Full Text of HB3995 102nd General Assembly
HB3995enr 102ND GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning regulation.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 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; | 16 | | (4) that offers prenatal care and community education | 17 | | services and coordinates these services with other health | 18 | | care services available in the community; and | 19 | | (5) that does not provide general anesthesia or | 20 | | surgery. | 21 | | "Certified nurse midwife" means an advanced practice | 22 | | registered nurse licensed in Illinois under the Nurse Practice | 23 | | Act with full practice authority or who is delegated such |
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| 1 | | authority as part of a written collaborative agreement with a | 2 | | physician who is associated with the birthing center or who | 3 | | has privileges at a nearby birthing hospital. | 4 | | "Department" means the Illinois Department of Public | 5 | | Health. | 6 | | "Hospital" does not include places where pregnant females | 7 | | are received, cared for, or treated during delivery if it is in | 8 | | a licensed birth center, nor include any facility required to | 9 | | be licensed as a birth center. | 10 | | "Physician" means a physician licensed to practice | 11 | | medicine in all its branches in Illinois. | 12 | | Section 10. License required. Except as provided by this | 13 | | Act, no person shall open, manage, conduct, offer, maintain, | 14 | | or advertise as a birth center without a valid license issued | 15 | | by the Department. All birth centers in existence as of the | 16 | | effective date of this Act shall obtain a valid license to | 17 | | operate within 2 years after the adoption of rules by the | 18 | | Department to implement this Act under Section 60. | 19 | | Section 15. Issuance and renewal of license. | 20 | | (a) An applicant for a license under this Act shall submit | 21 | | an application on forms prescribed by the Department. Each | 22 | | application shall be accompanied by a nonrefundable license | 23 | | fee, as established by rule by the Department under Section | 24 | | 60. |
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| 1 | | (b) The Department may grant a temporary initial license | 2 | | to an applicant. A temporary initial license expires on the | 3 | | earlier of the date the Department denies the license or the | 4 | | date 6 months after the temporary initial license was issued. | 5 | | (c) The Department shall issue a license under this Act | 6 | | if, after application, inspection, and investigation, it finds | 7 | | the applicant meets the requirements of this Act and the rules | 8 | | and standards adopted pursuant to this Act. | 9 | | (d) A license is renewable every year upon submission of: | 10 | | (i) the renewal application and fee and (ii) a report on a form | 11 | | prescribed by the Department that includes information related | 12 | | to quality of care at a birth center. The report must be in the | 13 | | form and documented by evidence as required by the Department | 14 | | by rule under Section 60.
| 15 | | Section 17. Certificate of need; licenses. | 16 | | (a) A birth center shall obtain a certificate of need from | 17 | | the Health Facilities and Services Review Board under the | 18 | | Health Facilities Planning Act before receiving a license by | 19 | | the Department under this Act. | 20 | | (b) If, after obtaining an initial certificate of need | 21 | | under subsection (a), a birth center seeks to increase the bed | 22 | | capacity of the birth center, the birth center must obtain a | 23 | | certificate of need from the Health Facilities and Services | 24 | | Review Board before increasing the bed capacity. | 25 | | (c) A birth center in a medically underserved area, as |
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| 1 | | determined by the U.S. Department of Health and Human | 2 | | Services, shall receive priority in obtaining a certificate of | 3 | | need under this Section.
| 4 | | Section 20. Linkages. | 5 | | (a) A birth center shall link and integrate its services | 6 | | with at least one birthing hospital with a minimum of a Level 1 | 7 | | perinatal designation. | 8 | | (b) A birth center shall have an established agreement | 9 | | with a nearby receiving birthing hospital with policies and | 10 | | procedures for timely transfer of maternal and neonatal | 11 | | patients. The agreement shall include a determination of | 12 | | maternal and neonatal conditions necessitating consultation | 13 | | and referral. This should include plans
for communication with | 14 | | the receiving hospital before and after
transfer.
| 15 | | Section 25. Staffing. | 16 | | (a) A birth center shall have a clinical director, who may | 17 | | be: | 18 | | (1) a physician who is either certified or eligible | 19 | | for certification by the American College of Obstetricians
| 20 | | and Gynecologists or the American Board of Osteopathic
| 21 | | Obstetricians and Gynecologists or has hospital
| 22 | | obstetrical privileges; or | 23 | | (2)
a certified nurse midwife.
