98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
SB2959

 

Introduced 2/4/2014, by Sen. Heather A. Steans

 

SYNOPSIS AS INTRODUCED:
 
See Index

    Amends the Emergency Medical Services (EMS) Systems Act and the Hospital Emergency Service Act. Provides that rehabilitation hospitals and psychiatric hospitals, along with long-term acute care hospitals, are hospitals that are not required to provide hospital emergency services. Amends the Hospital Licensing Act and the State Finance Act. Requires a license fee to be submitted with an application for a license to operate a hospital. Creates the Hospital Licensure Fund as a special fund in the State treasury to provide funding for the administration of the licensure program and patient safety and quality initiatives for the hospitals, including, without limitation, the implementation of the Illinois Adverse Health Care Events Reporting Law of 2005. Sets forth the sources of funding and permissible disbursements for the Fund. Amends the Illinois Adverse Health Care Event Reporting Law of 2005. Defines "adverse health care event" as an event identified as a serious reportable event by the National Quality Forum on the effective date of the amendatory Act. Provides that the Department of Public Health shall adopt, by rule, the list of adverse health care events, and provides that if the National Quality Forum revises its list of serious reportable events, then the term "adverse health care event" shall be similarly revised. Removes language concerning certain reportable events. Provides that if the adverse health care events are revised, the Department of Public Health shall notify all affected health care facilities promptly. Makes other changes. Effective immediately.


LRB098 17147 RPS 52234 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

SB2959LRB098 17147 RPS 52234 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. The Emergency Medical Services (EMS) Systems Act
5is amended by changing Section 3.190 as follows:
 
6    (210 ILCS 50/3.190)
7    Sec. 3.190. Emergency Department Classifications. The
8Department shall have the authority and responsibility to:
9        (a) Establish criteria for classifying the emergency
10    departments of all hospitals within the State as
11    Comprehensive, Basic, or Standby. In establishing such
12    criteria, the Department may consult with the Illinois
13    Hospital Licensing Board and incorporate by reference all
14    or part of existing standards adopted as rules pursuant to
15    the Hospital Licensing Act or Emergency Medical Treatment
16    Act;
17        (b) Classify the emergency departments of all
18    hospitals within the State in accordance with this Section;
19        (c) Annually publish, and distribute to all EMS
20    Systems, a list reflecting the classification of all
21    emergency departments.
22    For the purposes of paragraphs (a) and (b) of this Section,
23long-term acute care hospitals, rehabilitation hospitals, and

 

 

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1psychiatric hospitals, as defined under the Hospital Emergency
2Service Act, are not required to provide hospital emergency
3services. Long-term acute care hospitals, rehabilitation
4hospitals, and psychiatric hospitals with no emergency
5department and shall be classified as not available.
6(Source: P.A. 97-667, eff. 1-13-12; 98-463, eff. 8-16-13.)
 
7    Section 3. The Hospital Emergency Service Act is amended by
8changing Sections 1 and 1.3 as follows:
 
9    (210 ILCS 80/1)  (from Ch. 111 1/2, par. 86)
10    Sec. 1. Every hospital required to be licensed by the
11Department of Public Health pursuant to the Hospital Licensing
12Act which provides general medical and surgical hospital
13services, except long-term acute care hospitals,
14rehabilitation hospitals, and psychiatric hospitals identified
15in Section 1.3 of this Act, shall provide a hospital emergency
16service in accordance with rules and regulations adopted by the
17Department of Public Health and shall furnish such hospital
18emergency services to any applicant who applies for the same in
19case of injury or acute medical condition where the same is
20liable to cause death or severe injury or serious illness. For
21purposes of this Act, "applicant" includes any person who is
22brought to a hospital by ambulance or specialized emergency
23medical services vehicle as defined in the Emergency Medical
24Services (EMS) Systems Act.

 

 

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1(Source: P.A. 97-667, eff. 1-13-12.)
 
