HEALTH CARE FACILITY PLANNING

Illinois General Assembly - Full Text of HB4757

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HB4757 - 104th General Assembly

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HB4757 Enrolled
LRB104 20222 SPS 33673 b
1

AN ACT concerning State government.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

Section 5.
The Illinois Health Facilities Planning Act is
5
amended by changing Sections 2, 3, 4, 4.2, 5, 6, 6.2, 8.5, 8.7,
6
10, 11, 12, 12.2, and 13 as follows:

7

(20 ILCS 3960/2)

(from Ch. 111 1/2, par. 1152)
8

(Section scheduled to be repealed on December 31, 2029)
9

Sec. 2.
Purpose of the Act.
This Act shall establish a
10
procedure (1) which requires a person establishing,
11
constructing or modifying a health care facility, as herein
12
defined, to have the qualifications, background, character and
13
financial resources to adequately provide a proper service for
14
the community; (2) that promotes the orderly and economic
15
development of health care facilities in the State of Illinois
16
that avoids unnecessary duplication of such facilities; and
17
(3) that promotes planning for and development of health care
18
facilities needed for comprehensive health care especially in
19
areas where the health planning process has identified unmet
20
needs.
21

The changes made to this Act by this amendatory Act of the
22
96th General Assembly are intended to accomplish the following
23
objectives: to improve the financial ability of the public to

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1
obtain necessary health services; to establish an orderly and
2
comprehensive health care delivery system that will guarantee
3
the availability of quality health care to the general public;
4
to maintain and improve the provision of essential health care
5
services and increase the accessibility of those services to
6
the medically underserved and indigent; to assure that the
7
reduction and closure of health care services or facilities is
8
performed in an orderly and timely manner, and that these
9
actions are deemed to be in the best interests of the public;
10
and to assess the financial burden to patients caused by
11
unnecessary health care construction and modification.
12
Evidence-based assessments, projections and decisions will be
13
applied regarding capacity, quality, value and equity in the
14
delivery of health care services in Illinois. The integrity of
15
the Certificate of Need
Permit and Certificate of Exemption
16
processes are

process is
ensured through
ethical practices and
17
effective communication

revised ethics and communications

18
procedures. Cost containment and support for safety net
19
services must continue to be central tenets of the Certificate
20
of Need
Permit and Certificate of Exemption processes

process
.
21
(Source: P.A. 99-527, eff. 1-1-17
.)

22

(20 ILCS 3960/3)

(from Ch. 111 1/2, par. 1153)
23

(Section scheduled to be repealed on December 31, 2029)
24

Sec. 3.
Definitions.
As used in this Act:
25

"Certificate of need" or "permit" means the authorization

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1
for a health care facility to conduct activities or
2
transactions that require Board approval under this Act,
3
including constructing or modifying the health care facility
4
and acquiring major medical equipment.
5

"Certificate of exemption" or "exemption" means the
6
authorization for a health care facility to conduct activities
7
or transactions that are exempt from the permitting
8
requirements under this Act, including changes of ownership,
9
discontinuation of a single category of service, and the
10
establishment or expansion of a neonatal intensive care
11
service or the addition of beds.

12

"Health care facilities" means and includes the following
13
facilities, organizations, and related persons:
14

(1) An ambulatory surgical treatment center required
15

to be licensed pursuant to the Ambulatory Surgical
16

Treatment Center Act.
17

(2) An institution, place, building, or agency
18

required to be licensed pursuant to the Hospital Licensing
19

Act.
20

(3) Skilled and intermediate long term care facilities
21

licensed under the Nursing Home Care Act.
22

(A) If a demonstration project under the Nursing
23

Home Care Act applies for a certificate of need to
24

convert to a nursing facility, it shall meet the
25

licensure and certificate of need requirements in
26

effect as of the date of application.

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1

(B) Except as provided in item (A) of this
2

subsection, this Act does not apply to facilities
3

granted waivers under Section 3-102.2 of the Nursing
4

Home Care Act.
5

(3.5) Skilled and intermediate care facilities
6

licensed under the ID/DD Community Care Act or the MC/DD
7

Act. No permit or exemption is required for a facility
8

licensed under the ID/DD Community Care Act or the MC/DD
9

Act prior to the reduction of the number of beds at a
10

facility. If there is a total reduction of beds at a
11

facility licensed under the ID/DD Community Care Act or
12

the MC/DD Act, this is a discontinuation or closure of the
13

facility. If a facility licensed under the ID/DD Community
14

Care Act or the MC/DD Act reduces the number of beds or
15

discontinues the facility, that facility must notify the
16

Board as provided in Section 14.1 of this Act.
17

(3.7) Facilities licensed under the Specialized Mental
18

Health Rehabilitation Act of 2013.
19

(4) Hospitals, nursing homes, ambulatory surgical
20

treatment centers, or kidney disease treatment centers
21

maintained by the State or any department or agency
22

thereof.
23

(5) Kidney disease treatment centers, including a
24

free-standing hemodialysis unit required to meet the
25

requirements of 42 CFR 494 in order to be certified for
26

participation in Medicare and Medicaid under Titles XVIII

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1

and XIX of the federal Social Security Act.
2

(A) This Act does not apply to a dialysis facility
3

that provides only dialysis training, support, and
4

related services to individuals with end stage renal
5

disease who have elected to receive home dialysis.
6

(B) This Act does not apply to a dialysis unit
7

located in a licensed nursing home that offers or
8

provides dialysis-related services to residents with
9

end stage renal disease who have elected to receive
10

home dialysis within the nursing home.
11

(C) The Board, however, may require dialysis
12

facilities and licensed nursing homes under items (A)
13

and (B) of this subsection to report statistical
14

information on a quarterly basis to the Board to be
15

used by the Board to conduct analyses on the need for
16

proposed kidney disease treatment centers.
17

(6) An institution, place, building, or room used for
18

the performance of outpatient surgical procedures that is
19

leased, owned, or operated by or on behalf of an
20

out-of-state facility.
21

(7) An institution, place, building, or room used for
22

provision of a health care category of service, including,
23

but not limited to, cardiac catheterization and open heart
24

surgery.
25

(8) An institution, place, building, or room housing
26

major medical equipment used in the direct clinical

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1

diagnosis or treatment of patients, and whose project cost
2

is in excess of the capital expenditure minimum.
3

"Health care facilities" does not include the following
4
entities or facility transactions:
5

(1) Federally-owned facilities.
6

(2) Facilities used solely for healing by prayer or
7

spiritual means.
8

(3) An existing facility located on any campus
9

facility as defined in Section 5-5.8b of the Illinois
10

Public Aid Code, provided that the campus facility
11

encompasses 30 or more contiguous acres and that the new
12

or renovated facility is intended for use by a licensed
13

residential facility.
14

(4) Facilities licensed under the Supportive
15

Residences Licensing Act or the Assisted Living and Shared
16

Housing Act.
17

(5) Facilities designated as supportive living
18

facilities that are in good standing with the program
19

established under Section 5-5.01a of the Illinois Public
20

Aid Code.
21

(6) Facilities established and operating under the
22

Alternative Health Care Delivery Act as a children's
23

community-based health care center alternative health care
24

model demonstration program or as an Alzheimer's Disease
25

Management Center alternative health care model
26

demonstration program.

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1

(7) The closure of an entity or a portion of an entity
2

licensed under the Nursing Home Care Act, the Specialized
3

Mental Health Rehabilitation Act of 2013, the ID/DD
4

Community Care Act, or the MC/DD Act, with the exception
5

of facilities operated by a county or Illinois Veterans
6

Homes, that elect to convert, in whole or in part, to an
7

assisted living or shared housing establishment licensed
8

under the Assisted Living and Shared Housing Act and with
9

the exception of a facility licensed under the Specialized
10

Mental Health Rehabilitation Act of 2013 in connection
11

with a proposal to close a facility and re-establish the
12

facility in another location.
13

(8) Any change of ownership of a health care facility
14

that is licensed under the Nursing Home Care Act, the
15

Specialized Mental Health Rehabilitation Act of 2013, the
16

ID/DD Community Care Act, or the MC/DD Act, with the
17

exception of facilities operated by a county or Illinois
18

Veterans Homes. Changes of ownership of facilities
19

licensed under the Nursing Home Care Act must meet the
20

requirements set forth in Sections 3-101 through 3-119 of
21

the Nursing Home Care Act.
22

(9) (Blank).
23

With the exception of those health care facilities
24
specifically included in this Section, nothing in this Act
25
shall be intended to include facilities operated as a part of
26
the practice of a physician or other licensed health care

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1
professional, whether practicing in his individual capacity or
2
within the legal structure of any partnership, medical or
3
professional corporation, or unincorporated medical or
4
professional group. Further, this Act shall not apply to
5
physicians or other licensed health care professional's
6
practices where such practices are carried out in a portion of
7
a health care facility under contract with such health care
8
facility by a physician or by other licensed health care
9
professionals, whether practicing in his individual capacity
10
or within the legal structure of any partnership, medical or
11
professional corporation, or unincorporated medical or
12
professional groups, unless the entity constructs, modifies,
13
or establishes a health care facility as specifically defined
14
in this Section. This Act shall apply to construction or
15
modification and to establishment by such health care facility
16
of such contracted portion which is subject to facility
17
licensing requirements, irrespective of the party responsible
18
for such action or attendant financial obligation.
19

