Rep. Jay Hoffman

Filed: 4/8/2014





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2    AMENDMENT NO. ______. Amend House Bill 1322, AS AMENDED, by
3replacing everything after the enacting clause with the
5    "Section 1. The Emergency Medical Services (EMS) Systems
6Act is amended by changing Section 3.190 as follows:
7    (210 ILCS 50/3.190)
8    Sec. 3.190. Emergency Department Classifications. The
9Department shall have the authority and responsibility to:
10        (a) Establish criteria for classifying the emergency
11    departments of all hospitals within the State as
12    Comprehensive, Basic, or Standby. In establishing such
13    criteria, the Department may consult with the Illinois
14    Hospital Licensing Board and incorporate by reference all
15    or part of existing standards adopted as rules pursuant to
16    the Hospital Licensing Act or Emergency Medical Treatment



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1    Act;
2        (b) Classify the emergency departments of all
3    hospitals within the State in accordance with this Section;
4        (c) Annually publish, and distribute to all EMS
5    Systems, a list reflecting the classification of all
6    emergency departments.
7    For the purposes of paragraphs (a) and (b) of this Section,
8long-term acute care hospitals and rehabilitation hospitals,
9as defined under the Hospital Emergency Service Act, are not
10required to provide hospital emergency services. Long-term
11acute care hospitals and rehabilitation hospitals with no
12emergency department and shall be classified as not available.
13(Source: P.A. 97-667, eff. 1-13-12; 98-463, eff. 8-16-13.)
14    Section 3. The Hospital Emergency Service Act is amended by
15changing Sections 1 and 1.3 as follows:
16    (210 ILCS 80/1)  (from Ch. 111 1/2, par. 86)
17    Sec. 1. Every hospital required to be licensed by the
18Department of Public Health pursuant to the Hospital Licensing
19Act which provides general medical and surgical hospital
20services, except long-term acute care hospitals and
21rehabilitation hospitals identified in Section 1.3 of this Act,
22shall provide a hospital emergency service in accordance with
23rules and regulations adopted by the Department of Public
24Health and shall furnish such hospital emergency services to



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1any applicant who applies for the same in case of injury or
2acute medical condition where the same is liable to cause death
3or severe injury or serious illness. For purposes of this Act,
4"applicant" includes any person who is brought to a hospital by
5ambulance or specialized emergency medical services vehicle as
6defined in the Emergency Medical Services (EMS) Systems Act.
7(Source: P.A. 97-667, eff. 1-13-12.)
8    (210 ILCS 80/1.3)
9    Sec. 1.3. Long-term acute care hospitals and
10rehabilitation hospitals. For the purpose of this Act, general
11acute care hospitals designated by Medicare as long-term acute
12care hospitals and rehabilitation hospitals are not required to
13provide hospital emergency services described in Section 1 of
14this Act. Hospitals defined in this Section may provide
15hospital emergency services at their option.
16    Any long-term acute care hospital defined in this Section
17that opts to discontinue or otherwise not provide emergency
18services described in Section 1 shall:
19        (1) comply with all provisions of the federal Emergency
20    Medical Treatment and & Labor Act (EMTALA);
21        (2) comply with all provisions required under the
22    Social Security Act;
23        (3) provide annual notice to communities in the
24    hospital's service area about available emergency medical
25    services; and



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1        (4) make educational materials available to
2    individuals who are present at the hospital concerning the
3    availability of medical services within the hospital's
4    service area.
5    Long-term acute care hospitals that operate standby
6emergency services as of January 1, 2011 may discontinue
7hospital emergency services by notifying the Department of
8Public Health. Long-term acute care hospitals that operate
9basic or comprehensive emergency services must notify the
10Health Facilities and Services Review Board and follow the
11appropriate procedures.
12    Any rehabilitation hospital that opts to discontinue or
13otherwise not provide emergency services described in Section 1
15        (1) comply with all provisions of the federal Emergency
16    Medical Treatment and Active Labor Act (EMTALA);
17        (2) comply with all provisions required under the
18    Social Security Act;
19        (3) provide annual notice to communities in the
20    hospital's service area about available emergency medical
21    services;
22        (4) make educational materials available to
23    individuals who are present at the hospital concerning the
24    availability of medical services within the hospital's
25    service area;
26        (5) not use the term "hospital" in its name or on any



