State of Illinois
2017 and 2018


Introduced , by Rep. Robyn Gabel


New Act
5 ILCS 80/4.38 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 and for certain limitations on the activities of licensed midwives. Creates the Illinois Midwifery Board. Sets forth provisions concerning application, 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, 2028. Amends the Medical Practice Act of 1987, the Nurse Practice Act, and the Illinois Public Aid Code to make related changes.

LRB100 06207 SMS 16241 b






HB0677LRB100 06207 SMS 16241 b

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 this Act is
10to protect and benefit the public by setting standards for the
11qualifications, education, training, and experience of those
12who seek to obtain licensure as a licensed certified
13professional midwife, including a requirement to work
14collaboratively with hospital-based and privileged health care
15professionals to promote high standards of professional
16performance for those licensed to practice midwifery in
17out-of-hospital settings in this State, to promote a
18collaborative and integrated maternity care delivery system in
19Illinois with agreed-upon consulting, transfer and transport
20protocols in use by all health care professionals and licensed
21midwives across all health care settings to maximize patient
22safety and positive outcomes, to support accredited education
23and training as a prerequisite to licensure and to protect the



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1public from unprofessional conduct by persons licensed to
2practice midwifery, as defined in this Act. This Act shall be
3liberally construed to best carry out these purposes.
4    Section 10. Exemptions.
5    (a) This Act does not prohibit a person licensed under any
6other Act in this State from engaging in the practice for which
7he or she is licensed or from delegating services as provided
8for under that other Act.
9    (b) Nothing in this Act shall be construed to prohibit or
10require licensing under this Act with regard to:
11        (1) the rendering of services by a birth attendant, if
12    such attendance is in accordance with the birth attendant's
13    cultural traditions or religious faith and is rendered only
14    to women and families in that distinct cultural or
15    religious group as an exercise and enjoyment of their
16    religious freedom; and
17        (2) a student midwife working under the direction of a
18    licensed certified professional midwife.
19    Section 15. Definitions. In this Act:
20    "Board" means the Illinois Midwifery Board, as specified in
21this Act.
22    "Certified Professional Midwife" or "CPM" means a person
23who has met the standards for certification as a Certified
24Professional Midwife set by the North American Registry of



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1Midwives or its successor, including successful completion of a
2comprehensive written examination administered in a
3computerized 0testing center contracted by the North American
4Registry of Midwives.
5    "Department" means the Department of Financial and
6Professional Regulation.
7    "Health care practitioner" means physician licensed to
8practice medicine in all its branches or an advanced practice
9nurse who is a certified nurse midwife.
10    "Licensed certified professional midwife" or "LCPM" means
11a person who has successfully met the requirements under
12Section 30 of this Act.
13    "Midwifery Bridge Certificate" means the certificate
14issued by the North American Registry of Midwives that
15documents completion of 50 hours of accredited continuing
16education specific to content in emergency skills for
17pregnancy, birth, and newborn care, along with other midwifery
18topics addressing the core competencies established by the
19International Confederation of Midwives or its successor.
20Bridge topics shall include 14 hours of obstetric emergency
21skills training, such as birth emergency skills training (BEST)
22or an advanced life-saving in obstetrics (ALSO) course. The
23remaining 36 hours shall be divided among and include hours in
24the areas of pharmacology, lab interpretations of pregnancy,
25antepartum complications, intra-partum complications,
26postpartum complications, and neonatal care or any additional



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1requirements subsequently required by the North American
2Registry of Midwives or its successor.
3    "MEAC" means the Midwifery Education and Accreditation
4Council, or its successor.
5    "NARM" means the North American Registry of Midwives, or
6any successor organization, that has established and has
7continued to administer certification for the credentialing of
8Certified Professional Midwives.
9    "Patient" means a woman or newborn for whom a licensed
10certified professional midwife provides services.
11    "Postpartum period" means the first 6 weeks after delivery.
12    "Practice of midwifery" means, consistent with current
13national standards, this Act, and rules adopted by the
14Department, providing the necessary supervision, care,
15education, and advice to people with low-risk pregnancies
16during the antepartum, intra-partum, and postpartum period,
17conducting deliveries, and caring for the newborn, with such
18care including preventative measures, the detection of
19abnormal conditions in the mother and the child, the
20identification, referral and procurement of medical assistance
21when necessary care is beyond the scope of certified
22professional midwifery practice, and the execution of
23emergency measures in the absence of medical help. "Practice of
24midwifery" includes breastfeeding assistance and education,
25non-prescriptive family planning, and basic well-woman care
26limited to screenings for sexually transmitted infection.



