96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
HB0976

 

Introduced 2/10/2009, by Rep. Linda Chapa LaVia

 

SYNOPSIS AS INTRODUCED:
 
210 ILCS 3/25
210 ILCS 3/30
210 ILCS 3/35
210 ILCS 3/35.1 rep.
210 ILCS 85/3   from Ch. 111 1/2, par. 144
210 ILCS 85/4.6

    Amends the Alternative Health Care Delivery Act and the Hospital Licensing Act. Provides that there shall be no more than the total postsurgical recovery care centers with certificate of need for beds as of January 1, 2008 (instead of a total of 12 centers); deletes provisions concerning specific locations of postsurgical recovery care centers. Repeals a provision that once the Department of Public Health has authorized a total of 12 postsurgical recovery care centers, no new centers shall be authorized for the duration of the demonstration program. Provides that for purposes of the Hospital Licensing Act, "hospital" includes postsurgical recovery care hospitals, and provides for the licensing of such hospitals. Eliminates obsolete provisions and makes other changes. Effective July 1, 2009.


LRB096 08475 DRJ 18595 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB0976 LRB096 08475 DRJ 18595 b

1     AN ACT concerning regulation.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4     Section 5. The Alternative Health Care Delivery Act is
5 amended by changing Sections 25, 30, and 35 as follows:
 
6     (210 ILCS 3/25)
7     Sec. 25. Department responsibilities. The Department shall
8 have the responsibilities set forth in this Section.
9     (a) The Department shall adopt rules for each alternative
10 health care model authorized under this Act that shall include
11 but not be limited to the following:
12         (1) Further definition of the alternative health care
13     models.
14         (2) The definition and scope of the demonstration
15     program, including the implementation date and period of
16     operation, not to exceed 5 years.
17         (3) License application information required by the
18     Department.
19         (4) The care of patients in the alternative health care
20     models.
21         (5) Rights afforded to patients of the alternative
22     health care models.
23         (6) Physical plant requirements.

 

 

HB0976 - 2 - LRB096 08475 DRJ 18595 b

1         (7) License application and renewal fees, which may
2     cover the cost of administering the demonstration program.
3         (8) Information that may be necessary for the Board and
4     the Department to monitor and evaluate the alternative
5     health care model demonstration program.
6         (9) Administrative fines that may be assessed by the
7     Department for violations of this Act or the rules adopted
8     under this Act.
9     (b) The Department shall issue, renew, deny, suspend, or
10 revoke licenses for alternative health care models.
11     (c) The Department shall perform licensure inspections of
12 alternative health care models as deemed necessary by the
13 Department to ensure compliance with this Act or rules.
14     (d) The Department shall deposit application fees, renewal
15 fees, and fines into the Regulatory Evaluation and Basic
16 Enforcement Fund.
17     (e) The Department shall assist the Board in performing the
18 Board's responsibilities under this Act.
19     (f) (Blank). The Department shall conduct a study to
20 determine the feasibility, the potential risks and benefits to
21 patients, and the potential effect on the health care delivery
22 system of authorizing recovery care of nonsurgical patients in
23 postsurgical recovery center demonstration models. The
24 Department shall report the findings of the study to the
25 General Assembly no later than November 1, 1998. The Director
26 shall appoint an advisory committee with representation from

 

 

HB0976 - 3 - LRB096 08475 DRJ 18595 b

1 the Illinois Hospital and Health Systems Association, the
2 Illinois State Medical Society, and the Illinois Freestanding
3 Surgery Center Association, a physician who is board certified
4 in internal medicine, a consumer, and other representatives
5 deemed appropriate by the Director. The advisory committee
6 shall advise the Department as it carries out the study.
7     (g) (Blank). Before November 1, 1998 the Department shall
8 initiate a process to request public comments on how
9 postsurgical recovery centers admitting nonsurgical patients
10 should be regulated.
11 (Source: P.A. 90-600, eff. 6-25-98; 90-655, eff. 7-30-98.)
 
12     (210 ILCS 3/30)
13     Sec. 30. Demonstration program requirements. The
14 requirements set forth in this Section shall apply to
15 demonstration programs.
16     (a) There shall be no more than:
17         (i) 3 subacute care hospital alternative health care
18     models in the City of Chicago (one of which shall be
19     located on a designated site and shall have been licensed
20     as a hospital under the Illinois Hospital Licensing Act
21     within the 10 years immediately before the application for
22     a license);
23         (ii) 2 subacute care hospital alternative health care
24     models in the demonstration program for each of the
25     following areas:

 

 