| 24 | | (b) The clinical director shall be responsible for: |
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| 1 | | (1) the development of policies and procedures for | 2 | | services as provided by Department rules; | 3 | | (2) coordinating the clinical staff and overall | 4 | | provision of patient care; | 5 | | (3) developing and approving policies defining the | 6 | | criteria to determine which pregnancies are accepted as | 7 | | normal, uncomplicated, and low-risk; and | 8 | | (4) developing and approving policing regarding the | 9 | | anesthesia services available at the center.
| 10 | | (c) An obstetrician, family practitioner, or certified | 11 | | nurse midwife shall attend each person in labor from the time | 12 | | of admission through birth and throughout the immediate | 13 | | postpartum period. Attendance may be delegated only to another | 14 | | physician or a certified nurse midwife. | 15 | | (d) A second staff person shall be present at each birth | 16 | | who: | 17 | | (1) is licensed or certified in Illinois in a | 18 | | health-related field and under the supervision of a | 19 | | physician or a certified nurse midwife who is in | 20 | | attendance; | 21 | | (2) has specialized training in labor and delivery | 22 | | techniques and care of newborns; and | 23 | | (3) receives planned and ongoing training as needed to | 24 | | perform assigned duties effectively.
| 25 | | Section 30. Minimum standards. |
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| 1 | | (a) The Department's rules adopted pursuant to Section 60 | 2 | | of this Act shall contain minimum standards to protect the | 3 | | health and safety of a patient of a birth center. In adopting | 4 | | rules for birth centers, the Department shall consider: | 5 | | (1) the Commission for the Accreditation of Birth | 6 | | Centers' Standards for Freestanding Birth Centers; | 7 | | (2) the American Academy of Pediatrics and American | 8 | | College of Obstetricians and Gynecologists Guidelines for | 9 | | Perinatal Care; and | 10 | | (3) the Regionalized Perinatal Health Care Code.
| 11 | | Section 35. Quality of care. The Department's rules shall | 12 | | provide for a time period within which each birth center must | 13 | | become accredited by either the Commission for the | 14 | | Accreditation of Freestanding Birth Centers or The Joint | 15 | | Commission. | 16 | | A birth center shall implement a quality improvement | 17 | | program consistent with the requirements of the accrediting | 18 | | body and is encouraged to participate in quality improvement | 19 | | projects implemented by the Department's Administrative | 20 | | Perinatal Centers and other Department-supported perinatal | 21 | | quality improvement projects. Clinicians, or their clinical | 22 | | representative, attending persons in labor at the birth center | 23 | | shall attend morbidity and mortality reviews that occur at the | 24 | | receiving birthing hospital on their patients, when invited, | 25 | | at a mutually agreeable time. This includes, but is not |
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| 1 | | limited to, maternal and neonatal patients transferred to the | 2 | | receiving birthing hospital. | 3 | | Section 40. Reimbursement requirements. | 4 | | (a) A birth center shall seek certification under Titles | 5 | | XVIII and XIX of the federal Social Security Act. | 6 | | (b) Reimbursement rates set by the Department of | 7 | | Healthcare and Family Services should be based on all types of | 8 | | medically necessary covered services provided to both the | 9 | | birthing person and the baby, including: | 10 | | (1) a professional fee for both the birthing person | 11 | | and baby; | 12 | | (2) a facility fee for the birthing person that is no | 13 | | less than 75% of the statewide average facility payment | 14 | | rate made to a hospital for an uncomplicated vaginal | 15 | | birth; | 16 | | (3) a facility fee for the baby that is no less than | 17 | | 75% of the statewide average facility payment rate made to | 18 | | a hospital for a normal baby; and | 19 | | (4) additional fees for other services, medications, | 20 | | laboratory tests, and supplies provided. | 21 | | (c) A birth center shall provide charitable care | 22 | | consistent with that provided by comparable health care | 23 | | providers in the geographic area. | 24 | | (d) A birth center may not discriminate against any | 25 | | patient requiring treatment because of the source of payment |