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1    "Secretary" means the Secretary of Financial and
2Professional Regulation.
3    Section 20. Unlicensed practice. Beginning on January 1,
42019, no person may practice, attempt to practice, or hold
5himself or herself out to practice as a licensed certified
6professional midwife unless he or she is licensed under this
8    Section 25. Powers and duties of the Department; rules.
9    (a) The Department shall exercise the powers and duties
10prescribed by the Civil Administrative Code of Illinois for the
11administration of licensing Acts and shall exercise such other
12powers and duties necessary for effectuating the purposes of
13this Act.
14    (b) The Department shall adopt rules under the Illinois
15Administrative Procedure Act for the administration and
16enforcement of the Act and for the payment of fees connected to
17the Act and may prescribe forms that shall be issued in
18connection with the Act. In addition, the Department shall
19adopt rules establishing uniform State forms that licensed
20certified professional midwives must (1) provide to clients
21consistent with the Act, including informed consent forms, (2)
22complete and submit to the Board in each case in which the
23transport of a patient occurs in accordance with transport
24protocols recommended by the Board and adopted by the



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1Department by rule, and (3) complete to report patient outcomes
2to the Board.
3    (c) The rules adopted by the Department under this Section
4may not authorize a licensed certified professional midwife to
5practice beyond the scope of practice set forth in Section 45.
6    (d) The Department shall consult with the Board in adopting
7rules. Notice of proposed rulemaking shall be transmitted to
8the Board and the Department shall review the Board's response
9and any recommendations made. The Department shall notify the
10Board in writing of deviations from the Board's recommendations
11and responses.
12    (e) The Department may at any time seek the advice and the
13expert knowledge of the Board on any matter relating to the
14administration of this Act.
15    (f) The Department shall issue quarterly a report to the
16Board of the status of all complaints related to the profession
17filed with the Department.
18    (g) Administration by the Department of this Act must be
19consistent with standards regarding the practice of midwifery
20established by the National Association of Certified
21Professional Midwives or a successor organization, this Act and
22rules adopted pursuant to this Act.
23    Section 27. Requirements for schools. Schools providing
24education for licensed certified professional midwives shall
25provide a program of education that is accredited by the



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1Midwifery Education and Accreditation Council and that
2includes, but is not limited to, classes on the following
4        (1) the community and social determinants of health,
5    including income, literacy, education, water supply and
6    sanitation, housing, environmental hazards, food security,
7    disease patterns, and common threats to health;
8        (2) principles of community-based primary care using
9    health promotion and disease prevention and control
10    strategies;
11        (3) direct and indirect causes of maternal and neonatal
12    mortality and morbidity and strategies for reducing them;
13        (4) methodology for conducting maternal death review
14    and near-miss audits;
15        (5) principles of epidemiology and community
16    diagnosis, including water and sanitation, and how to use
17    these in care provision;
18        (6) methods of infection prevention and control
19    appropriate to the service being provided;
20        (7) principles of research, evidenced-based practice,
21    critical interpretation of professional literature, and
22    the interpretation of vital statistics and research
23    findings;
24        (8) indicators of quality health care services;
25        (9) principles of health education;
26        (10) national and local health services and



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1    infrastructures supporting the continuum of care through
2    organizations and referral systems, and how to access
3    needed resources for midwifery care;
4        (11) relevant national or local programs or
5    initiatives that provide services or knowledge of how to
6    assist community members to access services, such as
7    immunization and prevention or treatment of health
8    conditions prevalent in the country or locality;
9        (12) the concept of alarm or preparedness, the protocol
10    for referral to higher health facility levels, and
11    appropriate communication during transport and emergency
12    care;
13        (13) the legal and regulatory framework governing
14    reproductive health for women of all ages, including laws,
15    policies, protocols, and professional guidelines;
16        (14) human rights and their effects on the health of
17    individuals, including, but not limited to, health
18    disparities, domestic partner violence, and female genital
19    mutilation or cutting;
20        (15) advocacy and empowerment strategies for women;
21        (16) the history of childbirth practices and the
22    midwifery profession;
23        (17) unique healthcare needs of women from distinct
24    ethnic or cultural backgrounds or a variety of family
25    structures and sexual orientations;
26        (18) culturally sensitive care;



