Full Text of SB0026 94th General Assembly
SB0026 94TH GENERAL ASSEMBLY
|
|
|
94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006 SB0026
Introduced 1/26/2005, by Sen. James F. Clayborne, Jr. SYNOPSIS AS INTRODUCED: |
|
210 ILCS 60/3 |
from Ch. 111 1/2, par. 6103 |
210 ILCS 60/4 |
from Ch. 111 1/2, par. 6104 |
210 ILCS 60/5 |
from Ch. 111 1/2, par. 6105 |
210 ILCS 60/8 |
from Ch. 111 1/2, par. 6108 |
210 ILCS 60/8.5 new |
|
210 ILCS 60/9 |
from Ch. 111 1/2, par. 6109 |
|
Amends the Hospice Licensing Act. Adds a definition of "hospice" and deletes the definition of "full hospice"; also changes the definition of "palliative care". Deletes specific requirements with which full hospices must comply, and instead provides that hospices must comply with the requirements of the Act, including the standards adopted by the Department of Public Health. Deletes certain items that must be included in the Department's standards. Provides that the separate standards currently applicable to volunteer hospices are inoperative after June 30, 2006 and that the new standards to be adopted for all hospice programs do not apply to volunteer hospices until July 1, 2006. Provides that the hospice program must meet the minimum standards for certification under Medicare. Effective July 1, 2005.
|
| |
|
|
| FISCAL NOTE ACT MAY APPLY | |
|
|
A BILL FOR
|
|
|
|
|
SB0026 |
|
LRB094 03673 DRJ 33678 b |
|
| 1 |
| AN ACT concerning regulation.
| 2 |
| WHEREAS, The General Assembly intends to provide one | 3 |
| standard definition of "hospice" by establishing minimum | 4 |
| standards for all providers of hospice care in Illinois; and | 5 |
| WHEREAS, The General Assembly does not intend to force any | 6 |
| volunteer hospice program out of business but instead intends | 7 |
| to bring such programs into compliance with certain minimum | 8 |
| standards applicable to all providers of hospice care in | 9 |
| Illinois; therefore | 10 |
| Be it enacted by the People of the State of Illinois,
| 11 |
| represented in the General Assembly:
| 12 |
| Section 5. The Hospice Program Licensing Act is amended by | 13 |
| changing Sections 3, 4, 5, 8, and 9 and by adding Section 8.5 | 14 |
| as follows:
| 15 |
| (210 ILCS 60/3) (from Ch. 111 1/2, par. 6103)
| 16 |
| Sec. 3. Definitions. As used in this Act, unless the | 17 |
| context otherwise
requires:
| 18 |
| (a) "Bereavement" means the period of time during which the | 19 |
| hospice
patient's family experiences and adjusts to the death | 20 |
| of the hospice patient.
| 21 |
| (b) "Department" means the Illinois Department of Public | 22 |
| Health.
| 23 |
| (c) "Director" means the Director of the Illinois | 24 |
| Department of Public
Health.
| 25 |
| (d) " Hospice
Full hospice " means a coordinated program of | 26 |
| palliative care that provides for the physical, emotional, and | 27 |
| spiritual care needs of a terminally ill patient and his or her | 28 |
| family. The goal of such care is to achieve the highest quality | 29 |
| of life as defined by the patient and his or her family through | 30 |
| the relief of suffering and control of symptoms.
home and | 31 |
| inpatient care
providing directly, or through agreement, |
|
|
|
SB0026 |
- 2 - |
LRB094 03673 DRJ 33678 b |
|
| 1 |
| palliative and supportive medical,
health and other services to | 2 |
| terminally ill patients and their families.
A full hospice | 3 |
| utilizes a medically directed interdisciplinary hospice care
| 4 |
| team of professionals and volunteers. The program provides care | 5 |
| to meet
the physical, psychological, social, spiritual and | 6 |
| other special needs which
are experienced during the final | 7 |
| stages of illness and during dying and
bereavement. Home care | 8 |
| is to be provided on a part-time, intermittent,
regularly | 9 |
| scheduled basis, and on an on-call around-the-clock basis
| 10 |
| according to patient and family need.
