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Full Text of HB5370  97th General Assembly

HB5370 97TH GENERAL ASSEMBLY


 


 
97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB5370

 

Introduced 2/15/2012, by Rep. Maria Antonia Berrios - Kelly M. Cassidy

 

SYNOPSIS AS INTRODUCED:
 
New Act
5 ILCS 80/4.33 new
225 ILCS 60/4  from Ch. 111, par. 4400-4
225 ILCS 65/50-15  was 225 ILCS 65/5-15
305 ILCS 5/5-5  from Ch. 23, par. 5-5

    Creates the Home Birth Safety Act. Provides for the licensure of midwives by the Department of Financial and Professional Regulation. Creates the Illinois Midwifery Board. Sets forth provisions concerning qualifications, grounds for disciplinary action, and administrative procedures. Amends the Regulatory Sunset Act to set a repeal date for the new Act of January 1, 2023. Also amends the Medical Practice Act of 1987, the Nurse Practice Act, and the Illinois Public Aid Code to make related changes. Effective immediately.


LRB097 19017 CEL 64256 b

CORRECTIONAL BUDGET AND IMPACT NOTE ACT MAY APPLY
FISCAL NOTE ACT MAY APPLY
HOME RULE NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 1. Short title. This Act may be cited as the Home
5Birth Safety Act.
 
6    Section 5. Purpose. The practice of midwifery in
7out-of-hospital settings is hereby declared to affect the
8public health, safety, and welfare and to be subject to
9regulation in the public interest. The purpose of the Act is to
10protect and benefit the public by setting standards for the
11qualifications, education, training, and experience of those
12who seek to obtain licensure and hold the title of Licensed
13Midwife, to promote high standards of professional performance
14for those licensed to practice midwifery in out-of-hospital
15settings in this State, and to protect the public from
16unprofessional conduct by persons licensed to practice
17midwifery, as defined in this Act. This Act shall be liberally
18construed to best carry out these purposes.
 
19    Section 10. Exemptions.
20    (a) This Act does not prohibit a person licensed under any
21other Act in this State from engaging in the practice for which
22he or she is licensed or from delegating services as provided

 

 

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1for under that other Act.
2    (b) Nothing in this Act shall be construed to prohibit or
3require licensing under this Act, with regard to:
4        (1) the gratuitous rendering of services;
5        (2) the rendering of services by a person, if such
6    attendance is in accordance with the person's religious
7    faith and is rendered to persons with a similar religious
8    faith as an exercise and enjoyment of their religious
9    freedom; and
10        (3) a student midwife working under the direction of a
11    licensed midwife.
 
12    Section 15. Definitions. In this Act:
13    "Board" means the Illinois Midwifery Board.
14    "Certified professional midwife" means a person who has met
15the standards for certification set by the North American
16Registry of Midwives or a successor organization and has been
17awarded the Certified Professional Midwife (CPM) credential.
18    "Collaboration" means a process involving 2 or more health
19care professionals working together, each contributing one's
20respective area of expertise to provide more comprehensive
21patient care.
22    "Consultation" means the process whereby a licensed
23midwife seeks the advice or opinion of another health care
24professional.
25    "Department" means the Department of Financial and

 

 

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1Professional Regulation.
2    "Licensed midwife" means a person who has been granted a
3license under this Act to engage in the practice of midwifery.
4    "National Association of Certified Professional Midwives"
5or "NACPM" means the professional organization, or its
6successor, that promotes the growth and development of the
7profession of certified professional midwives.
8    "North American Registry of Midwives" or "NARM" means the
9accredited international agency, or its successor, that has
10established and has continued to administer certification for
11the credentialing of certified professional midwives.
12    "Practice of midwifery" means providing the necessary
13supervision, care, education, and advice to women during the
14antepartum, intrapartum, and postpartum period, conducting
15deliveries independently, and caring for the newborn, with such
16care including without limitation preventative measures, the
17detection of abnormal conditions in the mother and the child,
18the procurement of medical assistance, and the execution of
19emergency measures in the absence of medical help. "Practice of
20midwifery" includes non-prescriptive family planning.
21    "Secretary" means the Secretary of Financial and
22Professional Regulation.
23    "Written collaborative agreement" means a written
24agreement between a licensed midwife and a collaborating
25physician or advanced practice nurse.
 

 

 

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1    Section 20. Unlicensed practice. Beginning January 1,
22013, no person may practice, attempt to practice, or hold
3himself or herself out to practice as a licensed midwife unless
4he or she is licensed as a midwife under this Act.
 
5    Section 25. Title. A licensed midwife may identify himself
6or herself as a Licensed Midwife or a Licensed Home Birth
7Midwife and may use the abbreviation L.M.
 
8    Section 30. Informed consent.
9    (a) A licensed midwife shall, at an initial consultation
10with a client, provide a copy of the rules under this Act and
11disclose to the client orally and in writing all of the
12following:
13        (1) The licensed midwife's experience and training.
14        (2) Whether the licensed midwife has malpractice
15    liability insurance coverage and the policy limits of any
16    such coverage.
17        (3) A written protocol for the handling of medical
18    emergencies, including transportation to a hospital,
19    particular to each client.
20        (4) A notice that the client must obtain a physical
21    examination from a physician licensed to practice medicine
22    in all its branches, doctor of osteopathy, physician
23    assistant, or advanced practice nurse.
24    (b) A copy of the informed consent document, signed and

 

 

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1dated by the client, must be kept in each client's chart.
 
2    Section 33. Vicarious liability. No physician licensed to
3practice medicine in all its branches or advanced practice
4nurse shall be held liable for an injury solely resulting from
5an act or omission by a licensed midwife occurring outside of a
6hospital, doctor's office or health care facility.
7    Except as may otherwise be provided by law, nothing in this
8Section shall exempt any physician licensed to practice
9medicine in all its branches or advanced practice nurse from
10liability for his or her own negligent, grossly negligent, or
11willful or wanton acts or omissions.
 
12    Section 35. Advertising.
13    (a) Any person licensed under this Act may advertise the
14availability of professional midwifery services in the public
15media or on premises where professional services are rendered,
16if the advertising is truthful and not misleading and is in
17conformity with any rules regarding the practice of a licensed
18midwife.
19    (b) A licensee must include in every advertisement for
20midwifery services regulated under this Act his or her title as
21it appears on the license or the initials authorized under this
22Act.
 
23    Section 40. Powers and duties of the Department; rules.

 

 

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1    (a) The Department shall exercise the powers and duties
2prescribed by the Civil Administrative Code of Illinois for the
3administration of licensing Acts and shall exercise such other
4powers and duties necessary for effectuating the purposes of
5this Act.
6    (b) The Secretary shall adopt rules consistent with the
7provisions of this Act for the administration and enforcement
8of the Act and for the payment of fees connected to the Act and
9may prescribe forms that shall be issued in connection with the
10Act. The rules shall include, but not be limited to, the
11following:
12        (1) With regard to testing, care, and screening, a
13    licensed midwife shall:
14            (A) offer each client routine prenatal care and
15        testing in accordance with current American College of
16        Obstetricians and Gynecologists guidelines;
17            (B) provide all clients with a plan for 24-hour
18        on-call availability by a licensed midwife, certified
19        nurse-midwife, or licensed physician throughout
20        pregnancy, intrapartum, and 6 weeks postpartum;
21            (C) provide clients with labor support, fetal
22        monitoring, and routine assessment of vital signs once
23        active labor is established;
24            (D) supervise delivery of infant and placenta,
25        assess newborn and maternal well-being in immediate
26        postpartum, and perform Apgar scores;

 

 

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1            (E) administer, if necessary, oxytoxin (Pitocin)
2        solely as an anti-hemorrhagic agent, oxygen and
3        intravenous fluids for stabilization, and other drugs
4        or procedures as determined by the Department;
5            (F) perform routine cord management and inspect
6        for the appropriate number of vessels;
7            (G) inspect the placenta and membranes for
8        completeness;
9            (H) inspect the perineum and vagina postpartum for
10        lacerations and stabilize;
11            (I) observe mother and newborn postpartum until
12        stable condition is achieved, but in no event for less
13        than 2 hours;
14            (J) instruct the mother, father, and other support
15        persons, both verbally and in writing, of the special
16        care and precautions for both mother and newborn in the
17        immediate postpartum period;
18            (K) reevaluate maternal and newborn well-being
19        within 36 hours after delivery.
20            (L) use universal precautions with all biohazard
21        materials;
22            (M) ensure that a birth certificate is accurately
23        completed and filed in accordance with State law;
24            (N) offer to obtain and submit a blood sample, in
25        accordance with the recommendations for metabolic
26        screening of the newborn;

