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90_HB1623
New Act
5 ILCS 80/4.18 new
30 ILCS 105/5.449 new
745 ILCS 49/34 new
Creates the Comprehensive Childbirth Act to regulate the
practice of direct entry midwifery through certification
requirements. Amends the Regulatory Agency Sunset Act to
repeal the new Act on January 1, 2008. Amends the State
Finance Act to add the Direct Entry Midwife Certification
Fund. Amends the Good Samaritan Act to exempt direct entry
midwives from civil liability for uncompensated emergency
treatment.
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1 AN ACT to create the Comprehensive Childbirth Act,
2 amending named Acts.
3 Be it enacted by the People of the State of Illinois,
4 represented in the General Assembly:
5 Section 1. Short title. This Act may be cited as the
6 Comprehensive Childbirth Act.
7 Section 5. Legislative findings. The General Assembly
8 recognizes the need for a person to have the freedom to
9 choose the manner, cost, and setting for giving birth. The
10 General Assembly finds that access to prenatal care and
11 delivery services is limited by the inadequate number of
12 providers of the services and that the practice of midwifery
13 may help to reduce this shortage. The General Assembly also
14 recognizes the need for the safe and effective delivery of
15 newborn babies and the health, safety, and welfare of their
16 mothers in the delivery process. In the interest of public
17 health, this Body supports the regulation of the practice of
18 midwifery in this State to protect the health and welfare of
19 mothers and infants.
20 Section 10. Definitions. As used in this Act:
21 "Back-up physician" means a physician who, pursuant to an
22 agreement with a Direct Entry Midwife, examines a woman early
23 in her pregnancy, and remains available to the woman and the
24 Direct Entry Midwife through delivery.
25 "Board" means the Board of Direct Entry Midwifery.
26 "Department" means the Department of Public Health.
27 "Director" means the Director of Public Health.
28 "Direct Entry Midwife" means a person who is trained to
29 give the necessary care and advice to a woman during
30 pregnancy, labor, and the post-birth period, to conduct
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1 normal deliveries on her own responsibility, and to care for
2 a newborn infant.
3 "Local health department" means the county, city, or
4 district health department.
5 "Low-risk" means a pregnancy where, within reasonable
6 medical probability, the risk to the woman and child is no
7 greater than a normal pregnancy.
8 "Midwifery" means the practice of attending low-risk
9 pregnancy, labor, birth, and the post-birth period with the
10 informed consent of the mother.
11 "Physician" means a person who is licensed to practice
12 medicine in all its branches in this State.
13 "Restricted drugs and medication" means drugs and
14 medication regulated under the Illinois Controlled Substances
15 Act.
16 Section 15. Certification requirement. No person shall
17 practice as a Direct Entry Midwife, for compensation or
18 otherwise, unless currently certified as a Direct Entry
19 Midwife in accordance with this Act, or under the immediate
20 supervision of a physician, certified nurse midwife, or
21 certified Direct Entry Midwife who is present at the
22 delivery. A person who violates a provision of this Section
23 shall be guilty of a Class A misdemeanor.
24 Section 20. Qualifications for certification.
25 (a) To qualify for certification as a Direct Entry
26 Midwife, an applicant must submit:
27 (1) proof of completion of high school;
28 (2) proof of completion of clinical experience as
29 required by rule of the Department on the recommendation
30 of the Board;
31 (3) proof of current certification in
32 cardio-pulmonary resuscitation of adults and newborns;
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1 and
2 (4) proof of ability to recognize the warning signs
3 of abnormal conditions requiring referral to or
4 collaboration with a physician and ability to carry out
5 emergency medical measures when no medical help is
6 otherwise available.
7 (b) The Department shall certify to practice direct
8 entry midwifery an applicant who meets the requirements of
9 subsection (a), completes an application on a form prescribed
10 by the Department, and pays the required application fee.
