SB2434sam001 104TH GENERAL ASSEMBLY

Sen. Karina Villa

Filed: 4/4/2025

10400SB2434sam001 LRB104 11251 BAB 24936 a

AMENDMENT TO SENATE BILL 2434

AMENDMENT NO. ______. Amend Senate Bill 2434 by replacing everything after the enacting clause with the following:

"Section 1. Short title. This Act may be cited as the Certified Family Health Aide Program for Children and Adults Act.

Section 5. Purpose. The purpose of this Act is to create the certified family health aide designation.

Section 10. Definition. As used in this Act, "certified family health aide" means a person who:

(1) is 18 years of age or older;

(2) has the following relationship with the family member receiving or who is eligible to receive the services enumerated in this Section:

(i) spouse;

(ii) sibling or stepsibling;

(iii) parent, stepparent, or adoptive parent;

(iv) grandparent;

(v) mother-in-law or father-in-law;

(vi) brother-in-law or sister-in-law;

(vii) legal guardian; or

(viii) caregiver designated by the legally responsible caregiver;

(3) is a legally responsible caregiver, or has been designated by a legally responsible caregiver, for a person who receives or is eligible to receive:

(i) in-home shift nursing services under the Early and Periodic Screening, Diagnostic and Treatment requirement of Medicaid under 42 U.S.C. 1396d(r); or

(ii) in-home shift nursing through the home and community-based services waiver program authorized under Section 1915(c) of the Social Security Act for persons who are medically fragile and technology dependent; and

(4) is certified pursuant to this Section to perform or to assist in performance of (1) in-home shift nursing services under the Early and Periodic Screening, Diagnostic and Treatment requirement of Medicaid under 42 U.S.C. 1396d(r); or (2) in-home shift nursing services through the home and community-based services waiver program authorized under Section 1915(c) of the Social Security Act for a designated person or designated persons who are medically fragile and technology dependent and eligible to receive the services laid out in this Section, including:

(i) the same tasks as a certified nursing assistant;

(ii) medication administration;

(iii) enteral care and therapy; and

(iv) other needed services to support the individual as provided by rule.

Section 15. Certified family health aide program for children and adults.

(a) The Department of Public Health, in partnership with the Department of Healthcare and Family Services, shall create a certification pathway for a legally responsible caregiver, or a person who has been designated by a legally responsible caregiver, who is seeking certification as a certified family health aide, including the adoption of any necessary rules for the certification process. This certification pathway shall include documentation, in a manner designated by the Department of Public Health, of initial training provided by hospitals licensed in the Hospital Licensing Act, children's community-based health care centers as defined in the Alternative Health Care Delivery Act, or home nursing agencies as defined in the Home Health, Home Services, and Home Nursing Agency Licensing Act.

(b) A certified family health aide may only perform services to and for a person receiving or eligible to receive:

(1) in-home shift nursing services under the Early and Periodic Screening, Diagnostic and Treatment benefit requirement of Medicaid under 42 U.S.C. 1396d(r); or

(2) in-home shift nursing services through the home and community-based services waiver program authorized under Section 1915(c) of the Social Security Act for persons who are medically fragile and technology dependent.

To be eligible for reimbursement as a certified family health aide, a legally responsible caregiver or a person designated by a legally responsible caregiver must meet all certification requirements as set forth in this Section, in Section 5-2.06b of the Illinois Public Aid Code, and in any applicable administrative rule.

(d) The Department of Public Health, in consultation with the Department of Healthcare and Family Services, may adopt rules necessary to implement the provisions of this Act, including, but not limited to, rules requiring background checks for the certified family health aide, establishing the scope of services a certified family health aide can perform, and establishing any utilization controls of services performed by a certified family health aide.

Section 100. The Alternative Health Care Delivery Act is amended by changing Section 35 as follows:

(210 ILCS 3/35)

Sec. 35. Alternative health care models authorized. Notwithstanding any other law to the contrary, alternative health care models described in this Section may be established on a demonstration basis.

(1) (Blank).