2    (210 ILCS 80/1.3)
3    Sec. 1.3. Long-term acute care hospitals, rehabilitation
4hospitals, and psychiatric hospitals. For the purpose of this
5Act, general acute care hospitals designated by Medicare as
6long-term acute care hospitals, rehabilitation hospitals, or
7psychiatric hospitals are not required to provide hospital
8emergency services described in Section 1 of this Act.
9Hospitals defined in this Section may provide hospital
10emergency services at their option.
11    Any long-term acute care hospital defined in this Section
12that opts to discontinue or otherwise not provide emergency
13services described in Section 1 shall:
14        (1) comply with all provisions of the federal Emergency
15    Medical Treatment and & Labor Act (EMTALA);
16        (2) comply with all provisions required under the
17    Social Security Act;
18        (3) provide annual notice to communities in the
19    hospital's service area about available emergency medical
20    services; and
21        (4) make educational materials available to
22    individuals who are present at the hospital concerning the
23    availability of medical services within the hospital's
24    service area.
25    Long-term acute care hospitals that operate standby

 

 

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1emergency services as of January 1, 2011 may discontinue
2hospital emergency services by notifying the Department of
3Public Health. Long-term acute care hospitals that operate
4basic or comprehensive emergency services must notify the
5Health Facilities and Services Review Board and follow the
6appropriate procedures.
7    Any rehabilitation hospital or psychiatric hospital that
8opts to discontinue or otherwise not provide emergency services
9described in Section 1 shall:
10        (1) comply with all provisions of the federal Emergency
11    Medical Treatment and Active Labor Act (EMTALA);
12        (2) comply with all provisions required under the
13    Social Security Act;
14        (3) provide annual notice to communities in the
15    hospital's service area about available emergency medical
16    services;
17        (4) make educational materials available to
18    individuals who are present at the hospital concerning the
19    availability of medical services within the hospital's
20    service area;
21        (5) not use the term "hospital" in its name or on any
22    signage; and
23        (6) notify in writing the Department and the Health
24    Facilities and Services Review Board of the
25    discontinuation.
26(Source: P.A. 97-667, eff. 1-13-12; revised 9-11-13.)
 

 

 

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1    Section 5. The Hospital Licensing Act is amended by
2changing Sections 5 and 6 and by adding Section 14.5 as
3follows:
 
4    (210 ILCS 85/5)  (from Ch. 111 1/2, par. 146)
5    Sec. 5. (a) An application for a permit to establish a
6hospital shall be made to the Department upon forms provided by
7it. This application shall contain such information as the
8Department reasonably requires, which shall include
9affirmative evidence on which the Director may make the
10findings required under Section 6a of this Act.
11    (b) An application for a license to open, conduct, operate,
12and maintain a hospital shall be made to the Department upon
13forms provided by it, accompanied by a license fee of $55 per
14bed, or such lesser amount as the Department may establish by
15administrative rule in consultation with the Department of
16Healthcare and Family Services to comply with the limitations
17on health care-related taxes imposed by 42 U.S.C. 1396b(w)
18that, if violated, would result in reductions to the amount of
19federal financial participation received by the State for
20Medicaid expenditures, and shall contain such information as
21the Department reasonably requires, which may include
22affirmative evidence of ability to comply with the provisions
23of this Act and the standards, rules, and regulations,
24promulgated by virtue thereof.

 

 

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1    (c) All applications required under this Section shall be
2signed by the applicant and shall be verified. Applications on
3behalf of a corporation or association or a governmental unit
4or agency shall be made and verified by any two officers
5thereof.
6(Source: Laws 1965, p. 2350.)
 
7    (210 ILCS 85/6)  (from Ch. 111 1/2, par. 147)
8    Sec. 6. (a) Upon receipt of an application for a permit to
9establish a hospital the Director shall issue a permit if he
10finds (1) that the applicant is fit, willing, and able to
11provide a proper standard of hospital service for the community
12with particular regard to the qualification, background, and
13character of the applicant, (2) that the financial resources
14available to the applicant demonstrate an ability to construct,
15maintain, and operate a hospital in accordance with the
16standards, rules, and regulations adopted pursuant to this Act,
17and (3) that safeguards are provided which assure hospital
18operation and maintenance consistent with the public interest
19having particular regard to safe, adequate, and efficient
20hospital facilities and services.
21    The Director may request the cooperation of county and
22multiple-county health departments, municipal boards of
23health, and other governmental and non-governmental agencies
24in obtaining information and in conducting investigations
25relating to such applications.

