Public Act 097-0987
 
HB5050 EnrolledLRB097 14989 RPM 60031 b

    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 Sections 10 and 35 as follows:
 
    (210 ILCS 3/10)
    Sec. 10. Definitions. In this Act, unless the context
otherwise requires:
    "Ambulatory surgical treatment center" or "ASTC" means any
institution, place, or building licensed under the Ambulatory
Surgical Treatment Center Act.
    "Alternative health care model" means a facility or program
authorized under Section 35 of this 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.
(Source: P.A. 87-1188.)
 
    (210 ILCS 3/35)
    Sec. 35. Alternative health care models authorized.
Notwithstanding any other law to the contrary, alternative
health care models described in this Section may be established
on a demonstration basis.
        (1) (Blank).
        (2) Alternative health care delivery model;
    postsurgical recovery care center. A postsurgical recovery
    care center is a designated site which provides
    postsurgical recovery care for generally healthy patients
    undergoing surgical procedures that potentially require
    overnight nursing care, pain control, or observation that
    would otherwise be provided in an inpatient setting.
    Patients may be discharged from the postsurgical recovery
    care center in less than 24 hours if the attending
    physician or the facility's medical director believes the
    patient has recovered enough to be discharged. A
    postsurgical recovery care center is either freestanding
    or a defined unit of an ambulatory surgical treatment
    center or hospital. No facility, or portion of a facility,
    may participate in a demonstration program as a
    postsurgical recovery care center unless the facility has
    been licensed as an ambulatory surgical treatment center or
    hospital for at least 2 years before August 20, 1993 (the
    effective date of Public Act 88-441). The maximum length of
    stay for patients in a postsurgical recovery care center is
    not to exceed 48 hours unless the treating physician
    requests an extension of time from the recovery center's
    medical director on the basis of medical or clinical
    documentation that an additional care period is required
    for the recovery of a patient and the medical director
    approves the extension of time. In no case, however, shall
    a patient's length of stay in a postsurgical recovery care
    center be longer than 72 hours. If a patient requires an
    additional care period after the expiration of the 72-hour
    limit, the patient shall be transferred to an appropriate
    facility. Reports on variances from the 24-hour or 48-hour
    limit shall be sent to the Department for its evaluation.
    The reports shall, before submission to the Department,
    have removed from them all patient and physician
    identifiers. Blood products may be administered in the
    postsurgical recovery care center model. In order to handle
    cases of complications, emergencies, or exigent
    circumstances, every postsurgical recovery care center as
    defined in this paragraph shall maintain a contractual
    relationship, including a transfer agreement, with a
    general acute care hospital. A postsurgical recovery care
    center shall be no larger than 20 beds. A postsurgical
    recovery care center shall be located within 15 minutes
    travel time from the general acute care hospital with which
    the center maintains a contractual relationship, including
    a transfer agreement, as required under this paragraph.
        No postsurgical recovery care center shall
    discriminate against any patient requiring treatment
    because of the source of payment for services, including
    Medicare and Medicaid recipients.
        The Department shall adopt rules to implement the
    provisions of Public Act 88-441 concerning postsurgical
    recovery care centers within 9 months after August 20,
    1993. Notwithstanding any other law to the contrary, a
    postsurgical recovery care center model may provide sleep
    laboratory or similar sleep studies in accordance with
    applicable State and federal laws and regulations.
        (3) Alternative health care delivery model; children's
    community-based health care center. A children's
    community-based health care center model is a designated
    site that provides nursing care, clinical support
    services, and therapies for a period of one to 14 days for
    short-term stays and 120 days to facilitate transitions to
    home or other appropriate settings for medically fragile
    children, technology dependent children, and children with
    special health care needs who are deemed clinically stable
    by a physician and are younger than 22 years of age. This
    care is to be provided in a home-like environment that
    serves no more than 12 children at a time. Children's
    community-based health care center services must be
    available through the model to all families, including
    those whose care is paid for through the Department of
    Healthcare and Family Services, the Department of Children
    and Family Services, the Department of Human Services, and
    insurance companies who cover home health care services or
    private duty nursing care in the home.
        Each children's community-based health care center
    model location shall be physically separate and apart from
    any other facility licensed by the Department of Public
    Health under this or any other Act and shall provide the
    following services: respite care, registered nursing or
    licensed practical nursing care, transitional care to
    facilitate home placement or other appropriate settings
    and reunite families, medical day care, weekend camps, and
    diagnostic studies typically done in the home setting.
        Coverage for the services provided by the Department of
    Healthcare and Family Services under this paragraph (3) is
    contingent upon federal waiver approval and is provided
    only to Medicaid eligible clients participating in the home
    and community based services waiver designated in Section
    1915(c) of the Social Security Act for medically frail and
    technologically dependent children or children in
    Department of Children and Family Services foster care who