11 Section 25. Scope of certified practice. A certified
12 Direct Entry Midwife may provide care to women with low-risk
13 pregnancies that includes:
14 (1) prenatal supervision and counseling;
15 (2) preparation for childbirth;
16 (3) supervision and care during labor and delivery
17 and care of the mother and the newborn in the immediate
18 post-partum period, so long as progress meets criteria
19 generally accepted as normal, as determined by the Board.
20 Section 30. Expiration; renewal. Direct Entry Midwife
21 certification shall be valid for 2 years from the date of
22 issuance. An applicant for renewal shall submit:
23 (1) proof of completion of continuing education
24 required under this Act;
25 (2) letters from the applicant's back-up physician
26 of satisfactory performance by the applicant during the
27 previous certification period.
28 Section 35. Grounds for disciplinary action; notice;
29 hearing.
30 (a) Certification may be denied, revoked, or suspended,
31 renewal may be denied, or the certified Direct Entry Midwife
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1 may be placed on probation or otherwise disciplined by the
2 Department for any one or combination of the following
3 reasons:
4 (1) Attempting to procure or procuring initial or
5 renewal certification as a Direct Entry Midwife through
6 bribery, fraud, or misrepresentation.
7 (2) Commission of a crime relevant to the practice
8 of midwifery.
9 (3) Engaging in a pattern of practice or behavior
10 that demonstrates incompetence or an inability to
11 practice midwifery with reasonable skill and safety.
12 (4) Failure to file quarterly reports or filing
13 false quarterly reports required under Section 70.
14 (5) Engaging in unprofessional conduct, including
15 but not limited to failure to comply with the standards
16 and scope of practice for direct entry midwifery as
17 established under this Act, in which case actual injury
18 need not be established.
19 (b) When action is taken by the Department under this
20 Section against an applicant or certified Direct Entry
21 Midwife, the applicant or Midwife shall be furnished with
22 notice of the alleged violation and shall be afforded a
23 hearing before a hearing examiner designated by the Director,
24 with the right to appeal the decision of the hearing examiner
25 to the Director.
26 Section 40. Board creation; duties; rules.
27 (a) There is established a Board of Direct Entry
28 Midwifery, which shall consist of 5 members to be appointed
29 by the Director for 2-year terms. Members of the Board shall
30 serve without compensation and shall include:
31 (1) One physician who is a Board-certified
32 obstetrician, a physician eligible for certification by
33 the American College of Obstetrics and Gynecology, or a
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1 family physician currently practicing obstetrics who is
2 familiar with high-risk pregnancies and has experience
3 working with midwives.
4 (2) One physician who is board certified in a
5 medical specialty other than obstetrics.
6 (3) Two certified Direct Entry Midwives, except
7 that in the case of the initial appointments under this
8 item, the appointees may be persons who are not certified
9 but otherwise meet the qualifications of Section 20.
10 (4) One member of the general public who has been
11 attended by a midwife during at least one delivery, has
12 never offered her services to others as a midwife, and
13 has no financial interest in the practice of midwifery or
14 in any health care facility, agency, or insurer.
15 (b) The Board shall meet at least once every 6 months
16 and shall report annually to the Director concerning the
17 practice of direct entry midwifery in this State. The report
18 shall include any recommendations of the Board to increase
19 the quality and safety of Direct Entry Midwife services and
20 to ensure competence in the practice of direct entry
21 midwifery.
22 (c) The Board, in consultation with the Department,
23 shall establish the requirements for certification as a
24 Direct Entry Midwife, including the necessary clinical
25 experience and the standards of practice for Direct Entry
26 Midwives.
27 (d) The Board, in consultation with the Department,
28 shall establish the certification requirements for Direct
29 Entry Midwives certified in other states who wish to practice
30 midwifery in this State.
31 (e) The Board, in consultation with the Department,
32 shall establish the rules for the practice of midwifery,
33 including prenatal visits, home births, follow-up visits,
34 recordkeeping, maintenance of the midwife's equipment, and
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1 any other requirements deemed necessary.