To the maximum extent | 11 |
| possible, care shall be furnished in the patient's
home. Should | 12 |
| in-patient care be required, services are to be provided with
| 13 |
| the intent of minimizing the length of such care and shall only | 14 |
| be provided
in a hospital licensed under the Hospital Licensing | 15 |
| Act, or a skilled nursing
facility licensed under the Nursing | 16 |
| Home Care Act.
| 17 |
| (e) "Hospice care team" means an interdisciplinary working | 18 |
| unit composed
of but not limited to a physician licensed to | 19 |
| practice medicine in all of
its branches, a nurse licensed
| 20 |
| pursuant to the Nursing and
Advanced Practice Nursing Act, a | 21 |
| social worker, a pastoral or
other
counselor, and trained
| 22 |
| volunteers. The patient and the patient's family are considered | 23 |
| members of
the hospice care team when development or revision | 24 |
| of the patient's plan of
care takes place.
| 25 |
| (f) "Hospice patient" means a terminally ill person | 26 |
| receiving hospice
services.
| 27 |
| (g) "Hospice patient's family" means a hospice patient's | 28 |
| immediate family
consisting of a spouse, sibling, child, parent | 29 |
| and those individuals designated
as such by the patient for the | 30 |
| purposes of this Act.
| 31 |
| (g-1) "Hospice residence" means a home, apartment | 32 |
| building, or similar
building providing living quarters:
| 33 |
| (1) that is owned or operated by a person licensed to | 34 |
| operate as a full
hospice; and
| 35 |
| (2) at which hospice services are provided to facility | 36 |
| residents.
|
|
|
|
SB0026 |
- 3 - |
LRB094 03673 DRJ 33678 b |
|
| 1 |
| A building that is licensed under the Hospital Licensing | 2 |
| Act or the Nursing
Home Care Act is not a hospice residence.
| 3 |
| (h) "Hospice services" means palliative and supportive | 4 |
| care provided to
a hospice patient and his or her family to | 5 |
| meet the special need arising out of
the physical, emotional, | 6 |
| spiritual and social stresses which are experienced
during the | 7 |
| final stages of illness and during dying and bereavement. | 8 |
| Services
provided to the terminally ill patient shall be | 9 |
| furnished, to the maximum
extent possible, in the patient's | 10 |
| home. Should inpatient care be required,
services are to be | 11 |
| provided with the intent of minimizing the length of such
care.
| 12 |
| (i) "Palliative care" means the management of pain and | 13 |
| other distressing symptoms that incorporates medical, nursing, | 14 |
| psychosocial, and spiritual care according to the needs, | 15 |
| values, beliefs, and culture or cultures of the patient and his | 16 |
| or her family. The evaluation and treatment is | 17 |
| patient-centered, with a focus on the central role of the | 18 |
| family unit in decision-making.
treatment to provide for the | 19 |
| reduction or
abatement of pain and other troubling symptoms, | 20 |
| rather than treatment aimed
at investigation and intervention | 21 |
| for the purpose of cure or inappropriate
prolongation of life.
| 22 |
| (j) "Hospice service plan" means a plan detailing the | 23 |
| specific hospice
services offered by a full or volunteer
| 24 |
| hospice, and the administrative
and direct care personnel | 25 |
| responsible for those services. The plan shall
include but not | 26 |
| be limited to:
| 27 |
| (1) Identification of the person or persons | 28 |
| administratively responsible
for the program.
| 29 |
| (2) The estimated average monthly patient census.
| 30 |
| (3) The proposed geographic area the hospice will | 31 |
| serve.
| 32 |
| (4) A listing of those hospice services provided | 33 |
| directly by the hospice,
and those hospice services | 34 |
| provided indirectly through a contractual agreement.
