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| [ House Amendment 001 ] |
90_HB1030
410 ILCS 65/2 from Ch. 111 1/2, par. 8052
410 ILCS 65/3.3 new
Amends the Illinois Rural/Downstate Health Act. Defines
"health care network" as a nonprofit entity, consisting of
health care providers and others, that is organized to plan
and deliver health care services in areas where there is a
shortage of health care providers. Provides that the Center
for Rural Health may create health care networks that include
members that provide public health, comprehensive primary
care, emergency medical care, and acute patient care.
Establishes the organization of and services that may be
provided by the network.
LRB9000917SMdv
LRB9000917SMdv
1 AN ACT to amend the Illinois Rural/Downstate Health Act
2 by changing Section 2 and adding Section 3.3.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 5. The Illinois Rural/Downstate Health Act is
6 amended by changing Section 2 and adding Section 3.3 as
7 follows:
8 (410 ILCS 65/2) (from Ch. 111 1/2, par. 8052)
9 Sec. 2. The General Assembly finds that citizens in the
10 rural, downstate and designated shortage areas of this State
11 are increasingly faced with problems in accessing necessary
12 health care. The closure of small rural hospitals, the
13 inability of these areas to attract new physicians, the
14 elimination of existing physician services because of
15 increasing practice costs, including the cost of providing
16 malpractice insurance, and the lack of systems of emergency
17 medical care contribute to the access problems experience by
18 these residents. While Illinois is not unique in experiencing
19 these problems, the need to maintain or enhance the economies
20 of these areas of the State requires that new and innovative
21 strategies be identified and implemented to respond to the
22 health care needs of residents of these areas. It is
23 therefore the intent of this General Assembly to create a
24 program to respond to this problem.
25 For purposes of this Act, "designated shortage areas"
26 means medically underserved areas or health manpower shortage
27 area as defined by the United States Department of Health and
28 Human Services or as otherwise designated by the Illinois
29 Department of Public Health.
30 "Health care network" or "network" means a nonprofit
31 legal entity, consisting of rural and urban health care
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1 providers and others, that is organized to plan and deliver
2 health care services on a cooperative basis in areas where
3 there is a shortage of health care providers, except for some
4 secondary and tertiary care services.
5 (Source: P.A. 86-965; 86-1187.)
6 (410 ILCS 65/3.3 new)
7 Sec. 3.3. Health care networks.
8 (a) The Center may create health care networks that
9 include members that provide public health, comprehensive
10 primary care, emergency medical care, and acute patient care.
11 (b) If they are established, these networks may make
12 available health promotion, disease prevention, and primary
13 care services. They may have multiple points of entry,
14 including but not limited to, private physicians, community
15 health centers, county public health units, certified rural
16 health clinics, hospitals, or other providers; or they may
17 have a single point of entry.
18 (c) If they are established, these networks may develop
19 provisions for referral to tertiary inpatient care and to
20 other services not available in areas where there is a
21 shortage of health care providers. They may establish
22 standard protocols, coordinate and share patient records, and
23 develop patient information exchange systems. They may also
24 develop risk management and quality assurance programs for
25 network providers.
26 (d) Network areas do not need to conform to local
27 political boundaries or State administrative district
28 boundaries.
29 (e) If they are established, these networks may be
30 governed and organized in accordance with the following:
31 (1) They may be incorporated under the laws of this
32 State.
33 (2) They may have a board of directors that derives
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1 membership from local government, health care providers,
2 businesses, consumers, and others. The boards of
3 directors may be responsible for determining the content
4 of health care provider arrangements that link network
5 members. The agreements may specify the following:
6 (A) Who provides what services.
7 (B) The extent the health care provider
8 provides care to persons who lack insurance or are
9 otherwise unable to pay for care.
10 (C) The procedures for transfer of medical
11 records.
12 (D) The method used for the transportation of
13 patients between providers.
14 (E) Referral and patient flow, including
15 appointments and scheduling.
16 (F) Payment arrangements for the transfer or
17 referral of patients.
18 (f) If they are established, these networks, to the
19 extent feasible, may ensure the availability of the following
20 services either directly, by contract, or through referral
21 arrangements:
22 (1) Services available in the home, including home
23 health care and hospice care.
24 (2) Services accessible within 30 minutes travel
25 time or less, including the following:
26 (A) Emergency medical services, including
27 advanced life support, ambulance, and basic
28 emergency room services.
29 (B) Primary care and prenatal care.
30 (C) Community-based services for elders,
31 including adult day care and assistance with
32 activities of daily living.
33 (D) Public health services, including
34 communicable disease control, disease prevention,
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1 health education, and health promotion.
2 (E) Outpatient psychiatric and substance abuse
3 services.
4 (3) Services accessible within 45 minutes travel
5 time or less:
6 (A) Hospital acute inpatient care for persons
7 whose illnesses or medical problems are not severe.
8 (B) Level I obstetrical care, which includes
9 labor and delivery for low risk patients.
10 (C) Skilled nursing services, long term care,
11 including nursing home care.
12 (D) Dialysis.
13 (E) Osteopathic and chiropractic manipulative
14 therapy.
15 (4) Services accessible within 2 hours travel time
16 or less:
17 (A) Specialist physician care.
18 (B) Hospital acute patient care for severe
19 illnesses and medical problems.
20 (C) Level II and III obstetrical care, which
21 includes labor and delivery for high-risk patients
22 and neonatal intensive care.
23 (D) Comprehensive medical rehabilitation.
24 (E) Inpatient psychiatric and substance abuse
25 services.
26 (F) Magnetic resonance imaging, lithotripter
27 treatment, advanced radiology, and other
28 technologically advanced services.
29 (G) Subacute care.
30 (g) If they are established, these networks may actively
31 participate with area health education center programs,
32 whenever feasible, in developing and implementing
33 recruitment, training, and retention programs directed at
34 positively influencing the supply and distribution of health
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1 care professionals serving in, or training in, network areas.
2 (h) As funds become available, networks may emphasize
3 community care alternatives for elders who would otherwise be
4 placed in nursing homes.
5 (i) In those network areas that have an established
6 trauma agency approved by the Illinois Department of Public
7 Health, that trauma agency may be a participant in the
8 network.
9 (j) If they are established, these networks may use all
10 sources of public and private funds to support network
11 activities.
12 (k) As funds become available, networks may be developed
13 and implemented in 2 phases. Phase I may consist of a
14 network planning and development grant program. Planning
15 grants shall be used to organize networks, incorporate
16 network boards, and develop formal provider agreements as
17 provided for in this Section. Phase II may consist of
18 network operations. As funds become available, certified
19 networks may be eligible to receive grant funds to be used to
20 help defray the costs of providing patient care.
21 (l) For purposes of certifying networks that are
22 eligible for Phase II funding, the Center, in consultation
23 with the Illinois Department of Public Health, may certify
24 networks that meet the criteria delineated in this Section.
25 (m) The Center, in consultation with the Illinois
26 Department of Public Health, may establish rules that govern
27 the creation and certification of networks, including
28 establishing outcome measures for networks.