Bill Text: IL SB3531 | 2013-2014 | 98th General Assembly | Introduced

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Bill Title: Amends the Emergency Medical Services (EMS) Systems Act. Provides that the Trauma Center Medical Directors or the Trauma Center Medical Directors Committee may consider Level III Trauma Centers in identifying the types of facilities in which patients can be cared for. Provides that Level II and Level III Trauma Centers shall have some essential services available in-house, 24 hours per day, and other essential services readily available. Provides that an Acute Injury Stabilization Center shall have a comprehensive emergency department capable of initial management and transfer of the acutely injured. Provides that the Department of Public Health shall have the authority to establish and enforce minimum standards for designation and re-designation of 3 levels of trauma centers that meet trauma center national standards (instead of minimum standards for designation as a Level I or Level II Trauma Center). Creates provisions concerning minimum standards for Level III Trauma Centers and Acute Injury Stabilization Centers. Makes other changes.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2015-01-13 - Session Sine Die [SB3531 Detail]

Download: Illinois-2013-SB3531-Introduced.html

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98TH GENERAL ASSEMBLY State of Illinois 2013 and 2014 SB3531 Introduced 2/14/2014, by Sen. John M. Sullivan SYNOPSIS AS INTRODUCED:
210 ILCS 50/3.30
210 ILCS 50/3.90
210 ILCS 50/3.95
210 ILCS 50/3.100
210 ILCS 50/3.101 new
210 ILCS 50/3.102 new
210 ILCS 50/3.105
210 ILCS 50/3.110
210 ILCS 50/3.140
Amends the Emergency Medical Services (EMS) Systems Act. Provides that the Trauma Center Medical Directors or the Trauma Center Medical Directors Committee may consider Level III Trauma Centers in identifying the types of facilities in which patients can be cared for. Provides that Level II and Level III Trauma Centers shall have some essential services available in-house, 24 hours per day, and other essential services readily available. Provides that an Acute Injury Stabilization Center shall have a comprehensive emergency department capable of initial management and transfer of the acutely injured. Provides that the Department of Public Health shall have the authority to establish and enforce minimum standards for designation and re-designation of 3 levels of trauma centers that meet trauma center national standards (instead of minimum standards for designation as a Level I or Level II Trauma Center). Creates provisions concerning minimum standards for Level III Trauma Centers and Acute Injury Stabilization centers. Makes other changes.
LRB098 17146 RPS 52233 b
FISCAL NOTE ACT MAY APPLY
A BILL FOR
SB3531 LRB098 17146 RPS 52233 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Emergency Medical Services (EMS) Systems Act
is amended by changing Sections 3.30, 3.90, 3.95, 3.100, 3.105,
3.110, and 3.140 and by adding Section 3.101 and 3.102 as
follows:
(210 ILCS 50/3.30)
Sec. 3.30. EMS Region Plan; Content.
(a) The EMS Medical Directors Committee shall address at
least the following:
(1) Protocols for inter-System/inter-Region patient
transports, including identifying the conditions of
emergency patients which may not be transported to the
different levels of emergency department, based on their
Department classifications and relevant Regional
considerations (e.g. transport times and distances);
(2) Regional standing medical orders;
(3) Patient transfer patterns, including criteria for
determining whether a patient needs the specialized
services of a trauma center, along with protocols for the
bypassing of or diversion to any hospital, trauma center or
regional trauma center which are consistent with

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individual System bypass or diversion protocols and
protocols for patient choice or refusal;
(4) Protocols for resolving Regional or Inter-System
conflict;
(5) An EMS disaster preparedness plan which includes
the actions and responsibilities of all EMS participants
within the Region. Within 90 days of the effective date of
this amendatory Act of 1996, an EMS System shall submit to
the Department for review an internal disaster plan. At a
minimum, the plan shall include contingency plans for the
transfer of patients to other facilities if an evacuation
of the hospital becomes necessary due to a catastrophe,
including but not limited to, a power failure;
(6) Regional standardization of continuing education
requirements;
(7) Regional standardization of Do Not Resuscitate
(DNR) policies, and protocols for power of attorney for
health care;
(8) Protocols for disbursement of Department grants;
and
(9) Protocols for the triage, treatment, and transport
of possible acute stroke patients.
(b) The Trauma Center Medical Directors or Trauma Center
Medical Directors Committee shall address at least the
following:
(1) The identification of Regional Trauma Centers;

