95TH GENERAL ASSEMBLY
State of Illinois
2007 and 2008
HB1885

 

Introduced 2/23/2007, by Rep. Michael P. McAuliffe

 

SYNOPSIS AS INTRODUCED:
 
New Act
30 ILCS 105/5.675 new

    Creates the Retail Health Care Facility Permit Act and amends the State Finance Act. Defines "retail health care facility" as any institution, place, or building, or any portion thereof, devoted to the maintenance and operation of facilities for the performance of health care services and located within a retail store or pharmacy; requires a permit for the operation of such a facility, issued by the Department of Public Health, and sets forth requirements for obtaining a permit. Sets forth operating requirements for a retail health care facility. Provides for denial, suspension, revocation, or nonrenewal of a permit for certain reasons. Provides for monetary penalties for violations of the Act. Restricts advertising by a retail health care facility. Creates the Retail Health Care Facility Permit Fund, to be used by the Department in administering the Act. Effective July 1, 2007.


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CORRECTIONAL BUDGET AND IMPACT NOTE ACT MAY APPLY
FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1     AN ACT concerning regulation.
 
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 Retail
5 Health Care Facility Permit Act.
 
6     Section 5. Legislative purpose. It is declared to be the
7 public policy that the State has a legitimate interest in
8 assuring that health care services are performed under
9 circumstances that ensure maximum safety. Therefore, the
10 purpose of this Act is to provide for the better protection of
11 the public health through the development, establishment, and
12 enforcement of standards (i) for the care of individuals in
13 retail health care facilities and (ii) for the construction,
14 maintenance, and operation of retail health care facilities,
15 which, in light of advancing knowledge, will promote safe and
16 adequate treatment of individuals in retail health care
17 facilities.
 
18     Section 10. Definitions. In this Act:
19     "Department" means the Illinois Department of Public
20 Health or other health authority designated as its agent.
21     "Director" means the Director of Public Health or his or
22 her designee.

 

 

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1     "Operator" means the person designated by a permit holder
2 to operate the facility.
3     "Retail health care facility" or "facility" means any
4 institution, place, or building, or any portion thereof,
5 devoted to the maintenance and operation of facilities for the
6 performance of health care services and located within a retail
7 store or pharmacy. The facility may not provide surgical
8 services or any form of general anesthesia. Such facility shall
9 not provide beds or other accommodations for either long term
10 or overnight stay of patients, and individual patients shall be
11 discharged in an ambulatory condition without danger to the
12 continued well-being of the patients or shall be transferred to
13 a hospital. Hospitals, long term care facilities, ambulatory
14 treatment centers, blood banks, clinical laboratories, and
15 offices of physicians, advanced practices nurses, and
16 physician assistants as well as pharmacies that provide
17 pharmaceutical services, are not to be construed to be retail
18 health care facilities.
 
19     Section 15. Permit; fees; application.
20     (a) A permit issued by the Department shall be required
21 prior to the operation of any facility. The owner of the
22 facility shall file an application for a permit with the
23 Department on a form prescribed by the Department that shall
24 include at least the following information:
25         (1) Applicant's (owner) name, address, telephone

 

 

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1     number.
2         (2) Name of the facility, address telephone number.
3         (3) Nature of services to be provided at the facility.
4         (4) Primary function of the business in which the
5     facility is located.
6         (5) Operating procedures to be used in the facility.
7     (b) A fee of $2,500 shall be submitted with the application
8 to the Department.
9     (c) If the owner owns or operates more than one facility,
10 the owner shall file a separate application for each facility
11 owned or operated.
12     (d) Within 90 days after receipt of an application, the
13 Department's personnel shall complete the initial inspection
14 of the premises of the facility and ensure that the premises
15 and the facilities are or will be operated in accordance with
16 this Act.
17     (e) Upon submission of the application and the required
18 fee, and if the initial inspection of the premises indicates
19 that the premises and the facilities are or will be operated in
20 accordance with this Act, the Department shall issue a permit
21 to the owner.
22     (f) The permit issued by the Department shall be effective
23 for one year following the date of issuance. The Department may
24 stagger permit renewal dates on a quarterly basis with an
25 initial permit being effective from 9 months to 15 months. The
26 permit is valid only for the location and owner stated on the

 

 

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1 permit and is not transferable.
2     (g) The permit shall be displayed in a place within sight
3 of the public when entering the premises of the facility.
4     (h) In the event of a change of ownership, the new owner
5 must apply for a permit to own and operate a facility prior to
6 taking possession of the property. A provisional permit may be
7 issued by the Department until an initial inspection for a
8 permit can be performed by the Department.
 