"Person" means any one or more natural persons, legal
20
entities, governmental bodies other than federal, or any
21
combination thereof.
22

"Consumer" means any person other than a person (a) whose
23
major occupation currently involves or whose official capacity
24
within the last 12 months has involved the providing,
25
administering or financing of any type of health care
26
facility, (b) who is engaged in health research or the

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1
teaching of health, (c) who has a material financial interest
2
in any activity which involves the providing, administering or
3
financing of any type of health care facility, or (d) who is or
4
ever has been a member of the immediate family of the person
5
defined by item (a), (b), or (c).
6

"State Board" or "Board" means the Health Facilities and
7
Services Review Board.
8

"Construction or modification" means the establishment,
9
erection, building, alteration, reconstruction,
10
modernization, improvement, extension,
discontinuation,
11
change of ownership,
of or by a health care facility, or the
12
purchase or acquisition by or through a health care facility
13
of equipment or service for diagnostic or therapeutic purposes
14
or for facility administration or operation, or any capital
15
expenditure made by or on behalf of a health care facility
16
which exceeds the capital expenditure minimum; however, any
17
capital expenditure made by or on behalf of a health care
18
facility for (i) the construction or modification of a
19
facility licensed under the Assisted Living and Shared Housing
20
Act or (ii) a conversion project undertaken in accordance with
21
Section 30 of the Older Adult Services Act shall be excluded
22
from any obligations under this Act.
23

"Discontinuation" means to, on a voluntary or involuntary
24
basis, cease the operation of a health care facility or
25
discontinue a category of service.

26

"Establish" means the construction of a health care

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1
facility or the replacement of an existing
health care

2
facility on another site or the initiation of a category of
3
service.
4

"Major medical equipment" means medical equipment which is
5
used for the provision of medical and other health services
6
and which costs in excess of the capital expenditure minimum,
7
except that such term does not include medical equipment
8
acquired by or on behalf of a clinical laboratory to provide
9
clinical laboratory services if the clinical laboratory is
10
independent of a physician's office and a hospital and it has
11
been determined under Title XVIII of the Social Security Act
12
to meet the requirements of paragraphs (10) and (11) of
13
Section 1861(s) of such Act. In determining whether medical
14
equipment has a value in excess of the capital expenditure
15
minimum, the value of studies, surveys, designs, plans,
16
working drawings, specifications, and other activities
17
essential to the acquisition of such equipment shall be
18
included.
19

"Capital expenditure" means an expenditure: (A) made by or
20
on behalf of a health care facility (as such a facility is
21
defined in this Act); and (B) which under generally accepted
22
accounting principles is not properly chargeable as an expense
23
of operation and maintenance, or is made to obtain by lease or
24
comparable arrangement any facility or part thereof or any
25
equipment for a facility or part; and which exceeds the
26
capital expenditure minimum.

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1

For the purpose of this paragraph, the cost of any
2
studies, surveys, designs, plans, working drawings,
3
specifications, and other activities essential to the
4
acquisition, improvement, expansion, or replacement of any
5
plant or equipment with respect to which an expenditure is
6
made shall be included in determining if such expenditure
7
exceeds the capital expenditures minimum. Unless otherwise
8
interdependent, or submitted as one project by the applicant,
9
components of construction or modification undertaken by means
10
of a single construction contract or financed through the
11
issuance of a single debt instrument shall not be grouped
12
together as one project. Donations of equipment or facilities
13
to a health care facility which if acquired directly by such
14
facility would be subject to review under this Act shall be
15
considered capital expenditures, and a transfer of equipment
16
or facilities for less than fair market value shall be
17
considered a capital expenditure for purposes of this Act if a
18
transfer of the equipment or facilities at fair market value
19
would be subject to review.
20

"Capital expenditure minimum" means $11,500,000 for
21
projects by hospital applicants, $6,500,000 for applicants for
22
projects related to skilled and intermediate care long-term
23
care facilities licensed under the Nursing Home Care Act, and
24
$3,000,000 for projects by all other applicants, which shall
25
be annually adjusted to reflect the increase in construction
26
costs due to inflation, for major medical equipment and for

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1
all other capital expenditures.
2

"Financial commitment" means the commitment of at least
3
33% of total funds assigned to cover total project cost, which
4
occurs by the actual expenditure of 33% or more of the total
5
project cost or the commitment to expend 33% or more of the
6
total project cost by signed contracts or other legal means.
7

"Non-clinical service area" means an area (i) for the
8
benefit of the patients, visitors, staff, or employees of a
9
health care facility and (ii) not directly related to the
10
diagnosis, treatment, or rehabilitation of persons receiving
11
services from the health care facility. "Non-clinical service
12
areas" include, but are not limited to, chapels; gift shops;
13
news stands; computer systems; tunnels, walkways, and
14
elevators; telephone systems; projects to comply with life
15
safety codes; educational facilities; components in a patient
16
care unit used as educational space, consultation and
17
touchdown rooms, and on-call rooms; student housing; patient,
18
employee, staff, and visitor dining areas; administration and
19
volunteer offices; modernization of structural components
20
(such as roof replacement and masonry work); boiler repair or
21
replacement; vehicle maintenance and storage facilities;
22
parking facilities; mechanical systems for heating,
23
ventilation, and air conditioning; loading docks; and repair
24
or replacement of carpeting, tile, wall coverings, window
25
coverings or treatments, or furniture. "Non-clinical service
26
area" does not include health and fitness centers, areas in a

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1
patient care unit, or areas that are required by Department
2
licensing standards, including life safety code regulations,
3
such as hallways and other interdependent components to a
4
clinical area.
5

"Areawide" means a major area of the State delineated on a
6
geographic, demographic, and functional basis for health
7
planning and for health service and having within it one or
8
more local areas for health planning and health service. The
9
term "region", as contrasted with the term "subregion", and
10
the word "area" may be used synonymously with the term
11
"areawide".
12

"Local" means a subarea of a delineated major area that on
13
a geographic, demographic, and functional basis may be
14
considered to be part of such major area. The term "subregion"
15
may be used synonymously with the term "local".
16

"Physician" means a person licensed to practice in
17
accordance with the Medical Practice Act of 1987, as amended.
18

"Licensed health care professional" means a person
19
licensed to practice a health profession under pertinent
20
licensing statutes of the State of Illinois.
21

"Director" means the Director of the Illinois Department
22
of Public Health.
23

"Agency" or "Department" means the Illinois Department of
24
Public Health.
25

"Alternative health care model" means a facility or
26
program authorized under the Alternative Health Care Delivery

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1
Act.
2

"Out-of-state facility" means a person that is both (i)
3
licensed as a hospital or as an ambulatory surgery center
4
under the laws of another state or that qualifies as a hospital
5
or an ambulatory surgery center under regulations adopted
6
pursuant to the Social Security Act and (ii) not licensed
7
under the Ambulatory Surgical Treatment Center Act, the
8
Hospital Licensing Act, or the Nursing Home Care Act.
9
Affiliates of out-of-state facilities shall be considered
10
out-of-state facilities. Affiliates of Illinois licensed
11
health care facilities 100% owned by an Illinois licensed
12
health care facility, its parent, or Illinois physicians
13
licensed to practice medicine in all its branches shall not be
14
considered out-of-state facilities. Nothing in this definition
15
shall be construed to include an office or any part of an
16
office of a physician licensed to practice medicine in all its
17
branches in Illinois that is not required to be licensed under
18
the Ambulatory Surgical Treatment Center Act.
19

"Change of ownership of a health care facility" means a
20
change in the person who has ownership or control of a health
21
care facility's physical plant and capital assets. A change in
22
ownership is indicated by the following transactions: sale,
23
transfer, acquisition, lease, change of sponsorship, or other
24
means of transferring control.
25

"Related person" means any person that: (i) is at least
26
50% owned, directly or indirectly, by either the health care

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1
facility or a person owning, directly or indirectly, at least
2
50% of the health care facility; or (ii) owns, directly or
3
indirectly, at least 50% of the health care facility.
4

"Charity care" means care provided by a health care
5
facility for which the provider does not expect to receive
6
payment from the patient or a third-party payer.
7

"Freestanding emergency center" means a facility subject
8
to licensure under Section 32.5 of the Emergency Medical
9
Services (EMS) Systems Act.
10

"Category of service" means a grouping by generic class of
11
various types or levels of support functions, equipment, care,
12
or treatment provided to patients or residents, including, but
13
not limited to, classes such as medical-surgical, pediatrics,
14
or cardiac catheterization. A category of service may include
15
subcategories or levels of care that identify a particular
16
degree or type of care within the category of service. Nothing
17
in this definition shall be construed to include the practice
18
of a physician or other licensed health care professional
19
while functioning in an office providing for the care,
20
diagnosis, or treatment of patients. A category of service
21
that is subject to the Board's jurisdiction must be designated
22
in rules adopted by the Board.
23

"State Board Staff Report" means the document that sets
24
forth the review and findings of the State Board staff, as
25
prescribed by the State Board, regarding applications subject
26
to Board jurisdiction.

