a summary of the proposed change of
ownership for distribution at the public hearing.
(Source: P.A. 93-935, eff. 1-1-05.)

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(20 ILCS 3960/12) (from Ch. 111 1/2, par. 1162)
(Section scheduled to be repealed on July 1, 2009)
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 identified through the comprehensive health planning
process, 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). Prescribe criteria for recognition for
areawide health planning organizations, including, but not
limited to, standards for evaluating the scientific bases for
judgments on need and procedure for making these
determinations.
(4) Develop criteria and standards for health care
facilities planning, conduct statewide inventories of health
care facilities, maintain an updated inventory on the

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Department'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 Agency with
the health care facility plans areawide health planning
organizations and with other pertinent State Plans.
Inventories pursuant to this Section of skilled or intermediate
care facilities licensed under the Nursing Home Care Act 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

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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 the Center for Comprehensive Health
Planning and 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 or Center for Comprehensive Health
Planning or recognized areawide health planning organizations
in the administration of this Act; and enter into contracts
consistent with the appropriations for purposes enumerated in
this Act.
(7) The State Board shall prescribe, in consultation with
the recognized areawide health planning organizations,

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procedures for review, standards, and criteria which shall be
utilized to make periodic areawide reviews and determinations
of the appropriateness of any existing health services being
rendered by health care facilities subject to the Act. The
State Board shall consider recommendations of the Board
areawide health planning organization and the Agency in making
its determinations.
(8) Prescribe, in consultation with the Center for
Comprehensive Health Planning recognized areawide health
planning organizations, 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.
Six months after the effective date of this amendatory Act
of the 96th General Assembly, 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; or
(b) Projects proposing a (1) new service or (2)
discontinuation of a service, which shall be reviewed by
the State Agency within 60 days.

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(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 abridge the right of the Center for
Comprehensive Health Planning areawide health planning
organizations to make recommendations on the classification
and approval of projects, nor shall such rules 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 by the
Agency.
(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

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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.
(11) Issue written decisions upon request of the applicant
or an adversely affected party to the Board within 30 days of
the 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.
(12) Require at least one of its members to participate in
any public hearing, after the appointment of the 9 members to
the Board.
(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

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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,
establishment of more private rooms, the development of
alternative services, and current trends in long-term care
services.
(Source: P.A. 93-41, eff. 6-27-03; 94-983, eff. 6-30-06.)
(20 ILCS 3960/12.2)
(Section scheduled to be repealed on July 1, 2009)
Sec. 12.2. Powers of the State Board staff Agency. For
purposes of this Act, the staff Agency 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 Department's web site:
relevant (i) rules, (ii) standards, (iii) criteria, (iv) State
norms, (v) references used by Agency 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 Agency, and the

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appropriate recognized areawide health planning organization.
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) A monthly report that includes the status of
applications and recommendations regarding updates to the
standard, criteria, or the health plan as appropriate.
(D) State Agency reports showing the degree to which an
application conforms to the review standards, a summation
of relevant public testimony, and any additional

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information that staff wants to communicate.
(3) Coordinate with other State agencies having
responsibilities affecting health care facilities, including
the Center for Comprehensive Health Planning and those of
licensure and cost reporting.
(Source: P.A. 93-41, eff. 6-27-03.)
(20 ILCS 3960/12.3)
(Section scheduled to be repealed on July 1, 2009)
Sec. 12.3. Revision of criteria, standards, and rules. At
least every 2 years Before December 31, 2004, the State Board
shall review, revise, and update promulgate the criteria,
standards, and rules used to evaluate applications for permit.
To the extent practicable, the criteria, standards, and rules
shall be based on objective criteria using the inventory and
recommendations of the Comprehensive Health Plan for guidance.
The Board may appoint temporary advisory committees made up of
experts with professional competence in the subject matter of
the proposed standards or criteria to assist in the development
of revisions to standards and criteria. In particular, the
review of the criteria, standards, and rules shall consider:
(1) Whether the criteria and standards reflect current
industry standards and anticipated trends.
(2) Whether the criteria and standards can be reduced
or eliminated.
(3) Whether criteria and standards can be developed to

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authorize the construction of unfinished space for future
use when the ultimate need for such space can be reasonably
projected.
(4) Whether the criteria and standards take into
account issues related to population growth and changing
demographics in a community.
(5) Whether facility-defined service and planning
areas should be recognized.
(6) Whether categories of service that are subject to
review should be re-evaluated, including provisions
related to 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 more timely basis.
(Source: P.A. 93-41, eff. 6-27-03.)
(20 ILCS 3960/15.1) (from Ch. 111 1/2, par. 1165.1)
(Section scheduled to be repealed on July 1, 2009)
Sec. 15.1. No individual who, as a member of the State
Board or of an areawide health planning organization board, or
as an employee of the State or of an areawide health planning
organization, shall, by reason of his performance of any duty,
function, or activity required of, or authorized to be
undertaken by this Act, be liable for the payment of damages
under any law of the State, if he has acted within the scope of

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such duty, function, or activity, has exercised due care, and
has acted, with respect to that performance, without malice
toward any person affected by it.
(Source: P.A. 80-941.)
(20 ILCS 3960/19.5)
(Section scheduled to be repealed on July 1, 2009 and as
provided internally)
Sec. 19.5. Audit. Eighteen months after the last member of
the 9-member Board is appointed, as required under this
amendatory Act of the 96th General Assembly Upon the effective
date of this amendatory Act of the 91st General Assembly, the
Auditor General shall commence a performance audit of the
Center for Comprehensive Health Planning, State Board, and the
Certificate of Need processes must commence an audit of the
State Board to determine:
(1) whether progress is being made to develop a
Comprehensive Health Plan and whether resources are
sufficient to meet the goals of the Center for
Comprehensive Health Planning; whether the State Board can
demonstrate that the certificate of need process is
successful in controlling health care costs, allowing
public access to necessary health services, and
guaranteeing the availability of quality health care to the
general public;
(2) whether changes to the Certificate of Need

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processes are being implemented effectively, as well as
their impact, if any, on access to safety net services; and
whether the State Board is following its adopted rules and
procedures;
(3) whether fines and settlements are fair,
consistent, and in proportion to the degree of violations.
whether the State Board is consistent in awarding and
denying certificates of need; and
(4) whether the State Board's annual reports reflect a
cost savings to the State.
The Auditor General must report on the results of the audit
to the General Assembly.
This Section is repealed when the Auditor General files his
or her report with the General Assembly.
(Source: P.A. 91-782, eff. 6-9-00.)
(20 ILCS 3960/19.6)
(Section scheduled to be repealed on July 1, 2009)
Sec. 19.6. Repeal. This Act is repealed on December 31,
2019 July 1, 2009.
(Source: P.A. 94-983, eff. 6-30-06; 95-1, eff. 3-30-07; 95-5,
eff. 5-31-07; 95-771, eff. 7-31-08.)
(20 ILCS 3960/19.7 new)
Sec. 19.7. Special Nomination Panel.
(a) The Nomination Panel is established to provide a list

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of candidates to the Governor for appointment to the Illinois
Health Facilities and Services Review Board ("Board"), the
position of Chairman of the Board, and the Comprehensive Health
Planner. Members of the Nomination Panel shall be appointed by
a majority vote of the following appointing authorities: (1)
the Executive Ethics Commissioner appointed by the Secretary of
State; (2) the Executive Ethics Commissioner appointed by the
Treasurer; (3) the Executive Ethics Commissioner appointed by
the Comptroller; (4) the Executive Ethics Commissioner
appointed by the Attorney General; and (5) the Executive Ethics
Commissioner appointed to serve as the first Chairman of the
Executive Ethics Commission, or, upon his disqualification,
refusal to serve, or resignation, the longest-serving
Executive Ethics Commissioner appointed by the Governor.
However, the appointing authorities as of the effective date of
this amendatory Act of the 96th General Assembly shall remain
empowered to fill vacancies on the Nomination Panel until all
members of the new Board, the Chairman of the Board, and the
Comprehensive Health Planner have been appointed and
qualified, regardless of whether such appointing authorities
remain members of the Executive Ethics Commission. In the event
of such appointing authority's disqualification, resignation,
or refusal to serve as an appointing authority, the
Constitutional officer that appointed the Executive Ethics
Commissioner may name a designee to serve as an appointing
authority for the Nomination Panel. The appointing authorities