(2) Alternative health care delivery model; postsurgical recovery care center. A postsurgical recovery care center is a designated site which provides postsurgical recovery care for generally healthy patients undergoing surgical procedures that potentially require overnight nursing care, pain control, or observation that would otherwise be provided in an inpatient setting. Patients may be discharged from the postsurgical recovery care center in less than 24 hours if the attending physician or the facility's medical director believes the patient has recovered enough to be discharged. A postsurgical recovery care center is either freestanding or a defined unit of an ambulatory surgical treatment center or hospital. No facility, or portion of a facility, may participate in a demonstration program as a postsurgical recovery care center unless the facility has been licensed as an ambulatory surgical treatment center or hospital for at least 2 years before August 20, 1993 (the effective date of Public Act 88-441). The maximum length of stay for patients in a postsurgical recovery care center is not to exceed 48 hours unless the treating physician requests an extension of time from the recovery center's medical director on the basis of medical or clinical documentation that an additional care period is required for the recovery of a patient and the medical director approves the extension of time. In no case, however, shall a patient's length of stay in a postsurgical recovery care center be longer than 72 hours. If a patient requires an additional care period after the expiration of the 72-hour limit, the patient shall be transferred to an appropriate facility. Reports on variances from the 24-hour or 48-hour limit shall be sent to the Department for its evaluation. The reports shall, before submission to the Department, have removed from them all patient and physician identifiers. Blood products may be administered in the postsurgical recovery care center model. In order to handle cases of complications, emergencies, or exigent circumstances, every postsurgical recovery care center as defined in this paragraph shall maintain a contractual relationship, including a transfer agreement, with a general acute care hospital. A postsurgical recovery care center shall be no larger than 20 beds. A postsurgical recovery care center shall be located within 15 minutes travel time from the general acute care hospital with which the center maintains a contractual relationship, including a transfer agreement, as required under this paragraph.

No postsurgical recovery care center shall discriminate against any patient requiring treatment because of the source of payment for services, including Medicare and Medicaid recipients.

The Department shall adopt rules to implement the provisions of Public Act 88-441 concerning postsurgical recovery care centers within 9 months after August 20, 1993. Notwithstanding any other law to the contrary, a postsurgical recovery care center model may provide sleep laboratory or similar sleep studies in accordance with applicable State and federal laws and regulations.

(3) Alternative health care delivery model; children's community-based health care center. A children's community-based health care center model is a designated site that provides nursing care, clinical support services, and therapies for a period of one to 14 days for short-term stays and 120 days to facilitate transitions to home or other appropriate settings for medically fragile children, technology dependent children, and children with special health care needs who are deemed clinically stable by a physician and are younger than 22 years of age. This care is to be provided in a home-like environment that serves no more than 12 children at a time, except that a children's community-based health care center in existence on the effective date of this amendatory Act of the 100th General Assembly that is located in Chicago on grade level for Life Safety Code purposes may provide care to no more than 16 children at a time. Children's community-based health care center services must be available through the model to all families, including those whose care is paid for through the Department of Healthcare and Family Services, the Department of Children and Family Services, the Department of Human Services, and insurance companies who cover home health care services or private duty nursing care in the home.

Each children's community-based health care center model location shall be physically separate and apart from any other facility licensed by the Department of Public Health under this or any other Act and shall provide the following services: respite care, registered nursing or licensed practical nursing care, transitional care to facilitate home placement or other appropriate settings and reunite families, medical day care, weekend camps, and diagnostic studies typically done in the home setting.

A children's community-based health care center shall provide initial training, prior to home placement for, and shall keep records in a manner designated by the Department regarding, the certified family health aide, as defined in the Certified Family Health Aide Program for Children and Adults Act, identified as the legally responsible caregiver or designated by a legally responsible caregiver for the medical care of an individual who receives or is eligible to receive:

(i) in-home shift nursing services under the Early and Periodic Screening, Diagnostic and Treatment requirement of Medicaid under 42 U.S.C. 1396d(r); or

(ii) in-home shift nursing through the home and community-based services waiver program authorized under Section 1915(c) of the Social Security Act for persons who are medically fragile and technology dependent.

Coverage for the services provided by the Department of Healthcare and Family Services under this paragraph (3) is contingent upon federal waiver approval and is provided only to Medicaid eligible clients participating in the home and community based services waiver designated in Section 1915(c) of the Social Security Act for medically frail and technologically dependent children or children in Department of Children and Family Services foster care who receive home health benefits.