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(2) Protocols for inter-System and inter-Region trauma
patient transports, including identifying the conditions
of emergency patients which may not be transported to the
different levels of emergency department, based on their
Department classifications and relevant Regional
considerations (e.g. transport times and distances);
(3) Regional trauma standing medical orders;
(4) Trauma patient transfer patterns, including
criteria for determining whether a patient needs the
specialized services of a trauma center, along with
protocols for the bypassing of or diversion to any
hospital, trauma center or regional trauma center which are
consistent with individual System bypass or diversion
protocols and protocols for patient choice or refusal;
(5) The identification of which types of patients can
be cared for by Level I Trauma Centers, and Level II Trauma
Centers, and Level III Trauma Centers;
(6) Criteria for inter-hospital transfer of trauma
patients;
(7) The treatment of trauma patients in each trauma
center within the Region;
(8) A program for conducting a quarterly conference
which shall include at a minimum a discussion of morbidity
and mortality between all professional staff involved in
the care of trauma patients;
(9) The establishment of a Regional trauma quality

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assurance and improvement subcommittee, consisting of
trauma surgeons, which shall perform periodic medical
audits of each trauma center's trauma services, and forward
tabulated data from such reviews to the Department; and
(10) The establishment, within 90 days of the effective
date of this amendatory Act of 1996, of an internal
disaster plan, which shall include, at a minimum,
contingency plans for the transfer of patients to other
facilities if an evacuation of the hospital becomes
necessary due to a catastrophe, including but not limited
to, a power failure.
(c) The Region's EMS Medical Directors and Trauma Center
Medical Directors Committees shall appoint any subcommittees
which they deem necessary to address specific issues concerning
Region activities.
(Source: P.A. 96-514, eff. 1-1-10.)
(210 ILCS 50/3.90)
Sec. 3.90. Trauma Center Designations.
(a) "Trauma Center" means a hospital which: (1) within
designated capabilities provides optimal care to trauma
patients; (2) participates in an approved EMS System; and (3)
is duly designated pursuant to the provisions of this Act.
Level I Trauma Centers shall provide all essential services
in-house, 24 hours per day, in accordance with rules adopted by
the Department pursuant to this Act. Level II and Level III

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Trauma Centers shall have some essential services available
in-house, 24 hours per day, and other essential services
readily available, 24 hours per day, in accordance with rules
adopted by the Department pursuant to this Act.
(a-5) An Acute Injury Stabilization Center shall have a
basic or comprehensive emergency department capable of initial
management and transfer of the acutely injured in accordance
with rules adopted by the Department pursuant to this Act.
(b) The Department shall have the authority and
responsibility to:
(1) Establish and enforce minimum standards for
designation and re-designation of 3 levels of trauma
centers that meet trauma center national standards, as
modified by the Department in administrative rules as a
Level I or Level II Trauma Center, consistent with Sections
22 and 23 of this Act, through rules adopted pursuant to
this Act;
(2) Require hospitals applying for trauma center
designation to submit a plan for designation in a manner
and form prescribed by the Department through rules adopted
pursuant to this Act;
(3) Upon receipt of a completed plan for designation,
conduct a site visit to inspect the hospital for compliance
with the Department's minimum standards. Such visit shall
be conducted by specially qualified personnel with
experience in the delivery of emergency medical and/or

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trauma care. A report of the inspection shall be provided
to the Director within 30 days of the completion of the
site visit. The report shall note compliance or lack of
compliance with the individual standards for designation,
but shall not offer a recommendation on granting or denying
designation;
(4) Designate applicant hospitals as Level I, or Level
II, or Level III Trauma Centers which meet the minimum
standards established by this Act and the Department. The
Beginning September 1, 1997 the Department shall designate
a new trauma center only when a local or regional need for
such trauma center has been identified. The Department
shall request an assessment of local or regional need from
the applicable EMS Region's Trauma Center Medical
Directors Committee, with advice from the Regional Trauma
Advisory Committee. This shall not be construed as a needs
assessment for health planning or other purposes outside of
this Act;
(5) Designate Attempt to designate trauma centers in
all areas of the State. There shall be at least one Level I
Trauma Center serving each EMS Region, unless waived by the
Department. This subsection shall not be construed to
require a Level I Trauma Center to be located in each EMS
Region. Level I Trauma Centers shall serve as resources for
the Level II and Level III Trauma Centers and Acute Injury
Stabilization Centers in the EMS Regions. The extent of