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may hold so many public or non-public meetings as is required
to fulfill their duties, and may utilize the staff and budget
of the Executive Ethics Commission in carrying out their
duties; provided, however, that a final vote on appointees to
the Nomination Panel shall take place in a meeting governed by
the Open Meetings Act. Any ex parte communications regarding
the Nomination Panel must be made a part of the record at the
next public meeting and part of a written record. The
appointing authorities shall file a list of members of the
Nomination Panel with the Secretary of State within 60 days
after the effective date of this amendatory Act of the 96th
General Assembly. A vacancy on the Nomination Panel due to
disqualification or resignation must be filled within 60 days
of a vacancy and the appointing authorities must file the name
of the new appointee with the Secretary of State.
(b) The Nomination Panel shall consist of 9 members, who
may include former federal or State judges from Illinois,
former federal prosecutors from Illinois, former sworn federal
officers with investigatory experience with a federal agency,
or former members of federal agencies with experience in
regulatory oversight. Two members shall have at least 5 years
of experience with nonprofit agencies in Illinois committed to
public-interest advocacy. Members shall submit statements of
economic interest to the Secretary of State. Each member of the
Nomination Panel shall receive $300 for each day the Nomination
Panel meets. The Executive Ethics Commission shall provide

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staff and support to the Nomination Panel pursuant to
appropriations available for those purposes.
(c) Candidates for nomination to the Illinois Health
Facilities and Services Review Board, Chairman of the Board, or
the position of Comprehensive Health Planner may apply or be
nominated. All candidates must fill out a written application
and submit to a background investigation to be eligible for
consideration. The written application must include, at a
minimum, a sworn statement disclosing any communications that
the applicant has engaged in with a constitutional officer, a
member of the General Assembly, a special government agent (as
that term is defined in Section 4A-101 of the Illinois
Governmental Ethics Act), a member of the Board or the
Nomination Panel, a director, secretary, or other employee of
the executive branch of the State, or an employee of the
legislative branch of the State related to the regulation of
health facilities and services within the last year. A person
who knowingly provides false or misleading information on the
application or knowingly fails to disclose a communication
required to be disclosed in the sworn statement under this
Section is guilty of a Class 4 felony.
(d) Once an application is submitted to the Nomination
Panel and until (1) the nominee is rejected by the Nomination
Panel, (2) the nominee is rejected by the Governor, (3) the
candidate is rejected by the Senate, or (4) the candidate is
confirmed by the Senate, whichever is applicable, a candidate

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may not engage in ex parte communications, as that term is
defined in Section 5.7 of this Act.
(e) The Nomination Panel shall conduct a background
investigation on candidates eligible for nomination to the
Board, Chairman of the Board, or the position of Comprehensive
Health Planner. For the purpose of making the initial
nominations after the effective date of this amendatory Act of
the 96th General Assembly, the Nomination Panel shall request
the assistance of the Federal Bureau of Investigation to
conduct background investigations. If the Federal Bureau of
Investigation does not agree to conduct background
investigations, or the Federal Bureau of Investigations cannot
conduct the background investigations within 120 days after the
request is made, the Nomination Panel may contract with an
independent agency that specializes in conducting personal
investigations. The Nomination Panel may not engage the
services or enter into any contract with State or local law
enforcement agencies for the conduct of background
investigations.
(f) The Nomination Panel must review written applications,
determine eligibility for oral interviews, confirm
satisfactory background investigations, and hold public
hearings on qualifications of candidates. Initial interviews
of candidates need not be held in meetings subject to the Open
Meetings Act; members or staff may arrange for informal
interviews. Prior to recommendation, however, the Nomination

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Panel must question candidates in a meeting subject to the Open
Meetings Act under oath.
(g) The Nomination Panel must recommend candidates for
nomination to the Board, the Chairman of the Board, and the
position of Comprehensive Health Planner. The Nomination Panel
shall recommend 3 candidates for every open position and
prepare a memorandum detailing the candidates' qualifications.
The names and the memorandum must be delivered to the Governor
and filed with the Secretary of State. The Governor may choose
only from the recommendations of the Nomination Panel and must
nominate a candidate for every open position within 30 days of
receiving the recommendations. The Governor shall file the
names of his nominees with the Secretary of the Senate and the
Secretary of State. If the Governor does not name a nominee for
every open position, then the Nomination Panel may select the
remaining nominees for the Board, Chairman of the Board, or the
position of Comprehensive Health Planner. For the purpose of
making the initial recommendations after the effective date of
this amendatory Act of the 96th General Assembly, the
Nomination Panel shall make recommendations to the Governor no
later than 150 days after appointment of all members of the
Nomination Panel. For the purpose of filling subsequent
vacancies, the Nomination Panel shall make recommendations to
the Governor within 90 days of a vacancy in office.
(h) Selections by the Governor must receive the advice and
consent of the Illinois Senate by record vote of at least

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two-thirds of the members elected.
(20 ILCS 3960/8 rep.)
(20 ILCS 3960/9 rep.)
(20 ILCS 3960/15.5 rep.)
Section 25. The Illinois Health Facilities Planning Act is
amended by repealing Sections 8, 9, and 15.5.
Section 30. The Hospital Basic Services Preservation Act is
amended by changing Section 15 as follows:
(20 ILCS 4050/15)
Sec. 15. Basic services loans.
(a) Essential community hospitals seeking
collateralization of loans under this Act must apply to the
Illinois Health Facilities Planning Board on a form prescribed
by the Health Facilities and Services Review Board Illinois
Health Facilities Planning Board by rule. The Health Facilities
and Services Review Board Illinois Health Facilities Planning
Board shall review the application and, if it approves the
applicant's plan, shall forward the application and its
approval to the Hospital Basic Services Review Board.
(b) Upon receipt of the applicant's application and
approval from the Health Facilities and Services Review Board
Illinois Health Facilities Planning Board, the Hospital Basic
Services Review Board shall request from the applicant and the

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applicant shall submit to the Hospital Basic Services Review
Board all of the following information:
(1) A copy of the hospital's last audited financial
statement.
(2) The percentage of the hospital's patients each year
who are Medicaid patients.
(3) The percentage of the hospital's patients each year
who are Medicare patients.
(4) The percentage of the hospital's patients each year
who are uninsured.
(5) The percentage of services provided by the hospital
each year for which the hospital expected payment but for
which no payment was received.
(6) Any other information required by the Hospital
Basic Services Review Board by rule.
The Hospital Basic Services Review Board shall review the
applicant's original application, the approval of the Health
Facilities and Services Review Board Illinois Health
Facilities Planning Board, and the information provided by the
applicant to the Hospital Basic Services Review Board under
this Section and make a recommendation to the State Treasurer
to accept or deny the application.
(c) If the Hospital Basic Services Review Board recommends
that the application be accepted, the State Treasurer may
collateralize the applicant's basic service loan for eligible
expenses related to completing, attaining, or upgrading basic

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services, including, but not limited to, delivery,
installation, staff training, and other eligible expenses as
defined by the State Treasurer by rule. The total cost for any
one project to be undertaken by the applicants shall not exceed
$10,000,000 and the amount of each basic services loan
collateralized under this Act shall not exceed $5,000,000.
Expenditures related to basic service loans shall not exceed
the amount available in the Fund necessary to collateralize the
loans. The terms of any basic services loan collateralized
under this Act must be approved by the State Treasurer in
accordance with standards established by the State Treasurer by
rule.
(Source: P.A. 94-648, eff. 1-1-06.)
Section 35. The Illinois State Auditing Act is amended by
changing Section 3-1 as follows:
(30 ILCS 5/3-1) (from Ch. 15, par. 303-1)
Sec. 3-1. Jurisdiction of Auditor General. The Auditor
General has jurisdiction over all State agencies to make post
audits and investigations authorized by or under this Act or
the Constitution.
The Auditor General has jurisdiction over local government
agencies and private agencies only:
(a) to make such post audits authorized by or under
this Act as are necessary and incidental to a post audit of

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a State agency or of a program administered by a State
agency involving public funds of the State, but this
jurisdiction does not include any authority to review local
governmental agencies in the obligation, receipt,
expenditure or use of public funds of the State that are
granted without limitation or condition imposed by law,
other than the general limitation that such funds be used
for public purposes;
(b) to make investigations authorized by or under this
Act or the Constitution; and
(c) to make audits of the records of local government
agencies to verify actual costs of state-mandated programs
when directed to do so by the Legislative Audit Commission
at the request of the State Board of Appeals under the
State Mandates Act.
In addition to the foregoing, the Auditor General may
conduct an audit of the Metropolitan Pier and Exposition
Authority, the Regional Transportation Authority, the Suburban
Bus Division, the Commuter Rail Division and the Chicago
Transit Authority and any other subsidized carrier when
authorized by the Legislative Audit Commission. Such audit may
be a financial, management or program audit, or any combination
thereof.
The audit shall determine whether they are operating in
accordance with all applicable laws and regulations. Subject to
the limitations of this Act, the Legislative Audit Commission