9     Section 20. Permit renewal procedures; inspections.
10     (a) All permits issued by the Department under this Act
11 shall expire on a specified date and may be renewed by
12 submitting to the Department, at least 30 days before the
13 expiration date, a permit renewal application and the annual
14 renewal fee of $1,250.
15     (b) The Department may refuse to renew the permit of any
16 owner who has been found to be in violation of this Act for the
17 safe operation of facilities.
18     (c) Each facility shall be inspected at least once each
19 year after the initial year in which the facility was granted a
20 permit.
 
21     Section 25. Requirements for a permit.
22     (a) All retail health care facilities shall have policies
23 that ensure the following:
24         (1) All health care services provided must be in

 

 

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1     accordance with a limited scope of services as determined
2     by the facilities' medical director and approved by the
3     Department.
4         (2) No health care services may be provided unless a
5     physician licensed to practice medicine in all its
6     branches, an advanced practice nurse, or a physician
7     assistant is on the premises at the time the services are
8     provided.
9         (3) All health care services provided by an advanced
10     practice nurse (APN) shall be in accordance with the APN's
11     collaborative agreement with a physician as required by
12     Section 25 of the Nursing and Advanced Practice Nursing
13     Act. A copy of the collaborative agreement shall be
14     maintained at the facility. No physician may collaborate
15     with more than 2 advanced practice nurses practicing in
16     retail health care facilities. All health care services
17     provided by a physician assistant (PA) shall be in
18     accordance with the written guidelines established by the
19     supervising physician or physician/physician assistant
20     team as required by Section 4 of the Physician Assistant
21     Practice Act of 1987. A copy of the written guidelines
22     shall be maintained at the facility.
23         (4) The facility must have a medical director who is a
24     physician licensed to practice medicine in all its branches
25     with active medical staff privileges to admit patients to a
26     local licensed hospital. A physician may be a medical

 

 

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1     director of no more than 2 facilities.
2         (5) The facility must have a referral system to
3     physician practices or other health care entities
4     appropriate to the patient's symptoms outside the limited
5     scope of services provided by the facility.
6         (6) Collaboration of APNs or supervision of PAs shall
7     not be construed to necessarily require the presence of a
8     collaborating or supervising physician as long as methods
9     of communication are available for consultation with the
10     physician in person or by telecommunications in accordance
11     with written protocols.
12         (7) The facility shall maintain medical records for all
13     patients for the period required of a licensed hospital
14     under the Hospital Licensing Act.
15         (8) The facility shall provide notification of any
16     patient visits and outcomes to the patient's designated
17     physician.
18         (9) Patients must be provided the opportunity to
19     purchase any medications, fill any prescriptions, or seek
20     any services from any provider not affiliated with the
21     facility or the store or pharmacy in which it is located.
22     (b) All facility policies must meet the requirements of
23 this Act and the rules adopted under this Act.
 
24     Section 30. Standards for issuance of permit. The Director
25 shall issue a permit under this Act only if he or she finds

 

 

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1 that the applicant complies with this Act and the rules and
2 regulations adopted pursuant thereto and (i) is under the
3 medical direction of one or more physicians and (ii) permits
4 only a limited scope of covered services.
 
5     Section 35. Operating requirements. Each facility shall
6 have on hand at all times an operator adequately trained in the
7 correct operation of the facility. The facility shall comply
8 with the requirements of Section 25 of this Act and the
9 following:
10         (1) The facility must be operated by a physician
11     licensed to practice medicine in all its branches, an
12     advanced practice nurse, or physician assistant.
13         (2) Every personnel member shall wear on his or her
14     person a clearly visible identification indicating his or
15     her professional licensure status while acting in the
16     course of his or her duties. The facility must clearly
17     display a notice informing potential patients when a
18     physician is not on the premises.
19         (3) The facility shall establish appropriate
20     sanitation and hygienic protocols and facilities,
21     including but not limited to refrigeration, hazardous
22     waste disposal, separate restrooms, and handwashing
23     stations with running hot water, as determined by rule.
24         (4) The facility shall operate under written protocols
25     approved by the medical director and the advanced practice

 

 

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1     nurses or the physician assistants providing services at
2     the facility.
 
3     Section 40. Department standards; rules; regulations. The
4 Department shall issues rules and regulations deemed necessary
5 for the proper regulation of retail health care facilities. At
6 a minimum, the rules and regulations shall include, but need
7 not be limited to:
8         (1) Construction of the facility, including, but not
9     limited to, plumbing, heating, lighting, and ventilation
10     that will ensure the health, safety, comfort, and privacy
11     of patients and protection from fire hazards.
12         (2) Number and qualifications of all personnel,
13     including administrative and nursing personnel, having
14     responsibility for any part of the care provided to the
15     patients.
16         (3) Equipment essential to the health, welfare, and
17     safety of the patients.
18         (4) Facilities, programs, and services to be provided
19     in connection with the care of patients in the facility.
 