 

 

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1            (O) offer an injection of vitamin K for the
2        newborn, in accordance with the indication, dose, and
3        administration route set by the Department in rules.
4            (P) within one week after delivery, offer a newborn
5        hearing screening to every newborn or refer the parents
6        to a facility with a newborn hearing screening program;
7            (Q) within 2 hours after the birth, offer the
8        administration of anti-biotic ointment into the eyes
9        of the newborn, in accordance with State law on the
10        prevention of infant blindness; and
11            (R) maintain adequate antenatal and perinatal
12        records of each client and provide records to
13        consulting licensed physicians and licensed certified
14        nurse-midwives, in accordance with the federal Health
15        Insurance Portability and Accountability Act.
16        (2) With regard to collaboration, a licensed midwife
17    must form a written collaborative agreement with a medical
18    doctor or doctor of osteopathy licensed under the Medical
19    Practice Act of 1987 or with a certified nurse midwife
20    licensed as an advanced practice nurse under the Nurse
21    Practice Act. This agreement must:
22            (A) include documented quarterly review of all
23        clients under the care of the licensed midwife;
24            (B) include written protocols and procedures for
25        assessing risk and appropriateness for homebirth,
26        provide supportive care when care is transferred to

 

 

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1        another provider, if possible; and
2            (C) consider the standards regarding practice of
3        midwifery established by the National Association of
4        Certified Professional Midwives, including referral of
5        mother or baby to appropriate professionals when
6        either needs care outside the midwife's scope of
7        practice or expertise.
8        Collaboration does not require an employment
9    relationship between the collaborating physician or
10    certified nurse-midwife. Absent an employment
11    relationship, an agreement may not restrict the categories
12    of patients or third-party payment sources accepted by the
13    licensed midwife.
14        Nothing in this Act shall be construed to limit
15    delegation of tasks or duties by a physician or certified
16    nurse-midwife to a licensed midwife in accordance with
17    Section 54.2 of the Medical Practice Act of 1987 and
18    subsection (b) of Section 50-75 of the Nurse Practice Act.
19    Nothing in this Act shall be construed to limit the method
20    of delegation that may be authorized by any means,
21    including, but not limited to, oral, written, electronic,
22    standing orders, protocols, guidelines, or verbal orders.
23        This relationship must not be construed to necessarily
24    require the personal presence of the collaborating care
25    provider at all times at the place where services are
26    rendered, as long as there is communication available for

 

 

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1    consultation by radio, telephone, Internet, or
2    telecommunications.
3        A copy of the signed, written collaborative agreement
4    must be available to the Department upon request from both
5    the licensed midwife and the collaborating physician or
6    certified nurse-midwife.
7        If a licensed midwife makes 10 failed attempts,
8    documented by certified mail, to secure a written
9    collaborative agreement, then he or she may practice
10    unencumbered.
11        (3) With regard to prohibited practices, a licensed
12    midwife may not do any of the following:
13            (A) Administer prescription pharmacological agents
14        intended to induce or augment labor.
15            (B) Administer prescription pharmacological agents
16        to provide pain management.
17            (C) Use vacuum extractors or forceps.
18            (D) Prescribe medications.
19            (E) Perform major surgical procedures including,
20        but not limited to, abortions, cesarean sections, and
21        circumcisions.
22    (c) The Department shall consult with the Board in adopting
23rules. Notice of proposed rulemaking shall be transmitted to
24the Board and the Department shall review the Board's response
25and any recommendations made. The Department shall notify the
26Board in writing with proper explanation of deviations from the

 

 

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1Board's recommendations and responses.
2    (d) The Department may at any time seek the advice and the
3expert knowledge of the Board on any matter relating to the
4administration of this Act.
5    (e) The Department shall issue quarterly a report to the
6Board of the status of all complaints related to the profession
7filed with the Department.
8    (f) Administration by the Department of this Act must be
9consistent with standards regarding the practice of midwifery
10established by the National Association of Certified
11Professional Midwives or a successor organization whose
12essential documents include without limitation subject matter
13concerning scope of practice, standards of practice, informed
14consent, appropriate consultation, collaboration or referral,
15and acknowledgement of a woman's right to self determination
16concerning her maternity care.
 
17    Section 45. Illinois Midwifery Board.
18    (a) There is created under the authority of the Department
19the Illinois Midwifery Board, which shall consist of 7 members
20appointed by the Secretary, 4 of whom shall be licensed
21midwives who carry the CPM credential, except that initial
22appointees must have at least 3 years of experience in the
23practice of midwifery in an out-of-hospital setting, be
24certified by the North American Registry of Midwives, and meet
25the qualifications for licensure set forth in this Act; one of

 

 

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1whom shall be an obstetrician or a family practice physician
2licensed under the Medical Practice Act of 1987 who has a
3minimum of 2 years of experience providing home birth services
4or consulting with home birth providers; one of whom shall be a
5certified nurse midwife who has at least 2 years of experience
6in providing home birth services; and one of whom shall be a
7knowledgeable public member who has given birth with the
8assistance of a certified professional midwife in an
9out-of-hospital birth setting. Board members shall serve
104-year terms, except that in the case of initial appointments,
11terms shall be staggered as follows: 3 members shall serve for
124 years, 2 members shall serve for 3 years, and 2 members shall
13serve for 2 years. The Board shall annually elect a chairperson
14and vice chairperson.
15    (b) Any appointment made to fill a vacancy shall be for the
16unexpired portion of the term. Appointments to fill vacancies
17shall be made in the same manner as original appointments. No
18Board member may be reappointed for a term that would cause his
19or her continuous service on the Board to exceed 9 years.
20    (c) Board membership must have reasonable representation
21from different geographic areas of this State.
22    (d) The members of the Board shall be reimbursed for all
23legitimate, necessary, and authorized expenses incurred in
24attending the meetings of the Board.
25    (e) The Secretary may remove any member for cause at any
26time prior to the expiration of his or her term.

 

 

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1    (f) Four Board members shall constitute a quorum. A vacancy
2in the membership of the Board shall not impair the right of a
3quorum to perform all of the duties of the Board.
4    (g) The Board shall provide the Department with
5recommendations concerning the administration of this Act and
6perform each of the following duties:
7        (1) Recommend to the Department the prescription and,
8    from time to time, the revision of any rules that may be
9    necessary to carry out the provisions of this Act,
10    including those that are designed to protect the health,
11    safety, and welfare of the public.
12        (2) Conduct hearings and disciplinary conferences on
13    disciplinary charges of licensees.
14        (3) Report to the Department, upon completion of a
15    hearing, the disciplinary actions recommended to be taken
16    against a person found in violation of this Act.
17        (4) Recommend the approval, denial of approval, and
18    withdrawal of approval of required education and
19    continuing educational programs.
20    (h) The Secretary shall give due consideration to all
21recommendations of the Board. If the Secretary takes action
22contrary to a recommendation of the Board, the Secretary must
23promptly provide a written explanation of that action.
24    (i) The Board may recommend to the Secretary that one or
25more licensed midwives be selected by the Secretary to assist
26in any investigation under this Act. Compensation shall be

 

 

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1provided to any licensee who provides assistance under this
2subsection (i), in an amount determined by the Secretary.
3    (j) Members of the Board shall be immune from suit in an
4action based upon a disciplinary proceeding or other activity
5performed in good faith as a member of the Board, except for
6willful or wanton misconduct.
 