HB0976 - 4 - LRB096 08475 DRJ 18595 b

1             (1) Cook County outside the City of Chicago.
2             (2) DuPage, Kane, Lake, McHenry, and Will
3         Counties.
4             (3) Municipalities with a population greater than
5         50,000 not located in the areas described in item (i)
6         of subsection (a) and paragraphs (1) and (2) of item
7         (ii) of subsection (a); and
8         (iii) 4 subacute care hospital alternative health care
9     models in the demonstration program for rural areas.
10     In selecting among applicants for these licenses in rural
11 areas, the Health Facilities Planning Board and the Department
12 shall give preference to hospitals that may be unable for
13 economic reasons to provide continued service to the community
14 in which they are located unless the hospital were to receive
15 an alternative health care model license.
16     (a-5) There shall be no more than the a total of 12
17 postsurgical recovery care centers with certificate of need for
18 beds as of January 1, 2008. center alternative health care
19 models in the demonstration program, located as follows:
20         (1) Two in the City of Chicago.
21         (2) Two in Cook County outside the City of Chicago. At
22     least one of these shall be owned or operated by a hospital
23     devoted exclusively to caring for children.
24         (3) Two in Kane, Lake, and McHenry Counties.
25         (4) Four in municipalities with a population of 50,000
26     or more not located in the areas described in paragraphs

 

 

HB0976 - 5 - LRB096 08475 DRJ 18595 b

1     (1), (2), and (3), 3 of which shall be owned or operated by
2     hospitals, at least 2 of which shall be located in counties
3     with a population of less than 175,000, according to the
4     most recent decennial census for which data are available,
5     and one of which shall be owned or operated by an
6     ambulatory surgical treatment center.
7         (5) Two in rural areas, both of which shall be owned or
8     operated by hospitals.
9     There shall be no postsurgical recovery care center
10 alternative health care models located in counties with
11 populations greater than 600,000 but less than 1,000,000. A
12 proposed postsurgical recovery care center must be owned or
13 operated by a hospital if it is to be located within, or will
14 primarily serve the residents of, a health service area in
15 which more than 60% of the gross patient revenue of the
16 hospitals within that health service area are derived from
17 Medicaid and Medicare, according to the most recently available
18 calendar year data from the Illinois Health Care Cost
19 Containment Council. Nothing in this paragraph shall preclude a
20 hospital and an ambulatory surgical treatment center from
21 forming a joint venture or developing a collaborative agreement
22 to own or operate a postsurgical recovery care center.
23     (a-10) There shall be no more than a total of 8 children's
24 respite care center alternative health care models in the
25 demonstration program, which shall be located as follows:
26         (1) One in the City of Chicago.

 

 

HB0976 - 6 - LRB096 08475 DRJ 18595 b

1         (2) One in Cook County outside the City of Chicago.
2         (3) A total of 2 in the area comprised of DuPage, Kane,
3     Lake, McHenry, and Will counties.
4         (4) A total of 2 in municipalities with a population of
5     50,000 or more and not located in the areas described in
6     paragraphs (1), (2), or (3).
7         (5) A total of 2 in rural areas, as defined by the
8     Health Facilities Planning Board.
9     No more than one children's respite care model owned and
10 operated by a licensed skilled pediatric facility shall be
11 located in each of the areas designated in this subsection
12 (a-10).
13     (a-15) There shall be an authorized community-based
14 residential rehabilitation center alternative health care
15 model in the demonstration program. The community-based
16 residential rehabilitation center shall be located in the area
17 of Illinois south of Interstate Highway 70.
18     (a-20) There shall be an authorized Alzheimer's disease
19 management center alternative health care model in the
20 demonstration program. The Alzheimer's disease management
21 center shall be located in Will County, owned by a
22 not-for-profit entity, and endorsed by a resolution approved by
23 the county board before the effective date of this amendatory
24 Act of the 91st General Assembly.
25     (a-25) There shall be no more than 10 birth center
26 alternative health care models in the demonstration program,

 

 

HB0976 - 7 - LRB096 08475 DRJ 18595 b

1 located as follows:
2         (1) Four in the area comprising Cook, DuPage, Kane,
3     Lake, McHenry, and Will counties, one of which shall be
4     owned or operated by a hospital and one of which shall be
5     owned or operated by a federally qualified health center.
6         (2) Three in municipalities with a population of 50,000
7     or more not located in the area described in paragraph (1)
8     of this subsection, one of which shall be owned or operated
9     by a hospital and one of which shall be owned or operated
10     by a federally qualified health center.
11         (3) Three in rural areas, one of which shall be owned
12     or operated by a hospital and one of which shall be owned
13     or operated by a federally qualified health center.
14     The first 3 birth centers authorized to operate by the
15 Department shall be located in or predominantly serve the
16 residents of a health professional shortage area as determined
17 by the United States Department of Health and Human Services.
18 There shall be no more than 2 birth centers authorized to
19 operate in any single health planning area for obstetric
20 services as determined under the Illinois Health Facilities
21 Planning Act. If a birth center is located outside of a health
22 professional shortage area, (i) the birth center shall be
23 located in a health planning area with a demonstrated need for
24 obstetrical service beds, as determined by the Illinois Health
25 Facilities Planning Board or (ii) there must be a reduction in
26 the existing number of obstetrical service beds in the planning

