Rep. Jay Hoffman

Filed: 3/21/2014

 

 


 

 


 
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1
AMENDMENT TO HOUSE BILL 1322

2    AMENDMENT NO. ______. Amend House Bill 1322 by replacing
3everything after the enacting clause with the following:
 
4    "Section 1. The Emergency Medical Services (EMS) Systems
5Act is amended by changing Section 3.190 as follows:
 
6    (210 ILCS 50/3.190)
7    Sec. 3.190. Emergency Department Classifications. The
8Department shall have the authority and responsibility to:
9        (a) Establish criteria for classifying the emergency
10    departments of all hospitals within the State as
11    Comprehensive, Basic, or Standby. In establishing such
12    criteria, the Department may consult with the Illinois
13    Hospital Licensing Board and incorporate by reference all
14    or part of existing standards adopted as rules pursuant to
15    the Hospital Licensing Act or Emergency Medical Treatment
16    Act;

 

 

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1        (b) Classify the emergency departments of all
2    hospitals within the State in accordance with this Section;
3        (c) Annually publish, and distribute to all EMS
4    Systems, a list reflecting the classification of all
5    emergency departments.
6    For the purposes of paragraphs (a) and (b) of this Section,
7long-term acute care hospitals and rehabilitation hospitals,
8as defined under the Hospital Emergency Service Act, are not
9required to provide hospital emergency services. Long-term
10acute care hospitals and rehabilitation hospitals with no
11emergency department and shall be classified as not available.
12(Source: P.A. 97-667, eff. 1-13-12; 98-463, eff. 8-16-13.)
 
13    Section 3. The Hospital Emergency Service Act is amended by
14changing Sections 1 and 1.3 as follows:
 
15    (210 ILCS 80/1)  (from Ch. 111 1/2, par. 86)
16    Sec. 1. Every hospital required to be licensed by the
17Department of Public Health pursuant to the Hospital Licensing
18Act which provides general medical and surgical hospital
19services, except long-term acute care hospitals and
20rehabilitation hospitals identified in Section 1.3 of this Act,
21shall provide a hospital emergency service in accordance with
22rules and regulations adopted by the Department of Public
23Health and shall furnish such hospital emergency services to
24any applicant who applies for the same in case of injury or

 

 

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1acute medical condition where the same is liable to cause death
2or severe injury or serious illness. For purposes of this Act,
3"applicant" includes any person who is brought to a hospital by
4ambulance or specialized emergency medical services vehicle as
5defined in the Emergency Medical Services (EMS) Systems Act.
6(Source: P.A. 97-667, eff. 1-13-12.)
 
7    (210 ILCS 80/1.3)
8    Sec. 1.3. Long-term acute care hospitals and
9rehabilitation hospitals. For the purpose of this Act, general
10acute care hospitals designated by Medicare as long-term acute
11care hospitals and rehabilitation hospitals are not required to
12provide hospital emergency services described in Section 1 of
13this Act. Hospitals defined in this Section may provide
14hospital emergency services at their option.
15    Any long-term acute care hospital defined in this Section
16that opts to discontinue or otherwise not provide emergency
17services described in Section 1 shall:
18        (1) comply with all provisions of the federal Emergency
19    Medical Treatment and & Labor Act (EMTALA);
20        (2) comply with all provisions required under the
21    Social Security Act;
22        (3) provide annual notice to communities in the
23    hospital's service area about available emergency medical
24    services; and
25        (4) make educational materials available to

 

 

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1    individuals who are present at the hospital concerning the
2    availability of medical services within the hospital's
3    service area.
4    Long-term acute care hospitals that operate standby
5emergency services as of January 1, 2011 may discontinue
6hospital emergency services by notifying the Department of
7Public Health. Long-term acute care hospitals that operate
8basic or comprehensive emergency services must notify the
9Health Facilities and Services Review Board and follow the
10appropriate procedures.
11    Any rehabilitation hospital that opts to discontinue or
12otherwise not provide emergency services described in Section 1
13shall:
14        (1) comply with all provisions of the federal Emergency
15    Medical Treatment and Active Labor Act (EMTALA);
16        (2) comply with all provisions required under the
17    Social Security Act;
18        (3) provide annual notice to communities in the
19    hospital's service area about available emergency medical
20    services;
21        (4) make educational materials available to
22    individuals who are present at the hospital concerning the
23    availability of medical services within the hospital's
24    service area;
25        (5) not use the term "hospital" in its name or on any
26    signage; and

 

 

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1        (6) notify in writing the Department and the Health
2    Facilities and Services Review Board of the
3    discontinuation.
4(Source: P.A. 97-667, eff. 1-13-12; revised 9-11-13.)
 
