Illinois Administrative Code › Title 77 - PUBLIC HEALTH › Part 265 - BIRTH CENTER DEMONSTRATION PROGRAM CODE › Subpart A - GENERAL REQUIREMENTS › Section 265.1300 - Application for Initial License

Current through Register Vol. 48, No. 28, July 12, 2024
a)
				An application for a license to establish or operate a birth center shall be
				made in writing on forms provided by the Department.
b) A change of ownership will require a new
				application.
c) The application
				shall include proof of a Certificate of Need to establish and operate a Birth
				Center Model issued by the Health Facilities and Services Review Board under
				the Illinois Health Facilities Planning Act.
d) Application forms and other required
				information shall be submitted and approved pursuant to Subpart B of this Part,
				prior to surveys of the physical plant or review of building plans and
				specifications.
e) Each application
				shall be accompanied by a non-refundable license application fee of $500 plus
				$100 for each licensed birthing bed.
f) The application shall contain, at a
				minimum, the following information:
1) The
				name, address and telephone number of the applicant, if the applicant is an
				individual; in the case of a firm, partnership, or association, of every member
				thereof; in the case of a corporation, the name, address and phone number
				thereof and of its officers and its registered agent; and in the case of a unit
				of local government, the name, address and telephone number of its chief
				executive officer.
2) The name of
				the person or persons who will manage or operate the birth center.
3) The location of the birth center,
				including the name, address, and number of beds, not to exceed 10.
4) Information regarding any conviction of
				the applicant; or, if the applicant is a firm, partnership or association, of
				any of its members; or, if the applicant is a corporation, of any of its
				officers or directors; or of the person designated to manage or operate the
				birth center, of a felony, or of two or more misdemeanors involving moral
				turpitude in the last five years.
5) The name, address, telephone number,
				experience, credentials and any professional licensure or certification of the
				following persons:
A)
				Administrator;
B) Medical director;
				and
C) Director of Nursing and
				Midwifery Services.
6) A
				list of the medical staff, including name and license number.
7) A list of the number and type of proposed
				staff.
8) A detailed description of
				the services to be provided by the birth center, including the admission
				criteria (see Section
				265.1550
				).
9) Schematic architectural
				plans.
10) A copy of the contract
				between the birth center and hospital, including a transfer agreement pursuant
				to Section
				265.1250(h).
11) The letter of agreement with a perinatal
				center for referral of high risk infants based upon the Regionalized Perinatal
				Health Care Code.
12) 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.