By Benjamin Yount     Illinois Statehouse News

SPRINGFIELD  –  Illinois lawmakers say it looks like they're going to have decide just how much charity is required from a hospital's charity-care program.

The Illinois Supreme Court on Thursday ruled that a Champaign hospital, Provena Convenant Medical Center, did not provide enough charity care back in 2002.  The justices said that because the hospital did not offer enough care to the poor, the state was right to strip Provena of its tax-exempt status for that year.  Provena now has to pay millions of dollars in property taxes for 2002. 

But the high court did not explain how much charity is required for a hospital to remain tax exempt.

Lawmakers in Springfield say they apparently have to come up with that explanation.

State Sen. Mike Frerichs, D-Champaign, said he's been following the Provena case for almost eight years and said the hospital and the local community need more answers than they got from the Supreme Court ruling.

Frerichs said that without clear guidance about how much charity is required, one can see cash-strapped cities and other local governments turning  to hospitals as they search for revenue.

"I think we need to act quickly because I think you're going to see a lot of taxing bodies looking to pounce on hospitals in their areas.  And I think, ultimately, that is not the answer for good, quality medical care in our communities."

The Illinois Hospital Association is putting its weight behind that fear.  A statement from Illinois Hospital Association President Maryjane Wurth said "imposing new tax burdens could force hospitals…to reduce service and increase health care costs."

But an IHA spokesman said he's leery of pushing the General Assembly to get involved.  The spokesman said he wants all parties to "analyze the options" before acting.

State Rep. Chuck Jefferson, D-Rockford, said that's probably a good thing.  He's concerned about a one- size-fits-all approach from Springfield.

"You get a guy come through the door and say 'Well that's it.  We're out of charity case money for this year.  Come back next year.' I don't know how you do that," Jefferson said.

Illinois Attorney General Lisa Madigan in 2006 backed legislation requiring nonprofit hospitals to dedicate 8 percent of their annual income to charity care. The legislation failed after IHA fought the one-size-fits-all stance.

State Sen. Dave Syverson, R-Rockford, agreed that the legislature may not be the best arbiter of charity.  Syverson said a hospital can do plenty of good on its own.

"Charitable work is always done more compassionately and cost-effectively than having government do it.  If we start having health care facilities backing off on their charitable work because they're not going to get credit for it –that means these people are going to have to be served by government and the cost is going to be significantly more expensive."

State Sen. Mike Jacobs, D-East Moline, said once the government starts getting into the business of setting minimums, those regulations often become the maximum.

"I think most hospitals have stood up and done the right thing.  If there are individual cases where people don't think they're doing the right thing, I'd be interested in knowing who and what those are.  But I'm very reluctant to mandate to hospitals what they should do when they're having troubles just keeping their doors open."

But Justice Anne Burke in her dissenting opinion in the Provena case said the question of how much charity is enough for charity care is exactly the question that the General Assembly needs to answer.

Burke wrote that the high court's decision is "injecting" the court into "matters best left to the legislature."