Bill Text: IL HB5537 | 2023-2024 | 103rd General Assembly | Engrossed

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Bill Title: Amends the Illinois Health Facilities Planning Act. Removes an exception for skilled and intermediate long-term care facilities licensed under the Nursing Home Care Act from providing a Safety Net Impact Statement as part of its general review criteria. Includes nursing homes operated by a county in a list of safety net service providers. Provides that facilities operated by a county shall provide in the facility's Safety Net Impact Statement the number of the facility's Medicaid and Medicare certified beds for the 3 fiscal years prior to the application. Requires the State Board Staff Report to include a statement of findings regarding the project's safety net impact under specified circumstances, and that the State Board Staff's assessment shall be considered in determining whether the project fulfills the public interest requirements. Amends the County Homes Division of the Counties Code. Removes a requirement that two-thirds of the county board is required sell, dispose of, or lease for any term, any part of the home properties, and requires a referendum before selling any home (rather than requiring a referendum only for homes that were erected after referendum approval by the voters of the county). Adds referendum language for the selling, disposition of, or lease of a home.

Spectrum: Partisan Bill (Democrat 14-0)

Status: (Engrossed) 2024-05-17 - Rule 3-9(a) / Re-referred to Assignments [HB5537 Detail]

Download: Illinois-2023-HB5537-Engrossed.html

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HB5537 Engrossed LRB103 37655 AWJ 67782 b
AN ACT concerning health.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Health Facilities Planning Act is
amended by changing Section 5.4 as follows:
(20 ILCS 3960/5.4)
(Section scheduled to be repealed on December 31, 2029)
Sec. 5.4. Safety Net Impact Statement.
(a) General review criteria shall include a requirement
that all health care facilities, including nursing homes
operated by a county, but otherwise 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. A Safety Net Impact
Statement shall also be filed with an application to change
ownership of a nursing home operated by a county.
(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

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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, and nursing homes operated by a county.
(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, including
the impact on racial and health care disparities 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.
(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

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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 State Board
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. Nursing
homes operated by a county shall also provide the number
of the facility's Medicaid and Medicare certified beds for
the 3 fiscal years prior to the application.
(3) Any information the applicant believes is directly
relevant to safety net services, including information
regarding teaching, research, and any other service.
(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 Board shall post
the notice in 5 conspicuous places within the proposed area.
(f) Any person, community organization, provider, or

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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 Board Staff 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.
The State Board Staff Report shall also include a
statement of findings about an application's safety net impact
when the application:
(1) proposes a substantive project at a nursing home
operated by a county;
(2) includes a change of ownership of a nursing home
currently operated by a county; or
(3) proposes to discontinue services at a nursing home
operated by a county.
The findings shall be considered when determining whether

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an application fulfills the public interest requirements of
this Act.
(Source: P.A. 102-4, eff. 4-27-21.)
Section 10. The Counties Code is amended by changing
Section 5-21001 as follows:
(55 ILCS 5/5-21001) (from Ch. 34, par. 5-21001)
Sec. 5-21001. Establishment and maintenance of county
home. In any county which establishes and maintains a county
sheltered care home or a county nursing home for the care of
infirm or chronically ill persons, as provided in Section
5-1005, the County Board shall have power:
1. To acquire in the name of the county by purchase, grant,
gift, or legacy, a suitable tract or tracts of land upon which
to erect and maintain the home, and in connection therewith a
farm or acreage for the purpose of providing supplies for the
home and employment for such patients as are able to work and
benefit thereby.
The board shall expend not more than $20,000 for the
purchase of any such land or the erection of buildings without
a 2/3 vote of all its members in counties of 300,000 or more
population, or a favorable vote of at least a majority of all
its members in counties under 300,000 population.
2. To receive in the name of the county, gifts and legacies
to aid in the erection or maintenance of the home.