5    Section 5. The Hospital Licensing Act is amended by
6changing Sections 5 and 6 and by adding Section 14.5 as
7follows:
 
8    (210 ILCS 85/5)  (from Ch. 111 1/2, par. 146)
9    Sec. 5. (a) An application for a permit to establish a
10hospital shall be made to the Department upon forms provided by
11it. This application shall contain such information as the
12Department reasonably requires, which shall include
13affirmative evidence on which the Director may make the
14findings required under Section 6a of this Act.
15    (b) An application for a license to open, conduct, operate,
16and maintain a hospital shall be made to the Department upon
17forms provided by it, accompanied by a license fee of $55 per
18bed, or such lesser amount as the Department may establish by
19administrative rule in consultation with the Department of
20Healthcare and Family Services to comply with the limitations
21on health care-related taxes imposed by 42 U.S.C. 1396b(w)
22that, if violated, would result in reductions to the amount of
23federal financial participation received by the State for
24Medicaid expenditures, and shall contain such information as

 

 

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1the Department reasonably requires, which may include
2affirmative evidence of ability to comply with the provisions
3of this Act and the standards, rules, and regulations,
4promulgated by virtue thereof.
5    (c) All applications required under this Section shall be
6signed by the applicant and shall be verified. Applications on
7behalf of a corporation or association or a governmental unit
8or agency shall be made and verified by any two officers
9thereof.
10(Source: Laws 1965, p. 2350.)
 
11    (210 ILCS 85/6)  (from Ch. 111 1/2, par. 147)
12    Sec. 6. (a) Upon receipt of an application for a permit to
13establish a hospital the Director shall issue a permit if he
14finds (1) that the applicant is fit, willing, and able to
15provide a proper standard of hospital service for the community
16with particular regard to the qualification, background, and
17character of the applicant, (2) that the financial resources
18available to the applicant demonstrate an ability to construct,
19maintain, and operate a hospital in accordance with the
20standards, rules, and regulations adopted pursuant to this Act,
21and (3) that safeguards are provided which assure hospital
22operation and maintenance consistent with the public interest
23having particular regard to safe, adequate, and efficient
24hospital facilities and services.
25    The Director may request the cooperation of county and

 

 

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1multiple-county health departments, municipal boards of
2health, and other governmental and non-governmental agencies
3in obtaining information and in conducting investigations
4relating to such applications.
5    A permit to establish a hospital shall be valid only for
6the premises and person named in the application for such
7permit and shall not be transferable or assignable.
8    In the event the Director issues a permit to establish a
9hospital the applicant shall thereafter submit plans and
10specifications to the Department in accordance with Section 8
11of this Act.
12    (b) Upon receipt of an application for license to open,
13conduct, operate, and maintain a hospital, the Director shall
14issue a license if he finds the applicant and the hospital
15facilities comply with standards, rules, and regulations
16promulgated under this Act. A license, unless sooner suspended
17or revoked, shall be renewable annually upon approval by the
18Department and payment of a license fee as established pursuant
19to Section 5 of this Act. Each license shall be issued only for
20the premises and persons named in the application and shall not
21be transferable or assignable. Licenses shall be posted in a
22conspicuous place on the licensed premises. The Department may,
23either before or after the issuance of a license, request the
24cooperation of the State Fire Marshal, county and multiple
25county health departments, or municipal boards of health to
26make investigations to determine if the applicant or licensee

 

 

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1is complying with the minimum standards prescribed by the
2Department. The report and recommendations of any such agency
3shall be in writing and shall state with particularity its
4findings with respect to compliance or noncompliance with such
5minimum standards, rules, and regulations.
6    The Director may issue a provisional license to any
7hospital which does not substantially comply with the
8provisions of this Act and the standards, rules, and
9regulations promulgated by virtue thereof provided that he
10finds that such hospital has undertaken changes and corrections
11which upon completion will render the hospital in substantial
12compliance with the provisions of this Act, and the standards,
13rules, and regulations adopted hereunder, and provided that the
14health and safety of the patients of the hospital will be
15protected during the period for which such provisional license
16is issued. The Director shall advise the licensee of the
17conditions under which such provisional license is issued,
18including the manner in which the hospital facilities fail to
19comply with the provisions of the Act, standards, rules, and
20regulations, and the time within which the changes and
21corrections necessary for such hospital facilities to
22substantially comply with this Act, and the standards, rules,
23and regulations of the Department relating thereto shall be
24completed.
25(Source: P.A. 80-56.)
 