7    Section 50. Qualifications.
8    (a) A person is qualified for licensure as a midwife if
9that person meets each of the following qualifications:
10        (1) He or she has earned an associate's degree or
11    higher, or the equivalent of an associate's degree or
12    higher, in either nursing or midwifery from an accredited
13    post-secondary institution or has earned a general
14    associates degree or its equivalent, including completion
15    of all of the following coursework from an accredited
16    post-secondary institution in the following denominations:
17        (A) Laboratory Science (must include coursework in
18    Anatomy and Physiology and Microbiology): 12 credit hours.
19        (B) English or Communications: 6 credit hours.
20        (C) Social and Behavioral Science (Sociology and
21    Psychology): 6 credit hours.
22        (D) Math: 3 credit hours.
23        (E) Nutrition: 3 credit hours.
24        (F) Pharmacology: 3 credit hours.
25        (2) He or she has successfully completed a program of

 

 

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1    midwifery education approved by the North American
2    Registry of Midwives that includes both didactic and
3    clinical internship experience, the sum of which, on
4    average, takes 3 to 5 years to complete.
5        (3) He or she has passed a written and practical skills
6    examination for the practice of midwifery that has been
7    developed following the standards set by the National
8    Commission for Certifying Agencies or a successor
9    organization and is administered by the North American
10    Registry of Midwives.
11        (4) He or she holds a valid CPM credential granted by
12    the North American Registry of Midwives.
13    (b) Before March 1, 2013, a person seeking licensure as a
14licensed midwife who has not met the educational requirements
15set forth in this Section shall be qualified for licensure if
16that person does all of the following:
17        (1) Submits evidence of having successfully passed the
18    national certification exam described in subsection (a) of
19    this Section prior to January 1, 2006.
20        (2) Submits evidence of current certification in adult
21    CPR and in neonatal resuscitation.
22        (3) Has continually maintained active, up-to-date
23    recertification status as a certified professional midwife
24    with the North American Registry of Midwives.
25        (4) Submits evidence of practice for at least 5 years
26    as a midwife delivering in an out-of-hospital setting.

 

 

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1    (c) Nothing used in submitting evidence of practice of
2midwifery when applying for licensure under this Act shall be
3used as evidence or to take legal action against the applicant
4regarding the practice of midwifery, nursing, or medicine prior
5to the passage of this Act.
 
6    Section 55. Social Security Number on application. In
7addition to any other information required to be contained in
8the application, every application for an original, renewal,
9reinstated, or restored license under this Act shall include
10the applicant's Social Security Number.
 
11    Section 60. Continuing education.
12    (a) The Department shall require all licensed midwives to
13submit proof of the completion of at least 25 hours of
14continuing education in classes approved by the North American
15Registry of Midwives and 5 hours of peer review per 3-year
16license renewal cycle.
17    (b) Rules adopted under this Act shall require the licensed
18midwife to maintain CPM certification by meeting all the
19requirements set forth by the North American Registry of
20Midwives or its successor.
21    (c) Each licensee is responsible for maintaining records of
22completion of continuing education and shall be prepared to
23produce the records when requested by the Department.
 

 

 

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1    Section 65. Inactive status.
2    (a) A licensed midwife who notifies the Department in
3writing on forms prescribed by the Department may elect to
4place his or her license on an inactive status and shall be
5excused from payment of renewal fees until he or she notifies
6the Department in writing of his or her intent to restore the
7license.
8    (b) A licensed midwife whose license is on inactive status
9may not practice licensed midwifery in the State of Illinois.
10    (c) A licensed midwife requesting restoration from
11inactive status shall be required to pay the current renewal
12fee and to restore his or her license, as provided by the
13Department.
14    (d) Any licensee who engages in the practice of midwifery
15while his or her license is lapsed or on inactive status shall
16be considered to be practicing without a license, which shall
17be grounds for discipline.
 
18    Section 70. Renewal, reinstatement, or restoration of
19licensure; military service.
20    (a) The expiration date and renewal period for each license
21issued under this Act shall be set by the Department.
22    (b) All renewal applicants shall provide proof of having
23met the requirements of continuing education set forth by the
24North American Registry of Midwives or its successor. The
25Department shall provide for an orderly process for the

 

 

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1reinstatement of licenses that have not been renewed due to
2failure to meet continuing education requirements.
3    (c) Any licensed midwife who has permitted his or her
4license to expire or who has had his or her license on inactive
5status may have his or her license restored by making
6application to the Department and filing proof acceptable to
7the Department of fitness to have the license restored and by
8paying the required fees. Proof of fitness may include evidence
9attesting to active lawful practice in another jurisdiction.
10    (d) The Department shall determine, by an evaluation
11program, fitness for restoration of a license under this
12Section and shall establish procedures and requirements for
13restoration.
14    (e) Any licensed midwife whose license expired while he or
15she was (i) in federal service on active duty with the Armed
16Forces of the United States or the State Militia and called
17into service or training or (ii) or received education under
18the supervision of the United States preliminary to induction
19into the military service may have his or her license restored
20without paying any lapsed renewal fees, if, within 2 years
21after honorable termination of service, training, or
22education, he or she furnishes the Department with satisfactory
23evidence to the effect that he or she has been so engaged.
 
24    Section 75. Roster. The Department shall maintain a roster
25of the names and addresses of all licensees and of all persons

 

 

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1whose licenses have been suspended or revoked. This roster
2shall be available upon written request and payment of the
3required fee.
 
4    Section 80. Fees.
5    (a) The Department shall provide for a schedule of fees for
6the administration and enforcement of this Act, including
7without limitation original licensure, renewal, and
8restoration, which fees shall be nonrefundable.
9    (b) All fees collected under this Act shall be deposited
10into the General Professions Dedicated Fund and appropriated to
11the Department for the ordinary and contingent expenses of the
12Department in the administration of this Act.
 
13    Section 85. Returned checks; fines. Any person who delivers
14a check or other payment to the Department that is returned to
15the Department unpaid by the financial institution upon which
16it is drawn shall pay to the Department, in addition to the
17amount already owed to the Department, a fine of $50. The fines
18imposed by this Section are in addition to any other discipline
19provided under this Act for unlicensed practice or practice on
20a non-renewed license. The Department shall notify the person
21that fees and fines shall be paid to the Department by
22certified check or money order within 30 calendar days after
23the notification. If, after the expiration of 30 days from the
24date of the notification, the person has failed to submit the

 

 

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1necessary remittance, the Department shall automatically
2terminate the license or deny the application, without hearing.
3If, after termination or denial, the person seeks a license, he
4or she shall apply to the Department for restoration or
5issuance of the license and pay all fees and fines due to the
6Department. The Department may establish a fee for the
7processing of an application for restoration of a license to
8defray all expenses of processing the application. The
9Secretary may waive the fines due under this Section in
10individual cases where the Secretary finds that the fines would
11be unreasonable or unnecessarily burdensome.
 
12    Section 90. Unlicensed practice; civil penalty. Any person
13who practices, offers to practice, attempts to practice, or
14holds himself or herself out to practice midwifery or as a
15midwife without being licensed under this Act shall, in
16addition to any other penalty provided by law, pay a civil
17penalty to the Department in an amount not to exceed $5,000 for
18each offense, as determined by the Department. The civil
19penalty shall be assessed by the Department after a hearing is
20held in accordance with the provisions set forth in this Act
21regarding the provision of a hearing for the discipline of a
22licensee. The civil penalty shall be paid within 60 days after
23the effective date of the order imposing the civil penalty. The
24order shall constitute a judgment and may be filed and
25execution had thereon in the same manner as any judgment from

 

 

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1any court of record. The Department may investigate any
2unlicensed activity.
 
3    Section 95. Grounds for disciplinary action.
4    (a) The Department may refuse to issue or to renew or may
5revoke, suspend, place on probation, reprimand or take other
6disciplinary action as the Department may deem proper,
7including fines not to exceed $5,000 for each violation, with
8regard to any licensee or license for any one or combination of
9the following causes:
10        (1) Violations of this Act or its rules.
11        (2) Material misstatement in furnishing information to
12    the Department.
13        (3) Conviction of any crime under the laws of any U.S.
14    jurisdiction that is (i) a felony, (ii) a misdemeanor, an
15    essential element of which is dishonesty, or (iii) directly
16    related to the practice of the profession.
17        (4) Making any misrepresentation for the purpose of
18    obtaining a license.
19        (5) Professional incompetence or gross negligence.
20        (6) Gross malpractice.
21        (7) Aiding or assisting another person in violating any
22    provision of this Act or its rules.
23        (8) Failing to provide information within 60 days in
24    response to a written request made by the Department.
25        (9) Engaging in dishonorable, unethical, or

 

 

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1    unprofessional conduct of a character likely to deceive,
2    defraud, or harm the public.
3        (10) Habitual or excessive use or addiction to alcohol,
4    narcotics, stimulants, or any other chemical agent or drug
5    that results in the inability to practice with reasonable
6    judgment, skill, or safety.
7        (11) Discipline by another U.S. jurisdiction or
8    foreign nation if at least one of the grounds for the
9    discipline is the same or substantially equivalent to those
10    set forth in this Act.
11        (12) Directly or indirectly giving to or receiving from
12    any person, firm, corporation, partnership, or association
13    any fee, commission, rebate, or other form of compensation
14    for any professional services not actually or personally
15    rendered. This shall not be deemed to include rent or other
16    remunerations paid to an individual, partnership, or
17    corporation by a licensed midwife for the lease, rental, or
18    use of space, owned or controlled by the individual,
19    partnership, corporation, or association.
20        (13) A finding by the Department that the licensee,
21    after having his or her license placed on probationary
22    status, has violated the terms of probation.
23        (14) Abandonment of a patient without cause.
24        (15) Willfully making or filing false records or
25    reports relating to a licensee's practice, including, but
26    not limited to, false records filed with State agencies or

