ADMINISTRATIVE CODE

TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER g: EMERGENCY SERVICES AND HIGHWAY SAFETY
PART 527 PHYSICAL FITNESS FACILITY MEDICAL EMERGENCY PREPAREDNESS CODE

Section 527.100 Definitions

Section 527.200 Incorporated and Referenced Materials

Section 527.300 Physical Fitness Facility

Section 527.400 Medical Emergency Plan

Section 527.500 Coordination with Local Emergency Medical Services Systems

Section 527.600 Automated External Defibrillators Required

Section 527.700 Maintenance and Testing of Automated External Defibrillators

Section 527.800 Training

Section 527.900 Complaints and Inspections

Section 527.1000 Violations

Section 527.1100 Hearings

TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER g: EMERGENCY SERVICES AND HIGHWAY SAFETY
PART 527 PHYSICAL FITNESS FACILITY MEDICAL EMERGENCY PREPAREDNESS CODE
SECTION 527.100 DEFINITIONS

Section 527.100 Definitions

Act – the Physical Fitness Facility Medical Emergency Preparedness Act [210 ILCS 74].

Assistance – any act that aids or supports an individual who is engaging in physical fitness activities, including, but not limited to, instruction on the use of equipment and creation of personal fitness plans.

Automated External Defibrillator or AED – a medical device heart monitor and defibrillator that:

Has received approval of its pre-market notification, filed pursuant to 21 USC 360(k), from the United States Food and Drug Administration;

Is capable of recognizing the presence or absence of ventricular fibrillation and rapid ventricular tachycardia, and is capable of determining, without intervention by an operator, whether defibrillation should be performed;

Upon determining that defibrillation should be performed, either automatically charges and delivers an electrical impulse to an individual, or charges and delivers an electrical impulse at the command of the operator; and

In the case of a defibrillator that may be operated in either an automatic or manual mode, is set to operate in the automatic mode. (Section 10 of the Automated External Defibrillator Act)

"Cardiovascular exertion − physical exercise that uses large muscle groups and that substantially increases the heart rate. (Section 5.25(b) of the Act)

Defibrillation – administering an electrical impulse to an individual in order to stop ventricular fibrillation or rapid ventricular tachycardia. (Section 10 of the Automated External Defibrillator Act)

Department – the Department of Public Health. (Section 5.15 of the Act)

Director – the Director of Public Health. (Section 5.10 of the Act)

Emergency Medical Services (EMS) System or System – an organization of hospitals, vehicle service providers and personnel approved by the Department in a specific geographic area, which coordinates and provides pre-hospital and inter-hospital emergency care and non-emergency medical transports at a BLS (basic life support), ILS (intermediate life support) and/or ALS (advanced life support) level pursuant to a System Program Plan submitted to and approved by the Department and pursuant to the EMS Regional Plan adopted for the EMS Region in which the System is located. (Section 3.20 of the Emergency Medical Services (EMS) Systems Act)

Gaming – a competitive activity involving skill, chance or endurance on the part of two or more persons.

Hospital – has the meaning ascribed to that term in Section 3 of the Hospital Licensing Act [210 ILCS 85].

Medical emergency – the occurrence of a sudden, serious, and unexpected sickness or injury that would lead a reasonable person, possessing an average knowledge of medicine and health, to believe that the sick or injured person requires urgent or unscheduled medical care. (Section 5.20 of the Act)

9-1-1 – an emergency answer and response system in which the caller need only dial 9-1-1 on a telephone to obtain emergency services, including police, fire, medical ambulance and rescue.

Person – an individual, partnership, association, corporation, limited liability company, or organized group of persons (whether incorporated or not).

Physical fitness facility or facility – has the meaning ascribed to that term in Section 527.300.

Staffed Business Hours − those times when facilities are utilized and the owner or agent of the owner or an employee is present, other than maintenance or security personnel acting in those capacities.

Supervising – directing, inspecting, coaching, judging, refereeing, or being in charge of individuals while those individuals are engaging in physical fitness activities.

Third party operator – an individual or organization that has an agreement to use a physical fitness facility that the individual or organization does not own.