2 (f) In accordance with the requirement that Direct Entry
3 Midwives provide care only for low-risk pregnancies, the
4 Board in consultation with Department shall:
5 (1) implement rules defining conditions and
6 circumstances that exclude a woman from the
7 classification of "low-risk"; and
8 (2) periodically review those rules and make them
9 more or less stringent as warranted by the information
10 provided by the Direct Entry Midwives' quarterly reports.
11 Section 45. Education and examination requirements.
12 (a) The Board of Direct Entry Midwifery may develop
13 formal educational requirements in consultation with the
14 Department, including continuing education requirements and
15 examination requirements as prerequisites to the practice of
16 direct entry midwifery.
17 (b) An examination required under subsection (a) shall
18 be administered by the Department. The Department shall
19 establish a passing score and grade the examinations.
20 (c) If educational requirements are established under
21 subsection (a):
22 (1) Direct Entry Midwives currently certified or
23 who become certified within one year of the establishment
24 of the requirements shall be permitted to sit directly
25 for the examination without fulfilling the formal
26 educational prerequisites;
27 (2) Direct Entry Midwives shall be permitted to
28 continue in practice until the Department administers and
29 grades the examination; and
30 (3) the Department, in consultation with the Board
31 of Direct Entry Midwifery, shall review and approve
32 direct entry midwifery education programs in other
33 states, completion of which will permit applicants to sit
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1 for the examination in this State.
2 Section 50. Back-up physician. The Direct Entry Midwife
3 must require that a woman seeking services of the Direct
4 Entry Midwife have a physical examination by the Midwife's
5 back-up physician. The Direct Entry Midwife must have an
6 arrangement with the back-up physician for each client.
7 Section 55. Department review of Board rules; fees. The
8 Department shall periodically review the Board's rules. The
9 Department shall set by rule fees for original and renewal
10 licensure under this Act.
11 Section 60. Administering drugs or medications. A Direct
12 Entry Midwife shall not administer a restricted drug or
13 medication except when specifically ordered to do so by a
14 licensed physician or when administering medication in
15 accordance with the Infant Eye Disease Act.
16 Section 65. Informed consent of client; applicable laws
17 and rules.
18 (a) A Direct Entry Midwife shall inform a woman seeking
19 the Direct Entry Midwife's services of the requirements and
20 limitations of the Direct Entry Midwife's practice and shall
21 obtain the written consent of a woman seeking her services.
22 (b) The Direct Entry Midwife shall comply with all laws
23 and rules applicable to other birth attendants, including
24 prevention of infant blindness and filing of vital
25 statistics.
26 Section 70. Quarterly reports.
27 (a) A Direct Entry Midwife shall submit to the
28 Department on a quarterly basis a summary report in a form
29 prescribed by the Department and containing information
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1 required by the Department or Board.
2 (b) The Department will make available to local health
3 departments an ample supply of quarterly report forms for use
4 by Direct Entry Midwives.
5 (c) The Department shall compile the information in the
6 quarterly reports and make the compilations available to the
7 Board, Direct Entry Midwives, and other interested persons
8 and groups on request.
9 Section 95. Injunction. Cease and desist order.
10 (a) If a person or other entity violates a provision of
11 this Act, the Director, in the name of the People of the
12 State of Illinois through the Attorney General of the State
13 of Illinois, or the State's Attorney of the county in which
14 the violation is alleged to have occurred, may petition the
15 circuit court for an order enjoining such violation or for an
16 order enforcing compliance with this Act. Upon the filing of
17 a verified petition, the court may issue a temporary
18 restraining order, without bond, and may preliminarily and
19 permanently enjoin such violation. If it is established that
20 the person or other entity has violated or is violating the
21 injunction, the court may punish the offender for contempt of
22 court. Proceedings under this Section shall be in addition
23 to, and not in lieu of, all other remedies and penalties
24 provided by this Act.