 

 

HB0976 - 8 - LRB096 08475 DRJ 18595 b

1 area so that the establishment of the birth center does not
2 result in an increase in the total number of obstetrical
3 service beds in the health planning area.
4     (b) Alternative health care models, other than a model
5 authorized under subsection (a-20), shall obtain a certificate
6 of need from the Illinois Health Facilities Planning Board
7 under the Illinois Health Facilities Planning Act before
8 receiving a license by the Department. If, after obtaining its
9 initial certificate of need, an alternative health care
10 delivery model that is a community based residential
11 rehabilitation center seeks to increase the bed capacity of
12 that center, it must obtain a certificate of need from the
13 Illinois Health Facilities Planning Board before increasing
14 the bed capacity. Alternative health care models in medically
15 underserved areas shall receive priority in obtaining a
16 certificate of need.
17     (c) An alternative health care model license shall be
18 issued for a period of one year and shall be annually renewed
19 if the facility or program is in substantial compliance with
20 the Department's rules adopted under this Act. A licensed
21 alternative health care model that continues to be in
22 substantial compliance after the conclusion of the
23 demonstration program shall be eligible for annual renewals
24 unless and until a different licensure program for that type of
25 health care model is established by legislation. The Department
26 may issue a provisional license to any alternative health care

 

 

HB0976 - 9 - LRB096 08475 DRJ 18595 b

1 model that does not substantially comply with the provisions of
2 this Act and the rules adopted under this Act if (i) the
3 Department finds that the alternative health care model has
4 undertaken changes and corrections which upon completion will
5 render the alternative health care model in substantial
6 compliance with this Act and rules and (ii) the health and
7 safety of the patients of the alternative health care model
8 will be protected during the period for which the provisional
9 license is issued. The Department shall advise the licensee of
10 the conditions under which the provisional license is issued,
11 including the manner in which the alternative health care model
12 fails to comply with the provisions of this Act and rules, and
13 the time within which the changes and corrections necessary for
14 the alternative health care model to substantially comply with
15 this Act and rules shall be completed.
16     (d) Alternative health care models shall seek
17 certification under Titles XVIII and XIX of the federal Social
18 Security Act. In addition, alternative health care models shall
19 provide charitable care consistent with that provided by
20 comparable health care providers in the geographic area.
21     (d-5) The Department of Healthcare and Family Services
22 (formerly Illinois Department of Public Aid), in cooperation
23 with the Illinois Department of Public Health, shall develop
24 and implement a reimbursement methodology for all facilities
25 participating in the demonstration program. The Department of
26 Healthcare and Family Services shall keep a record of services

 

 

HB0976 - 10 - LRB096 08475 DRJ 18595 b

1 provided under the demonstration program to recipients of
2 medical assistance under the Illinois Public Aid Code and shall
3 submit an annual report of that information to the Illinois
4 Department of Public Health.
5     (e) Alternative health care models shall, to the extent
6 possible, link and integrate their services with nearby health
7 care facilities.
8     (f) Each alternative health care model shall implement a
9 quality assurance program with measurable benefits and at
10 reasonable cost.
11 (Source: P.A. 95-331, eff. 8-21-07; 95-445, eff. 1-1-08.)
 
12     (210 ILCS 3/35)
13     Sec. 35. Alternative health care models authorized.
14 Notwithstanding any other law to the contrary, alternative
15 health care models described in this Section may be established
16 on a demonstration basis.
17         (1) Alternative health care model; subacute care
18     hospital. A subacute care hospital is a designated site
19     which provides medical specialty care for patients who need
20     a greater intensity or complexity of care than generally
21     provided in a skilled nursing facility but who no longer
22     require acute hospital care. The average length of stay for
23     patients treated in subacute care hospitals shall not be
24     less than 20 days, and for individual patients, the
25     expected length of stay at the time of admission shall not

 

 

