Full Text of HB5050 97th General Assembly
HB5050enr 97TH GENERAL ASSEMBLY |
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| 1 | | AN ACT concerning public health.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Alternative Health Care Delivery Act is | 5 | | amended by changing Sections 10 and 35 as follows:
| 6 | | (210 ILCS 3/10)
| 7 | | Sec. 10. Definitions. In this Act, unless the context
| 8 | | otherwise requires:
| 9 | | "Ambulatory surgical treatment center" or "ASTC" means any | 10 | | institution, place, or building licensed under the Ambulatory | 11 | | Surgical Treatment Center Act. | 12 | | "Alternative health care model" means a facility or program
| 13 | | authorized under Section 35 of this Act.
| 14 | | "Board" means the State Board of Health.
| 15 | | "Department" means the Illinois Department of Public | 16 | | Health.
| 17 | | "Demonstration program" means a program to license and | 18 | | study
alternative health care models authorized under this Act.
| 19 | | "Director" means the Director of Public Health.
| 20 | | (Source: P.A. 87-1188.)
| 21 | | (210 ILCS 3/35)
| 22 | | Sec. 35. Alternative health care models authorized. |
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| 1 | | Notwithstanding
any other law to the contrary, alternative | 2 | | health care models
described in this Section may be established | 3 | | on a demonstration basis.
| 4 | | (1) (Blank).
| 5 | | (2) Alternative health care delivery model; | 6 | | postsurgical recovery care
center. A postsurgical recovery | 7 | | care center is a designated site which
provides | 8 | | postsurgical recovery care for generally healthy patients
| 9 | | undergoing surgical procedures that potentially require | 10 | | overnight nursing care, pain
control, or observation that | 11 | | would otherwise be provided in an inpatient
setting. | 12 | | Patients may be discharged from the postsurgical recovery | 13 | | care center in less than 24 hours if the attending | 14 | | physician or the facility's medical director believes the | 15 | | patient has recovered enough to be discharged. A | 16 | | postsurgical recovery care center is either freestanding | 17 | | or a
defined unit of an ambulatory surgical treatment | 18 | | center or hospital.
No facility, or portion of a facility, | 19 | | may participate in a demonstration
program as a | 20 | | postsurgical recovery care center unless the facility has | 21 | | been
licensed as an ambulatory surgical treatment center or | 22 | | hospital for at least 2
years before August 20, 1993 (the | 23 | | effective date of Public Act 88-441). The
maximum length of | 24 | | stay for patients in a
postsurgical recovery care center is | 25 | | not to exceed 48 hours unless the treating
physician | 26 | | requests an extension of time from the recovery center's |
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| 1 | | medical
director on the basis of medical or clinical | 2 | | documentation that an additional
care period is required | 3 | | for the recovery of a patient and the medical director
| 4 | | approves the extension of time. In no case, however, shall | 5 | | a patient's length
of stay in a postsurgical recovery care | 6 | | center be longer than 72 hours. If a
patient requires an | 7 | | additional care period after the expiration of the 72-hour
| 8 | | limit, the patient shall be transferred to an appropriate | 9 | | facility. Reports on
variances from the 24-hour or 48-hour | 10 | | limit shall be sent to the Department for its
evaluation. | 11 | | The reports shall, before submission to the Department, | 12 | | have
removed from them all patient and physician | 13 | | identifiers. Blood products may be administered in the | 14 | | postsurgical recovery care center model. In order to handle
| 15 | | cases of complications, emergencies, or exigent | 16 | | circumstances, every
postsurgical recovery care center as | 17 | | defined in this paragraph shall maintain a
contractual | 18 | | relationship, including a transfer agreement, with a | 19 | | general acute
care hospital. A postsurgical recovery care | 20 | | center shall be no larger than 20
beds. A postsurgical | 21 | | recovery care center shall be located within 15 minutes
| 22 | | travel time from the general acute care hospital with which | 23 | | the center
maintains a contractual relationship, including | 24 | | a transfer agreement, as
required under this paragraph.
| 25 | | No postsurgical recovery care center shall | 26 | | discriminate against any patient
requiring treatment |
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| 1 | | because of the source of payment for services, including
| 2 | | Medicare and Medicaid recipients.
| 3 | | The Department shall adopt rules to implement the | 4 | | provisions of Public
Act 88-441 concerning postsurgical | 5 | | recovery care centers within 9 months after
August 20, | 6 | | 1993. Notwithstanding any other law to the contrary, a | 7 | | postsurgical recovery care center model may provide sleep | 8 | | laboratory or similar sleep studies in accordance with | 9 | | applicable State and federal laws and regulations.
