Full Text of HB3995 102nd General Assembly
HB3995ham001 102ND GENERAL ASSEMBLY | Rep. Robyn Gabel Filed: 3/22/2021
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| 1 | | AMENDMENT TO HOUSE BILL 3995
| 2 | | AMENDMENT NO. ______. Amend House Bill 3995 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 1. Short title. This Act may be cited as the Birth | 5 | | Center Licensing Act. | 6 | | Section 5. Definitions. In this Act: | 7 | | "Birth center" means a designated site, other than a | 8 | | hospital: | 9 | | (1) in which births are planned to occur following a | 10 | | normal, uncomplicated, and low-risk pregnancy; | 11 | | (2) that is not the pregnant person's usual place of | 12 | | residence; | 13 | | (3) that is exclusively dedicated to serving the | 14 | | childbirth-related needs of pregnant persons and their | 15 | | newborns, and has no more than 10 beds; and | 16 | | (4) that offers prenatal care and community education |
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| 1 | | services and coordinates these services with other health | 2 | | care services available in the community. | 3 | | "Department" means the Department of Public Health. | 4 | | "Hospital" does not include places where pregnant females | 5 | | are received, cared for, or treated during delivery if it is in | 6 | | a licensed birth center, nor include any facility required to | 7 | | be licensed as a birth center. | 8 | | Section 10. License required. Except as provided by this | 9 | | Act, no person shall open, manage, conduct, offer, maintain, | 10 | | or advertise as a birth center without a valid license issued | 11 | | by the Department. All birth centers in existence as of the | 12 | | effective date of this Act shall obtain a valid license to | 13 | | operate within 2 years after the adoption of rules by the | 14 | | Department to implement this Act under Section 60. | 15 | | Section 15. Issuance and renewal of license. | 16 | | (a) An applicant for a license under this Act shall submit | 17 | | an application on forms prescribed by the Department. Each | 18 | | application shall be accompanied by a nonrefundable license | 19 | | fee, as established by rule by the Department under Section | 20 | | 60. | 21 | | (b) The Department may grant a temporary initial license | 22 | | to an applicant. A temporary initial license expires on the | 23 | | earlier of the date the Department denies the license or the | 24 | | date 6 months after the temporary initial license was issued. |
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| 1 | | (c) The Department shall issue a license under this Act | 2 | | if, after application, inspection, and investigation, it finds | 3 | | the applicant meets the requirements of this Act and the rules | 4 | | and standards adopted pursuant to this Act. | 5 | | (d) A license is renewable every year upon submission of: | 6 | | (i) the renewal application and fee and (ii) a report on a form | 7 | | prescribed by the Department that includes information related | 8 | | to quality of care at a birth center. The report must be in the | 9 | | form and documented by evidence as required by the Department | 10 | | by rule under Section 60.
| 11 | | Section 17. Certificate of need; licenses. | 12 | | (a) A birth center shall obtain a certificate of need from | 13 | | the Health Facilities and Services Review Board under the | 14 | | Health Facilities Planning Act before receiving a license by | 15 | | the Department under this Act. | 16 | | (b) If, after obtaining an initial certificate of need | 17 | | under subsection (a), a birth center seeks to increase the bed | 18 | | capacity of the birth center, the birth center must obtain a | 19 | | certificate of need from the Health Facilities and Services | 20 | | Review Board before increasing the bed capacity. | 21 | | (c) A birth center in a medically underserved area, as | 22 | | determined by the U.S. Department of Health and Human | 23 | | Services, shall receive priority in obtaining a certificate of | 24 | | need under this Section.
