(210 ILCS 5/1) (from Ch. 111 1/2, par. 157-8.1)
Sec. 1.
This Act may be cited as
the Ambulatory Surgical Treatment Center Act.
(Source: P. A. 78-227.)
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(210 ILCS 5/2) (from Ch. 111 1/2, par. 157-8.2)
Sec. 2.
It is declared to be the
public policy that the State has a legitimate interest
in assuring that all medical procedures, including
abortions, are performed under circumstances that
insure maximum safety. Therefore, the purpose of
this Act is to provide for the better protection
of the public health through the development, establishment,
and enforcement of standards (1) for the care of
individuals in ambulatory surgical treatment centers,
and (2) for the construction, maintenance and operation
of ambulatory surgical treatment centers, which,
in light of advancing knowledge, will promote safe
and adequate treatment of such individuals in ambulatory
surgical treatment centers.
(Source: P. A. 78-227.)
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(210 ILCS 5/3) (from Ch. 111 1/2, par. 157-8.3)
Sec. 3. As used in this
Act, unless the context otherwise requires, the following
words and phrases shall have the meanings ascribed
to them:
(A) "Ambulatory surgical
treatment center" means any institution, place or building
devoted primarily to the maintenance and operation of facilities
for the performance of surgical procedures or any facility in
which a medical or surgical procedure is utilized to terminate
a pregnancy, irrespective of whether the facility is devoted
primarily to this purpose. Such facility shall not provide beds
or other accommodations for the overnight stay of patients; however,
facilities devoted exclusively to the treatment of children may
provide accommodations and beds for their patients for up to
23 hours following admission. Individual patients shall be discharged
in an ambulatory condition without danger to the continued well
being of the patients or shall be transferred to a hospital.
The term "ambulatory
surgical treatment center" does not include any of the following:
(1)
Any institution, place, building or agency
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required to be licensed pursuant to
the "Hospital Licensing Act", approved July 1, 1953, as amended.
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(2)
Any person or institution required to be
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licensed pursuant to the "Nursing
Home Care Act", approved August 23, 1979, as amended.
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(3)
Hospitals or ambulatory surgical treatment
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centers maintained by the State or
any department or agency thereof, where such
department or agency has authority under
law to establish and enforce standards for
the hospitals or ambulatory surgical treatment
centers under its management and control.
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(4)
Hospitals or ambulatory surgical treatment
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centers maintained by the Federal
Government or agencies thereof.
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(5)
Any place, agency, clinic, or practice, public
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or private, whether organized for
profit or not, devoted exclusively to the
performance of dental or oral surgical procedures.
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(B) "Person" means
any individual, firm, partnership, corporation, company,
association, or joint stock association, or the legal
successor thereof.
(C) "Department" means
the Department of Public Health of the State of Illinois.
(D) "Director" means
the Director of the Department of Public Health of the State of Illinois.
(E) "Physician" means
a person licensed to practice medicine in all of its branches in
the State of Illinois.
(F) "Dentist" means
a person licensed to practice dentistry under the Illinois Dental
Practice Act.
(G) "Podiatrist" means
a person licensed to practice podiatry under the Podiatric Medical
Practice Act of 1987.
(Source: P.A. 88-371; 88-441; 88-490;
88-670, eff. 12-2-94.)
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(210 ILCS 5/4) (from Ch. 111 1/2, par. 157-8.4)
Sec. 4. No person shall
open, conduct or maintain an ambulatory surgical
treatment center without first obtaining a license
from the Department.
Nothing in this Act shall
be construed to impair or abridge the power of municipalities
to license and regulate ambulatory surgical treatment centers,
provided that the municipal ordinance requires compliance with
at least the minimum requirements developed by the Department
pursuant to this Act.
The Administrative Review
Law, as heretofore or hereafter amended, shall be applicable
to the judicial review of final administrative decisions of the
regulatory agency of the municipality. Any municipality having
an ordinance licensing and regulating ambulatory surgical treatment
centers which provides for minimum standards and regulations
which meet at least the minimum requirements established pursuant
to this Act shall make such periodic reports to the Department
as the Department may deem necessary. This report shall include
a list of ambulatory surgical treatment centers meeting standards
substantially equivalent to those promulgated by the Department
under this Act. The Department may issue a license to such ambulatory
surgical treatment centers based upon such reports or the Department
may conduct investigations or inspections to determine whether
a license should be issued to these ambulatory surgical treatment
centers.
(Source: P.A. 82-783.)
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(210 ILCS 5/5) (from Ch. 111 1/2, par. 157-8.5)
Sec. 5. An application for
a license to operate an ambulatory surgical treatment
center shall be made to the Department upon forms
provided by it and shall contain such information
as the Department reasonably requires, which may
include affirmative evidence of ability to comply
with the provisions of this Act and the standards,
rules and regulations, promulgated by virtue thereof.