| 10 | | (3) Alternative health care delivery model; children's | 11 | | community-based
health care center. A children's | 12 | | community-based health care center model is a
designated | 13 | | site that provides nursing care, clinical support | 14 | | services, and
therapies for a period of one to 14 days for | 15 | | short-term stays and 120 days to
facilitate transitions to | 16 | | home or other appropriate settings for medically
fragile | 17 | | children, technology
dependent children, and children with | 18 | | special health care needs who are deemed
clinically stable | 19 | | by a physician and are younger than 22 years of age. This
| 20 | | care is to be provided in a home-like environment that | 21 | | serves no more than 12
children at a time. Children's | 22 | | community-based health care center
services must be | 23 | | available through the model to all families, including | 24 | | those
whose care is paid for through the Department of | 25 | | Healthcare and Family Services, the Department of
Children | 26 | | and Family Services, the Department of Human Services, and |
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| 1 | | insurance
companies who cover home health care services or | 2 | | private duty nursing care in
the home.
| 3 | | Each children's community-based health care center | 4 | | model location shall be
physically separate and
apart from | 5 | | any other facility licensed by the Department of Public | 6 | | Health under
this or any other Act and shall provide the | 7 | | following services: respite care,
registered nursing or | 8 | | licensed practical nursing care, transitional care to
| 9 | | facilitate home placement or other appropriate settings | 10 | | and reunite families,
medical day care, weekend
camps, and | 11 | | diagnostic studies typically done in the home setting.
| 12 | | Coverage for the services provided by the
Department of | 13 | | Healthcare and Family Services
under this paragraph (3) is | 14 | | contingent upon federal waiver approval and is
provided | 15 | | only to Medicaid eligible clients participating in the home | 16 | | and
community based services waiver designated in Section | 17 | | 1915(c) of the Social
Security Act for medically frail and | 18 | | technologically dependent children or
children in | 19 | | Department of Children and Family Services foster care who | 20 | | receive
home health benefits.
| 21 | | (4) Alternative health care delivery model; community | 22 | | based residential
rehabilitation center.
A community-based | 23 | | residential rehabilitation center model is a designated
| 24 | | site that provides rehabilitation or support, or both, for | 25 | | persons who have
experienced severe brain injury, who are | 26 | | medically stable, and who no longer
require acute |
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| 1 | | rehabilitative care or intense medical or nursing | 2 | | services. The
average length of stay in a community-based | 3 | | residential rehabilitation center
shall not exceed 4 | 4 | | months. As an integral part of the services provided,
| 5 | | individuals are housed in a supervised living setting while | 6 | | having immediate
access to the community. The residential | 7 | | rehabilitation center authorized by
the Department may | 8 | | have more than one residence included under the license.
A | 9 | | residence may be no larger than 12 beds and shall be | 10 | | located as an integral
part of the community. Day treatment | 11 | | or
individualized outpatient services shall be provided | 12 | | for persons who reside in
their own home. Functional | 13 | | outcome goals shall be established for each
individual. | 14 | | Services shall include, but are not limited to, case | 15 | | management,
training and assistance with activities of | 16 | | daily living, nursing
consultation, traditional therapies | 17 | | (physical, occupational, speech),
functional interventions | 18 | | in the residence and community (job placement,
shopping, | 19 | | banking, recreation), counseling, self-management | 20 | | strategies,
productive activities, and multiple | 21 | | opportunities for skill acquisition and
practice | 22 | | throughout the day. The design of individualized program | 23 | | plans shall
be consistent with the outcome goals that are | 24 | | established for each resident.
The programs provided in | 25 | | this setting shall be accredited by the
Commission
on | 26 | | Accreditation of Rehabilitation Facilities (CARF). The |
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| 1 | | program shall have
been accredited by CARF as a Brain | 2 | | Injury Community-Integrative Program for at
least 3 years.
| 3 | | (5) Alternative health care delivery model; | 4 | | Alzheimer's disease
management center. An Alzheimer's | 5 | | disease management center model is a
designated site that | 6 | | provides a safe and secure setting for care of persons
| 7 | | diagnosed with Alzheimer's disease. An Alzheimer's disease | 8 | | management center
model shall be a facility separate from | 9 | | any other facility licensed by the
Department of Public | 10 | | Health under this or any other Act. An Alzheimer's
disease | 11 | | management center shall conduct and document an assessment | 12 | | of each
resident every 6 months. The assessment shall | 13 | | include an evaluation of daily
functioning, cognitive | 14 | | status, other medical conditions, and behavioral
problems. | 15 | | An Alzheimer's disease management center shall develop and | 16 | | implement
an ongoing treatment plan for each resident. The | 17 | | treatment
plan shall have defined goals.