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3. To appoint a superintendent and all necessary employees
for the management and control of the home and to prescribe
their compensation and duties.
4. To arrange for physicians' or other health care
professionals' services and other medical care for the
patients in the home and prescribe the compensation and duties
of physicians so designated.
5. To control the admission and discharge of patients in
the home.
6. To fix the rate per day, week, or month which it will
charge for care and maintenance of the patients. Rates so
established may vary according to the amount of care required,
but the rates shall be uniform for all persons or agencies
purchasing care in the home except rates for persons who are
able to purchase their own care may approximate actual cost.
7. To make all rules and regulations for the management of
the home and of the patients therein.
8. To make appropriations from the county treasury for the
purchase of land and the erection of buildings for the home,
and to defray the expenses necessary for the care and
maintenance of the home and for providing maintenance,
personal care and nursing services to the patients therein,
and to cause an amount sufficient for those purposes to be
levied upon the taxable property of the counties and collected
as other taxes and further providing that in counties with a
population of not more than 1,000,000 to levy and collect

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annually a tax of not to exceed .1% of the value, as equalized
or assessed by the Department of Revenue, of all the taxable
property in the county for these purposes. The tax shall be in
addition to all other taxes which the county is authorized to
levy on the aggregate valuation of the property within the
county and shall not be included in any limitation of the tax
rate upon which taxes are required to be extended, but shall be
excluded therefrom and in addition thereto. The tax shall be
levied and collected in like manner as the general taxes of the
county, and when collected, shall be paid into a special fund
in the county treasury and used only as herein authorized. No
such tax shall be levied or increased from a rate lower than
the maximum rate in any such county until the question of
levying such tax has first been submitted to the voters of such
county at an election held in such county, and has been
approved by a majority of such voters voting thereon. The
corporate authorities shall certify the question of levying
such tax to the proper election officials, who shall submit
the question to the voters at an election held in accordance
with the general election law.
The proposition shall be in substantially the following
form:
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Shall ........ County be authorized
to levy and collect a tax at a rate not YES
to exceed .1% for the purpose of -------------------

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........ (purchasing, maintaining) a NO
county nursing home?
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If a majority of votes cast on the question are in favor,
the county shall be authorized to levy the tax.
If the county has levied such tax at a rate lower than the
maximum rate set forth in this Section, the county board may
increase the rate of the tax, but not to exceed such maximum
rate, by certifying the proposition of such increase to the
proper election officials for submission to the voters of the
county at a regular election in accordance with the general
election law. The proposition shall be in substantially the
following form:
----------------------------------------------
Shall the maximum rate
of the tax levied by........ YES
County for the purpose of.......
(purchasing, maintaining) a ----------------------------
county nursing home be
increased from........ to NO
........ (not to exceed .1%)
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If a majority of all the votes cast upon the proposition
are in favor thereof, the county board may levy the tax at a
rate not to exceed the rate set forth in this Section.
9. To Upon the vote of a 2/3 majority of all the members of

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the board, to sell, dispose of or lease for any term, any part
of the home properties in such manner and upon such terms as it
deems best for the interest of the county, and to make and
execute all necessary conveyances thereof in the same manner
as other conveyances of real estate may be made by a county.
However, if the home was erected after referendum approval by
the voters of the county, it shall not be sold or disposed of
except after referendum approval thereof by a majority of the
voters of the county voting thereon.
A referendum to sell the home shall be in substantially
the following form:
-------------------------------------------------------------
Shall........County sell (county
home) to (entity name), an (entity
type) located at (principal address),
which was incorporated on (incorporation date),
and whose managers and members are ....
.... for (sale price)?
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Votes shall be recorded as "Yes" or "No".
A referendum to close the home shall be in substantially
the following form:
-------------------------------------------------------------
Shall........County close
(county home), the county nursing home
located at (address)?

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Votes shall be recorded as "Yes" or "No".
The proposition to lease the home shall be in
substantially the following form:
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Shall........County lease (county
home) to (entity name), an (entity
type) located at (principal address),
which was incorporated on (incorporation date),
and whose managers and members are ...
.... for (lease amount) for a term of
not more than (years)?