(4) Alternative health care delivery model; community based residential rehabilitation center. A community-based residential rehabilitation center model is a designated site that provides rehabilitation or support, or both, for persons who have experienced severe brain injury, who are medically stable, and who no longer require acute rehabilitative care or intense medical or nursing services. The average length of stay in a community-based residential rehabilitation center shall not exceed 4 months. As an integral part of the services provided, individuals are housed in a supervised living setting while having immediate access to the community. The residential rehabilitation center authorized by the Department may have more than one residence included under the license. A residence may be no larger than 12 beds and shall be located as an integral part of the community. Day treatment or individualized outpatient services shall be provided for persons who reside in their own home. Functional outcome goals shall be established for each individual. Services shall include, but are not limited to, case management, training and assistance with activities of daily living, nursing consultation, traditional therapies (physical, occupational, speech), functional interventions in the residence and community (job placement, shopping, banking, recreation), counseling, self-management strategies, productive activities, and multiple opportunities for skill acquisition and practice throughout the day. The design of individualized program plans shall be consistent with the outcome goals that are established for each resident. The programs provided in this setting shall be accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). The program shall have been accredited by CARF as a Brain Injury Community-Integrative Program for at least 3 years.

(5) Alternative health care delivery model; Alzheimer's disease management center. An Alzheimer's disease management center model is a designated site that provides a safe and secure setting for care of persons diagnosed with Alzheimer's disease. An Alzheimer's disease management center model shall be a facility separate from any other facility licensed by the Department of Public Health under this or any other Act. An Alzheimer's disease management center shall conduct and document an assessment of each resident every 6 months. The assessment shall include an evaluation of daily functioning, cognitive status, other medical conditions, and behavioral problems. An Alzheimer's disease management center shall develop and implement an ongoing treatment plan for each resident. The treatment plan shall have defined goals. The Alzheimer's disease management center shall treat behavioral problems and mood disorders using nonpharmacologic approaches such as environmental modification, task simplification, and other appropriate activities. All staff must have necessary training to care for all stages of Alzheimer's Disease. An Alzheimer's disease management center shall provide education and support for residents and caregivers. The education and support shall include referrals to support organizations for educational materials on community resources, support groups, legal and financial issues, respite care, and future care needs and options. The education and support shall also include a discussion of the resident's need to make advance directives and to identify surrogates for medical and legal decision-making. The provisions of this paragraph establish the minimum level of services that must be provided by an Alzheimer's disease management center. An Alzheimer's disease management center model shall have no more than 100 residents. Nothing in this paragraph (5) shall be construed as prohibiting a person or facility from providing services and care to persons with Alzheimer's disease as otherwise authorized under State law.

(6) Alternative health care delivery model; birth center. A birth center shall be exclusively dedicated to serving the childbirth-related needs of women and their newborns and shall have no more than 10 beds. A birth center is a designated site that is away from the mother's usual place of residence and in which births are planned to occur following a normal, uncomplicated, and low-risk pregnancy. A birth center shall offer prenatal care and community education services and shall coordinate these services with other health care services available in the community.

(A) A birth center shall not be separately licensed if it is one of the following:

(1) A part of a hospital; or

(2) A freestanding facility that is physically distinct from a hospital but is operated under a license issued to a hospital under the Hospital Licensing Act.

(B) A separate birth center license shall be required if the birth center is operated as:

(1) A part of the operation of a federally qualified health center as designated by the United States Department of Health and Human Services; or

(2) A facility other than one described in subparagraph (A)(1), (A)(2), or (B)(1) of this paragraph (6) whose costs are reimbursable under Title XIX of the federal Social Security Act.

In adopting rules for birth centers, the Department shall consider: the American Association of Birth Centers' Standards for Freestanding Birth Centers; the American Academy of Pediatrics/American College of Obstetricians and Gynecologists Guidelines for Perinatal Care; and the Regionalized Perinatal Health Care Code. The Department's rules shall stipulate the eligibility criteria for birth center admission. The Department's rules shall stipulate the necessary equipment for emergency care according to the American Association of Birth Centers' standards and any additional equipment deemed necessary by the Department. The Department's rules shall provide for a time period within which each birth center not part of a hospital must become accredited by either the Commission for the Accreditation of Freestanding Birth Centers or The Joint Commission.