The
Alzheimer's | 18 | | disease management center shall treat behavioral problems | 19 | | and mood
disorders using nonpharmacologic approaches such | 20 | | as environmental modification,
task simplification, and | 21 | | other appropriate activities.
All staff must have | 22 | | necessary
training to care for all stages of Alzheimer's | 23 | | Disease. An
Alzheimer's disease
management center shall | 24 | | provide education and support for residents and
| 25 | | caregivers. The
education and support shall include | 26 | | referrals to support organizations for
educational |
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| 1 | | materials on community resources, support groups, legal | 2 | | and
financial issues, respite care, and future care needs | 3 | | and options. The
education and support shall also include a | 4 | | discussion of the resident's need to
make advance | 5 | | directives and to identify surrogates for medical and legal
| 6 | | decision-making. The provisions of this paragraph | 7 | | establish the minimum level
of services that must be | 8 | | provided by an Alzheimer's disease management
center. An | 9 | | Alzheimer's disease management center model shall have no | 10 | | more
than 100 residents. Nothing in this paragraph (5) | 11 | | shall be construed as
prohibiting a person or facility from | 12 | | providing services and care to persons
with Alzheimer's | 13 | | disease as otherwise authorized under State law.
| 14 | | (6) Alternative health care delivery model; birth | 15 | | center. A birth
center shall be exclusively dedicated to | 16 | | serving the childbirth-related needs of women and their | 17 | | newborns and shall have no more than 10 beds. A birth | 18 | | center is a designated site
that is away from the mother's | 19 | | usual place of residence and in which births are
planned to | 20 | | occur following a normal, uncomplicated, and low-risk | 21 | | pregnancy. A
birth center shall offer prenatal care and | 22 | | community education services and
shall coordinate these | 23 | | services with other health care services available in
the | 24 | | community.
| 25 | | (A) A birth center shall not be separately licensed | 26 | | if it
is one of the following: |
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| 1 | | (1) A part of a hospital; or | 2 | | (2) A freestanding facility that is physically
| 3 | | distinct from a hospital but is operated under a
| 4 | | license issued to a hospital under the Hospital
| 5 | | Licensing Act. | 6 | | (B) A separate birth center license shall be | 7 | | required if the birth center is operated as: | 8 | | (1) A part of the operation of a federally
| 9 | | qualified health center as designated by the | 10 | | United
States Department of Health and Human | 11 | | Services; or | 12 | | (2) A facility other than one described in | 13 | | subparagraph (A)(1), (A)(2), or (B)(1) of this | 14 | | paragraph (6) whose costs are
reimbursable under | 15 | | Title XIX of the federal Social
Security Act. | 16 | | In adopting rules for birth centers, the Department | 17 | | shall consider:
the American Association
of Birth Centers' | 18 | | Standards for Freestanding Birth Centers; the American | 19 | | Academy of Pediatrics/American College of Obstetricians | 20 | | and Gynecologists Guidelines for Perinatal Care; and the | 21 | | Regionalized Perinatal Health Care Code. The Department's | 22 | | rules shall stipulate the eligibility criteria for birth | 23 | | center admission. The Department's rules shall
stipulate | 24 | | the necessary equipment for emergency care
according to the | 25 | | American Association of Birth Centers'
standards and any | 26 | | additional equipment deemed necessary by the Department. |
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| 1 | | The Department's rules shall provide for a time
period | 2 | | within which each birth center not part of a
hospital must | 3 | | become accredited by either the Commission for the
| 4 | | Accreditation of Freestanding Birth Centers or The Joint | 5 | | Commission. | 6 | | A birth center shall be certified to participate in the | 7 | | Medicare and Medicaid
programs under Titles XVIII and XIX, | 8 | | respectively, of the federal Social
Security Act.
To the | 9 | | extent necessary, the Illinois Department of Healthcare | 10 | | and Family Services shall apply for
a waiver from the | 11 | | United States Health Care Financing Administration to | 12 | | allow
birth centers to be reimbursed under Title XIX of the | 13 | | federal Social Security
Act. | 14 | | A birth center that is not operated under a hospital | 15 | | license shall be located within a ground travel time | 16 | | distance from the general acute care hospital with which
| 17 | | the birth center maintains a contractual relationship,
| 18 | | including a transfer agreement, as required under this
| 19 | | paragraph, that allows for an emergency caesarian delivery | 20 | | to be started within 30 minutes of the decision a caesarian | 21 | | delivery is necessary. A birth center operating under a | 22 | | hospital license shall be located within a ground travel | 23 | | time distance from the licensed hospital that allows for an | 24 | | emergency caesarian delivery to be started within 30 | 25 | | minutes of the decision a caesarian delivery is necessary. | 26 | | The services of a
medical director physician, licensed |
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| 1 | | to practice medicine in all its branches, who is certified | 2 | | or eligible for certification by the
American College of | 3 | | Obstetricians and Gynecologists or the
American Board of | 4 | | Osteopathic Obstetricians and Gynecologists or has | 5 | | hospital
obstetrical privileges are required in birth | 6 | | centers. The medical director in consultation with the | 7 | | Director of Nursing and Midwifery Services shall | 8 | | coordinate the clinical staff and overall provision of | 9 | | patient care.
