Full Text of HB3995 102nd General Assembly
HB3995ham002 102ND GENERAL ASSEMBLY | Rep. Robyn Gabel Filed: 4/15/2021
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| 1 | | AMENDMENT TO HOUSE BILL 3995
| 2 | | AMENDMENT NO. ______. Amend House Bill 3995 by replacing | 3 | | everything after the enacting clause with the following:
| 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; | 16 | | (4) that offers prenatal care and community education |
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| 1 | | services and coordinates these services with other health | 2 | | care services available in the community; and | 3 | | (5) that does not provide general anesthesia or | 4 | | surgery. | 5 | | "Certified nurse midwife" means an advanced practice | 6 | | registered nurse licensed in Illinois under the Nurse Practice | 7 | | Act with full practice authority or who is delegated such | 8 | | authority as part of a written collaborative agreement with a | 9 | | physician who is associated with the birthing center or who | 10 | | has privileges at a nearby birthing hospital. | 11 | | "Department" means the Illinois Department of Public | 12 | | Health. | 13 | | "Hospital" does not include places where pregnant females | 14 | | are received, cared for, or treated during delivery if it is in | 15 | | a licensed birth center, nor include any facility required to | 16 | | be licensed as a birth center. | 17 | | "Physician" means a physician licensed to practice | 18 | | medicine in all its branches in Illinois. | 19 | | Section 10. License required. Except as provided by this | 20 | | Act, no person shall open, manage, conduct, offer, maintain, | 21 | | or advertise as a birth center without a valid license issued | 22 | | by the Department. All birth centers in existence as of the | 23 | | effective date of this Act shall obtain a valid license to | 24 | | operate within 2 years after the adoption of rules by the | 25 | | Department to implement this Act under Section 60. |
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| 1 | | Section 15. Issuance and renewal of license. | 2 | | (a) An applicant for a license under this Act shall submit | 3 | | an application on forms prescribed by the Department. Each | 4 | | application shall be accompanied by a nonrefundable license | 5 | | fee, as established by rule by the Department under Section | 6 | | 60. | 7 | | (b) The Department may grant a temporary initial license | 8 | | to an applicant. A temporary initial license expires on the | 9 | | earlier of the date the Department denies the license or the | 10 | | date 6 months after the temporary initial license was issued. | 11 | | (c) The Department shall issue a license under this Act | 12 | | if, after application, inspection, and investigation, it finds | 13 | | the applicant meets the requirements of this Act and the rules | 14 | | and standards adopted pursuant to this Act. | 15 | | (d) A license is renewable every year upon submission of: | 16 | | (i) the renewal application and fee and (ii) a report on a form | 17 | | prescribed by the Department that includes information related | 18 | | to quality of care at a birth center. The report must be in the | 19 | | form and documented by evidence as required by the Department | 20 | | by rule under Section 60.
| 21 | | Section 17. Certificate of need; licenses. | 22 | | (a) A birth center shall obtain a certificate of need from | 23 | | the Health Facilities and Services Review Board under the | 24 | | Health Facilities Planning Act before receiving a license by |
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| 1 | | the Department under this Act. | 2 | | (b) If, after obtaining an initial certificate of need | 3 | | under subsection (a), a birth center seeks to increase the bed | 4 | | capacity of the birth center, the birth center must obtain a | 5 | | certificate of need from the Health Facilities and Services | 6 | | Review Board before increasing the bed capacity. | 7 | | (c) A birth center in a medically underserved area, as | 8 | | determined by the U.S. Department of Health and Human | 9 | | Services, shall receive priority in obtaining a certificate of | 10 | | need under this Section.
| 11 | | Section 20. Linkages. | 12 | | (a) A birth center shall link and integrate its services | 13 | | with at least one birthing hospital with a minimum of a Level 1 | 14 | | perinatal designation. | 15 | | (b) A birth center shall have an established agreement | 16 | | with a nearby receiving birthing hospital with policies and | 17 | | procedures for timely transfer of maternal and neonatal | 18 | | patients. The agreement shall include a determination of | 19 | | maternal and neonatal conditions necessitating consultation | 20 | | and referral. This should include plans
for communication with | 21 | | the receiving hospital before and after
transfer.