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1        (19) traditional and modern health practices that are
2    beneficial, neutral, or harmful;
3        (20) benefits and risks of available birth settings;
4        (21) strategies for advocating with women for a variety
5    of safe birth settings;
6        (22) the purpose and role of national and local
7    midwifery organizations that provide guidelines for
8    professional behaviors, which include that the midwife:
9            (A) is responsible and accountable for clinical
10        decisions and actions;
11            (B) acts consistently in accordance with
12        professional ethics, values, and human rights as
13        defined by national and local professional midwifery
14        organizations;
15            (C) acts consistently in accordance with standards
16        of practice as defined by national and local
17        professional midwifery organizations;
18            (D) maintains and updates knowledge and skills in
19        order to remain current in practice;
20            (E) uses standard or universal precautions,
21        infection prevention and control strategies, and clean
22        technique;
23            (F) behaves in a courteous, non-judgmental,
24        non-discriminatory, and culturally appropriate manner
25        with all clients;
26            (G) is respectful of individuals and their culture



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1        and customs, regardless of socioeconomic status, race,
2        ethnic origin, sexual orientation, gender, physical
3        ability, cognitive ability, or religious belief;
4            (H) maintains the confidentiality of all
5        information shared by the woman and communicates
6        essential information among other health care
7        providers or family members only with explicit
8        permission from the woman and in situations of
9        compelling need;
10            (I) uses shared decision-making in partnership
11        with women and their families to enable and support
12        them in making informed choices about their health,
13        including the need or desire for referral or transfer
14        to other health care providers or facilities for
15        continued care when health care needs exceed the
16        abilities of the licensed certified professional
17        midwife, and their right to refuse testing or
18        intervention;
19            (J) works collaboratively with other health care
20        workers to improve the delivery of services to women
21        and families;
22            (K) follows appropriate protocol and etiquette for
23        transport or transfer of care of the mother or newborn
24        from home or birth center to the hospital during
25        pregnancy, in labor, or postpartum; and
26            (L) provides opportunity for client feedback;



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1        (23) classes ensuring that the midwife has the skill or
2    ability to:
3            (A) engage in health education discussions with
4        and for women and their families;
5            (B) use appropriate communication and listening
6        skills across all domains of competency;
7            (C) assemble, use, and maintain equipment and
8        supplies appropriate to setting of practice;
9            (D) document and interpret relevant findings for
10        services provided across all domains of competency,
11        including what was done and what needs follow-up
12        according to current best practices;
13            (E) comply with all local regulations for birth and
14        death registration, mandatory reporting for physical
15        abuse, and infectious disease reporting;
16            (F) take a leadership role in the practice arena
17        based on professional beliefs and values; and
18            (G) assume administration and management tasks and
19        activities, including, but not limited to, compliance
20        with privacy and protected health information
21        regulations, such as compliance with the requirements
22        of the Health Insurance Portability and Accountability
23        Act, and compliance with workplace safety regulations,
24        including compliance with regulations of the
25        Occupational Safety and Health Administration;
26        (24) anatomy and physiology of the human body;



