AUTHORITY: Alternative Health Care Delivery Act [210 ILCS 3].
SOURCE: Adopted at 35 Ill. Reg. 6501, effective March 31, 2011; amended at 43 Ill. Reg. 1633, effective January 18, 2019; amended at 46 Ill. Reg. 18820, effective November 4, 2022.
SUBPART A: GENERAL REQUIREMENTS
Section 265.1000 Scope and Purpose
a) The purpose of this Part is to implement the Birth Center Demonstration Program under the Alternative Health Care Delivery Act, which allows up to 10 birth centers to be licensed by the Illinois Department of Public Health as birth center alternative health care delivery models.
b) This Part establishes general provisions, licensing procedures, building requirements, enforcement provisions, and operational and clinical standards for the provision and coordination of treatment and services in birth centers.
Section 265.1050 Definitions
Act – the Alternative Health Care Delivery Act.
Administrator – the person who is directly responsible for the operation and administration of the birth center, irrespective of the person's assigned title.
Applicant – any person, acting individually or with any other person, who proposes to build, own, establish or operate a birth center.
Adequate – enough in either quantity or quality, as determined by a reasonable person familiar with the professional standards of the subject under review, to meet the needs of the clients of a facility under the particular set of circumstances in existence at the time of review.
Advanced practice nurse or APN – a person who has met the qualifications for a certified nurse midwife (CNM); certified nurse practitioner (CNP); certified registered nurse anesthetist (CRNA); or clinical nurse specialist (CNS) and has been licensed by the Department of Financial and Professional Regulation. (Section 50-10 of the Nurse Practice Act)
Antepartum – the period of time before labor or childbirth.
Birth assistant – a person licensed or certified in Illinois by the Department of Financial and Professional Regulation in a health-related field and under the supervision of the physician or certified nurse midwife in attendance, who has specialized training in labor and delivery techniques and care of newborns, and receives planned and ongoing training as needed to perform assigned duties effectively. (Section 35(6) of the Act)
Birth attendant – an obstetrician, family practitioner physician, or certified nurse midwife who attends each woman in labor from the time of admission and throughout the immediate postpartum period. (Section 35(6) of the Act)
Birth center or center – an alternative health care delivery model that is exclusively dedicated to serving the childbirth-related needs of women and their newborns and has no more than 10 beds. A birth center is a designated site that is away from the mother's usual place of residence in which births are planned to occur following a normal, uncomplicated, and low-risk pregnancy.
Birth room – a room specifically designed and equipped for a single occupancy client to give birth under the care of professionals in that health care specialty.
Birth unit – a number of birth rooms grouped or clustered around a central area/station that maintains direct supervision (electronic supervision is not permitted) of the birth rooms.
Certified nurse midwife or CNM – a registered nurse who meets the requirements for licensure as an advanced practice nurse under the category of certified nurse midwife under Section 15 of the Nurse Practice Act.
Charitable care – the intentioned provision of free or discounted birth center services to persons who cannot afford to pay for the services.
Client – a woman who gives birth at a center and the infant of that birth.
Community education services – information and education provided to the pregnant woman and her family, during both early and late pregnancy, that promote healthy outcomes for the woman and her infant.
Demonstration Program or Program – a program to license and study alternative health care models authorized under the Act. (Section 10 of the Act)
Department – the Illinois Department of Public Health. (Section 10 of the Act)
Federally qualified health center – a community health center funded under Section 330 of the federal Public Health Service Act (42 USC 254b).
Governing body – a board of trustees, governing board, board of directors or other body or individual responsible for governing a birth center.
Health-related field – either a registered nurse or licensed practical nurse, physician, physician assistant, or other classifications that are licensed, registered or certified by the Illinois Department of Financial and Professional Regulation.
Hospital – any institution, place, building or agency licensed pursuant to the Hospital Licensing Act. (Section 3 of the Hospital Licensing Act)
Immediate postpartum period – a minimum of two hours following the delivery of the placenta and until the client is clinically stable.
Inspection – any survey, evaluation, or investigation of the birth center's compliance with the Act and this Part by the Department or designee.
Intrapartum – the time from the onset of true labor until the delivery of the infant and placenta.
Licensee – the person or entity licensed to operate the birth center.
Low-risk pregnancy – a pregnancy that, based on history, application of risk criteria, and adequate prenatal care, is broadly predicted to have a normal, uncomplicated outcome.
Medical care facility – a hospital, birthing center, and any other licensed facility that provides obstetrical and newborn nursery services. (Section 2 of the Early Hearing Detection and Intervention Act)
Medical director – a physician, licensed to practice medicine in all of its branches, who is certified or eligible for certification by the American Board of Obstetricians and Gynecologists, who provides guidance, leadership, oversight and quality assurance to the birth center.
Newborn infant or newborn – an infant who is less than 72 hours old.
Nurse – a registered nurse or licensed practical nurse as defined in the Nurse Practice Act.
Operator – the person responsible for the control, maintenance and governance of the birth center, its personnel and physical plant.
Owner – the individual, partnership, corporation, or other person who owns the birth center.
Perinatal center – a referral facility designated under the Regionalized Perinatal Health Care Code and intended to care for the high risk patient before, during, or after labor and delivery and characterized by sophistication and availability of personnel, equipment, laboratory, transportation techniques, consultation and other support services.
Person – any individual, partnership, corporation, association, municipality, political subdivision, trust, estate or other legal entity.
Physician – any person licensed to practice medicine in all of its branches under the Medical Practice Act of 1987.
Prenatal care – medical care for a pregnant woman and her fetus throughout her pregnancy.
Program narrative – a description of the center's proposed operation, which clarifies or explains choices related to such items as space, equipment, finishes or other specifications in the architectural plans. The program narrative shall include, but is not limited to, the:
Number of beds;
Medical needs of proposed clients;
Proposed food service operation;
Proposed laundry operation; and
Interrelation of the functions of the birth center.
Quality assurance – an ongoing, objective and systematic process of monitoring, evaluating and improving the quality, appropriateness and effectiveness of care.
Quality improvement or performance improvement – an organized, structured process that selectively identifies projects to achieve improvement in products or services.
Registered nurse – a person who is licensed as a registered professional nurse under the Nurse Practice Act.
Risk assessment – a process by which historical, physical, and laboratory data are applied for the prediction of pregnancy outcome.
Sanitize – to destroy microorganisms by cleaning or disinfecting.
Sterilization – the use of a physical or chemical procedure to destroy all microbial life, including bacterial endospores.
Substantial compliance or substantially comply – meeting requirements, except for variance from the strict and literal performance that results in unimportant omissions or defects, given the particular circumstances involved.
Supervision – authoritative procedural guidance by a qualified person for the accomplishment of a function or activity within his/her sphere of competence, with initial direction and periodic inspection of the actual act of accomplishing the function or activity.
Support person – an individual who provides emotional support and help with relaxation techniques and comfort measures.
Survey – a detailed, complete inspection of the birth center.
Universal/standard precautions – as defined by the Centers for Disease Control and Prevention (CDC), recommendations designed to prevent transmission of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and other blood borne pathogens when providing health care.
Vaginal delivery – spontaneous labor and delivery.
(Source: Amended at 43 Ill. Reg. 1633, effective January 18, 2019)