All applications required
under this Section shall be signed by the applicant, verified,
and accompanied by a license fee of $500.
(Source: P.A. 81-224.)
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(210 ILCS 5/6) (from Ch. 111 1/2, par. 157-8.6)
Sec. 6. Upon receipt of
an application for a license, the Director may deny
the application for any of the following reasons:
(1)
Conviction of the applicant, or if the applicant
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is a firm, partnership or association,
of any of its members, or if a corporation,
of any of its officers or directors, or of
the person designated to manage or supervise
the facility, of a felony, or of 2 or more
misdemeanors involving moral turpitude, as
shown by a certified copy of the record of
the court of conviction, or, in the case
of the conviction of a misdemeanor by a court
not of record, as shown by other evidence,
if the Director determines, after investigation,
that such person has not been sufficiently
rehabilitated to warrant the public trust;
or other satisfactory evidence that the moral
character of the applicant, or manager, or
supervisor of the facility is not reputable;
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(2)
The licensure status or record of the applicant,
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or if the applicant is a firm, partnership
or association, of any of its members, or
if a corporation, of any of its officers
or directors, or of the person designated
to manage or supervise the facility, from
any other state where the applicant has done
business in a similar capacity indicates
that granting a license to the applicant
would be detrimental to the interests of
the public; or
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(3)
The applicant has insufficient financial or
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other resources to operate and conduct
the facility in accordance with the requirements
of this Act and the minimum standards, rules
and regulations promulgated thereunder.
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The Director
shall only issue a license if he finds that the applicant
facility complies with this Act and the rules, regulations
and standards promulgated pursuant thereto and:
(a)
is under the medical supervision of one or more
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(b)
permits a surgical procedure to be performed
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only by a physician, podiatrist or
dentist who at the time is privileged to
have his patients admitted by himself or
an associated physician and is himself privileged
to perform surgical procedures in at least
one Illinois hospital; and
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(c)
maintains adequate medical records for each
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A license, unless
sooner suspended or revoked, shall be renewable annually
upon approval by the Department and payment of a
license fee of $300. Each license shall be issued
only for the premises and persons named in the application
and shall not be transferable or assignable. The
licenses shall be posted in a conspicuous place on
the licensed premises. A placard or registry of all
physicians on staff in the facility shall be centrally
located and available for inspection to any interested
person. The Department may, either before or after
the issuance of a license, request the cooperation
of the State Fire Marshal. The report and recommendations
of this agency shall be in writing and shall state
with particularity its findings with respect to compliance
or noncompliance with such minimum standards, rules
and regulations.
The Director may issue a
provisional license to any ambulatory surgical treatment center
which does not substantially comply with the provisions of this
Act and the standards, rules and regulations promulgated by virtue
thereof provided that he finds that such ambulatory surgical treatment
center will undertake changes and corrections which upon completion
will render the ambulatory surgical treatment center in substantial
compliance with the provisions of this Act, and the standards,
rules and regulations adopted hereunder, and provided that the
health and safety of the patients of the ambulatory surgical treatment
center will be protected during the period for which such provisional
license is issued. The Director shall advise the licensee of the
conditions under which such provisional license is issued, including
the manner in which the facilities fail to comply with the provisions
of the Act, standards, rules and regulations, and the time within
which the changes and corrections necessary for such ambulatory
surgical treatment center to substantially comply with this Act,
and the standards, rules and regulations of the Department relating
thereto shall be completed.
A person or facility not
licensed under this Act or the Hospital Licensing Act shall not
hold itself out to the public as a "surgery center" or
as a "center for surgery".
(Source: P.A. 88-490.)
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(210 ILCS 5/6.1) (from Ch. 111 1/2, par. 157-8.6-1)
Sec. 6.1. Notwithstanding
any other provision of this Act, any corporation operating an
Ambulatory Surgical Treatment Center devoted primarily to providing
facilities for abortion must have a physician, who is licensed
to practice medicine in all of its branches and is actively engaged
in the practice of medicine at the Center, on the board of directors
as a condition to licensure of the Center.
(Source: P.A. 81-771.)
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(210 ILCS 5/6.5)
Sec. 6.5. Clinical privileges;
advanced practice nurses. All ambulatory surgical treatment centers
(ASTC) licensed under this Act shall comply with the following
requirements:
(1) No ASTC policy, rule,
regulation, or practice shall be inconsistent with the provision
of adequate collaboration, including medical direction of licensed
advanced practice nurses, in accordance with Section 54.5 of
the Medical Practice Act of 1987.