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| 1 | | Section 20. Linkages. | 2 | | (a) A birth center shall, to the extent possible, link and | 3 | | integrate its services with nearby health care facilities. | 4 | | (b) A birth center shall have a written plan for transfer | 5 | | of patients that addresses emergency and nonemergency
| 6 | | situations for both pregnant persons and newborns in | 7 | | antepartum,
intrapartum, and postpartum phases. This should | 8 | | include plans
for communication with the receiving hospital | 9 | | before and after
transfer.
| 10 | | Section 25. Staffing. | 11 | | (a) A birth center shall have a clinical director, who may | 12 | | be: | 13 | | (1) a physician who is either certified or eligible | 14 | | for certification by the American College of Obstetricians
| 15 | | and Gynecologists or the American Board of Osteopathic
| 16 | | Obstetricians and Gynecologists or has hospital
| 17 | | obstetrical privileges; or | 18 | | (2)
a midwife who is either certified or eligible for
| 19 | | certification by his or her governing body.
| 20 | | (b) The clinical director shall be responsible for: | 21 | | (1) the development of policies and procedures for | 22 | | services as provided by Department rules; | 23 | | (2) coordinating the clinical staff and overall | 24 | | provision of patient care; | 25 | | (3) developing and approving policies defining the |
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| 1 | | criteria to determine which pregnancies are accepted as | 2 | | normal, uncomplicated, and low-risk; and | 3 | | (4) developing and approving policing regarding the | 4 | | anesthesia services available at the center.
| 5 | | (c) An obstetrician, family practitioner, or midwife | 6 | | licensed in Illinois shall attend each person in labor from | 7 | | the time of admission through birth and throughout the | 8 | | immediate postpartum period. Attendance may be delegated only | 9 | | to another physician or midwife licensed in Illinois. | 10 | | (d) A second staff person shall be present at each birth | 11 | | who: | 12 | | (1) is licensed or certified in Illinois in a | 13 | | health-related field and under the supervision of a | 14 | | physician or a licensed midwife in Illinois that is in | 15 | | attendance; | 16 | | (2) has specialized training in labor and delivery | 17 | | techniques and care of newborns; and | 18 | | (3) receives planned and ongoing training as needed to | 19 | | perform assigned duties effectively.
| 20 | | Section 30. Minimum standards. | 21 | | (a) The Department's rules adopted pursuant to Section 60 | 22 | | of this Act shall contain minimum standards to protect the | 23 | | health and safety of a patient of a birth center. In adopting | 24 | | rules for birth centers, the Department shall consider: | 25 | | (1) the Commission for the Accreditation of Birth |
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| 1 | | Centers' Standards for Freestanding Birth Centers; | 2 | | (2) the American Academy of Pediatrics and American | 3 | | College of Obstetricians and Gynecologists Guidelines for | 4 | | Perinatal Care; and | 5 | | (3) the Regionalized Perinatal Health Care Code.
| 6 | | Section 35. Quality of care. The Department's rules shall | 7 | | provide for a time period within which each birth center must | 8 | | become accredited by either the Commission for the | 9 | | Accreditation of Freestanding Birth Centers or The Joint | 10 | | Commission. | 11 | | A birth center shall implement a quality improvement | 12 | | program consistent with the requirements of the accrediting | 13 | | body. | 14 | | Section 40. Reimbursement requirements. | 15 | | (a) A birth center shall seek certification under Titles | 16 | | XVIII and XIX of the federal Social Security Act. | 17 | | (b) Reimbursement rates set by the Department of | 18 | | Healthcare and Family Services should be based on all types of | 19 | | medically necessary covered services provided to both the | 20 | | birthing person and the baby, including: | 21 | | (1) a professional fee for both the birthing person | 22 | | and baby; | 23 | | (2) a facility fee for the birthing person that is no | 24 | | less than 75% of the statewide average facility payment |
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| 1 | | rate made to a hospital for an uncomplicated vaginal | 2 | | birth; | 3 | | (3) a facility fee for the baby that is no less than | 4 | | 75% of the statewide average facility payment rate made to | 5 | | a hospital for a normal baby; and | 6 | | (4) additional fees for other services, medications, | 7 | | laboratory tests, and supplies provided. | 8 | | (c) A birth center shall provide charitable care | 9 | | consistent with that provided by comparable health care | 10 | | providers in the geographic area. | 11 | | (d) A birth center may not discriminate against any | 12 | | patient requiring treatment because of the source of payment | 13 | | for services, including Medicare and Medicaid recipients. | 14 | | Section 45. Reporting requirements. The Department shall | 15 | | by rule require each birth center to report information every | 16 | | year that is consistent with the birth center's license | 17 | | renewal schedule, which the Department shall make publicly | 18 | | available and which shall include the following: | 19 | | (1) utilization data involving patient length of stay; | 20 | | (2) admissions and discharges; | 21 | | (3) complications; | 22 | | (4) transfers; | 23 | | (5) deaths; | 24 | | (6) any other publicly reported data required under | 25 | | the Consumer Guide to Health Care; and |
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| 1 | | (7) post-discharge patient status data where patients | 2 | | are
followed for 14 days after discharge from the birth | 3 | | center
to determine whether the mother or baby developed a
| 4 | | complication or infection. | 5 | | Section 50. Training. A birth center shall establish and | 6 | | implement a policy to ensure appropriate training and | 7 | | competency of individuals employed within the birth center. | 8 | | The policy shall, at a minimum, define the acts and practices | 9 | | that are allowed or prohibited for such employees, establish | 10 | | how training will be conducted, and illustrate how initial | 11 | | competency will be established. | 12 | | Section 55. Inspections; special inspections; reports. | 13 | | (a) The Department shall deem an accreditation body | 14 | | applicable to birth centers as a substitute for its own | 15 | | periodic inspection.