 

 

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1    A permit to establish a hospital shall be valid only for
2the premises and person named in the application for such
3permit and shall not be transferable or assignable.
4    In the event the Director issues a permit to establish a
5hospital the applicant shall thereafter submit plans and
6specifications to the Department in accordance with Section 8
7of this Act.
8    (b) Upon receipt of an application for license to open,
9conduct, operate, and maintain a hospital, the Director shall
10issue a license if he finds the applicant and the hospital
11facilities comply with standards, rules, and regulations
12promulgated under this Act. A license, unless sooner suspended
13or revoked, shall be renewable annually upon approval by the
14Department and payment of a license fee as established pursuant
15to Section 5 of this Act. Each license shall be issued only for
16the premises and persons named in the application and shall not
17be transferable or assignable. Licenses shall be posted in a
18conspicuous place on the licensed premises. The Department may,
19either before or after the issuance of a license, request the
20cooperation of the State Fire Marshal, county and multiple
21county health departments, or municipal boards of health to
22make investigations to determine if the applicant or licensee
23is complying with the minimum standards prescribed by the
24Department. The report and recommendations of any such agency
25shall be in writing and shall state with particularity its
26findings with respect to compliance or noncompliance with such

 

 

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1minimum standards, rules, and regulations.
2    The Director may issue a provisional license to any
3hospital which does not substantially comply with the
4provisions of this Act and the standards, rules, and
5regulations promulgated by virtue thereof provided that he
6finds that such hospital has undertaken changes and corrections
7which upon completion will render the hospital in substantial
8compliance with the provisions of this Act, and the standards,
9rules, and regulations adopted hereunder, and provided that the
10health and safety of the patients of the hospital will be
11protected during the period for which such provisional license
12is issued. The Director shall advise the licensee of the
13conditions under which such provisional license is issued,
14including the manner in which the hospital facilities fail to
15comply with the provisions of the Act, standards, rules, and
16regulations, and the time within which the changes and
17corrections necessary for such hospital facilities to
18substantially comply with this Act, and the standards, rules,
19and regulations of the Department relating thereto shall be
20completed.
21(Source: P.A. 80-56.)
 
22    (210 ILCS 85/14.5 new)
23    Sec. 14.5. Hospital Licensure Fund.
24    (a) There is created in the State treasury the Hospital
25Licensure Fund. The Fund is created for the purpose of

 

 

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1providing funding for the administration of the licensure
2program and patient safety and quality initiatives for
3hospitals, including, without limitation, the implementation
4of the Illinois Adverse Health Care Events Reporting Law of
52005.
6    (b) The Fund shall consist of the following:
7        (1) fees collected pursuant to this Section;
8        (2) federal matching funds received by the State as a
9    result of expenditures made by the Department that are
10    attributable to moneys deposited in the Fund;
11        (3) interest earned on moneys deposited in the Fund;
12    and
13        (4) other moneys received for the Fund from any other
14    source, including interest earned thereon.
15    (c) Disbursements from the Fund shall be made only for:
16        (1) initially, the implementation of the Illinois
17    Adverse Health Care Events Reporting Law of 2005;
18        (2) subsequently, programs, information, or
19    assistance, including measures to address public
20    complaints, designed to measurably improve quality and
21    patient safety; and
22        (3) the reimbursement of moneys collected by the
23    Department through error or mistake.
24    (d) The uses described in paragraphs (1) and (2) of
25subsection (c) shall be developed in conjunction with a
26statewide organization representing a majority of hospitals.
 