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such relationships shall be defined in the EMS Region Plan;
(6) Inspect designated trauma centers to assure
compliance with the provisions of this Act and the rules
adopted pursuant to this Act. Information received by the
Department through filed reports, inspection, or as
otherwise authorized under this Act shall not be disclosed
publicly in such a manner as to identify individuals or
hospitals, except in proceedings involving the denial,
suspension or revocation of a trauma center designation or
imposition of a fine on a trauma center;
(7) Renew trauma center designations every 2 years,
with onsite inspections conducted every 4 years after an
on-site inspection, based on compliance with renewal
requirements and standards for continuing operation, as
prescribed by the Department through rules adopted
pursuant to this Act;
(8) Refuse to issue or renew a trauma center
designation, after providing an opportunity for a hearing,
when findings show that it does not meet the standards and
criteria prescribed by the Department;
(9) Review and determine whether a trauma center's
annual morbidity and mortality rates for trauma patients
significantly exceed the State average for such rates,
using a uniform recording methodology based on nationally
recognized standards. Such determination shall be
considered as a factor in any decision by the Department to

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renew or refuse to renew a trauma center designation under
this Act, but shall not constitute the sole basis for
refusing to renew a trauma center designation;
(10) Take the following action, as appropriate, after
determining that a trauma center is in violation of this
Act or any rule adopted pursuant to this Act:
(A) If the Director determines that the violation
presents a substantial probability that death or
serious physical harm will result and if the trauma
center fails to eliminate the violation immediately or
within a fixed period of time, not exceeding 10 days,
as determined by the Director, the Director may
immediately revoke the trauma center designation. The
trauma center may appeal the revocation within 15 days
after receiving the Director's revocation order, by
requesting a hearing as provided by Section 29 of this
Act. The Director shall notify the chair of the
Region's Trauma Center Medical Directors Committee and
EMS Medical Directors for appropriate EMS Systems of
such trauma center designation revocation;
(B) If the Director determines that the violation
does not present a substantial probability that death
or serious physical harm will result, the Director
shall issue a notice of violation and request a plan of
correction which shall be subject to the Department's
approval. The trauma center shall have 10 days after

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receipt of the notice of violation in which to submit a
plan of correction. The Department may extend this
period for up to 30 days. The plan shall include a
fixed time period not in excess of 90 days within which
violations are to be corrected. The plan of correction
and the status of its implementation by the trauma
center shall be provided, as appropriate, to the EMS
Medical Directors for appropriate EMS Systems. If the
Department rejects a plan of correction, it shall send
notice of the rejection and the reason for the
rejection to the trauma center. The trauma center shall
have 10 days after receipt of the notice of rejection
in which to submit a modified plan. If the modified
plan is not timely submitted, or if the modified plan
is rejected, the trauma center shall follow an approved
plan of correction imposed by the Department. If, after
notice and opportunity for hearing, the Director
determines that a trauma center has failed to comply
with an approved plan of correction, the Director may
revoke the trauma center designation. The trauma
center shall have 15 days after receiving the
Director's notice in which to request a hearing. Such
hearing shall conform to the provisions of Section
3.135 30 of this Act;
(11) The Department may delegate authority to local
health departments in jurisdictions which include a

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substantial number of trauma centers. The delegated
authority to those local health departments shall include,
but is not limited to, the authority to designate trauma
centers with final approval by the Department, maintain a
regional data base with concomitant reporting of trauma
registry data, and monitor, inspect and investigate trauma
centers within their jurisdiction, in accordance with the
requirements of this Act and the rules promulgated by the
Department;
(A) The Department shall monitor the performance
of local health departments with authority delegated
pursuant to this Section, based upon performance
criteria established in rules promulgated by the
Department;
(B) Delegated authority may be revoked for
substantial non-compliance with the Department's
rules. Notice of an intent to revoke shall be served
upon the local health department by certified mail,
stating the reasons for revocation and offering an
opportunity for an administrative hearing to contest
the proposed revocation. The request for a hearing must
be in writing and received by the Department within 10
working days of the local health department's receipt
of notification;
(C) The director of a local health department may
relinquish its delegated authority upon 60 days