HB0976 - 11 - LRB096 08475 DRJ 18595 b

1     be less than 10 days. Variations from minimum lengths of
2     stay shall be reported to the Department. There shall be no
3     more than 13 subacute care hospitals authorized to operate
4     by the Department. Subacute care includes physician
5     supervision, registered nursing, and physiological
6     monitoring on a continual basis. A subacute care hospital
7     is either a freestanding building or a distinct physical
8     and operational entity within a hospital or nursing home
9     building. A subacute care hospital shall only consist of
10     beds currently existing in licensed hospitals or skilled
11     nursing facilities, except, in the City of Chicago, on a
12     designated site that was licensed as a hospital under the
13     Illinois Hospital Licensing Act within the 10 years
14     immediately before the application for an alternative
15     health care model license. During the period of operation
16     of the demonstration project, the existing licensed beds
17     shall remain licensed as hospital or skilled nursing
18     facility beds as well as being licensed under this Act. In
19     order to handle cases of complications, emergencies, or
20     exigent circumstances, a subacute care hospital shall
21     maintain a contractual relationship, including a transfer
22     agreement, with a general acute care hospital. If a
23     subacute care model is located in a general acute care
24     hospital, it shall utilize all or a portion of the bed
25     capacity of that existing hospital. In no event shall a
26     subacute care hospital use the word "hospital" in its

 

 

HB0976 - 12 - LRB096 08475 DRJ 18595 b

1     advertising or marketing activities or represent or hold
2     itself out to the public as a general acute care hospital.
3         (2) Alternative health care delivery model;
4     postsurgical recovery care center. A postsurgical recovery
5     care center is a designated site which provides
6     postsurgical recovery care for generally healthy patients
7     undergoing surgical procedures that require overnight
8     nursing care, pain control, or observation that would
9     otherwise be provided in an inpatient setting. A
10     postsurgical recovery care center is either freestanding
11     or a defined unit of an ambulatory surgical treatment
12     center or hospital. No facility, or portion of a facility,
13     may participate in a demonstration program as a
14     postsurgical recovery care center unless the facility has
15     been licensed as an ambulatory surgical treatment center or
16     hospital for at least 2 years before August 20, 1993 (the
17     effective date of Public Act 88-441). The maximum length of
18     stay for patients in a postsurgical recovery care center is
19     not to exceed 48 hours unless the treating physician
20     requests an extension of time from the recovery center's
21     medical director on the basis of medical or clinical
22     documentation that an additional care period is required
23     for the recovery of a patient and the medical director
24     approves the extension of time. In no case, however, shall
25     a patient's length of stay in a postsurgical recovery care
26     center be longer than 72 hours. If a patient requires an

 

 

HB0976 - 13 - LRB096 08475 DRJ 18595 b

1     additional care period after the expiration of the 72-hour
2     limit, the patient shall be transferred to an appropriate
3     facility. Reports on variances from the 48-hour limit shall
4     be sent to the Department for its evaluation. The reports
5     shall, before submission to the Department, have removed
6     from them all patient and physician identifiers. In order
7     to handle cases of complications, emergencies, or exigent
8     circumstances, every postsurgical recovery care center as
9     defined in this paragraph shall maintain a contractual
10     relationship, including a transfer agreement, with a
11     general acute care hospital. A postsurgical recovery care
12     center shall be no larger than 20 beds. A postsurgical
13     recovery care center shall be located within 15 minutes
14     travel time from the general acute care hospital with which
15     the center maintains a contractual relationship, including
16     a transfer agreement, as required under this paragraph.
17         No postsurgical recovery care center shall
18     discriminate against any patient requiring treatment
19     because of the source of payment for services, including
20     Medicare and Medicaid recipients.
21         The Department shall adopt rules to implement the
22     provisions of Public Act 88-441 concerning postsurgical
23     recovery care centers within 9 months after August 20,
24     1993.
25         (3) Alternative health care delivery model; children's
26     community-based health care center. A children's

 

 

HB0976 - 14 - LRB096 08475 DRJ 18595 b

1     community-based health care center model is a designated
2     site that provides nursing care, clinical support
3     services, and therapies for a period of one to 14 days for
4     short-term stays and 120 days to facilitate transitions to
5     home or other appropriate settings for medically fragile
6     children, technology dependent children, and children with
7     special health care needs who are deemed clinically stable
8     by a physician and are younger than 22 years of age. This
9     care is to be provided in a home-like environment that
10     serves no more than 12 children at a time. Children's
11     community-based health care center services must be
12     available through the model to all families, including
13     those whose care is paid for through the Department of
14     Healthcare and Family Services, the Department of Children
15     and Family Services, the Department of Human Services, and
16     insurance companies who cover home health care services or
17     private duty nursing care in the home.
18         Each children's community-based health care center
19     model location shall be physically separate and apart from
20     any other facility licensed by the Department of Public
21     Health under this or any other Act and shall provide the
22     following services: respite care, registered nursing or
23     licensed practical nursing care, transitional care to
24     facilitate home placement or other appropriate settings
25     and reunite families, medical day care, weekend camps, and
26     diagnostic studies typically done in the home setting.