 

 

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1    (210 ILCS 85/14.5 new)
2    Sec. 14.5. Hospital Licensure Fund.
3    (a) There is created in the State treasury the Hospital
4Licensure Fund. The Fund is created for the purpose of
5providing funding for the administration of the licensure
6program and patient safety and quality initiatives for
7hospitals, including, without limitation, the implementation
8of the Illinois Adverse Health Care Events Reporting Law of
92005.
10    (b) The Fund shall consist of the following:
11        (1) fees collected pursuant to this Section;
12        (2) federal matching funds received by the State as a
13    result of expenditures made by the Department that are
14    attributable to moneys deposited in the Fund;
15        (3) interest earned on moneys deposited in the Fund;
16    and
17        (4) other moneys received for the Fund from any other
18    source, including interest earned thereon.
19    (c) Disbursements from the Fund shall be made only for:
20        (1) initially, the implementation of the Illinois
21    Adverse Health Care Events Reporting Law of 2005;
22        (2) subsequently, programs, information, or
23    assistance, including measures to address public
24    complaints, designed to measurably improve quality and
25    patient safety; and
26        (3) the reimbursement of moneys collected by the

 

 

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1    Department through error or mistake.
2    (d) The uses described in paragraph (2) of subsection (c)
3shall be developed in conjunction with a statewide organization
4representing a majority of hospitals.
 
5    Section 8. The Illinois Adverse Health Care Events
6Reporting Law of 2005 is amended by changing Sections 10-10 and
710-15 as follows:
 
8    (410 ILCS 522/10-10)
9    Sec. 10-10. Definitions. As used in this Law, the following
10terms have the following meanings:
11    "Adverse health care event" means any event identified as a
12serious reportable event by the National Quality Forum and the
13Centers for Medicare and Medicaid Services on the effective
14date of this amendatory Act of the 98th General Assembly. The
15Department shall adopt, by rule, the list of adverse health
16care events. The rules in effect on May 1, 2013, that define
17"adverse health care event" shall remain in effect until new
18rules are adopted in accordance with this amendatory Act of the
1998th General Assembly. If the National Quality Forum or the
20Centers for Medicare and Medicaid Services thereafter revises
21its list of serious reportable events through addition,
22deletion, or modification, then the term "adverse health care
23event" for purposes of this Law shall be similarly revised,
24effective no sooner than 6 months after the revision by the

 

 

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1originating organization described in subsections (b) through
2(g) of Section 10-15.
3    "Department" means the Illinois Department of Public
4Health.
5    "Health care facility" means a hospital maintained by the
6State or any department or agency thereof where such department
7or agency has authority under law to establish and enforce
8standards for the hospital under its management and control, a
9hospital maintained by any university or college established
10under the laws of this State and supported principally by
11public funds raised by taxation, a hospital licensed under the
12Hospital Licensing Act, a hospital organized under the
13University of Illinois Hospital Act, and an ambulatory surgical
14treatment center licensed under the Ambulatory Surgical
15Treatment Center Act.
16(Source: P.A. 94-242, eff. 7-18-05.)
 
17    (410 ILCS 522/10-15)
18    Sec. 10-15. Health care facility requirements to report,
19analyze, and correct.
20    (a) Reports of adverse health care events required. Each
21health care facility shall report to the Department the
22occurrence of any of the adverse health care events described
23in subsections (b) through (g) no later than 30 days after
24discovery of the event. The report shall be filed in a format
25specified by the Department and shall identify the health care

 

 

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1facility, but shall not include any information identifying or
2that tends to identify any of the health care professionals,
3employees, or patients involved.
4    (b) (Blank). Surgical events. Events reportable under this
5subsection are:
6        (1) Surgery performed on a wrong body part that is not
7    consistent with the documented informed consent for that
8    patient. Reportable events under this clause do not include
9    situations requiring prompt action that occur in the course
10    of surgery or situations whose urgency precludes obtaining
11    informed consent.
12        (2) Surgery performed on the wrong patient.
13        (3) The wrong surgical procedure performed on a patient
14    that is not consistent with the documented informed consent
15    for that patient. Reportable events under this clause do
16    not include situations requiring prompt action that occur
17    in the course of surgery or situations whose urgency
18    precludes obtaining informed consent.
19        (4) Retention of a foreign object in a patient after
20    surgery or other procedure, excluding objects
21    intentionally implanted as part of a planned intervention
22    and objects present prior to surgery that are intentionally
23    retained.
24        (5) Death during or immediately after surgery of a
25    normal, healthy patient who has no organic, physiologic,
26    biochemical, or psychiatric disturbance and for whom the

 

 