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1

"Patient care unit" means a physically identifiable and
2
organized unit in a clearly defined administrative and
3
geographic area that meets applicable standards of service in
4
which nursing care and therapeutic services are provided on a
5
continuous basis and to which specific nursing and support
6
staff are assigned. "Patient care unit" does not include
7
education spaces, consultation and touchdown rooms, and
8
on-call rooms that are not required by Department licensing
9
standards.
10

"Provider" includes, but is not limited to, a hospital,
11
long-term care facility, end-stage renal dialysis facility,
12
ambulatory surgical treatment center, freestanding emergency
13
center, or birth center.
14
(Source: P.A. 104-365, eff. 1-1-26
.)

15

(20 ILCS 3960/4)

(from Ch. 111 1/2, par. 1154)
16

(Section scheduled to be repealed on December 31, 2029)
17

Sec. 4.
Health Facilities and Services Review Board;
18
membership; appointment; term; compensation; quorum.

19

(a) There is created the Health Facilities and Services
20
Review Board, which shall perform the functions described in
21
this Act. The Department shall provide operational support to
22
the Board as necessary, including the provision of office
23
space, supplies, and clerical, financial, and accounting
24
services. The Board may contract for functions or operational
25
support as needed. The Board may also contract with experts

HB4757 Enrolled
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LRB104 20222 SPS 33673 b
1
related to specific health services or facilities and create
2
technical advisory panels to assist in the development of
3
criteria, standards, and procedures used in the evaluation of
4
applications for permit and exemption.
5

(b) The State Board shall consist of 11 voting members.
6
All members shall be residents of Illinois and at least 4 shall
7
reside outside the Chicago Metropolitan Statistical Area
8
Census Data
. Consideration shall be given to potential
9
appointees who reflect the ethnic and cultural diversity of
10
the State. Neither Board members nor Board staff shall be
11
convicted felons or have pled guilty to a felony.
12

Each member shall have a reasonable knowledge of the
13
practice, procedures and principles of the health care
14
delivery system in Illinois, including at least 5 members who
15
shall be knowledgeable about health care delivery systems,
16
health systems planning, finance, or the management of health
17
care facilities currently regulated under the Act. One member
18
shall be a representative of a non-profit health care consumer
19
advocacy organization. One member shall be a representative
20
from the community with experience on the effects of
21
discontinuing health care services or the closure of health
22
care facilities on the surrounding community; provided,
23
however, that all other members of the Board shall be
24
appointed before this member shall be appointed. A spouse,
25
parent, sibling, or child of a Board member cannot be an
26
employee, agent, or under contract with services or facilities

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1
subject to the Act. Prior to appointment and in the course of
2
service on the Board, members of the Board shall disclose the
3
employment or other financial interest of any other relative
4
of the member, if known, in service or facilities subject to
5
the Act. Members of the Board shall declare any conflict of
6
interest that may exist with respect to the status of those
7
relatives and recuse themselves from voting on any issue for
8
which a conflict of interest is declared. No person shall be
9
appointed or continue to serve as a member of the State Board
10
who is, or whose spouse, parent, sibling, or child is, a member
11
of the Board of Directors of, has a financial interest in, or
12
has a business relationship with a health care facility.
13

Notwithstanding any provision of this Section to the
14
contrary, the term of office of each member of the State Board
15
serving on the day before the effective date of this
16
amendatory Act of the 96th General Assembly is abolished on
17
the date upon which members of the Board, as established by
18
this amendatory Act of the 96th General Assembly, have been
19
appointed and can begin to take action as a Board.
20

(c) The State Board shall be appointed by the Governor,
21
with the advice and consent of the Senate. Not more than 6 of
22
the appointments shall be of the same political party at the
23
time of the appointment.
24

The Secretary of Human Services, the Director of
25
Healthcare and Family Services, and the Director of Public
26
Health, or their designated representatives, shall serve as

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1
ex-officio, non-voting members of the State Board.
2

(d) Of those members initially appointed by the Governor
3
following the effective date of this amendatory Act of the
4
96th General Assembly, 3 shall serve for terms expiring July
5
1, 2011, 3 shall serve for terms expiring July 1, 2012, and 3
6
shall serve for terms expiring July 1, 2013. Thereafter, each
7
appointed member shall hold office for a term of 3 years,
8
provided that any member appointed to fill a vacancy occurring
9
prior to the expiration of the term for which his or her
10
predecessor was appointed shall be appointed for the remainder
11
of such term and the term of office of each successor shall
12
commence on July 1 of the year in which his predecessor's term
13
expires. Each member shall hold office until his or her
14
successor is appointed and qualified. The Governor may
15
reappoint a member for additional terms, but no member shall
16
serve more than 3 terms, subject to review and re-approval
17
every 3 years.
18

(e) State Board members, while serving on business of the
19
State Board, shall receive actual and necessary travel and
20
subsistence expenses while so serving away from their places
21
of residence. Until March 1, 2010, a member of the State Board
22
who experiences a significant financial hardship due to the
23
loss of income on days of attendance at meetings or while
24
otherwise engaged in the business of the State Board may be
25
paid a hardship allowance, as determined by and subject to the
26
approval of the Governor's Travel Control Board.

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1

(f) The Governor shall designate one of the members to
2
serve as the Chairman of the Board, who shall be a person with
3
expertise in health care delivery system planning, finance or
4
management of health care facilities that are regulated under
5
the Act. The Chairman shall annually review Board member
6
performance and shall report the attendance record of each
7
Board member to the General Assembly.
8

(g) The State Board, through the Chairman, shall prepare a
9
separate and distinct budget approved by the General Assembly
10
and shall hire and supervise its own professional staff
11
responsible for carrying out the responsibilities of the
12
Board.
13

(h) The State Board shall meet at least every 45 days, or
14
as often as the Chairman of the State Board deems necessary, or
15
upon the request of a majority of the members.
16

(i) Six members of the State Board shall constitute a
17
quorum. The affirmative vote of 6 of the members of the State
18
Board shall be necessary for any action requiring a vote to be
19
taken by the State Board. A vacancy in the membership of the
20
State Board shall not impair the right of a quorum to exercise
21
all the rights and perform all the duties of the State Board as
22
provided by this Act.
23

(j) A State Board member shall disqualify himself or
24
herself from the consideration of any application for a permit
25
or exemption in which the State Board member or the State Board
26
member's spouse, parent, sibling, or child: (i) has an

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1
economic interest in the matter; or (ii) is employed by,
2
serves as a consultant for, or is a member of the governing
3
board of the applicant or a party opposing the application.
4

(k) The Chairman, Board members, and Board staff must
5
comply with the Illinois Governmental Ethics Act.
6
(Source: P.A. 102-4, eff. 4-27-21.)

7

(20 ILCS 3960/4.2)
8

(Section scheduled to be repealed on December 31, 2029)
9

Sec. 4.2.
Ex parte communications.
10

(a) Except in the disposition of matters that agencies are
11
authorized by law to entertain or dispose of on an ex parte
12
basis including, but not limited to rulemaking, the State
13
Board, any State Board member, employee, or a hearing officer
14
shall not engage in ex parte communication in connection with
15
the substance of any formally filed application for a permit
16
with any person or party or the representative of any party.
17
This subsection (a) applies when the Board, member, employee,
18
or
administrative law judge

hearing officer
knows, or should
19
know upon reasonable inquiry, that the application or
20
exemption has been formally filed with the
State
Board.
21
Nothing in this Section shall prohibit
State Board employees

22
staff members
from providing technical assistance to
23
applicants. Nothing in this Section shall prohibit
State Board
24
employees

staff
from verifying or clarifying an applicant's
25
information as it prepares the State Board Staff Report. Once

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1
an application for permit or exemption is filed and deemed
2
complete, a written record of any communication between
State
3
Board employees

staff
and an applicant shall be prepared by
4
staff and made part of the public record, using a prescribed,
5
standardized format, and shall be included in the application
6
file.
7

(b) A State Board member or employee may communicate with
8
other members or employees and any State Board member or
9
hearing officer may have the aid and advice of one or more
10
personal assistants.
11

(c) An ex parte communication received by the State Board,
12
any State Board member, employee, or
an administrative law
13
judge

a hearing officer
shall be made a part of the record of
14
the matter, including all written communications, all written
15
responses to the communications, and a memorandum stating the
16
substance of all oral communications and all responses made
17
and the identity of each person from whom the ex parte
18
communication was received.
19

(d) "Ex parte communication" means
any written or oral

a

20
communication
between a person who is not a State Board member
21
or employee and a State Board member or employee
that
imparts
22
or requests material information or makes a material argument
23
regarding potential action

reflects
on the substance of a
24
pending or impending
permit or exemption application or
State
25
Board proceeding and that takes place outside the
open
record
26
of the proceeding.
"Ex parte communication" does not include:

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(i) statements by a person publicly made in a public forum;
2
(ii) statements regarding matters of procedure and practice,
3
such as the format of application materials, the number of
4
copies required, the manner of filing, and the status of a
5
matter; and (iii) statements made between a State Board member
6
or employee and another State Board member or employee.