| 35 |
| (5) The name and qualifications of those persons or | 36 |
| entities under
contract
to provide indirect hospice |
|
|
|
SB0026 |
- 4 - |
LRB094 03673 DRJ 33678 b |
|
| 1 |
| services.
| 2 |
| (6) The name and qualifications of those persons | 3 |
| providing direct hospice
services, with the exception of | 4 |
| volunteers.
| 5 |
| (7) A description of how the hospice plans to utilize | 6 |
| volunteers in the
provision of hospice services.
| 7 |
| (8) A description of the program's record keeping | 8 |
| system.
| 9 |
| (k) "Terminally ill" means a medical prognosis by a | 10 |
| physician licensed
to practice medicine in all of its branches | 11 |
| that a patient has an anticipated
life expectancy of one year | 12 |
| or less.
| 13 |
| (l) "Volunteer" means a person who offers his or her | 14 |
| services to a hospice
without compensation. Reimbursement for a | 15 |
| volunteer's expenses in providing
hospice service shall not be | 16 |
| considered compensation.
| 17 |
| (m) "Volunteer hospice" means a program which provides | 18 |
| hospice services
to patients regardless of their ability to | 19 |
| pay, with emphasis on the
utilization of volunteers to provide | 20 |
| services, under the administration of
a not-for-profit agency. | 21 |
| This definition does not prohibit the employment of
staff.
| 22 |
| (Source: P.A. 93-319, eff. 7-23-03.)
| 23 |
| (210 ILCS 60/4) (from Ch. 111 1/2, par. 6104)
| 24 |
| Sec. 4. License.
| 25 |
| (a) No person shall establish, conduct or maintain a
full | 26 |
| or volunteer hospice without first obtaining a license from the
| 27 |
| Department. A hospice residence may be operated only at the | 28 |
| locations listed
on the license. A full hospice owning or | 29 |
| operating a hospice residence is not
subject to the provisions | 30 |
| of the Nursing Home Care Act in owning or operating a
hospice | 31 |
| residence.
| 32 |
| (b) No public or private agency shall advertise or present | 33 |
| itself to the
public as a full or volunteer hospice which | 34 |
| provides hospice services without
meeting the provisions of | 35 |
| subsection (a).
|
|
|
|
SB0026 |
- 5 - |
LRB094 03673 DRJ 33678 b |
|
| 1 |
| (c) The license shall be valid only in the possession
of | 2 |
| the hospice to which it was originally issued and shall not be
| 3 |
| transferred or assigned to any other person, agency, or | 4 |
| corporation.
| 5 |
| (d) The license shall be renewed annually.
| 6 |
| (e) The license shall be displayed in a conspicuous place | 7 |
| inside the hospice
program office.
| 8 |
| (Source: P.A. 93-319, eff. 7-23-03.)
| 9 |
| (210 ILCS 60/5) (from Ch. 111 1/2, par. 6105)
| 10 |
| Sec. 5. Application for License. An application for license | 11 |
| or renewal
thereof to operate as a full or volunteer hospice | 12 |
| shall be made to the
Department upon forms provided by it, and | 13 |
| shall contain information
reasonably required by the | 14 |
| Department , taking into consideration the
different categories | 15 |
| of hospice programs . The application shall be accompanied by:
| 16 |
| (1) The hospice service plan;
| 17 |
| (2) A financial statement containing information deemed | 18 |
| appropriate by
the Department for the category of the | 19 |
| applicant; and
| 20 |
| (3) A uniform license fee determined by the Department | 21 |
| based on the hospice
program's category .
| 22 |
| (Source: P.A. 84-427.)
| 23 |
| (210 ILCS 60/8) (from Ch. 111 1/2, par. 6108)
| 24 |
| Sec. 8. General Requirements for Full Hospices. Hospices
| 25 |
| Full hospices shall comply
with the following requirements of | 26 |
| this Act, including the standards adopted by the Department | 27 |
| under Section 9 .
| 28 |
| (a) The hospice program's services shall include physician | 29 |
| services, nursing
services, medical social services, | 30 |
| counseling, and volunteer services.