 

 

HB0976 - 15 - LRB096 08475 DRJ 18595 b

1         Coverage for the services provided by the Department of
2     Healthcare and Family Services under this paragraph (3) is
3     contingent upon federal waiver approval and is provided
4     only to Medicaid eligible clients participating in the home
5     and community based services waiver designated in Section
6     1915(c) of the Social Security Act for medically frail and
7     technologically dependent children or children in
8     Department of Children and Family Services foster care who
9     receive home health benefits.
10         (4) Alternative health care delivery model; community
11     based residential rehabilitation center. A community-based
12     residential rehabilitation center model is a designated
13     site that provides rehabilitation or support, or both, for
14     persons who have experienced severe brain injury, who are
15     medically stable, and who no longer require acute
16     rehabilitative care or intense medical or nursing
17     services. The average length of stay in a community-based
18     residential rehabilitation center shall not exceed 4
19     months. As an integral part of the services provided,
20     individuals are housed in a supervised living setting while
21     having immediate access to the community. The residential
22     rehabilitation center authorized by the Department may
23     have more than one residence included under the license. A
24     residence may be no larger than 12 beds and shall be
25     located as an integral part of the community. Day treatment
26     or individualized outpatient services shall be provided

 

 

HB0976 - 16 - LRB096 08475 DRJ 18595 b

1     for persons who reside in their own home. Functional
2     outcome goals shall be established for each individual.
3     Services shall include, but are not limited to, case
4     management, training and assistance with activities of
5     daily living, nursing consultation, traditional therapies
6     (physical, occupational, speech), functional interventions
7     in the residence and community (job placement, shopping,
8     banking, recreation), counseling, self-management
9     strategies, productive activities, and multiple
10     opportunities for skill acquisition and practice
11     throughout the day. The design of individualized program
12     plans shall be consistent with the outcome goals that are
13     established for each resident. The programs provided in
14     this setting shall be accredited by the Commission on
15     Accreditation of Rehabilitation Facilities (CARF). The
16     program shall have been accredited by CARF as a Brain
17     Injury Community-Integrative Program for at least 3 years.
18         (5) Alternative health care delivery model;
19     Alzheimer's disease management center. An Alzheimer's
20     disease management center model is a designated site that
21     provides a safe and secure setting for care of persons
22     diagnosed with Alzheimer's disease. An Alzheimer's disease
23     management center model shall be a facility separate from
24     any other facility licensed by the Department of Public
25     Health under this or any other Act. An Alzheimer's disease
26     management center shall conduct and document an assessment

 

 

HB0976 - 17 - LRB096 08475 DRJ 18595 b

1     of each resident every 6 months. The assessment shall
2     include an evaluation of daily functioning, cognitive
3     status, other medical conditions, and behavioral problems.
4     An Alzheimer's disease management center shall develop and
5     implement an ongoing treatment plan for each resident. The
6     treatment plan shall have defined goals. The Alzheimer's
7     disease management center shall treat behavioral problems
8     and mood disorders using nonpharmacologic approaches such
9     as environmental modification, task simplification, and
10     other appropriate activities. All staff must have
11     necessary training to care for all stages of Alzheimer's
12     Disease. An Alzheimer's disease management center shall
13     provide education and support for residents and
14     caregivers. The education and support shall include
15     referrals to support organizations for educational
16     materials on community resources, support groups, legal
17     and financial issues, respite care, and future care needs
18     and options. The education and support shall also include a
19     discussion of the resident's need to make advance
20     directives and to identify surrogates for medical and legal
21     decision-making. The provisions of this paragraph
22     establish the minimum level of services that must be
23     provided by an Alzheimer's disease management center. An
24     Alzheimer's disease management center model shall have no
25     more than 100 residents. Nothing in this paragraph (5)
26     shall be construed as prohibiting a person or facility from

 

 

HB0976 - 18 - LRB096 08475 DRJ 18595 b

1     providing services and care to persons with Alzheimer's
2     disease as otherwise authorized under State law.
3         (6) Alternative health care delivery model; birth
4     center. A birth center shall be exclusively dedicated to
5     serving the childbirth-related needs of women and their
6     newborns and shall have no more than 10 beds. A birth
7     center is a designated site that is away from the mother's
8     usual place of residence and in which births are planned to
9     occur following a normal, uncomplicated, and low-risk
10     pregnancy. A birth center shall offer prenatal care and
11     community education services and shall coordinate these
12     services with other health care services available in the
13     community.
14             (A) A birth center shall not be separately licensed
15         if it is one of the following:
16                 (1) A part of a hospital; or
17                 (2) A freestanding facility that is physically
18             distinct from a hospital but is operated under a
19             license issued to a hospital under the Hospital
20             Licensing Act.
21             (B) A separate birth center license shall be
22         required if the birth center is operated as:
23                 (1) A part of the operation of a federally
24             qualified health center as designated by the
25             United States Department of Health and Human
26             Services; or