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1        (25) the biology of human reproduction, the menstrual
2    cycle, and the process of conception;
3        (26) the growth and development of the unborn baby;
4        (27) signs and symptoms of pregnancy;
5        (28) examinations and tests for confirmation of
6    pregnancy;
7        (29) signs and symptoms and methods for diagnosis of an
8    ectopic pregnancy;
9        (30) principles of dating pregnancy by menstrual
10    history, size of uterus, fundal growth patterns, and use of
11    ultrasound;
12        (31) components of a health history and focused
13    physical examination for antenatal visits;
14        (32) manifestations of various degrees of female
15    genital mutilation or cutting and their potential;
16        (33) factors involved in decisions relating to
17    unintended or mistimed pregnancies;
18        (34) normal findings or results of basic screening
19    laboratory tests, including, but not limited to, (i)
20    routine pregnancy blood work, (ii) urine dipstick, (iii)
21    fetal screening, such as genetic testing, biophysical
22    profiles, first and second trimester screen, non-stress
23    test, and ultrasound, (iv) glucose tolerance screen, (v)
24    pre-eclampsia screening tests, and (vi) Group B
25    streptococcus vaginal or rectal culture;
26        (35) normal progression of pregnancy, such as body



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1    changes, common discomforts, expected fundal growth
2    patterns, and weight gain;
3        (36) implications of deviation from expected fundal
4    growth patterns, including intrauterine growth retardation
5    or restriction, oligohydramnios and polyhydramnios, and
6    multiple fetuses;
7        (37) fetal risk factors requiring transfer of women to
8    higher levels of care prior to labor and birth;
9        (38) normal psychological changes in pregnancy,
10    indicators of psychosocial stress, and impact of pregnancy
11    on the woman and the family;
12        (39) safe locally available non-pharmacological
13    methods for the relief of common discomforts of pregnancy;
14        (40) how to determine fetal well-being during
15    pregnancy, including fetal heart rate and activity
16    patterns, amniocentesis, and ultrasound technology;
17        (41) components of a healthy diet and the nutritional
18    requirements of the pregnant woman and fetus, including the
19    appropriate use of vitamin and mineral supplements;
20        (42) health education needs in pregnancy, such as
21    information about relief of common discomforts, hygiene,
22    sexuality, and work inside and outside the home;
23        (43) basic principles of pharmacokinetics of drugs
24    prescribed, dispensed, or furnished to women during
25    pregnancy;
26        (44) effects of prescribed medications, ultrasound,



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1    street drugs, traditional medicines, and over-the-counter
2    drugs on pregnancy and the fetus;
3        (45) effects of smoking, alcohol abuse, and illicit
4    drug use on the pregnant woman and fetus;
5        (46) effects of environmental exposures, food-borne
6    illnesses, or certain activities on the pregnant woman and
7    fetus, such as heavy metals, listeriosis, pesticides, food
8    additives, saunas, and toxoplasmosis;
9        (47) the essential elements of birth planning,
10    including, but not limited to, preparation for labor and
11    birth and emergency preparedness;
12        (48) the physical preparation for labor;
13        (49) the components of preparation of the home and
14    family for the newborn;
15        (50) techniques for increasing relaxation and pain
16    relief measures available for labor;
17        (51) signs, symptoms, and potential effects of
18    conditions that are life-threatening to the pregnant woman
19    or her fetus, including, but not limited to, (i)
20    pre-eclampsia or eclampsia, (ii) vaginal bleeding, (iii)
21    premature labor, (iv) Rh isoimmunization, and (v)
22    syphilis;
23        (52) means and methods of advising about care,
24    treatment, and support for the HIV-positive pregnant
25    woman, including measures to prevent maternal-to-child
26    transmission (PMTCT) and feeding options;



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1        (53) signs, symptoms, and indications for referral of
2    selected complications and conditions of pregnancy that
3    affect either the mother or the fetus, including, but not
4    limited to, (i) anemia, (ii) asthma, (iii) HIV infection,
5    (iv) thyroid disorders, (v) diabetes, (vi) cardiac
6    conditions, (vii) malpresentations and abnormal lie,
7    (viii) placental disorders, (ix) pre-term labor, (x)
8    post-dates pregnancy, and (xi) hydatidiform mole;
9        (54) the prenatal methods for encouraging optimal
10    positioning at term, including external manual version;
11        (55) the physiology of lactation and methods to prepare
12    women for breastfeeding;
13        (56) classes ensuring that the midwife has the skill or
14    ability to:
15            (A) take an initial history and perform an ongoing
16        history for each antenatal visit;
17            (B) perform a complete physical examination and
18        explain the findings to the woman;
19            (C) take and assess maternal vital signs,
20        including temperature, blood pressure, and pulse;
21            (D) draw blood and collect urine and vaginal
22        culture specimens for laboratory testing;
23            (E) assess maternal nutrition and its relationship
24        to fetal growth and give appropriate advice on the
25        nutritional requirements of pregnancy and how to
26        achieve them;