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may by resolution specify additional determinations to be
included in the scope of the audit.
In addition to the foregoing, the Auditor General must also
conduct a financial audit of the Illinois Sports Facilities
Authority's expenditures of public funds in connection with the
reconstruction, renovation, remodeling, extension, or
improvement of all or substantially all of any existing
"facility", as that term is defined in the Illinois Sports
Facilities Authority Act.
The Auditor General may also conduct an audit, when
authorized by the Legislative Audit Commission, of any hospital
which receives 10% or more of its gross revenues from payments
from the State of Illinois, Department of Healthcare and Family
Services (formerly Department of Public Aid), Medical
Assistance Program.
The Auditor General is authorized to conduct financial and
compliance audits of the Illinois Distance Learning Foundation
and the Illinois Conservation Foundation.
As soon as practical after the effective date of this
amendatory Act of 1995, the Auditor General shall conduct a
compliance and management audit of the City of Chicago and any
other entity with regard to the operation of Chicago O'Hare
International Airport, Chicago Midway Airport and Merrill C.
Meigs Field. The audit shall include, but not be limited to, an
examination of revenues, expenses, and transfers of funds;
purchasing and contracting policies and practices; staffing

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levels; and hiring practices and procedures. When completed,
the audit required by this paragraph shall be distributed in
accordance with Section 3-14.
The Auditor General shall conduct a financial and
compliance and program audit of distributions from the
Municipal Economic Development Fund during the immediately
preceding calendar year pursuant to Section 8-403.1 of the
Public Utilities Act at no cost to the city, village, or
incorporated town that received the distributions.
The Auditor General must conduct an audit of the Health
Facilities and Services Review Board Health Facilities
Planning Board pursuant to Section 19.5 of the Illinois Health
Facilities Planning Act.
The Auditor General of the State of Illinois shall annually
conduct or cause to be conducted a financial and compliance
audit of the books and records of any county water commission
organized pursuant to the Water Commission Act of 1985 and
shall file a copy of the report of that audit with the Governor
and the Legislative Audit Commission. The filed audit shall be
open to the public for inspection. The cost of the audit shall
be charged to the county water commission in accordance with
Section 6z-27 of the State Finance Act. The county water
commission shall make available to the Auditor General its
books and records and any other documentation, whether in the
possession of its trustees or other parties, necessary to
conduct the audit required. These audit requirements apply only

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through July 1, 2007.
The Auditor General must conduct audits of the Rend Lake
Conservancy District as provided in Section 25.5 of the River
Conservancy Districts Act.
The Auditor General must conduct financial audits of the
Southeastern Illinois Economic Development Authority as
provided in Section 70 of the Southeastern Illinois Economic
Development Authority Act.
(Source: P.A. 95-331, eff. 8-21-07.)
Section 40. The Alternative Health Care Delivery Act is
amended by changing Sections 20, 30, and 36.5 as follows:
(210 ILCS 3/20)
Sec. 20. Board responsibilities. The State Board of Health
shall have the responsibilities set forth in this Section.
(a) The Board shall investigate new health care delivery
models and recommend to the Governor and the General Assembly,
through the Department, those models that should be authorized
as alternative health care models for which demonstration
programs should be initiated. In its deliberations, the Board
shall use the following criteria:
(1) The feasibility of operating the model in Illinois,
based on a review of the experience in other states
including the impact on health professionals of other
health care programs or facilities.

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(2) The potential of the model to meet an unmet need.
(3) The potential of the model to reduce health care
costs to consumers, costs to third party payors, and
aggregate costs to the public.
(4) The potential of the model to maintain or improve
the standards of health care delivery in some measurable
fashion.
(5) The potential of the model to provide increased
choices or access for patients.
(b) The Board shall evaluate and make recommendations to
the Governor and the General Assembly, through the Department,
regarding alternative health care model demonstration programs
established under this Act, at the midpoint and end of the
period of operation of the demonstration programs. The report
shall include, at a minimum, the following:
(1) Whether the alternative health care models
improved access to health care for their service
populations in the State.
(2) The quality of care provided by the alternative
health care models as may be evidenced by health outcomes,
surveillance reports, and administrative actions taken by
the Department.
(3) The cost and cost effectiveness to the public,
third-party payors, and government of the alternative
health care models, including the impact of pilot programs
on aggregate health care costs in the area. In addition to

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any other information collected by the Board under this
Section, the Board shall collect from postsurgical
recovery care centers uniform billing data substantially
the same as specified in Section 4-2(e) of the Illinois
Health Finance Reform Act. To facilitate its evaluation of
that data, the Board shall forward a copy of the data to
the Illinois Health Care Cost Containment Council. All
patient identifiers shall be removed from the data before
it is submitted to the Board or Council.
(4) The impact of the alternative health care models on
the health care system in that area, including changing
patterns of patient demand and utilization, financial
viability, and feasibility of operation of service in
inpatient and alternative models in the area.
(5) The implementation by alternative health care
models of any special commitments made during application
review to the Health Facilities and Services Review Board
Illinois Health Facilities Planning Board.
(6) The continuation, expansion, or modification of
the alternative health care models.
(c) The Board shall advise the Department on the definition
and scope of alternative health care models demonstration
programs.
(d) In carrying out its responsibilities under this
Section, the Board shall seek the advice of other Department
advisory boards or committees that may be impacted by the

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alternative health care model or the proposed model of health
care delivery. The Board shall also seek input from other
interested parties, which may include holding public hearings.
(e) The Board shall otherwise advise the Department on the
administration of the Act as the Board deems appropriate.
(Source: P.A. 87-1188; 88-441.)
(210 ILCS 3/30)
Sec. 30. Demonstration program requirements. The
requirements set forth in this Section shall apply to
demonstration programs.
(a) There shall be no more than:
(i) 3 subacute care hospital alternative health care
models in the City of Chicago (one of which shall be
located on a designated site and shall have been licensed
as a hospital under the Illinois Hospital Licensing Act
within the 10 years immediately before the application for
a license);
(ii) 2 subacute care hospital alternative health care
models in the demonstration program for each of the
following areas:
(1) Cook County outside the City of Chicago.
(2) DuPage, Kane, Lake, McHenry, and Will
Counties.
(3) Municipalities with a population greater than
50,000 not located in the areas described in item (i)

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of subsection (a) and paragraphs (1) and (2) of item
(ii) of subsection (a); and
(iii) 4 subacute care hospital alternative health care
models in the demonstration program for rural areas.
In selecting among applicants for these licenses in rural
areas, the Health Facilities and Services Review Board Health
Facilities Planning Board and the Department shall give
preference to hospitals that may be unable for economic reasons
to provide continued service to the community in which they are
located unless the hospital were to receive an alternative
health care model license.
(a-5) There shall be no more than a total of 12
postsurgical recovery care center alternative health care
models in the demonstration program, located as follows:
(1) Two in the City of Chicago.
(2) Two in Cook County outside the City of Chicago. At
least one of these shall be owned or operated by a hospital
devoted exclusively to caring for children.
(3) Two in Kane, Lake, and McHenry Counties.
(4) Four in municipalities with a population of 50,000
or more not located in the areas described in paragraphs
(1), (2), and (3), 3 of which shall be owned or operated by
hospitals, at least 2 of which shall be located in counties
with a population of less than 175,000, according to the
most recent decennial census for which data are available,
and one of which shall be owned or operated by an

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ambulatory surgical treatment center.
(5) Two in rural areas, both of which shall be owned or
operated by hospitals.
There shall be no postsurgical recovery care center
alternative health care models located in counties with
populations greater than 600,000 but less than 1,000,000. A
proposed postsurgical recovery care center must be owned or
operated by a hospital if it is to be located within, or will
primarily serve the residents of, a health service area in
which more than 60% of the gross patient revenue of the
hospitals within that health service area are derived from
Medicaid and Medicare, according to the most recently available
calendar year data from the Illinois Health Care Cost
Containment Council. Nothing in this paragraph shall preclude a
hospital and an ambulatory surgical treatment center from
forming a joint venture or developing a collaborative agreement
to own or operate a postsurgical recovery care center.
(a-10) There shall be no more than a total of 8 children's
respite care center alternative health care models in the
demonstration program, which shall be located as follows:
(1) One in the City of Chicago.
(2) One in Cook County outside the City of Chicago.
(3) A total of 2 in the area comprised of DuPage, Kane,
Lake, McHenry, and Will counties.
(4) A total of 2 in municipalities with a population of
50,000 or more and not located in the areas described in

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paragraphs (1), (2), or (3).
(5) A total of 2 in rural areas, as defined by the
Health Facilities and Services Review Board Health
Facilities Planning Board.
No more than one children's respite care model owned and
operated by a licensed skilled pediatric facility shall be
located in each of the areas designated in this subsection
(a-10).
(a-15) There shall be an authorized community-based
residential rehabilitation center alternative health care
model in the demonstration program. The community-based
residential rehabilitation center shall be located in the area
of Illinois south of Interstate Highway 70.
(a-20) There shall be an authorized Alzheimer's disease
management center alternative health care model in the
demonstration program. The Alzheimer's disease management
center shall be located in Will County, owned by a
not-for-profit entity, and endorsed by a resolution approved by
the county board before the effective date of this amendatory
Act of the 91st General Assembly.
(a-25) There shall be no more than 10 birth center
alternative health care models in the demonstration program,
located as follows:
(1) Four in the area comprising Cook, DuPage, Kane,
Lake, McHenry, and Will counties, one of which shall be
owned or operated by a hospital and one of which shall be

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owned or operated by a federally qualified health center.
(2) Three in municipalities with a population of 50,000
or more not located in the area described in paragraph (1)
of this subsection, one of which shall be owned or operated
by a hospital and one of which shall be owned or operated
by a federally qualified health center.
(3) Three in rural areas, one of which shall be owned
or operated by a hospital and one of which shall be owned
or operated by a federally qualified health center.
The first 3 birth centers authorized to operate by the
Department shall be located in or predominantly serve the
residents of a health professional shortage area as determined
by the United States Department of Health and Human Services.
There shall be no more than 2 birth centers authorized to
operate in any single health planning area for obstetric
services as determined under the Illinois Health Facilities
Planning Act. If a birth center is located outside of a health
professional shortage area, (i) the birth center shall be
located in a health planning area with a demonstrated need for
obstetrical service beds, as determined by the Health
Facilities and Services Review Board Illinois Health
Facilities Planning Board or (ii) there must be a reduction in
the existing number of obstetrical service beds in the planning
area so that the establishment of the birth center does not
result in an increase in the total number of obstetrical
service beds in the health planning area.