7
Communications regarding matters of procedure and practice,
8
such as the format of pleading, number of copies required,
9
manner of service, and status of proceedings, are not
10
considered ex parte communications.
Technical assistance with
11
respect to an application, not intended to influence any
12
decision on the application, may be provided by employees to
13
the applicant. Any
technical
assistance shall be documented in
14
writing by the applicant and employees within 10 business days
15
after the
technical
assistance is provided
and made part of
16
the open record
.
17

(e) For purposes of this Section, "employee" means a
18
person the State Board or the Agency employs on a full-time,
19
part-time, contract, or intern basis.
20

(f) The State Board, State Board member, or
administrative
21
law judge

hearing examiner
presiding over the proceeding, in
22
the event of a violation of this Section, must take whatever
23
action is necessary to ensure that the violation does not
24
prejudice any party or adversely affect the fairness of the
25
proceedings.
26

(g) Nothing in this Section shall be construed to prevent

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1
the State Board or any member of the State Board from
2
consulting with the attorney for the State Board.
3
(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18;
4
101-81, eff. 7-12-19.)

5

(20 ILCS 3960/5)

(from Ch. 111 1/2, par. 1155)
6

(Section scheduled to be repealed on December 31, 2029)
7

Sec. 5.
Construction, modification, or establishment of
8
health care facilities or acquisition of major medical
9
equipment; permits or exemptions.

No person shall
10
construct, modify or establish a health care facility or
11
acquire major medical equipment without first obtaining a
12
permit or exemption from the State Board.
13

The State Board shall not delegate to the staff of the
14
State Board or any other person or entity the authority to
15
grant permits or exemptions whenever the staff or other person
16
or entity would be required to exercise any discretion
17
affecting the decision to grant a permit or exemption.
18

The State Board may, by rule, delegate authority to the
19
Chairman to grant permits or exemptions when applications meet
20
all of the State Board's review criteria and are unopposed.
21

A permit or exemption shall be obtained prior to the
22
acquisition of major medical equipment or to the construction
23
or modification of a health care facility which:
24

(a) requires a total capital expenditure in excess of
25

the capital expenditure minimum; or

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1

(b) substantially changes the scope or changes the
2

functional operation of the facility; or
3

(c) changes the bed capacity of a health care facility
4

by increasing the total number of beds or by distributing
5

beds among various categories of service or by relocating
6

beds from one physical facility or site to another by more
7

than 20 beds or more than 10% of total bed capacity as
8

defined by the State Board, whichever is less, over a
9

2-year period.
10

A permit shall be valid only for the defined construction
11
or modifications, site
determined by legal street address or
12
corresponding legal description
,
project
amount
,
and person
or
13
persons
named in the application for such permit.
The State
14
Board may approve the transfer of an existing permit without
15
regard to whether the permit to be transferred has yet been
16
financially committed, except for permits to establish a new
17
facility or category of service.
A permit shall be valid until
18
such time as the project has been completed, provided that the
19
project commences and proceeds to completion with due
20
diligence by the completion date or extension date approved by
21
the Board.
22

A permit holder must do the following: (i) submit the
23
final completion and cost report for the project within 90
24
days after the approved project completion date or extension
25
date and (ii) submit annual progress reports no earlier than
26
30 days before and no later than 30 days after each anniversary

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1
date of the Board's approval of the permit until the project is
2
completed. To maintain a valid permit and to monitor progress
3
toward project commencement and completion, routine
4
post-permit reports shall be limited to annual progress
5
reports and the final completion and cost report. Annual
6
progress reports shall include information regarding the
7
committed funds expended toward the approved project. For
8
projects to be completed in 12 months or less, the permit
9
holder shall report financial commitment in the final
10
completion and cost report. For projects to be completed
11
between 12 to 24 months, the permit holder shall report
12
financial commitment in the first annual report. For projects
13
to be completed in more than 24 months, the permit holder shall
14
report financial commitment in the second annual progress
15
report. The report shall contain information regarding
16
expenditures and financial commitments. The State Board may
17
extend the financial commitment period after considering a
18
permit holder's showing of good cause and request for
19
additional time to complete the project.
The State Board may
20
approve the transfer of an existing permit without regard to
21
whether the permit to be transferred has been financially
22
committed, except for permits to establish a new facility or
23
category of service.

24

The
permit

Certificate of Need
process required under this
25
Act is designed to restrain rising health care costs by
26
preventing unnecessary construction or modification of health

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1
care facilities. The Board must assure that the establishment,
2
construction, or modification of a health care facility or the
3
acquisition of major medical equipment is consistent with the
4
public interest and that the proposed project is consistent
5
with the orderly and economic development or acquisition of
6
those facilities and equipment and is in accord with the
7
standards, criteria, or plans of need adopted and approved by
8
the Board. Board decisions regarding the construction of
9
health care facilities must consider capacity, quality, value,
10
and equity. Projects may deviate from the costs, fees, and
11
expenses provided in their project cost information for the
12
project's cost components, provided that the final total
13
project cost does not exceed the approved permit amount.
14
Project alterations shall not increase the total approved
15
permit amount by more than the limit set forth under the
16
Board's rules.
17

The acquisition by any person of major medical equipment
18
that will not be owned by or located in a health care facility
19
and that will not be used to provide services to inpatients of
20
a health care facility shall be exempt from review provided
21
that a notice is filed in accordance with exemption
22
requirements.
23

Notwithstanding any other provision of this Act, no permit
24
or exemption is required for the construction or modification
25
of a non-clinical service area of a health care facility.
26
(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18
.)

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1

(20 ILCS 3960/6)

(from Ch. 111 1/2, par. 1156)
2

(Section scheduled to be repealed on December 31, 2029)
3

Sec. 6.
Application for permit or exemption; exemption
4
regulations.
5

(a) An application for a permit or exemption shall be made
6
to the State Board upon forms provided by the State Board. This
7
application shall contain such information as the State Board
8
deems necessary. The State Board shall not require an
9
applicant to file a Letter of Intent before an application is
10
filed. Such application shall include affirmative evidence on
11
which the State Board or Chairman may make its decision on the
12
approval or denial of the permit or exemption.
13

(b) The State Board shall establish by regulation the
14
procedures and requirements regarding issuance of exemptions.
15
An exemption shall be approved when information required by
16
the Board by rule is submitted. Projects eligible for an
17
exemption, rather than a permit, include, but are not limited
18
to, change of ownership of a health care facility and
19
discontinuation of a category of service, other than a health
20
care facility maintained by the State or any agency or
21
department thereof or a nursing home maintained by a county.
22
The Board may accept an application for an exemption for the
23
discontinuation of a category of service at a health care
24
facility only once in a 6-month period following (1) the
25
previous application for exemption at the same health care

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1
facility or (2) the final decision of the Board regarding the
2
discontinuation of a category of service at the same health
3
care facility, whichever occurs later. A discontinuation of a
4
category of service shall otherwise require an application for
5
a permit if an application for an exemption has already been
6
approved

accepted
within the 6-month period. For a change of
7
ownership among related persons of a health care facility, the
8
State Board shall provide by rule for an expedited process for
9
obtaining an exemption. For the purposes of this Section,
10
"change of ownership among related persons" means a
11
transaction in which the parties to the transaction are under
12
common control or ownership before and after the transaction
13
is complete.
14

(c) All applications shall be signed by the applicant and
15
shall be verified by any 2 officers thereof.
16

(c-5) Any written review or findings of the Board staff
17
set forth in the State Board Staff Report concerning an
18
application for a permit must be made available to the public
19
and the applicant at least 14 calendar days before the meeting
20
of the State Board at which the review or findings are
21
considered. The applicant and members of the public may
22
submit, to the State Board, written responses regarding the
23
facts set forth in the review or findings of the Board staff.
24
Members of the public and the applicant shall have until 10
25
days before the meeting of the State Board to submit any
26
written response concerning the Board staff's written review

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1
or findings. The Board staff may revise any findings to
2
address corrections of factual errors cited in the public
3
response. At the meeting, the State Board may, in its
4
discretion, permit the submission of other additional written
5
materials.
6

(d) Upon receipt of an application for a permit, the State
7
Board shall approve and authorize the issuance of a permit if
8
it finds (1) that the applicant is fit, willing, and able to
9
provide a proper standard of health care service for the
10
community with particular regard to the qualification,
11
background and character of the applicant, (2) that economic
12
feasibility is demonstrated in terms of effect on the existing
13
and projected operating budget of the applicant and of the
14
health care facility; in terms of the applicant's ability to
15
establish and operate such facility in accordance with
16
licensure regulations promulgated under pertinent state laws;
17
and in terms of the projected impact on the total health care
18
expenditures in the facility and community, (3) that
19
safeguards are provided that assure that the establishment,
20
construction or modification of the health care facility or
21
acquisition of major medical equipment is consistent with the
22
public interest, and (4) that the proposed project is
23
consistent with the orderly and economic development of such
24
facilities and equipment and is in accord with standards,
25
criteria, or plans of need adopted and approved pursuant to
26
the provisions of Section 12 of this Act.

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1
(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18;
2
101-83, eff. 7-15-19.)