The Department, whenever it determines | 16 | | necessary, may conduct a
special inspection, survey, or | 17 | | evaluation of a birth center to assess
compliance with | 18 | | licensure requirements and standards or a plan of
correction | 19 | | submitted as a result of deficiencies cited by the
Department | 20 | | or accrediting body.
| 21 | | (b) Upon the Department's completion of any special | 22 | | inspection, survey, or evaluation, the appropriate Department | 23 | | personnel who conducted the special inspection, survey, or | 24 | | evaluation shall submit a copy of his or her report to the |
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| 1 | | licensee upon exiting the birth center, and shall submit the | 2 | | actual report to the appropriate regional office. | 3 | | (c) The Department's report and any recommendation for | 4 | | action under this Act shall be sent to the Department's | 5 | | central office together with a plan of correction from the | 6 | | birth center. | 7 | | (d) The plan of correction may contain related comments or | 8 | | documentation provided by the birth center that may refute | 9 | | findings in the report, explain extenuating circumstances that | 10 | | the birth center could not reasonably have prevented, or | 11 | | indicate methods and timetables for correction of deficiencies | 12 | | described in the report. | 13 | | (e) A birth center has 10 days after the date of the | 14 | | Department's special inspection, survey, or evaluation to | 15 | | submit a plan of correction. The Department shall determine | 16 | | whether a birth center is in violation of this Section no later | 17 | | than 60 days after completion of each special inspection, | 18 | | survey, evaluation, or plan of correction. | 19 | | (f) The Department shall maintain all special inspection, | 20 | | survey, or evaluation reports for at least 5 years in a manner | 21 | | accessible to the public.
| 22 | | Section 60. Rules. | 23 | | (a) The Department shall adopt rules for the | 24 | | administration and enforcement of this Act. | 25 | | (b) Rules adopted by the Department under this Act shall |
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| 1 | | stipulate:
| 2 | | (1) the eligibility criteria for birth center | 3 | | admission that are consistent with accreditation standards | 4 | | and the midwife's or physician's scope of practice; | 5 | | (2) the necessary equipment for emergency care | 6 | | according to the Commission for Accreditation of Birth | 7 | | Centers' standards; | 8 | | (3) the travel time distance from the birth center | 9 | | that is not located within a rural area and a general acute | 10 | | care hospital with which the birth center the maintains a | 11 | | transfer agreement that allows for an emergency cesarean | 12 | | delivery to be started within 30 minutes of the decision | 13 | | that a cesarean delivery is necessary; | 14 | | (4) the travel time distance from the birth center | 15 | | that is located within a rural area and a general acute | 16 | | care hospital with which the birth center maintains a | 17 | | transfer agreement that allows for an emergency cesarean | 18 | | delivery to be started within 45 minutes of the decision | 19 | | that a cesarean delivery is necessary; | 20 | | (5) that the use of general anesthesia at a birth | 21 | | center is prohibited; and
| 22 | | (6) the equipment used by the birth center to ensure | 23 | | that it is compatible with the health and safety of the | 24 | | patients.
| 25 | | Section 99. Effective date. This Act takes effect upon |
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| 1 | | becoming law.".
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