a) Introduction
1) This Section contains review criteria that
pertain to the birth center model category of service. The birth center model
category of service is a demonstration program that is authorized by the
Alternative Health Care Delivery
Act. Definitions pertaining to this category
of service are contained in 77 Ill. Adm. Code
1100 and
1130 and in the
Alternative Health Care Delivery
Act. These birth center model review criteria
are utilized in addition to the applicable review criteria of Subpart B and 77
Ill. Adm. Code
1120.
2) A
Certificate of Need (CON) permit shall be obtained to establish a birth center
model. CON application forms are available from HFSRB's website
(www.hfsrb.illinois.gov).
3)
Failure to obtain a permit will result in the application of sanctions as
provided for in the Illinois Health Facilities Planning Act.
4) CON applications for permits received for
the birth center model shall be deemed complete upon receipt by
HFSRB.
5) As the purpose of the
demonstration project is to evaluate the birth center model for quality
factors, access and the impact on health care costs, each applicant approved
for the category of service will be required to periodically submit data
necessary for evaluating the model's effectiveness.
b) Review Criteria
1) Location Requirements
A)
There shall be no more than 10
birth center alternative health care models in the demonstration
program including:
i) A total of 4
located in the combined Cook, DuPage, Kane, Lake, McHenry and Will
counties;
ii) A total of 3 located
in municipalities with a population of 50,000 or more not located in an area
described in subsection (b)(1)(A)(i); and
iii) A total of 3 located in rural
areas.
B) In each of the
geographic groups identified in subsection (b)(1)(A), one birth center shall be
owned or operated by a hospital and one birth center shall be owned and
operated by a federally qualified health center.
C) Documentation
i) The applicant shall document that the
proposed birth center will be located in one of the geographic areas stated in
the Alternative Health Care Delivery Act and described in subsection (b)(1)(A);
and
ii) The applicant shall
document that the proposed birth center is owned or operated by a hospital or
owned or operated by a federally qualified health center or owned and operated
by a private person or entity.
D) As stated in Section 30 of the Alternative
Health Care Delivery Act, there shall be no more than 2 birth centers
authorized to operate in any single health planning area for obstetric services
as determined under the Illinois Health Facilities Planning Act [ 20
ILCS 3960 ].
2) Service
Provision to a Health Professional Shortage Area
A)
The first 3 birth centers
authorized to be operated by IDPH shall be located in or
predominantly serve the residents of a health professional shortage area, as
determined by the U.S. Department of Health and Human Services. [
210 ILCS
3/30 ] The applicant shall document whether the
proposed site is located in or will predominantly serve the residents of a
health professional shortage area.
B)
If a birth center is located
outside of a health professional shortage area:
i)
the birth center shall be located
in a health planning area with a demonstrated need for obstetrical service
beds, as determined by the Health Facilities and Services Review Board;
or
ii)
there shall be a reduction in the existing number of
obstetrical service beds in the planning area so that the establishment of the
birth center does not result in an increase in the total number of obstetrical
service beds in the health planning area. [
210 ILCS
3/30 ]
3) Admission Policies
A birth center may not discriminate against any
patient requiring treatment because of the source of payment for services,
including Medicare and Medicaid recipients. [
210 ILCS
3/35 ] Documentation shall consist of copies of all
admission policies to be in effect at the facility and a signed statement that
no restrictions on admissions due to these factors will occur.
4) Bed Capacity
The applicant shall document that the proposed birth center
will have no more than 10 beds.
5) Staffing Availability
The applicant shall document that relevant clinical and
professional staffing needs for the proposed project were considered and that
licensure staffing requirements can be met. In addition, the applicant shall
document that necessary staffing is available by providing a narrative
explanation of how the proposed staffing will be achieved.
6) Emergency Surgical Backup
The applicant shall document that either:
A) The birth center will operate under a
hospital license and will be located within 30 minutes ground travel
time from the hospital to allow for an emergency caesarian delivery to be
started within 30 minutes after the decision that a caesarian
delivery is necessary; or
B) A contractual agreement has been signed
with a licensed hospital for the referral and transfer of patients in need of
an emergency caesarian delivery. Birth centers shall be located within
30 minutes ground travel time from the licensed hospital to allow for an
emergency caesarian delivery to be started within 30 minutes after
the decision that a caesarian delivery is necessary. [
210 ILCS
3/35 ]
7) Education
A birth center shall offer prenatal care and
community education services and shall coordinate these services with other
health care services available in the community. [
210 ILCS
3/35 ] Documentation shall consist of a written
narrative on the prenatal care and community education services offered by the
birth center and how these services are being coordinated with other health
services in the community.
8) Inclusion in Perinatal System
A) Requirements
i)
At a minimum, the birth
center's participation shall require a birth center to establish a
letter of agreement with a hospital designated under the Perinatal
System.
ii)
A
hospital that operated or has a letter of agreement with a birth center shall
include the birth center under its maternity service plan under the Hospital
Licensing Act and shall include the birth center in the hospital's letter of
agreement with its perinatal center. [
210 ILCS
3/30 ]
B) Documentation
i) A hospital that operated or has a letter
of agreement with a birth center shall provide a copy of the hospital's letter
of agreement with its perinatal center and of copy of the hospital's maternity
service plan.
ii) An applicant that
is not a hospital shall identify the regional perinatal center that will
provide neonatal intensive care services, as needed, to the applicant birth
center patients. A letter of intent, signed by both the administrator of the
proposed birth center and the administrator of the regional perinatal center,
shall be provided.
9) Medicare/Medicaid Certification
The applicant shall document that the proposed birth center
will be certified to participate in the Medicare and Medicaid programs under
titles XVIII and XIX, respectively, of the federal Social Security Act (
42 USC
1395 and
1396
).
10) Charity Care
All birth centers shall provide
charitable care consistent with that provided by comparable health care
providers in the geographic area. [
210 ILCS
3/30 ] The applicant shall provide to HFSRB a copy of
the charity care policy that will be adopted by the proposed birth
center.
11) Quality
Assurance
Each birth center shall implement a
quality assurance program with measurable benefits. [
210 ILCS
3/30 ] The applicant shall provide to HFSRB a copy of
the quality assurance program to be adopted by the birth
center.
