HB5050 97TH GENERAL ASSEMBLY

LRB097 14989 RPM 60031 b

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.

A BILL FOR

AN ACT concerning public health.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Alternative Health Care Delivery Act is amended by changing Section 10 and by adding Sections 85 and 90 as follows:

(210 ILCS 3/10)

Sec. 10. Definitions. In this Act, unless the context otherwise requires:

"Alternative health care model" means a facility or program authorized under Section 35 of this Act.

"Ambulatory surgical treatment center" or "ASTC" means any institution, place, or building licensed pursuant to the Ambulatory Surgical Treatment Center Act.

"Board" means the State Board of Health.

"Department" means the Illinois Department of Public Health.

"Demonstration program" means a program to license and study alternative health care models authorized under this Act.

"Director" means the Director of Public Health.

"Postsurgical recovery care center model" means a designated site that provides postsurgical recovery care for generally healthy patients undergoing surgical procedures who require post-operative nursing care, pain control, or observation that would otherwise be provided in an in-patient setting.

(Source: P.A. 87-1188.)

(210 ILCS 3/85 new)

Sec. 85. Approval of protocols for the admission of postsurgical patients.

(a) The Department shall enforce by rule the provisions of this Section with respect to each postsurgical recovery care center model.

(b) An admission protocol specifying the criteria for admitting a postsurgical patient to the postsurgical recovery care center model shall be included in each application for a license to operate a postsurgical recovery care center model. The admission protocol must address at least the following:

(1) The admission of all patients to the postsurgical recovery care center model shall be performed by a member of the medical staff with admitting privileges, and all such patients shall be under the professional care of a member of the medical staff.

(2) The criteria for admission that include limiting services provided as follows:

(A) the patient must have been discharged from the post-anesthesia care unit or recovery room of the ASTC or hospital where the procedure was performed; the patient may not be directly admitted to the postsurgical recovery care center model from the operating room;

(B) patients must be 3 years of age or older;

(C) patients with an active, acute, or chronic infectious condition shall not be eligible for admission;

(D) patients must fall within anesthesia class I or II or fall within anesthesia class III with only mild to moderate systematic disease but medically stable;

(E) patients may require a postoperative overnight stay;

(F) patients shall require a stay of not more than 48 hours; however, this may be extended to 72 hours when the necessity of the extension is documented by the treating physician and approved by the Medical Director;

(G) the level of care needed by the patient is consistent with the definition of a postsurgical recovery care center model, and hospitalization is not required;

(H) the patient is physiologically stable at the time of admission and has experienced no intraoperative or postoperative complications that would cause the patient to be ineligible for admission based on this Act; and

(I) the patient does not require the administration of blood in relation to an intraoperative or postoperative complication, but may require the administration of blood in the ordinary course of their care.

(3) The types of surgical procedures performed in ambulatory surgical treatment centers or hospitals that the postsurgical recovery care center model intends to admit, including documentation that the expected postoperative stay is less than 48 hours and the postoperative complication rate is minimal.

(4) The patient's medical record at the time of admission, including the following:

(A) a current history and physical examination conducted or approved by members of the medical staff;

(B) patient diagnosis;

(C) a discharge summary from the referring facility or physician, including the surgical procedure performed, the type of anesthesia used, medications given, recovery events, and any other pertinent information regarding the patient's status;

(D) physician orders;

(E) documentation concerning advance directives; and

(F) any other underlying medical condition that could be relevant to the patient's care.

(c) The admission protocol and any subsequent revisions shall be approved by the applicant's consulting committee prior to submission to the Department, and documentation of the approval must be submitted with the request for the Department's approval.

(d) The initial and any revised admission protocols may not be put into effect without prior approval of the Department as provided in this Section.

(e) The Department shall review all admission protocols submitted with the application, renewal application, and any separate submission under this Section to ensure that the admission protocol provides for the admission of only postsurgical patients who can safely be cared for outside of a licensed acute care hospital. The Department shall disapprove any admission protocol that allows an admission that would be life threatening in nature or that does not meet the requirements set forth in subsection (b) of this Section.

(f) Upon receipt of the information from the applicant, the Department shall either approve the admission protocol or disapprove the admission protocol as provided under subsection (e) of this Section. The Department shall seek the recommendations of medical specialists and other professional consultants concerning the safety of specific admission protocols when it determines that such consultation is necessary. The Department shall also consider any additional information submitted by medical specialists and other professionals and by medical specialty and other professional societies in making these determinations.

(210 ILCS 3/90 new)

Sec. 90. Laboratory, pharmacy, and radiological services.

(a) The Department shall enforce by rule the provisions of this Section with respect to each postsurgical recovery care center model.

(b) Each postsurgical recovery care center model shall meet the following requirements:

(1) possess a valid Clinical Laboratory Improvement Amendments (CLIA) certificate for those tests performed by the postsurgical recovery care center model; and

(2) have a written agreement with a laboratory that possesses a valid CLIA certificate to perform any required laboratory procedures that are not performed in the postsurgical recovery care center model.

(c) Blood may be administered in the postsurgical recovery care center model for non-emergent reasons related to the ordinary course of patient care but not for intraoperative or postoperative complications. Blood products may be administered in the postsurgical recovery care center model.

(d) Pharmacy services shall be provided directly by the postsurgical recovery care center model or by contract with a pharmacy licensed pursuant to the Pharmacy Practice Act.

(e) Pharmacy services not provided by contract must be under the direction of a registered pharmacist employed by the postsurgical recovery care center model on a full-time, part-time, or consulting basis.

(f) All drugs and medicines shall be stored and dispensed in accordance with applicable State and federal laws and regulations.

(g) All blood and blood products shall be stored, administered, and monitored in accordance with State and federal laws and regulations.

(h) Radiologic services sufficient to perform and interpret the radiological examinations necessary to meet the needs of the patients must be provided.

(i) All X-rays shall be read by a member of the medical staff or a consulting radiologist approved by the consulting committee.