 

 

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1    departments.
2        (16) Physical illness or mental illness, including,
3    but not limited to, deterioration through the aging process
4    or loss of motor skill that results in the inability to
5    practice the profession with reasonable judgment, skill,
6    or safety.
7        (17) Failure to provide a patient with a copy of his or
8    her record upon the written request of the patient.
9        (18) Conviction by any court of competent
10    jurisdiction, either within or without this State, of any
11    violation of any law governing the practice of licensed
12    midwifery or conviction in this or another state of any
13    crime that is a felony under the laws of this State or
14    conviction of a felony in a federal court, if the
15    Department determines, after investigation, that the
16    person has not been sufficiently rehabilitated to warrant
17    the public trust.
18        (19) A finding that licensure has been applied for or
19    obtained by fraudulent means.
20        (20) Being named as a perpetrator in an indicated
21    report by the Department of Healthcare and Family Services
22    under the Abused and Neglected Child Reporting Act and upon
23    proof by clear and convincing evidence that the licensee
24    has caused a child to be an abused child or a neglected
25    child, as defined in the Abused and Neglected Child
26    Reporting Act.

 

 

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1        (21) Practicing or attempting to practice under a name
2    other than the full name shown on a license issued under
3    this Act.
4        (22) Immoral conduct in the commission of any act, such
5    as sexual abuse, sexual misconduct, or sexual
6    exploitation, related to the licensee's practice.
7        (23) Maintaining a professional relationship with any
8    person, firm, or corporation when the licensed midwife
9    knows or should know that a person, firm, or corporation is
10    violating this Act.
11        (24) Failure to provide satisfactory proof of having
12    participated in approved continuing education programs as
13    determined by the Board and approved by the Secretary.
14    Exceptions for extreme hardships are to be defined by the
15    Department.
16    (b) The Department may refuse to issue or may suspend the
17license of any person who fails to (i) file a tax return or to
18pay the tax, penalty, or interest shown in a filed return or
19(ii) pay any final assessment of the tax, penalty, or interest,
20as required by any tax Act administered by the Illinois
21Department of Revenue, until the time that the requirements of
22that tax Act are satisfied.
23    (c) The determination by a circuit court that a licensee is
24subject to involuntary admission or judicial admission as
25provided in the Mental Health and Developmental Disabilities
26Code operates as an automatic suspension. The suspension shall

 

 

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1end only upon a finding by a court that the patient is no
2longer subject to involuntary admission or judicial admission,
3the issuance of an order so finding and discharging the
4patient, and the recommendation of the Board to the Secretary
5that the licensee be allowed to resume his or her practice.
6    (d) In enforcing this Section, the Department, upon a
7showing of a possible violation, may compel any person licensed
8to practice under this Act or who has applied for licensure or
9certification pursuant to this Act to submit to a mental or
10physical examination, or both, as required by and at the
11expense of the Department. The examining physicians shall be
12those specifically designated by the Department. The
13Department may order an examining physician to present
14testimony concerning the mental or physical examination of the
15licensee or applicant. No information shall be excluded by
16reason of any common law or statutory privilege relating to
17communications between the licensee or applicant and the
18examining physician. The person to be examined may have, at his
19or her own expense, another physician of his or her choice
20present during all aspects of the examination. Failure of any
21person to submit to a mental or physical examination when
22directed shall be grounds for suspension of a license until the
23person submits to the examination if the Department finds,
24after notice and hearing, that the refusal to submit to the
25examination was without reasonable cause.
26    If the Department finds an individual unable to practice

 

 

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1because of the reasons set forth in this subsection (d), the
2Department may require that individual to submit to care,
3counseling, or treatment by physicians approved or designated
4by the Department, as a condition, term, or restriction for
5continued, reinstated, or renewed licensure to practice or, in
6lieu of care, counseling, or treatment, the Department may file
7a complaint to immediately suspend, revoke, or otherwise
8discipline the license of the individual. Any person whose
9license was granted, reinstated, renewed, disciplined, or
10supervised subject to such terms, conditions, or restrictions
11and who fails to comply with such terms, conditions, or
12restrictions shall be referred to the Secretary for a
13determination as to whether or not the person shall have his or
14her license suspended immediately, pending a hearing by the
15Department.
16    In instances in which the Secretary immediately suspends a
17person's license under this Section, a hearing on that person's
18license must be convened by the Department within 15 days after
19the suspension and completed without appreciable delay. The
20Department may review the person's record of treatment and
21counseling regarding the impairment, to the extent permitted by
22applicable federal statutes and regulations safeguarding the
23confidentiality of medical records.
24    A person licensed under this Act and affected under this
25subsection (d) shall be afforded an opportunity to demonstrate
26to the Department that he or she can resume practice in

 

 

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1compliance with acceptable and prevailing standards under the
2provisions of his or her license.
 
3    Section 100. Failure to pay restitution. The Department,
4without further process or hearing, shall suspend the license
5or other authorization to practice of any person issued under
6this Act who has been certified by court order as not having
7paid restitution to a person under Section 8A-3.5 of the
8Illinois Public Aid Code or under Section 46-1 of the Criminal
9Code of 1961. A person whose license or other authorization to
10practice is suspended under this Section is prohibited from
11practicing until restitution is made in full.
 
12    Section 105. Injunction; cease and desist order.
13    (a) If a person violates any provision of this Act, the
14Secretary may, in the name of the People of the State of
15Illinois, through the Attorney General or the State's Attorney
16of any county in which the action is brought, petition for an
17order enjoining the violation or enforcing compliance with this
18Act. Upon the filing of a verified petition in court, the court
19may issue a temporary restraining order, without notice or
20bond, and may preliminarily and permanently enjoin the
21violation. If it is established that the person has violated or
22is violating the injunction, the court may punish the offender
23for contempt of court. Proceedings under this Section shall be
24in addition to, and not in lieu of, all other remedies and

 

 

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1penalties provided by this Act.
2    (b) If any person practices as a licensed midwife or holds
3himself or herself out as a licensed midwife without being
4licensed under the provisions of this Act, then any licensed
5midwife, any interested party, or any person injured thereby
6may, in addition to the Secretary, petition for relief as
7provided in subsection (a) of this Section.
8    (c) Whenever, in the opinion of the Department, any person
9violates any provision of this Act, the Department may issue a
10rule to show cause why an order to cease and desist should not
11be entered against that person. The rule shall clearly set
12forth the grounds relied upon by the Department and shall
13provide a period of 7 days after the date of the rule to file an
14answer to the satisfaction of the Department. Failure to answer
15to the satisfaction of the Department shall cause an order to
16cease and desist to be issued immediately.
 
17    Section 110. Violation; criminal penalty.
18    (a) Whoever knowingly practices or offers to practice
19midwifery in this State without being licensed for that purpose
20or exempt under this Act shall be guilty of a Class A
21misdemeanor and, for each subsequent conviction, shall be
22guilty of a Class 4 felony.
23    (b) Notwithstanding any other provision of this Act, all
24criminal fines, moneys, or other property collected or received
25by the Department under this Section or any other State or

 

 

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1federal statute, including, but not limited to, property
2forfeited to the Department under Section 505 of the Illinois
3Controlled Substances Act or Section 85 of the Methamphetamine
4Control and Community Protection Act, shall be deposited into
5the Professional Regulation Evidence Fund.
 
