HB1322 EngrossedLRB098 07917 DRJ 38003 b

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

 

 

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

 

 

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1    (210 ILCS 80/1.3)
2    Sec. 1.3. Long-term acute care hospitals and
3rehabilitation hospitals. For the purpose of this Act, general
4acute care hospitals designated by Medicare as long-term acute
5care hospitals and rehabilitation hospitals are not required to
6provide hospital emergency services described in Section 1 of
7this Act. Hospitals defined in this Section may provide
8hospital emergency services at their option.
9    Any long-term acute care hospital defined in this Section
10that opts to discontinue or otherwise not provide emergency
11services described in Section 1 shall:
12        (1) comply with all provisions of the federal Emergency
13    Medical Treatment and & Labor Act (EMTALA);
14        (2) comply with all provisions required under the
15    Social Security Act;
16        (3) provide annual notice to communities in the
17    hospital's service area about available emergency medical
18    services; and
19        (4) make educational materials available to
20    individuals who are present at the hospital concerning the
21    availability of medical services within the hospital's
22    service area.
23    Long-term acute care hospitals that operate standby
24emergency services as of January 1, 2011 may discontinue
25hospital emergency services by notifying the Department of
26Public Health. Long-term acute care hospitals that operate

 

 

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1basic or comprehensive emergency services must notify the
2Health Facilities and Services Review Board and follow the
3appropriate procedures.
4    Any rehabilitation hospital that opts to discontinue or
5otherwise not provide emergency services described in Section 1
6shall:
7        (1) comply with all provisions of the federal Emergency
8    Medical Treatment and Active Labor Act (EMTALA);
9        (2) comply with all provisions required under the
10    Social Security Act;
11        (3) provide annual notice to communities in the
12    hospital's service area about available emergency medical
13    services;
14        (4) make educational materials available to
15    individuals who are present at the hospital concerning the
16    availability of medical services within the hospital's
17    service area;
18        (5) not use the term "hospital" in its name or on any
19    signage; and
20        (6) notify in writing the Department and the Health
21    Facilities and Services Review Board of the
22    discontinuation.
23(Source: P.A. 97-667, eff. 1-13-12; revised 9-11-13.)
 
24    Section 5. The Hospital Licensing Act is amended by
25changing Sections 5 and 6 and by adding Section 14.5 as

 

 

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1follows:
 
2    (210 ILCS 85/5)  (from Ch. 111 1/2, par. 146)
3    Sec. 5. (a) An application for a permit to establish a
4hospital shall be made to the Department upon forms provided by
5it. This application shall contain such information as the
6Department reasonably requires, which shall include
7affirmative evidence on which the Director may make the
8findings required under Section 6a of this Act.
9    (b) An application for a license to open, conduct, operate,
10and maintain a hospital shall be made to the Department upon
11forms provided by it, accompanied by a license fee of $55 per
12bed (except as otherwise provided in this subsection), or such
13lesser amount as the Department may establish by administrative
14rule in consultation with the Department of Healthcare and
15Family Services to comply with the limitations on health
16care-related taxes imposed by 42 U.S.C. 1396b(w) that, if
17violated, would result in reductions to the amount of federal
18financial participation received by the State for Medicaid
19expenditures, and shall contain such information as the
20Department reasonably requires, which may include affirmative
21evidence of ability to comply with the provisions of this Act
22and the standards, rules, and regulations, promulgated by
23virtue thereof. The license fee for a critical access hospital,
24as defined in Section 5-5e.1 of the Illinois Public Aid Code,
25or a safety-net hospital, as defined in Section 5-5e of the

 

 

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1Illinois Public Aid Code, shall be $0 per bed.
2    (c) All applications required under this Section shall be
3signed by the applicant and shall be verified. Applications on
4behalf of a corporation or association or a governmental unit
5or agency shall be made and verified by any two officers
6thereof.
7(Source: Laws 1965, p. 2350.)
 