 

 

HB0976 - 19 - LRB096 08475 DRJ 18595 b

1                 (2) A facility other than one described in
2             subparagraph (A)(1), (A)(2), or (B)(1) of this
3             paragraph (6) whose costs are reimbursable under
4             Title XIX of the federal Social Security Act.
5         In adopting rules for birth centers, the Department
6     shall consider: the American Association of Birth Centers'
7     Standards for Freestanding Birth Centers; the American
8     Academy of Pediatrics/American College of Obstetricians
9     and Gynecologists Guidelines for Perinatal Care; and the
10     Regionalized Perinatal Health Care Code. The Department's
11     rules shall stipulate the eligibility criteria for birth
12     center admission. The Department's rules shall stipulate
13     the necessary equipment for emergency care according to the
14     American Association of Birth Centers' standards and any
15     additional equipment deemed necessary by the Department.
16     The Department's rules shall provide for a time period
17     within which each birth center not part of a hospital must
18     become accredited by either the Commission for the
19     Accreditation of Freestanding Birth Centers or The Joint
20     Commission.
21         A birth center shall be certified to participate in the
22     Medicare and Medicaid programs under Titles XVIII and XIX,
23     respectively, of the federal Social Security Act. To the
24     extent necessary, the Illinois Department of Healthcare
25     and Family Services shall apply for a waiver from the
26     United States Health Care Financing Administration to

 

 

HB0976 - 20 - LRB096 08475 DRJ 18595 b

1     allow birth centers to be reimbursed under Title XIX of the
2     federal Social Security Act.
3         A birth center that is not operated under a hospital
4     license shall be located within a ground travel time
5     distance from the general acute care hospital with which
6     the birth center maintains a contractual relationship,
7     including a transfer agreement, as required under this
8     paragraph, that allows for an emergency caesarian delivery
9     to be started within 30 minutes of the decision a caesarian
10     delivery is necessary. A birth center operating under a
11     hospital license shall be located within a ground travel
12     time distance from the licensed hospital that allows for an
13     emergency caesarian delivery to be started within 30
14     minutes of the decision a caesarian delivery is necessary.
15         The services of a medical director physician, licensed
16     to practice medicine in all its branches, who is certified
17     or eligible for certification by the American College of
18     Obstetricians and Gynecologists or the American Board of
19     Osteopathic Obstetricians and Gynecologists or has
20     hospital obstetrical privileges are required in birth
21     centers. The medical director in consultation with the
22     Director of Nursing and Midwifery Services shall
23     coordinate the clinical staff and overall provision of
24     patient care. The medical director or his or her physician
25     designee shall be available on the premises or within a
26     close proximity as defined by rule. The medical director

 

 

HB0976 - 21 - LRB096 08475 DRJ 18595 b

1     and the Director of Nursing and Midwifery Services shall
2     jointly develop and approve policies defining the criteria
3     to determine which pregnancies are accepted as normal,
4     uncomplicated, and low-risk, and the anesthesia services
5     available at the center. No general anesthesia may be
6     administered at the center.
7         If a birth center employs certified nurse midwives, a
8     certified nurse midwife shall be the Director of Nursing
9     and Midwifery Services who is responsible for the
10     development of policies and procedures for services as
11     provided by Department rules.
12         An obstetrician, family practitioner, or certified
13     nurse midwife shall attend each woman in labor from the
14     time of admission through birth and throughout the
15     immediate postpartum period. Attendance may be delegated
16     only to another physician or certified nurse midwife.
17     Additionally, a second staff person shall also be present
18     at each birth who is licensed or certified in Illinois in a
19     health-related field and under the supervision of the
20     physician or certified nurse midwife in attendance, has
21     specialized training in labor and delivery techniques and
22     care of newborns, and receives planned and ongoing training
23     as needed to perform assigned duties effectively.
24         The maximum length of stay in a birth center shall be
25     consistent with existing State laws allowing a 48-hour stay
26     or appropriate post-delivery care, if discharged earlier

 

 

HB0976 - 22 - LRB096 08475 DRJ 18595 b

1     than 48 hours.
2         A birth center shall participate in the Illinois
3     Perinatal System under the Developmental Disability
4     Prevention Act. At a minimum, this participation shall
5     require a birth center to establish a letter of agreement
6     with a hospital designated under the Perinatal System. A
7     hospital that operates or has a letter of agreement with a
8     birth center shall include the birth center under its
9     maternity service plan under the Hospital Licensing Act and
10     shall include the birth center in the hospital's letter of
11     agreement with its regional perinatal center.
12         A birth center may not discriminate against any patient
13     requiring treatment because of the source of payment for
14     services, including Medicare and Medicaid recipients.
15         No general anesthesia and no surgery may be performed
16     at a birth center. The Department may by rule add birth
17     center patient eligibility criteria or standards as it
18     deems necessary. The Department shall by rule require each
19     birth center to report the information which the Department
20     shall make publicly available, which shall include, but is
21     not limited to, the following:
22             (i) Birth center ownership.
23             (ii) Sources of payment for services.
24             (iii) Utilization data involving patient length of
25         stay.
26             (iv) Admissions and discharges.