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(b) Alternative health care models, other than a model
authorized under subsections (a-15) and subsection (a-20),
shall obtain a certificate of need from the Health Facilities
and Services Review Board Illinois Health Facilities Planning
Board under the Illinois Health Facilities Planning Act before
receiving a license by the Department. If, after obtaining its
initial certificate of need, an alternative health care
delivery model that is a community based residential
rehabilitation center seeks to increase the bed capacity of
that center, it must obtain a certificate of need from the
Health Facilities and Services Review Board Illinois Health
Facilities Planning Board before increasing the bed capacity.
Alternative health care models in medically underserved areas
shall receive priority in obtaining a certificate of need.
(c) An alternative health care model license shall be
issued for a period of one year and shall be annually renewed
if the facility or program is in substantial compliance with
the Department's rules adopted under this Act. A licensed
alternative health care model that continues to be in
substantial compliance after the conclusion of the
demonstration program shall be eligible for annual renewals
unless and until a different licensure program for that type of
health care model is established by legislation. The Department
may issue a provisional license to any alternative health care
model that does not substantially comply with the provisions of
this Act and the rules adopted under this Act if (i) the

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Department finds that the alternative health care model has
undertaken changes and corrections which upon completion will
render the alternative health care model in substantial
compliance with this Act and rules and (ii) the health and
safety of the patients of the alternative health care model
will be protected during the period for which the provisional
license is issued. The Department shall advise the licensee of
the conditions under which the provisional license is issued,
including the manner in which the alternative health care model
fails to comply with the provisions of this Act and rules, and
the time within which the changes and corrections necessary for
the alternative health care model to substantially comply with
this Act and rules shall be completed.
(d) Alternative health care models shall seek
certification under Titles XVIII and XIX of the federal Social
Security Act. In addition, alternative health care models shall
provide charitable care consistent with that provided by
comparable health care providers in the geographic area.
(d-5) The Department of Healthcare and Family Services
(formerly Illinois Department of Public Aid), in cooperation
with the Illinois Department of Public Health, shall develop
and implement a reimbursement methodology for all facilities
participating in the demonstration program. The Department of
Healthcare and Family Services shall keep a record of services
provided under the demonstration program to recipients of
medical assistance under the Illinois Public Aid Code and shall

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submit an annual report of that information to the Illinois
Department of Public Health.
(e) Alternative health care models shall, to the extent
possible, link and integrate their services with nearby health
care facilities.
(f) Each alternative health care model shall implement a
quality assurance program with measurable benefits and at
reasonable cost.
(Source: P.A. 95-331, eff. 8-21-07; 95-445, eff. 1-1-08.)
(210 ILCS 3/36.5)
Sec. 36.5. Alternative health care models authorized.
Notwithstanding any other law to the contrary, alternative
health care models described in part 1 of Section 35 shall be
licensed without additional consideration by the Health
Facilities and Services Review Board Illinois Health
Facilities Planning Board if:
(1) an application for such a model was filed with the
Health Facilities and Services Review Board Illinois
Health Facilities Planning Board prior to September 1,
1994;
(2) the application was received by the Health
Facilities and Services Review Board Illinois Health
Facilities Planning Board and was awarded at least the
minimum number of points required for approval by the Board
or, if the application was withdrawn prior to Board action,

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the staff report recommended at least the minimum number of
points required for approval by the Board; and
(3) the applicant complies with all regulations of the
Illinois Department of Public Health to receive a license
pursuant to part 1 of Section 35.
(Source: P.A. 89-393, eff. 8-20-95.)
Section 45. The Assisted Living and Shared Housing Act is
amended by changing Section 145 as follows:
(210 ILCS 9/145)
Sec. 145. Conversion of facilities. Entities licensed as
facilities under the Nursing Home Care Act may elect to convert
to a license under this Act. Any facility that chooses to
convert, in whole or in part, shall follow the requirements in
the Nursing Home Care Act and rules promulgated under that Act
regarding voluntary closure and notice to residents. Any
conversion of existing beds licensed under the Nursing Home
Care Act to licensure under this Act is exempt from review by
the Health Facilities and Services Review Board Health
Facilities Planning Board.
(Source: P.A. 91-656, eff. 1-1-01.)
Section 50. The Emergency Medical Services (EMS) Systems
Act is amended by changing Section 32.5 as follows:

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(210 ILCS 50/32.5)
Sec. 32.5. Freestanding Emergency Center.
(a) Until June 30, 2009, the Department shall issue an
annual Freestanding Emergency Center (FEC) license to any
facility that:
(1) is located: (A) in a municipality with a population
of 75,000 or fewer inhabitants; (B) within 20 miles of the
hospital that owns or controls the FEC; and (C) within 20
miles of the Resource Hospital affiliated with the FEC as
part of the EMS System;
(2) is wholly owned or controlled by an Associate or
Resource Hospital, but is not a part of the hospital's
physical plant;
(3) meets the standards for licensed FECs, adopted by
rule of the Department, including, but not limited to:
(A) facility design, specification, operation, and
maintenance standards;
(B) equipment standards; and
(C) the number and qualifications of emergency
medical personnel and other staff, which must include
at least one board certified emergency physician
present at the FEC 24 hours per day.
(4) limits its participation in the EMS System strictly
to receiving a limited number of BLS runs by emergency
medical vehicles according to protocols developed by the
Resource Hospital within the FEC's designated EMS System

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and approved by the Project Medical Director and the
Department;
(5) provides comprehensive emergency treatment
services, as defined in the rules adopted by the Department
pursuant to the Hospital Licensing Act, 24 hours per day,
on an outpatient basis;
(6) provides an ambulance and maintains on site
ambulance services staffed with paramedics 24 hours per
day;
(7) maintains helicopter landing capabilities approved
by appropriate State and federal authorities;
(8) complies with all State and federal patient rights
provisions, including, but not limited to, the Emergency
Medical Treatment Act and the federal Emergency Medical
Treatment and Active Labor Act;
(9) maintains a communications system that is fully
integrated with its Resource Hospital within the FEC's
designated EMS System;
(10) reports to the Department any patient transfers
from the FEC to a hospital within 48 hours of the transfer
plus any other data determined to be relevant by the
Department;
(11) submits to the Department, on a quarterly basis,
the FEC's morbidity and mortality rates for patients
treated at the FEC and other data determined to be relevant
by the Department;

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(12) does not describe itself or hold itself out to the
general public as a full service hospital or hospital
emergency department in its advertising or marketing
activities;
(13) complies with any other rules adopted by the
Department under this Act that relate to FECs;
(14) passes the Department's site inspection for
compliance with the FEC requirements of this Act;
(15) submits a copy of the permit issued by the Health
Facilities and Services Review Board Illinois Health
Facilities Planning Board indicating that the facility has
complied with the Illinois Health Facilities Planning Act
with respect to the health services to be provided at the
facility;
(16) submits an application for designation as an FEC
in a manner and form prescribed by the Department by rule;
and
(17) pays the annual license fee as determined by the
Department by rule.
(b) The Department shall:
(1) annually inspect facilities of initial FEC
applicants and licensed FECs, and issue annual licenses to
or annually relicense FECs that satisfy the Department's
licensure requirements as set forth in subsection (a);
(2) suspend, revoke, refuse to issue, or refuse to
renew the license of any FEC, after notice and an