25 (b) If any person practices as a Direct Entry Midwife or
26 holds himself or herself out as a Direct Entry Midwife
27 without being licensed under the provisions of this Act, then
28 any Direct Entry Midwife, any interested party, or any person
29 injured thereby may, in addition to the Director or a State's
30 Attorney, petition for relief as provided in this Section.
31 (c) Whenever in the opinion of the Department a person
32 or other entity violates a provision of this Act, the
33 Department may issue a notice to show cause why an order to
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1 cease and desist should not be entered against that person or
2 other entity. The notice shall clearly set forth the grounds
3 relied upon by the Department and shall provide a period of 7
4 days from the date of the notice to file an answer to the
5 satisfaction of the Department. Failure to answer to the
6 satisfaction of the Department shall cause an order to cease
7 and desist to be issued immediately.
8 (Source: P.A. 88-428; 88-595, eff. 8-26-94.)
9 Section 80. Liability exemption for back-up physicians.
10 Back-up physicians shall not be vicariously liable for civil
11 damages for the negligence of certified Direct Entry Midwives
12 solely because they agreed to or did provide back-up
13 services.
14 Section 85. Illinois Administrative Procedure Act. The
15 Illinois Administrative Procedure Act is hereby expressly
16 adopted and incorporated in this Act as if all of the
17 provisions of that Act were included in this Act, except that
18 the provision of subsection (d) of Section 10-65 of the
19 Illinois Administrative Procedure Act that provides that at
20 hearings the licensee has the right to show compliance with
21 all lawful requirements for retention, continuation, or
22 renewal of the license is specifically excluded. For the
23 purposes of this Act, the notice required under Section 10-25
24 of the Illinois Administrative Procedure Act is deemed
25 sufficient when mailed to the last known address of a party.
26 Section 90. Administrative Review Law; venue.
27 (a) All final administrative decisions of the Department
28 are subject to judicial review under the Administrative
29 Review Law and its rules. The term "administrative decision"
30 is defined as in Section 3-101 of the Code of Civil
31 Procedure.
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1 (b) Proceedings for judicial review shall be commenced
2 in the circuit court of the county in which the party
3 applying for review resides, but if the party is not a
4 resident of this State, the venue shall be in Sangamon
5 County.
6 Section 95. Home rule powers. A home rule unit may not
7 regulate Direct Entry Midwives in a manner more restrictive
8 than the regulation of Direct Entry Midwives by the State.
9 This Section is a limitation under subsection (i) of Section
10 6 of Article VII of the Illinois Constitution on the
11 concurrent exercise by home rule units of powers and
12 functions exercised by the State.
13 Section 100. Deposit of moneys. There is created the
14 Direct Entry Midwife Certification Fund as a special fund in
15 the State Treasury. All fees collected under this Act shall
16 be deposited into the Fund. Pursuant to appropriation, moneys
17 in the Fund shall be used by the Department to administer and
18 enforce this Act.
19 Section 200. The Regulatory Agency Sunset Act is amended
20 by adding Section 4.18 as follows:
21 (5 ILCS 80/4.18 new)
22 Sec. 4.18. Act repealed on January 1, 2008. The following
23 Act is repealed on January 1, 2008:
24 The Comprehensive Childbirth Act.
25 Section 225. The State Finance Act is amended by adding
26 Section 5.449 as follows:
27 (30 ILCS 105/5.449 new)
28 Sec. 5.449. The Direct Entry Midwife Certification Fund.
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1 Section 250. The Good Samaritan Act is amended by adding
2 Section 34 as follows:
3 (745 ILCS 49/34 new)
4 Sec. 34. Direct Entry Midwife exemption. A person
5 licensed under the Comprehensive Childbirth Act who in good
6 faith provides emergency care without fee to a person shall
7 not be liable for civil damages as a result of his or her
8 acts or omissions, except for willful or wanton misconduct on
9 the part of the person in providing the care.