| 22 | | Section 25. Staffing. | 23 | | (a) A birth center shall have a clinical director, who may | 24 | | be: |
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| 1 | | (1) a physician who is either certified or eligible | 2 | | for certification by the American College of Obstetricians
| 3 | | and Gynecologists or the American Board of Osteopathic
| 4 | | Obstetricians and Gynecologists or has hospital
| 5 | | obstetrical privileges; or | 6 | | (2)
a certified nurse midwife.
| 7 | | (b) The clinical director shall be responsible for: | 8 | | (1) the development of policies and procedures for | 9 | | services as provided by Department rules; | 10 | | (2) coordinating the clinical staff and overall | 11 | | provision of patient care; | 12 | | (3) developing and approving policies defining the | 13 | | criteria to determine which pregnancies are accepted as | 14 | | normal, uncomplicated, and low-risk; and | 15 | | (4) developing and approving policing regarding the | 16 | | anesthesia services available at the center.
| 17 | | (c) An obstetrician, family practitioner, or certified | 18 | | nurse midwife shall attend each person in labor from the time | 19 | | of admission through birth and throughout the immediate | 20 | | postpartum period. Attendance may be delegated only to another | 21 | | physician or a certified nurse midwife. | 22 | | (d) A second staff person shall be present at each birth | 23 | | who: | 24 | | (1) is licensed or certified in Illinois in a | 25 | | health-related field and under the supervision of a | 26 | | physician or a certified nurse midwife who is in |
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| 1 | | attendance; | 2 | | (2) has specialized training in labor and delivery | 3 | | techniques and care of newborns; and | 4 | | (3) receives planned and ongoing training as needed to | 5 | | perform assigned duties effectively.
| 6 | | Section 30. Minimum standards. | 7 | | (a) The Department's rules adopted pursuant to Section 60 | 8 | | of this Act shall contain minimum standards to protect the | 9 | | health and safety of a patient of a birth center. In adopting | 10 | | rules for birth centers, the Department shall consider: | 11 | | (1) the Commission for the Accreditation of Birth | 12 | | Centers' Standards for Freestanding Birth Centers; | 13 | | (2) the American Academy of Pediatrics and American | 14 | | College of Obstetricians and Gynecologists Guidelines for | 15 | | Perinatal Care; and | 16 | | (3) the Regionalized Perinatal Health Care Code.
| 17 | | Section 35. Quality of care. The Department's rules shall | 18 | | provide for a time period within which each birth center must | 19 | | become accredited by either the Commission for the | 20 | | Accreditation of Freestanding Birth Centers or The Joint | 21 | | Commission. | 22 | | A birth center shall implement a quality improvement | 23 | | program consistent with the requirements of the accrediting | 24 | | body and is encouraged to participate in quality improvement |
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| 1 | | projects implemented by the Department's Administrative | 2 | | Perinatal Centers and other Department-supported perinatal | 3 | | quality improvement projects. Clinicians, or their clinical | 4 | | representative, attending persons in labor at the birth center | 5 | | shall attend morbidity and mortality reviews that occur at the | 6 | | receiving birthing hospital on their patients, when invited, | 7 | | at a mutually agreeable time. This includes, but is not | 8 | | limited to, maternal and neonatal patients transferred to the | 9 | | receiving birthing hospital. | 10 | | Section 40. Reimbursement requirements. | 11 | | (a) A birth center shall seek certification under Titles | 12 | | XVIII and XIX of the federal Social Security Act. | 13 | | (b) Reimbursement rates set by the Department of | 14 | | Healthcare and Family Services should be based on all types of | 15 | | medically necessary covered services provided to both the | 16 | | birthing person and the baby, including: | 17 | | (1) a professional fee for both the birthing person | 18 | | and baby; | 19 | | (2) a facility fee for the birthing person that is no | 20 | | less than 75% of the statewide average facility payment | 21 | | rate made to a hospital for an uncomplicated vaginal | 22 | | birth; | 23 | | (3) a facility fee for the baby that is no less than | 24 | | 75% of the statewide average facility payment rate made to | 25 | | a hospital for a normal baby; and |