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opportunity for a hearing, when the Department finds that
the FEC has failed to comply with the standards and
requirements of the Act or rules adopted by the Department
under the Act;
(3) issue an Emergency Suspension Order for any FEC
when the Director or his or her designee has determined
that the continued operation of the FEC poses an immediate
and serious danger to the public health, safety, and
welfare. An opportunity for a hearing shall be promptly
initiated after an Emergency Suspension Order has been
issued; and
(4) adopt rules as needed to implement this Section.
(Source: P.A. 95-584, eff. 8-31-07.)
Section 55. The Health Care Worker Self-Referral Act is
amended by changing Sections 5, 15, and 30 as follows:
(225 ILCS 47/5)
Sec. 5. Legislative intent. The General Assembly
recognizes that patient referrals by health care workers for
health services to an entity in which the referring health care
worker has an investment interest may present a potential
conflict of interest. The General Assembly finds that these
referral practices may limit or completely eliminate
competitive alternatives in the health care market. In some
instances, these referral practices may expand and improve care

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or may make services available which were previously
unavailable. They may also provide lower cost options to
patients or increase competition. Generally, referral
practices are positive occurrences. However, self-referrals
may result in over utilization of health services, increased
overall costs of the health care systems, and may affect the
quality of health care.
It is the intent of the General Assembly to provide
guidance to health care workers regarding acceptable patient
referrals, to prohibit patient referrals to entities providing
health services in which the referring health care worker has
an investment interest, and to protect the citizens of Illinois
from unnecessary and costly health care expenditures.
Recognizing the need for flexibility to quickly respond to
changes in the delivery of health services, to avoid results
beyond the limitations on self referral provided under this Act
and to provide minimal disruption to the appropriate delivery
of health care, the Health Facilities and Services Review Board
Health Facilities Planning Board shall be exclusively and
solely authorized to implement and interpret this Act through
adopted rules.
The General Assembly recognizes that changes in delivery of
health care has resulted in various methods by which health
care workers practice their professions. It is not the intent
of the General Assembly to limit appropriate delivery of care,
nor force unnecessary changes in the structures created by

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workers for the health and convenience of their patients.
(Source: P.A. 87-1207.)
(225 ILCS 47/15)
Sec. 15. Definitions. In this Act:
(a) "Board" means the Health Facilities and Services Review
Board Health Facilities Planning Board.
(b) "Entity" means any individual, partnership, firm,
corporation, or other business that provides health services
but does not include an individual who is a health care worker
who provides professional services to an individual.
(c) "Group practice" means a group of 2 or more health care
workers legally organized as a partnership, professional
corporation, not-for-profit corporation, faculty practice plan
or a similar association in which:
(1) each health care worker who is a member or employee
or an independent contractor of the group provides
substantially the full range of services that the health
care worker routinely provides, including consultation,
diagnosis, or treatment, through the use of office space,
facilities, equipment, or personnel of the group;
(2) the services of the health care workers are
provided through the group, and payments received for
health services are treated as receipts of the group; and
(3) the overhead expenses and the income from the
practice are distributed by methods previously determined

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by the group.
(d) "Health care worker" means any individual licensed
under the laws of this State to provide health services,
including but not limited to: dentists licensed under the
Illinois Dental Practice Act; dental hygienists licensed under
the Illinois Dental Practice Act; nurses and advanced practice
nurses licensed under the Nurse Practice Act; occupational
therapists licensed under the Illinois Occupational Therapy
Practice Act; optometrists licensed under the Illinois
Optometric Practice Act of 1987; pharmacists licensed under the
Pharmacy Practice Act; physical therapists licensed under the
Illinois Physical Therapy Act; physicians licensed under the
Medical Practice Act of 1987; physician assistants licensed
under the Physician Assistant Practice Act of 1987; podiatrists
licensed under the Podiatric Medical Practice Act of 1987;
clinical psychologists licensed under the Clinical
Psychologist Licensing Act; clinical social workers licensed
under the Clinical Social Work and Social Work Practice Act;
speech-language pathologists and audiologists licensed under
the Illinois Speech-Language Pathology and Audiology Practice
Act; or hearing instrument dispensers licensed under the
Hearing Instrument Consumer Protection Act, or any of their
successor Acts.
(e) "Health services" means health care procedures and
services provided by or through a health care worker.
(f) "Immediate family member" means a health care worker's

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spouse, child, child's spouse, or a parent.
(g) "Investment interest" means an equity or debt security
issued by an entity, including, without limitation, shares of
stock in a corporation, units or other interests in a
partnership, bonds, debentures, notes, or other equity
interests or debt instruments except that investment interest
for purposes of Section 20 does not include interest in a
hospital licensed under the laws of the State of Illinois.
(h) "Investor" means an individual or entity directly or
indirectly owning a legal or beneficial ownership or investment
interest, (such as through an immediate family member, trust,
or another entity related to the investor).
(i) "Office practice" includes the facility or facilities
at which a health care worker, on an ongoing basis, provides or
supervises the provision of professional health services to
individuals.
(j) "Referral" means any referral of a patient for health
services, including, without limitation:
(1) The forwarding of a patient by one health care
worker to another health care worker or to an entity
outside the health care worker's office practice or group
practice that provides health services.
(2) The request or establishment by a health care
worker of a plan of care outside the health care worker's
office practice or group practice that includes the
provision of any health services.

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(Source: P.A. 95-639, eff. 10-5-07; 95-689, eff. 10-29-07;
95-876, eff. 8-21-08.)
(225 ILCS 47/30)
Sec. 30. Rulemaking. The Health Facilities and Services
Review Board Health Facilities Planning Board shall
exclusively and solely implement the provisions of this Act
pursuant to rules adopted in accordance with the Illinois
Administrative Procedure Act concerning, but not limited to:
(a) Standards and procedures for the administration of this
Act.
(b) Procedures and criteria for exceptions from the
prohibitions set forth in Section 20.
(c) Procedures and criteria for determining practical
compliance with the needs and alternative investor criteria in
Section 20.
(d) Procedures and criteria for determining when a written
request for an opinion set forth in Section 20 is complete.
(e) Procedures and criteria for advising health care
workers of the applicability of this Act to practices pursuant
to written requests.
(Source: P.A. 87-1207.)
Section 60. The Illinois Public Aid Code is amended by
changing Section 5-5.02 as follows:

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(305 ILCS 5/5-5.02) (from Ch. 23, par. 5-5.02)
Sec. 5-5.02. Hospital reimbursements.
(a) Reimbursement to Hospitals; July 1, 1992 through
September 30, 1992. Notwithstanding any other provisions of
this Code or the Illinois Department's Rules promulgated under
the Illinois Administrative Procedure Act, reimbursement to
hospitals for services provided during the period July 1, 1992
through September 30, 1992, shall be as follows:
(1) For inpatient hospital services rendered, or if
applicable, for inpatient hospital discharges occurring,
on or after July 1, 1992 and on or before September 30,
1992, the Illinois Department shall reimburse hospitals
for inpatient services under the reimbursement
methodologies in effect for each hospital, and at the
inpatient payment rate calculated for each hospital, as of
June 30, 1992. For purposes of this paragraph,
"reimbursement methodologies" means all reimbursement
methodologies that pertain to the provision of inpatient
hospital services, including, but not limited to, any
adjustments for disproportionate share, targeted access,
critical care access and uncompensated care, as defined by
the Illinois Department on June 30, 1992.
(2) For the purpose of calculating the inpatient
payment rate for each hospital eligible to receive
quarterly adjustment payments for targeted access and
critical care, as defined by the Illinois Department on

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June 30, 1992, the adjustment payment for the period July
1, 1992 through September 30, 1992, shall be 25% of the
annual adjustment payments calculated for each eligible
hospital, as of June 30, 1992. The Illinois Department
shall determine by rule the adjustment payments for
targeted access and critical care beginning October 1,
1992.
(3) For the purpose of calculating the inpatient
payment rate for each hospital eligible to receive
quarterly adjustment payments for uncompensated care, as
defined by the Illinois Department on June 30, 1992, the
adjustment payment for the period August 1, 1992 through
September 30, 1992, shall be one-sixth of the total
uncompensated care adjustment payments calculated for each
eligible hospital for the uncompensated care rate year, as
defined by the Illinois Department, ending on July 31,
1992. The Illinois Department shall determine by rule the
adjustment payments for uncompensated care beginning
October 1, 1992.
(b) Inpatient payments. For inpatient services provided on
or after October 1, 1993, in addition to rates paid for
hospital inpatient services pursuant to the Illinois Health
Finance Reform Act, as now or hereafter amended, or the
Illinois Department's prospective reimbursement methodology,
or any other methodology used by the Illinois Department for
inpatient services, the Illinois Department shall make

