Certificate of Need Program
The Health Facilities Planning Act (the Act) (20 ILCS 3960), established Illinois’ certificate of need (CON) program. CON is designed to restrain rising health care costs by preventing unnecessary construction or modification of health care facilities. The Act promotes the development of a comprehensive health care delivery system that assures the availability of quality facilities, related services, and equipment to the public, while simultaneously addressing the issues of community need, accessibility, and financing. In addition, CON promotes cost containment, better management and improved planning by health care providers.
The Act established the Health Facilities Planning Board (since renamed the Health Facilities and Services Review Board (Review Board)) which issues permits (certificates of need) for construction or modification projects proposed by or on behalf of healthcare facilities, and for approving transactions for the acquisition of major medical equipment. To obtain a permit, a person must justify that a proposed project is needed and financially and economically feasible. Included in the application review is the opportunity for public comments and a public hearing that provides for community input into the process.
The Review Board is an independent nine member commission appointed by the Governor with Senate confirmation. The Secretary of the Illinois Department of Human Services and the
Directors of the Illinois Department of Healthcare and Family Services and Department of Public Health serve as ex-officio non-voting members. The issuance of a permit requires five affirmative votes. The Illinois Department of Public Health’s Division of Health Systems Development provides primary staff support for the Review Board.
Entities subject to the Act include licensed and state-operated: hospitals; long-term care facilities; dialysis centers; ambulatory surgery centers; alternative health care delivery models, free standing emergency centers, and birthing centers. Facilities operated by the federal government are exempt. Transactions requiring a permit include construction or modification by or on behalf of a health care facility exceeding the capital expenditure minimum that is in excess of $12,495,668 for hospitals, $7,062,768 for long term care facilities and for all other applicants $3,259,740. The same capital expenditure thresholds apply to the acquisition of major medical equipment. In addition a substantial increase in a facility’s bed capacity or a substantial change in the scope or functional operation of a facility and the proposed establishment or discontinuation of a facility or category of service must obtain a permit or exemption. Long term care facilities no longer are required to submit a certificate of need for the discontinuation or a change of ownership of a long term care facility.