Trained AED user – a person who has successfully completed a course of instruction in cardiopulmonary resuscitation that includes an AED component in accordance with the standards of a nationally recognized organization such as the American Red Cross or the American Heart Association or a course of instruction in accordance with the Automated External Defibrillator Code (77 Ill. Adm. Code 525) to use an automated external defibrillator, or who is licensed to practice medicine in all its branches in this State. (Section 10 of the Automated External Defibrillator Act)

(Source: Amended at 34 Ill. Reg. 11419, effective July 21, 2010)

Section 527.200 Incorporated and Referenced Materials

a) The following private and professional organization standards are incorporated in this Part:

1) 2005 AHA Guidelines for CPR and ECC

American Heart Association

208 South LaSalle St.

Suite 900

Chicago, Illinois 60604-1197

2) American Red Cross First Aid/CPR/AED for the Workplace (2006)

American Red Cross

311 W. John Gwynn Avenue

Peoria, Illinois 61605-2566

b) All incorporations by reference of the standards of nationally recognized organizations refer to the standards on the date specified and do not include any subsequent amendments or editions.

c) The following State of Illinois statutes are referenced in this Part:

1) Automated External Defibrillator Act [410 ILCS 4]

2) Emergency Medical Services (EMS) Systems Act [210 ILCS 50]

3) Hospital Licensing Act [210 ILCS 85]

4) Illinois Administrative Procedure Act [5 ILCS 100]

5) Park District Code [70 ILCS 1205]

6) Chicago Park District Act [70 ILCS 1505]

7) Metro-East Park and Recreation District Act [70 ILCS 1605]

8) Downstate Forest Preserve District Act [70 ILCS 805]

9) Cook County Forest Preserve District Act [70 ILCS 810]

10) Conservation District Act [70 ILCS 410]

d) The following State of Illinois rules are referenced in this Part:

1) Automated External Defibrillator Code (77 Ill. Adm. Code 525).

2) Practice and Procedure in Administrative Hearings (77 Ill. Adm. Code 100).

(Source: Amended at 37 Ill. Reg. 1247, effective January 18, 2013)

Section 527.300 Physical Fitness Facility

a) For the purposes of this Part, the term "physical fitness facility" or "facility" includes any indoor establishment that meets all of the following requirements:

1) In whole or in part, is owned or operated by a park district, municipality, or other unit of local government, including a home rule unit, or by a public or private elementary or secondary school, college, university, or technical or trade school.

3) Includes, but is not limited to, the following indoor facilities: a swimming pool; stadium; athletic field; football stadium; soccer field; baseball diamond; track and field facility; tennis court; basketball court; volleyball court; aerobics studio; dance studio; boxing gym; martial-arts or self-defense studio; wrestling gym; weight-lifting facility; treadmill or stationary bicycle facility; velodrome; racquetball court; gymnastics facility; or any other indoor establishment focusing primarily on cardiovascular exertion where participants engage in relatively continuous active physical exercise that uses large muscle groups and that substantially increases the heart rate. (Section 5.25 of the Act)

b) For the purposes of this Part, "physical fitness facility" or "facility" includes any of the following outdoor facilities that is:

1) Owned by a municipality, township or other unit of local government, including a home rule unit, or by a public or private elementary school or secondary school, college, university, or technical or trade school; and

2) Is supervised by one or more persons, other than maintenance or security personnel, employed by the unit of local government, school, college, or university for the purpose of directly supervising the physical fitness activities taking place at any of these facilities: a swimming pool; athletic field; football stadium; soccer field; baseball diamond; track and field facility; tennis court; basketball court; volleyball court; golf course; or any other outdoor establishment focusing primarily on cardiovascular exertion where participants engage in relatively continuous active physical exercise that uses large muscle groups and that substantially increases the heart rate. (Section 5.25 of the Act)

c) Except as provided in subsection (d) of this Section, a physical fitness facility also includes any other indoor or outdoor establishment, whether public or private, that provides services or facilities focusing on cardiovascular exertion or gaming. (Section 5.25 of the Act)

d) For the purposes of this Part, the term "physical fitness facility" or "facility" does not include:

1) A facility that serves fewer than 100 individual participants over the course of a calendar year. For purposes of the Act and this Part, "individuals" includes only those persons actively engaged in physical exercise that uses large muscle groups and that substantially increases the heart rate. (Section 5.25 of the Act) A facility relying on this subsection (d)(1) shall maintain adequate documentation for every year that the facility relies on this subsection. Such documentation shall be preserved by the facility for not less than three years and be provided to the Department upon request;

2) Any outdoor facility owned or operated by a park district organized under the Park District Code, the Chicago Park District Act, or the Metro-East Park and Recreation District Act;

3) Any facility owned or operated by a forest preserve district organized under the Downstate Forest Preserve District Act or the Cook County Forest Preserve District Act or a conservation district organized under the Conservation District Act;

4) A facility located in a hospital or in a hotel or motel;

5) Any facility that does not employ any persons to provide instruction, training, coaching, refereeing, judging, or assistance for persons using the facility (Section 5.25 of the Act);