8    (210 ILCS 85/6)  (from Ch. 111 1/2, par. 147)
9    Sec. 6. (a) Upon receipt of an application for a permit to
10establish a hospital the Director shall issue a permit if he
11finds (1) that the applicant is fit, willing, and able to
12provide a proper standard of hospital service for the community
13with particular regard to the qualification, background, and
14character of the applicant, (2) that the financial resources
15available to the applicant demonstrate an ability to construct,
16maintain, and operate a hospital in accordance with the
17standards, rules, and regulations adopted pursuant to this Act,
18and (3) that safeguards are provided which assure hospital
19operation and maintenance consistent with the public interest
20having particular regard to safe, adequate, and efficient
21hospital facilities and services.
22    The Director may request the cooperation of county and
23multiple-county health departments, municipal boards of
24health, and other governmental and non-governmental agencies
25in obtaining information and in conducting investigations

 

 

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

 

 

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

 

 

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1Licensure Fund. The Fund is created for the purpose of
2providing funding for the administration of the licensure
3program and patient safety and quality initiatives for
4hospitals, including, without limitation, the implementation
5of the Illinois Adverse Health Care Events Reporting Law of
62005.
7    (b) The Fund shall consist of the following:
8        (1) fees collected pursuant to Section 5 of the
9    Hospital Licensing Act;
10        (2) federal matching funds received by the State as a
11    result of expenditures made by the Department that are
12    attributable to moneys deposited in the Fund;
13        (3) interest earned on moneys deposited in the Fund;
14    and
15        (4) other moneys received for the Fund from any other
16    source, including interest earned thereon.
17    (c) Disbursements from the Fund shall be made only for:
18        (1) initially, the implementation of the Illinois
19    Adverse Health Care Events Reporting Law of 2005;
20        (2) subsequently, programs, information, or
21    assistance, including measures to address public
22    complaints, designed to measurably improve quality and
23    patient safety; and
24        (3) the reimbursement of moneys collected by the
25    Department through error or mistake.
26    (d) The uses described in paragraph (2) of subsection (c)

 

 

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1shall be developed in conjunction with a statewide organization
2representing a majority of hospitals.
 
3    Section 8. The Illinois Adverse Health Care Events
4Reporting Law of 2005 is amended by changing Sections 10-10 and
510-15 as follows:
 
6    (410 ILCS 522/10-10)
7    Sec. 10-10. Definitions. As used in this Law, the following
8terms have the following meanings:
9    "Adverse health care event" means any event identified as a
10serious reportable event by the National Quality Forum and the
11Centers for Medicare and Medicaid Services on the effective
12date of this amendatory Act of the 98th General Assembly. The
13Department shall adopt, by rule, the list of adverse health
14care events. The rules in effect on May 1, 2013, that define
15"adverse health care event" shall remain in effect until new
16rules are adopted in accordance with this amendatory Act of the
1798th General Assembly. If the National Quality Forum or the
18Centers for Medicare and Medicaid Services thereafter revises
19its list of serious reportable events through addition,
20deletion, or modification, then the term "adverse health care
21event" for purposes of this Law shall be similarly revised,
22effective no sooner than 6 months after the revision by the
23originating organization described in subsections (b) through
24(g) of Section 10-15.

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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1    someone impersonating a physician, nurse, pharmacist, or
2    other licensed health care provider.
3        (2) Abduction of a patient of any age.
4        (3) Sexual assault on a patient within or on the
5    grounds of a health care facility.
6        (4) Death or significant injury of a patient or staff
7    member resulting from a physical assault that occurs within
8    or on the grounds of a health care facility.
9    (g-5) If the adverse health care events subject to this Law
10are revised as described in Section 10-10, then the Department
11shall provide notice to all affected health care facilities
12promptly upon the revision and shall inform affected health
13care facilities of the effective date of the revision for
14purposes of reporting under this Law.
15    (h) Definitions. As pertains to an adverse health care
16event used in this Section 10-15:
17     "Death" means patient death related to an adverse event
18and not related solely to the natural course of the patient's
19illness or underlying condition. Events otherwise reportable
20under this Section 10-15 shall be reported even if the death
21might have otherwise occurred as the natural course of the
22patient's illness or underlying condition.
23    "Serious disability" means a physical or mental
24impairment, including loss of a body part, related to an
25adverse event and not related solely to the natural course of
26the patient's illness or underlying condition, that

 

 

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1substantially limits one or more of the major life activities
2of an individual or a loss of bodily function, if the
3impairment or loss lasts more than 7 days prior to discharge or
4is still present at the time of discharge from an inpatient
5health care facility.
6(Source: P.A. 94-242, eff. 7-18-05.)
 
7    Section 10. The State Finance Act is amended by adding
8Section 5.855 as follows:
 
9    (30 ILCS 105/5.855 new)
10    Sec. 5.855. The Hospital Licensure Fund.
 
11    Section 99. Effective date. This Act takes effect upon
12becoming law.