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1            (F) perform a complete abdominal assessment
2        including measuring fundal height, lie, position, and
3        presentation;
4            (G) assess fetal growth using manual measurements;
5            (H) evaluate fetal growth, placental location, and
6        amniotic fluid volume by using manual measurements or
7        techniques and by referring for ultrasound
8        visualization and measurement;
9            (I) listen to the fetal heart rate, palpate the
10        uterus for fetal activity, and interpret findings;
11            (J) monitor fetal heart rate with Doppler;
12            (K) perform a pelvic examination, including sizing
13        the uterus, if indicated and when appropriate during
14        the course of pregnancy;
15            (L) perform clinical pelvimetry (evaluation of
16        bony pelvis) to determine the adequacy of the bony
17        structures;
18            (M) calculate the estimated date of birth and
19        assess gestational period through query about the last
20        menstrual period, bimanual examination, urine
21        pregnancy testing, or any combination thereof;
22            (N) provide health education to adolescents,
23        women, and families about normal pregnancy
24        progression, danger signs and symptoms, and when and
25        how to contact the midwife;
26            (O) teach or demonstrate measures to decrease



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1        common discomforts of pregnancy;
2            (P) provide guidance and basic preparation for
3        labor, birth, and parenting;
4            (Q) provide education regarding avoidance of
5        potentially harmful environmental exposures,
6        food-borne illnesses, or activities;
7            (R) identify variations during the course of the
8        pregnancy and institute appropriate first-line
9        independent or collaborative management based upon
10        evidence-based guidelines, local standards, and
11        available resources for (i) low or inadequate maternal
12        nutrition, including eating disorders and pica; (ii)
13        anemia; (iii) ectopic pregnancy; (iv) hyperemesis
14        gravidarum; (v) genital herpes; (vi) inadequate or
15        excessive uterine growth, including suspected
16        oligohydramnios or polyhydramnios, and molar
17        pregnancy; (vii) gestational diabetes; (viii)
18        insufficient cervix; (ix) elevated blood pressure,
19        proteinuria, presence of significant edema, severe
20        frontal headaches, visual changes, and epigastric pain
21        associated with elevated blood pressure; (x) vaginal
22        bleeding with or without cramping; (xi) multiple
23        gestation and abnormal lie or malpresentation at term;
24        (xii) intrauterine fetal death; (xiii) rupture of
25        membranes prior to term; (xiv) post term pregnancy;
26        (xv) exposure to or contraction of infectious disease,



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1        such as HIV, Hepatitis B and Hepatitis C, Varicella,
2        Rubella, and cytomegalovirus; (xvi) Group B
3        streptococcus positive vaginal or rectal culture;
4        (xvii) Toxoplasmosis; and (xviii) depression;
5            (S) identify deviations from normal during the
6        course of pregnancy and initiate the referral process
7        for conditions that require higher levels of
8        intervention;
9            (T) dispense, furnish, or administer (however
10        authorized to do so in the jurisdiction of practice)
11        selected, life-saving drugs, such as antibiotics,
12        anticonvulsants, antimalarials, antihypertensives, and
13        antiretrovirals, to women in need because of a
14        presenting condition; and
15            (U) provide individualized care according to the
16        needs and desires of each woman;
17        (57) physiology of the first, second, and third stages
18    of labor;
19        (58) anatomy of the fetal skull, critical diameters,
20    and landmarks;
21        (59) psychological and cultural aspects of labor and
22    birth;
23        (60) indicators of the latent phase and the onset of
24    active labor;
25        (61) indications for stimulation of the onset of labor,
26    and augmentation of uterine contractility;



