SB0625 EngrossedLRB098 04438 JWD 34466 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Emergency Medical Services (EMS) Systems Act
5is amended by changing Sections 3.30, 3.90, 3.95, 3.100, 3.105,
63.110, and 3.140 and by adding Section 3.101 and 3.102 as
7follows:
 
8    (210 ILCS 50/3.30)
9    Sec. 3.30. EMS Region Plan; Content.
10    (a) The EMS Medical Directors Committee shall address at
11least the following:
12        (1) Protocols for inter-System/inter-Region patient
13    transports, including identifying the conditions of
14    emergency patients which may not be transported to the
15    different levels of emergency department, based on their
16    Department classifications and relevant Regional
17    considerations (e.g. transport times and distances);
18        (2) Regional standing medical orders;
19        (3) Patient transfer patterns, including criteria for
20    determining whether a patient needs the specialized
21    services of a trauma center, along with protocols for the
22    bypassing of or diversion to any hospital, trauma center or
23    regional trauma center which are consistent with

 

 

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1    individual System bypass or diversion protocols and
2    protocols for patient choice or refusal;
3        (4) Protocols for resolving Regional or Inter-System
4    conflict;
5        (5) An EMS disaster preparedness plan which includes
6    the actions and responsibilities of all EMS participants
7    within the Region. Within 90 days of the effective date of
8    this amendatory Act of 1996, an EMS System shall submit to
9    the Department for review an internal disaster plan. At a
10    minimum, the plan shall include contingency plans for the
11    transfer of patients to other facilities if an evacuation
12    of the hospital becomes necessary due to a catastrophe,
13    including but not limited to, a power failure;
14        (6) Regional standardization of continuing education
15    requirements;
16        (7) Regional standardization of Do Not Resuscitate
17    (DNR) policies, and protocols for power of attorney for
18    health care;
19        (8) Protocols for disbursement of Department grants;
20    and
21        (9) Protocols for the triage, treatment, and transport
22    of possible acute stroke patients.
23    (b) The Trauma Center Medical Directors or Trauma Center
24Medical Directors Committee shall address at least the
25following:
26        (1) The identification of Regional Trauma Centers;

 

 

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

 

 

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1    assurance and improvement subcommittee, consisting of
2    trauma surgeons, which shall perform periodic medical
3    audits of each trauma center's trauma services, and forward
4    tabulated data from such reviews to the Department; and
5        (10) The establishment, within 90 days of the effective
6    date of this amendatory Act of 1996, of an internal
7    disaster plan, which shall include, at a minimum,
8    contingency plans for the transfer of patients to other
9    facilities if an evacuation of the hospital becomes
10    necessary due to a catastrophe, including but not limited
11    to, a power failure.
12    (c) The Region's EMS Medical Directors and Trauma Center
13Medical Directors Committees shall appoint any subcommittees
14which they deem necessary to address specific issues concerning
15Region activities.
16(Source: P.A. 96-514, eff. 1-1-10.)
 
17    (210 ILCS 50/3.90)
18    Sec. 3.90. Trauma Center Designations.
19    (a) "Trauma Center" means a hospital which: (1) within
20designated capabilities provides optimal care to trauma
21patients; (2) participates in an approved EMS System; and (3)
22is duly designated pursuant to the provisions of this Act.
23Level I Trauma Centers shall provide all essential services
24in-house, 24 hours per day, in accordance with rules adopted by
25the Department pursuant to this Act. Level II and Level III

 

 

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1Trauma Centers shall have some essential services available
2in-house, 24 hours per day, and other essential services
3readily available, 24 hours per day, in accordance with rules
4adopted by the Department pursuant to this Act.
5    (a-5) An Acute Injury Stabilization Center shall have a
6comprehensive emergency department capable of initial
7management and transfer of the acutely injured in accordance
8with rules adopted by the Department pursuant to this Act.
9    (b) The Department shall have the authority and
10responsibility to:
11        (1) Establish and enforce minimum standards for
12    designation and re-designation of 3 levels of trauma
13    centers that meet trauma center national standards, as
14    modified by the Department in administrative rules as a
15    Level I or Level II Trauma Center, consistent with Sections
16    22 and 23 of this Act, through rules adopted pursuant to
17    this Act;
18        (2) Require hospitals applying for trauma center
19    designation to submit a plan for designation in a manner
20    and form prescribed by the Department through rules adopted
21    pursuant to this Act;
22        (3) Upon receipt of a completed plan for designation,
23    conduct a site visit to inspect the hospital for compliance
24    with the Department's minimum standards. Such visit shall
25    be conducted by specially qualified personnel with
26    experience in the delivery of emergency medical and/or

 

 

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

 

 

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

 

 

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

 

 

