[ Search ] [ PDF text ] [ Legislation ]
[ Home ] [ Back ] [ Bottom ]
| [ Introduced ] | [ Engrossed ] |
92_HB2787ham001
LRB9202251ACacam07
1 AMENDMENT TO HOUSE BILL 2787
2 AMENDMENT NO. . Amend House Bill 2787 by replacing
3 the title with the following:
4 "AN ACT concerning health care facilities."; and
5 by replacing everything after the enacting clause with the
6 following:
7 "Section 1. Short title. This Act may be cited as the
8 Prompt Care Facility Registration Act.
9 Section 5. Findings and purpose.
10 (a) The Illinois General Assembly makes all of the
11 following findings:
12 (1) Hospital emergency services are not always the
13 most appropriate level of care for patients seeking
14 unscheduled medical care or for patients who do not have
15 a regular physician who can treat a significant or acute
16 medical condition not considered critical, debilitating,
17 or life-threatening.
18 (2) Hospital emergency rooms are over-utilized and
19 too often over-burdened with many injuries or illnesses
20 that could be managed in a less intensive clinical
21 setting or physician's office.
-2- LRB9202251ACacam07
1 (3) Over-utilization of hospital emergency
2 departments contributes to excess medical and health
3 insurance costs.
4 (4) Prompt care facilities are a growing
5 alternative to hospital emergency departments.
6 (5) The use of the term "urgent" or "emergi-" or a
7 similar term in a prompt care facility's posted or
8 advertised name may confuse the public and prospective
9 patients regarding the type of services offered relative
10 to those provided by a hospital emergency department.
11 There is significant risk to the public health and safety
12 if persons requiring treatment for a critical or
13 life-threatening condition inappropriately use prompt
14 care facilities.
15 (6) To control costs and ensure more appropriate
16 use of the health care delivery system, some managed care
17 entities and other health insurers require use of
18 alternative health care facilities such as prompt care
19 facilities for certain non-critical medical emergencies.
20 Enrollees are not always sure about the policies and
21 procedures that must be followed in the use of such
22 facilities, especially the standards that will
23 differentiate between use of these facilities and a
24 hospital emergency department.
25 (7) There is a need to more clearly define the role
26 and function of prompt care facilities in the health care
27 delivery system, and to more effectively educate health
28 care payers and consumers about the most appropriate use
29 of prompt care facilities.
30 (b) The purpose of this Act is to define the role and
31 function of prompt care facilities, require the registration
32 of such facilities, and require public education regarding
33 the appropriate use of such facilities.
-3- LRB9202251ACacam07
1 Section 10. Definitions. For the purposes of this Act:
2 "Department" means the Department of Public Health.
3 "Prompt care facility" means an outpatient treatment
4 center that (i) advertises or provides unscheduled health
5 care services and (ii) uses or advertises a facility with the
6 term "urgent care center", "emergi-center", or "prompt care
7 center" or gives the impression to the public that it
8 provides health care services for conditions requiring
9 immediate, urgent, or emergency care, as defined by the
10 Department.
11 "Prompt care facility" does not include any of the
12 following:
13 (i) A medical facility that is licensed under the
14 Hospital Licensing Act or the Ambulatory Surgical
15 Treatment Center Act or any other health care institution
16 licensed under the laws of the State of Illinois.
17 (ii) Dispensaries and first aid stations located
18 within business or industrial establishments maintained
19 solely for the use of employees.
20 (iii) Adult foster care homes.
21 (iv) Places where 4 or fewer adults receive adult
22 day health services.
23 (v) Places at which persons receive health-related
24 services only from relatives or legal guardians.
25 (vi) The personal residence of a terminally ill
26 person or the personal residence of that person's
27 relative or guardian, where that person receives hospice
28 services.
29 (vii) All medical and health-related facilities and
30 services that are provided to inmates in a state prison.
31 (viii) A physician office or clinic that does not
32 advertise using the term "urgent care center",
33 "emergi-center", or "prompt care center" or give the
34 impression to the public that it provides health care
-4- LRB9202251ACacam07
1 services for conditions requiring immediate, urgent, or
2 emergency care, as defined by the Department.
3 Section 15. Registration requirement. Beginning January
4 1, 2004, no person shall establish, conduct, or maintain a
5 prompt care facility without first being registered with the
6 Department.
7 Section 20. Ownership of prompt care facility. No
8 person or entity may own a prompt care facility other than a
9 licensed hospital, a hospital affiliate as defined under the
10 Hospital Licensing Act, an individual licensed physician, a
11 group of licensed physicians, or any combination thereof.
12 Section 25. Referral and emergency transportation plans.
13 As a condition of registration, each prompt care facility
14 must develop and implement referral and emergency
15 transportation plans for use in critical medical
16 emergencies. These plans shall include policies and
17 procedures for accessing the emergency medical services
18 system, including the use of ambulances and paramedic
19 personnel for transporting patients to the facility and from
20 the facility to hospital emergency departments, when
21 necessary. All policies and procedures shall be approved by
22 a physician licensed to practice medicine it all its branches
23 or the facility medical director.
24 Section 30. Educating the public. Prompt care
25 facilities must educate the public and prospective patients
26 about the categories or types of services available at prompt
27 care facilities and their appropriate use.
28 Section 35. Rules. The Department shall adopt rules for
29 the implementation of this Act, including rules concerning
-5- LRB9202251ACacam07
1 registration fees, penalties for noncompliance, and the
2 suspension or termination of operation of facilities that are
3 not registered. The Department shall adopt rules regulating
4 the use of the term "urgent" or "emergi-" or a similar term
5 in a prompt care facility's posted or advertised name so as
6 to minimize, to the extent practicable, the likelihood of
7 confusion regarding the type of services provided by a prompt
8 care facility relative to those of a hospital emergency
9 department.
10 Section 90. The Department of Public Health Powers and
11 Duties Law of the Civil Administrative Code of Illinois is
12 amended by adding Section 2310-543 as follows:
13 (20 ILCS 2310/2310-543 new)
14 Sec. 2310-543. Prompt care facilities.
15 (a) The Department must define the categories or types
16 of health care services available at prompt care facilities
17 registered pursuant to the Prompt Care Facility Registration
18 Act.
19 (b) The Department must educate the public and
20 prospective patients about the categories or types of health
21 care services available at prompt care facilities and their
22 appropriate use.
23 (c) The Department must compile data regarding the
24 utilization of prompt care facilities and report it findings
25 regarding their function and impact on the health delivery
26 system and health care costs to the Governor and the General
27 Assembly every 2 years on or before January 1.
28 Section 95. The Managed Care Reform and Patient Rights
29 Act is amended by adding Section 43 as follows:
30 (215 ILCS 134/43 new)
-6- LRB9202251ACacam07
1 Sec. 43. Prompt care facilities.
2 (a) A health care plan must ensure that its enrollees
3 are clearly informed about their rights and responsibilities
4 in obtaining referrals to and making appropriate use of
5 prompt care facilities.
6 (b) A health care plan must review the performance of
7 and re-credential prompt care facilities at least once every
8 3 years.
9 (c) Nothing in this Section is intended to affect the
10 rights of enrollees or relieve a health care plan of its
11 responsibilities with respect to the provision of and
12 coverage of emergency services or treatment of an emergency
13 medical condition, as those terms are defined by this Act,
14 and as those responsibilities and rights are otherwise
15 provided under this Act, especially Section 65 of this Act.
16 (d) For the purposes of this Section, "prompt care
17 facility" has the meaning given to that term in the Prompt
18 Care Facility Registration Act.
19 Section 999. Effective date. This Act takes effect upon
20 becoming law.".