3

(20 ILCS 3960/6.2)
4

(Section scheduled to be repealed on December 31, 2029)
5

Sec. 6.2.
Review of permits
and exemptions; public
6
hearings
; State Board Staff Reports.
7

(a)
Upon receipt of an application for
an exemption or
a
8
permit to establish, construct, or modify a health care
9
facility, the State Board staff shall notify the applicant in
10
writing within 10
business

working
days either that the
11
application is or is not substantially complete. If the
12
application is substantially complete, the State Board staff
13
shall notify the applicant of the beginning of the review
14
process. If the application is not substantially complete, the
15
Board staff shall explain within the 10-day period why the
16
application is incomplete.
17

(b)
The State Board staff shall afford a reasonable amount
18
of time as established by the State Board, but not to exceed
19
120 days, for the review of the application. The 120-day
20
period begins on the day the application is found to be
21
substantially complete, as that term is defined by the State
22
Board. During the 120-day period, the applicant may request an
23
extension. An applicant may modify the application
, as
24
established by the State Board by rule,
at any time before a
25
final administrative decision has been made on the

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1
application.
2

The State Board staff shall submit its State Board Staff
3
Report to the State Board for its decision-making regarding
4
approval or denial of the permit.
5

(c)
When an application for
an exemption or
a permit is
6
initially reviewed by State Board staff, as provided in this
7
Section, the State Board shall, upon request by the applicant
8
or an interested person, afford an opportunity for a public
9
hearing within a reasonable amount of time after receipt of
10
the complete application, but not to exceed 90 days after
11
receipt of the complete application. Notice of the hearing
12
shall be made promptly, not less than 10
business
days before
13
the hearing, by certified mail to the applicant and, not less
14
than 10
business
days before the hearing, by publication
on
15
the State Board's website,
in
the principal office and
16
website, if available, of the local government

a newspaper of
17
general circulation
in the area or community to be affected
,
18
and in the location where the meeting is to be held
. The
19
hearing shall be held in the area or community in which the
20
proposed project is to be located and shall be for the purpose
21
of allowing the applicant and any interested person to present
22
public testimony concerning the approval, denial, renewal, or
23
revocation of the permit
or exemption
. All interested persons
24
attending the hearing shall be given a reasonable opportunity
25
to present their views or arguments in writing or orally, and a
26
record of all of the testimony shall accompany any findings of

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1
the State Board staff. The State Board shall adopt reasonable
2
rules and regulations governing the procedure and conduct of
3
the hearings.
4

(d) The staff of the State Board shall submit its State
5
Board Staff Report to the State Board for approval or denial of
6
the permit or exemption.

7
(Source: P.A. 99-114, eff. 7-23-15; 100-681, eff. 8-3-18
.)

8

(20 ILCS 3960/8.5)
9

(Section scheduled to be repealed on December 31, 2029)
10

Sec. 8.5.
Certificate of exemption for change of ownership
11
of a health care facility; discontinuation of a category of
12
service; public notice and public hearing.
13

(a) Upon a finding that an application for a change of
14
ownership is complete, the State Board shall publish a
legal

15
notice
on 3 consecutive days

on the State Board's website and
16
in the principal office and website, if available, of the
17
local government in the area or community to be affected

in a
18
newspaper of general circulation in the area or community to
19
be affected
and afford the public an opportunity to request a
20
hearing.
If the application is for a facility located in a
21
Metropolitan Statistical Area, an additional legal notice
22
shall be published in a newspaper of limited circulation, if
23
one exists, in the area in which the facility is located. If
24
the newspaper of limited circulation is published on a daily
25
basis, the additional legal notice shall be published on 3

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1
consecutive days. The applicant shall pay the cost incurred by
2
the Board in publishing the change of ownership notice in
3
newspapers as required under this subsection.
The
legal
notice
4
shall also be
posted on the Health Facilities and Services
5
Review Board's web site and
sent to the State Representative
6
and State Senator of the district in which the health care
7
facility is located and to the Office of the Attorney General.
8
An application for change of ownership of a hospital shall not
9
be deemed complete without a signed certification that for a
10
period of 2 years after the change of ownership transaction is
11
effective, the hospital will not adopt a charity care policy
12
that is more restrictive than the policy in effect during the
13
year prior to the transaction. An application for a change of
14
ownership need not contain signed transaction documents so
15
long as it includes the following key terms of the
16
transaction: names and background of the parties; structure of
17
the transaction; the person who will be the licensed or
18
certified entity after the transaction; the ownership or
19
membership interests in such licensed or certified entity both
20
prior to and after the transaction; fair market value of
21
assets to be transferred; and the purchase price or other form
22
of consideration to be provided for those assets. The issuance
23
of the certificate of exemption shall be contingent upon the
24
applicant submitting a statement to the Board within 90 days
25
after the closing date of the transaction, or such longer
26
period as provided by the Board, certifying that the change of

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1
ownership has been completed in accordance with the key terms
2
contained in the application. If such key terms of the
3
transaction change, a new application shall be required.
4

Where a change of ownership is among related persons, and
5
there are no other changes being proposed at the health care
6
facility that would otherwise require a permit or exemption
7
under this Act, the applicant shall submit an application
8
consisting of a standard notice in a form set forth by the
9
Board briefly explaining the reasons for the proposed change
10
of ownership. Once such an application is submitted to the
11
Board and reviewed by the Board staff, the
State
Board
Chair

12
shall take action on an application for an exemption for a
13
change of ownership among related persons
at the next meeting

14
within 45 days
after the application has been deemed complete,
15
provided the application meets the applicable standards under
16
this Section.
If the Board Chair has a conflict of interest or
17
for other good cause, the Chair may request review by the
18
Board.
Notwithstanding any other provision of this Act, for
19
purposes of this Section, a change of ownership among related
20
persons means a transaction where the parties to the
21
transaction are under common control or ownership before and
22
after the transaction is completed.
23

Nothing in this Act shall be construed as authorizing the
24
Board to impose any conditions, obligations, or limitations,
25
other than those required by this Section, with respect to the
26
issuance of an exemption for a change of ownership, including,

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1
but not limited to, the time period before which a subsequent
2
change of ownership of the health care facility could be
3
sought, or the commitment to continue to offer for a specified
4
time period any services currently offered by the health care
5
facility.
6

The changes made by this amendatory Act of the 103rd
7
General Assembly are inoperative on and after January 1, 2027.
8

(a-3) (Blank).
9

(a-5)
If a public hearing is requested, it shall be held at
10
least 15, but not more than 30 calendar days, after issuance of
11
the notice in the community in which the facility is located.
12
The hearing shall be held in the affected area or community in
13
a place of reasonable size and accessibility and a full and
14
complete written transcript of the proceedings shall be made.
15
All interested persons attending the hearing shall be given a
16
reasonable opportunity to present their positions in writing
17
or orally. The applicant shall provide a summary or describe
18
the proposed change of ownership at the public hearing.
Upon a
19
finding that an application to discontinue a category of
20
service is complete and provides the requested information, as
21
specified by the State Board, an exemption shall be issued. No
22
later than 30 days after the
approval

issuance
of the
23
exemption
by the State Board
, the health care facility must
24
give written notice of the discontinuation of the category of
25
service to the State Senator and State Representative serving
26
the legislative district in which the health care facility is

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1
located. No later than 90 days after a discontinuation of a
2
category of service, the applicant must submit a statement to
3
the State Board certifying that the discontinuation is
4
complete.
5

(b)
(Blank).

If a public hearing is requested, it shall be
6
held at least 15 days but no more than 30 days after the date
7
of publication of the legal notice in the community in which
8
the facility is located. The hearing shall be held in the
9
affected area or community in a place of reasonable size and
10
accessibility and a full and complete written transcript of
11
the proceedings shall be made. All interested persons
12
attending the hearing shall be given a reasonable opportunity
13
to present their positions in writing or orally. The applicant
14
shall provide a summary or describe the proposed change of
15
ownership at the public hearing.
16

(c)
(Blank).

For the purposes of this Section "newspaper
17
of limited circulation" means a newspaper intended to serve a
18
particular or defined population of a specific geographic area
19
within a Metropolitan Statistical Area such as a municipality,
20
town, village, township, or community area, but does not
21
include publications of professional and trade associations.
22

(d) The changes made to this Section by this amendatory
23
Act of the 101st General Assembly shall apply to all
24
applications submitted after the effective date of this
25
amendatory Act of the 101st General Assembly.
26
(Source: P.A. 103-526, eff. 1-1-24
.)