 

 

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1    Section 8. The Illinois Adverse Health Care Events
2Reporting Law of 2005 is amended by changing Sections 10-10 and
310-15 as follows:
 
4    (410 ILCS 522/10-10)
5    Sec. 10-10. Definitions. As used in this Law, the following
6terms have the following meanings:
7    "Adverse health care event" means any event identified as a
8serious reportable event by the National Quality Forum on the
9effective date of this amendatory Act of the 98th General
10Assembly. The Department shall adopt, by rule, the list of
11adverse health care events. The rules in effect on May 1, 2013,
12that define "adverse health care event" shall remain in effect
13until new rules are adopted in accordance with this amendatory
14Act of the 98th General Assembly. If the National Quality Forum
15thereafter revises its list of serious reportable events
16through addition, deletion, or modification, then the term
17"adverse health care event" for purposes of this Law shall be
18similarly revised, effective no sooner than 6 months after the
19revision by the National Quality Forum. described in
20subsections (b) through (g) of Section 10-15.
21    "Department" means the Illinois Department of Public
22Health.
23    "Health care facility" means a hospital maintained by the
24State or any department or agency thereof where such department

 

 

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1or agency has authority under law to establish and enforce
2standards for the hospital under its management and control, a
3hospital maintained by any university or college established
4under the laws of this State and supported principally by
5public funds raised by taxation, a hospital licensed under the
6Hospital Licensing Act, a hospital organized under the
7University of Illinois Hospital Act, and an ambulatory surgical
8treatment center licensed under the Ambulatory Surgical
9Treatment Center Act.
10(Source: P.A. 94-242, eff. 7-18-05.)
 
11    (410 ILCS 522/10-15)
12    Sec. 10-15. Health care facility requirements to report,
13analyze, and correct.
14    (a) Reports of adverse health care events required. Each
15health care facility shall report to the Department the
16occurrence of any of the adverse health care events described
17in subsections (b) through (g) no later than 30 days after
18discovery of the event. The report shall be filed in a format
19specified by the Department and shall identify the health care
20facility, but shall not include any information identifying or
21that tends to identify any of the health care professionals,
22employees, or patients involved.
23    (b) (Blank). Surgical events. Events reportable under this
24subsection are:
25        (1) Surgery performed on a wrong body part that is not

 

 

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1    consistent with the documented informed consent for that
2    patient. Reportable events under this clause do not include
3    situations requiring prompt action that occur in the course
4    of surgery or situations whose urgency precludes obtaining
5    informed consent.
6        (2) Surgery performed on the wrong patient.
7        (3) The wrong surgical procedure performed on a patient
8    that is not consistent with the documented informed consent
9    for that patient. Reportable events under this clause do
10    not include situations requiring prompt action that occur
11    in the course of surgery or situations whose urgency
12    precludes obtaining informed consent.
13        (4) Retention of a foreign object in a patient after
14    surgery or other procedure, excluding objects
15    intentionally implanted as part of a planned intervention
16    and objects present prior to surgery that are intentionally
17    retained.
18        (5) Death during or immediately after surgery of a
19    normal, healthy patient who has no organic, physiologic,
20    biochemical, or psychiatric disturbance and for whom the
21    pathologic processes for which the operation is to be
22    performed are localized and do not entail a systemic
23    disturbance.
24    (c) (Blank). Product or device events. Events reportable
25under this subsection are:
26        (1) Patient death or serious disability associated

 

 

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1    with the use of contaminated drugs, devices, or biologics
2    provided by the health care facility when the contamination
3    is the result of generally detectable contaminants in
4    drugs, devices, or biologics regardless of the source of
5    the contamination or the product.
6        (2) Patient death or serious disability associated
7    with the use or function of a device in patient care in
8    which the device is used or functions other than as
9    intended. "Device" includes, but is not limited to,
10    catheters, drains, and other specialized tubes, infusion
11    pumps, and ventilators.
12        (3) Patient death or serious disability associated
13    with intravascular air embolism that occurs while being
14    cared for in a health care facility, excluding deaths
15    associated with neurosurgical procedures known to present
16    a high risk of intravascular air embolism.
17    (d) (Blank). Patient protection events. Events reportable
18under this subsection are:
19        (1) An infant discharged to the wrong person.
20        (2) Patient death or serious disability associated
21    with patient disappearance for more than 4 hours, excluding
22    events involving adults who have decision-making capacity.
23        (3) Patient suicide or attempted suicide resulting in
24    serious disability while being cared for in a health care
25    facility due to patient actions after admission to the
26    health care facility, excluding deaths resulting from

 

 