A birth center shall be certified to participate in the Medicare and Medicaid programs under Titles XVIII and XIX, respectively, of the federal Social Security Act. To the extent necessary, the Illinois Department of Healthcare and Family Services shall apply for a waiver from the United States Health Care Financing Administration to allow birth centers to be reimbursed under Title XIX of the federal Social Security Act.

A birth center that is not operated under a hospital license shall be located within a ground travel time distance from the general acute care hospital with which the birth center maintains a contractual relationship, including a transfer agreement, as required under this paragraph, that allows for an emergency caesarian delivery to be started within 30 minutes of the decision a caesarian delivery is necessary. A birth center operating under a hospital license shall be located within a ground travel time distance from the licensed hospital that allows for an emergency caesarian delivery to be started within 30 minutes of the decision a caesarian delivery is necessary.

The services of a medical director physician, licensed to practice medicine in all its branches, who is certified or eligible for certification by the American College of Obstetricians and Gynecologists or the American Board of Osteopathic Obstetricians and Gynecologists or has hospital obstetrical privileges are required in birth centers. The medical director in consultation with the Director of Nursing and Midwifery Services shall coordinate the clinical staff and overall provision of patient care. The medical director or his or her physician designee shall be available on the premises or within a close proximity as defined by rule. The medical director and the Director of Nursing and Midwifery Services shall jointly develop and approve policies defining the criteria to determine which pregnancies are accepted as normal, uncomplicated, and low-risk, and the anesthesia services available at the center. No general anesthesia may be administered at the center.

If a birth center employs certified nurse midwives, a certified nurse midwife shall be the Director of Nursing and Midwifery Services who is responsible for the development of policies and procedures for services as provided by Department rules.

An obstetrician, family practitioner, or certified nurse midwife shall attend each woman in labor from the time of admission through birth and throughout the immediate postpartum period. Attendance may be delegated only to another physician or certified nurse midwife. Additionally, a second staff person shall also be present at each birth who is licensed or certified in Illinois in a health-related field and under the supervision of the physician or certified nurse midwife in attendance, 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.

The maximum length of stay in a birth center shall be consistent with existing State laws allowing a 48-hour stay or appropriate post-delivery care, if discharged earlier than 48 hours.

A birth center shall participate in the Illinois Perinatal System under the Developmental Disability Prevention Act. At a minimum, this participation shall require a birth center to establish a letter of agreement with a hospital designated under the Perinatal System. A hospital that operates or has a letter of agreement with a birth center shall include the birth center under its maternity service plan under the Hospital Licensing Act and shall include the birth center in the hospital's letter of agreement with its regional perinatal center.

A birth center may not discriminate against any patient requiring treatment because of the source of payment for services, including Medicare and Medicaid recipients.

No general anesthesia and no surgery may be performed at a birth center. The Department may by rule add birth center patient eligibility criteria or standards as it deems necessary. The Department shall by rule require each birth center to report the information which the Department shall make publicly available, which shall include, but is not limited to, the following:

(i) Birth center ownership.

(ii) Sources of payment for services.

(iii) Utilization data involving patient length of stay.

(iv) Admissions and discharges.

(v) Complications.

(vi) Transfers.

(vii) Unusual incidents.

(viii) Deaths.

(ix) Any other publicly reported data required under the Illinois Consumer Guide.

(x) Post-discharge patient status data where patients are followed for 14 days after discharge from the birth center to determine whether the mother or baby developed a complication or infection.

Within 9 months after the effective date of this amendatory Act of the 95th General Assembly, the Department shall adopt rules that are developed with consideration of: the American Association of Birth Centers' Standards for Freestanding Birth Centers; the American Academy of Pediatrics/American College of Obstetricians and Gynecologists Guidelines for Perinatal Care; and the Regionalized Perinatal Health Care Code.

The Department shall adopt other rules as necessary to implement the provisions of this amendatory Act of the 95th General Assembly within 9 months after the effective date of this amendatory Act of the 95th General Assembly.

(Source: P.A. 100-518, eff. 12-8-17 (see Section 5 of P.A. 100-558 for the effective date of changes made by P.A. 100-518).)