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1

(20 ILCS 3960/8.7)
2

(Section scheduled to be repealed on December 31, 2029)
3

Sec. 8.7.
Application for permit for discontinuation of a
4
health care facility or category of service; public notice and
5
public hearing.
6

(a) Upon a finding that an application to
discontinue

7
close
a health care facility or discontinue a category of
8
service is complete, the State Board shall publish a
legal

9
notice on
the State Board's website and in the principal
10
office and website, if available, of the local government in
11
the area or community to be affected

3 consecutive days in a
12
newspaper of general circulation in the area or community to
13
be affected
and afford the public an opportunity to request a
14
hearing.
If the application is for a facility located in a
15
Metropolitan Statistical Area, an additional legal notice
16
shall be published in a newspaper of limited circulation, if
17
one exists, in the area in which the facility is located. If
18
the newspaper of limited circulation is published on a daily
19
basis, the additional legal notice shall be published on 3
20
consecutive days.
The
legal
notice shall also be
posted on the
21
Health Facilities and Services Review Board's website and
sent
22
to the State Representative and State Senator of the district
23
in which the health care facility is located. In addition, the
24
health care facility shall provide notice of closure to the
25
local media that the health care facility would routinely

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1
notify about facility events.
2

An application to close a health care facility shall only
3
be deemed complete if it includes evidence that the health
4
care facility provided written notice at least 30 days prior
5
to filing the application of its intent to do so to the
6
municipality in which it is located, the State Representative
7
and State Senator of the district in which the health care
8
facility is located, the State Board, the Director of Public
9
Health, and the Director of Healthcare and Family Services.
10
The changes made to this subsection by this amendatory Act of
11
the 101st General Assembly shall apply to all applications
12
submitted after the effective date of this amendatory Act of
13
the 101st General Assembly.
14

(b) No later than 30 days after issuance of a permit to
15
discontinue

close
a health care facility or discontinue a
16
category of service, the permit holder shall give written
17
notice of the
closure or
discontinuation to the State Senator
18
and State Representative serving the legislative district in
19
which the health care facility is located.
20

(c)
(1)
If there is a pending lawsuit that challenges an
21
application to discontinue a health care facility that either
22
names the Board as a party or alleges fraud in the filing of
23
the application, the Board may defer action on the application
24
until all litigation related to the application is complete

25
for up to 6 months after the date of the initial deferral of
26
the application
.

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1

(2) The Board may defer action on an application to
2
discontinue a hospital that is pending before the Board as of
3
the effective date of this amendatory Act of the 102nd General
4
Assembly for up to 60 days after the effective date of this
5
amendatory Act of the 102nd General Assembly.
6

(3) The Board may defer taking final action on an
7
application to discontinue a hospital that is filed on or
8
after January 12, 2021, until the earlier to occur of: (i) the
9
expiration of the statewide disaster declaration proclaimed by
10
the Governor of the State of Illinois due to the COVID-19
11
pandemic that is in effect on January 12, 2021, or any
12
extension thereof, or July 1, 2021, whichever occurs later; or
13
(ii) the expiration of the declaration of a public health
14
emergency due to the COVID-19 pandemic as declared by the
15
Secretary of the U.S. Department of Health and Human Services
16
that is in effect on January 12, 2021, or any extension
17
thereof, or July 1, 2021, whichever occurs later. This
18
paragraph (3) is repealed as of the date of the expiration of
19
the statewide disaster declaration proclaimed by the Governor
20
of the State of Illinois due to the COVID-19 pandemic that is
21
in effect on January 12, 2021, or any extension thereof, or
22
July 1, 2021, whichever occurs later.

23

(d)
(Blank).

The changes made to this Section by this
24
amendatory Act of the 101st General Assembly shall apply to
25
all applications submitted after the effective date of this
26
amendatory Act of the 101st General Assembly.

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1

(e) An application for a permit under this Section is
2
required for the discontinuation of a hospital regardless of
3
whether the facility is licensed independently or licensed
4
under a dual campus license.
5
(Source: P.A. 101-83, eff. 7-15-19; 101-650, eff. 7-7-20;
6
102-4, eff. 4-27-21.)

7

(20 ILCS 3960/10)

(from Ch. 111 1/2, par. 1160)
8

(Section scheduled to be repealed on December 31, 2029)
9

Sec. 10.
Administrative hearings following an initial
10
denial or revocation of a permit.

Presenting information
11
relevant to the approval of a permit or certificate or in
12
opposition to the denial of the application; notice of outcome
13
and review proceedings.

When a motion by the State Board, to
14
approve an application for a permit, fails to pass, the
15
applicant or the holder of the permit, as the case may be, and
16
such other parties as the State Board permits, will be given an
17
opportunity to appear before the State Board and present such
18
information as may be relevant to the approval of a permit.
19

Subsequent to an appearance by the applicant before the
20
State Board or default of such opportunity to appear, a motion
21
by the State Board to approve an application for a permit which
22
fails to pass shall be considered
an initial
denial of the
23
application for a permit, as the case may be. Such action of
an
24
initial
denial or an action by the State Board to revoke a
25
permit shall be communicated to the applicant or holder of the

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1
permit. Such person or organization shall be afforded an
2
opportunity for a hearing before an administrative law judge,
3
who is appointed by the Chairman of the State Board. A written
4
notice of a request for such hearing shall be served upon the
5
Chairman of the State Board
or the Agency
within 30 days
6
following notification of the decision of the State Board. The
7
administrative law judge shall take actions necessary to
8
ensure that the hearing is completed within a reasonable
9
period of time, but not to exceed 120 days, except for delays
10
or continuances agreed to by the person requesting the
11
hearing. Following its consideration of the report of the
12
hearing, or upon default of the party to the hearing, the State
13
Board shall make its final determination, specifying its
14
findings and conclusions within 90 days of receiving the
15
written report of the hearing. A copy of such determination
16
shall be sent by certified mail or served personally upon the
17
party.
18

A full and complete record shall be kept of all
19
administrative hearing
proceedings, including the notice of
20
hearing, complaint, and all other documents in the nature of
21
pleadings, written motions filed in the proceedings, and the
22
report and orders of the State Board or hearing officer. All
23
testimony shall be reported
by either a court reporter or some
24
other reliable means of recording
but need not be transcribed
25
unless the decision is appealed in accordance with the
26
Administrative Review Law, as now or hereafter amended. A copy

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1
or copies of the
administrative hearing
transcript may be
2
obtained by any
interested
party
granted the right to
3
intervene
on payment of the cost of preparing such copy or
4
copies.
5

The State Board or
administrative law judge

hearing
6
officer
shall upon its own or
the administrative law judge's

7
his
motion, or on the written request of any party to the
8
administrative hearing
proceeding who has, in the State
9
Board's or
administrative law judge's

hearing officer's

10
opinion, demonstrated the relevancy of such request to the
11
outcome of the proceedings, issue subpoenas requiring the
12
attendance and the giving of testimony by witnesses, and
13
subpoenas duces tecum requiring the production of books,
14
papers, records, or memoranda. The fees of witnesses for
15
attendance and travel shall be the same as the fees of
16
witnesses before the circuit court of this State.
17

When the witness is subpoenaed at the instance of the
18
State Board, or its
administrative law judge

hearing officer
,
19
such fees shall be paid in the same manner as other expenses of
20
the
State
Board, and when the witness is subpoenaed at the
21
instance of any other party to any such proceeding the State
22
Board may, in accordance with its rules, require that the cost
23
of service of the subpoena or subpoena duces tecum and the fee
24
of the witness be borne by the party at whose instance the
25
witness is summoned. In such case, the State Board in its
26
discretion, may require a deposit to cover the cost of such

HB4757 Enrolled
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1
service and witness fees. A subpoena or subpoena duces tecum
2
so issued shall be served in the same manner as a subpoena
3
issued out of a court.
4

Any circuit court of this State upon the application of
5
the State Board or upon the application of any other party to
6
the
administrative hearing
proceeding, may, in its discretion,
7
compel the attendance of witnesses, the production of books,
8
papers, records, or memoranda and the giving of testimony
9
before it or its
administrative law judge

hearing officer

10
conducting an investigation or holding a hearing authorized by
11
this Act, by an attachment for contempt, or otherwise, in the
12
same manner as production of evidence may be compelled before
13
the court.
14
(Source: P.A. 99-527, eff. 1-1-17; 100-681, eff. 8-3-18
.)

15

(20 ILCS 3960/11)

(from Ch. 111 1/2, par. 1161)
16

(Section scheduled to be repealed on December 31, 2029)
17

Sec. 11.
Any person who is adversely affected by a final
18
decision of the State Board may have such decision judicially
19
reviewed. The provisions of the Administrative Review Law, as
20
now or hereafter amended, and the rules adopted pursuant
21
thereto shall apply to and govern all proceedings for the
22
judicial review of final administrative decisions of the State
23
Board. The term "administrative decisions" is as defined in
24
Section 3-101 of the Code of Civil Procedure. In order to
25
comply with subsection (b) of Section 3-108 of the

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1
Administrative Review Law of the Code of Civil Procedure,
upon
2
the filing of an administrative judicial review action,
the
3
State Board shall transcribe each State Board meeting using a
4
certified court reporter. The transcript shall contain the
5
record of the findings and decisions of the State Board.
6
(Source: P.A. 98-1086, eff. 8-26-14
.)

7

(20 ILCS 3960/12)

(from Ch. 111 1/2, par. 1162)
8

(Section scheduled to be repealed on December 31, 2029)
9

Sec. 12.
Powers and duties of State Board.
For purposes of
10
this Act, the State Board shall exercise the following powers
11
and duties:
12

(1) Prescribe rules, regulations, standards, criteria,
13

procedures or reviews which may vary according to the
14

purpose for which a particular review is being conducted
15

or the type of project reviewed and which are required to
16

carry out the provisions and purposes of this Act.
17

Policies and procedures of the State Board shall take into
18

consideration the priorities and needs of medically
19

underserved areas and other health care services, giving
20

special consideration to the impact of projects on access
21

to safety net services.
22

(2) Adopt procedures for public notice and hearing on
23

all proposed rules, regulations, standards, criteria, and
24

plans required to carry out the provisions of this Act.
25

(3) (Blank).

