FREESTANDING EMERGENCY CENTERS

Illinois General Assembly - Full Text of HB5239

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HB5239 - 104th General Assembly

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB5239

Introduced 2/10/2026, by Rep. Natalie A. Manley

SYNOPSIS AS INTRODUCED:

210 ILCS 50/32.5

Amends the Emergency Medical Services (EMS) Systems Act. Provides
that the Department of Public Health shall issue an annual Freestanding
Emergency Center license to a facility if the facility complies with
specified requirements, except that: (i) the Freestanding Emergency Center
may be located in a municipality with a population greater than 50,000
inhabitants and (ii) the Freestanding Emergency Center may, if operated as
provider-based under specified federal regulations, describe itself or
hold itself out to the general public as a hospital emergency department in
its advertising and marketing activities.
LRB104 20143 BAB 33594 b

A BILL FOR

HB5239
LRB104 20143 BAB 33594 b
1

AN ACT concerning regulation.

2

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

4

Section 5.
The Emergency Medical Services (EMS) Systems
5
Act is amended by changing Section 32.5 as follows:

6

(210 ILCS 50/32.5)
7

Sec. 32.5.
Freestanding Emergency Center.
8

(a) The Department shall issue an annual Freestanding
9
Emergency Center (FEC) license to any facility that has
10
received a permit from the Health Facilities and Services
11
Review Board to establish a Freestanding Emergency Center by
12
January 1, 2015, and:
13

(1) is located: (A) in a municipality with a
14

population of 50,000 or fewer inhabitants; (B) within 50
15

miles of the hospital that owns or controls the FEC; and
16

(C) within 50 miles of the Resource Hospital affiliated
17

with the FEC as part of the EMS System;
18

(2) is wholly owned or controlled by an Associate or
19

Resource Hospital, but is not a part of the hospital's
20

physical plant;
21

(3) meets the standards for licensed FECs, adopted by
22

rule of the Department, including, but not limited to:
23

(A) facility design, specification, operation, and

HB5239
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LRB104 20143 BAB 33594 b
1

maintenance standards;
2

(B) equipment standards; and
3

(C) the number and qualifications of emergency
4

medical personnel and other staff, which must include
5

at least one board certified emergency physician
6

present at the FEC 24 hours per day.
7

(4) limits its participation in the EMS System
8

strictly to receiving a limited number of patients by
9

ambulance: (A) according to the FEC's 24-hour
10

capabilities; (B) according to protocols developed by the
11

Resource Hospital within the FEC's designated EMS System;
12

and (C) as pre-approved by both the EMS Medical Director
13

and the Department;
14

(5) provides comprehensive emergency treatment
15

services, as defined in the rules adopted by the
16

Department pursuant to the Hospital Licensing Act, 24
17

hours per day, on an outpatient basis;
18

(6) provides an ambulance and maintains on site
19

ambulance services staffed with paramedics 24 hours per
20

day;
21

(7) (blank);
22

(8) complies with all State and federal patient rights
23

provisions, including, but not limited to, the Emergency
24

Medical Treatment Act and the federal Emergency Medical
25

Treatment and Active Labor Act;
26

(9) maintains a communications system that is fully

HB5239
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LRB104 20143 BAB 33594 b
1

integrated with its Resource Hospital within the FEC's
2

designated EMS System;
3

(10) reports to the Department any patient transfers
4

from the FEC to a hospital within 48 hours of the transfer
5

plus any other data determined to be relevant by the
6

Department;
7

(11) submits to the Department, on a quarterly basis,
8

the FEC's morbidity and mortality rates for patients
9

treated at the FEC and other data determined to be
10

relevant by the Department;
11

(12) does not describe itself or hold itself out to
12

the general public as a full service hospital or hospital
13

emergency department in its advertising or marketing
14

activities;
15

(13) complies with any other rules adopted by the
16

Department under this Act that relate to FECs;
17

(14) passes the Department's site inspection for
18

compliance with the FEC requirements of this Act;
19

(15) submits a copy of the permit issued by the Health
20

Facilities and Services Review Board indicating that the
21

facility has complied with the Illinois Health Facilities
22

Planning Act with respect to the health services to be
23

provided at the facility;
24

(16) submits an application for designation as an FEC
25

in a manner and form prescribed by the Department by rule;
26

and

HB5239
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LRB104 20143 BAB 33594 b
1