6    Section 115. Investigation; notice; hearing. The
7Department may investigate the actions of any applicant or of
8any person or persons holding or claiming to hold a license
9under this Act. Before refusing to issue or to renew or taking
10any disciplinary action regarding a license, the Department
11shall, at least 30 days prior to the date set for the hearing,
12notify in writing the applicant or licensee of the nature of
13any charges and that a hearing shall be held on a date
14designated. The Department shall direct the applicant or
15licensee to file a written answer with the Board under oath
16within 20 days after the service of the notice and inform the
17applicant or licensee that failure to file an answer shall
18result in default being taken against the applicant or licensee
19and that the license may be suspended, revoked, or placed on
20probationary status or that other disciplinary action may be
21taken, including limiting the scope, nature, or extent of
22practice, as the Secretary may deem proper. Written notice may
23be served by personal delivery or certified or registered mail
24to the respondent at the address of his or her last
25notification to the Department. If the person fails to file an

 

 

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1answer after receiving notice, his or her license may, in the
2discretion of the Department, be suspended, revoked, or placed
3on probationary status, or the Department may take any
4disciplinary action deemed proper, including limiting the
5scope, nature, or extent of the person's practice or the
6imposition of a fine, without a hearing, if the act or acts
7charged constitute sufficient grounds for such action under
8this Act. At the time and place fixed in the notice, the Board
9shall proceed to hear the charges and the parties or their
10counsel shall be accorded ample opportunity to present such
11statements, testimony, evidence, and argument as may be
12pertinent to the charges or to their defense. The Board may
13continue a hearing from time to time.
 
14    Section 120. Formal hearing; preservation of record. The
15Department, at its expense, shall preserve a record of all
16proceedings at the formal hearing of any case. The notice of
17hearing, complaint, and all other documents in the nature of
18pleadings and written motions filed in the proceedings, the
19transcript of testimony, the report of the Board or hearing
20officer, and order of the Department shall be the record of the
21proceeding. The Department shall furnish a transcript of the
22record to any person interested in the hearing upon payment of
23the fee required under Section 2105-115 of the Department of
24Professional Regulation Law.
 

 

 

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1    Section 125. Witnesses; production of documents; contempt.
2Any circuit court may upon application of the Department or its
3designee or of the applicant or licensee against whom
4proceedings under Section 95 of this Act are pending, enter an
5order requiring the attendance of witnesses and their testimony
6and the production of documents, papers, files, books, and
7records in connection with any hearing or investigation. The
8court may compel obedience to its order by proceedings for
9contempt.
 
10    Section 130. Subpoena; oaths. The Department shall have the
11power to subpoena and bring before it any person in this State
12and to take testimony either orally or by deposition or both
13with the same fees and mileage and in the same manner as
14prescribed in civil cases in circuit courts of this State. The
15Secretary, the designated hearing officer, and every member of
16the Board has the power to administer oaths to witnesses at any
17hearing that the Department is authorized to conduct and any
18other oaths authorized in any Act administered by the
19Department. Any circuit court may, upon application of the
20Department or its designee or upon application of the person
21against whom proceedings under this Act are pending, enter an
22order requiring the attendance of witnesses and their
23testimony, and the production of documents, papers, files,
24books, and records in connection with any hearing or
25investigation. The court may compel obedience to its order by

 

 

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1proceedings for contempt.
 
2    Section 135. Findings of fact, conclusions of law, and
3recommendations. At the conclusion of the hearing the Board
4shall present to the Secretary a written report of its findings
5of fact, conclusions of law, and recommendations. The report
6shall contain a finding as to whether or not the accused person
7violated this Act or failed to comply with the conditions
8required under this Act. The Board shall specify the nature of
9the violation or failure to comply and shall make its
10recommendations to the Secretary.
11    The report of findings of fact, conclusions of law, and
12recommendations of the Board shall be the basis for the
13Department's order. If the Secretary disagrees in any regard
14with the report of the Board, the Secretary may issue an order
15in contravention of the report. The finding is not admissible
16in evidence against the person in a criminal prosecution
17brought for the violation of this Act, but the hearing and
18findings are not a bar to a criminal prosecution brought for
19the violation of this Act.
 
20    Section 140. Hearing officer. The Secretary may appoint any
21attorney duly licensed to practice law in the State of Illinois
22to serve as the hearing officer in any action for departmental
23refusal to issue, renew, or license an applicant or for
24disciplinary action against a licensee. The hearing officer

 

 

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1shall have full authority to conduct the hearing. The hearing
2officer shall report his or her findings of fact, conclusions
3of law, and recommendations to the Board and the Secretary. The
4Board shall have 60 calendar days after receipt of the report
5to review the report of the hearing officer and present its
6findings of fact, conclusions of law, and recommendations to
7the Secretary. If the Board fails to present its report within
8the 60-day period, the Secretary may issue an order based on
9the report of the hearing officer. If the Secretary disagrees
10with the recommendation of the Board or the hearing officer, he
11or she may issue an order in contravention of that
12recommendation.
 
13    Section 145. Service of report; motion for rehearing. In
14any case involving the discipline of a license, a copy of the
15Board's report shall be served upon the respondent by the
16Department, either personally or as provided in this Act for
17the service of the notice of hearing. Within 20 days after the
18service, the respondent may present to the Department a motion
19in writing for a rehearing that shall specify the particular
20grounds for rehearing. If no motion for rehearing is filed,
21then upon the expiration of the time specified for filing a
22motion, or if a motion for rehearing is denied, then upon the
23denial, the Secretary may enter an order in accordance with
24this Act. If the respondent orders from the reporting service
25and pays for a transcript of the record within the time for

 

 

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1filing a motion for rehearing, the 20-day period within which
2the motion may be filed shall commence upon the delivery of the
3transcript to the respondent.
 
4    Section 150. Rehearing. Whenever the Secretary is
5satisfied that substantial justice has not been done in the
6revocation, suspension, or refusal to issue or renew a license,
7the Secretary may order a rehearing by the same or another
8hearing officer or by the Board.
 
9    Section 155. Prima facie proof. An order or a certified
10copy thereof, over the seal of the Department and purporting to
11be signed by the Secretary, shall be prima facie proof of the
12following:
13        (1) that the signature is the genuine signature of the
14    Secretary;
15        (2) that such Secretary is duly appointed and
16    qualified; and
17        (3) that the Board and its members are qualified to
18    act.
 
19    Section 160. Restoration of license. At any time after the
20suspension or revocation of any license, the Department may
21restore the license to the accused person, unless after an
22investigation and a hearing the Department determines that
23restoration is not in the public interest.
 

 

 

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1    Section 165. Surrender of license. Upon the revocation or
2suspension of any license, the licensee shall immediately
3surrender the license to the Department. If the licensee fails
4to do so, the Department shall have the right to seize the
5license.
 
6    Section 170. Summary suspension. The Secretary may
7summarily suspend the license of a licensee under this Act
8without a hearing, simultaneously with the institution of
9proceedings for a hearing provided for in this Act, if the
10Secretary finds that evidence in his or her possession
11indicates that continuation in practice would constitute an
12imminent danger to the public. In the event that the Secretary
13summarily suspends a license without a hearing, a hearing by
14the Department must be held within 30 days after the suspension
15has occurred.
 
16    Section 175. Certificate of record. The Department shall
17not be required to certify any record to the court or file any
18answer in court or otherwise appear in any court in a judicial
19review proceeding, unless there is filed in the court, with the
20complaint, a receipt from the Department acknowledging payment
21of the costs of furnishing and certifying the record. Failure
22on the part of the plaintiff to file a receipt in court shall
23be grounds for dismissal of the action.
 

 

 

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1    Section 180. Administrative Review Law. All final
2administrative decisions of the Department are subject to
3judicial review under the Administrative Review Law and its
4rules. The term "administrative decision" is defined as in
5Section 3-101 of the Code of Civil Procedure.
 
6    Section 185. Illinois Administrative Procedure Act. The
7Illinois Administrative Procedure Act is hereby expressly
8adopted and incorporated in this Act as if all of the
9provisions of such Act were included in this Act, except that
10the provision of subsection (d) of Section 10-65 of the
11Illinois Administrative Procedure Act that provides that at
12hearings the licensee has the right to show compliance with all
13lawful requirements for retention, continuation, or renewal of
14the license is specifically excluded. For purposes of this Act,
15the notice required under Section 10-25 of the Illinois
16Administrative Procedure Act is deemed sufficient when mailed
17to the last known address of a party.
 
18    Section 190. Home rule. Pursuant to paragraph (h) of
19Section 6 of Article VII of the Illinois Constitution of 1970,
20the power to regulate and issue licenses for the practice of
21midwifery shall, except as may otherwise be provided within and
22pursuant to the provisions of this Act, be exercised by the
23State and may not be exercised by any unit of local government,

 

 

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1including home rule units.
 
2    Section 195. Severability. The provisions of this Act are
3severable under Section 1.31 of the Statute on Statutes.
 
4    Section 900. The Regulatory Sunset Act is amended by adding
5Section 4.33 as follows:
 
6    (5 ILCS 80/4.33 new)
7    Sec. 4.33. Act repealed on January 1, 2023. The following
8Act is repealed on January 1, 2023:
9    The Home Birth Safety Act.
 