(2) Operative surgical procedures
shall be performed only by a physician licensed to practice medicine
in all its branches under the Medical Practice Act of 1987, a
dentist licensed under the Illinois Dental Practice Act, or a
podiatrist licensed under the Podiatric Medical Practice Act
of 1987, with medical staff membership and surgical clinical
privileges granted by the consulting committee of the ASTC. A
licensed physician, dentist, or podiatrist may be assisted by
a physician licensed to practice medicine in all its branches,
dentist, dental assistant, podiatrist, licensed advanced practice
nurse, licensed physician assistant, licensed registered nurse,
licensed practical nurse, surgical assistant, surgical technician,
or other individuals granted clinical privileges to assist in
surgery by the consulting committee of the ASTC. Payment for
services rendered by an assistant in surgery who is not an ambulatory
surgical treatment center employee shall be paid at the appropriate
non-physician modifier rate if the payor would have made
payment had the same services been provided by a physician.
(3) The anesthesia service
shall be under the direction of a physician licensed to practice
medicine in all its branches who has had specialized preparation
or experience in the area or who has completed a residency in
anesthesiology. An anesthesiologist, Board certified or Board
eligible, is recommended. Anesthesia services may only be administered
pursuant to the order of a physician licensed to practice medicine
in all its branches, licensed dentist, or licensed podiatrist.
(A)
The individuals who, with clinical privileges
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granted by the medical staff and ASTC,
may administer anesthesia services are limited
to the following:
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(i)
an anesthesiologist; or
(ii)
a physician licensed to practice medicine
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(iii)
a dentist with authority to administer
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anesthesia under Section 8.1 of the
Illinois Dental Practice Act; or
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(iv)
a licensed certified registered nurse
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(B)
For anesthesia services, an anesthesiologist
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shall participate through discussion
of and agreement with the anesthesia plan
and shall remain physically present and be
available on the premises during the delivery
of anesthesia services for diagnosis, consultation,
and treatment of emergency medical conditions.
In the absence of 24-hour availability
of anesthesiologists with clinical privileges,
an alternate policy (requiring participation,
presence, and availability of a physician
licensed to practice medicine in all its
branches) shall be developed by the medical
staff consulting committee in consultation
with the anesthesia service and included
in the medical staff consulting committee
policies.
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(C)
A certified registered nurse anesthetist is not
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required to possess prescriptive authority
or a written collaborative agreement meeting
the requirements of Section 15-15 of
the Nursing and Advanced Practice Nursing
Act to provide anesthesia services ordered
by a licensed physician, dentist, or podiatrist.
Licensed certified registered nurse anesthetists
are authorized to select, order, and administer
drugs and apply the appropriate medical devices
in the provision of anesthesia services under
the anesthesia plan agreed with by the anesthesiologist
or, in the absence of an available anesthesiologist
with clinical privileges, agreed with by
the operating physician, operating dentist,
or operating podiatrist in accordance with
the medical staff consulting committee policies
of a licensed ambulatory surgical treatment
center.
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(Source: P.A. 93-352, eff. 1-1-04.)
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(210 ILCS 5/7a) (from Ch. 111 1/2, par. 157-8.7a)
Sec. 7a. (a) As a condition
of the issuance or renewal of the license of any ambulatory surgical
treatment center, the applicant shall file a statement of ownership.
The applicant shall agree to update the information required
in the statement of ownership every 6 months from the initial
date of filing.
(b) The statement of ownership
shall include the following:
(1) The name, telephone
number and occupation of every person who has entered into a
contract to manage or operate or who owns or controls, directly
or indirectly, any of the shares of stock of, or any other financial
interest in, the facility which is the subject of the application
or license, and the percentage of such interest; and
(2) The address of any facility,
wherever located, any financial interest in which is owned or
controlled, directly or indirectly, by the applicant, if the
facility is required to be licensed if it were located in this
State.
(Source: P.A. 81-224.)
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(210 ILCS 5/7b) (from Ch. 111 1/2, par. 157-8.7b)
Sec. 7b. (a) Each licensee
shall file an attested financial statement with the Department
by July 1, 1980 and at times thereafter as required. An audited
financial statement may be required of a particular facility,
if the Director determines that additional information is needed.
(b) No public funds shall
be expended for the care or treatment of any patient in an ambulatory
surgical treatment center which has failed to file the financial
statement required by this Section, and no public funds shall
be paid to or on behalf of a facility which has failed to file
a statement.
(c) The Director shall promulgate
regulations for the filing of financial statements, and shall
provide in these regulations for forms, information required,
intervals and dates of filing, and such other provisions as he
may deem necessary. Regulations shall be published in sufficient
time to permit those licensees who must first file financial
statements time in which to do so.