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adjustment payments, in an amount calculated pursuant to the
methodology described in paragraph (c) of this Section, to
hospitals that the Illinois Department determines satisfy any
one of the following requirements:
(1) Hospitals that are described in Section 1923 of the
federal Social Security Act, as now or hereafter amended;
or
(2) Illinois hospitals that have a Medicaid inpatient
utilization rate which is at least one-half a standard
deviation above the mean Medicaid inpatient utilization
rate for all hospitals in Illinois receiving Medicaid
payments from the Illinois Department; or
(3) Illinois hospitals that on July 1, 1991 had a
Medicaid inpatient utilization rate, as defined in
paragraph (h) of this Section, that was at least the mean
Medicaid inpatient utilization rate for all hospitals in
Illinois receiving Medicaid payments from the Illinois
Department and which were located in a planning area with
one-third or fewer excess beds as determined by the Health
Facilities and Services Review Board Illinois Health
Facilities Planning Board, and that, as of June 30, 1992,
were located in a federally designated Health Manpower
Shortage Area; or
(4) Illinois hospitals that:
(A) have a Medicaid inpatient utilization rate
that is at least equal to the mean Medicaid inpatient

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utilization rate for all hospitals in Illinois
receiving Medicaid payments from the Department; and
(B) also have a Medicaid obstetrical inpatient
utilization rate that is at least one standard
deviation above the mean Medicaid obstetrical
inpatient utilization rate for all hospitals in
Illinois receiving Medicaid payments from the
Department for obstetrical services; or
(5) Any children's hospital, which means a hospital
devoted exclusively to caring for children. A hospital
which includes a facility devoted exclusively to caring for
children shall be considered a children's hospital to the
degree that the hospital's Medicaid care is provided to
children if either (i) the facility devoted exclusively to
caring for children is separately licensed as a hospital by
a municipality prior to September 30, 1998 or (ii) the
hospital has been designated by the State as a Level III
perinatal care facility, has a Medicaid Inpatient
Utilization rate greater than 55% for the rate year 2003
disproportionate share determination, and has more than
10,000 qualified children days as defined by the Department
in rulemaking.
(c) Inpatient adjustment payments. The adjustment payments
required by paragraph (b) shall be calculated based upon the
hospital's Medicaid inpatient utilization rate as follows:
(1) hospitals with a Medicaid inpatient utilization

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rate below the mean shall receive a per day adjustment
payment equal to $25;
(2) hospitals with a Medicaid inpatient utilization
rate that is equal to or greater than the mean Medicaid
inpatient utilization rate but less than one standard
deviation above the mean Medicaid inpatient utilization
rate shall receive a per day adjustment payment equal to
the sum of $25 plus $1 for each one percent that the
hospital's Medicaid inpatient utilization rate exceeds the
mean Medicaid inpatient utilization rate;
(3) hospitals with a Medicaid inpatient utilization
rate that is equal to or greater than one standard
deviation above the mean Medicaid inpatient utilization
rate but less than 1.5 standard deviations above the mean
Medicaid inpatient utilization rate shall receive a per day
adjustment payment equal to the sum of $40 plus $7 for each
one percent that the hospital's Medicaid inpatient
utilization rate exceeds one standard deviation above the
mean Medicaid inpatient utilization rate; and
(4) hospitals with a Medicaid inpatient utilization
rate that is equal to or greater than 1.5 standard
deviations above the mean Medicaid inpatient utilization
rate shall receive a per day adjustment payment equal to
the sum of $90 plus $2 for each one percent that the
hospital's Medicaid inpatient utilization rate exceeds 1.5
standard deviations above the mean Medicaid inpatient

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utilization rate.
(d) Supplemental adjustment payments. In addition to the
adjustment payments described in paragraph (c), hospitals as
defined in clauses (1) through (5) of paragraph (b), excluding
county hospitals (as defined in subsection (c) of Section 15-1
of this Code) and a hospital organized under the University of
Illinois Hospital Act, shall be paid supplemental inpatient
adjustment payments of $60 per day. For purposes of Title XIX
of the federal Social Security Act, these supplemental
adjustment payments shall not be classified as adjustment
payments to disproportionate share hospitals.
(e) The inpatient adjustment payments described in
paragraphs (c) and (d) shall be increased on October 1, 1993
and annually thereafter by a percentage equal to the lesser of
(i) the increase in the DRI hospital cost index for the most
recent 12 month period for which data are available, or (ii)
the percentage increase in the statewide average hospital
payment rate over the previous year's statewide average
hospital payment rate. The sum of the inpatient adjustment
payments under paragraphs (c) and (d) to a hospital, other than
a county hospital (as defined in subsection (c) of Section 15-1
of this Code) or a hospital organized under the University of
Illinois Hospital Act, however, shall not exceed $275 per day;
that limit shall be increased on October 1, 1993 and annually
thereafter by a percentage equal to the lesser of (i) the
increase in the DRI hospital cost index for the most recent

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12-month period for which data are available or (ii) the
percentage increase in the statewide average hospital payment
rate over the previous year's statewide average hospital
payment rate.
(f) Children's hospital inpatient adjustment payments. For
children's hospitals, as defined in clause (5) of paragraph
(b), the adjustment payments required pursuant to paragraphs
(c) and (d) shall be multiplied by 2.0.
(g) County hospital inpatient adjustment payments. For
county hospitals, as defined in subsection (c) of Section 15-1
of this Code, there shall be an adjustment payment as
determined by rules issued by the Illinois Department.
(h) For the purposes of this Section the following terms
shall be defined as follows:
(1) "Medicaid inpatient utilization rate" means a
fraction, the numerator of which is the number of a
hospital's inpatient days provided in a given 12-month
period to patients who, for such days, were eligible for
Medicaid under Title XIX of the federal Social Security
Act, and the denominator of which is the total number of
the hospital's inpatient days in that same period.
(2) "Mean Medicaid inpatient utilization rate" means
the total number of Medicaid inpatient days provided by all
Illinois Medicaid-participating hospitals divided by the
total number of inpatient days provided by those same
hospitals.

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(3) "Medicaid obstetrical inpatient utilization rate"
means the ratio of Medicaid obstetrical inpatient days to
total Medicaid inpatient days for all Illinois hospitals
receiving Medicaid payments from the Illinois Department.
(i) Inpatient adjustment payment limit. In order to meet
the limits of Public Law 102-234 and Public Law 103-66, the
Illinois Department shall by rule adjust disproportionate
share adjustment payments.
(j) University of Illinois Hospital inpatient adjustment
payments. For hospitals organized under the University of
Illinois Hospital Act, there shall be an adjustment payment as
determined by rules adopted by the Illinois Department.
(k) The Illinois Department may by rule establish criteria
for and develop methodologies for adjustment payments to
hospitals participating under this Article.
(Source: P.A. 93-40, eff. 6-27-03.)
Section 65. The Older Adult Services Act is amended by
changing Sections 20, 25, and 30 as follows:
(320 ILCS 42/20)
Sec. 20. Priority service areas; service expansion.
(a) The requirements of this Section are subject to the
availability of funding.
(b) The Department shall expand older adult services that
promote independence and permit older adults to remain in their

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own homes and communities. Priority shall be given to both the
expansion of services and the development of new services in
priority service areas.
(c) Inventory of services. The Department shall develop and
maintain an inventory and assessment of (i) the types and
quantities of public older adult services and, to the extent
possible, privately provided older adult services, including
the unduplicated count, location, and characteristics of
individuals served by each facility, program, or service and
(ii) the resources supporting those services.
(d) Priority service areas. The Departments shall assess
the current and projected need for older adult services
throughout the State, analyze the results of the inventory, and
identify priority service areas, which shall serve as the basis
for a priority service plan to be filed with the Governor and
the General Assembly no later than July 1, 2006, and every 5
years thereafter.
(e) Moneys appropriated by the General Assembly for the
purpose of this Section, receipts from donations, grants, fees,
or taxes that may accrue from any public or private sources to
the Department for the purpose of this Section, and savings
attributable to the nursing home conversion program as
calculated in subsection (h) shall be deposited into the
Department on Aging State Projects Fund. Interest earned by
those moneys in the Fund shall be credited to the Fund.
(f) Moneys described in subsection (e) from the Department

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on Aging State Projects Fund shall be used for older adult
services, regardless of where the older adult receives the
service, with priority given to both the expansion of services
and the development of new services in priority service areas.
Fundable services shall include:
(1) Housing, health services, and supportive services:
(A) adult day care;
(B) adult day care for persons with Alzheimer's
disease and related disorders;
(C) activities of daily living;
(D) care-related supplies and equipment;
(E) case management;
(F) community reintegration;
(G) companion;
(H) congregate meals;
(I) counseling and education;
(J) elder abuse prevention and intervention;
(K) emergency response and monitoring;
(L) environmental modifications;
(M) family caregiver support;
(N) financial;
(O) home delivered meals;
(P) homemaker;
(Q) home health;
(R) hospice;
(S) laundry;

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(T) long-term care ombudsman;
(U) medication reminders;
(V) money management;
(W) nutrition services;
(X) personal care;
(Y) respite care;
(Z) residential care;
(AA) senior benefits outreach;
(BB) senior centers;
(CC) services provided under the Assisted Living
and Shared Housing Act, or sheltered care services that
meet the requirements of the Assisted Living and Shared
Housing Act, or services provided under Section
5-5.01a of the Illinois Public Aid Code (the Supportive
Living Facilities Program);
(DD) telemedicine devices to monitor recipients in
their own homes as an alternative to hospital care,
nursing home care, or home visits;
(EE) training for direct family caregivers;
(FF) transition;
(GG) transportation;
(HH) wellness and fitness programs; and
(II) other programs designed to assist older
adults in Illinois to remain independent and receive
services in the most integrated residential setting
possible for that person.

