Illinois General Assembly - Full Text of HB0005
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Full Text of HB0005  101st General Assembly




State of Illinois
2019 and 2020


Introduced 1/9/2019, by Rep. Mary E. Flowers


20 ILCS 1305/10-15
20 ILCS 2310/2310-223 new
210 ILCS 50/3.20

    Amends the Department of Human Services Act. Requires the Department of Human Services to ensure access to substance use and mental health services statewide for pregnant and postpartum women, and to ensure that programs are gender-responsive, are trauma-informed, serve women and young children, and prioritize justice-involved pregnant and postpartum women. Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Requires the Department of Public Health to establish a classification system for specified levels of maternal care. Requires the Department to implement substantive measures that benefit maternal care and provide a greater amount of available information in order to further medical research. Amends the Emergency Medical Services (EMS) Systems Act. Requires the Department of Public Health to ensure that EMS systems are transporting pregnant women to the appropriate facilities based on the Department of Public Health's classification system for levels of maternal care. Effective immediately.

LRB101 04078 CPF 49086 b






HB0005LRB101 04078 CPF 49086 b

1    AN ACT concerning health.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Department of Human Services Act is amended
5by changing Section 10-15 as follows:
6    (20 ILCS 1305/10-15)
7    Sec. 10-15. Pregnant women with a substance use disorder;
8mental health services. The Department shall develop
9guidelines for use in non-hospital residential care facilities
10for pregnant women who have a substance use disorder with
11respect to the care of those clients.
12    The Department shall administer infant mortality and
13prenatal programs, through its provider agencies, to develop
14special programs for case finding and service coordination for
15pregnant women who have a substance use disorder.
16    The Department shall ensure access to substance use and
17mental health services statewide for pregnant and postpartum
18women, and ensure that programs are gender-responsive, are
19trauma-informed, serve women and young children, and
20prioritize justice-involved pregnant and postpartum women.
21(Source: P.A. 100-759, eff. 1-1-19.)
22    Section 10. The Department of Public Health Powers and



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1Duties Law of the Civil Administrative Code of Illinois is
2amended by adding Section 2310-223 as follows:
3    (20 ILCS 2310/2310-223 new)
4    Sec. 2310-223. Maternal care.
5    (a) The Department shall establish a classification system
6for the following levels of maternal care:
7        (1) basic care: care of uncomplicated pregnancies with
8    the ability to detect, stabilize, and initiate management
9    of unanticipated maternal-fetal or neonatal problems that
10    occur during the antepartum, intrapartum, or postpartum
11    period until the patient can be transferred to a facility
12    at which specialty maternal care is available;
13        (2) specialty care: basic care plus care of appropriate
14    high-risk antepartum, intrapartum, or postpartum
15    conditions, both directly admitted and transferred to
16    another facility;
17        (3) subspecialty care: specialty care plus care of more
18    complex maternal medical conditions, obstetric
19    complications, and fetal conditions; and
20        (4) regional perinatal health care: subspecialty care
21    plus on-site medical and surgical care of the most complex
22    maternal conditions, critically ill pregnant women, and
23    fetuses throughout antepartum, intrapartum, and postpartum
24    care.
25    (b) The Department shall:



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1        (1) introduce uniform designations for levels of
2    maternal care that are complimentary but distinct from
3    levels of neonatal care;
4        (2) establish clear, uniform criteria for designation
5    of maternal centers that are integrated with emergency
6    response systems to help ensure that the appropriate
7    personnel, physical space, equipment, and technology are
8    available to achieve optimal outcomes, as well as to
9    facilitate subsequent data collection regarding
10    risk-appropriate care;
11        (3) require each health care facility to have a clear
12    understanding of its capability to handle increasingly
13    complex levels of maternal care, and to have a well-defined
14    threshold for transferring women to health care facilities
15    that offer a higher level of care; to ensure optimal care
16    of all pregnant women, the Department shall require all
17    birth centers, hospitals, and higher-level facilities to
18    collaborate in order to develop and maintain maternal and
19    neonatal transport plans and cooperative agreements
20    capable of managing the health care needs of women who
21    develop complications; the Department shall require that
22    receiving hospitals openly accept transfers;
23        (4) require higher-level facilities to provide
24    training for quality improvement initiatives, educational
25    support, and severe morbidity and mortality case review for
26    lower-level hospitals; the Department shall ensure that,