20     Section 45. Denial, suspension, revocation, or nonrenewal
21 of permits. A permit may be denied, suspended, or revoked, or
22 the renewal of a permit may be denied, for any of the following
23 reasons:
24         (1) Violation of any of the provisions of this Act or

 

 

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1     the rules and regulations adopted by the Department
2     hereunder.
3         (2) Conviction of an applicant or permit holder of an
4     offense arising from false, fraudulent, deceptive, or
5     misleading advertising. The record of conviction or a
6     certified copy shall be conclusive evidence of the
7     conviction.
8         (3) Revocation of a permit during the previous 5 years,
9     or surrender or expiration of a permit during the pendency
10     of an action by the Department to revoke or suspend a
11     permit during the previous 5 years. A controlling owner or
12     controlling combination of owners of the applicant; or any
13     affiliate of the individual applicant or controlling owner
14     of the applicant or affiliate of the applicant was a
15     controlling owner of the prior permit.
 
16     Section 50. Administration; enforcement.
17     (a) The Department may establish a training program for the
18 Department's agents for administration and enforcement of this
19 Act.
20     (b) In the administration and enforcement of this Act, the
21 Department may designate and use full-time municipal,
22 district, county, or multi-county health departments as its
23 agents in the administration and enforcement of this Act and
24 the rules adopted under this Act.
 

 

 

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1     Section 55. Investigation; hearing; notice. The Department
2 may investigate an applicant or permit holder upon its own
3 motion, and shall investigate an applicant or permit holder
4 upon the verified complaint in writing of any person setting
5 forth facts that if proven would constitute grounds for the
6 denial of an application for a permit, or refusal to renew a
7 permit, or revocation of a permit, or suspension of a permit.
8 The Department, after notice and opportunity for hearing, may
9 deny any application for, or suspend or revoke, a permit or may
10 refuse to renew a permit. Before denying an application, or
11 refusing to renew a permit or suspending or revoking a permit,
12 the Department shall notify the applicant in writing. The
13 notice shall specify the reasons for the Department's
14 contemplated action. The applicant or permit holder must
15 request a hearing within 10 days after receipt of the notice.
16 Failure to request a hearing within 10 days shall constitute a
17 waiver of the right to a hearing.
 
18     Section 60. Conduct of hearing.
19     (a) The hearing shall be conducted by the Director or by an
20 individual designated in writing by the Director as a hearing
21 officer. The Director or hearing officer may compel by subpoena
22 or subpoena duces tecum the attendance and testimony of
23 witnesses and the production of books and papers and may
24 administer oaths to witnesses. The hearing shall be conducted
25 at a place designated by the Department. The procedures

 

 

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1 governing hearings and the issuance of final orders under this
2 Act shall be in accordance with rules adopted by the
3 Department.
4     (b) All subpoenas issued by the Director or hearing officer
5 may be served as provided for in civil actions. The fees of
6 witnesses for attendance and travel shall be the same as the
7 fees for witnesses before the circuit court and shall be paid
8 by the party to the proceeding at whose request the subpoena is
9 issued. If a subpoena is issued at the request of the
10 Department, the witness fee shall be paid as an administrative
11 expense.
12     (c) In cases of refusal of a witness to attend or testify,
13 or to produce books or papers, concerning any matter upon which
14 he or she might be lawfully examined, the circuit court of the
15 county in which the hearing is held, upon application of any
16 party to the proceeding, may compel obedience by proceeding as
17 for contempt as in cases of a like refusal to obey a similar
18 order of the court.
 
19     Section 65. Findings of fact; conclusions of law; decision.
20 The Director or hearing officer shall make findings of fact and
21 conclusions of law following the hearing, and the Director
22 shall render his or her decision, or the hearing officer his or
23 her proposal for decision, within 45 days after the termination
24 of the hearing unless additional time is required by the
25 Director or hearing officer for a proper disposition of the

 

 

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1 matter. A copy of the final decision of the Director shall be
2 served upon the applicant or permit holder in person or by
3 certified mail.
 
4     Section 70. Surrender of permit. Upon the revocation of a
5 permit, a permit holder shall be required to surrender the
6 permit to the Department, and upon his failure or refusal to do
7 so, the Department shall have the right to seize the same.
 