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(2) Older Adult Services Demonstration Grants,
pursuant to subsection (g) of this Section.
(g) Older Adult Services Demonstration Grants. The
Department shall establish a program of demonstration grants to
assist in the restructuring of the delivery system for older
adult services and provide funding for innovative service
delivery models and system change and integration initiatives.
The Department shall prescribe, by rule, the grant application
process. At a minimum, every application must include:
(1) The type of grant sought;
(2) A description of the project;
(3) The objective of the project;
(4) The likelihood of the project meeting identified
needs;
(5) The plan for financing, administration, and
evaluation of the project;
(6) The timetable for implementation;
(7) The roles and capabilities of responsible
individuals and organizations;
(8) Documentation of collaboration with other service
providers, local community government leaders, and other
stakeholders, other providers, and any other stakeholders
in the community;
(9) Documentation of community support for the
project, including support by other service providers,
local community government leaders, and other

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stakeholders;
(10) The total budget for the project;
(11) The financial condition of the applicant; and
(12) Any other application requirements that may be
established by the Department by rule.
Each project may include provisions for a designated staff
person who is responsible for the development of the project
and recruitment of providers.
Projects may include, but are not limited to: adult family
foster care; family adult day care; assisted living in a
supervised apartment; personal services in a subsidized
housing project; evening and weekend home care coverage; small
incentive grants to attract new providers; money following the
person; cash and counseling; managed long-term care; and at
least one respite care project that establishes a local
coordinated network of volunteer and paid respite workers,
coordinates assignment of respite workers to caregivers and
older adults, ensures the health and safety of the older adult,
provides training for caregivers, and ensures that support
groups are available in the community.
A demonstration project funded in whole or in part by an
Older Adult Services Demonstration Grant is exempt from the
requirements of the Illinois Health Facilities Planning Act. To
the extent applicable, however, for the purpose of maintaining
the statewide inventory authorized by the Illinois Health
Facilities Planning Act, the Department shall send to the

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Health Facilities and Services Review Board Health Facilities
Planning Board a copy of each grant award made under this
subsection (g).
The Department, in collaboration with the Departments of
Public Health and Healthcare and Family Services, shall
evaluate the effectiveness of the projects receiving grants
under this Section.
(h) No later than July 1 of each year, the Department of
Public Health shall provide information to the Department of
Healthcare and Family Services to enable the Department of
Healthcare and Family Services to annually document and verify
the savings attributable to the nursing home conversion program
for the previous fiscal year to estimate an annual amount of
such savings that may be appropriated to the Department on
Aging State Projects Fund and notify the General Assembly, the
Department on Aging, the Department of Human Services, and the
Advisory Committee of the savings no later than October 1 of
the same fiscal year.
(Source: P.A. 94-342, eff. 7-26-05; 95-331, eff. 8-21-07.)
(320 ILCS 42/25)
Sec. 25. Older adult services restructuring. No later than
January 1, 2005, the Department shall commence the process of
restructuring the older adult services delivery system.
Priority shall be given to both the expansion of services and
the development of new services in priority service areas.

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Subject to the availability of funding, the restructuring shall
include, but not be limited to, the following:
(1) Planning. The Department shall develop a plan to
restructure the State's service delivery system for older
adults. The plan shall include a schedule for the
implementation of the initiatives outlined in this Act and all
other initiatives identified by the participating agencies to
fulfill the purposes of this Act. Financing for older adult
services shall be based on the principle that "money follows
the individual". The plan shall also identify potential
impediments to delivery system restructuring and include any
known regulatory or statutory barriers.
(2) Comprehensive case management. The Department shall
implement a statewide system of holistic comprehensive case
management. The system shall include the identification and
implementation of a universal, comprehensive assessment tool
to be used statewide to determine the level of functional,
cognitive, socialization, and financial needs of older adults.
This tool shall be supported by an electronic intake,
assessment, and care planning system linked to a central
location. "Comprehensive case management" includes services
and coordination such as (i) comprehensive assessment of the
older adult (including the physical, functional, cognitive,
psycho-social, and social needs of the individual); (ii)
development and implementation of a service plan with the older
adult to mobilize the formal and family resources and services

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identified in the assessment to meet the needs of the older
adult, including coordination of the resources and services
with any other plans that exist for various formal services,
such as hospital discharge plans, and with the information and
assistance services; (iii) coordination and monitoring of
formal and family service delivery, including coordination and
monitoring to ensure that services specified in the plan are
being provided; (iv) periodic reassessment and revision of the
status of the older adult with the older adult or, if
necessary, the older adult's designated representative; and
(v) in accordance with the wishes of the older adult, advocacy
on behalf of the older adult for needed services or resources.
(3) Coordinated point of entry. The Department shall
implement and publicize a statewide coordinated point of entry
using a uniform name, identity, logo, and toll-free number.
(4) Public web site. The Department shall develop a public
web site that provides links to available services, resources,
and reference materials concerning caregiving, diseases, and
best practices for use by professionals, older adults, and
family caregivers.
(5) Expansion of older adult services. The Department shall
expand older adult services that promote independence and
permit older adults to remain in their own homes and
communities.
(6) Consumer-directed home and community-based services.
The Department shall expand the range of service options

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available to permit older adults to exercise maximum choice and
control over their care.
(7) Comprehensive delivery system. The Department shall
expand opportunities for older adults to receive services in
systems that integrate acute and chronic care.
(8) Enhanced transition and follow-up services. The
Department shall implement a program of transition from one
residential setting to another and follow-up services,
regardless of residential setting, pursuant to rules with
respect to (i) resident eligibility, (ii) assessment of the
resident's health, cognitive, social, and financial needs,
(iii) development of transition plans, and (iv) the level of
services that must be available before transitioning a resident
from one setting to another.
(9) Family caregiver support. The Department shall develop
strategies for public and private financing of services that
supplement and support family caregivers.
(10) Quality standards and quality improvement. The
Department shall establish a core set of uniform quality
standards for all providers that focus on outcomes and take
into consideration consumer choice and satisfaction, and the
Department shall require each provider to implement a
continuous quality improvement process to address consumer
issues. The continuous quality improvement process must
benchmark performance, be person-centered and data-driven, and
focus on consumer satisfaction.

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(11) Workforce. The Department shall develop strategies to
attract and retain a qualified and stable worker pool, provide
living wages and benefits, and create a work environment that
is conducive to long-term employment and career development.
Resources such as grants, education, and promotion of career
opportunities may be used.
(12) Coordination of services. The Department shall
identify methods to better coordinate service networks to
maximize resources and minimize duplication of services and
ease of application.
(13) Barriers to services. The Department shall identify
barriers to the provision, availability, and accessibility of
services and shall implement a plan to address those barriers.
The plan shall: (i) identify barriers, including but not
limited to, statutory and regulatory complexity, reimbursement
issues, payment issues, and labor force issues; (ii) recommend
changes to State or federal laws or administrative rules or
regulations; (iii) recommend application for federal waivers
to improve efficiency and reduce cost and paperwork; (iv)
develop innovative service delivery models; and (v) recommend
application for federal or private service grants.
(14) Reimbursement and funding. The Department shall
investigate and evaluate costs and payments by defining costs
to implement a uniform, audited provider cost reporting system
to be considered by all Departments in establishing payments.
To the extent possible, multiple cost reporting mandates shall

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not be imposed.
(15) Medicaid nursing home cost containment and Medicare
utilization. The Department of Healthcare and Family Services
(formerly Department of Public Aid), in collaboration with the
Department on Aging and the Department of Public Health and in
consultation with the Advisory Committee, shall propose a plan
to contain Medicaid nursing home costs and maximize Medicare
utilization. The plan must not impair the ability of an older
adult to choose among available services. The plan shall
include, but not be limited to, (i) techniques to maximize the
use of the most cost-effective services without sacrificing
quality and (ii) methods to identify and serve older adults in
need of minimal services to remain independent, but who are
likely to develop a need for more extensive services in the
absence of those minimal services.
(16) Bed reduction. The Department of Public Health shall
implement a nursing home conversion program to reduce the
number of Medicaid-certified nursing home beds in areas with
excess beds. The Department of Healthcare and Family Services
shall investigate changes to the Medicaid nursing facility
reimbursement system in order to reduce beds. Such changes may
include, but are not limited to, incentive payments that will
enable facilities to adjust to the restructuring and expansion
of services required by the Older Adult Services Act, including
adjustments for the voluntary closure or layaway of nursing
home beds certified under Title XIX of the federal Social