Section 105. The Home Health, Home Services, and Home Nursing Agency Licensing Act is amended by changing Section 2.11 and by adding Section 2.13 as follows:

(210 ILCS 55/2.11)

Sec. 2.11. "Home nursing agency" means an agency that provides services directly, or acts as a placement agency, in order to deliver skilled nursing and home health aide services to persons in their personal residences or a certified family health aide, as defined by the Certified Family Health Aide Program for Children and Adults Act, for individuals receiving or eligible to receive the following services: (1) in-home shift nursing services under the Early and Periodic Screening, Diagnostic and Treatment requirement of Medicaid under 42 U.S.C. 1396d(r); or (2) in-home shift nursing services through the home and community-based services waiver program authorized under Section 1915(c) of the Social Security Act for persons who are medically fragile and technology dependent. A home nursing agency provides services that would require a licensed nurse to perform. Home health aide services are provided under the direction of a registered professional nurse or advanced practice registered nurse. A home nursing agency does not require licensure as a home health agency under this Act. "Home nursing agency" does not include an individually licensed nurse acting as a private contractor or a person that provides or procures temporary employment in health care facilities, as defined in the Nurse Agency Licensing Act.

(Source: P.A. 100-513, eff. 1-1-18.)

(210 ILCS 55/2.13 new)

Sec. 2.13. Certified family health aide. A home nursing agency shall provide initial and ongoing training for, and shall keep records in a manner designated by the Department regarding, the certified family health aide, as defined in the Certified Family Health Aide Program for Children and Adults Act, identified as the legally responsible caregiver or designated by the legally responsible caregiver for an individual who receives or is eligible to receive:

(1) in-home shift nursing services under the Early and Periodic Screening, Diagnostic and Treatment requirement of Medicaid under 42 U.S.C. 1396d(r); or

(2) in-home shift nursing through the home and community-based services waiver program authorized under Section 1915(c) of the Social Security Act for persons who are medically fragile and technology dependent.

Section 110. The Hospital Licensing Act is amended by adding Section 17 as follows:

(210 ILCS 85/17 new)

Sec. 17. Certified family health aide. Hospitals managing the care of an individual to be discharged under the care of a home nursing agency shall provide initial training, and shall document in a manner designated by the Department, for the certified family health aide, as defined in the Certified Family Health Aide Program for Children and Adults Act, identified as the legally responsible caregiver or designated by a legally responsible caregiver for an individual who receives or is eligible to receive in-home shift nursing services under the Early and Periodic Screening, Diagnostic and Treatment requirement of Medicaid under 42 U.S.C. 1396d(r) or in-home shift nursing through the home and community-based services waiver program authorized under Section 1915(c) of the Social Security Act for persons who are medically fragile and technology dependent.

Section 115. The Nurse Practice Act is amended by changing Section 50-15 as follows:

(225 ILCS 65/50-15) (was 225 ILCS 65/5-15)

(Section scheduled to be repealed on January 1, 2028)

Sec. 50-15. Policy; application of Act.

(a) For the protection of life and the promotion of health, and the prevention of illness and communicable diseases, any person practicing or offering to practice advanced, professional, or practical nursing in Illinois shall submit evidence that he or she is qualified to practice, and shall be licensed as provided under this Act. No person shall practice or offer to practice advanced, professional, or practical nursing in Illinois or use any title, sign, card or device to indicate that such a person is practicing professional or practical nursing unless such person has been licensed under the provisions of this Act.

(b) This Act does not prohibit the following:

(1) The practice of nursing in Federal employment in the discharge of the employee's duties by a person who is employed by the United States government or any bureau, division or agency thereof and is a legally qualified and licensed nurse of another state or territory and not in conflict with Sections 50-50, 55-10, 60-10, and 70-5 of this Act.

(2) Nursing that is included in the program of study by students enrolled in programs of nursing or in current nurse practice update courses approved by the Department.

(3) The furnishing of nursing assistance in an emergency.

(4) The practice of nursing by a nurse who holds an active license in another state when providing services to patients in Illinois during a bonafide emergency or in immediate preparation for or during interstate transit.

(5) The incidental care of the sick by members of the family, domestic servants or housekeepers, or care of the sick where treatment is by prayer or spiritual means.

(6) Persons from being employed as unlicensed assistive personnel in private homes, long term care facilities, nurseries, hospitals or other institutions.

(7) The practice of practical nursing by one who is a licensed practical nurse under the laws of another U.S. jurisdiction and has applied in writing to the Department, in form and substance satisfactory to the Department, for a license as a licensed practical nurse and who is qualified to receive such license under this Act, until (i) the expiration of 6 months after the filing of such written application, (ii) the withdrawal of such application, or (iii) the denial of such application by the Department.

