97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB5050

 

Introduced 2/7/2012, by Rep. David R. Leitch

 

SYNOPSIS AS INTRODUCED:
 
210 ILCS 3/10
210 ILCS 3/85 new
210 ILCS 3/90 new

    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.


LRB097 14989 RPM 60031 b

 

 

A BILL FOR

 

HB5050LRB097 14989 RPM 60031 b

1    AN ACT concerning public health.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Alternative Health Care Delivery Act is
5amended by changing Section 10 and by adding Sections 85 and 90
6as follows:
 
7    (210 ILCS 3/10)
8    Sec. 10. Definitions. In this Act, unless the context
9otherwise requires:
10    "Alternative health care model" means a facility or program
11authorized under Section 35 of this Act.
12    "Ambulatory surgical treatment center" or "ASTC" means any
13institution, place, or building licensed pursuant to the
14Ambulatory Surgical Treatment Center Act.
15    "Board" means the State Board of Health.
16    "Department" means the Illinois Department of Public
17Health.
18    "Demonstration program" means a program to license and
19study alternative health care models authorized under this Act.
20    "Director" means the Director of Public Health.
21    "Postsurgical recovery care center model" means a
22designated site that provides postsurgical recovery care for
23generally healthy patients undergoing surgical procedures who

 

 

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1require post-operative nursing care, pain control, or
2observation that would otherwise be provided in an in-patient
3setting.
4(Source: P.A. 87-1188.)
 
5    (210 ILCS 3/85 new)
6    Sec. 85. Approval of protocols for the admission of
7postsurgical patients.
8    (a) The Department shall enforce by rule the provisions of
9this Section with respect to each postsurgical recovery care
10center model.
11    (b) An admission protocol specifying the criteria for
12admitting a postsurgical patient to the postsurgical recovery
13care center model shall be included in each application for a
14license to operate a postsurgical recovery care center model.
15The admission protocol must address at least the following:
16        (1) The admission of all patients to the postsurgical
17    recovery care center model shall be performed by a member
18    of the medical staff with admitting privileges, and all
19    such patients shall be under the professional care of a
20    member of the medical staff.
21        (2) The criteria for admission that include limiting
22    services provided as follows:
23            (A) the patient must have been discharged from the
24        post-anesthesia care unit or recovery room of the ASTC
25        or hospital where the procedure was performed; the

 

 

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1        patient may not be directly admitted to the
2        postsurgical recovery care center model from the
3        operating room;
4            (B) patients must be 3 years of age or older;
5            (C) patients with an active, acute, or chronic
6        infectious condition shall not be eligible for
7        admission;
8            (D) patients must fall within anesthesia class I or
9        II or fall within anesthesia class III with only mild
10        to moderate systematic disease but medically stable;
11            (E) patients may require a postoperative overnight
12        stay;
13            (F) patients shall require a stay of not more than
14        48 hours; however, this may be extended to 72 hours
15        when the necessity of the extension is documented by
16        the treating physician and approved by the Medical
17        Director;
18            (G) the level of care needed by the patient is
19        consistent with the definition of a postsurgical
20        recovery care center model, and hospitalization is not
21        required;
22            (H) the patient is physiologically stable at the
23        time of admission and has experienced no
24        intraoperative or postoperative complications that
25        would cause the patient to be ineligible for admission
26        based on this Act; and

 

 

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1            (I) the patient does not require the
2        administration of blood in relation to an
3        intraoperative or postoperative complication, but may
4        require the administration of blood in the ordinary
5        course of their care.
6        (3) The types of surgical procedures performed in
7    ambulatory surgical treatment centers or hospitals that
8    the postsurgical recovery care center model intends to
9    admit, including documentation that the expected
10    postoperative stay is less than 48 hours and the
11    postoperative complication rate is minimal.
12        (4) The patient's medical record at the time of
13    admission, including the following:
14            (A) a current history and physical examination
15        conducted or approved by members of the medical staff;
16            (B) patient diagnosis;
17            (C) a discharge summary from the referring
18        facility or physician, including the surgical
19        procedure performed, the type of anesthesia used,
20        medications given, recovery events, and any other
21        pertinent information regarding the patient's status;
22            (D) physician orders;
23            (E) documentation concerning advance directives;
24        and
25            (F) any other underlying medical condition that
26        could be relevant to the patient's care.

 

 

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1    (c) The admission protocol and any subsequent revisions
2shall be approved by the applicant's consulting committee prior
3to submission to the Department, and documentation of the
4approval must be submitted with the request for the
5Department's approval.
6    (d) The initial and any revised admission protocols may not
7be put into effect without prior approval of the Department as
8provided in this Section.
9    (e) The Department shall review all admission protocols
10submitted with the application, renewal application, and any
11separate submission under this Section to ensure that the
12admission protocol provides for the admission of only
13postsurgical patients who can safely be cared for outside of a
14licensed acute care hospital. The Department shall disapprove
15any admission protocol that allows an admission that would be
16life threatening in nature or that does not meet the
17requirements set forth in subsection (b) of this Section.
18    (f) Upon receipt of the information from the applicant, the
19Department shall either approve the admission protocol or
20disapprove the admission protocol as provided under subsection
21(e) of this Section. The Department shall seek the
22recommendations of medical specialists and other professional
23consultants concerning the safety of specific admission
24protocols when it determines that such consultation is
25necessary. The Department shall also consider any additional
26information submitted by medical specialists and other

 

 

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1professionals and by medical specialty and other professional
2societies in making these determinations.
 
3    (210 ILCS 3/90 new)
4    Sec. 90. Laboratory, pharmacy, and radiological services.
5    (a) The Department shall enforce by rule the provisions of
6this Section with respect to each postsurgical recovery care
7center model.
8    (b) Each postsurgical recovery care center model shall meet
9the following requirements:
10        (1) possess a valid Clinical Laboratory Improvement
11    Amendments (CLIA) certificate for those tests performed by
12    the postsurgical recovery care center model; and
13        (2) have a written agreement with a laboratory that
14    possesses a valid CLIA certificate to perform any required
15    laboratory procedures that are not performed in the
16    postsurgical recovery care center model.
17    (c) Blood may be administered in the postsurgical recovery
18care center model for non-emergent reasons related to the
19ordinary course of patient care but not for intraoperative or
20postoperative complications. Blood products may be
21administered in the postsurgical recovery care center model.
22    (d) Pharmacy services shall be provided directly by the
23postsurgical recovery care center model or by contract with a
24pharmacy licensed pursuant to the Pharmacy Practice Act.
25    (e) Pharmacy services not provided by contract must be

 

 

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1under the direction of a registered pharmacist employed by the
2postsurgical recovery care center model on a full-time,
3part-time, or consulting basis.
4    (f) All drugs and medicines shall be stored and dispensed
5in accordance with applicable State and federal laws and
6regulations.
7    (g) All blood and blood products shall be stored,
8administered, and monitored in accordance with State and
9federal laws and regulations.
10    (h) Radiologic services sufficient to perform and
11interpret the radiological examinations necessary to meet the
12needs of the patients must be provided.
13    (i) All X-rays shall be read by a member of the medical
14staff or a consulting radiologist approved by the consulting
15committee.
16