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Security Act. Any savings shall be reallocated to fund
home-based or community-based older adult services pursuant to
Section 20.
(17) Financing. The Department shall investigate and
evaluate financing options for older adult services and shall
make recommendations in the report required by Section 15
concerning the feasibility of these financing arrangements.
These arrangements shall include, but are not limited to:
(A) private long-term care insurance coverage for
older adult services;
(B) enhancement of federal long-term care financing
initiatives;
(C) employer benefit programs such as medical savings
accounts for long-term care;
(D) individual and family cost-sharing options;
(E) strategies to reduce reliance on government
programs;
(F) fraudulent asset divestiture and financial
planning prevention; and
(G) methods to supplement and support family and
community caregiving.
(18) Older Adult Services Demonstration Grants. The
Department shall implement a program of demonstration grants
that will assist in the restructuring of the older adult
services delivery system, and shall provide funding for
innovative service delivery models and system change and

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integration initiatives pursuant to subsection (g) of Section
20.
(19) Bed need methodology update. For the purposes of
determining areas with excess beds, the Departments shall
provide information and assistance to the Health Facilities and
Services Review Board Health Facilities Planning Board to
update the Bed Need Methodology for Long-Term Care to update
the assumptions used to establish the methodology to make them
consistent with modern older adult services.
(20) Affordable housing. The Departments shall utilize the
recommendations of Illinois' Annual Comprehensive Housing
Plan, as developed by the Affordable Housing Task Force through
the Governor's Executive Order 2003-18, in their efforts to
address the affordable housing needs of older adults.
The Older Adult Services Advisory Committee shall
investigate innovative and promising practices operating as
demonstration or pilot projects in Illinois and in other
states. The Department on Aging shall provide the Older Adult
Services Advisory Committee with a list of all demonstration or
pilot projects funded by the Department on Aging, including
those specified by rule, law, policy memorandum, or funding
arrangement. The Committee shall work with the Department on
Aging to evaluate the viability of expanding these programs
into other areas of the State.
(Source: P.A. 93-1031, eff. 8-27-04; 94-236, eff. 7-14-05;
94-766, eff. 1-1-07.)

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(320 ILCS 42/30)
Sec. 30. Nursing home conversion program.
(a) The Department of Public Health, in collaboration with
the Department on Aging and the Department of Healthcare and
Family Services, shall establish a nursing home conversion
program. Start-up grants, pursuant to subsections (l) and (m)
of this Section, shall be made available to nursing homes as
appropriations permit as an incentive to reduce certified beds,
retrofit, and retool operations to meet new service delivery
expectations and demands.
(b) Grant moneys shall be made available for capital and
other costs related to: (1) the conversion of all or a part of
a nursing home to an assisted living establishment or a special
program or unit for persons with Alzheimer's disease or related
disorders licensed under the Assisted Living and Shared Housing
Act or a supportive living facility established under Section
5-5.01a of the Illinois Public Aid Code; (2) the conversion of
multi-resident bedrooms in the facility into single-occupancy
rooms; and (3) the development of any of the services
identified in a priority service plan that can be provided by a
nursing home within the confines of a nursing home or
transportation services. Grantees shall be required to provide
a minimum of a 20% match toward the total cost of the project.
(c) Nothing in this Act shall prohibit the co-location of
services or the development of multifunctional centers under

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subsection (f) of Section 20, including a nursing home offering
community-based services or a community provider establishing
a residential facility.
(d) A certified nursing home with at least 50% of its
resident population having their care paid for by the Medicaid
program is eligible to apply for a grant under this Section.
(e) Any nursing home receiving a grant under this Section
shall reduce the number of certified nursing home beds by a
number equal to or greater than the number of beds being
converted for one or more of the permitted uses under item (1)
or (2) of subsection (b). The nursing home shall retain the
Certificate of Need for its nursing and sheltered care beds
that were converted for 15 years. If the beds are reinstated by
the provider or its successor in interest, the provider shall
pay to the fund from which the grant was awarded, on an
amortized basis, the amount of the grant. The Department shall
establish, by rule, the bed reduction methodology for nursing
homes that receive a grant pursuant to item (3) of subsection
(b).
(f) Any nursing home receiving a grant under this Section
shall agree that, for a minimum of 10 years after the date that
the grant is awarded, a minimum of 50% of the nursing home's
resident population shall have their care paid for by the
Medicaid program. If the nursing home provider or its successor
in interest ceases to comply with the requirement set forth in
this subsection, the provider shall pay to the fund from which

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the grant was awarded, on an amortized basis, the amount of the
grant.
(g) Before awarding grants, the Department of Public Health
shall seek recommendations from the Department on Aging and the
Department of Healthcare and Family Services. The Department of
Public Health shall attempt to balance the distribution of
grants among geographic regions, and among small and large
nursing homes. The Department of Public Health shall develop,
by rule, the criteria for the award of grants based upon the
following factors:
(1) the unique needs of older adults (including those
with moderate and low incomes), caregivers, and providers
in the geographic area of the State the grantee seeks to
serve;
(2) whether the grantee proposes to provide services in
a priority service area;
(3) the extent to which the conversion or transition
will result in the reduction of certified nursing home beds
in an area with excess beds;
(4) the compliance history of the nursing home; and
(5) any other relevant factors identified by the
Department, including standards of need.
(h) A conversion funded in whole or in part by a grant
under this Section must not:
(1) diminish or reduce the quality of services
available to nursing home residents;

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(2) force any nursing home resident to involuntarily
accept home-based or community-based services instead of
nursing home services;
(3) diminish or reduce the supply and distribution of
nursing home services in any community below the level of
need, as defined by the Department by rule; or
(4) cause undue hardship on any person who requires
nursing home care.
(i) The Department shall prescribe, by rule, the grant
application process. At a minimum, every application must
include:
(1) the type of grant sought;
(2) a description of the project;
(3) the objective of the project;
(4) the likelihood of the project meeting identified
needs;
(5) the plan for financing, administration, and
evaluation of the project;
(6) the timetable for implementation;
(7) the roles and capabilities of responsible
individuals and organizations;
(8) documentation of collaboration with other service
providers, local community government leaders, and other
stakeholders, other providers, and any other stakeholders
in the community;
(9) documentation of community support for the

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project, including support by other service providers,
local community government leaders, and other
stakeholders;
(10) the total budget for the project;
(11) the financial condition of the applicant; and
(12) any other application requirements that may be
established by the Department by rule.
(j) A conversion project funded in whole or in part by a
grant under this Section is exempt from the requirements of the
Illinois Health Facilities Planning Act. The Department of
Public Health, however, shall send to the Health Facilities and
Services Review Board Health Facilities Planning Board a copy
of each grant award made under this Section.
(k) Applications for grants are public information, except
that nursing home financial condition and any proprietary data
shall be classified as nonpublic data.
(l) The Department of Public Health may award grants from
the Long Term Care Civil Money Penalties Fund established under
Section 1919(h)(2)(A)(ii) of the Social Security Act and 42 CFR
488.422(g) if the award meets federal requirements.
(Source: P.A. 95-331, eff. 8-21-07.)
Section 99. Effective date. This Act takes effect upon
becoming law.
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INDEX
Statutes amended in order of appearance
5 ILCS 120/1.02 from Ch. 102, par. 41.02
5 ILCS 430/5-50
20 ILCS 5/5-565 was 20 ILCS 5/6.06
20 ILCS 2310/2310-217 new
20 ILCS 3960/2 from Ch. 111 1/2, par. 1152
20 ILCS 3960/3 from Ch. 111 1/2, par. 1153
20 ILCS 3960/4 from Ch. 111 1/2, par. 1154
20 ILCS 3960/4.2
20 ILCS 3960/5 from Ch. 111 1/2, par. 1155
20 ILCS 3960/5.4 new
20 ILCS 3960/6 from Ch. 111 1/2, par. 1156
20 ILCS 3960/8.5
20 ILCS 3960/12 from Ch. 111 1/2, par. 1162
20 ILCS 3960/12.2
20 ILCS 3960/12.3
20 ILCS 3960/15.1 from Ch. 111 1/2, par. 1165.1
20 ILCS 3960/19.5
20 ILCS 3960/19.6
20 ILCS 3960/19.7 new
20 ILCS 3960/8 rep.
20 ILCS 3960/9 rep.
20 ILCS 3960/15.5 rep.
20 ILCS 4050/15
HB3651 - 123 - LRB096 11637 RPM 22183 b
30 ILCS 5/3-1 from Ch. 15, par. 303-1
210 ILCS 3/20
210 ILCS 3/30
210 ILCS 3/36.5
210 ILCS 9/145
210 ILCS 50/32.5
225 ILCS 47/5
225 ILCS 47/15
225 ILCS 47/30
305 ILCS 5/5-5.02 from Ch. 23, par. 5-5.02
320 ILCS 42/20
320 ILCS 42/25
320 ILCS 42/30