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HB5188 - 104th General Assembly

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB5188

Introduced 2/10/2026, by Rep. Lilian Jiménez

SYNOPSIS AS INTRODUCED:

20 ILCS 2310/2310-715

Amends Department of Public Health Powers and Duties Law of the Civil
Administrative Code of Illinois. In provisions regarding a Safety-Net
Hospital Health Equity and Access Leadership (HEAL) Grant Program, changes
references to safety-net hospitals to references to community safety-net
hospitals. Updates references to dates in those provisions. Defines
"community safety-net hospital", "health system", and "medically
underserved area". Makes changes to required provisions in the report to
the General Assembly regarding criteria for a community safety-net
hospital to be eligible for the program, deletes required provisions in
the report to the General Assembly regarding potential projects eligible
for grant funds, and adds required provisions in the report to the General
Assembly regarding an application process and criteria, as well as
policies, standards, and procedures to administer the program and ensure
accountability.
LRB104 18401 BDA 31843 b

A BILL FOR

HB5188
LRB104 18401 BDA 31843 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 Department of Public Health Powers and
5
Duties Law of the Civil Administrative Code of Illinois is
6
amended by changing Section 2310-715 as follows:

7

(20 ILCS 2310/2310-715)
8

Sec. 2310-715.
Community
Safety-Net Hospital Health Equity
9
and Access Leadership (HEAL) Grant Program.
10

(a) Findings. The General Assembly finds that there are
11
communities in Illinois that experience significant health
12
care disparities
, as recently emphasized by the COVID-19
13
pandemic,
aggravated by social determinants of health and a
14
lack of sufficient access to high quality health care
15
resources, particularly community-based services, preventive
16
care, obstetric care, chronic disease management, and
17
specialty care.
Community safety-net

Safety-net
hospitals, as
18
defined under
the

this Section

Illinois Public Aid Code
, serve
19
as the anchors of the health care system for many of these
20
communities.
These

Safety-net
hospitals not only care for
21
their patients, they also are rooted in their communities
and
22
provide

by providing
jobs and
partner

partnering
with local
23
organizations to help address the social determinants of

HB5188
- 2 -
LRB104 18401 BDA 31843 b
1
health, such as food, housing, and transportation needs.
2

However,
community
safety-net hospitals serve a
3
significant number of Medicare, Medicaid, and uninsured
4
patients, and therefore, are heavily dependent on underfunded
5
government payers, and are heavily burdened by uncompensated
6
care. At the same time, the overall cost of providing care has
7
increased substantially in recent years, driven by increasing
8
costs for staffing, prescription drugs, technology, and
9
infrastructure.
10

For
all of
these reasons, the General Assembly finds that
11
the long-term sustainability of
community
safety-net hospitals
12
is threatened. While the General Assembly
has provided

is
13
providing
funding to the Department to be paid to support the
14
expenses of specific
community
safety-net hospitals in
15
previous fiscal years

State Fiscal Year 2023
, such annual, ad
16
hoc funding is not a reliable and stable source of funding that
17
will enable
community
safety-net hospitals to develop
18
strategies to achieve long term sustainability. Such annual,
19
ad hoc funding also does not provide the State with
20
transparency and accountability to ensure that such funding is
21
being used effectively and efficiently to maximize the benefit
22
to members of the community.
23

Therefore, it is the intent of the General Assembly that
24
the Department of Public Health and the Department of
25
Healthcare and Family Services jointly
create

provide options
26
and recommendations to the General Assembly by February 1,

HB5188
- 3 -
LRB104 18401 BDA 31843 b
1
2023, for the establishment of
a permanent
Community

2
Safety-Net Hospital Health Equity and Access Leadership (HEAL)
3
Grant Program, in accordance with this Section. It is the
4
intention of the General Assembly that
, beginning in fiscal
5
year 2027

during State fiscal years 2024 through 2029
, the
6
Community Safety-Net

Safety-Net
Hospital Health Equity and
7
Access Leadership (HEAL) Grant Program shall be supported by
8
an annual funding pool of
at least

up to
$100,000,000, subject
9
to appropriation.
10

(a-5) Definitions. As used in this Section:
11

"Community safety-net hospital" means a hospital that
12
satisfies the criteria under Section 5-5e.1 of the Illinois
13
Public Aid Code and that is not part of a health system with
14
more than $1,000,000,000 in assets.
15

"Health system" means a group of hospitals that are owned
16
and operated by the same entity.
17

"Medically underserved area" means a geographic area with
18
a shortage of primary health care services for residents.

