HB5462 98TH GENERAL ASSEMBLY

LRB098 19268 RPS 54420 b

98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
HB5462

Introduced , by Rep. Thomas Morrison

SYNOPSIS AS INTRODUCED:

210 ILCS 5/3	from Ch. 111 1/2, par. 157-8.3
210 ILCS 5/6.2 new
210 ILCS 5/6.5
210 ILCS 5/10d	from Ch. 111 1/2, par. 157-8.10d
210 ILCS 5/10f	from Ch. 111 1/2, par. 157-8.10f
210 ILCS 5/10h new

Amends the Ambulatory Surgical Treatment Center Act. Provides that "ambulatory surgical treatment center" includes any facility in which a medical or surgical procedure is utilized to terminate 50 or more pregnancies in any calendar year (instead of to terminate a pregnancy). Requires a physician to remain on the premises of an ambulatory surgical treatment center on any day when an abortion is performed at the facility and to have admitting privileges at a hospital that is located within 30 miles of the ambulatory surgical treatment center. Provides that any facility that performs more than 50 abortions in a calendar year shall comply with all of the statutes and rules that are applicable to ambulatory surgical treatment centers. Authorizes the Director of Public Health to seek an injunction against any facility that is in violation of the Act. Creates a private right of action against a facility or physician that performs an abortion in willful violation of the Act. Makes other changes.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning regulation.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Ambulatory Surgical Treatment Center Act is amended by changing Sections 3, 6.5, 10d, and 10f and by adding Sections 6.2 and 10h as follows:

(210 ILCS 5/3) (from Ch. 111 1/2, par. 157-8.3)

Sec. 3. As used in this Act, unless the context otherwise requires, the following words and phrases shall have the meanings ascribed to them:

(A) "Ambulatory surgical treatment center" means any institution, place or building devoted primarily to the maintenance and operation of facilities for the performance of surgical procedures or any facility in which a medical or surgical procedure is utilized to terminate 50 or more pregnancies in any calendar year a pregnancy, irrespective of whether the facility is devoted primarily to this purpose. Such facility shall not provide beds or other accommodations for the overnight stay of patients; however, facilities devoted exclusively to the treatment of children may provide accommodations and beds for their patients for up to 23 hours following admission. Individual patients shall be discharged in an ambulatory condition without danger to the continued well being of the patients or shall be transferred to a hospital.

The term "ambulatory surgical treatment center" does not include any of the following:

(1) Any institution, place, building or agency required to be licensed pursuant to the "Hospital Licensing Act", approved July 1, 1953, as amended.

(2) Any person or institution required to be licensed pursuant to the Nursing Home Care Act, the Specialized Mental Health Rehabilitation Act, or the ID/DD Community Care Act.

(3) Hospitals or ambulatory surgical treatment centers maintained by the State or any department or agency thereof, where such department or agency has authority under law to establish and enforce standards for the hospitals or ambulatory surgical treatment centers under its management and control.

(4) Hospitals or ambulatory surgical treatment centers maintained by the Federal Government or agencies thereof.

(5) Any place, agency, clinic, or practice, public or private, whether organized for profit or not, devoted exclusively to the performance of dental or oral surgical procedures.

(B) "Person" means any individual, firm, partnership, corporation, company, association, or joint stock association, or the legal successor thereof.

(C) "Department" means the Department of Public Health of the State of Illinois.

(D) "Director" means the Director of the Department of Public Health of the State of Illinois.

(E) "Physician" means a person licensed to practice medicine in all of its branches in the State of Illinois.

(F) "Dentist" means a person licensed to practice dentistry under the Illinois Dental Practice Act.

(G) "Podiatric physician" means a person licensed to practice podiatry under the Podiatric Medical Practice Act of 1987.

(H) "Abortion" means the act of using or prescribing any instrument, medicine, drug, method, or device or any other substance with the intent to terminate the clinically diagnosable pregnancy of a woman with knowledge that the termination by those means will, with reasonable likelihood, cause the death of the unborn child. "Abortion" does not include the use or prescription of any instrument, medicine, drug, method, or device or any other substance to terminate the clinically diagnosable pregnancy of a woman if done with the intent to save the life or preserve the health of the unborn child, remove a dead unborn child caused by spontaneous abortion, or remove an ectopic pregnancy.

(J) "Admitting privileges" means the right of a physician to admit patients to a particular hospital for the purposes of providing specific diagnostic or therapeutic services to the patient in that hospital.