 

 

HB0976 - 23 - LRB096 08475 DRJ 18595 b

1             (v) Complications.
2             (vi) Transfers.
3             (vii) Unusual incidents.
4             (viii) Deaths.
5             (ix) Any other publicly reported data required
6         under the Illinois Consumer Guide.
7             (x) Post-discharge patient status data where
8         patients are followed for 14 days after discharge from
9         the birth center to determine whether the mother or
10         baby developed a complication or infection.
11         Within 9 months after the effective date of this
12     amendatory Act of the 95th General Assembly, the Department
13     shall adopt rules that are developed with consideration of:
14     the American Association of Birth Centers' Standards for
15     Freestanding Birth Centers; the American Academy of
16     Pediatrics/American College of Obstetricians and
17     Gynecologists Guidelines for Perinatal Care; and the
18     Regionalized Perinatal Health Care Code.
19         The Department shall adopt other rules as necessary to
20     implement the provisions of this amendatory Act of the 95th
21     General Assembly within 9 months after the effective date
22     of this amendatory Act of the 95th General Assembly.
23 (Source: P.A. 95-331, eff. 8-21-07; 95-445, eff. 1-1-08.)
 
24     (210 ILCS 3/35.1 rep.)
25     Section 6. The Alternative Health Care Delivery Act is

 

 

HB0976 - 24 - LRB096 08475 DRJ 18595 b

1 amended by repealing Section 35.1.
 
2     Section 10. The Hospital Licensing Act is amended by
3 changing Sections 3 and 4.6 as follows:
 
4     (210 ILCS 85/3)  (from Ch. 111 1/2, par. 144)
5     Sec. 3. As used in this Act:
6     (A) "Hospital" means any institution, place, building, or
7 agency, public or private, whether organized for profit or not,
8 devoted primarily to the maintenance and operation of
9 facilities for the diagnosis and treatment or care of 2 or more
10 unrelated persons admitted for overnight stay or longer in
11 order to obtain medical, including obstetric, psychiatric and
12 nursing, care of illness, disease, injury, infirmity, or
13 deformity.
14     The term "hospital", without regard to length of stay,
15 shall also include:
16         (a) any facility which is devoted primarily to
17     providing psychiatric and related services and programs
18     for the diagnosis and treatment or care of 2 or more
19     unrelated persons suffering from emotional or nervous
20     diseases;
21         (b) all places where pregnant females are received,
22     cared for, or treated during delivery irrespective of the
23     number of patients received.
24     The term "hospital" includes general and specialized

 

 

HB0976 - 25 - LRB096 08475 DRJ 18595 b

1 hospitals, postsurgical recovery care hospitals, tuberculosis
2 sanitaria, mental or psychiatric hospitals and sanitaria, and
3 includes maternity homes, lying-in homes, and homes for unwed
4 mothers in which care is given during delivery.
5     The term "hospital" does not include:
6         (1) any person or institution required to be licensed
7     pursuant to the Nursing Home Care Act, as amended;
8         (2) hospitalization or care facilities maintained by
9     the State or any department or agency thereof, where such
10     department or agency has authority under law to establish
11     and enforce standards for the hospitalization or care
12     facilities under its management and control;
13         (3) hospitalization or care facilities maintained by
14     the federal government or agencies thereof;
15         (4) hospitalization or care facilities maintained by
16     any university or college established under the laws of
17     this State and supported principally by public funds raised
18     by taxation;
19         (5) any person or facility required to be licensed
20     pursuant to the Alcoholism and Other Drug Abuse and
21     Dependency Act;
22         (6) any facility operated solely by and for persons who
23     rely exclusively upon treatment by spiritual means through
24     prayer, in accordance with the creed or tenets of any
25     well-recognized church or religious denomination; or
26         (7) An Alzheimer's disease management center

 

 

