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Public Act 102-0518
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| HB3995 Enrolled | LRB102 14648 CPF 21906 b |
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AN ACT concerning regulation.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 1. Short title. This Act may be cited as the Birth |
Center Licensing Act.
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Section 5. Definitions. In this Act: |
"Birth center" means a designated site, other than a |
hospital: |
(1) in which births are planned to occur following a |
normal, uncomplicated, and low-risk pregnancy; |
(2) that is not the pregnant person's usual place of |
residence; |
(3) that is exclusively dedicated to serving the |
childbirth-related needs of pregnant persons and their |
newborns, and has no more than 10 beds; |
(4) that offers prenatal care and community education |
services and coordinates these services with other health |
care services available in the community; and |
(5) that does not provide general anesthesia or |
surgery. |
"Certified nurse midwife" means an advanced practice |
registered nurse licensed in Illinois under the Nurse Practice |
Act with full practice authority or who is delegated such |
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authority as part of a written collaborative agreement with a |
physician who is associated with the birthing center or who |
has privileges at a nearby birthing hospital. |
"Department" means the Illinois Department of Public |
Health. |
"Hospital" does not include places where pregnant females |
are received, cared for, or treated during delivery if it is in |
a licensed birth center, nor include any facility required to |
be licensed as a birth center. |
"Physician" means a physician licensed to practice |
medicine in all its branches in Illinois.
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Section 10. License required. Except as provided by this |
Act, no person shall open, manage, conduct, offer, maintain, |
or advertise as a birth center without a valid license issued |
by the Department. All birth centers in existence as of the |
effective date of this Act shall obtain a valid license to |
operate within 2 years after the adoption of rules by the |
Department to implement this Act under Section 60.
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Section 15. Issuance and renewal of license. |
(a) An applicant for a license under this Act shall submit |
an application on forms prescribed by the Department. Each |
application shall be accompanied by a nonrefundable license |
fee, as established by rule by the Department under Section |
60. |
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(b) The Department may grant a temporary initial license |
to an applicant. A temporary initial license expires on the |
earlier of the date the Department denies the license or the |
date 6 months after the temporary initial license was issued. |
(c) The Department shall issue a license under this Act |
if, after application, inspection, and investigation, it finds |
the applicant meets the requirements of this Act and the rules |
and standards adopted pursuant to this Act. |
(d) A license is renewable every year upon submission of: |
(i) the renewal application and fee and (ii) a report on a form |
prescribed by the Department that includes information related |
to quality of care at a birth center. The report must be in the |
form and documented by evidence as required by the Department |
by rule under Section 60.
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Section 17. Certificate of need; licenses. |
(a) A birth center shall obtain a certificate of need from |
the Health Facilities and Services Review Board under the |
Health Facilities Planning Act before receiving a license by |
the Department under this Act. |
(b) If, after obtaining an initial certificate of need |
under subsection (a), a birth center seeks to increase the bed |
capacity of the birth center, the birth center must obtain a |
certificate of need from the Health Facilities and Services |
Review Board before increasing the bed capacity. |
(c) A birth center in a medically underserved area, as |
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determined by the U.S. Department of Health and Human |
Services, shall receive priority in obtaining a certificate of |
need under this Section.
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Section 20. Linkages. |
(a) A birth center shall link and integrate its services |
with at least one birthing hospital with a minimum of a Level 1 |
perinatal designation. |
(b) A birth center shall have an established agreement |
with a nearby receiving birthing hospital with policies and |
procedures for timely transfer of maternal and neonatal |
patients. The agreement shall include a determination of |
maternal and neonatal conditions necessitating consultation |
and referral. This should include plans
for communication with |
the receiving hospital before and after
transfer.
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Section 25. Staffing. |
(a) A birth center shall have a clinical director, who may |
be: |
(1) a physician who is either certified or eligible |
for certification by the American College of Obstetricians
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and Gynecologists or the American Board of Osteopathic
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Obstetricians and Gynecologists or has hospital
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obstetrical privileges; or |
(2)
a certified nurse midwife.
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(b) The clinical director shall be responsible for: |
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(1) the development of policies and procedures for |
services as provided by Department rules; |
(2) coordinating the clinical staff and overall |
provision of patient care; |
(3) developing and approving policies defining the |
criteria to determine which pregnancies are accepted as |
normal, uncomplicated, and low-risk; and |
(4) developing and approving policing regarding the |
anesthesia services available at the center.
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(c) An obstetrician, family practitioner, or certified |
nurse midwife shall attend each person in labor from the time |
of admission through birth and throughout the immediate |
postpartum period. Attendance may be delegated only to another |
physician or a certified nurse midwife. |
(d) A second staff person shall be present at each birth |
who: |
(1) is licensed or certified in Illinois in a |
health-related field and under the supervision of a |
physician or a certified nurse midwife who is in |
attendance; |
(2) has specialized training in labor and delivery |
techniques and care of newborns; and |
(3) receives planned and ongoing training as needed to |
perform assigned duties effectively.
