HB 3651, which proposes amendments to the Illinois Health Facilities Planning Act (IHFPA) and various related legislation, was recently introduced in the Illinois House of Representatives. The proposed changes arose out of the work of a Task Force convened pursuant to legislative initiative to review the efficacy of the IHFPA and the Health Facilities Planning Board (Board) as they relate to the Certificate of Need (CON) process and health planning generally in Illinois. The proposed amendments are not yet law and will undoubtedly be subject to review and some rewrite. However, they indicate how the state legislature is contemplating amending the IHFPA. Following are some of the highlights in the proposed amendments to the IHFPA which may affect readers and their organizations as they proceed forward with health planning and CON applications.
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The Board’s name will be changed to the Illinois Health Facilities and Services Review Board. The bill provides for the development of a Center for Comprehensive Health Plan by the Center for Comprehensive Health Planning which will be established to conduct evaluations and make recommendations regarding accessibility of health care facilities and services throughout the State. The Board is required to take into consideration the findings and recommendations of the Comprehensive Health Plan when considering CON applications.
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The proposed amendments increase the capital expenditure threshold to $11.5 million for hospitals and $3 million for other health care facilities. The definition of “health care facilities” is expanded to include entities which purchase and use major medical equipment for the diagnosis and treatment of patients, as well as a person, place, building or room used to provide health care categories of services reviewed by the Board, including cardiac catheterization.
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Unless otherwise interdependent, projects will not have to be grouped together for purposes of determining the capital expenditure threshold because they are part of a single construction contract or financed through the issuance of a single debt instrument.
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The Board will be comprised of nine members, one of whom shall be the Chairman, who shall be a full-time employee of the Illinois Department of Public Health. The other members shall be part-time and paid. A nominating panel shall be convened and shall nominate members and they shall be appointed by the Governor of Illinois.
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A hospital’s ability to add or redesignate beds without CON approval (under some circumstances) will be increased to 20 beds, from 10.
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The post-permit obligations will be reduced to annual reports and a final cost report. The final cost project may not exceed the total approved cost, but can deviate by line item.
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The requirement of a Letter of Intent is eliminated.
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A Safety Net Impact Statement will be required. Among other things, the Statement requires an applicant detail the impact of its project on safety net hospitals, charity care data, Medicaid data and the impact on other hospitals in the area that provide a significant amount of charity care or care to Medicaid/Medicare recipients. This requirement appears to apply to all applicants regardless of for-profit or not-for-profit status or type of facility.
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Comments on State Agency Reports must be submitted at least 10 days prior to the anticipated Board meeting wherein the project will be heard.
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The only substantive project categories will be new or replacement facilities, new service offerings, discontinuation, addition or redistribution of beds by more than 20 beds or 10 percent of total bed capacity.
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The Chair of the Board may approve projects which meet all applicable review criteria.
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A final decision will occur when the Board approves or denies a project. The Board must publish fines and settlement orders.
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The Executive Secretary position will be eliminated. At least one Board member will be required or suggested to attend public hearings, and Board members will be fined for unexcused absences from meetings.
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The Board’s rules must be reviewed and if necessary updated every two months, in part to take into account the Comprehensive Center for Health Planning recommendations/findings.
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The program will be monitored by the auditor general 18 months after the nine-member Board is seated. However, the IHFPA will be in place for 10 years.