United States: Illinois to Retain Health Planning

Article by Kara M. Friedman and Kristian Werling

In the late hours of the 93rd General Assembly’s spring session, both Houses of the Illinois legislature approved a bill which, assuming it hurdles the last obstacle-the Governor’s desk-preserves health planning in Illinois. Based on the June 9, 2000 enactment of Senate Bill 807, the Illinois Health Facilities Planning Act was scheduled for repeal on July 1, 2003. The approval of SB 1332 by both Houses of the General Assembly, however, extends such repeal or "sunset" until July 1, 2008, and amends both the Illinois Health Facilities Planning Act and the Hospital Licensing Act. Additionally, the bill makes several procedural changes and substantive changes to both Acts.

The most significant changes made by SB 1332 affect the Health Facilities Planning Board itself. The bill reduces the number of members of the Board from its current fifteen voting members to nine voting members and provides that no more than five members of the board may be from the same political party. The members continue to be appointed by the Governor and will serve for three-year staggered terms. However, certain characteristics and recommendations that the Governor was to consider when making appointments to the Planning Board were removed. That is, the Planning Board members are no longer required to represent the various interested parties in the health planning process such as payors, hospitals and other providers. The new bill also imposes term limits which restrict Board members to two three-year terms.

SB 1332 also contains a requirement that the Planning Board "review, revise, and promulgate the criteria, standards and rules used to evaluate applications for permit" before December 31, 2004. The Act specifies several areas that the review must consider including, among other things, whether the criteria can be reduced or expanded and whether facility-defined service and planning areas should be recognized. This mandate signals that the Planning Board will be spending a significant amount of time over the next 18 months reviewing the current criteria, standards and rules that affect health planning.

A substantive change made by the bill impacts the approvals needed and process used for a change of ownership of a health care facility. The bill amends the Health Facilities Planning Act to include a definition of "change of ownership of a health care facility." The new definition slightly modifies the definition that was previously adopted in the Planning Board rules. Additionally, the bill mandates that the Planning Board provide by rule for an expedited process when a change of ownership of a health care facility occurs between related persons.

In addition to these changes in the Health Facilities Planning Act, SB 1332 makes several amendments and additions to the Hospital Licensing Act. First, the changes will expedite project approval by providing a formal mechanism to allow hospital administrators to discuss the project plans with the Illinois Department of Public Health before the plans are submitted. Additionally, Public Health will also now be required to perform the occupancy inspection no later than ten business days after an applicant provides notice of project completion (a "letter of readiness") to Public Health. Previously, Public Health had thirty (30) business days to provide such inspection. Finally, the bill alters several aspects of the inspection process, including notification requirements and providing for a post-inspection briefing. Note that these licensure changes only affect hospitals and not other health care facilities.

As of the date of publication of this Legal Update, SB 1332 is not yet effective law as the Governor has not signed it. The bill states that it shall become effective upon becoming a law. An open issue is how the Planning Board will deal with the procedural changes related to board membership during this interim period. The Act terminates the term of office of each current member of the Planning Board as of the effective date of the bill, but provides that all members shall continue to have powers and exercise them until all new members of the Planning Board are appointed and take office. The Governor’s office has indicated that the Governor will not have appointed all of the new members of the Planning Board prior to the June meeting of the Planning Board. If the Governor fails to approve this bill before July 1, 2003, when the current Act sunsets, this may cause further confusion as to the interim status of the Planning Board and whether the Health Facilities Planning Act in its current form was repealed before the revisions of SB 1332 take effect. Currently, there is no indication as to when the bill will be signed into law.