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1        receipt of the notice of violation in which to submit a
2        plan of correction. The Department may extend this
3        period for up to 30 days. The plan shall include a
4        fixed time period not in excess of 90 days within which
5        violations are to be corrected. The plan of correction
6        and the status of its implementation by the trauma
7        center shall be provided, as appropriate, to the EMS
8        Medical Directors for appropriate EMS Systems. If the
9        Department rejects a plan of correction, it shall send
10        notice of the rejection and the reason for the
11        rejection to the trauma center. The trauma center shall
12        have 10 days after receipt of the notice of rejection
13        in which to submit a modified plan. If the modified
14        plan is not timely submitted, or if the modified plan
15        is rejected, the trauma center shall follow an approved
16        plan of correction imposed by the Department. If, after
17        notice and opportunity for hearing, the Director
18        determines that a trauma center has failed to comply
19        with an approved plan of correction, the Director may
20        revoke the trauma center designation. The trauma
21        center shall have 15 days after receiving the
22        Director's notice in which to request a hearing. Such
23        hearing shall conform to the provisions of Section
24        3.135 30 of this Act;
25        (11) The Department may delegate authority to local
26    health departments in jurisdictions which include a

 

 

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

 

 

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1        written notification to the Director of Public Health.
2(Source: P.A. 89-177, eff. 7-19-95.)
 
3    (210 ILCS 50/3.95)
4    Sec. 3.95. Level I Trauma Center Minimum Standards. The
5Department shall establish, through rules adopted pursuant to
6this Act, standards for Level I Trauma Centers which shall
7include, but need not be limited to:
8    (a) The designation by the trauma center of a Trauma Center
9Medical Director and specification of his qualifications;
10    (b) The types of surgical services the trauma center must
11have available for trauma patients, including but not limited
12to a twenty-four hour in-house surgeon with operating
13privileges and ancillary staff necessary for immediate
14surgical intervention;
15    (c) The types of nonsurgical services the trauma center
16must have available for trauma patients;
17    (d) The numbers and qualifications of emergency medical
18personnel;
19    (e) The types of equipment that must be available to trauma
20patients;
21    (f) Requiring the trauma center to be affiliated with an
22EMS System;
23    (g) Requiring the trauma center to have a communications
24system that is fully integrated with all Level II Trauma
25Centers, Level III Trauma Centers, Acute Injury Stabilization

 

 

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1Centers, and EMS Systems with which it is affiliated;
2    (h) The types of data the trauma center must collect and
3submit to the Department relating to the trauma services it
4provides. Such data may include information on post-trauma care
5directly related to the initial traumatic injury provided to
6trauma patients until their discharge from the facility and
7information on discharge plans;
8    (i) Requiring the trauma center to have helicopter landing
9capabilities approved by appropriate State and federal
10authorities, if the trauma center is located within a
11municipality having a population of less than two million
12people; and
13    (j) Requiring written agreements with Level II Trauma
14Centers, Level III Trauma Centers, and Acute Injury
15Stabilization Centers in the EMS Regions it serves, executed
16within a reasonable time designated by the Department.
17(Source: P.A. 89-177, eff. 7-19-95.)
 
18    (210 ILCS 50/3.100)
19    Sec. 3.100. Level II Trauma Center Minimum Standards. The
20Department shall establish, through rules adopted pursuant to
21this Act, standards for Level II Trauma Centers which shall
22include, but need not be limited to:
23    (a) The designation by the trauma center of a Trauma Center
24Medical Director and specification of his qualifications;
25    (b) The types of surgical services the trauma center must

 

 

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1have available for trauma patients. The Department shall not
2require the availability of all surgical services required of
3Level I Trauma Centers;
4    (c) The types of nonsurgical services the trauma center
5must have available for trauma patients;
6    (d) The numbers and qualifications of emergency medical
7personnel, taking into consideration the more limited trauma
8services available in a Level II Trauma Center;
9    (e) The types of equipment that must be available for
10trauma patients;
11    (f) Requiring the trauma center to have a written agreement
12with a Level I Trauma Centers, Level III Trauma Centers, and
13Acute Injury Stabilization Centers Center serving the EMS
14Region outlining their respective responsibilities in
15providing trauma services, executed within a reasonable time
16designated by the Department, unless the requirement for a
17Level I Trauma Center to serve that EMS Region has been waived
18by the Department;
19    (g) Requiring the trauma center to be affiliated with an
20EMS System;
21    (h) Requiring the trauma center to have a communications
22system that is fully integrated with the Level I Trauma
23Centers, Level III Trauma Centers, Acute Injury Stabilization
24Centers, and the EMS Systems with which it is affiliated;
25    (i) The types of data the trauma center must collect and
26submit to the Department relating to the trauma services it

 

 

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1provides. Such data may include information on post-trauma care
2directly related to the initial traumatic injury provided to
3trauma patients until their discharge from the facility and
4information on discharge plans;
5    (j) Requiring the trauma center to have helicopter landing
6capabilities approved by appropriate State and federal
7authorities, if the trauma center is located within a
8municipality having a population of less than two million
9people.
10(Source: P.A. 89-177, eff. 7-19-95.)
 