6) Yoga studios; driving ranges; bowling lanes; putting greens; batting cages; or other facilities where and when participants do not focus primarily on cardiovascular exertion by engaging in active physical exercise that uses large muscle groups and that substantially increases the heart rate;

7) Any facility during any activity or program organized by a private or not-for-profit organization and organized and supervised by a person or persons other than the employees of the unit of local government, school, college, or university. (Section 5.25 of the Act)

(Source: Amended at 38 Ill. Reg. 5527, effective February 11, 2014)

Section 527.400 Medical Emergency Plan

a) The operator of a facility shall adopt and implement a plan for responding to a medical emergency at the facility. The plan shall encompass the use of an AED and shall provide a timely, proper response to the occurrence of any other sudden, serious, and unexpected sickness or injury that would lead a reasonable person, possessing an average knowledge of medicine and health, to believe that the sick or injured person requires urgent or unscheduled medical care. The plan shall also designate office contacts for the specific facility staff to be notified in a medical emergency. The plan shall be filed with the Department by submitting a copy to the following address:

Illinois Department of Public Health

Division of EMS & Highway Safety

422 S. 5^th St. − 3^rd Floor

Springfield IL 62701

b) Facility staff shall ensure that 9-1-1 is called immediately for medical emergencies, including each time an AED is used at the facility. Third party or other authorized users of the facility shall promptly notify the facility operator if the AED is used.

c) The plan shall be updated with the Department after a change in the facility that affects the ability to comply with a medical emergency such as, but not limited to, facility closure for more than 45 days, inoperable AED for more than 45 days, or lack of trained staff for more than 45 days.

(Source: Amended at 34 Ill. Reg. 11419, effective July 21, 2010)

Section 527.500 Coordination with Local Emergency Medical Services Systems

A facility possessing an AED shall notify an agent of the local emergency communications or vehicle dispatch center of the existence, location, and type of the automated external defibrillator. (Section 20(b) of the Automated External Defibrillator Act)

(Source: Amended at 34 Ill. Reg. 11419, effective July 21, 2010)

Section 527.600 Automated External Defibrillators Required

a) Each facility shall have at least one operable AED on the premises at all times.

b) If the AED becomes inoperable, the facility shall replace or repair the AED within 10 days. Patrons shall be notified when an operable AED is not on the premises. The AED shall be mobile and accessible at all times when the AED is operable.

c) In the case of an outdoor physical fitness facility, the AED must be housed in a building, if any, that is within 300 feet of the outdoor facility where an event or activity is being conducted. If there is such a building within the required distance, the building must provide unimpeded and open access to the housed AED during the time the event or activity is being conducted. The building's entrances shall further provide marked directions to the housed AED. (Section 15(b-10) of the Act)

d) Facilities described in Section 5.25(1.5) of the Act must have an AED on site as well as a trained AED user available only during activities or events sponsored and conducted or supervised by a person or persons employed by the unit of local government, school, college, or university. (Section 15(b-15) of the Act)

e) If multiple facilities are located on the same floor of a building, one AED can be used for multiple facilities so long as the AED is located not more than 300 feet from each facility and access to the AED is unimpeded from each facility.

f) A physical fitness facility must ensure that there is a trained AED user on staff during staffed business hours. For purposes of the Act and this Part, "trained AED user" has the meaning ascribed to that term in Section 10 of the Automated External Defibrillator Act and Section 527.100 of this Part.

g) Facility owners/operators may enter into written contracts with third party operators to ensure that a proper number of AEDs and trained AED users are present during all third party sponsored activities that are not otherwise supervised by the owners/operators of the facility.

h) Questions concerning this Part shall be directed to the following address:

Illinois Department of Public Health

Division of EMS & Highway Safety

422 S. 5^th St. − 3^rd Floor

Springfield IL 62701

i) Entities requesting a formal Department determination on the application of the Act shall be subject to inspection under Section 527.900.

(Source: Amended at 37 Ill. Reg. 1247, effective January 18, 2013)

Section 527.700 Maintenance and Testing of Automated External Defibrillators

a) The AED shall be maintained and tested according to the manufacturer's guidelines.

b) The owner of the AED shall retain a copy of the maintenance and testing manual at the physical fitness facility and shall keep a copy of the manual with the AED.

