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92_HB2787eng HB2787 Engrossed LRB9202251JScs 1 AN ACT concerning health care facilities. 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 5 Prompt Care Facility Registration Act. 6 Section 5. Findings and purpose. 7 (a) The Illinois General Assembly makes all of the 8 following findings: 9 (1) Hospital emergency services are not always the 10 most appropriate level of care for patients seeking 11 unscheduled medical care or for patients who do not have 12 a regular physician who can treat a significant or acute 13 medical condition not considered critical, debilitating, 14 or life-threatening. 15 (2) Hospital emergency rooms are over-utilized and 16 too often over-burdened with many injuries or illnesses 17 that could be managed in a less intensive clinical 18 setting or physician's office. 19 (3) Over-utilization of hospital emergency 20 departments contributes to excess medical and health 21 insurance costs. 22 (4) Prompt care facilities are a growing 23 alternative to hospital emergency departments. 24 (5) The use of the term "urgent" or "emergi-" or a 25 similar term in a prompt care facility's posted or 26 advertised name may confuse the public and prospective 27 patients regarding the type of services offered relative 28 to those provided by a hospital emergency department. 29 There is significant risk to the public health and safety 30 if persons requiring treatment for a critical or 31 life-threatening condition inappropriately use prompt HB2787 Engrossed -2- LRB9202251JScs 1 care facilities. 2 (6) To control costs and ensure more appropriate 3 use of the health care delivery system, some managed care 4 entities and other health insurers require use of 5 alternative health care facilities such as prompt care 6 facilities for certain non-critical medical emergencies. 7 Enrollees are not always sure about the policies and 8 procedures that must be followed in the use of such 9 facilities, especially the standards that will 10 differentiate between use of these facilities and a 11 hospital emergency department. 12 (7) There is a need to more clearly define the role 13 and function of prompt care facilities in the health care 14 delivery system, and to more effectively educate health 15 care payers and consumers about the most appropriate use 16 of prompt care facilities. 17 (b) The purpose of this Act is to define the role and 18 function of prompt care facilities, require the registration 19 of such facilities, and require public education regarding 20 the appropriate use of such facilities. 21 Section 10. Definitions. For the purposes of this Act: 22 "Department" means the Department of Public Health. 23 "Prompt care facility" means an outpatient treatment 24 center that (i) advertises or provides unscheduled health 25 care services and (ii) uses or advertises a facility with the 26 term "urgent care center", "emergi-center", or "prompt care 27 center" or gives the impression to the public that it 28 provides health care services for conditions requiring 29 immediate, urgent, or emergency care, as defined by the 30 Department. 31 "Prompt care facility" does not include any of the 32 following: 33 (i) A medical facility that is licensed under the HB2787 Engrossed -3- LRB9202251JScs 1 Hospital Licensing Act or the Ambulatory Surgical 2 Treatment Center Act or any other health care institution 3 licensed under the laws of the State of Illinois. 4 (ii) Dispensaries and first aid stations located 5 within business or industrial establishments maintained 6 solely for the use of employees. 7 (iii) Adult foster care homes. 8 (iv) Places where 4 or fewer adults receive adult 9 day health services. 10 (v) Places at which persons receive health-related 11 services only from relatives or legal guardians. 12 (vi) The personal residence of a terminally ill 13 person or the personal residence of that person's 14 relative or guardian, where that person receives hospice 15 services. 16 (vii) All medical and health-related facilities and 17 services that are provided to inmates in a state prison. 18 (viii) A physician office or clinic that does not 19 advertise using the term "urgent care center", 20 "emergi-center", or "prompt care center" or give the 21 impression to the public that it provides health care 22 services for conditions requiring immediate, urgent, or 23 emergency care, as defined by the Department. 24 Section 15. Registration requirement. Beginning January 25 1, 2004, no person shall establish, conduct, or maintain a 26 prompt care facility without first being registered with the 27 Department. 28 Section 20. Ownership of prompt care facility. No 29 person or entity may own a prompt care facility other than a 30 licensed hospital, a hospital affiliate as defined under the 31 Hospital Licensing Act, an individual licensed physician, a 32 group of licensed physicians, or any combination thereof. HB2787 Engrossed -4- LRB9202251JScs 1 Section 25. Referral and emergency transportation plans. 2 As a condition of registration, each prompt care facility 3 must develop and implement referral and emergency 4 transportation plans for use in critical medical 5 emergencies. These plans shall include policies and 6 procedures for accessing the emergency medical services 7 system, including the use of ambulances and paramedic 8 personnel for transporting patients to the facility and from 9 the facility to hospital emergency departments, when 10 necessary. All policies and procedures shall be approved by 11 a physician licensed to practice medicine in all its branches 12 or the facility medical director. 13 Section 30. Educating the public. Prompt care 14 facilities must educate the public and prospective patients 15 about the categories or types of services available at prompt 16 care facilities and their appropriate use. 17 Section 35. Rules. The Department shall adopt rules for 18 the implementation of this Act, including rules concerning 19 registration fees, penalties for noncompliance, and the 20 suspension or termination of operation of facilities that are 21 not registered. The Department shall adopt rules regulating 22 the use of the term "urgent" or "emergi-" or a similar term 23 in a prompt care facility's posted or advertised name so as 24 to minimize, to the extent practicable, the likelihood of 25 confusion regarding the type of services provided by a prompt 26 care facility relative to those of a hospital emergency 27 department. 28 Section 90. The Department of Public Health Powers and 29 Duties Law of the Civil Administrative Code of Illinois is 30 amended by adding Section 2310-543 as follows: HB2787 Engrossed -5- LRB9202251JScs 1 (20 ILCS 2310/2310-543 new) 2 Sec. 2310-543. Prompt care facilities. 3 (a) The Department must define the categories or types 4 of health care services available at prompt care facilities 5 registered pursuant to the Prompt Care Facility Registration 6 Act. 7 (b) The Department must educate the public and 8 prospective patients about the categories or types of health 9 care services available at prompt care facilities and their 10 appropriate use. 11 (c) The Department must compile data regarding the 12 utilization of prompt care facilities and report its findings 13 regarding their function and impact on the health delivery 14 system and health care costs to the Governor and the General 15 Assembly every 2 years on or before January 1. 16 Section 95. The Managed Care Reform and Patient Rights 17 Act is amended by adding Section 43 as follows: 18 (215 ILCS 134/43 new) 19 Sec. 43. Prompt care facilities. 20 (a) A health care plan must ensure that its enrollees 21 are clearly informed about their rights and responsibilities 22 in obtaining referrals to and making appropriate use of 23 prompt care facilities. 24 (b) A health care plan must review the performance of 25 and re-credential prompt care facilities at least once every 26 3 years. 27 (c) Nothing in this Section is intended to affect the 28 rights of enrollees or relieve a health care plan of its 29 responsibilities with respect to the provision of and 30 coverage of emergency services or treatment of an emergency 31 medical condition, as those terms are defined by this Act, 32 and as those responsibilities and rights are otherwise HB2787 Engrossed -6- LRB9202251JScs 1 provided under this Act, especially Section 65 of this Act. 2 (d) For the purposes of this Section, "prompt care 3 facility" has the meaning given to that term in the Prompt 4 Care Facility Registration Act. 5 Section 999. Effective date. This Act takes effect upon 6 becoming law.