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1    pathologic processes for which the operation is to be
2    performed are localized and do not entail a systemic
3    disturbance.
4    (c) (Blank). Product or device events. Events reportable
5under this subsection are:
6        (1) Patient death or serious disability associated
7    with the use of contaminated drugs, devices, or biologics
8    provided by the health care facility when the contamination
9    is the result of generally detectable contaminants in
10    drugs, devices, or biologics regardless of the source of
11    the contamination or the product.
12        (2) Patient death or serious disability associated
13    with the use or function of a device in patient care in
14    which the device is used or functions other than as
15    intended. "Device" includes, but is not limited to,
16    catheters, drains, and other specialized tubes, infusion
17    pumps, and ventilators.
18        (3) Patient death or serious disability associated
19    with intravascular air embolism that occurs while being
20    cared for in a health care facility, excluding deaths
21    associated with neurosurgical procedures known to present
22    a high risk of intravascular air embolism.
23    (d) (Blank). Patient protection events. Events reportable
24under this subsection are:
25        (1) An infant discharged to the wrong person.
26        (2) Patient death or serious disability associated

 

 

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1    with patient disappearance for more than 4 hours, excluding
2    events involving adults who have decision-making capacity.
3        (3) Patient suicide or attempted suicide resulting in
4    serious disability while being cared for in a health care
5    facility due to patient actions after admission to the
6    health care facility, excluding deaths resulting from
7    self-inflicted injuries that were the reason for admission
8    to the health care facility.
9    (e) (Blank). Care management events. Events reportable
10under this subsection are:
11        (1) Patient death or serious disability associated
12    with a medication error, including, but not limited to,
13    errors involving the wrong drug, the wrong dose, the wrong
14    patient, the wrong time, the wrong rate, the wrong
15    preparation, or the wrong route of administration,
16    excluding reasonable differences in clinical judgment on
17    drug selection and dose.
18        (2) Patient death or serious disability associated
19    with a hemolytic reaction due to the administration of
20    ABO-incompatible blood or blood products.
21        (3) Maternal death or serious disability associated
22    with labor or delivery in a low-risk pregnancy while being
23    cared for in a health care facility, excluding deaths from
24    pulmonary or amniotic fluid embolism, acute fatty liver of
25    pregnancy, or cardiomyopathy.
26        (4) Patient death or serious disability directly

 

 

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1    related to hypoglycemia, the onset of which occurs while
2    the patient is being cared for in a health care facility
3    for a condition unrelated to hypoglycemia.
4    (f) (Blank). Environmental events. Events reportable under
5this subsection are:
6        (1) Patient death or serious disability associated
7    with an electric shock while being cared for in a health
8    care facility, excluding events involving planned
9    treatments such as electric countershock.
10        (2) Any incident in which a line designated for oxygen
11    or other gas to be delivered to a patient contains the
12    wrong gas or is contaminated by toxic substances.
13        (3) Patient death or serious disability associated
14    with a burn incurred from any source while being cared for
15    in a health care facility that is not consistent with the
16    documented informed consent for that patient. Reportable
17    events under this clause do not include situations
18    requiring prompt action that occur in the course of surgery
19    or situations whose urgency precludes obtaining informed
20    consent.
21        (4) Patient death associated with a fall while being
22    cared for in a health care facility.
23        (5) Patient death or serious disability associated
24    with the use of restraints or bedrails while being cared
25    for in a health care facility.
26    (g) (Blank). Physical security events. Events reportable

 

 

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1under this subsection are:
2        (1) Any instance of care ordered by or provided by
3    someone impersonating a physician, nurse, pharmacist, or
4    other licensed health care provider.
5        (2) Abduction of a patient of any age.
6        (3) Sexual assault on a patient within or on the
7    grounds of a health care facility.
8        (4) Death or significant injury of a patient or staff
9    member resulting from a physical assault that occurs within
10    or on the grounds of a health care facility.
11    (g-5) If the adverse health care events subject to this Law
12are revised as described in Section 10-10, then the Department
13shall provide notice to all affected health care facilities
14promptly upon the revision and shall inform affected health
15care facilities of the effective date of the revision for
16purposes of reporting under this Law.
17    (h) Definitions. As pertains to an adverse health care
18event used in this Section 10-15:
19     "Death" means patient death related to an adverse event
20and not related solely to the natural course of the patient's
21illness or underlying condition. Events otherwise reportable
22under this Section 10-15 shall be reported even if the death
23might have otherwise occurred as the natural course of the
24patient's illness or underlying condition.
25    "Serious disability" means a physical or mental
26impairment, including loss of a body part, related to an

 

 

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1adverse event and not related solely to the natural course of
2the patient's illness or underlying condition, that
3substantially limits one or more of the major life activities
4of an individual or a loss of bodily function, if the
5impairment or loss lasts more than 7 days prior to discharge or
6is still present at the time of discharge from an inpatient
7health care facility.
8(Source: P.A. 94-242, eff. 7-18-05.)
 
9    Section 10. The State Finance Act is amended by adding
10Section 5.855 as follows:
 
11    (30 ILCS 105/5.855 new)
12    Sec. 5.855. The Hospital Licensure Fund.
 
13    Section 99. Effective date. This Act takes effect upon
14becoming law.".