(K) "Born alive" means the complete expulsion or extraction of an infant from his or her mother, regardless of the state of gestational development, that, after expulsion or extraction, whether or not the umbilical cord has been cut or the placenta is attached, and regardless of whether the expulsion or extraction occurs as a result of natural or induced labor, cesarean section, or induced abortion, shows any evidence of life, including, but not limited to, breathing having a heartbeat, umbilical cord pulsation, or the definite movement of voluntary muscles.

(L) "Pregnancy" means the reproductive condition of having an unborn child in the woman's uterus.

(M) "Unborn child" means an individual of the species homo sapiens from fertilization to live birth.

(Source: P.A. 97-38, eff. 6-28-11; 97-227, eff. 1-1-12; 97-813, eff. 7-13-12; 98-214, eff. 8-9-13.)

(210 ILCS 5/6.2 new)

Sec. 6.2. Exceptions and preferences for abortion clinics; other statutes and rules. Notwithstanding any other statute, rule, or regulation to the contrary, an ambulatory surgical treatment center utilized to terminate pregnancies must comply with all of the statutes, rules, and regulations generally applicable to other ambulatory surgical treatment centers. If an ambulatory surgical treatment center is required to perform construction or other physical renovation to comply with the statutes, rules, and regulations applicable pursuant to this Act, then the ambulatory surgical treatment center shall complete any such construction or other physical renovation no later than January 1, 2016.

(210 ILCS 5/6.5)

Sec. 6.5. Clinical privileges; advanced practice nurses. All ambulatory surgical treatment centers (ASTC) licensed under this Act shall comply with the following requirements:

(1) No ASTC policy, rule, regulation, or practice shall be inconsistent with the provision of adequate collaboration and consultation in accordance with Section 54.5 of the Medical Practice Act of 1987.

(2) Operative surgical procedures shall be performed only by a physician licensed to practice medicine in all its branches under the Medical Practice Act of 1987, a dentist licensed under the Illinois Dental Practice Act, or a podiatric physician licensed under the Podiatric Medical Practice Act of 1987, with medical staff membership and surgical clinical privileges granted by the consulting committee of the ASTC. A licensed physician, dentist, or podiatric physician may be assisted by a physician licensed to practice medicine in all its branches, dentist, dental assistant, podiatric physician, licensed advanced practice nurse, licensed physician assistant, licensed registered nurse, licensed practical nurse, surgical assistant, surgical technician, or other individuals granted clinical privileges to assist in surgery by the consulting committee of the ASTC. Payment for services rendered by an assistant in surgery who is not an ambulatory surgical treatment center employee shall be paid at the appropriate non-physician modifier rate if the payor would have made payment had the same services been provided by a physician.

(2.5) A registered nurse licensed under the Nurse Practice Act and qualified by training and experience in operating room nursing shall be present in the operating room and function as the circulating nurse during all invasive or operative procedures. For purposes of this paragraph (2.5), "circulating nurse" means a registered nurse who is responsible for coordinating all nursing care, patient safety needs, and the needs of the surgical team in the operating room during an invasive or operative procedure.

(3) An advanced practice nurse is not required to possess prescriptive authority or a written collaborative agreement meeting the requirements of the Nurse Practice Act to provide advanced practice nursing services in an ambulatory surgical treatment center. An advanced practice nurse must possess clinical privileges granted by the consulting medical staff committee and ambulatory surgical treatment center in order to provide services. Individual advanced practice nurses may also be granted clinical privileges to order, select, and administer medications, including controlled substances, to provide delineated care. The attending physician must determine the advance practice nurse's role in providing care for his or her patients, except as otherwise provided in the consulting staff policies. The consulting medical staff committee shall periodically review the services of advanced practice nurses granted privileges.

(4) The anesthesia service shall be under the direction of a physician licensed to practice medicine in all its branches who has had specialized preparation or experience in the area or who has completed a residency in anesthesiology. An anesthesiologist, Board certified or Board eligible, is recommended. Anesthesia services may only be administered pursuant to the order of a physician licensed to practice medicine in all its branches, licensed dentist, or licensed podiatric physician.

(A) The individuals who, with clinical privileges granted by the medical staff and ASTC, may administer anesthesia services are limited to the following:

(i) an anesthesiologist; or

(ii) a physician licensed to practice medicine in all its branches; or

(iii) a dentist with authority to administer anesthesia under Section 8.1 of the Illinois Dental Practice Act; or

(iv) a licensed certified registered nurse anesthetist; or

(v) a podiatric physician licensed under the Podiatric Medical Practice Act of 1987.