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| 1 | | for services, including Medicare and Medicaid recipients. | 2 | | Section 45. Reporting requirements. The Department shall | 3 | | by rule require each birth center to report information every | 4 | | year that is consistent with the birth center's license | 5 | | renewal schedule, which the Department shall make publicly | 6 | | available and which shall include the following: | 7 | | (1) utilization data involving patient length of stay; | 8 | | (2) admissions and discharges; | 9 | | (3) complications; | 10 | | (4) transfers; | 11 | | (5) deaths; | 12 | | (6) any other publicly reported data required under | 13 | | the Consumer Guide to Health Care; and | 14 | | (7) post-discharge patient status data where patients | 15 | | are
followed for 14 days after discharge from the birth | 16 | | center
to determine whether the mother or baby developed a
| 17 | | complication or infection. | 18 | | Section 50. Training. A birth center shall, in | 19 | | consultation with the clinical director, establish and | 20 | | implement a policy to ensure appropriate training and | 21 | | competency of individuals employed within the birth center. | 22 | | The policy shall, at a minimum, define the acts and practices | 23 | | that are allowed or prohibited for such employees, establish | 24 | | how training will be conducted, and illustrate how initial |
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| 1 | | competency will be established. | 2 | | Section 55. Inspections; special inspections; reports. | 3 | | (a) The Department, whenever it determines necessary, may | 4 | | conduct a
special inspection, survey, or evaluation of a birth | 5 | | center to assess
compliance with licensure requirements and | 6 | | standards or a plan of
correction submitted as a result of | 7 | | deficiencies cited by the
Department or an accrediting body.
| 8 | | (b) Upon the Department's completion of any special | 9 | | inspection, survey, or evaluation, the appropriate Department | 10 | | personnel who conducted the special inspection, survey, or | 11 | | evaluation shall submit a copy of his or her report to the | 12 | | licensee upon exiting the birth center, and shall submit the | 13 | | actual report to the appropriate regional office. | 14 | | (c) The Department's report and any recommendation for | 15 | | action under this Act shall be sent to the Department's | 16 | | central office together with a plan of correction from the | 17 | | birth center. | 18 | | (d) The plan of correction may contain related comments or | 19 | | documentation provided by the birth center that may refute | 20 | | findings in the report, explain extenuating circumstances that | 21 | | the birth center could not reasonably have prevented, or | 22 | | indicate methods and timetables for correction of deficiencies | 23 | | described in the report. | 24 | | (e) A birth center has 10 days after the date of the | 25 | | Department's special inspection, survey, or evaluation to |
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| 1 | | submit a plan of correction. The Department shall determine | 2 | | whether a birth center is in violation of this Section no later | 3 | | than 60 days after completion of each special inspection, | 4 | | survey, evaluation, or plan of correction. | 5 | | (f) The Department shall maintain all special inspection, | 6 | | survey, or evaluation reports for at least 5 years in a manner | 7 | | accessible to the public.
| 8 | | Section 60. Rules. | 9 | | (a) The Department shall adopt rules for the | 10 | | administration and enforcement of this Act. | 11 | | (b) Rules adopted by the Department under this Act shall | 12 | | stipulate:
| 13 | | (1) the eligibility criteria for birth center | 14 | | admission that are consistent with accreditation standards | 15 | | and the certified nurse midwife's or physician's scope of | 16 | | practice; | 17 | | (2) the necessary equipment for emergency care | 18 | | according to the Commission for Accreditation of Birth | 19 | | Centers' standards; | 20 | | (3) the minimum elements required in the transfer | 21 | | agreement between a birth center and a receiving birth | 22 | | hospital with at least a Level 1 perinatal designation, | 23 | | including the amount of travel time between facilities in | 24 | | rural and nonrural areas, the staff required to transfer | 25 | | patients, and the mode of emergency transportation between |
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| 1 | | facilities; and | 2 | | (4) the equipment used by the birth center to ensure | 3 | | that it is compatible with the health and safety of the | 4 | | patients.
| 5 | | Section 99. Effective date. This Act takes effect upon | 6 | | becoming law.
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