HB5050 EnrolledLRB097 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 Sections 10 and 35 as follows:
 
6    (210 ILCS 3/10)
7    Sec. 10. Definitions. In this Act, unless the context
8otherwise requires:
9    "Ambulatory surgical treatment center" or "ASTC" means any
10institution, place, or building licensed under the Ambulatory
11Surgical Treatment Center Act.
12    "Alternative health care model" means a facility or program
13authorized under Section 35 of this Act.
14    "Board" means the State Board of Health.
15    "Department" means the Illinois Department of Public
16Health.
17    "Demonstration program" means a program to license and
18study alternative health care models authorized under this Act.
19    "Director" means the Director of Public Health.
20(Source: P.A. 87-1188.)
 
21    (210 ILCS 3/35)
22    Sec. 35. Alternative health care models authorized.

 

 

HB5050 Enrolled- 2 -LRB097 14989 RPM 60031 b

1Notwithstanding any other law to the contrary, alternative
2health care models described in this Section may be established
3on a demonstration basis.
4        (1) (Blank).
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
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

 

 

HB5050 Enrolled- 3 -LRB097 14989 RPM 60031 b

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
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
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
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
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.
25        No postsurgical recovery care center shall
26    discriminate against any patient requiring treatment

 

 

HB5050 Enrolled- 4 -LRB097 14989 RPM 60031 b

1    because of the source of payment for services, including
2    Medicare and Medicaid recipients.
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.
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
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

 

 

HB5050 Enrolled- 5 -LRB097 14989 RPM 60031 b

1    insurance companies who cover home health care services or
2    private duty nursing care in the home.
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
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.
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.
21        (4) Alternative health care delivery model; community
22    based residential rehabilitation center. A community-based
23    residential rehabilitation center model is a designated
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

 

 

HB5050 Enrolled- 6 -LRB097 14989 RPM 60031 b

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,
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

 

 

HB5050 Enrolled- 7 -LRB097 14989 RPM 60031 b

1    program shall have been accredited by CARF as a Brain
2    Injury Community-Integrative Program for at least 3 years.
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
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
25    caregivers. The education and support shall include
26    referrals to support organizations for educational

 

 

HB5050 Enrolled- 8 -LRB097 14989 RPM 60031 b

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
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.
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.
25            (A) A birth center shall not be separately licensed
26        if it is one of the following:

 

 

HB5050 Enrolled- 9 -LRB097 14989 RPM 60031 b

1                (1) A part of a hospital; or
2                (2) A freestanding facility that is physically
3            distinct from a hospital but is operated under a
4            license issued to a hospital under the Hospital
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
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.

 

 

HB5050 Enrolled- 10 -LRB097 14989 RPM 60031 b

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
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
17    the birth center maintains a contractual relationship,
18    including a transfer agreement, as required under this
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

 

 

HB5050 Enrolled- 11 -LRB097 14989 RPM 60031 b

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

 

 

HB5050 Enrolled- 12 -LRB097 14989 RPM 60031 b

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
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
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
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

 

 

HB5050 Enrolled- 13 -LRB097 14989 RPM 60031 b

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

 

 

HB5050 Enrolled- 14 -LRB097 14989 RPM 60031 b

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.)