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1        (62) normal progression of labor;
2        (63) how to use the partograph, including, but not
3    limited to, completing the record and interpreting
4    information to determine timely and appropriate labor
5    management;
6        (64) measures to assess fetal well-being in labor;
7        (65) measures to assess maternal well-being in labor;
8        (66) process of fetal passage or descent through the
9    pelvis during labor and birth, mechanisms of labor in
10    various fetal presentations, and positions;
11        (67) comfort measures in the first and second stages of
12    labor, such as family presence or assistance, positioning
13    for labor and birth, hydration, emotional support, and
14    non-pharmacological methods of pain relief;
15        (68) pharmacological measures for management and
16    control of labor pain, including the relative risks,
17    disadvantages, and safety of specific methods of pain
18    management and their effect on the normal physiology of
19    labor;
20        (69) signs and symptoms of complications in labor,
21    including, but not limited to, (i) bleeding, (ii) labor
22    arrest or dysfunction, (iii) malpresentation, (iv)
23    eclampsia, (v) maternal distress, (vi) fetal distress,
24    (vii) infection, and (viii) prolapsed cord;
25        (70) the benefits, risks, criteria for risk
26    assessment, and midwifery management of vaginal birth



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1    after a cesarean;
2        (71) indicators, risk factors, special needs, and
3    prenatal management of a pregnant woman with a multiple
4    gestation;
5        (72) principles of prevention of pelvic floor damage
6    and perineal tears;
7        (73) indications for performing an episiotomy;
8        (74) principles of expectant (physiologic) management
9    of the third stage of labor;
10        (75) principles of active management of the third stage
11    of labor;
12        (76) principles underpinning the technique for repair
13    of perineal tears and episiotomy;
14        (77) indicators of need for emergency management,
15    referral, or transfer for obstetric emergencies,
16    including, but not limited to, cord prolapse, shoulder
17    dystocia, placental abruption, uterine rupture, uterine
18    bleeding, and retained placenta;
19        (78) indicators of need for operative deliveries,
20    vacuum extraction, and use of forceps, including, but not
21    limited to, fetal distress and cephalopelvic
22    disproportion;
23        (79) indicators of need for and appropriate
24    administration of the following pharmacologic agents:
25    lidocaine/xylocaine for suturing, oxygen, methergine,
26    oxytocin (Pitocin) for postpartum hemorrhage, rhogam,



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1    vitamin K, antibiotics for group B strep prophylaxis,
2    intravenous fluids, and newborn eye prophylaxis; and
3        (80) classes to ensure that the midwife has the skill
4    or ability to:
5            (A) take a specific history and maternal vital
6        signs in labor;
7            (B) perform a focused physical examination in
8        labor;
9            (C) perform a complete abdominal assessment for
10        fetal position and descent;
11            (D) time and assess the effectiveness of uterine
12        contractions;
13            (E) perform a complete and accurate pelvic
14        examination for dilatation, effacement, descent,
15        presenting part, position, status of membranes, and
16        adequacy of pelvis for birth of baby vaginally;
17            (F) monitor and chart progress of labor;
18            (G) provide physical and psychological support for
19        woman and family and promote normal birth, including
20        encouragement of adequate rest and sleep;
21            (H) facilitate the presence of a support person
22        during labor and birth;
23            (I) provide adequate hydration, nutrition, and
24        non-pharmacological comfort measures during labor and
25        birth;
26            (J) provide for bladder care, including



HB0677- 22 -LRB100 06207 SMS 16241 b

1        performance of urinary catheterization when indicated;
2            (K) promptly identify abnormal labor patterns or
3        progress and initiate appropriate and timely
4        intervention or referral, including, but not limited
5        to, occiput posterior position, asynclitism, pendulous
6        abdomen, maternal exhaustion, and maternal
7        dehydration;
8            (L) stimulate or augment uterine contractility
9        using non-pharmacologic agents;
10            (M) administer local anaesthetic to the perineum
11        when episiotomy is anticipated or perineal repair is
12        required;
13            (N) perform an episiotomy if needed;
14            (O) perform appropriate hand maneuvers for a
15        vertex birth;
16            (P) perform appropriate hand maneuvers for face
17        and breech deliveries;
18            (Q) manage the birth of multiples;
19            (R) recognize the various severities of meconium
20        stained amniotic fluid and perform suctioning of the
21        airway, as appropriate;
22            (S) clamp and cut the cord;
23            (T) institute immediate life-saving interventions
24        in obstetrical emergencies to save the life of the
25        fetus while requesting medical attention, awaiting
26        transfer, or both, including, but not limited to, (i)