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1    signage; and
2        (6) notify in writing the Department and the Health
3    Facilities and Services Review Board of the
4    discontinuation.
5(Source: P.A. 97-667, eff. 1-13-12; revised 9-11-13.)
6    Section 5. The Hospital Licensing Act is amended by
7changing Sections 5 and 6 and by adding Section 14.5 as
9    (210 ILCS 85/5)  (from Ch. 111 1/2, par. 146)
10    Sec. 5. (a) An application for a permit to establish a
11hospital shall be made to the Department upon forms provided by
12it. This application shall contain such information as the
13Department reasonably requires, which shall include
14affirmative evidence on which the Director may make the
15findings required under Section 6a of this Act.
16    (b) An application for a license to open, conduct, operate,
17and maintain a hospital shall be made to the Department upon
18forms provided by it, accompanied by a license fee of $55 per
19bed (except as otherwise provided in this subsection), or such
20lesser amount as the Department may establish by administrative
21rule in consultation with the Department of Healthcare and
22Family Services to comply with the limitations on health
23care-related taxes imposed by 42 U.S.C. 1396b(w) that, if
24violated, would result in reductions to the amount of federal



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1financial participation received by the State for Medicaid
2expenditures, and shall contain such information as the
3Department reasonably requires, which may include affirmative
4evidence of ability to comply with the provisions of this Act
5and the standards, rules, and regulations, promulgated by
6virtue thereof. The license fee for a critical access hospital,
7as defined in Section 5-5e.1 of the Illinois Public Aid Code,
8or a safety-net hospital, as defined in Section 5-5e of the
9Illinois Public Aid Code, shall be $0 per bed.
10    (c) All applications required under this Section shall be
11signed by the applicant and shall be verified. Applications on
12behalf of a corporation or association or a governmental unit
13or agency shall be made and verified by any two officers
15(Source: Laws 1965, p. 2350.)
16    (210 ILCS 85/6)  (from Ch. 111 1/2, par. 147)
17    Sec. 6. (a) Upon receipt of an application for a permit to
18establish a hospital the Director shall issue a permit if he
19finds (1) that the applicant is fit, willing, and able to
20provide a proper standard of hospital service for the community
21with particular regard to the qualification, background, and
22character of the applicant, (2) that the financial resources
23available to the applicant demonstrate an ability to construct,
24maintain, and operate a hospital in accordance with the
25standards, rules, and regulations adopted pursuant to this Act,



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1and (3) that safeguards are provided which assure hospital
2operation and maintenance consistent with the public interest
3having particular regard to safe, adequate, and efficient
4hospital facilities and services.
5    The Director may request the cooperation of county and
6multiple-county health departments, municipal boards of
7health, and other governmental and non-governmental agencies
8in obtaining information and in conducting investigations
9relating to such applications.
10    A permit to establish a hospital shall be valid only for
11the premises and person named in the application for such
12permit and shall not be transferable or assignable.
13    In the event the Director issues a permit to establish a
14hospital the applicant shall thereafter submit plans and
15specifications to the Department in accordance with Section 8
16of this Act.
17    (b) Upon receipt of an application for license to open,
18conduct, operate, and maintain a hospital, the Director shall
19issue a license if he finds the applicant and the hospital
20facilities comply with standards, rules, and regulations
21promulgated under this Act. A license, unless sooner suspended
22or revoked, shall be renewable annually upon approval by the
23Department and payment of a license fee as established pursuant
24to Section 5 of this Act. Each license shall be issued only for
25the premises and persons named in the application and shall not
26be transferable or assignable. Licenses shall be posted in a



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1conspicuous place on the licensed premises. The Department may,
2either before or after the issuance of a license, request the
3cooperation of the State Fire Marshal, county and multiple
4county health departments, or municipal boards of health to
5make investigations to determine if the applicant or licensee
6is complying with the minimum standards prescribed by the
7Department. The report and recommendations of any such agency
8shall be in writing and shall state with particularity its
9findings with respect to compliance or noncompliance with such
10minimum standards, rules, and regulations.
11    The Director may issue a provisional license to any
12hospital which does not substantially comply with the
13provisions of this Act and the standards, rules, and
14regulations promulgated by virtue thereof provided that he
15finds that such hospital has undertaken changes and corrections
16which upon completion will render the hospital in substantial
17compliance with the provisions of this Act, and the standards,
18rules, and regulations adopted hereunder, and provided that the
19health and safety of the patients of the hospital will be
20protected during the period for which such provisional license
21is issued. The Director shall advise the licensee of the
22conditions under which such provisional license is issued,
23including the manner in which the hospital facilities fail to
24comply with the provisions of the Act, standards, rules, and
25regulations, and the time within which the changes and
26corrections necessary for such hospital facilities to