(17) pays the annual license fee as determined by the
2

Department by rule.
3

(a-5) Notwithstanding any other provision of this Section,
4
the Department may issue an annual FEC license to a facility
5
that is located in a county that does not have a licensed
6
general acute care hospital if the facility's application for
7
a permit from the Illinois Health Facilities Planning Board
8
has been deemed complete by the Department of Public Health by
9
January 1, 2014 and if the facility complies with the
10
requirements set forth in paragraphs (1) through (17) of
11
subsection (a).
12

(a-10) Notwithstanding any other provision of this
13
Section, the Department may issue an annual FEC license to a
14
facility if the facility has, by January 1, 2014, filed a
15
letter of intent to establish an FEC and if the facility
16
complies with the requirements set forth in paragraphs (1)
17
through (17) of subsection (a).
18

(a-15) Notwithstanding any other provision of this
19
Section, the Department shall issue an annual FEC license to a
20
facility if the facility: (i) discontinues operation as a
21
hospital within 180 days after December 4, 2015 (the effective
22
date of Public Act 99-490) with a Health Facilities and
23
Services Review Board project number of E-017-15; (ii) has an
24
application for a permit to establish an FEC from the Health
25
Facilities and Services Review Board that is deemed complete
26
by January 1, 2017; and (iii) complies with the requirements

HB5239
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LRB104 20143 BAB 33594 b
1
set forth in paragraphs (1) through (17) of subsection (a) of
2
this Section.
3

(a-20) Notwithstanding any other provision of this
4
Section, the Department shall issue an annual FEC license to a
5
facility if:
6

(1) the facility is a hospital that has discontinued
7

inpatient hospital services;
8

(2) the Department of Healthcare and Family Services
9

has approved the conversion to an FEC as a project subject
10

to the hospital's transformation under subsection (d-5) of
11

Section 14-12 of the Illinois Public Aid Code;
12

(3) the facility complies with the requirements set
13

forth in paragraphs (1) through (17), provided however
14

that the FEC may be located in a municipality with a
15

population greater than 50,000 inhabitants and shall not
16

be subject to the requirements of the Illinois Health
17

Facilities Planning Act that are applicable to the
18

conversion to an FEC if the Department of Healthcare and
19

Family Services has approved the conversion to an FEC as a
20

project subject to the hospital's transformation under
21

subsection (d-5) of Section 14-12 of the Illinois Public
22

Aid Code; and
23

(4) the facility is located at the same physical
24

location where the facility served as a hospital.
25

(a-25) Notwithstanding any other provision of this
26
Section, the Department shall issue an annual FEC license to a

HB5239
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LRB104 20143 BAB 33594 b
1
facility if the facility complies with the requirements set
2
forth in subsection (a), except that: (i) the FEC may be
3
located in a municipality with a population greater than
4
50,000 inhabitants and (ii) the FEC may, if operated as
5
provider-based under 42 CFR 413.65, describe itself or hold
6
itself out to the general public as a hospital emergency
7
department in its advertising and marketing activities.

8

(b) The Department shall:
9

(1) annually inspect facilities of initial FEC
10

applicants and licensed FECs, and issue annual licenses to
11

or annually relicense FECs that satisfy the Department's
12

licensure requirements as set forth in subsection (a);
13

(2) suspend, revoke, refuse to issue, or refuse to
14

renew the license of any FEC, after notice and an
15

opportunity for a hearing, when the Department finds that
16

the FEC has failed to comply with the standards and
17

requirements of the Act or rules adopted by the Department
18

under the Act;
19

(3) issue an Emergency Suspension Order for any FEC
20

when the Director or his or her designee has determined
21

that the continued operation of the FEC poses an immediate
22

and serious danger to the public health, safety, and
23

welfare. An opportunity for a hearing shall be promptly
24

initiated after an Emergency Suspension Order has been
25

issued; and
26

(4) adopt rules as needed to implement this Section.

HB5239
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LRB104 20143 BAB 33594 b
1
(Source: P.A. 100-581, eff. 3-12-18; 101-650, eff. 7-7-20.)

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