HB0677- 23 -LRB100 06207 SMS 16241 b

1        prolapsed cord, (ii) placental abruption, (iii)
2        uterine rupture, (iv) malpresentation, (v) shoulder
3        dystocia, and (vi) fetal distress;
4            (U) manage a nuchal cord or arm at birth;
5            (V) support expectant (physiologic) management of
6        the third stage of labor;
7            (W) assess the need for and conduct active
8        management of the third stage of labor, following the
9        most current evidence-based protocol;
10            (X) inspect the placenta and membranes for
11        completeness;
12            (Y) perform fundal massage to stimulate postpartum
13        uterine contraction and uterine tone;
14            (Z) provide a safe environment for mother and
15        infant to promote attachment or bonding;
16            (AA) estimate and record maternal blood loss;
17            (BB) inspect the vagina and cervix for
18        lacerations;
19            (CC) repair an episiotomy, if needed;
20            (DD) repair first and second degree perineal or
21        vaginal lacerations;
22            (EE) manage postpartum bleeding and hemorrhage
23        using appropriate techniques and uterotonic agents as
24        indicated;
25            (FF) dispense, furnish, or administer (however
26        authorized to do so in the jurisdiction of practice)



HB0677- 24 -LRB100 06207 SMS 16241 b

1        selected, life-saving drugs, including antibiotics and
2        antihemorrhagics, to women in need because of a
3        presenting condition;
4            (GG) perform manual removal of placenta;
5            (HH) perform internal and external bimanual
6        compression of the uterus to control hemorrhage;
7            (II) perform aortic compression;
8            (JJ) identify and manage shock;
9            (KK) insert an intravenous line, administer
10        fluids, and draw blood for laboratory testing;
11            (LL) arrange for and undertake timely referral and
12        transfer of women with serious complications to a
13        higher level health facility, taking appropriate drugs
14        and equipment and arranging for a companion caregiver
15        on the journey in order to continue giving emergency
16        care as required; and
17            (MM) perform adult cardiopulmonary resuscitation.
18    Section 30. Qualifications for licensed certified
19professional midwives.
20    (a) Each applicant who successfully meets the requirements
21of this Section shall be licensed as a licensed certified
22professional midwife.
23    (b) An applicant for licensure as a licensed certified
24professional midwife must do each of the following:
25        (1) Submit a completed written application, on forms



HB0677- 25 -LRB100 06207 SMS 16241 b

1    provided by the Department, and fees, as established by the
2    Department.
3        (2) Be at least 21 years old.
4        (3) Be a high school graduate or have completed
5    equivalent education.
6        (4) Successfully complete one of the following formal
7    midwifery education and training programs:
8            (A) Accredited Educational Pathway:
9                (i) Applicants who are Certified Professional
10            Midwives and who have successfully completed an
11            educational program or pathway accredited by the
12            MEAC are eligible for licensure as a licensed
13            certified professional midwife.
14                (ii) After January 1, 2022, all new applicants
15            for licensure as a licensed certified professional
16            midwife must have graduated from an educational
17            program or pathway accredited by MEAC.
18            (B) Non-accredited Educational Pathway:
19                (i) Applicants who are Certified Professional
20            Midwives before January 1, 2022, and who have
21            completed non-accredited education pathways will
22            be required to obtain the NARM Midwifery Bridge
23            Certificate in order to become licensed as a
24            licensed certified professional midwife.
25                (ii) Applicants who have maintained licensure
26            in a state that does not require accredited



HB0677- 26 -LRB100 06207 SMS 16241 b

1            education, regardless of the date of their
2            certification, shall obtain the NARM Midwifery
3            Bridge Certificate to be eligible for licensure as
4            a licensed certified professional midwife.
5        (5) Hold a current valid Certified Professional
6    Midwife Credential granted by NARM or its successor
7    organization.
8        (6) Hold current cardiopulmonary resuscitation (CPR)
9    certification for health care professionals or providers
10    issued by the American Red Cross or the American Heart
11    Association.
12        (7) Within the last 2 years have successfully completed
13    the American Academy of Pediatric/American Heart
14    Association neonatal resuscitation program (NRP).
15        (8) Have not violated the provisions of this Act
16    concerning the grounds for disciplinary action. The
17    Department may take into consideration any felony
18    conviction of the applicant, but such a conviction may not
19    operate as an absolute bar to licensure as a licensed
20    certified professional midwife.
21        (9) Submit to the criminal history records check
22    required under Section 35 of this Act.
23        (10) Meet all other requirements established by the
24    Department by rule.
25    Section 35. Criminal history records background check.