10    Section 905. The Medical Practice Act of 1987 is amended by
11changing Section 4 as follows:
 
12    (225 ILCS 60/4)  (from Ch. 111, par. 4400-4)
13    (Section scheduled to be repealed on December 31, 2012)
14    Sec. 4. Exemptions. This Act does not apply to the
15following:
16        (1) persons lawfully carrying on their particular
17    profession or business under any valid existing regulatory
18    Act of this State, including without limitation persons
19    engaged in the practice of midwifery who are licensed under
20    the Home Birth Safety Act;
21        (2) persons rendering gratuitous services in cases of

 

 

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1    emergency; or
2        (3) persons treating human ailments by prayer or
3    spiritual means as an exercise or enjoyment of religious
4    freedom.
5(Source: P.A. 96-7, eff. 4-3-09; 97-622, eff. 11-23-11.)
 
6    Section 910. The Nurse Practice Act is amended by changing
7Section 50-15 as follows:
 
8    (225 ILCS 65/50-15)   (was 225 ILCS 65/5-15)
9    (Section scheduled to be repealed on January 1, 2018)
10    Sec. 50-15. Policy; application of Act.
11    (a) For the protection of life and the promotion of health,
12and the prevention of illness and communicable diseases, any
13person practicing or offering to practice advanced,
14professional, or practical nursing in Illinois shall submit
15evidence that he or she is qualified to practice, and shall be
16licensed as provided under this Act. No person shall practice
17or offer to practice advanced, professional, or practical
18nursing in Illinois or use any title, sign, card or device to
19indicate that such a person is practicing professional or
20practical nursing unless such person has been licensed under
21the provisions of this Act.
22    (b) This Act does not prohibit the following:
23        (1) The practice of nursing in Federal employment in
24    the discharge of the employee's duties by a person who is

 

 

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1    employed by the United States government or any bureau,
2    division or agency thereof and is a legally qualified and
3    licensed nurse of another state or territory and not in
4    conflict with Sections 50-50, 55-10, 60-10, and 70-5 of
5    this Act.
6        (2) Nursing that is included in the program of study by
7    students enrolled in programs of nursing or in current
8    nurse practice update courses approved by the Department.
9        (3) The furnishing of nursing assistance in an
10    emergency.
11        (4) The practice of nursing by a nurse who holds an
12    active license in another state when providing services to
13    patients in Illinois during a bonafide emergency or in
14    immediate preparation for or during interstate transit.
15        (5) The incidental care of the sick by members of the
16    family, domestic servants or housekeepers, or care of the
17    sick where treatment is by prayer or spiritual means.
18        (6) Persons from being employed as unlicensed
19    assistive personnel in private homes, long term care
20    facilities, nurseries, hospitals or other institutions.
21        (7) The practice of practical nursing by one who is a
22    licensed practical nurse under the laws of another U.S.
23    jurisdiction and has applied in writing to the Department,
24    in form and substance satisfactory to the Department, for a
25    license as a licensed practical nurse and who is qualified
26    to receive such license under this Act, until (i) the

 

 

HB5370- 40 -LRB097 19017 CEL 64256 b

1    expiration of 6 months after the filing of such written
2    application, (ii) the withdrawal of such application, or
3    (iii) the denial of such application by the Department.
4        (8) The practice of advanced practice nursing by one
5    who is an advanced practice nurse under the laws of another
6    state, territory of the United States, or country and has
7    applied in writing to the Department, in form and substance
8    satisfactory to the Department, for a license as an
9    advanced practice nurse and who is qualified to receive
10    such license under this Act, until (i) the expiration of 6
11    months after the filing of such written application, (ii)
12    the withdrawal of such application, or (iii) the denial of
13    such application by the Department.
14        (9) The practice of professional nursing by one who is
15    a registered professional nurse under the laws of another
16    state, territory of the United States or country and has
17    applied in writing to the Department, in form and substance
18    satisfactory to the Department, for a license as a
19    registered professional nurse and who is qualified to
20    receive such license under Section 55-10, until (1) the
21    expiration of 6 months after the filing of such written
22    application, (2) the withdrawal of such application, or (3)
23    the denial of such application by the Department.
24        (10) The practice of professional nursing that is
25    included in a program of study by one who is a registered
26    professional nurse under the laws of another state or

 

 

HB5370- 41 -LRB097 19017 CEL 64256 b

1    territory of the United States or foreign country,
2    territory or province and who is enrolled in a graduate
3    nursing education program or a program for the completion
4    of a baccalaureate nursing degree in this State, which
5    includes clinical supervision by faculty as determined by
6    the educational institution offering the program and the
7    health care organization where the practice of nursing
8    occurs.
9        (11) Any person licensed in this State under any other
10    Act from engaging in the practice for which she or he is
11    licensed, including without limitation any person engaged
12    in the practice of midwifery who is licensed under the Home
13    Birth Safety Act.
14        (12) Delegation to authorized direct care staff
15    trained under Section 15.4 of the Mental Health and
16    Developmental Disabilities Administrative Act consistent
17    with the policies of the Department.
18        (13) The practice, services, or activities of persons
19    practicing the specified occupations set forth in
20    subsection (a) of, and pursuant to a licensing exemption
21    granted in subsection (b) or (d) of, Section 2105-350 of
22    the Department of Professional Regulation Law of the Civil
23    Administrative Code of Illinois, but only for so long as
24    the 2016 Olympic and Paralympic Games Professional
25    Licensure Exemption Law is operable.
26        (14) County correctional personnel from delivering

 

 

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1    prepackaged medication for self-administration to an
2    individual detainee in a correctional facility.
3    Nothing in this Act shall be construed to limit the
4delegation of tasks or duties by a physician, dentist, or
5podiatrist to a licensed practical nurse, a registered
6professional nurse, or other persons.
7(Source: P.A. 95-639, eff. 10-5-07; 95-876, eff. 8-21-08; 96-7,
8eff. 4-3-09; 96-516, eff. 8-14-09; 96-1000, eff. 7-2-10.)
 
9    Section 990. The Illinois Public Aid Code is amended by
10changing Section 5-5 as follows:
 
11    (305 ILCS 5/5-5)  (from Ch. 23, par. 5-5)
12    Sec. 5-5. Medical services. The Illinois Department, by
13rule, shall determine the quantity and quality of and the rate
14of reimbursement for the medical assistance for which payment
15will be authorized, and the medical services to be provided,
16which may include all or part of the following: (1) inpatient
17hospital services; (2) outpatient hospital services; (3) other
18laboratory and X-ray services; (4) skilled nursing home
19services; (5) physicians' services whether furnished in the
20office, the patient's home, a hospital, a skilled nursing home,
21or elsewhere; (6) medical care, or any other type of remedial
22care furnished by licensed practitioners, including the
23services of certified professional midwives licensed pursuant
24to the Home Birth Safety Act; (7) home health care services;

 

 

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1(8) private duty nursing service; (9) clinic services; (10)
2dental services, including prevention and treatment of
3periodontal disease and dental caries disease for pregnant
4women, provided by an individual licensed to practice dentistry
5or dental surgery; for purposes of this item (10), "dental
6services" means diagnostic, preventive, or corrective
7procedures provided by or under the supervision of a dentist in
8the practice of his or her profession; (11) physical therapy
9and related services; (12) prescribed drugs, dentures, and
10prosthetic devices; and eyeglasses prescribed by a physician
11skilled in the diseases of the eye, or by an optometrist,
12whichever the person may select; (13) other diagnostic,
13screening, preventive, and rehabilitative services, for
14children and adults; (14) transportation and such other
15expenses as may be necessary; (15) medical treatment of sexual
16assault survivors, as defined in Section 1a of the Sexual
17Assault Survivors Emergency Treatment Act, for injuries
18sustained as a result of the sexual assault, including
19examinations and laboratory tests to discover evidence which
20may be used in criminal proceedings arising from the sexual
21assault; (16) the diagnosis and treatment of sickle cell
22anemia; and (17) any other medical care, and any other type of
23remedial care recognized under the laws of this State, but not
24including abortions, or induced miscarriages or premature
25births, unless, in the opinion of a physician, such procedures
26are necessary for the preservation of the life of the woman

 

 

HB5370- 44 -LRB097 19017 CEL 64256 b

1seeking such treatment, or except an induced premature birth
2intended to produce a live viable child and such procedure is
3necessary for the health of the mother or her unborn child. The
4Illinois Department, by rule, shall prohibit any physician from
5providing medical assistance to anyone eligible therefor under
6this Code where such physician has been found guilty of
7performing an abortion procedure in a wilful and wanton manner
8upon a woman who was not pregnant at the time such abortion
9procedure was performed. The term "any other type of remedial
10care" shall include nursing care and nursing home service for
11persons who rely on treatment by spiritual means alone through
12prayer for healing.
13    Notwithstanding any other provision of this Section, a
14comprehensive tobacco use cessation program that includes
15purchasing prescription drugs or prescription medical devices
16approved by the Food and Drug Administration shall be covered
17under the medical assistance program under this Article for
18persons who are otherwise eligible for assistance under this
19Article.
20    Notwithstanding any other provision of this Code, the
21Illinois Department may not require, as a condition of payment
22for any laboratory test authorized under this Article, that a
23physician's handwritten signature appear on the laboratory
24test order form. The Illinois Department may, however, impose
25other appropriate requirements regarding laboratory test order
26documentation.