    receive home health benefits.
        (4) Alternative health care delivery model; community
    based residential rehabilitation center. A community-based
    residential rehabilitation center model is a designated
    site that provides rehabilitation or support, or both, for
    persons who have experienced severe brain injury, who are
    medically stable, and who no longer require acute
    rehabilitative care or intense medical or nursing
    services. The average length of stay in a community-based
    residential rehabilitation center shall not exceed 4
    months. As an integral part of the services provided,
    individuals are housed in a supervised living setting while
    having immediate access to the community. The residential
    rehabilitation center authorized by the Department may
    have more than one residence included under the license. A
    residence may be no larger than 12 beds and shall be
    located as an integral part of the community. Day treatment
    or individualized outpatient services shall be provided
    for persons who reside in their own home. Functional
    outcome goals shall be established for each individual.
    Services shall include, but are not limited to, case
    management, training and assistance with activities of
    daily living, nursing consultation, traditional therapies
    (physical, occupational, speech), functional interventions
    in the residence and community (job placement, shopping,
    banking, recreation), counseling, self-management
    strategies, productive activities, and multiple
    opportunities for skill acquisition and practice
    throughout the day. The design of individualized program
    plans shall be consistent with the outcome goals that are
    established for each resident. The programs provided in
    this setting shall be accredited by the Commission on
    Accreditation of Rehabilitation Facilities (CARF). The
    program shall have been accredited by CARF as a Brain
    Injury Community-Integrative Program for at least 3 years.
        (5) Alternative health care delivery model;
    Alzheimer's disease management center. An Alzheimer's
    disease management center model is a designated site that
    provides a safe and secure setting for care of persons
    diagnosed with Alzheimer's disease. An Alzheimer's disease
    management center model shall be a facility separate from
    any other facility licensed by the Department of Public
    Health under this or any other Act. An Alzheimer's disease
    management center shall conduct and document an assessment
    of each resident every 6 months. The assessment shall
    include an evaluation of daily functioning, cognitive
    status, other medical conditions, and behavioral problems.
    An Alzheimer's disease management center shall develop and
    implement an ongoing treatment plan for each resident. The
    treatment plan shall have defined goals. The Alzheimer's
    disease management center shall treat behavioral problems
    and mood disorders using nonpharmacologic approaches such
    as environmental modification, task simplification, and
    other appropriate activities. All staff must have
    necessary training to care for all stages of Alzheimer's
    Disease. An Alzheimer's disease management center shall
    provide education and support for residents and
    caregivers. The education and support shall include
    referrals to support organizations for educational
    materials on community resources, support groups, legal
    and financial issues, respite care, and future care needs
    and options. The education and support shall also include a
    discussion of the resident's need to make advance
    directives and to identify surrogates for medical and legal
    decision-making. The provisions of this paragraph
    establish the minimum level of services that must be
    provided by an Alzheimer's disease management center. An
    Alzheimer's disease management center model shall have no
    more than 100 residents. Nothing in this paragraph (5)
    shall be construed as prohibiting a person or facility from
    providing services and care to persons with Alzheimer's
    disease as otherwise authorized under State law.
        (6) Alternative health care delivery model; birth
    center. A birth center shall be exclusively dedicated to
    serving the childbirth-related needs of women and their
    newborns and shall have no more than 10 beds. A birth
    center is a designated site that is away from the mother's
    usual place of residence and in which births are planned to
    occur following a normal, uncomplicated, and low-risk
    pregnancy. A birth center shall offer prenatal care and
    community education services and shall coordinate these
    services with other health care services available in the
    community.
            (A) A birth center shall not be separately licensed
        if it is one of the following:
                (1) A part of a hospital; or
                (2) A freestanding facility that is physically
            distinct from a hospital but is operated under a
            license issued to a hospital under the Hospital
            Licensing Act.
            (B) A separate birth center license shall be
        required if the birth center is operated as:
                (1) A part of the operation of a federally
            qualified health center as designated by the
            United States Department of Health and Human
            Services; or
                (2) A facility other than one described in
            subparagraph (A)(1), (A)(2), or (B)(1) of this
            paragraph (6) whose costs are reimbursable under
            Title XIX of the federal Social Security Act.
        In adopting rules for birth centers, the Department
    shall consider: the American Association of Birth Centers'
    Standards for Freestanding Birth Centers; the American
    Academy of Pediatrics/American College of Obstetricians
    and Gynecologists Guidelines for Perinatal Care; and the
    Regionalized Perinatal Health Care Code. The Department's
    rules shall stipulate the eligibility criteria for birth
    center admission. The Department's rules shall stipulate
    the necessary equipment for emergency care according to the
    American Association of Birth Centers' standards and any
