Bill Text: IL HB5050 | 2011-2012 | 97th General Assembly | Engrossed
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Amends the Alternative Health Care Delivery Act. Sets forth definitions for "ambulatory surgical treatment center" and "postsurgical recovery care center model". Requires the Department of Public Health to enforce by rule certain provisions concerning the approval of protocols for the admission of postsurgical patients with respect to each postsurgical recovery care center model. Sets forth criteria for admission to a postsurgical recovery care center model, including the administration of blood in relation to an intraoperative or postoperative complication. Requires the Department of Public Health to enforce by rule certain provisions concerning laboratory, pharmacy, and radiological services with respect to each postsurgical recovery care center model.
Spectrum: Slight Partisan Bill (Republican 2-1)
Status: (Passed) 2012-08-17 - Public Act . . . . . . . . . 97-0987 [HB5050 Detail]
Download: Illinois-2011-HB5050-Engrossed.html
Bill Title: Amends the Alternative Health Care Delivery Act. Sets forth definitions for "ambulatory surgical treatment center" and "postsurgical recovery care center model". Requires the Department of Public Health to enforce by rule certain provisions concerning the approval of protocols for the admission of postsurgical patients with respect to each postsurgical recovery care center model. Sets forth criteria for admission to a postsurgical recovery care center model, including the administration of blood in relation to an intraoperative or postoperative complication. Requires the Department of Public Health to enforce by rule certain provisions concerning laboratory, pharmacy, and radiological services with respect to each postsurgical recovery care center model.
Spectrum: Slight Partisan Bill (Republican 2-1)
Status: (Passed) 2012-08-17 - Public Act . . . . . . . . . 97-0987 [HB5050 Detail]
Download: Illinois-2011-HB5050-Engrossed.html
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1 | AN ACT concerning public health.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Alternative Health Care Delivery Act is | ||||||
5 | amended by changing Sections 10 and 35 as follows:
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6 | (210 ILCS 3/10)
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7 | Sec. 10. Definitions. In this Act, unless the context
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8 | otherwise requires:
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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
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13 | authorized under Section 35 of this Act.
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14 | "Board" means the State Board of Health.
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15 | "Department" means the Illinois Department of Public | ||||||
16 | Health.
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17 | "Demonstration program" means a program to license and | ||||||
18 | study
alternative health care models authorized under this Act.
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19 | "Director" means the Director of Public Health.
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20 | (Source: P.A. 87-1188.)
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21 | (210 ILCS 3/35)
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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.
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4 | (1) (Blank).
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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
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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
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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
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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
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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
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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.
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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
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2 | Medicare and Medicaid recipients.
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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.
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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
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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.
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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
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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.
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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.
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21 | (4) Alternative health care delivery model; community | ||||||
22 | based residential
rehabilitation center.
A community-based | ||||||
23 | residential rehabilitation center model is a designated
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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,
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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.
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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
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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
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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
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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.
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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.
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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
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3 | distinct from a hospital but is operated under a
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4 | license issued to a hospital under the Hospital
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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
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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
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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
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17 | the birth center maintains a contractual relationship,
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18 | including a transfer agreement, as required under this
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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
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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
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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
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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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