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1

(4) Develop criteria and standards for health care
2

facilities planning, conduct statewide inventories of
3

health care facilities, maintain an updated inventory on
4

the Board's web site reflecting the most recent bed and
5

service changes and updated need determinations when new
6

census data become available or new need formulae are
7

adopted, and develop health care facility plans which
8

shall be utilized in the review of applications for permit
9

under this Act. Such health facility plans shall be
10

coordinated by the Board with pertinent State Plans.
11

Inventories pursuant to this Section of skilled or
12

intermediate care facilities licensed under the Nursing
13

Home Care Act, skilled or intermediate care facilities
14

licensed under the ID/DD Community Care Act, skilled or
15

intermediate care facilities licensed under the MC/DD Act,
16

facilities licensed under the Specialized Mental Health
17

Rehabilitation Act of 2013, or nursing homes licensed
18

under the Hospital Licensing Act shall be conducted on an
19

annual basis no later than July 1 of each year and shall
20

include among the information requested a list of all
21

services provided by a facility to its residents and to
22

the community at large and differentiate between active
23

and inactive beds.
24

In developing health care facility plans, the State
25

Board shall consider, but shall not be limited to, the
26

following:

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1

(a) The size, composition and growth of the
2

population of the area to be served;
3

(b) The number of existing and planned facilities
4

offering similar programs;
5

(c) The extent of utilization of existing
6

facilities;
7

(d) The availability of facilities which may serve
8

as alternatives or substitutes;
9

(e) The availability of personnel necessary to the
10

operation of the facility;
11

(f) Multi-institutional planning and the
12

establishment of multi-institutional systems where
13

feasible;
14

(g) The financial and economic feasibility of
15

proposed construction or modification; and
16

(h) In the case of health care facilities
17

established by a religious body or denomination, the
18

needs of the members of such religious body or
19

denomination may be considered to be public need.
20

The health care facility plans which are developed and
21

adopted in accordance with this Section shall form the
22

basis for the plan of the State to deal most effectively
23

with statewide health needs in regard to health care
24

facilities.
25

(5) Coordinate with other state agencies having
26

responsibilities affecting health care facilities,

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LRB104 20222 SPS 33673 b
1

including those of licensure and cost reporting.
2

(6) Solicit, accept, hold and administer on behalf of
3

the State any grants or bequests of money, securities or
4

property for use by the State Board in the administration
5

of this Act; and enter into contracts consistent with the
6

appropriations for purposes enumerated in this Act.
7

(7) (Blank).
8

(8) Prescribe rules, regulations, standards, and
9

criteria for the conduct of an expeditious review of
10

applications for permits for projects of construction or
11

modification of a health care facility, which projects are
12

classified as emergency, substantive, or non-substantive
13

in nature.
14

Substantive projects shall include no more than the
15

following:
16

(a) Projects to construct (1) a new or replacement
17

facility located on a new site or (2) a replacement
18

facility located on the same site as the original
19

facility and the cost of the replacement facility
20

exceeds the capital expenditure minimum, which shall
21

be reviewed by the Board within 120 days;
22

(b) Projects proposing a (1) new service within an
23

existing healthcare facility or (2) discontinuation of
24

a service within an existing healthcare facility,
25

which shall be reviewed by the Board within 60 days; or
26

(c) Projects proposing a change in the bed

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1

capacity of a health care facility by an increase in
2

the total number of beds or by a redistribution of beds
3

among various categories of service or by a relocation
4

of beds from one physical facility or site to another
5

by more than 20 beds or more than 10% of total bed
6

capacity, as defined by the State Board, whichever is
7

less, over a 2-year period.
8

The Chairman may approve applications for exemption
9

that meet the criteria set forth in rules or refer them to
10

the full Board. The Chairman may approve any unopposed
11

application
for permit
that meets all of the review
12

criteria or refer them to the full Board.
13

Such rules shall not prevent the conduct of a public
14

hearing upon the timely request of an interested party.
15

Such reviews shall not exceed 60 days from the date the
16

application is declared to be complete.
17

(9) Prescribe rules, regulations, standards, and
18

criteria pertaining to the granting of permits for
19

construction and modifications which are emergent in
20

nature and must be undertaken immediately to prevent or
21

correct structural deficiencies or hazardous conditions
22

that may harm or injure persons using the facility, as
23

defined in the rules and regulations of the State Board.
24

This procedure is exempt from public hearing requirements
25

of this Act.
26

(10) Prescribe rules, regulations, standards and

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1

criteria for the conduct of an expeditious review, not
2

exceeding 60 days, of applications for permits for
3

projects to construct or modify health care facilities
4

which are needed for the care and treatment of persons who
5

have acquired immunodeficiency syndrome (AIDS) or related
6

conditions.
7

(10.5) Provide its
basis or
rationale when voting on
8

an item before it at a State Board meeting in order to
9

comply with subsection (b) of Section 3-108 of the Code of
10

Civil Procedure.
11

(11)
If the State Board denies or fails to approve an
12

application for permit or exemption, the State Board
13

shall, upon request by the applicant, include in the final
14

decision a detailed explanation as to why the application
15

was denied and identify what specific criteria or
16

standards the applicant did not fulfill.