Section 527.800 Training

a) Physical fitness facility staff shall be trained in cardiopulmonary resuscitation and the use of an AED according to Sections 525.300 and 525.400 of the Automated External Defibrillator Code. The facility shall have at least one trained AED user on staff during staffed business hours, and also shall ensure that appropriate numbers of facility staff and applicable supervisors are trained to avoid lapses in compliance with this Part.

b) Each member of the facility staff shall be trained concerning the location of the AED and the requirements of the facility's medical emergency plan. Third party operators and authorized users of the facility shall also be informed, by postings or other notifications, of the location of the AED and of the emergency plan.

c) The facility staff shall take reasonable measures to ensure that the AED is operated only by trained AED users for the intended purposes of the AED. This provision shall not be construed to prohibit the use of the AED by others in a medical emergency requiring the use of the AED.

d) Any non-employee coach, non-employee instructor, non-employee judge, non-employee referee, or other similarly situated non-employee anticipated rescuer who uses a physical fitness facility in conjunction with the supervision of physical fitness activities is encouraged to complete a course of instruction that would qualify such a person as a trained AED user, as defined in Section 10 of the Automated External Defibrillator Act and Section 527.100 of this Part. (Section 15(b-5) of the Act)

(Source: Amended at 34 Ill. Reg. 11419, effective July 21, 2010)

Section 527.900 Complaints and Inspections

a) Complaints against a facility alleging violations of the Act must be in writing and include the name, address, and telephone number of the complainant. These written complaints shall be submitted to the Illinois Department of Public Health at the following address:

Illinois Department of Public Health

Division of EMS & Highway Safety

500 East Monroe – 8^th Floor

Springfield IL 62701

b) The Department or delegated representative will inspect a facility after receipt of a valid complaint. A complaint that does not include the complainant's name, address and telephone number or does not allege a specific violation of the Act will be deemed invalid. If a complaint is invalidated, then no inspection will be conducted and no further response to the complainant will be necessary.

c) The Department or delegated representative also will inspect an entity requesting a formal determination of whether the Act applies to the entity. The determination shall be made in writing by the Director or the Director's designee, shall state the reasons for the determination, and may include the entity's reasons for disagreement, if any. If the entity disagrees with a determination that the Act's requirements apply, and the entity fails to comply with the Act, then the Department shall issue the facility an administrative warning. In the entity's comments to the administrative warning, it also may state the reasons for disagreeing with the Department's determination. Second or subsequent violations of the Act shall be subject to civil monetary penalties.

Section 527.1000 Violations

a) A person violates the Act by:

1) failing to comply with the Act;

2) failing to adopt or implement a proper medical emergency plan;

3) failing to have the requisite number of AEDs on the premises; or

4) failing to have appropriate numbers of trained AED users and applicable supervisors on staff and to avoid lapses in compliance with this Code.

b) Upon receipt of a written administrative warning to a facility for an initial violation of the Act, the facility has 10 business days to respond with written comments concerning the facility's remedial response. In the entity's comments to the administrative warning, it may state, for the Department's consideration, the reasons for disagreeing with the Department's determination. The facility may waive the right to submit a written response. Whether or not the facility waives the right to respond, the facility shall immediately remediate the circumstances to cure the violation.

c) Upon receipt of notice of a subsequent violation of the Act, the facility has 10 business days either to pay any assigned civil monetary penalty or to request an administrative hearing. If the facility fails to pay the civil monetary penalty or to submit a request for a hearing within 10 days after receipt of the notice, then the Department will issue a final order closing the case and will refer the matter to the Attorney General for collection of any monetary penalty.

d) The Department may assess a civil monetary penalty for a second or subsequent violation based on factors including, but not limited to, compliance history, nature of the offense or severity of the injury resulting from the offenses.

e) The civil monetary penalty for a second violation of the Act is $1,500, and the penalty for a third or subsequent violation of the Act is $2,000. The Department may assess only a total $1,500 penalty for a second violation irrespective of the number of deficiencies found. For a third or subsequent violation, however, the Department may assess a separate $2,000 monetary penalty for each deficiency if more than one violation of the Act is found at a facility during the third or subsequent inspection.

f) Written comments to an administrative warning, requests for hearings, or fines shall be submitted to the following address:

Illinois Department of Public Health

Division of EMS & Highway Safety

422 S. 5^th St. – 3^rd Floor

Springfield IL 62701

(Source: Amended at 37 Ill. Reg. 1247, effective January 18, 2013)

Section 527.1100 Hearings

77 Ill. Adm. Code 100 (Practice and Procedure in Administrative Hearings) and Article 10 of the Illinois Administrative Procedure Act (IAPA) shall apply to all proceedings conducted under this Part. Where the terms "license" and "licensing" are used in 77 Ill. Adm. Code 100 and the IAPA, the definitions of those terms and other terms in 77 Ill. Adm. Code 100 shall be expanded to include hearings concerning physical fitness facilities. In case of conflict between 77 Ill. Adm. Code 100 and the Act or the IAPA and the Act, the terms of the Act shall control.

(Source: Amended at 37 Ill. Reg. 1247, effective January 18, 2013)