These services shall be
| 31 |
| coordinated with those of the hospice patient's primary or | 32 |
| attending physician.
| 33 |
| (b) The hospice program shall coordinate its services with | 34 |
| professional
and nonprofessional services already in the |
|
|
|
SB0026 |
- 6 - |
LRB094 03673 DRJ 33678 b |
|
| 1 |
| community. The program may
contract out for elements of its | 2 |
| services; however, direct patient contact
and overall | 3 |
| coordination of hospice services shall be maintained by the
| 4 |
| hospice care team. Any contract entered into between a hospice | 5 |
| and
a health care facility or service provider shall specify | 6 |
| that the hospice
retain the responsibility for planning and | 7 |
| coordinating hospice services
and care on behalf of a hospice | 8 |
| patient and his family. All contracts shall
be in compliance | 9 |
| with this Act. No hospice which contracts for any hospice
| 10 |
| service shall charge fees for services provided directly by the | 11 |
| hospice
care team which duplicate contractual services | 12 |
| provided to the individual
patient or his family.
| 13 |
| (c) The hospice care team shall be responsible for the | 14 |
| coordination of
home and inpatient care.
| 15 |
| (d) The hospice program shall have a medical director who | 16 |
| shall be a physician
licensed to practice medicine in all of | 17 |
| its branches. The medical
director shall have overall | 18 |
| responsibility for medical direction of the
care and treatment | 19 |
| of patients and their families rendered by the hospice
care | 20 |
| team, and shall consult and cooperate with the patient's | 21 |
| attending physician.
| 22 |
| (e) The hospice program shall have a bereavement program | 23 |
| which shall provide
a continuum of supportive services for the | 24 |
| family.
| 25 |
| (f) The hospice program shall foster independence of the | 26 |
| patient and his
family by providing training, encouragement and | 27 |
| support so that the patient
and family can care for themselves | 28 |
| as much as possible.
| 29 |
| (g) The hospice program shall not impose the dictates of | 30 |
| any value or
belief system on its patients and their families.
| 31 |
| (h) The hospice program shall clearly define its admission | 32 |
| criteria.
Decisions on admissions shall be made by a hospice | 33 |
| care team and shall be
dependent upon the expressed request and | 34 |
| informed consent of the patient
or the patient's legal | 35 |
| guardian.
| 36 |
| (i) The hospice program shall keep accurate, current and |
|
|
|
SB0026 |
- 7 - |
LRB094 03673 DRJ 33678 b |
|
| 1 |
| confidential
records on all hospice patients and their | 2 |
| families.
| 3 |
| (j) The hospice program shall utilize the services of | 4 |
| trained volunteers.
| 5 |
| (k) The hospice program shall consist of both home care and | 6 |
| inpatient
care which incorporates the following | 7 |
| characteristics:
| 8 |
| (1) The home care component shall be the primary form of | 9 |
| care, and shall
be available on a part-time, intermittent, | 10 |
| regularly scheduled basis and
on an on-call around-the-clock | 11 |
| basis, according to patient and family need.
| 12 |
| (2) The inpatient component shall primarily be used only | 13 |
| for short-term stays.
| 14 |
| If possible, inpatient care should closely approximate a | 15 |
| home-like environment,
and provide overnight family visitation | 16 |
| within the facility.
| 17 |
| (Source: P.A. 83-457.)
| 18 |
| (210 ILCS 60/8.5 new)
| 19 |
| Sec. 8.5. Volunteer hospice. The changes made by this | 20 |
| amendatory Act of the 94th General Assembly do not apply to a | 21 |
| volunteer hospice until July 1, 2006.
| 22 |
| (210 ILCS 60/9) (from Ch. 111 1/2, par. 6109)
| 23 |
| Sec. 9. Standards. The Department shall prescribe, by | 24 |
| regulation,
minimum standards for licensed hospice programs.
| 25 |
| (a) (Blank).