(d) The Director shall seek
the advice and comments of other State and Federal agencies which
require the submission of financial data from facilities licensed
under this Act and shall incorporate the information requirements
of these agencies into the forms it adopts or issues under this
Act and shall otherwise coordinate its regulations with the requirements
of these agencies so as to impose the least possible burden on
licensees. No other State agency may require submission of financial
data except as expressly authorized by law or as necessary to
meet requirements of federal law or regulation. Information obtained
under this Section shall be made available, upon request, by
the Department to any other State agency or legislative commission
to which such information is necessary for investigations or
to execute the intent of State or Federal law or regulation.
(Source: P.A. 81-224.)
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(210 ILCS 5/8) (from Ch. 111 1/2, par. 157-8.8)
Sec. 8. Facility plan review;
fees.
(a) Before commencing construction
of new facilities or specified types of alteration or additions
to an existing ambulatory surgical treatment center involving
major construction, as defined by rule by the Department, with
an estimated cost greater than $100,000, architectural drawings
and specifications therefor shall be submitted to the Department
for review and approval. A facility may submit architectural
drawings and specifications for other construction projects for
Department review according to subsection (b) that shall not
be subject to fees under subsection (d). Review of drawings and
specifications shall be conducted by an employee of the Department
meeting the qualifications established by the Department of Central
Management Services class specifications for such an individual's
position or by a person contracting with the Department who meets
those class specifications. Final approval of the drawings and
specifications for compliance with design and construction standards
shall be obtained from the Department before the alteration,
addition, or new construction is begun.
(b) The Department shall
inform an applicant in writing within 10 working days after receiving
drawings and specifications and the required fee, if any, from
the applicant whether the applicant's submission is complete
or incomplete. Failure to provide the applicant with this notice
within 10 working days shall result in the submission being deemed
complete for purposes of initiating the 60-day review period
under this Section. If the submission is incomplete, the Department
shall inform the applicant of the deficiencies with the submission
in writing. If the submission is complete and the required fee,
if any, has been paid, the Department shall approve or disapprove
drawings and specifications submitted to the Department no later
than 60 days following receipt by the Department. The drawings
and specifications shall be of sufficient detail, as provided
by Department rule, to enable the Department to render a determination
of compliance with design and construction standards under this
Act. If the Department finds that the drawings are not of sufficient
detail for it to render a determination of compliance, the plans
shall be determined to be incomplete and shall not be considered
for purposes of initiating the 60 day review period. If a submission
of drawings and specifications is incomplete, the applicant may
submit additional information. The 60-day review period
shall not commence until the Department determines that a submission
of drawings and specifications is complete or the submission
is deemed complete. If the Department has not approved or disapproved
the drawings and specifications within 60 days, the construction,
major alteration, or addition shall be deemed approved. If the
drawings and specifications are disapproved, the Department shall
state in writing, with specificity, the reasons for the disapproval.
The entity submitting the drawings and specifications may submit
additional information in response to the written comments from
the Department or request a reconsideration of the disapproval.
A final decision of approval or disapproval shall be made within
45 days of the receipt of the additional information or reconsideration
request. If denied, the Department shall state the specific reasons
for the denial.
(c) The Department shall
provide written approval for occupancy pursuant to subsection
(g) and shall not issue a violation to a facility as a result
of a licensure or complaint survey based upon the facility's
physical structure if:
(1)
the Department reviewed and approved or deemed
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approved the drawings and specifications
for compliance with design and construction
standards;
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(2)
the construction, major alteration, or addition
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(3)
the law or rules have not been amended since the
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(4)
the conditions at the facility indicate that
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there is a reasonable degree of safety
provided for the patients.
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(d) The Department
shall charge the following fees in connection with
its reviews conducted before June 30, 2004 under
this Section:
(1)
(Blank).
(2)
(Blank).
(3)
If the estimated dollar value of the alteration,
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addition, or new construction is $100,000
or more but less than $500,000, the fee shall
be the greater of $2,400 or 1.2% of that
value.
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(4)
If the estimated dollar value of the alteration,
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addition, or new construction is $500,000
or more but less than $1,000,000, the fee
shall be the greater of $6,000 or 0.96% of
that value.
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(5)
If the estimated dollar value of the alteration,
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addition, or new construction is $1,000,000
or more but less than $5,000,000, the fee
shall be the greater of $9,600 or 0.22% of
that value.
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(6)
If the estimated dollar value of the alteration,
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addition, or new construction is $5,000,000
or more, the fee shall be the greater of
$11,000 or 0.11% of that value, but shall
not exceed $40,000.
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The fees provided
in this subsection (d) shall not apply to major construction
projects involving facility changes that are required
by Department rule amendments.
The fees provided in this
subsection (d) shall also not apply to major construction projects
if 51% or more of the estimated cost of the project is attributed
to capital equipment. For major construction projects where 51%
or more of the estimated cost of the project is attributed to capital
equipment, the Department shall by rule establish a fee that is
reasonably related to the cost of reviewing the project.
The Department shall not
commence the facility plan review process under this Section until
the applicable fee has been paid.
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