    additional equipment deemed necessary by the Department.
    The Department's rules shall provide for a time period
    within which each birth center not part of a hospital must
    become accredited by either the Commission for the
    Accreditation of Freestanding Birth Centers or The Joint
    Commission.
        A birth center shall be certified to participate in the
    Medicare and Medicaid programs under Titles XVIII and XIX,
    respectively, of the federal Social Security Act. To the
    extent necessary, the Illinois Department of Healthcare
    and Family Services shall apply for a waiver from the
    United States Health Care Financing Administration to
    allow birth centers to be reimbursed under Title XIX of the
    federal Social Security Act.
        A birth center that is not operated under a hospital
    license shall be located within a ground travel time
    distance from the general acute care hospital with which
    the birth center maintains a contractual relationship,
    including a transfer agreement, as required under this
    paragraph, that allows for an emergency caesarian delivery
    to be started within 30 minutes of the decision a caesarian
    delivery is necessary. A birth center operating under a
    hospital license shall be located within a ground travel
    time distance from the licensed hospital that allows for an
    emergency caesarian delivery to be started within 30
    minutes of the decision a caesarian delivery is necessary.
        The services of a medical director physician, licensed
    to practice medicine in all its branches, who is certified
    or eligible for certification by the American College of
    Obstetricians and Gynecologists or the American Board of
    Osteopathic Obstetricians and Gynecologists or has
    hospital obstetrical privileges are required in birth
    centers. The medical director in consultation with the
    Director of Nursing and Midwifery Services shall
    coordinate the clinical staff and overall provision of
    patient care. The medical director or his or her physician
    designee shall be available on the premises or within a
    close proximity as defined by rule. The medical director
    and the Director of Nursing and Midwifery Services shall
    jointly develop and approve policies defining the criteria
    to determine which pregnancies are accepted as normal,
    uncomplicated, and low-risk, and the anesthesia services
    available at the center. No general anesthesia may be
    administered at the center.
        If a birth center employs certified nurse midwives, a
    certified nurse midwife shall be the Director of Nursing
    and Midwifery Services who is responsible for the
    development of policies and procedures for services as
    provided by Department rules.
        An obstetrician, family practitioner, or certified
    nurse midwife shall attend each woman in labor from the
    time of admission through birth and throughout the
    immediate postpartum period. Attendance may be delegated
    only to another physician or certified nurse midwife.
    Additionally, a second staff person shall also be present
    at each birth who is licensed or certified in Illinois in a
    health-related field and under the supervision of the
    physician or certified nurse midwife in attendance, has
    specialized training in labor and delivery techniques and
    care of newborns, and receives planned and ongoing training
    as needed to perform assigned duties effectively.
        The maximum length of stay in a birth center shall be
    consistent with existing State laws allowing a 48-hour stay
    or appropriate post-delivery care, if discharged earlier
    than 48 hours.
        A birth center shall participate in the Illinois
    Perinatal System under the Developmental Disability
    Prevention Act. At a minimum, this participation shall
    require a birth center to establish a letter of agreement
    with a hospital designated under the Perinatal System. A
    hospital that operates or has a letter of agreement with a
    birth center shall include the birth center under its
    maternity service plan under the Hospital Licensing Act and
    shall include the birth center in the hospital's letter of
    agreement with its regional perinatal center.
        A birth center may not discriminate against any patient
    requiring treatment because of the source of payment for
    services, including Medicare and Medicaid recipients.
        No general anesthesia and no surgery may be performed
    at a birth center. The Department may by rule add birth
    center patient eligibility criteria or standards as it
    deems necessary. The Department shall by rule require each
    birth center to report the information which the Department
    shall make publicly available, which shall include, but is
    not limited to, the following:
            (i) Birth center ownership.
            (ii) Sources of payment for services.
            (iii) Utilization data involving patient length of
        stay.
            (iv) Admissions and discharges.
            (v) Complications.
            (vi) Transfers.
            (vii) Unusual incidents.
            (viii) Deaths.
            (ix) Any other publicly reported data required
        under the Illinois Consumer Guide.
            (x) Post-discharge patient status data where
        patients are followed for 14 days after discharge from
        the birth center to determine whether the mother or
        baby developed a complication or infection.
        Within 9 months after the effective date of this
    amendatory Act of the 95th General Assembly, the Department
    shall adopt rules that are developed with consideration of:
    the American Association of Birth Centers' Standards for
    Freestanding Birth Centers; the American Academy of
    Pediatrics/American College of Obstetricians and
    Gynecologists Guidelines for Perinatal Care; and the
    Regionalized Perinatal Health Care Code.
        The Department shall adopt other rules as necessary to
    implement the provisions of this amendatory Act of the 95th
    General Assembly within 9 months after the effective date
    of this amendatory Act of the 95th General Assembly.
(Source: P.A. 97-135, eff. 7-14-11.)

Effective Date: 1/1/2013