peculiar procedure for the only health facilities planning board i submit to the court that the issue before us today is why did the board after twice denying this integra application for a project for new hospital take the unprecedented step reconsider its denial based on a single misfiled document that in fact supported their prior denials yet upon their so called reconsideration reversed itself or prove the project without even acknowledging the so called misfiled b requiring the reconsideration much less explaining all the documents that resulted in a change or explaining their change and without allowing written comments at the time the thing made that decision here and this scrutiny by this court in reversal of what this board did we start from the proposition that the granting of a permit is not it as a right it's not a right you have instead under to the one health sylvie's planning act there has to hospitals so as to not have duplications services not to help house rules that are in existence of effect that we put out of existence through additional one for you if you will supply and to keep the cost of healthcare down those that work how's it working it's working probably better now than it had in the past after the two thousand and nine rewrite of the act because of some of the missteps that this board talk but how is it working in this case it didn't work how was it working in genoa doing even health care in terms of keeping health care costs down in this is really addressed to the specific the facilities and here are absent this act we could literally have a hospital in every corner exactly as you're suggesting protecting the public so we don't have now distribution of services or we don't have oversupply of services and that's in effect where misstep this here's to really the regular reason or i could really say this year there were procedural peculiarities in the way this war it came to this reversal of itself those procedural regularities included at the time that it came back from the administrative law judge they did not allow britain on it when do you have to meet every single criteria no you do you have to still be evaluated according to those criteria yes here is one of the most important criteria which goes to the need for the hospital was not met this was a new hospital as a new hospital it had to either provide all physicians or for letters which are very clearly described in the regulations to include substantial information it says that a number of physicians will refer i'm not cases to the when they produce the board they didn't follow the rules again the rules have ridiculous definitions as to what rapid population growth are or population growth within their statuary scheme those were not met instead what they did is they took a set of assumptions that the board at the same meeting they voted to approve change their bed meet instead affectively some temporal all of your assumptions they're wrong but nonetheless the board went forward with because they now had census data and the census data stamp wished that as objective leave there was not then the type of growth that everyone had been in quotes assuming so that assumption was wrong rather then looking submit to the court that it's also clearly erroneous under that standard alternately what was approved was approved despite a record that established a state agency report the professionals for the board identifying specific if you will rights here or that weren't a supplemental state agency report that identified similar sorts of criteria and it's important to look at what criteria weren't met those are quite sure that we could say are the ones on the and around this particular planning area for those hospitals which are also providing levels of service and support in the community are operating at less than the target level that the state board has established the cost of that we will start taking from those hospitals more and more people there's only fortunately or unfortunately so many people to go around and that's why the planning act look to when the board should look to balancing that so we do not have a maldistribution or a hospital where there is not a neat and that's how the public is hurt because now we have other hospitals they can't perform lack of better word and not service because they're occupancy is the law when we look at those are they also looking at the team one twenty four fourteen thousand one twenty four in the quote says well the proceedings before the state board will be rather quickly tainted by the unauthorized action and any decision rendered by the board would be full weight the decision contravene procedure step forth in the planning act and would be invalid that wasn't sent by advocate that wasn't sent by mercy that wasn't said by sherman it was said by syntagma and i think that's prophetic and that's what actually happened here they ended up this board with a procedure that was procedural in tainted substantively tainted i submit gives us the impression that it's the only war that operated behind closed doors in all respects was inappropriate and that is why it would be heard by the people that are interested that didn't occur here none of these deliberations for this reversal none of the deliberations for the so called articulation of reasons under medina that the circuit court required were done in public and that's really one of the it's undisputed that sen take his application for a certificate of need satisfy the overwhelming majority of the being created here is set forth in the regulations it's also undisputed that the regulations authorize the board to issue a versus the illinois health facility or you know and i'm not actually sure that that is at the heart of this matter i mean what the case law looks to me is whether or not the board's decision was sufficiently substantiated and you know if you look at so in terms of board subsequent vote to approve the application