HB0976 - 26 - LRB096 08475 DRJ 18595 b

1     alternative health care model licensed under the
2     Alternative Health Care Delivery Act.
3     (B) "Person" means the State, and any political subdivision
4 or municipal corporation, individual, firm, partnership,
5 corporation, company, association, or joint stock association,
6 or the legal successor thereof.
7     (C) "Department" means the Department of Public Health of
8 the State of Illinois.
9     (D) "Director" means the Director of Public Health of the
10 State of Illinois.
11     (E) "Perinatal" means the period of time between the
12 conception of an infant and the end of the first month after
13 birth.
14     (F) "Federally designated organ procurement agency" means
15 the organ procurement agency designated by the Secretary of the
16 U.S. Department of Health and Human Services for the service
17 area in which a hospital is located; except that in the case of
18 a hospital located in a county adjacent to Wisconsin which
19 currently contracts with an organ procurement agency located in
20 Wisconsin that is not the organ procurement agency designated
21 by the U.S. Secretary of Health and Human Services for the
22 service area in which the hospital is located, if the hospital
23 applies for a waiver pursuant to 42 USC 1320b-8(a), it may
24 designate an organ procurement agency located in Wisconsin to
25 be thereafter deemed its federally designated organ
26 procurement agency for the purposes of this Act.

 

 

HB0976 - 27 - LRB096 08475 DRJ 18595 b

1     (G) "Tissue bank" means any facility or program operating
2 in Illinois that is certified by the American Association of
3 Tissue Banks or the Eye Bank Association of America and is
4 involved in procuring, furnishing, donating, or distributing
5 corneas, bones, or other human tissue for the purpose of
6 injecting, transfusing, or transplanting any of them into the
7 human body. "Tissue bank" does not include a licensed blood
8 bank. For the purposes of this Act, "tissue" does not include
9 organs.
10 (Source: P.A. 91-838, eff. 6-16-00.)
 
11     (210 ILCS 85/4.6)
12     Sec. 4.6. Additional licensing requirements.
13     (a) Notwithstanding any other law or rule to the contrary,
14 without the issuance of a Certificate of Need Permit or
15 Certificate of Exemption from Illinois Health Facilities
16 Planning Board, the Department may license as a hospital a
17 building that meets either of the following criteria:
18         (1) It (i) is owned or operated by a hospital licensed
19     under this Act, (ii) is located in a municipality with a
20     population of less than 60,000, and (iii) includes a
21     postsurgical recovery care center licensed under the
22     Alternative Health Care Delivery Act for a period of not
23     less than 2 years, an ambulatory surgical treatment center
24     licensed under the Ambulatory Surgical Treatment Center
25     Act, and a Freestanding Emergency Center licensed under the

 

 

HB0976 - 28 - LRB096 08475 DRJ 18595 b

1     Emergency Medical Services (EMS) Systems Act. Only the
2     components of the building which are currently licensed
3     shall be eligible under the provisions of this Section.
4         (2) It is a postsurgical recovery care center under the
5     Alternative Health Care Delivery Act, is affiliated with or
6     connected to a licensed hospital or ambulatory surgical
7     treatment center, that previously received a Certificate
8     of Need from the Illinois Health Facilities Planning Board
9     and maintains an organized medical staff of physicians,
10     permanent facilities that include inpatient beds, medical
11     services, including physician services, and continuous
12     registered professional nursing services for not less than
13     24 hours every day. These licenses will be for postsurgical
14     recovery care hospitals.
15     (b) Prior to issuing a license, the Department shall
16 inspect the facility and require the facility to meet such of
17 the Department's rules relating to the establishment of
18 hospitals as the Department determines are appropriate to such
19 facility. The Department's licensure of the facility as a
20 postsurgical recovery care hospital shall be the only approval
21 required for the facility to make improvements and operate as a
22 postsurgical recovery care hospital. Once the Department
23 approves the facility and issues a hospital license, all other
24 licenses as listed in subsection (a) above shall be null and
25 void. Upon receiving licensure as a postsurgical recovery care
26 hospital, any facility licensed under subdivision (a)(2) of

 

 

HB0976 - 29 - LRB096 08475 DRJ 18595 b

1 this Section shall be subject to the following limitations:
2         (1) The facility shall not have a number of beds that
3     is greater than the number of authorized postsurgical
4     recovery care beds.
5         (2) The facility shall continue to be subject to the
6     length-of-stay limitations set forth in Section 35 of the
7     Alternative Health Care Delivery Act.
8         (3) The facility shall seek certification under
9     Section 1861(e) of the federal Social Security Act.
10     (c) A license as a postsurgical recovery care hospital Only
11 one license may be issued under the authority of subdivision
12 (a)(2) of this Section only to a postsurgical recovery care
13 center established under the Alternative Health Care Delivery
14 Act. No license may be issued after 18 months after the
15 effective date of this amendatory Act of the 91st General
16 Assembly. No license may be issued after 36 months after the
17 effective date of this amendatory Act of the 96th General
18 Assembly.
19 (Source: P.A. 91-736, eff. 6-2-00.)
 
20     Section 99. Effective date. This Act takes effect July 1,
21 2009.