(8) The practice of advanced practice registered nursing by one who is an advanced practice registered nurse under the laws of another United States jurisdiction or a foreign jurisdiction and has applied in writing to the Department, in form and substance satisfactory to the Department, for a license as an advanced practice registered nurse and who is qualified to receive such license under this Act, until (i) the expiration of 6 months after the filing of such written application, (ii) the withdrawal of such application, or (iii) the denial of such application by the Department.

(9) The practice of professional nursing by one who is a registered professional nurse under the laws of another United States jurisdiction or a foreign jurisdiction and has applied in writing to the Department, in form and substance satisfactory to the Department, for a license as a registered professional nurse and who is qualified to receive such license under Section 55-10, until (1) the expiration of 6 months after the filing of such written application, (2) the withdrawal of such application, or (3) the denial of such application by the Department.

(10) The practice of professional nursing that is included in a program of study by one who is a registered professional nurse under the laws of another United States jurisdiction or a foreign jurisdiction and who is enrolled in a graduate nursing education program or a program for the completion of a baccalaureate nursing degree in this State, which includes clinical supervision by faculty as determined by the educational institution offering the program and the health care organization where the practice of nursing occurs.

(11) Any person licensed in this State under any other Act from engaging in the practice for which she or he is licensed.

(12) Delegation to authorized direct care staff trained under Section 15.4 of the Mental Health and Developmental Disabilities Administrative Act consistent with the policies of the Department.

(13) (Blank).

(14) County correctional personnel from delivering prepackaged medication for self-administration to an individual detainee in a correctional facility.

(15) The practice of relevant care by a legally responsible caregiver or a person designated by a legally responsible caregiver who has been certified as a certified family health aide, as defined in the Certified Family Health Aide Program for Children and Adults Act, to perform for a person who receives or is eligible to receive the following services: (i) in-home shift nursing services under the Early and Periodic Screening, Diagnostic and Treatment requirement of Medicaid under 42 U.S.C. 1396d(r); or (ii) in-home shift nursing services through the home and community-based services waiver program authorized under Section 1915(c) of the Social Security Act for persons who are medically fragile and technology dependent.

Nothing in this Act shall be construed to limit the delegation of tasks or duties by a physician, dentist, or podiatric physician to a licensed practical nurse, a registered professional nurse, or other persons.

(Source: P.A. 100-513, eff. 1-1-18.)

Section 120. The Illinois Public Aid Code is amended by adding Section 5-2.06b as follows:

(305 ILCS 5/5-2.06b new)

Sec. 5-2.06b. Certified family health aide program for children and adults.

(a) The Department of Healthcare and Family Services may apply for a Home and Community-Based Services State Plan amendment and federal waiver amendment necessary to reimburse a legally responsible caregiver or a person designated by a legally responsible caregiver, as defined in the Certified Family Health Aide Program for Children and Adults Act, who has achieved certification as a certified family health aide to perform or assist in performance of: (1) in-home shift nursing services under the Early and Periodic Screening, Diagnostic and Treatment requirement of Medicaid under 42 U.S.C. 1396d(r); or the home and community-based services waiver program authorized under Section 1915(c) of the Social Security Act for a designated person or designated persons who are medically fragile and technology dependent and in need and eligible for these services. Upon federal approval of any State Plan amendment or waiver amendment, the Department may adopt rules in partnership with the Department of Public Health to specify the federally approved services eligible for reimbursement under the certified family health aide certification and to adopt any other policies or procedures necessary to implement this Section.

(b) The Department of Healthcare and Family Services, in partnership with the Department of Public Health, shall convene an advisory working group of stakeholders to provide guidance and expertise regarding implementation of the certified family health aide program. The Department of Healthcare and Family Services shall convene this advisory working group within 60 days after the effective date of this amendatory Act of the 104th General Assembly. This working group may include, but is not limited to, at least one representative from the University of Illinois at Chicago, Division of Specialized Care for Children, at least 4 representatives of home nurse agencies, at least one physician with medical experience with the population being served by the program, at least one representative from a children's hospital, at least one legally responsible caregiver as described in item (3) of Section 10 of the Certified Family Health Aide Program for Children and Adults Act, and at least one representative of a Children's Community-Based Health Care Clinic.".