19

(b) By February 1,
2027

2023
, the Department of Public
20
Health and the Department of Healthcare and Family Services
21
shall provide a joint report to the General Assembly on
22
options and recommendations for the establishment of a
23
permanent
Community
Safety-Net Hospital Health Equity and
24
Access Leadership (HEAL) Grant Program to be administered by
25
the State.
For this report, "safety-net hospital" means a
26
hospital identified by the Department of Healthcare and Family

HB5188
- 4 -
LRB104 18401 BDA 31843 b
1
Services under Section 5-5e.1 of the Illinois Public Aid Code.
2
The Departments of Public Health and Healthcare and Family
3
Services may consult with the statewide association
4
representing a majority of hospitals and
community
safety-net
5
hospitals on the report. The report may include, but need not
6
be limited to:
7

(1) Criteria for a
community
safety-net hospital to be
8

eligible for the program, such as:
9

(A) The hospital is a
community safety-net
10

hospital as defined in this Section

participating
11

provider in at least one Medicaid managed care plan
.
12

(B) The hospital is located in a medically
13

underserved area.
14

(C) The hospital's Medicaid utilization rate (for
15

both inpatient and outpatient services).
16

(D) The hospital's Medicare utilization rate (for
17

both inpatient and outpatient services).
18

(E) The hospital's uncompensated care percentage.
19

(C)

(F)
The
hospital is demonstrably working to
20

expand

hospital's role in providing
access to
21

services, reducing health disparities, and improving
22

health equity in its service area.
23

(G) The hospital's performance on quality
24

indicators.
25

(2)
Information regarding additional requirements for
26

the Community Safety-Net Hospital Health Equity and Access

HB5188
- 5 -
LRB104 18401 BDA 31843 b
1

Leadership (HEAL) Grant Program, such as:

2

(A) an application process and criteria to
3

determine which applications should receive funding,
4

established by the Department of Healthcare and Family
5

Services and the Department of Public Health, with
6

formal input from stakeholders; and
7

(B) policies, standards, and procedures developed
8

by the Department of Healthcare and Family Services
9

and the Department of Public Health, with formal input
10

from stakeholders, to both administer the program and
11

ensure accountability, that include, at a minimum:

12

(i) transparency: participant hospitals must
13

open all governing board meetings to the public
14

and include space and time for public comment;
15

(ii) stakeholder oversight or codetermination:
16

participant hospitals must:

17

(I) have governing boards comprised of, at
18

a minimum, 51% community members, frontline
19

hospital workers, and patients; and
20

(II) create an advocacy council comprised
21

of community members, frontline hospital
22

workers, patients, and other key stakeholders
23

that has meaningful input into hospital
24

management and strategic decision making that
25

meets at least quarterly and upon its own
26

initiative; and

HB5188
- 6 -
LRB104 18401 BDA 31843 b
1

(iii) wage and labor standards: participant
2

hospitals must:

3

(I) pay workers a living wage;
4

(II) permit workers to form or join a
5

labor organization of their choice without
6

interference from management; and
7

(III) staff adequately and negotiate a
8

process for resolving formal objections to
9

unsafe staffing.

10

Potential projects eligible for grant funds which may
11

include projects to reduce health disparities, advance
12

health equity, or improve access to or the quality of
13

health care services.
14

(3) Potential policies, standards, and procedures to
15

ensure accountability for the use of grant funds.
16

(4) Potential strategies to generate federal Medicaid
17

matching funds for expenditures under the program.
18

(5) Potential policies, processes, and procedures for
19

the administration of the program.
20
(Source: P.A. 102-886, eff. 5-17-22; 103-154, eff. 6-30-23.)

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