Rep. Julie Hamos

Filed: 5/18/2007

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 264

2     AMENDMENT NO. ______. Amend Senate Bill 264, AS AMENDED, in
3 Section 5, Sec. 35, by replacing all of item (6) with the
4 following:
5         "(6) Alternative health care delivery model; birth
6     center. A birth center shall be exclusively dedicated to
7     serving the childbirth-related needs of women and their
8     newborns and shall have no more than 10 beds. A birth
9     center is a designated site that is away from the mother's
10     usual place of residence and in which births are planned to
11     occur following a normal, uncomplicated, and low-risk
12     pregnancy. A birth center shall offer prenatal care and
13     community education services and shall coordinate these
14     services with other health care services available in the
15     community.
16             (A) A birth center shall not be separately licensed
17         if it is one of the following:
18                 (1) A part of a hospital; or

 

 

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1                 (2) A freestanding facility that is physically
2             distinct from a hospital but is operated under a
3             license issued to a hospital under the Hospital
4             Licensing Act.
5             (B) A separate birth center license shall be
6         required if the birth center is operated as:
7                 (1) A part of the operation of a federally
8             qualified health center as designated by the
9             United States Department of Health and Human
10             Services; or
11                 (2) A facility other than one described in
12             subparagraph (A)(1), (A)(2), or (B)(1) of this
13             paragraph (6) whose costs are reimbursable under
14             Title XIX of the federal Social Security Act.
15         In adopting rules for birth centers, the Department
16     shall consider: the American Association of Birth Centers'
17     Standards for Freestanding Birth Centers; the American
18     Academy of Pediatrics/American College of Obstetricians
19     and Gynecologists Guidelines for Perinatal Care; and the
20     Regionalized Perinatal Health Care Code. The Department's
21     rules shall stipulate the eligibility criteria for birth
22     center admission. The Department's rules shall stipulate
23     the necessary equipment for emergency care according to the
24     American Association of Birth Centers' standards and any
25     additional equipment deemed necessary by the Department.
26     The Department's rules shall provide for a time period

 

 

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1     within which each birth center not part of a hospital must
2     become accredited by either the Commission for the
3     Accreditation of Freestanding Birth Centers or The Joint
4     Commission.
5         A birth center shall be certified to participate in the
6     Medicare and Medicaid programs under Titles XVIII and XIX,
7     respectively, of the federal Social Security Act. To the
8     extent necessary, the Illinois Department of Healthcare
9     and Family Services shall apply for a waiver from the
10     United States Health Care Financing Administration to
11     allow birth centers to be reimbursed under Title XIX of the
12     federal Social Security Act.
13         A birth center that is not operated under a hospital
14     license shall be located within a ground travel time
15     distance from the general acute care hospital with which
16     the birth center maintains a contractual relationship,
17     including a transfer agreement, as required under this
18     paragraph, that allows for an emergency caesarian delivery
19     to be started within 30 minutes of the decision a caesarian
20     delivery is necessary. A birth center operating under a
21     hospital license shall be located within a ground travel
22     time distance from the licensed hospital that allows for an
23     emergency caesarian delivery to be started within 30
24     minutes of the decision a caesarian delivery is necessary.
25         The services of a medial director physician, licensed
26     to practice medicine in all its branches, who is certified

 

 

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1     or eligible for certification by the American College of
2     Obstetricians and Gynecologists or the American Board of
3     Osteopathic Obstetricians and Gynecologists or has
4     hospital obstetrical privileges are required in birth
5     centers. The medical director in consultation with the
6     Director of Nursing and Midwifery Services shall
7     coordinate the clinical staff and overall provision of
8     patient care. The medical director or his or her physician
9     designee shall be available on the premises or within a
10     close proximity as defined by rule. The medical director
11     and the Director of Nursing and Midwifery Services shall
12     jointly develop and approve policies defining the criteria
13     to determine which pregnancies are accepted as normal,
14     uncomplicated, and low-risk, and the anesthesia services
15     available at the center. No general anesthesia may be
16     administered at the center.
17         If a birth center employs certified nurse midwives, a
18     certified nurse midwife shall be the Director of Nursing
19     and Midwifery Services who is responsible for the
20     development of policies and procedures for services as
21     provided by Department rules.
22         An obstetrician, family practitioner, or certified
23     nurse midwife shall attend each woman in labor from the
24     time of admission through birth and throughout the
25     immediate postpartum period. Attendance may be delegated
26     only to another physician or certified nurse midwife.

 

 

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1     Additionally, a second staff person shall also be present
2     at each birth who is licensed or certified in Illinois in a
3     health-related field and under the supervision of the
4     physician or certified nurse midwife in attendance, has
5     specialized training in labor and delivery techniques and
6     care of newborns, and receives planned and ongoing training
7     as needed to perform assigned duties effectively.
8         The maximum length of stay in a birth center shall be
9     consistent with existing State laws allowing a 48-hour stay
10     or appropriate post-delivery care, if discharged earlier
11     than 48 hours.
12         A birth center shall participate in the Illinois
13     Perinatal System under the Developmental Disability
14     Prevention Act. At a minimum, this participation shall
15     require a birth center to establish a letter of agreement
16     with a hospital designated under the Perinatal System. A
17     hospital that operates or has a letter of agreement with a
18     birth center shall include the birth center under its
19     maternity service plan under the Hospital Licensing Act and
20     shall include the birth center in the hospital's letter of
21     agreement with its regional perinatal center.
22         A birth center may not discriminate against any patient
23     requiring treatment because of the source of payment for
24     services, including Medicare and Medicaid recipients.
25         No general anesthesia and no surgery may be performed
26     at a birth center. The Department may by rule add birth

 

 

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1     center patient eligibility criteria or standards as it
2     deems necessary. The Department shall by rule require each
3     birth center to report the information which the Department
4     shall make publicly available, which shall include, but is
5     not limited to, the following:
6             (i) Birth center ownership.
7             (ii) Sources of payment for services.
8             (iii) Utilization data involving patient length of
9         stay.
10             (iv) Admissions and discharges.
11             (v) Complications.
12             (vi) Transfers.
13             (vii) Unusual incidents.
14             (viii) Deaths.
15             (xi) Any other publicly reported data required
16         under the Illinois Consumer Guide.
17             (x) Post-discharge patient status data where
18         patients are followed for 14 days after discharge from
19         the birth center to determine whether the mother or
20         baby developed a complication or infection.
21         Within 9 months after the effective date of this
22     amendatory Act of the 95th General Assembly, the Department
23     shall adopt rules that are developed with consideration of:
24     the American Association of Birth Centers' Standards for
25     Freestanding Birth Centers; the American Academy of
26     Pediatrics/American College of Obstetricians and

 

 

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1     Gynecologists Guidelines for Perinatal Care; and the
2     Regionalized Perinatal Health Care Code.
3         The Department shall adopt other rules as necessary to
4     implement the provisions of this amendatory Act of the 95th
5     General Assembly within 9 months after the effective date
6     of this amendatory Act of the 95th General Assembly.".