Issue written
17

decisions upon request of the applicant or an adversely
18

affected party to the Board.
Requests for a written
19

decision shall be made within 15 days after the
State

20

Board meeting in which a final decision has been made. A
21

"final decision" for purposes of this Act is the decision
22

to approve or deny an application, or take other actions
23

permitted under this Act, at the time and date of the
24

meeting that such action is scheduled by the
State
Board.
25

The transcript of the State Board meeting shall be
the
26

basis for the written decision and will be
incorporated

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1

into the
State
Board's final decision. The staff of the
2

State
Board shall prepare a written copy of the final
3

decision and the
State
Board shall approve a final copy
4

for inclusion in the formal record. The
State
Board shall
5

consider, for approval, the written draft of the final
6

decision no later than the next scheduled
State
Board
7

meeting. The written decision shall identify the
8

applicable criteria and factors listed in this Act and the
9

State
Board's regulations that were taken into
10

consideration by the
State
Board when coming to a final
11

decision.
If the Board denies or fails to approve an
12

application for permit or exemption, the Board shall
13

include in the final decision a detailed explanation as to
14

why the application was denied and identify what specific
15

criteria or standards the applicant did not fulfill.
16

(12) (Blank).
17

(13) Provide a mechanism for the public to comment on,
18

and request changes to, draft rules and standards.
19

(14) Implement public information campaigns to
20

regularly inform the general public about the opportunity
21

for public hearings and public hearing procedures.
22

(15) Establish a separate set of rules and guidelines
23

for long-term care that recognizes that nursing homes are
24

a different business line and service model from other
25

regulated facilities. An open and transparent process
26

shall be developed that considers the following: how

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1

skilled nursing fits in the continuum of care with other
2

care providers, modernization of nursing homes,
3

establishment of more private rooms, development of
4

alternative services, and current trends in long-term care
5

services. The Chairman of the Board shall appoint a
6

permanent Health Services Review Board Long-term Care
7

Facility Advisory Subcommittee that shall develop and
8

recommend to the Board the rules to be established by the
9

Board under this paragraph (15). The Subcommittee shall
10

also provide continuous review and commentary on policies
11

and procedures relative to long-term care and the review
12

of related projects. The Subcommittee shall make
13

recommendations to the Board no later than January 1, 2016
14

and every January thereafter pursuant to the
15

Subcommittee's responsibility for the continuous review
16

and commentary on policies and procedures relative to
17

long-term care. In consultation with other experts from
18

the health field of long-term care, the Board and the
19

Subcommittee shall study new approaches to the current bed
20

need formula and Health Service Area boundaries to
21

encourage flexibility and innovation in design models
22

reflective of the changing long-term care marketplace and
23

consumer preferences and submit its recommendations to the
24

Chairman of the Board no later than January 1, 2017. The
25

Subcommittee shall evaluate, and make recommendations to
26

the State Board regarding, the buying, selling, and

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1

exchange of beds between long-term care facilities within
2

a specified geographic area or drive time. The Board shall
3

file the proposed related administrative rules for the
4

separate rules and guidelines for long-term care required
5

by this paragraph (15) by no later than September 30,
6

2011. The Subcommittee shall be provided a reasonable and
7

timely opportunity to review and comment on any review,
8

revision, or updating of the criteria, standards,
9

procedures, and rules used to evaluate project
10

applications as provided under Section 12.3 of this Act.
11

The Chairman of the Board shall appoint voting members
12

of the Subcommittee, who shall serve for a period of 3
13

years, with one-third of the terms expiring each January,
14

to be determined by lot. Appointees shall include, but not
15

be limited to, recommendations from each of the 3
16

statewide long-term care associations, with an equal
17

number to be appointed from each. Compliance with this
18

provision shall be through the appointment and
19

reappointment process. All appointees serving as of April
20

1, 2015 shall serve to the end of their term as determined
21

by lot or until the appointee voluntarily resigns,
22

whichever is earlier.
23

One representative from the Department of Public
24

Health, the Department of Healthcare and Family Services,
25

the Department on Aging, and the Department of Human
26

Services may each serve as an ex-officio non-voting member

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1

of the Subcommittee. The Chairman of the Board shall
2

select a Subcommittee Chair, who shall serve for a period
3

of 3 years.
4

(16) Prescribe the format of the State Board Staff
5

Report. A State Board Staff Report shall pertain to
6

applications that include, but are not limited to,
7

applications for permit or exemption, applications for
8

permit renewal, applications for extension of the
9

financial commitment period, applications requesting a
10

declaratory ruling, or applications under the Health Care
11

Worker Self-Referral Act. State Board Staff Reports shall
12

compare applications to the relevant review criteria under
13

the Board's rules.
14

(17) Establish a separate set of rules and guidelines
15

for facilities licensed under the Specialized Mental
16

Health Rehabilitation Act of 2013. An application for the
17

re-establishment of a facility in connection with the
18

relocation of the facility shall not be granted unless the
19

applicant has a contractual relationship with at least one
20

hospital to provide emergency and inpatient mental health
21

services required by facility consumers, and at least one
22

community mental health agency to provide oversight and
23

assistance to facility consumers while living in the
24

facility, and appropriate services, including case
25

management, to assist them to prepare for discharge and
26

reside stably in the community thereafter. No new

HB4757 Enrolled
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1

facilities licensed under the Specialized Mental Health
2

Rehabilitation Act of 2013 shall be established after June
3

16, 2014 (the effective date of Public Act 98-651) except
4

in connection with the relocation of an existing facility
5

to a new location. An application for a new location shall
6

not be approved unless there are adequate community
7

services accessible to the consumers within a reasonable
8

distance, or by use of public transportation, so as to
9

facilitate the goal of achieving maximum individual
10

self-care and independence. At no time shall the total
11

number of authorized beds under this Act in facilities
12

licensed under the Specialized Mental Health
13

Rehabilitation Act of 2013 exceed the number of authorized
14

beds on June 16, 2014 (the effective date of Public Act
15

98-651).
16

(18) Elect a Vice Chairman to preside over State Board
17

meetings and otherwise act in place of the Chairman when
18

the Chairman is unavailable.
19
(Source: P.A. 100-518, eff. 6-1-18; 100-681, eff. 8-3-18;
20
101-83, eff. 7-15-19.)

21

(20 ILCS 3960/12.2)
22

(Section scheduled to be repealed on December 31, 2029)
23

Sec. 12.2.
Powers of the State Board staff.
For purposes
24
of this Act, the staff shall exercise the following powers and
25
duties:

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1

(1) Review applications for permits and exemptions in
2

accordance with the standards, criteria, and plans of need
3

established by the State Board under this Act and certify
4

its finding to the State Board.
5

(1.5) Post the following on the Board's web site:
6

relevant (i) rules, (ii) standards, (iii) criteria, (iv)
7

State norms, (v) references used by Board staff in making
8

determinations about whether application criteria are met,
9

and (vi) notices of project-related filings, including
10

notice of public comments related to the application.
11

(2) Charge and collect an amount determined by the
12

State Board and the staff to be reasonable fees for the
13

processing of applications by the State Board. The State
14

Board shall set the amounts by rule. Application fees for
15

continuing care retirement communities, and other health
16

care models that include regulated and unregulated
17

components, shall apply only to those components subject
18

to regulation under this Act. All fees and fines collected
19

under the provisions of this Act shall be deposited into
20

the Illinois Health Facilities Planning Fund to be used
21

for the expenses of administering this Act.
22

(2.1) Publish the following reports on the State Board
23

website:
24

(A) An annual accounting, aggregated by category
25

and with names of parties redacted, of fees, fines,
26

and other revenue collected as well as expenses

HB4757 Enrolled
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1

incurred, in the administration of this Act.
2

(B) An annual report, with names of the parties
3

redacted, that summarizes all settlement agreements
4

entered into with the State Board that resolve an
5

alleged instance of noncompliance with State Board
6

requirements under this Act.
7

(C) (Blank).
8

(D) Board reports showing the degree to which an
9

application conforms to the review standards, a
10

summation of relevant public testimony, and any
11

additional information that staff wants to
12

communicate.
13

(3) Coordinate with other State agencies having
14

responsibilities affecting health care facilities,
15

including licensure and cost reporting agencies.
16

(4) Issue advisory opinions upon request. Staff
17

advisory opinions do not constitute determinations by the
18

State Board. Determinations by the State Board are made
19

through the declaratory ruling process.
20

For purposes of this Section, "staff" means a person the
21
State Board or the Agency employs on a full-time, part-time,
22
contract, or intern basis.

23
(Source: P.A. 100-681, eff. 8-3-18; 101-83, eff. 7-15-19.)

24

(20 ILCS 3960/13)

(from Ch. 111 1/2, par. 1163)
25

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

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1

Sec. 13.
Review and investigation

Investigation
of
2
applications for permits.
The State Board
and State Board
3
employees
shall make or cause to be made such
a review of all
4
submitted applications or
investigations as it deems necessary
5
in connection with an application for a permit
or exemption
,
6
or in connection with a determination of whether or not
a
7
project or transaction

construction or modification
that has
8
been commenced is in accord with the
exemption or
permit
9
issued by the State Board, or whether
a project or transaction

10
construction or modification
has been commenced without a
11
permit
or exemption
having been obtained. The State Board may
12
issue subpoenas duces tecum requiring the production of
13
records and may administer oaths to such witnesses.
14

Any circuit court of this State, upon the application of
15
the State Board or upon the application of any
proper
party to
16
such proceedings, may, in its discretion, compel the
17
attendance of witnesses, the production of books, papers,
18
records, or memoranda and the giving of testimony before the
19
State Board, by a proceeding as for contempt, or otherwise, in
20
the same manner as production of evidence may be compelled
21
before the court.
22

The State Board shall require all health facilities
23
operating in this State to provide such reasonable reports at
24
such times and containing such information as is needed by it
25
to carry out the purposes and provisions of this Act. Prior to
26
collecting information from health facilities, the State Board

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1
shall make reasonable efforts through a public process to
2
consult with health facilities and associations that represent
3
them to determine whether data and information requests will
4
result in useful information for health planning, whether
5
sufficient information is available from other sources, and
6
whether data requested is routinely collected by health
7
facilities and is available without retrospective record
8
review. Data and information requests shall not impose undue
9
paperwork burdens on health care facilities and personnel.
10
Health facilities not complying with this requirement shall be
11
reported to licensing, accrediting, certifying, or payment
12
agencies as being in violation of State law. Health care
13
facilities and other parties at interest shall have reasonable
14
access, under rules established by the State Board, to all
15
planning information submitted in accord with this Act
16
pertaining to their area.
17

Among the reports to be required by the State Board are
18
facility questionnaires for health care facilities licensed
19
under the Ambulatory Surgical Treatment Center Act, the
20
Hospital Licensing Act, the Nursing Home Care Act, the ID/DD
21
Community Care Act, the MC/DD Act, or the Specialized Mental
22
Health Rehabilitation Act of 2013 and health care facilities
23
that are required to meet the requirements of 42 CFR 494 in
24
order to be certified for participation in Medicare and
25
Medicaid under Titles XVIII and XIX of the federal Social
26
Security Act. These questionnaires shall be conducted on an

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1
annual basis and compiled by the State Board. For health care
2
facilities licensed under the Nursing Home Care Act or the
3
Specialized Mental Health Rehabilitation Act of 2013, these
4
reports shall include, but not be limited to, the
5
identification of specialty services provided by the facility
6
to patients, residents, and the community at large. Annual
7
reports for facilities licensed under the ID/DD Community Care
8
Act and facilities licensed under the MC/DD Act shall be
9
different from the annual reports required of other health
10
care facilities and shall be specific to those facilities
11
licensed under the ID/DD Community Care Act or the MC/DD Act.
12
The Health Facilities and Services Review Board shall consult
13
with associations representing facilities licensed under the
14
ID/DD Community Care Act and associations representing
15
facilities licensed under the MC/DD Act when developing the
16
information requested in these annual reports. For health care
17
facilities that contain long term care beds, the reports shall
18
also include the number of staffed long term care beds,
19
physical capacity for long term care beds at the facility, and
20
long term care beds available for immediate occupancy. For
21
purposes of this paragraph, "long term care beds" means beds
22
(i) licensed under the Nursing Home Care Act, (ii) licensed
23
under the ID/DD Community Care Act, (iii) licensed under the
24
MC/DD Act, (iv) licensed under the Hospital Licensing Act, or
25
(v) licensed under the Specialized Mental Health
26
Rehabilitation Act of 2013 and certified as skilled nursing or

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1
nursing facility beds under Medicaid or Medicare.
2
(Source: P.A. 100-681, eff. 8-3-18; 100-957, eff. 8-19-18;
3
101-81, eff. 7-12-19.)

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