The medical director or his or her physician | 10 | | designee shall be available on the premises or within a | 11 | | close proximity as defined by rule. The medical director | 12 | | and the Director of Nursing and Midwifery Services shall | 13 | | jointly develop and approve policies defining the criteria | 14 | | to determine which pregnancies are accepted as normal, | 15 | | uncomplicated, and low-risk, and the anesthesia services | 16 | | available at the center. No general anesthesia may be | 17 | | administered at the center. | 18 | | If a birth center employs
certified nurse midwives, a | 19 | | certified nurse midwife shall be the Director of
Nursing | 20 | | and Midwifery
Services who is responsible for the | 21 | | development of policies and procedures for
services as | 22 | | provided by Department rules. | 23 | | An obstetrician, family
practitioner, or certified | 24 | | nurse midwife shall attend each woman in labor from
the | 25 | | time of admission through birth and throughout the | 26 | | immediate postpartum
period. Attendance may be delegated |
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| 1 | | only to another physician or certified
nurse
midwife. | 2 | | Additionally, a second staff person shall also be present | 3 | | at each
birth who is licensed or certified in Illinois in a | 4 | | health-related field and under the supervision of the | 5 | | physician or certified nurse midwife
in attendance, has | 6 | | specialized training in labor and delivery techniques and
| 7 | | care of newborns, and receives planned and ongoing training | 8 | | as needed to
perform assigned duties effectively. | 9 | | The maximum length of stay in a birth center shall be
| 10 | | consistent with existing State laws allowing a 48-hour stay | 11 | | or appropriate
post-delivery care, if discharged earlier | 12 | | than 48 hours. | 13 | | A birth center shall
participate in the Illinois | 14 | | Perinatal
System under the Developmental Disability | 15 | | Prevention Act. At a minimum, this
participation shall | 16 | | require a birth center to establish a letter of agreement
| 17 | | with a hospital designated under the Perinatal System. A | 18 | | hospital that
operates or has a letter of agreement with a | 19 | | birth center shall include the
birth center under its | 20 | | maternity service plan under the Hospital Licensing Act
and | 21 | | shall include the birth center in the hospital's letter of | 22 | | agreement with
its regional perinatal center. | 23 | | A birth center may not discriminate against any patient | 24 | | requiring treatment
because of the source of payment for | 25 | | services, including Medicare and Medicaid
recipients. | 26 | | No general anesthesia and no surgery may be performed |
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| 1 | | at a birth center.
The Department may by rule add birth | 2 | | center patient eligibility criteria or standards as it | 3 | | deems necessary.
The Department shall by rule require each | 4 | | birth center to report the information which the Department | 5 | | shall make publicly available, which shall include, but is | 6 | | not limited to, the following: | 7 | | (i) Birth center ownership. | 8 | | (ii) Sources of payment for services. | 9 | | (iii) Utilization data involving patient length of | 10 | | stay. | 11 | | (iv) Admissions and discharges. | 12 | | (v) Complications. | 13 | | (vi) Transfers. | 14 | | (vii) Unusual incidents. | 15 | | (viii) Deaths. | 16 | | (ix) Any other publicly reported data required | 17 | | under the Illinois Consumer Guide. | 18 | | (x) Post-discharge patient status data where | 19 | | patients are followed for 14 days after discharge from | 20 | | the birth center to determine whether the mother or | 21 | | baby developed a complication or infection. | 22 | | Within 9 months after the effective date of this | 23 | | amendatory Act of the 95th
General Assembly, the Department | 24 | | shall adopt rules that are developed with consideration of: | 25 | | the American Association of Birth Centers' Standards for | 26 | | Freestanding Birth Centers; the American Academy of |
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| 1 | | Pediatrics/American College of Obstetricians and | 2 | | Gynecologists Guidelines for Perinatal Care; and the | 3 | | Regionalized Perinatal Health Care Code. | 4 | | The Department shall adopt other rules as necessary to | 5 | | implement the provisions of this
amendatory Act of the 95th | 6 | | General Assembly within 9 months after the
effective date | 7 | | of this amendatory Act of the 95th General Assembly. | 8 | | (Source: P.A. 97-135, eff. 7-14-11.)
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