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written notification to the Director of Public Health.
(Source: P.A. 89-177, eff. 7-19-95.)
(210 ILCS 50/3.95)
Sec. 3.95. Level I Trauma Center Minimum Standards. The
Department shall establish, through rules adopted pursuant to
this Act, standards for Level I Trauma Centers which shall
include, but need not be limited to:
(a) The designation by the trauma center of a Trauma Center
Medical Director and specification of his qualifications;
(b) The types of surgical services the trauma center must
have available for trauma patients, including but not limited
to a twenty-four hour in-house surgeon with operating
privileges and ancillary staff necessary for immediate
surgical intervention;
(c) The types of nonsurgical services the trauma center
must have available for trauma patients;
(d) The numbers and qualifications of emergency medical
personnel;
(e) The types of equipment that must be available to trauma
patients;
(f) Requiring the trauma center to be affiliated with an
EMS System;
(g) Requiring the trauma center to have a communications
system that is fully integrated with all Level II Trauma
Centers, Level III Trauma Centers, Acute Injury Stabilization

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Centers, and EMS Systems with which it is affiliated;
(h) The types of data the trauma center must collect and
submit to the Department relating to the trauma services it
provides. Such data may include information on post-trauma care
directly related to the initial traumatic injury provided to
trauma patients until their discharge from the facility and
information on discharge plans;
(i) Requiring the trauma center to have helicopter landing
capabilities approved by appropriate State and federal
authorities, if the trauma center is located within a
municipality having a population of less than two million
people; and
(j) Requiring written agreements with Level II Trauma
Centers, Level III Trauma Centers, and Acute Injury
Stabilization Centers in the EMS Regions it serves, executed
within a reasonable time designated by the Department.
(Source: P.A. 89-177, eff. 7-19-95.)
(210 ILCS 50/3.100)
Sec. 3.100. Level II Trauma Center Minimum Standards. The
Department shall establish, through rules adopted pursuant to
this Act, standards for Level II Trauma Centers which shall
include, but need not be limited to:
(a) The designation by the trauma center of a Trauma Center
Medical Director and specification of his qualifications;
(b) The types of surgical services the trauma center must

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have available for trauma patients. The Department shall not
require the availability of all surgical services required of
Level I Trauma Centers;
(c) The types of nonsurgical services the trauma center
must have available for trauma patients;
(d) The numbers and qualifications of emergency medical
personnel, taking into consideration the more limited trauma
services available in a Level II Trauma Center;
(e) The types of equipment that must be available for
trauma patients;
(f) Requiring the trauma center to have a written agreement
with a Level I Trauma Centers, Level III Trauma Centers, and
Acute Injury Stabilization Centers Center serving the EMS
Region outlining their respective responsibilities in
providing trauma services, executed within a reasonable time
designated by the Department, unless the requirement for a
Level I Trauma Center to serve that EMS Region has been waived
by the Department;
(g) Requiring the trauma center to be affiliated with an
EMS System;
(h) Requiring the trauma center to have a communications
system that is fully integrated with the Level I Trauma
Centers, Level III Trauma Centers, Acute Injury Stabilization
Centers, and the EMS Systems with which it is affiliated;
(i) The types of data the trauma center must collect and
submit to the Department relating to the trauma services it

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provides. Such data may include information on post-trauma care
directly related to the initial traumatic injury provided to
trauma patients until their discharge from the facility and
information on discharge plans;
(j) Requiring the trauma center to have helicopter landing
capabilities approved by appropriate State and federal
authorities, if the trauma center is located within a
municipality having a population of less than two million
people.
(Source: P.A. 89-177, eff. 7-19-95.)
(210 ILCS 50/3.101 new)
Sec. 3.101. Level III Trauma Center minimum standards. The
Department shall establish, through rules adopted pursuant to
this Act, standards for Level III Trauma Centers which shall
include, but need not be limited to:
(1) the designation by the trauma center of a Trauma
Center Medical Director and specification of his or her
qualifications;
(2) the types of surgical services the trauma center
must have available for trauma patients; the Department
shall not require the availability of all surgical services
required of Level I or Level II Trauma Centers;
(3) the types of nonsurgical services the trauma center
must have available for trauma patients;
(4) the numbers and qualifications of emergency