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| 1 | | (4) additional fees for other services, medications, | 2 | | laboratory tests, and supplies provided. | 3 | | (c) A birth center shall provide charitable care | 4 | | consistent with that provided by comparable health care | 5 | | providers in the geographic area. | 6 | | (d) A birth center may not discriminate against any | 7 | | patient requiring treatment because of the source of payment | 8 | | for services, including Medicare and Medicaid recipients. | 9 | | Section 45. Reporting requirements. The Department shall | 10 | | by rule require each birth center to report information every | 11 | | year that is consistent with the birth center's license | 12 | | renewal schedule, which the Department shall make publicly | 13 | | available and which shall include the following: | 14 | | (1) utilization data involving patient length of stay; | 15 | | (2) admissions and discharges; | 16 | | (3) complications; | 17 | | (4) transfers; | 18 | | (5) deaths; | 19 | | (6) any other publicly reported data required under | 20 | | the Consumer Guide to Health Care; and | 21 | | (7) post-discharge patient status data where patients | 22 | | are
followed for 14 days after discharge from the birth | 23 | | center
to determine whether the mother or baby developed a
| 24 | | complication or infection. |
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| 1 | | Section 50. Training. A birth center shall, in | 2 | | consultation with the clinical director, establish and | 3 | | implement a policy to ensure appropriate training and | 4 | | competency of individuals employed within the birth center. | 5 | | The policy shall, at a minimum, define the acts and practices | 6 | | that are allowed or prohibited for such employees, establish | 7 | | how training will be conducted, and illustrate how initial | 8 | | competency will be established. | 9 | | Section 55. Inspections; special inspections; reports. | 10 | | (a) The Department, whenever it determines necessary, may | 11 | | conduct a
special inspection, survey, or evaluation of a birth | 12 | | center to assess
compliance with licensure requirements and | 13 | | standards or a plan of
correction submitted as a result of | 14 | | deficiencies cited by the
Department or an accrediting body.
| 15 | | (b) Upon the Department's completion of any special | 16 | | inspection, survey, or evaluation, the appropriate Department | 17 | | personnel who conducted the special inspection, survey, or | 18 | | evaluation shall submit a copy of his or her report to the | 19 | | licensee upon exiting the birth center, and shall submit the | 20 | | actual report to the appropriate regional office. | 21 | | (c) The Department's report and any recommendation for | 22 | | action under this Act shall be sent to the Department's | 23 | | central office together with a plan of correction from the | 24 | | birth center. | 25 | | (d) The plan of correction may contain related comments or |
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| 1 | | documentation provided by the birth center that may refute | 2 | | findings in the report, explain extenuating circumstances that | 3 | | the birth center could not reasonably have prevented, or | 4 | | indicate methods and timetables for correction of deficiencies | 5 | | described in the report. | 6 | | (e) A birth center has 10 days after the date of the | 7 | | Department's special inspection, survey, or evaluation to | 8 | | submit a plan of correction. The Department shall determine | 9 | | whether a birth center is in violation of this Section no later | 10 | | than 60 days after completion of each special inspection, | 11 | | survey, evaluation, or plan of correction. | 12 | | (f) The Department shall maintain all special inspection, | 13 | | survey, or evaluation reports for at least 5 years in a manner | 14 | | accessible to the public.
| 15 | | Section 60. Rules. | 16 | | (a) The Department shall adopt rules for the | 17 | | administration and enforcement of this Act. | 18 | | (b) Rules adopted by the Department under this Act shall | 19 | | stipulate:
| 20 | | (1) the eligibility criteria for birth center | 21 | | admission that are consistent with accreditation standards | 22 | | and the certified nurse midwife's or physician's scope of | 23 | | practice; | 24 | | (2) the necessary equipment for emergency care | 25 | | according to the Commission for Accreditation of Birth |
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| 1 | | Centers' standards; | 2 | | (3) the minimum elements required in the transfer | 3 | | agreement between a birth center and a receiving birth | 4 | | hospital with at least a Level 1 perinatal designation, | 5 | | including the amount of travel time between facilities in | 6 | | rural and nonrural areas, the staff required to transfer | 7 | | patients, and the mode of emergency transportation between | 8 | | facilities; and | 9 | | (4) the equipment used by the birth center to ensure | 10 | | that it is compatible with the health and safety of the | 11 | | patients.
| 12 | | Section 99. Effective date. This Act takes effect upon | 13 | | becoming law.".
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