Bill Text: IL HB0005 | 2019-2020 | 101st General Assembly | Engrossed

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Amends the Department of Human Services Act. Requires the Department of Human Services to ensure access to substance use and mental health services statewide for pregnant and postpartum women, and to ensure that programs are gender-responsive, are trauma-informed, serve women and young children, and prioritize justice-involved pregnant and postpartum women. Amends the Department of Public Health Powers and Duties Law of the Civil Administrative Code of Illinois. Requires the Department of Public Health to establish a classification system for specified levels of maternal care. Requires the Department to implement substantive measures that benefit maternal care and provide a greater amount of available information in order to further medical research. Amends the Emergency Medical Services (EMS) Systems Act. Requires the Department of Public Health to ensure that EMS systems are transporting pregnant women to the appropriate facilities based on the Department of Public Health's classification system for levels of maternal care. Effective immediately.

Spectrum: Partisan Bill (Democrat 13-0)

Status: (Passed) 2019-08-23 - Public Act . . . . . . . . . 101-0447 [HB0005 Detail]

Download: Illinois-2019-HB0005-Engrossed.html

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AN ACT concerning health.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Department of Human Services Act is amended
by changing Section 10-15 as follows:
(20 ILCS 1305/10-15)
Sec. 10-15. Pregnant women with a substance use disorder;
mental health services. The Department shall develop
guidelines for use in non-hospital residential care facilities
for pregnant women who have a substance use disorder with
respect to the care of those clients.
The Department shall administer infant mortality and
prenatal programs, through its provider agencies, to develop
special programs for case finding and service coordination for
pregnant women who have a substance use disorder.
The Department shall ensure access to substance use and
mental health services statewide for pregnant and postpartum
women, and ensure that programs are gender-responsive, are
trauma-informed, serve women and young children, and
prioritize justice-involved pregnant and postpartum women.
(Source: P.A. 100-759, eff. 1-1-19.)
Section 10. The Department of Public Health Powers and

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Duties Law of the Civil Administrative Code of Illinois is
amended by adding Section 2310-223 as follows:
(20 ILCS 2310/2310-223 new)
Sec. 2310-223. Maternal care.
(a) The Department shall establish a classification system
for the following levels of maternal care:
(1) basic care: care of uncomplicated pregnancies with
the ability to detect, stabilize, and initiate management
of unanticipated maternal-fetal or neonatal problems that
occur during the antepartum, intrapartum, or postpartum
period until the patient can be transferred to a facility
at which specialty maternal care is available;
(2) specialty care: basic care plus care of appropriate
high-risk antepartum, intrapartum, or postpartum
conditions, both directly admitted and transferred to
another facility;
(3) subspecialty care: specialty care plus care of more
complex maternal medical conditions, obstetric
complications, and fetal conditions; and
(4) regional perinatal health care: subspecialty care
plus on-site medical and surgical care of the most complex
maternal conditions, critically ill pregnant women, and
fetuses throughout antepartum, intrapartum, and postpartum
care.
(b) The Department shall:

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(1) introduce uniform designations for levels of
maternal care that are complimentary but distinct from
levels of neonatal care;
(2) establish clear, uniform criteria for designation
of maternal centers that are integrated with emergency
response systems to help ensure that the appropriate
personnel, physical space, equipment, and technology are
available to achieve optimal outcomes, as well as to
facilitate subsequent data collection regarding
risk-appropriate care;
(3) require each health care facility to have a clear
understanding of its capability to handle increasingly
complex levels of maternal care, and to have a well-defined
threshold for transferring women to health care facilities
that offer a higher level of care; to ensure optimal care
of all pregnant women, the Department shall require all
birth centers, hospitals, and higher-level facilities to
collaborate in order to develop and maintain maternal and
neonatal transport plans and cooperative agreements
capable of managing the health care needs of women who
develop complications; the Department shall require that
receiving hospitals openly accept transfers;
(4) require higher-level facilities to provide
training for quality improvement initiatives, educational
support, and severe morbidity and mortality case review for
lower-level hospitals; the Department shall ensure that,

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in those regions that do not have a facility that qualifies
as a regional perinatal health care facility, any specialty
care facility in the region will provide the educational
and consultation function;
(5) require facilities and regional systems to develop
methods to track severe maternal morbidity and mortality to
assess the efficacy of utilizing maternal levels of care;
(6) analyze data collected from all facilities and
regional systems in order to inform future updates to the
levels of maternal care;
(7) require follow-up interdisciplinary work groups to
further explore the implementation needs that are
necessary to adopt the proposed classification system for
levels of maternal care in all facilities that provide
maternal care;
(8) disseminate data and materials to raise public
awareness about the importance of prenatal care and
maternal health;
(9) create or expand home visiting programs to target
high-risk mothers in Illinois during pregnancy and
postpartum periods, such as doula programs, and expand
efforts to provide universal home visiting to all mothers
within 3 weeks of giving birth; and
(10) engage the Illinois Chapter of the American
Academy of Pediatrics in creating a quality improvement
initiative to expand efforts of pediatricians conducting