8     Section 75. Review under Administrative Review law; venue;
9 costs. All final administrative decisions of the Department
10 under this Act shall be subject to judicial review under the
11 provisions of Article III of the Code of Civil Procedure. The
12 term "administrative decision" is defined as under Section
13 3-101 of the Code of Civil Procedure. Proceedings for judicial
14 review shall be commenced in the circuit court of the county in
15 which the party applying for review resides; provided, that if
16 the party is not a resident of this State, the venue shall be
17 in Sangamon County. The Department shall not be required to
18 certify any record or file any answer or otherwise appear in
19 any proceeding for judicial review unless the party filing the
20 complaint deposits with the clerk of the court the sum of $0.95
21 per page, representing the costs of certification of the record
22 or file. Failure on the part of the plaintiff to make the
23 deposit shall be grounds for dismissal of the action.
 

 

 

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1     Section 80. Administrative Procedure Act; application. The
2 provisions of the Illinois Administrative Procedure Act are
3 hereby expressly adopted and shall apply to all administrative
4 rules and procedures of the Department under this Act, except
5 that in the case of a conflict between the Illinois
6 Administrative Procedure Act and this Act, the provisions of
7 this Act shall control, and except that Section 5 of the
8 Illinois Administrative Procedure Act relating to procedures
9 for rulemaking does not apply to the adoption of any rules
10 required by federal law in connection with which the Department
11 is precluded by law from exercising any discretion.
 
12     Section 85. Penalties. The Department may establish and
13 assess civil monetary penalties against a permit holder for
14 violations of this Act or regulations adopted under this Act.
15 In no circumstance may any such penalty exceed $1,000 per day
16 for each day the permit holder remains in violation.
 
17     Section 90. Public nuisance.
18     (a) Any facility operating without a valid permit or
19 operating on a revoked permit is guilty of committing a public
20 nuisance.
21     (b) A person convicted of knowingly maintaining a public
22 nuisance under this Section commits a Class A misdemeanor. Each
23 subsequent offense under this Section is a Class 4 felony.
24     (c) The Attorney General of this State or the State's

 

 

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1 Attorney of the county in which the nuisance exists may
2 commence an action to abate the nuisance. The court, without
3 notice or bond, may enter a temporary restraining order or a
4 preliminary injunction to enjoin the defendant from operating
5 in violation of this Act.
 
6     Section 95. Advertising.
7     (a) Any facility may advertise the availability of
8 professional services in the public media or on the premises
9 where such professional services are rendered. Such
10 advertising shall be limited to the following information:
11         (1) Publication of the facility's name, office hours,
12     address, and telephone number.
13         (2) Information pertaining to the professionals
14     providing services at the facility.
15         (3) Information on usual and customary fees for routine
16     professional services offered.
17         (4) Announcement of the opening of, change of, absence
18     from, or return to business.
19         (5) Announcement of additions to or deletions from
20     professional licensed staff.
21         (6) The issuance of business or appointment cards.
22     (b) It is unlawful for any facility licensed under this Act
23 to use testimonials or claims of superior quality of care to
24 entice the public. It is unlawful to advertise fee comparisons
25 of available services with those of other persons licensed

 

 

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1 under this Act or any other Illinois law.
2     (c) This Act does not authorize the advertising of
3 professional services that a facility is not licensed to
4 render, nor shall an advertiser use statements that contain
5 false, fraudulent, deceptive, or misleading material or
6 guarantees of success, statements that play upon the vanity or
7 fears of the public, or statements that promote or produce
8 unfair competition.
9     (d) It is unlawful and punishable under Section 85 for any
10 facility licensed under this Act to knowingly advertise that
11 the facility will accept as payment for services rendered by
12 assignment from any third party payor the amount the third
13 party payor covers as payment in full, if the effect is to give
14 the impression of eliminating the need of payment by the
15 patient of any required deductible or copayment applicable in
16 the patient's health benefit plan.
17     (e) As used in this Section, "advertise" means solicitation
18 by the permit holder or through another by means of handbills,
19 posters, circulars, motion pictures, radio, newspapers,
20 television, the Internet, or the World Wide Web, or in any
21 other manner.
 
22     Section 100. Retail Health Care Facility Permit Fund. There
23 is created in the State Treasury a special fund to be known as
24 the Retail Health Care Facility Permit Fund. All fees and
25 penalties collected by the Department under this Act, and any

 

 

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1 federal funds collected pursuant to the administration of this
2 Act, shall be deposited into the Fund. The amount deposited
3 shall be appropriated by the General Assembly to the Department
4 for the purpose of conducting activities relating to retail
5 health care facilities under this Act.
 
6     Section 190. Severability. The provisions of this Act are
7 severable under Section 1.31 of the Statute on Statutes.
 
8     Section 900. The State Finance Act is amended by adding
9 Section 5.675 as follows:
 
10     (30 ILCS 105/5.675 new)
11     Sec. 5.675. The Retail Health Care Facility Permit Fund.
 
12     Section 999. Effective date. This Act takes effect July 1,
13 2007.