at the december twenty and levin vote there was a flair for a tie meaning because they didn't get a mature majority vote it was not approved at the subsequent vote there missing there is also substantial compliance and the board's decision should be hear from for that reason again going back to this issue of you know sort of what changed now that that is determined of this issue because we don't think it is or determine to do this case we don't think it is but you know in addition to the additional board member who was present there was testimony if you look through the open you know the record under the open meetings that various persons were allowed to comment and there was additional discussion that the board members heard during that time period that could have swayed their vote from you know the late my recollection is that there were more than three and i have my own recollection is also that the opposing hospitals were able to cope with it as well i don't think there was ever a time were only sent tiger was allowed to address the issue for medical surgical intensive care beds as well as intensive care unit beds the staff room he's shown that the need to increase from within three hundred to one hundred and thirty eight for medical surgical beds and the increase from opposing hospitals insistence that the board didn't explain its reasons is just contradicted by this evidence and at bottom mercy an advocate are asking this court to me weigh the evidence concerning this and takers that were cation in their favor but this court will not be first the administrative agencies decision unless there's a definite and firm conviction that a mistake has been committed and we respectfully submit that that standard has not been met in this case for those reasons and those set forth in a council my name is dan lawler i represent the permit holders some type of health system and center hospital humbly rush he says in the conclusion of his reply brief that this appeal is not about whether the board can change its mind or agreed the health facilities planning act allows multiple votes on a project if the legislature did not intend the board to change its decisions it would not have allowed multiple opportunities for it to do so conclusions linked together by a coherent rationale the board did this in its written decisions this prop about the bourne changing its mind let's look at that a majority of the board members voting on this project did not change their minds from the initial denial to the final decision approving the project five of them voted the same one board member was an app that initial vote he voted for the project and the final vote didn't change his mind you got six bird numbers who didn't change their mind there were three who did two who voted against the project the first time around voted for the project with or throw the project on the final approval and what did those board members happy for them that they didn't have before well these were two board members who  concerned about the impact on existing facilities this new report that they have said was so important that was put into the record and the board reconsidered it was addressed to that figures that centers on exports were using it justified vindicated sin ted was projections that this project would not adversely impact existing facilities that was not before on the  before what they are referring to that was before the board was a footnote on one page of a ten thousand page record and that's all of a half when they have the reconsideration voted on the final approval they had before them the expert sworn testimony explaining the impact of this new report that the board was to reconsider that was having also saying that the board has discretion to weigh the evidence and they don't have to wait at the same time that every time it comes before the board so that's another factor so go  on how many signed up and they have multiple signed now what they're complaining about yes yes we were able to give all comments but the form didn't let us get written comments well first of all they didn't request that second of all they've never told us what that written comment was going to be this record is full of their written comments most of the times that they came before the war they just repeated stuff that they had said previously s back and forth and how they change their mind and that's what is lacking counsel now suggests that there was new evidence if there was new evidence and the new evidence some home made a difference it wasn't in the public record of any discussion of deliberation and it surely  was not in what's the sick leave the board articulated in his written decision of september twenty fourth as being the reason for changing this is a case i would submit to the court we look at it on her political standard to review this court amplification because that right war we changed our mind because in other words and we only don't explain why we're doing now but what we did last time and why we seize on mine in this case they must do the latter because that's first what the circuit court judge said they must do but more importantly they must do the latter because nothing changed except for their mind there is no new status report there's no supplemental report there's no discussion so for purposes of review this court and any court looks at what the board does and says i don't know why they did what they did and that's why here it's important for them to explain why they did what they did which is a one hundred eighty or  medina was obligated under the just the circuit court's decision it was obligated based upon what they said they were doing to explain why they did what they did and having failed to do that they simply missed what this a requires which is consistency open has transparency none of which was here we would reach this court therefore to reverse the board decision and therefore make them permanent thank you