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postpartum depression screening at well baby visits during
the first year of life.
Section 15. The Emergency Medical Services (EMS) Systems
Act is amended by changing Section 3.20 as follows:
(210 ILCS 50/3.20)
Sec. 3.20. Emergency Medical Services (EMS) Systems.
(a) "Emergency Medical Services (EMS) System" means 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, ILS and/or ALS level pursuant to a System
program plan submitted to and approved by the Department, and
pursuant to the EMS Region Plan adopted for the EMS Region in
which the System is located.
(b) One hospital in each System program plan must be
designated as the Resource Hospital. All other hospitals which
are located within the geographic boundaries of a System and
which have standby, basic or comprehensive level emergency
departments must function in that EMS System as either an
Associate Hospital or Participating Hospital and follow all
System policies specified in the System Program Plan, including
but not limited to the replacement of drugs and equipment used
by providers who have delivered patients to their emergency

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departments. All hospitals and vehicle service providers
participating in an EMS System must specify their level of
participation in the System Program Plan.
(c) The Department shall have the authority and
responsibility to:
(1) Approve BLS, ILS and ALS level EMS Systems which
meet minimum standards and criteria established in rules
adopted by the Department pursuant to this Act, including
the submission of a Program Plan for Department approval.
Beginning September 1, 1997, the Department shall approve
the development of a new EMS System only when a local or
regional need for establishing such System has been
verified by the Department. This shall not be construed as
a needs assessment for health planning or other purposes
outside of this Act. Following Department approval, EMS
Systems must be fully operational within one year from the
date of approval.
(2) Monitor EMS Systems, based on minimum standards for
continuing operation as prescribed in rules adopted by the
Department pursuant to this Act, which shall include
requirements for submitting Program Plan amendments to the
Department for approval.
(3) Renew EMS System approvals every 4 years, after an
inspection, based on compliance with the standards for
continuing operation prescribed in rules adopted by the
Department pursuant to this Act.

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(4) Suspend, revoke, or refuse to renew approval of any
EMS System, after providing an opportunity for a hearing,
when findings show that it does not meet the minimum
standards for continuing operation as prescribed by the
Department, or is found to be in violation of its
previously approved Program Plan.
(5) Require each EMS System to adopt written protocols
for the bypassing of or diversion to any hospital, trauma
center or regional trauma center, which provide that a
person shall not be transported to a facility other than
the nearest hospital, regional trauma center or trauma
center unless the medical benefits to the patient
reasonably expected from the provision of appropriate
medical treatment at a more distant facility outweigh the
increased risks to the patient from transport to the more
distant facility, or the transport is in accordance with
the System's protocols for patient choice or refusal.
(6) Require that the EMS Medical Director of an ILS or
ALS level EMS System be a physician licensed to practice
medicine in all of its branches in Illinois, and certified
by the American Board of Emergency Medicine or the American
Osteopathic Board of Emergency Medicine, and that the EMS
Medical Director of a BLS level EMS System be a physician
licensed to practice medicine in all of its branches in
Illinois, with regular and frequent involvement in
pre-hospital emergency medical services. In addition, all

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EMS Medical Directors shall:
(A) Have experience on an EMS vehicle at the
highest level available within the System, or make
provision to gain such experience within 12 months
prior to the date responsibility for the System is
assumed or within 90 days after assuming the position;
(B) Be thoroughly knowledgeable of all skills
included in the scope of practices of all levels of EMS
personnel within the System;
(C) Have or make provision to gain experience
instructing students at a level similar to that of the
levels of EMS personnel within the System; and
(D) For ILS and ALS EMS Medical Directors,
successfully complete a Department-approved EMS
Medical Director's Course.
(7) Prescribe statewide EMS data elements to be
collected and documented by providers in all EMS Systems
for all emergency and non-emergency medical services, with
a one-year phase-in for commencing collection of such data
elements.
(8) Define, through rules adopted pursuant to this Act,
the terms "Resource Hospital", "Associate Hospital",
"Participating Hospital", "Basic Emergency Department",
"Standby Emergency Department", "Comprehensive Emergency
Department", "EMS Medical Director", "EMS Administrative
Director", and "EMS System Coordinator".

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(A) (Blank).
(B) (Blank).
(9) Investigate the circumstances that caused a
hospital in an EMS system to go on bypass status to
determine whether that hospital's decision to go on bypass
status was reasonable. The Department may impose
sanctions, as set forth in Section 3.140 of the Act, upon a
Department determination that the hospital unreasonably
went on bypass status in violation of the Act.
(10) Evaluate the capacity and performance of any
freestanding emergency center established under Section
32.5 of this Act in meeting emergency medical service needs
of the public, including compliance with applicable
emergency medical standards and assurance of the
availability of and immediate access to the highest quality
of medical care possible.
(11) Permit limited EMS System participation by
facilities operated by the United States Department of
Veterans Affairs, Veterans Health Administration. Subject
to patient preference, Illinois EMS providers may
transport patients to Veterans Health Administration
facilities that voluntarily participate in an EMS System.
Any Veterans Health Administration facility seeking
limited participation in an EMS System shall agree to
comply with all Department administrative rules
implementing this Section. The Department may promulgate

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rules, including, but not limited to, the types of Veterans
Health Administration facilities that may participate in
an EMS System and the limitations of participation.
(12) Ensure that EMS systems are transporting pregnant
women to the appropriate facilities based on the
classification of the levels of maternal care described
under subsection (a) of Section 2310-223 of the Department
of Public Health Powers and Duties Law of the Civil
Administrative Code of Illinois.
(Source: P.A. 97-333, eff. 8-12-11; 98-973, eff. 8-15-14.)
Section 99. Effective date. This Act takes effect upon
becoming law.