11    (210 ILCS 50/3.101 new)
12    Sec. 3.101. Level III Trauma Center minimum standards. The
13Department shall establish, through rules adopted pursuant to
14this Act, standards for Level III Trauma Centers which shall
15include, but need not be limited to:
16        (1) the designation by the trauma center of a Trauma
17    Center Medical Director and specification of his or her
18    qualifications;
19        (2) the types of surgical services the trauma center
20    must have available for trauma patients; the Department
21    shall not require the availability of all surgical services
22    required of Level I or Level II Trauma Centers;
23        (3) the types of nonsurgical services the trauma center
24    must have available for trauma patients;
25        (4) the numbers and qualifications of emergency

 

 

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

 

 

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1        (10) requiring the trauma center to have helicopter
2    landing capabilities approved by appropriate State and
3    federal authorities, if the trauma center is located within
4    a municipality having a population of less than 2,000,000
5    people.
 
6    (210 ILCS 50/3.102 new)
7    Sec. 3.102. Acute Injury Stabilization Center minimum
8standards. The Department shall establish, through rules
9adopted pursuant to this Act, standards for Acute Injury
10Stabilization Centers which shall include, but need not be
11limited to, Comprehensive or Basic Emergency Department
12services pursuant to the Hospital Licensing Act.
 
13    (210 ILCS 50/3.105)
14    Sec. 3.105. Trauma Center Misrepresentation. No After the
15effective date of this amendatory Act of 1995, no facility
16shall use the phrase "trauma center" or words of similar
17meaning in relation to itself or hold itself out as a trauma
18center without first obtaining designation pursuant to this
19Act.
20(Source: P.A. 89-177, eff. 7-19-95.)
 
21    (210 ILCS 50/3.110)
22    Sec. 3.110. EMS system and trauma center confidentiality
23and immunity.

 

 

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1    (a) All information contained in or relating to any medical
2audit performed of a trauma center's trauma services or an
3Acute Injury Stabilization Center pursuant to this Act or by an
4EMS Medical Director or his designee of medical care rendered
5by System personnel, shall be afforded the same status as is
6provided information concerning medical studies in Article
7VIII, Part 21 of the Code of Civil Procedure. Disclosure of
8such information to the Department pursuant to this Act shall
9not be considered a violation of Article VIII, Part 21 of the
10Code of Civil Procedure.
11    (b) Hospitals, trauma centers and individuals that perform
12or participate in medical audits pursuant to this Act shall be
13immune from civil liability to the same extent as provided in
14Section 10.2 of the Hospital Licensing Act.
15    (c) All information relating to the State Emergency Medical
16Services Disciplinary Review Board or a local review board,
17except final decisions, shall be afforded the same status as is
18provided information concerning medical studies in Article
19VIII, Part 21 of the Code of Civil Procedure. Disclosure of
20such information to the Department pursuant to this Act shall
21not be considered a violation of Article VIII, Part 21 of the
22Code of Civil Procedure.
23(Source: P.A. 92-651, eff. 7-11-02.)
 
24    (210 ILCS 50/3.140)
25    Sec. 3.140. Violations; Fines.

 

 

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1    (a) The Department shall have the authority to impose fines
2on any licensed vehicle service provider, designated trauma
3center, Acute Injury Stabilization Center, resource hospital,
4associate hospital, or participating hospital.
5    (b) The Department shall adopt rules pursuant to this Act
6which establish a system of fines related to the type and level
7of violation or repeat violation, including but not limited to:
8        (1) A fine not exceeding $10,000 for a violation which
9    created a condition or occurrence presenting a substantial
10    probability that death or serious harm to an individual
11    will or did result therefrom; and
12        (2) A fine not exceeding $5,000 for a violation which
13    creates or created a condition or occurrence which
14    threatens the health, safety or welfare of an individual.
15    (c) A Notice of Intent to Impose Fine may be issued in
16conjunction with or in lieu of a Notice of Intent to Suspend,
17Revoke, Nonrenew or Deny, and shall conform to the requirements
18specified in Section 3.130(d) of this Act. All Hearings
19conducted pursuant to a Notice of Intent to Impose Fine shall
20conform to the requirements specified in Section 3.135 of this
21Act.
22    (d) All fines collected pursuant to this Section shall be
23deposited into the EMS Assistance Fund.
24(Source: P.A. 89-177, eff. 7-19-95.)