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1substantially comply with this Act, and the standards, rules,
2and regulations of the Department relating thereto shall be
4(Source: P.A. 80-56.)
5    (210 ILCS 85/14.5 new)
6    Sec. 14.5. Hospital Licensure Fund.
7    (a) There is created in the State treasury the Hospital
8Licensure Fund. The Fund is created for the purpose of
9providing funding for the administration of the licensure
10program and patient safety and quality initiatives for
11hospitals, including, without limitation, the implementation
12of the Illinois Adverse Health Care Events Reporting Law of
14    (b) The Fund shall consist of the following:
15        (1) fees collected pursuant to Section 5 of the
16    Hospital Licensing Act;
17        (2) federal matching funds received by the State as a
18    result of expenditures made by the Department that are
19    attributable to moneys deposited in the Fund;
20        (3) interest earned on moneys deposited in the Fund;
21    and
22        (4) other moneys received for the Fund from any other
23    source, including interest earned thereon.
24    (c) Disbursements from the Fund shall be made only for:
25        (1) initially, the implementation of the Illinois



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1    Adverse Health Care Events Reporting Law of 2005;
2        (2) subsequently, programs, information, or
3    assistance, including measures to address public
4    complaints, designed to measurably improve quality and
5    patient safety; and
6        (3) the reimbursement of moneys collected by the
7    Department through error or mistake.
8    (d) The uses described in paragraph (2) of subsection (c)
9shall be developed in conjunction with a statewide organization
10representing a majority of hospitals.
11    Section 8. The Illinois Adverse Health Care Events
12Reporting Law of 2005 is amended by changing Sections 10-10 and
1310-15 as follows:
14    (410 ILCS 522/10-10)
15    Sec. 10-10. Definitions. As used in this Law, the following
16terms have the following meanings:
17    "Adverse health care event" means any event identified as a
18serious reportable event by the National Quality Forum and the
19Centers for Medicare and Medicaid Services on the effective
20date of this amendatory Act of the 98th General Assembly. The
21Department shall adopt, by rule, the list of adverse health
22care events. The rules in effect on May 1, 2013, that define
23"adverse health care event" shall remain in effect until new
24rules are adopted in accordance with this amendatory Act of the



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198th General Assembly. If the National Quality Forum or the
2Centers for Medicare and Medicaid Services thereafter revises
3its list of serious reportable events through addition,
4deletion, or modification, then the term "adverse health care
5event" for purposes of this Law shall be similarly revised,
6effective no sooner than 6 months after the revision by the
7originating organization described in subsections (b) through
8(g) of Section 10-15.
9    "Department" means the Illinois Department of Public
11    "Health care facility" means a hospital maintained by the
12State or any department or agency thereof where such department
13or agency has authority under law to establish and enforce
14standards for the hospital under its management and control, a
15hospital maintained by any university or college established
16under the laws of this State and supported principally by
17public funds raised by taxation, a hospital licensed under the
18Hospital Licensing Act, a hospital organized under the
19University of Illinois Hospital Act, and an ambulatory surgical
20treatment center licensed under the Ambulatory Surgical
21Treatment Center Act.
22(Source: P.A. 94-242, eff. 7-18-05.)
23    (410 ILCS 522/10-15)
24    Sec. 10-15. Health care facility requirements to report,
25analyze, and correct.



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1    (a) Reports of adverse health care events required. Each
2health care facility shall report to the Department the
3occurrence of any of the adverse health care events described
4in subsections (b) through (g) no later than 30 days after
5discovery of the event. The report shall be filed in a format
6specified by the Department and shall identify the health care
7facility, but shall not include any information identifying or
8that tends to identify any of the health care professionals,
9employees, or patients involved.
10    (b) (Blank). Surgical events. Events reportable under this
11subsection are:
12        (1) Surgery performed on a wrong body part that is not
13    consistent with the documented informed consent for that
14    patient. Reportable events under this clause do not include
15    situations requiring prompt action that occur in the course
16    of surgery or situations whose urgency precludes obtaining
17    informed consent.
18        (2) Surgery performed on the wrong patient.
19        (3) The wrong surgical procedure performed on a patient
20    that is not consistent with the documented informed consent
21    for that patient. Reportable events under this clause do
22    not include situations requiring prompt action that occur
23    in the course of surgery or situations whose urgency
24    precludes obtaining informed consent.
25        (4) Retention of a foreign object in a patient after
26    surgery or other procedure, excluding objects



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1    intentionally implanted as part of a planned intervention
2    and objects present prior to surgery that are intentionally
3    retained.
4        (5) Death during or immediately after surgery of a
5    normal, healthy patient who has no organic, physiologic,
6    biochemical, or psychiatric disturbance and for whom the
7    pathologic processes for which the operation is to be
8    performed are localized and do not entail a systemic
9    disturbance.
10    (c) (Blank). Product or device events. Events reportable
11under this subsection are:
12        (1) Patient death or serious disability associated
13    with the use of contaminated drugs, devices, or biologics
14    provided by the health care facility when the contamination
15    is the result of generally detectable contaminants in
16    drugs, devices, or biologics regardless of the source of
17    the contamination or the product.
18        (2) Patient death or serious disability associated
19    with the use or function of a device in patient care in
20    which the device is used or functions other than as
21    intended. "Device" includes, but is not limited to,
22    catheters, drains, and other specialized tubes, infusion
23    pumps, and ventilators.
24        (3) Patient death or serious disability associated
25    with intravascular air embolism that occurs while being
26    cared for in a health care facility, excluding deaths