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Section 30. Minimum standards. |
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(a) The Department's rules adopted pursuant to Section 60 |
of this Act shall contain minimum standards to protect the |
health and safety of a patient of a birth center. In adopting |
rules for birth centers, the Department shall consider: |
(1) the Commission for the Accreditation of Birth |
Centers' Standards for Freestanding Birth Centers; |
(2) the American Academy of Pediatrics and American |
College of Obstetricians and Gynecologists Guidelines for |
Perinatal Care; and |
(3) the Regionalized Perinatal Health Care Code.
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Section 35. Quality of care. The Department's rules shall |
provide for a time period within which each birth center must |
become accredited by either the Commission for the |
Accreditation of Freestanding Birth Centers or The Joint |
Commission. |
A birth center shall implement a quality improvement |
program consistent with the requirements of the accrediting |
body and is encouraged to participate in quality improvement |
projects implemented by the Department's Administrative |
Perinatal Centers and other Department-supported perinatal |
quality improvement projects. Clinicians, or their clinical |
representative, attending persons in labor at the birth center |
shall attend morbidity and mortality reviews that occur at the |
receiving birthing hospital on their patients, when invited, |
at a mutually agreeable time. This includes, but is not |
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limited to, maternal and neonatal patients transferred to the |
receiving birthing hospital.
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Section 40. Reimbursement requirements. |
(a) A birth center shall seek certification under Titles |
XVIII and XIX of the federal Social Security Act. |
(b) Reimbursement rates set by the Department of |
Healthcare and Family Services should be based on all types of |
medically necessary covered services provided to both the |
birthing person and the baby, including: |
(1) a professional fee for both the birthing person |
and baby; |
(2) a facility fee for the birthing person that is no |
less than 75% of the statewide average facility payment |
rate made to a hospital for an uncomplicated vaginal |
birth; |
(3) a facility fee for the baby that is no less than |
75% of the statewide average facility payment rate made to |
a hospital for a normal baby; and |
(4) additional fees for other services, medications, |
laboratory tests, and supplies provided. |
(c) A birth center shall provide charitable care |
consistent with that provided by comparable health care |
providers in the geographic area. |
(d) A birth center may not discriminate against any |
patient requiring treatment because of the source of payment |
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for services, including Medicare and Medicaid recipients.
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Section 45. Reporting requirements. The Department shall |
by rule require each birth center to report information every |
year that is consistent with the birth center's license |
renewal schedule, which the Department shall make publicly |
available and which shall include the following: |
(1) utilization data involving patient length of stay; |
(2) admissions and discharges; |
(3) complications; |
(4) transfers; |
(5) deaths; |
(6) any other publicly reported data required under |
the Consumer Guide to Health Care; and |
(7) post-discharge patient status data where patients |
are
followed for 14 days after discharge from the birth |
center
to determine whether the mother or baby developed a
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complication or infection.
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Section 50. Training. A birth center shall, in |
consultation with the clinical director, establish and |
implement a policy to ensure appropriate training and |
competency of individuals employed within the birth center. |
The policy shall, at a minimum, define the acts and practices |
that are allowed or prohibited for such employees, establish |
how training will be conducted, and illustrate how initial |
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competency will be established.
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Section 55. Inspections; special inspections; reports. |
(a) The Department, whenever it determines necessary, may |
conduct a
special inspection, survey, or evaluation of a birth |
center to assess
compliance with licensure requirements and |
standards or a plan of
correction submitted as a result of |
deficiencies cited by the
Department or an accrediting body.
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(b) Upon the Department's completion of any special |
inspection, survey, or evaluation, the appropriate Department |
personnel who conducted the special inspection, survey, or |
evaluation shall submit a copy of his or her report to the |
licensee upon exiting the birth center, and shall submit the |
actual report to the appropriate regional office. |
(c) The Department's report and any recommendation for |
action under this Act shall be sent to the Department's |
central office together with a plan of correction from the |
birth center. |
(d) The plan of correction may contain related comments or |
documentation provided by the birth center that may refute |
findings in the report, explain extenuating circumstances that |
the birth center could not reasonably have prevented, or |
indicate methods and timetables for correction of deficiencies |
described in the report. |
(e) A birth center has 10 days after the date of the |
Department's special inspection, survey, or evaluation to |
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submit a plan of correction. The Department shall determine |
whether a birth center is in violation of this Section no later |
than 60 days after completion of each special inspection, |
survey, evaluation, or plan of correction. |
(f) The Department shall maintain all special inspection, |
survey, or evaluation reports for at least 5 years in a manner |
accessible to the public.
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Section 60. Rules. |
(a) The Department shall adopt rules for the |
administration and enforcement of this Act. |
(b) Rules adopted by the Department under this Act shall |
stipulate:
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(1) the eligibility criteria for birth center |
admission that are consistent with accreditation standards |
and the certified nurse midwife's or physician's scope of |
practice; |
(2) the necessary equipment for emergency care |
according to the Commission for Accreditation of Birth |
Centers' standards; |
(3) the minimum elements required in the transfer |
agreement between a birth center and a receiving birth |
hospital with at least a Level 1 perinatal designation, |
including the amount of travel time between facilities in |
rural and nonrural areas, the staff required to transfer |
patients, and the mode of emergency transportation between |