Full Text of HB3995 102nd General Assembly
HB3995 102ND GENERAL ASSEMBLY |
| | 102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022 HB3995 Introduced 3/4/2021, by Rep. Robyn Gabel SYNOPSIS AS INTRODUCED: |
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Creates the Birth Center Licensing Act. Provides that, except as provided by the Act, no person shall open, manage, conduct, offer, maintain, or advertise as a birth center without a valid license issued by the Department of Public Health. Requires all birth centers in existence as of the effective date of the Act to obtain a valid license to operate within 2 years after the adoption of rules by the Department to implement the Act. Provides that an applicant for a license under the Act shall submit an application on forms prescribed by the Department, which shall be accompanied by a nonrefundable license fee, as established by rule by the Department. Provides that licenses under the Act are renewable every 3 years upon submission of specified materials. Requires birth centers, to the extent possible, to link and integrate services with nearby health care facilities. Contains provisions concerning staffing requirements; minimum standards to protect the health and safety of a patient of a birth center; and requirements for reimbursement, reporting, training, and inspections. Requires the Department to adopt specified rules. Contains other provisions. Effective immediately.
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| | | FISCAL NOTE ACT MAY APPLY | |
| | A BILL FOR |
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| 1 | | AN ACT concerning regulation.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 1. Short title. This Act may be cited as the Birth | 5 | | Center Licensing Act. | 6 | | Section 5. Definitions. In this Act: | 7 | | "Birth center" means a designated site, other than a | 8 | | hospital: | 9 | | (1) in which births are planned to occur following a | 10 | | normal, uncomplicated, and low-risk pregnancy; | 11 | | (2) that is not the pregnant person's usual place of | 12 | | residence; | 13 | | (3) that is exclusively dedicated to serving the | 14 | | childbirth-related needs of pregnant persons and their | 15 | | newborns, and has no more than 10 beds; and | 16 | | (4) that offers prenatal care and community education | 17 | | services and coordinates these services with other health | 18 | | care services available in the community. | 19 | | "Department" means the Department of Public Health. | 20 | | "Hospital" does not include places where pregnant females | 21 | | are received, cared for, or treated during delivery if it is in | 22 | | a licensed birth center, nor include any facility required to | 23 | | be licensed as a birth center. |
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| 1 | | Section 10. License required. Except as provided by this | 2 | | Act, no person shall open, manage, conduct, offer, maintain, | 3 | | or advertise as a birth center without a valid license issued | 4 | | by the Department. All birth centers in existence as of the | 5 | | effective date of this Act shall obtain a valid license to | 6 | | operate within 2 years after the adoption of rules by the | 7 | | Department to implement this Act under Section 60. | 8 | | Section 15. Issuance and renewal of license. | 9 | | (a) An applicant for a license under this Act shall submit | 10 | | an application on forms prescribed by the Department. Each | 11 | | application shall be accompanied by a nonrefundable license | 12 | | fee, as established by rule by the Department under Section | 13 | | 60. | 14 | | (b) The Department may grant a temporary initial license | 15 | | to an applicant. A temporary initial license expires on the | 16 | | earlier of the date the Department denies the license or the | 17 | | date 6 months after the temporary initial license was issued. | 18 | | (c) The Department shall issue a license if, after | 19 | | application, inspection, and investigation, it finds the | 20 | | applicant meets the requirements of this Act and the rules and | 21 | | standards adopted pursuant to this Act. | 22 | | (d) A license is renewable every 3 years upon submission | 23 | | of (i) the renewal application and fee and (ii) a report on a | 24 | | form prescribed by the Department that includes information |
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| 1 | | related to quality of care at a birth center. The report must | 2 | | be in the form and documented by evidence as required by the | 3 | | Department by rule under Section 60.
| 4 | | Section 20. Linkages. | 5 | | (a) A birth center shall, to the extent possible, link and | 6 | | integrate its services with nearby health care facilities. | 7 | | (b) A birth center shall have a written plan for transfer | 8 | | of patients that addresses emergency and nonemergency
| 9 | | situations for both pregnant persons and newborns in | 10 | | antepartum,
intrapartum, and postpartum phases. This should | 11 | | include plans
for communication with the receiving hospital | 12 | | before and after
transfer.