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1    associated with neurosurgical procedures known to present
2    a high risk of intravascular air embolism.
3    (d) (Blank). Patient protection events. Events reportable
4under this subsection are:
5        (1) An infant discharged to the wrong person.
6        (2) Patient death or serious disability associated
7    with patient disappearance for more than 4 hours, excluding
8    events involving adults who have decision-making capacity.
9        (3) Patient suicide or attempted suicide resulting in
10    serious disability while being cared for in a health care
11    facility due to patient actions after admission to the
12    health care facility, excluding deaths resulting from
13    self-inflicted injuries that were the reason for admission
14    to the health care facility.
15    (e) (Blank). Care management events. Events reportable
16under this subsection are:
17        (1) Patient death or serious disability associated
18    with a medication error, including, but not limited to,
19    errors involving the wrong drug, the wrong dose, the wrong
20    patient, the wrong time, the wrong rate, the wrong
21    preparation, or the wrong route of administration,
22    excluding reasonable differences in clinical judgment on
23    drug selection and dose.
24        (2) Patient death or serious disability associated
25    with a hemolytic reaction due to the administration of
26    ABO-incompatible blood or blood products.



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1        (3) Maternal death or serious disability associated
2    with labor or delivery in a low-risk pregnancy while being
3    cared for in a health care facility, excluding deaths from
4    pulmonary or amniotic fluid embolism, acute fatty liver of
5    pregnancy, or cardiomyopathy.
6        (4) Patient death or serious disability directly
7    related to hypoglycemia, the onset of which occurs while
8    the patient is being cared for in a health care facility
9    for a condition unrelated to hypoglycemia.
10    (f) (Blank). Environmental events. Events reportable under
11this subsection are:
12        (1) Patient death or serious disability associated
13    with an electric shock while being cared for in a health
14    care facility, excluding events involving planned
15    treatments such as electric countershock.
16        (2) Any incident in which a line designated for oxygen
17    or other gas to be delivered to a patient contains the
18    wrong gas or is contaminated by toxic substances.
19        (3) Patient death or serious disability associated
20    with a burn incurred from any source while being cared for
21    in a health care facility that is not consistent with the
22    documented informed consent for that patient. Reportable
23    events under this clause do not include situations
24    requiring prompt action that occur in the course of surgery
25    or situations whose urgency precludes obtaining informed
26    consent.



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1        (4) Patient death associated with a fall while being
2    cared for in a health care facility.
3        (5) Patient death or serious disability associated
4    with the use of restraints or bedrails while being cared
5    for in a health care facility.
6    (g) (Blank). Physical security events. Events reportable
7under this subsection are:
8        (1) Any instance of care ordered by or provided by
9    someone impersonating a physician, nurse, pharmacist, or
10    other licensed health care provider.
11        (2) Abduction of a patient of any age.
12        (3) Sexual assault on a patient within or on the
13    grounds of a health care facility.
14        (4) Death or significant injury of a patient or staff
15    member resulting from a physical assault that occurs within
16    or on the grounds of a health care facility.
17    (g-5) If the adverse health care events subject to this Law
18are revised as described in Section 10-10, then the Department
19shall provide notice to all affected health care facilities
20promptly upon the revision and shall inform affected health
21care facilities of the effective date of the revision for
22purposes of reporting under this Law.
23    (h) Definitions. As pertains to an adverse health care
24event used in this Section 10-15:
25     "Death" means patient death related to an adverse event
26and not related solely to the natural course of the patient's



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1illness or underlying condition. Events otherwise reportable
2under this Section 10-15 shall be reported even if the death
3might have otherwise occurred as the natural course of the
4patient's illness or underlying condition.
5    "Serious disability" means a physical or mental
6impairment, including loss of a body part, related to an
7adverse event and not related solely to the natural course of
8the patient's illness or underlying condition, that
9substantially limits one or more of the major life activities
10of an individual or a loss of bodily function, if the
11impairment or loss lasts more than 7 days prior to discharge or
12is still present at the time of discharge from an inpatient
13health care facility.
14(Source: P.A. 94-242, eff. 7-18-05.)
15    Section 10. The State Finance Act is amended by adding
16Section 5.855 as follows:
17    (30 ILCS 105/5.855 new)
18    Sec. 5.855. The Hospital Licensure Fund.
19    Section 99. Effective date. This Act takes effect upon
20becoming law.".