(B) For anesthesia services, an anesthesiologist shall participate through discussion of and agreement with the anesthesia plan and shall remain physically present and be available on the premises during the delivery of anesthesia services for diagnosis, consultation, and treatment of emergency medical conditions. In the absence of 24-hour availability of anesthesiologists with clinical privileges, an alternate policy (requiring participation, presence, and availability of a physician licensed to practice medicine in all its branches) shall be developed by the medical staff consulting committee in consultation with the anesthesia service and included in the medical staff consulting committee policies.

(C) A certified registered nurse anesthetist is not required to possess prescriptive authority or a written collaborative agreement meeting the requirements of Section 65-35 of the Nurse Practice Act to provide anesthesia services ordered by a licensed physician, dentist, or podiatric physician. Licensed certified registered nurse anesthetists are authorized to select, order, and administer drugs and apply the appropriate medical devices in the provision of anesthesia services under the anesthesia plan agreed with by the anesthesiologist or, in the absence of an available anesthesiologist with clinical privileges, agreed with by the operating physician, operating dentist, or operating podiatric physician in accordance with the medical staff consulting committee policies of a licensed ambulatory surgical treatment center.

(5) On any day when any abortion is performed in an ambulatory surgical treatment center, a physician who has admitting privileges at an accredited hospital that is located in this State and is located within 30 miles of the ambulatory surgical treatment center must remain on the premises of the ambulatory surgical treatment center to facilitate the transfer to a hospital, if necessary, of an abortion patient or a child born alive until all abortion patients are stable and ready to leave the post-surgical recovery room. Each day this Section is violated constitutes a separate violation for purposes of assessing civil penalties or fines.

(Source: P.A. 98-214, eff. 8-9-13.)

(210 ILCS 5/10d) (from Ch. 111 1/2, par. 157-8.10d)

Sec. 10d. Fines and penalties.

(a) When the Director determines that a facility has failed to comply with this Act or the Illinois Adverse Health Care Events Reporting Law of 2005 or any rule adopted under either of those Acts, the Department may issue a notice of fine assessment which shall specify the violations for which the fine is assessed. The Department may assess a fine of up to $500 per violation per day commencing on the date the violation was identified and ending on the date the violation is corrected, or action is taken to suspend, revoke or deny renewal of the license, whichever comes first.

(b) In determining whether a fine is to be assessed or the amount of such fine, the Director shall consider the following factors:

(1) The gravity of the violation, including the probability that death or serious physical or mental harm to a patient will result or has resulted, the severity of the actual or potential harm, and the extent to which the provisions of the applicable statutes or rules were violated;

(2) The reasonable diligence exercised by the licensee and efforts to correct violations;

(3) The duration, frequency, and relevance of any Any previous violations committed by the licensee; and

(4) The financial benefit to the facility or to the licensee of committing or continuing the violation.

(c) The Attorney General or the State's Attorney for the county in which the violation occurred may bring an action in a court of competent jurisdiction to enforce the collection of civil penalties or fines.

(Source: P.A. 94-242, eff. 7-18-05.)

(210 ILCS 5/10f) (from Ch. 111 1/2, par. 157-8.10f)

Sec. 10f. Denial, suspension, revocation or refusal to renew a license; suspension of a service.

(a) When the Director determines that there is or has been a substantial or continued failure to comply with this Act or any rule promulgated hereunder, the Department may issue an order of license denial, suspension or revocation, or refusal to renew a license, in accordance with subsection (a) of Section 10g of this Act.

(b) When the Director determines that a facility has failed to demonstrate the capacity to safely provide one or more of its services to patients, the Department may issue an order of service suspension in accordance with subsection (a) of Section 10g of this Act.

(c) If, however, the Department finds that the public interest, health, safety, or welfare imperatively requires emergency action, and if the Director incorporates a finding to that effect in the order, summary suspension of a service or a license to open, conduct, operate, and maintain an ambulatory surgical treatment center or any part thereof may be ordered pending proceedings for license revocation or other action, which shall be promptly instituted and determined.

(d) In addition to any other penalty provided by law, whenever in the judgment of the Director any person has engaged or is about to engage in any acts or practices that constitute or will constitute a violation of this Act, the Director shall make application to any court of competent jurisdiction for an order enjoining those acts or practices. Upon a showing by the Director that the person has engaged or is about to engage in any of those acts or practices that constitute a violation of this Act, an injunction, restraining order, or other order as may be appropriate shall be granted by the court without bond.

(Source: P.A. 86-1292.)

(210 ILCS 5/10h new)

Sec. 10h. Private right of action. A woman upon whom an abortion has been performed in violation of this Act, or, if the woman is an unemancipated minor, the parent or legal guardian of the woman, may commence a civil action for actual and punitive damages against the facility where the abortion was performed or the person who performed the abortion for any willful violation of this Act.