The standards for full hospices shall
include | 26 |
| but not be limited to:
| 27 |
| (1) Compliance with the requirements in Section 8.
| 28 |
| (2) The number and qualifications of persons providing | 29 |
| direct hospice
services.
| 30 |
| (3) The qualifications of those persons contracted | 31 |
| with to provide
indirect
hospice services.
| 32 |
| (4) The palliative and supportive care and bereavement | 33 |
| counseling provided
to a hospice patient and his family.
| 34 |
| (5) Hospice services provided on an inpatient basis.
|
|
|
|
SB0026 |
- 8 - |
LRB094 03673 DRJ 33678 b |
|
| 1 |
| (6) Utilization review of patient care.
| 2 |
| (7) The quality of care provided to patients.
| 3 |
| (8) Procedures for the accurate and centralized | 4 |
| maintenance of records
on hospice services provided to | 5 |
| patients and their families.
| 6 |
| (9) The use of volunteers in the hospice program, and | 7 |
| the training of
those volunteers.
| 8 |
| (10) The rights of the patient and the patient's | 9 |
| family.
| 10 |
| (b)
The standards for volunteer hospice programs shall | 11 |
| include but not be
limited to:
| 12 |
| (1) The direct and indirect services provided by the | 13 |
| hospice, including
the qualifications of personnel | 14 |
| providing medical care.
| 15 |
| (2) Quality review of the services provided by the | 16 |
| hospice program.
| 17 |
| (3) Procedures for the accurate and centralized | 18 |
| maintenance of records
on hospice services provided to | 19 |
| patients and their families.
| 20 |
| (4) The rights of the patient and the patient's family.
| 21 |
| (5) The use of volunteers in the hospice program.
| 22 |
| (6) The disclosure to the patients of the range of | 23 |
| hospice services
provided and not provided by the hospice | 24 |
| program.
| 25 |
| This subsection (b) is inoperative after June 30, 2006.
| 26 |
| (c) The standards for hospices owning or operating hospice | 27 |
| residences
shall address the following:
| 28 |
| (1) The safety, cleanliness, and general adequacy of | 29 |
| the premises,
including provision for maintenance of fire | 30 |
| and health standards that conform
to State laws and | 31 |
| municipal codes, to provide for the physical comfort,
| 32 |
| well-being, care, and protection of the residents.
| 33 |
| (2) Provisions and criteria for admission, discharge, | 34 |
| and transfer of
residents.
| 35 |
| (3) Fee and other contractual agreements with | 36 |
| residents.
|
|
|
|
SB0026 |
- 9 - |
LRB094 03673 DRJ 33678 b |
|
| 1 |
| (4) Medical and supportive services for residents.
| 2 |
| (5) Maintenance of records and residents' right of | 3 |
| access of those
records.
| 4 |
| (6) Procedures for reporting abuse or neglect of | 5 |
| residents.
| 6 |
| (7) The number of persons who may be served in a | 7 |
| residence, which shall
not exceed 16 persons per location.
| 8 |
| (8) The ownership, operation, and maintenance of | 9 |
| buildings containing a
hospice residence.
| 10 |
| (9) The number of licensed hospice residences
shall not | 11 |
| exceed 6 before December
31, 1996 and shall not exceed 12 | 12 |
| before December 31, 1997. The Department
shall conduct a | 13 |
| study of the benefits of hospice residences and make a
| 14 |
| recommendation to the General Assembly as to the need to | 15 |
| limit the number of
hospice residences after June 30, 1997.
| 16 |
| (d) A hospice program must meet the minimum standards for | 17 |
| certification under the Medicare program and set forth in the | 18 |
| Conditions of Participation under 42 CFR Part 418.
In | 19 |
| developing the standards for hospices, the Department shall | 20 |
| take
into consideration the category of the hospice programs.
| 21 |
| (Source: P.A. 89-278, eff. 8-10-95.)
| 22 |
| Section 99. Effective date. This Act takes effect July 1, | 23 |
| 2005.
|
|