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1    in those regions that do not have a facility that qualifies
2    as a regional perinatal health care facility, any specialty
3    care facility in the region will provide the educational
4    and consultation function;
5        (5) require facilities and regional systems to develop
6    methods to track severe maternal morbidity and mortality to
7    assess the efficacy of utilizing maternal levels of care;
8        (6) analyze data collected from all facilities and
9    regional systems in order to inform future updates to the
10    levels of maternal care;
11        (7) require follow-up interdisciplinary work groups to
12    further explore the implementation needs that are
13    necessary to adopt the proposed classification system for
14    levels of maternal care in all facilities that provide
15    maternal care;
16        (8) disseminate data and materials to raise public
17    awareness about the importance of prenatal care and
18    maternal health;
19        (9) create or expand home visiting programs to target
20    high-risk mothers in Illinois during pregnancy and
21    postpartum periods, such as doula programs, and expand
22    efforts to provide universal home visiting to all mothers
23    within 3 weeks of giving birth; and
24        (10) engage the Illinois Chapter of the American
25    Academy of Pediatrics in creating a quality improvement
26    initiative to expand efforts of pediatricians conducting



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1    postpartum depression screening at well baby visits during
2    the first year of life.
3    Section 15. The Emergency Medical Services (EMS) Systems
4Act is amended by changing Section 3.20 as follows:
5    (210 ILCS 50/3.20)
6    Sec. 3.20. Emergency Medical Services (EMS) Systems.
7    (a) "Emergency Medical Services (EMS) System" means an
8organization of hospitals, vehicle service providers and
9personnel approved by the Department in a specific geographic
10area, which coordinates and provides pre-hospital and
11inter-hospital emergency care and non-emergency medical
12transports at a BLS, ILS and/or ALS level pursuant to a System
13program plan submitted to and approved by the Department, and
14pursuant to the EMS Region Plan adopted for the EMS Region in
15which the System is located.
16    (b) One hospital in each System program plan must be
17designated as the Resource Hospital. All other hospitals which
18are located within the geographic boundaries of a System and
19which have standby, basic or comprehensive level emergency
20departments must function in that EMS System as either an
21Associate Hospital or Participating Hospital and follow all
22System policies specified in the System Program Plan, including
23but not limited to the replacement of drugs and equipment used
24by providers who have delivered patients to their emergency



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1departments. All hospitals and vehicle service providers
2participating in an EMS System must specify their level of
3participation in the System Program Plan.
4    (c) The Department shall have the authority and
5responsibility to:
6        (1) Approve BLS, ILS and ALS level EMS Systems which
7    meet minimum standards and criteria established in rules
8    adopted by the Department pursuant to this Act, including
9    the submission of a Program Plan for Department approval.
10    Beginning September 1, 1997, the Department shall approve
11    the development of a new EMS System only when a local or
12    regional need for establishing such System has been
13    verified by the Department. This shall not be construed as
14    a needs assessment for health planning or other purposes
15    outside of this Act. Following Department approval, EMS
16    Systems must be fully operational within one year from the
17    date of approval.
18        (2) Monitor EMS Systems, based on minimum standards for
19    continuing operation as prescribed in rules adopted by the
20    Department pursuant to this Act, which shall include
21    requirements for submitting Program Plan amendments to the
22    Department for approval.
23        (3) Renew EMS System approvals every 4 years, after an
24    inspection, based on compliance with the standards for
25    continuing operation prescribed in rules adopted by the
26    Department pursuant to this Act.



