Freestanding Emergency Center Rule Approved by JCAR

June 3, 2008

On May 20, 2008, the Illinois Joint Commission on Administrative Rules (JCAR) met and considered Freestanding Emergency Center (FEC) rules that had been proposed by the Illinois Health Facilities Planning Board. During the meeting, JCAR made no objection to the final adoption of a rule allowing the Illinois Health Facilities Planning Board to accept applications for a certificate of need permit to establish Freestanding Emergency Centers (FEC). With the receipt of a certificate of no objection from JCAR, the Planning Board has the ability to officially publish the final rule in the Illinois Register. Publication is required to make the new rule effective. This action is anticipated in the coming weeks.

In addition, the Planning Board reported at its May meeting that it will publish a FEC establishment application template upon the final publication of the FEC rule. The FEC application will be made available on the Planning Board’s website.

The timeframe to establish an FEC is limited. The legislation, Senate Bill 1579 (Public Act 95-584), amends the Emergency Medical Services (EMS) Act and allows for the establishment of new FEC’s. The Act further provides that the Illinois Department of Public Health shall issue an annual freestanding emergency center license only until June 30, 2009. As a result, the window of opportunity is limited and a hospital system interested in establishing a freestanding emergency center will likely need to file a CON application this year if it desires to pursue the provision of this service.

The circumstances under which a hospital can establish a FEC are limited. The law limits licensure to a facility that (1) is located in a municipality with a new population of 75,000 or fewer residents, (2) is located within 20 miles of the owning or controlling full service hospital, and (3) is located within 20 miles of a resource hospital affiliated with the FEC as a part of the EMS system.

The EMS Act became effective in 1996 and established a FEC demonstration program which resulted in the establishment of a two FEC’s; however, neither FEC is operational today. The FEC for Bolingbrook Medical Center and Trinity Medical Center were dissolved when full-service hospitals were developed nearby. The demonstration program allowed the Illinois Department of Public Health to examine the quality of care provided in a FEC setting. In 2004, the demonstration program became permanent. The most recent law, S.B. 1579, was sponsored by Sen. Susan Garrett (D-Highland Park) and Rep. Barbara Flynn Currie (D-Chicago) presumably to allow Lake Forest Hospital to expand its acute care center to a FEC at its Grayslake campus.

At present, there are three letters of intent pending with the Planning Board to establish a new FEC. Letters of intent require a 60 day notice period before a Certificate of Need application may be filed with the Planning Board and a letter expires one year from the date of receipt if an application is never filed. FEC intent letters filed with the Planning Board are as follows:

  1. Lake Forest Hospital in Grayslake, IL (received by Planning Board 8-13-07)
  2. CHS Lindenhurst in Lindenhurst, IL (received by Planning Board on 11-9-07)
  3. Rush-Copley in Yorkville, IL (received by Planning Board on 12-27-07)

Two FEC proposals introduced by Advocate Healthcare for Round Lake, IL and Tinley Park, IL were withdrawn at the last meeting of the Planning Board.