 

 

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1    The Department of Healthcare and Family Services shall
2provide the following services to persons eligible for
3assistance under this Article who are participating in
4education, training or employment programs operated by the
5Department of Human Services as successor to the Department of
6Public Aid:
7        (1) dental services provided by or under the
8    supervision of a dentist; and
9        (2) eyeglasses prescribed by a physician skilled in the
10    diseases of the eye, or by an optometrist, whichever the
11    person may select.
12    Notwithstanding any other provision of this Code and
13subject to federal approval, the Department may adopt rules to
14allow a dentist who is volunteering his or her service at no
15cost to render dental services through an enrolled
16not-for-profit health clinic without the dentist personally
17enrolling as a participating provider in the medical assistance
18program. A not-for-profit health clinic shall include a public
19health clinic or Federally Qualified Health Center or other
20enrolled provider, as determined by the Department, through
21which dental services covered under this Section are performed.
22The Department shall establish a process for payment of claims
23for reimbursement for covered dental services rendered under
24this provision.
25    The Illinois Department, by rule, may distinguish and
26classify the medical services to be provided only in accordance

 

 

HB5370- 46 -LRB097 19017 CEL 64256 b

1with the classes of persons designated in Section 5-2.
2    The Department of Healthcare and Family Services must
3provide coverage and reimbursement for amino acid-based
4elemental formulas, regardless of delivery method, for the
5diagnosis and treatment of (i) eosinophilic disorders and (ii)
6short bowel syndrome when the prescribing physician has issued
7a written order stating that the amino acid-based elemental
8formula is medically necessary.
9    The Illinois Department shall authorize the provision of,
10and shall authorize payment for, screening by low-dose
11mammography for the presence of occult breast cancer for women
1235 years of age or older who are eligible for medical
13assistance under this Article, as follows:
14        (A) A baseline mammogram for women 35 to 39 years of
15    age.
16        (B) An annual mammogram for women 40 years of age or
17    older.
18        (C) A mammogram at the age and intervals considered
19    medically necessary by the woman's health care provider for
20    women under 40 years of age and having a family history of
21    breast cancer, prior personal history of breast cancer,
22    positive genetic testing, or other risk factors.
23        (D) A comprehensive ultrasound screening of an entire
24    breast or breasts if a mammogram demonstrates
25    heterogeneous or dense breast tissue, when medically
26    necessary as determined by a physician licensed to practice

 

 

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1    medicine in all of its branches.
2    All screenings shall include a physical breast exam,
3instruction on self-examination and information regarding the
4frequency of self-examination and its value as a preventative
5tool. For purposes of this Section, "low-dose mammography"
6means the x-ray examination of the breast using equipment
7dedicated specifically for mammography, including the x-ray
8tube, filter, compression device, and image receptor, with an
9average radiation exposure delivery of less than one rad per
10breast for 2 views of an average size breast. The term also
11includes digital mammography.
12    On and after January 1, 2012, providers participating in a
13quality improvement program approved by the Department shall be
14reimbursed for screening and diagnostic mammography at the same
15rate as the Medicare program's rates, including the increased
16reimbursement for digital mammography.
17    The Department shall convene an expert panel including
18representatives of hospitals, free-standing mammography
19facilities, and doctors, including radiologists, to establish
20quality standards.
21    Subject to federal approval, the Department shall
22establish a rate methodology for mammography at federally
23qualified health centers and other encounter-rate clinics.
24These clinics or centers may also collaborate with other
25hospital-based mammography facilities.
26    The Department shall establish a methodology to remind

 

 

HB5370- 48 -LRB097 19017 CEL 64256 b

1women who are age-appropriate for screening mammography, but
2who have not received a mammogram within the previous 18
3months, of the importance and benefit of screening mammography.
4    The Department shall establish a performance goal for
5primary care providers with respect to their female patients
6over age 40 receiving an annual mammogram. This performance
7goal shall be used to provide additional reimbursement in the
8form of a quality performance bonus to primary care providers
9who meet that goal.
10    The Department shall devise a means of case-managing or
11patient navigation for beneficiaries diagnosed with breast
12cancer. This program shall initially operate as a pilot program
13in areas of the State with the highest incidence of mortality
14related to breast cancer. At least one pilot program site shall
15be in the metropolitan Chicago area and at least one site shall
16be outside the metropolitan Chicago area. An evaluation of the
17pilot program shall be carried out measuring health outcomes
18and cost of care for those served by the pilot program compared
19to similarly situated patients who are not served by the pilot
20program.
21    Any medical or health care provider shall immediately
22recommend, to any pregnant woman who is being provided prenatal
23services and is suspected of drug abuse or is addicted as
24defined in the Alcoholism and Other Drug Abuse and Dependency
25Act, referral to a local substance abuse treatment provider
26licensed by the Department of Human Services or to a licensed

 

 

HB5370- 49 -LRB097 19017 CEL 64256 b

1hospital which provides substance abuse treatment services.
2The Department of Healthcare and Family Services shall assure
3coverage for the cost of treatment of the drug abuse or
4addiction for pregnant recipients in accordance with the
5Illinois Medicaid Program in conjunction with the Department of
6Human Services.
7    All medical providers providing medical assistance to
8pregnant women under this Code shall receive information from
9the Department on the availability of services under the Drug
10Free Families with a Future or any comparable program providing
11case management services for addicted women, including
12information on appropriate referrals for other social services
13that may be needed by addicted women in addition to treatment
14for addiction.
15    The Illinois Department, in cooperation with the
16Departments of Human Services (as successor to the Department
17of Alcoholism and Substance Abuse) and Public Health, through a
18public awareness campaign, may provide information concerning
19treatment for alcoholism and drug abuse and addiction, prenatal
20health care, and other pertinent programs directed at reducing
21the number of drug-affected infants born to recipients of
22medical assistance.
23    Neither the Department of Healthcare and Family Services
24nor the Department of Human Services shall sanction the
25recipient solely on the basis of her substance abuse.
26    The Illinois Department shall establish such regulations

 

 

HB5370- 50 -LRB097 19017 CEL 64256 b

1governing the dispensing of health services under this Article
2as it shall deem appropriate. The Department should seek the
3advice of formal professional advisory committees appointed by
4the Director of the Illinois Department for the purpose of
5providing regular advice on policy and administrative matters,
6information dissemination and educational activities for
7medical and health care providers, and consistency in
8procedures to the Illinois Department.
9    Notwithstanding any other provision of law, a health care
10provider under the medical assistance program may elect, in
11lieu of receiving direct payment for services provided under
12that program, to participate in the State Employees Deferred
13Compensation Plan adopted under Article 24 of the Illinois
14Pension Code. A health care provider who elects to participate
15in the plan does not have a cause of action against the State
16for any damages allegedly suffered by the provider as a result
17of any delay by the State in crediting the amount of any
18contribution to the provider's plan account.
19    The Illinois Department may develop and contract with
20Partnerships of medical providers to arrange medical services
21for persons eligible under Section 5-2 of this Code.
22Implementation of this Section may be by demonstration projects
23in certain geographic areas. The Partnership shall be
24represented by a sponsor organization. The Department, by rule,
25shall develop qualifications for sponsors of Partnerships.
26Nothing in this Section shall be construed to require that the

 

 