| 13 | | Section 25. Staffing. | 14 | | (a) A birth center shall have a clinical director, who may | 15 | | be: | 16 | | (1) a physician who is either certified or eligible | 17 | | for certification by the American College of Obstetricians
| 18 | | and Gynecologists or the American Board of Osteopathic
| 19 | | Obstetricians and Gynecologists or has hospital
| 20 | | obstetrical privileges; or | 21 | | (2)
a midwife who is either certified or eligible for
| 22 | | certification by his or her governing body.
| 23 | | (b) The clinical director shall be responsible for: | 24 | | (1) the development of policies and procedures for |
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| 1 | | services as provided by Department rules; | 2 | | (2) coordinating the clinical staff and overall | 3 | | provision of patient care; | 4 | | (3) developing and approving policies defining the | 5 | | criteria to determine which pregnancies are accepted as | 6 | | normal, uncomplicated, and low-risk; and | 7 | | (4) developing and approving policing regarding the | 8 | | anesthesia services available at the center.
| 9 | | (c) An obstetrician, family practitioner, or midwife | 10 | | licensed in Illinois shall attend each person in labor from | 11 | | the time of admission through birth and throughout the | 12 | | immediate postpartum period. Attendance may be delegated only | 13 | | to another physician or midwife licensed in Illinois. | 14 | | (d) A second staff person shall be present at each birth | 15 | | who: | 16 | | (1) is licensed or certified in Illinois in a | 17 | | health-related field and under the supervision of a | 18 | | physician or a licensed midwife in Illinois that is in | 19 | | attendance; | 20 | | (2) has specialized training in labor and delivery | 21 | | techniques and care of newborns; and | 22 | | (3) receives planned and ongoing training as needed to | 23 | | perform assigned duties effectively.
| 24 | | Section 30. Minimum standards. | 25 | | (a) The Department's rules adopted pursuant to Section 60 |
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| 1 | | of this Act shall contain minimum standards to protect the | 2 | | health and safety of a patient of a birth center. In adopting | 3 | | rules for birth centers, the Department shall consider: | 4 | | (1) the Commission for the Accreditation of Birth | 5 | | Centers' Standards for Freestanding Birth Centers; | 6 | | (2) the American Academy of Pediatrics and American | 7 | | College of Obstetricians and Gynecologists Guidelines for | 8 | | Perinatal Care; and | 9 | | (3) the Regionalized Perinatal Health Care Code.
| 10 | | Section 35. Quality of care. The Department's rules shall | 11 | | provide for a time period within which each birth center must | 12 | | become accredited by either the Commission for the | 13 | | Accreditation of Freestanding Birth Centers or The Joint | 14 | | Commission. | 15 | | A birth center shall implement a quality improvement | 16 | | program consistent with the requirements of the accrediting | 17 | | body. | 18 | | Section 40. Reimbursement requirements. | 19 | | (a) A birth center shall seek certification under Titles | 20 | | XVIII and XIX of the federal Social Security Act. | 21 | | (b) Reimbursement rates set by the Department of | 22 | | Healthcare and Family Services should be based on all types of | 23 | | medically necessary covered services provided to both the | 24 | | birthing person and the baby, including: |
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| 1 | | (1) a professional fee for both the birthing person | 2 | | and baby; | 3 | | (2) a facility fee for the birthing person that is no | 4 | | less than 75% of the statewide average facility payment | 5 | | rate made to a hospital for an uncomplicated vaginal | 6 | | birth; | 7 | | (3) a facility fee for the baby that is no less than | 8 | | 75% of the statewide average facility payment rate made to | 9 | | a hospital for a normal baby; and | 10 | | (4) additional fees for other services, medications, | 11 | | laboratory tests, and supplies provided. | 12 | | (c) A birth center shall provide charitable care | 13 | | consistent with that provided by comparable health care | 14 | | providers in the geographic area. | 15 | | (d) A birth center may not discriminate against any | 16 | | patient requiring treatment because of the source of payment | 17 | | for services, including Medicare and Medicaid recipients. | 18 | | Section 45. Reporting requirements. The Department shall | 19 | | by rule require each birth center to report information every | 20 | | 3 years that is consistent with the birth center's license | 21 | | renewal schedule, which the Department shall make publicly | 22 | | available and which shall include the following: | 23 | | (1) utilization data involving patient length of stay; | 24 | | (2) admissions and discharges; | 25 | | (3) complications; |
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| 1 | | (4) transfers; | 2 | | (5) deaths; | 3 | | (6) any other publicly reported data required under | 4 | | the Consumer Guide to Health Care; and | 5 | | (7) post-discharge patient status data where patients | 6 | | are
followed for 14 days after discharge from the birth | 7 | | center
to determine whether the mother or baby developed a
| 8 | | complication or infection. | 9 | | Section 50. Training. A birth center shall establish and | 10 | | implement a policy to ensure appropriate training and | 11 | | competency of individuals employed within the birth center. | 12 | | The policy shall, at a minimum, define the acts and practices | 13 | | that are allowed or prohibited for such employees, establish | 14 | | how training will be conducted, and illustrate how initial | 15 | | competency will be established. | 16 | | Section 55. Inspections; special inspections; reports. | 17 | | (a) The Department shall deem an accreditation body | 18 | | applicable to birth centers as a substitute for its own | 19 | | periodic inspection.