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1        (4) Suspend, revoke, or refuse to renew approval of any
2    EMS System, after providing an opportunity for a hearing,
3    when findings show that it does not meet the minimum
4    standards for continuing operation as prescribed by the
5    Department, or is found to be in violation of its
6    previously approved Program Plan.
7        (5) Require each EMS System to adopt written protocols
8    for the bypassing of or diversion to any hospital, trauma
9    center or regional trauma center, which provide that a
10    person shall not be transported to a facility other than
11    the nearest hospital, regional trauma center or trauma
12    center unless the medical benefits to the patient
13    reasonably expected from the provision of appropriate
14    medical treatment at a more distant facility outweigh the
15    increased risks to the patient from transport to the more
16    distant facility, or the transport is in accordance with
17    the System's protocols for patient choice or refusal.
18        (6) Require that the EMS Medical Director of an ILS or
19    ALS level EMS System be a physician licensed to practice
20    medicine in all of its branches in Illinois, and certified
21    by the American Board of Emergency Medicine or the American
22    Osteopathic Board of Emergency Medicine, and that the EMS
23    Medical Director of a BLS level EMS System be a physician
24    licensed to practice medicine in all of its branches in
25    Illinois, with regular and frequent involvement in
26    pre-hospital emergency medical services. In addition, all



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1    EMS Medical Directors shall:
2            (A) Have experience on an EMS vehicle at the
3        highest level available within the System, or make
4        provision to gain such experience within 12 months
5        prior to the date responsibility for the System is
6        assumed or within 90 days after assuming the position;
7            (B) Be thoroughly knowledgeable of all skills
8        included in the scope of practices of all levels of EMS
9        personnel within the System;
10            (C) Have or make provision to gain experience
11        instructing students at a level similar to that of the
12        levels of EMS personnel within the System; and
13            (D) For ILS and ALS EMS Medical Directors,
14        successfully complete a Department-approved EMS
15        Medical Director's Course.
16        (7) Prescribe statewide EMS data elements to be
17    collected and documented by providers in all EMS Systems
18    for all emergency and non-emergency medical services, with
19    a one-year phase-in for commencing collection of such data
20    elements.
21        (8) Define, through rules adopted pursuant to this Act,
22    the terms "Resource Hospital", "Associate Hospital",
23    "Participating Hospital", "Basic Emergency Department",
24    "Standby Emergency Department", "Comprehensive Emergency
25    Department", "EMS Medical Director", "EMS Administrative
26    Director", and "EMS System Coordinator".



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1            (A) (Blank).
2            (B) (Blank).
3        (9) Investigate the circumstances that caused a
4    hospital in an EMS system to go on bypass status to
5    determine whether that hospital's decision to go on bypass
6    status was reasonable. The Department may impose
7    sanctions, as set forth in Section 3.140 of the Act, upon a
8    Department determination that the hospital unreasonably
9    went on bypass status in violation of the Act.
10        (10) Evaluate the capacity and performance of any
11    freestanding emergency center established under Section
12    32.5 of this Act in meeting emergency medical service needs
13    of the public, including compliance with applicable
14    emergency medical standards and assurance of the
15    availability of and immediate access to the highest quality
16    of medical care possible.
17        (11) Permit limited EMS System participation by
18    facilities operated by the United States Department of
19    Veterans Affairs, Veterans Health Administration. Subject
20    to patient preference, Illinois EMS providers may
21    transport patients to Veterans Health Administration
22    facilities that voluntarily participate in an EMS System.
23    Any Veterans Health Administration facility seeking
24    limited participation in an EMS System shall agree to
25    comply with all Department administrative rules
26    implementing this Section. The Department may promulgate



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1    rules, including, but not limited to, the types of Veterans
2    Health Administration facilities that may participate in
3    an EMS System and the limitations of participation.
4        (12) Ensure that EMS systems are transporting pregnant
5    women to the appropriate facilities based on the
6    classification of the levels of maternal care described
7    under subsection (a) of Section 2310-223 of the Department
8    of Public Health Powers and Duties Law of the Civil
9    Administrative Code of Illinois.
10(Source: P.A. 97-333, eff. 8-12-11; 98-973, eff. 8-15-14.)
11    Section 99. Effective date. This Act takes effect upon
12becoming law.