HB5370- 51 -LRB097 19017 CEL 64256 b

1sponsor organization be a medical organization.
2    The sponsor must negotiate formal written contracts with
3medical providers for physician services, inpatient and
4outpatient hospital care, home health services, treatment for
5alcoholism and substance abuse, and other services determined
6necessary by the Illinois Department by rule for delivery by
7Partnerships. Physician services must include prenatal and
8obstetrical care. The Illinois Department shall reimburse
9medical services delivered by Partnership providers to clients
10in target areas according to provisions of this Article and the
11Illinois Health Finance Reform Act, except that:
12        (1) Physicians participating in a Partnership and
13    providing certain services, which shall be determined by
14    the Illinois Department, to persons in areas covered by the
15    Partnership may receive an additional surcharge for such
16    services.
17        (2) The Department may elect to consider and negotiate
18    financial incentives to encourage the development of
19    Partnerships and the efficient delivery of medical care.
20        (3) Persons receiving medical services through
21    Partnerships may receive medical and case management
22    services above the level usually offered through the
23    medical assistance program.
24    Medical providers shall be required to meet certain
25qualifications to participate in Partnerships to ensure the
26delivery of high quality medical services. These

 

 

HB5370- 52 -LRB097 19017 CEL 64256 b

1qualifications shall be determined by rule of the Illinois
2Department and may be higher than qualifications for
3participation in the medical assistance program. Partnership
4sponsors may prescribe reasonable additional qualifications
5for participation by medical providers, only with the prior
6written approval of the Illinois Department.
7    Nothing in this Section shall limit the free choice of
8practitioners, hospitals, and other providers of medical
9services by clients. In order to ensure patient freedom of
10choice, the Illinois Department shall immediately promulgate
11all rules and take all other necessary actions so that provided
12services may be accessed from therapeutically certified
13optometrists to the full extent of the Illinois Optometric
14Practice Act of 1987 without discriminating between service
15providers.
16    The Department shall apply for a waiver from the United
17States Health Care Financing Administration to allow for the
18implementation of Partnerships under this Section.
19    The Illinois Department shall require health care
20providers to maintain records that document the medical care
21and services provided to recipients of Medical Assistance under
22this Article. Such records must be retained for a period of not
23less than 6 years from the date of service or as provided by
24applicable State law, whichever period is longer, except that
25if an audit is initiated within the required retention period
26then the records must be retained until the audit is completed

 

 

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1and every exception is resolved. The Illinois Department shall
2require health care providers to make available, when
3authorized by the patient, in writing, the medical records in a
4timely fashion to other health care providers who are treating
5or serving persons eligible for Medical Assistance under this
6Article. All dispensers of medical services shall be required
7to maintain and retain business and professional records
8sufficient to fully and accurately document the nature, scope,
9details and receipt of the health care provided to persons
10eligible for medical assistance under this Code, in accordance
11with regulations promulgated by the Illinois Department. The
12rules and regulations shall require that proof of the receipt
13of prescription drugs, dentures, prosthetic devices and
14eyeglasses by eligible persons under this Section accompany
15each claim for reimbursement submitted by the dispenser of such
16medical services. No such claims for reimbursement shall be
17approved for payment by the Illinois Department without such
18proof of receipt, unless the Illinois Department shall have put
19into effect and shall be operating a system of post-payment
20audit and review which shall, on a sampling basis, be deemed
21adequate by the Illinois Department to assure that such drugs,
22dentures, prosthetic devices and eyeglasses for which payment
23is being made are actually being received by eligible
24recipients. Within 90 days after the effective date of this
25amendatory Act of 1984, the Illinois Department shall establish
26a current list of acquisition costs for all prosthetic devices

 

 

HB5370- 54 -LRB097 19017 CEL 64256 b

1and any other items recognized as medical equipment and
2supplies reimbursable under this Article and shall update such
3list on a quarterly basis, except that the acquisition costs of
4all prescription drugs shall be updated no less frequently than
5every 30 days as required by Section 5-5.12.
6    The rules and regulations of the Illinois Department shall
7require that a written statement including the required opinion
8of a physician shall accompany any claim for reimbursement for
9abortions, or induced miscarriages or premature births. This
10statement shall indicate what procedures were used in providing
11such medical services.
12    The Illinois Department shall require all dispensers of
13medical services, other than an individual practitioner or
14group of practitioners, desiring to participate in the Medical
15Assistance program established under this Article to disclose
16all financial, beneficial, ownership, equity, surety or other
17interests in any and all firms, corporations, partnerships,
18associations, business enterprises, joint ventures, agencies,
19institutions or other legal entities providing any form of
20health care services in this State under this Article.
21    The Illinois Department may require that all dispensers of
22medical services desiring to participate in the medical
23assistance program established under this Article disclose,
24under such terms and conditions as the Illinois Department may
25by rule establish, all inquiries from clients and attorneys
26regarding medical bills paid by the Illinois Department, which

 

 

HB5370- 55 -LRB097 19017 CEL 64256 b

1inquiries could indicate potential existence of claims or liens
2for the Illinois Department.
3    Enrollment of a vendor that provides non-emergency medical
4transportation, defined by the Department by rule, shall be
5conditional for 180 days. During that time, the Department of
6Healthcare and Family Services may terminate the vendor's
7eligibility to participate in the medical assistance program
8without cause. That termination of eligibility is not subject
9to the Department's hearing process.
10    The Illinois Department shall establish policies,
11procedures, standards and criteria by rule for the acquisition,
12repair and replacement of orthotic and prosthetic devices and
13durable medical equipment. Such rules shall provide, but not be
14limited to, the following services: (1) immediate repair or
15replacement of such devices by recipients without medical
16authorization; and (2) rental, lease, purchase or
17lease-purchase of durable medical equipment in a
18cost-effective manner, taking into consideration the
19recipient's medical prognosis, the extent of the recipient's
20needs, and the requirements and costs for maintaining such
21equipment. Such rules shall enable a recipient to temporarily
22acquire and use alternative or substitute devices or equipment
23pending repairs or replacements of any device or equipment
24previously authorized for such recipient by the Department.
25    The Department shall execute, relative to the nursing home
26prescreening project, written inter-agency agreements with the

 

 

HB5370- 56 -LRB097 19017 CEL 64256 b

1Department of Human Services and the Department on Aging, to
2effect the following: (i) intake procedures and common
3eligibility criteria for those persons who are receiving
4non-institutional services; and (ii) the establishment and
5development of non-institutional services in areas of the State
6where they are not currently available or are undeveloped.
7    The Illinois Department shall develop and operate, in
8cooperation with other State Departments and agencies and in
9compliance with applicable federal laws and regulations,
10appropriate and effective systems of health care evaluation and
11programs for monitoring of utilization of health care services
12and facilities, as it affects persons eligible for medical
13assistance under this Code.
14    The Illinois Department shall report annually to the
15General Assembly, no later than the second Friday in April of
161979 and each year thereafter, in regard to:
17        (a) actual statistics and trends in utilization of
18    medical services by public aid recipients;
19        (b) actual statistics and trends in the provision of
20    the various medical services by medical vendors;
21        (c) current rate structures and proposed changes in
22    those rate structures for the various medical vendors; and
23        (d) efforts at utilization review and control by the
24    Illinois Department.
25    The period covered by each report shall be the 3 years
26ending on the June 30 prior to the report. The report shall

 

 

HB5370- 57 -LRB097 19017 CEL 64256 b

1include suggested legislation for consideration by the General
2Assembly. The filing of one copy of the report with the
3Speaker, one copy with the Minority Leader and one copy with
4the Clerk of the House of Representatives, one copy with the
5President, one copy with the Minority Leader and one copy with
6the Secretary of the Senate, one copy with the Legislative
7Research Unit, and such additional copies with the State
8Government Report Distribution Center for the General Assembly
9as is required under paragraph (t) of Section 7 of the State
10Library Act shall be deemed sufficient to comply with this
11Section.
12    Rulemaking authority to implement Public Act 95-1045, if
13any, is conditioned on the rules being adopted in accordance
14with all provisions of the Illinois Administrative Procedure
15Act and all rules and procedures of the Joint Committee on
16Administrative Rules; any purported rule not so adopted, for
17whatever reason, is unauthorized.
18(Source: P.A. 96-156, eff. 1-1-10; 96-806, eff. 7-1-10; 96-926,
19eff. 1-1-11; 96-1000, eff. 7-2-10; 97-48, eff. 6-28-11; 97-638,
20eff. 1-1-12.)
 
21    Section 999. Effective date. This Act takes effect upon
22becoming law.