The Department, whenever it determines | 20 | | necessary, may conduct a
special inspection, survey, or | 21 | | evaluation of a birth center to assess
compliance with | 22 | | licensure requirements and standards or a plan of
correction | 23 | | submitted as a result of deficiencies cited by the
Department | 24 | | or accrediting body.
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| 1 | | (b) Upon the Department's completion of any special | 2 | | inspection, survey, or evaluation, the appropriate Department | 3 | | personnel who conducted the special inspection, survey, or | 4 | | evaluation shall submit a copy of his or her report to the | 5 | | licensee upon exiting the birth center, and shall submit the | 6 | | actual report to the appropriate regional office. | 7 | | (c) The Department's report and any recommendation for | 8 | | action under this Act shall be sent to the Department's | 9 | | central office together with a plan of correction from the | 10 | | birth center. | 11 | | (d) The plan of correction may contain related comments or | 12 | | documentation provided by the birth center that may refute | 13 | | findings in the report, explain extenuating circumstances that | 14 | | the birth center could not reasonably have prevented, or | 15 | | indicate methods and timetables for correction of deficiencies | 16 | | described in the report. | 17 | | (e) A birth center has 10 days after the date of the | 18 | | Department's special inspection, survey, or evaluation to | 19 | | submit a plan of correction. The Department shall determine | 20 | | whether a birth center is in violation of this Section no later | 21 | | than 60 days after completion of each special inspection, | 22 | | survey, evaluation, or plan of correction. | 23 | | (f) The Department shall maintain all special inspection, | 24 | | survey, or evaluation reports for at least 5 years in a manner | 25 | | accessible to the public.
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| 1 | | Section 60. Rules. | 2 | | (a) The Department shall adopt rules for the | 3 | | administration and enforcement of this Act. | 4 | | (b) Rules adopted by the Department under this Act shall | 5 | | stipulate:
| 6 | | (1) the eligibility criteria for birth center | 7 | | admission that are consistent with accreditation standards | 8 | | and the midwife's or physician's scope of practice; | 9 | | (2) the necessary equipment for emergency care | 10 | | according to the Commission for Accreditation of Birth | 11 | | Centers' standards; | 12 | | (3) the travel time distance from the birth center | 13 | | that is not located within a rural area and a general acute | 14 | | care hospital with which the birth center the maintains a | 15 | | transfer agreement that allows for an emergency cesarean | 16 | | delivery to be started within 30 minutes of the decision | 17 | | that a cesarean delivery is necessary; | 18 | | (4) the travel time distance from the birth center | 19 | | that is located within a rural area and a general acute | 20 | | care hospital with which the birth center maintains a | 21 | | transfer agreement that allows for an emergency cesarean | 22 | | delivery to be started within 45 minutes of the decision | 23 | | that a cesarean delivery is necessary; | 24 | | (5) that the use of general anesthesia at a birth | 25 | | center is prohibited; and
| 26 | | (6) the equipment used by the birth center to ensure |
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| 1 | | that it is compatible with the health and safety of the | 2 | | patients.
| 3 | | Section 99. Effective date. This Act takes effect upon | 4 | | becoming law.
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