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1    self-inflicted injuries that were the reason for admission
2    to the health care facility.
3    (e) (Blank). Care management events. Events reportable
4under this subsection are:
5        (1) Patient death or serious disability associated
6    with a medication error, including, but not limited to,
7    errors involving the wrong drug, the wrong dose, the wrong
8    patient, the wrong time, the wrong rate, the wrong
9    preparation, or the wrong route of administration,
10    excluding reasonable differences in clinical judgment on
11    drug selection and dose.
12        (2) Patient death or serious disability associated
13    with a hemolytic reaction due to the administration of
14    ABO-incompatible blood or blood products.
15        (3) Maternal death or serious disability associated
16    with labor or delivery in a low-risk pregnancy while being
17    cared for in a health care facility, excluding deaths from
18    pulmonary or amniotic fluid embolism, acute fatty liver of
19    pregnancy, or cardiomyopathy.
20        (4) Patient death or serious disability directly
21    related to hypoglycemia, the onset of which occurs while
22    the patient is being cared for in a health care facility
23    for a condition unrelated to hypoglycemia.
24    (f) (Blank). Environmental events. Events reportable under
25this subsection are:
26        (1) Patient death or serious disability associated

 

 

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1    with an electric shock while being cared for in a health
2    care facility, excluding events involving planned
3    treatments such as electric countershock.
4        (2) Any incident in which a line designated for oxygen
5    or other gas to be delivered to a patient contains the
6    wrong gas or is contaminated by toxic substances.
7        (3) Patient death or serious disability associated
8    with a burn incurred from any source while being cared for
9    in a health care facility that is not consistent with the
10    documented informed consent for that patient. Reportable
11    events under this clause do not include situations
12    requiring prompt action that occur in the course of surgery
13    or situations whose urgency precludes obtaining informed
14    consent.
15        (4) Patient death associated with a fall while being
16    cared for in a health care facility.
17        (5) Patient death or serious disability associated
18    with the use of restraints or bedrails while being cared
19    for in a health care facility.
20    (g) (Blank). Physical security events. Events reportable
21under this subsection are:
22        (1) Any instance of care ordered by or provided by
23    someone impersonating a physician, nurse, pharmacist, or
24    other licensed health care provider.
25        (2) Abduction of a patient of any age.
26        (3) Sexual assault on a patient within or on the

 

 

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1    grounds of a health care facility.
2        (4) Death or significant injury of a patient or staff
3    member resulting from a physical assault that occurs within
4    or on the grounds of a health care facility.
5    (g-5) If the adverse health care events subject to this Law
6are revised as described in Section 10-10, then the Department
7shall provide notice to all affected health care facilities
8promptly upon the revision and shall inform affected health
9care facilities of the effective date of the revision for
10purposes of reporting under this Law.
11    (h) Definitions. As pertains to an adverse health care
12event used in this Section 10-15:
13     "Death" means patient death related to an adverse event
14and not related solely to the natural course of the patient's
15illness or underlying condition. Events otherwise reportable
16under this Section 10-15 shall be reported even if the death
17might have otherwise occurred as the natural course of the
18patient's illness or underlying condition.
19    "Serious disability" means a physical or mental
20impairment, including loss of a body part, related to an
21adverse event and not related solely to the natural course of
22the patient's illness or underlying condition, that
23substantially limits one or more of the major life activities
24of an individual or a loss of bodily function, if the
25impairment or loss lasts more than 7 days prior to discharge or
26is still present at the time of discharge from an inpatient

 

 

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1health care facility.
2(Source: P.A. 94-242, eff. 7-18-05.)
 
3    Section 10. The State Finance Act is amended by adding
4Section 5.855 as follows:
 
5    (30 ILCS 105/5.855 new)
6    Sec. 5.855. The Hospital Licensure Fund.
 
7    Section 99. Effective date. This Act takes effect upon
8becoming law.

 

 

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1 INDEX
2 Statutes amended in order of appearance
3    210 ILCS 50/3.190
4    210 ILCS 80/1from Ch. 111 1/2, par. 86
5    210 ILCS 80/1.3
6    210 ILCS 85/5from Ch. 111 1/2, par. 146
7    210 ILCS 85/6from Ch. 111 1/2, par. 147
8    210 ILCS 85/14.5 new
9    410 ILCS 522/10-10
10    410 ILCS 522/10-15
11    30 ILCS 105/5.855 new