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medical personnel, taking into consideration the more
limited trauma services available in a Level III Trauma
Center;
(5) the types of equipment that must be available for
trauma patients;
(6) requiring the trauma center to have a written
agreement with Level I Trauma Centers, Level II Trauma
Centers, and Acute Injury Stabilization Centers serving
the EMS Region outlining their respective responsibilities
in providing trauma services, executed within a reasonable
time designated by the Department, unless the requirement
for a Level I Trauma Center to serve that EMS Region has
been waived by the Department;
(7) requiring the trauma center to be affiliated with
an EMS System;
(8) requiring the trauma center to have a
communications system that is fully integrated with the
Level I Trauma Centers, Level II Trauma Centers, Acute
Injury Stabilization Centers, and the EMS Systems with
which it is affiliated;
(9) the types of data the trauma center must collect
and submit to the Department relating to the trauma
services it provides; such data may include information on
post-trauma care directly related to the initial traumatic
injury provided to trauma patients until their discharge
from the facility and information on discharge plans; and

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(10) requiring the trauma center to have helicopter
landing capabilities that have been approved by
appropriate State and federal authorities.
(210 ILCS 50/3.102 new)
Sec. 3.102. Acute Injury Stabilization Center minimum
standards. The Department shall establish, through rules
adopted pursuant to this Act, standards for Acute Injury
Stabilization Centers which shall include, but need not be
limited to, Comprehensive or Basic Emergency Department
services pursuant to the Hospital Licensing Act.
(210 ILCS 50/3.105)
Sec. 3.105. Trauma Center Misrepresentation. No After the
effective date of this amendatory Act of 1995, no facility
shall use the phrase "trauma center" or words of similar
meaning in relation to itself or hold itself out as a trauma
center without first obtaining designation pursuant to this
Act.
(Source: P.A. 89-177, eff. 7-19-95.)
(210 ILCS 50/3.110)
Sec. 3.110. EMS system and trauma center confidentiality
and immunity.
(a) All information contained in or relating to any medical
audit performed of a trauma center's trauma services or an

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Acute Injury Stabilization Center pursuant to this Act or by an
EMS Medical Director or his designee of medical care rendered
by System personnel, shall be afforded the same status as is
provided information concerning medical studies in Article
VIII, Part 21 of the Code of Civil Procedure. Disclosure of
such information to the Department pursuant to this Act shall
not be considered a violation of Article VIII, Part 21 of the
Code of Civil Procedure.
(b) Hospitals, trauma centers and individuals that perform
or participate in medical audits pursuant to this Act shall be
immune from civil liability to the same extent as provided in
Section 10.2 of the Hospital Licensing Act.
(c) All information relating to the State Emergency Medical
Services Disciplinary Review Board or a local review board,
except final decisions, shall be afforded the same status as is
provided information concerning medical studies in Article
VIII, Part 21 of the Code of Civil Procedure. Disclosure of
such information to the Department pursuant to this Act shall
not be considered a violation of Article VIII, Part 21 of the
Code of Civil Procedure.
(Source: P.A. 92-651, eff. 7-11-02.)
(210 ILCS 50/3.140)
Sec. 3.140. Violations; Fines.
(a) The Department shall have the authority to impose fines
on any licensed vehicle service provider, designated trauma

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center, Acute Injury Stabilization Center, resource hospital,
associate hospital, or participating hospital.
(b) The Department shall adopt rules pursuant to this Act
which establish a system of fines related to the type and level
of violation or repeat violation, including but not limited to:
(1) A fine not exceeding $10,000 for a violation which
created a condition or occurrence presenting a substantial
probability that death or serious harm to an individual
will or did result therefrom; and
(2) A fine not exceeding $5,000 for a violation which
creates or created a condition or occurrence which
threatens the health, safety or welfare of an individual.
(c) A Notice of Intent to Impose Fine may be issued in
conjunction with or in lieu of a Notice of Intent to Suspend,
Revoke, Nonrenew or Deny, and shall conform to the requirements
specified in Section 3.130(d) of this Act. All Hearings
conducted pursuant to a Notice of Intent to Impose Fine shall
conform to the requirements specified in Section 3.135 of this
Act.
(d) All fines collected pursuant to this Section shall be
deposited into the EMS Assistance Fund.
(Source: P.A. 89-177, eff. 7-19-95.)