HB0677- 27 -LRB100 06207 SMS 16241 b

1Each applicant for licensure by examination or restoration
2shall submit his or her fingerprints to the Department of State
3Police in an electronic format that complies with the form and
4manner for requesting and furnishing criminal history record
5information prescribed by the Department of State Police. These
6fingerprints shall be checked against the Department of State
7Police and Federal Bureau of Investigation criminal history
8record databases now and hereafter filed. The Department of
9State Police shall charge applicants a fee for conducting the
10criminal history records check, which shall be deposited into
11the State Police Services Fund and shall not exceed the actual
12cost of the records check. The Department of State Police shall
13furnish, pursuant to positive identification, records of
14Illinois convictions to the Department and shall forward the
15national crime history record information to the Department.
16The Department may require applicants to pay a separate
17fingerprinting fee, either to the Department or to a vendor.
18The Department, in its discretion, may allow an applicant who
19does not have reasonable access to a designated vendor to
20provide his or her fingerprints in an alternative manner. The
21Department may adopt any rules necessary to implement this
23    Section 40. Title. Only a licensed certified professional
24midwife may identify himself or herself as a "licensed
25certified professional midwife" or use the abbreviation



HB0677- 28 -LRB100 06207 SMS 16241 b

2    Section 45. Scope of practice of licensed certified
3professional midwives.
4    (a) "Practice of midwifery" means:
5        (1) providing maternity care that is consistent with a
6    midwife's training, education, and experience; and
7        (2) identifying and referring patients who require
8    medical care to an appropriate health care provider.
9    (b) The practice of midwifery includes:
10        (1) Providing the necessary supervision, care, and
11    advice to a patient during a low-risk pregnancy, labor,
12    delivery, and postpartum period.
13        (2) Newborn care that is provided in a manner that is:
14            (A) consistent with national certified
15        professional midwifery standards; and
16            (B) based on the acquisition of clinical skills
17        necessary for the care of pregnant women and newborns,
18        including antepartum, intra-partum, and postpartum
19        care.
20        (3) Obtaining informed consent to provide services to
21    the patient in accordance with Section 50 of this Act.
22        (4) Discussing:
23            (A) any general risk factors associated with the
24        services to be provided;
25            (B) any specific risk factors pertaining to the



HB0677- 29 -LRB100 06207 SMS 16241 b

1        health and circumstances of the individual patient;
2            (C) conditions that preclude care by a licensed
3        certified professional midwife; and
4            (D) the conditions under which consultation,
5        transfer of care, or transport of the patient must be
6        implemented.
7        (5) Obtaining a health history of the patient and
8    performing a physical examination.
9        (6) Developing a written plan of care specific to the
10    patient, to ensure continuity of care throughout the
11    antepartum, intra-partum, and postpartum periods, that
12    includes:
13            (A) a plan for the management of any specific risk
14        factors pertaining to the individual health and
15        circumstances of the individual patient; and
16            (B) a plan to be followed in the event of an
17        emergency; including a plan for transportation.
18        (7) Evaluating the results of patient care and
19    reporting patient outcomes to the Department on a uniform
20    State form in accordance with rules.
21        (8) Consulting and collaborating with a health care
22    practitioner regarding the care of a patient, and referring
23    and transferring care to a health care practitioner, as
24    required.
25        (9) Referral of all patients, within 72 hours after
26    delivery, to a pediatric health care practitioner for care



HB0677- 30 -LRB100 06207 SMS 16241 b

1    of the newborn.
2        (10) Obtaining and administering appropriate
3    medications and using equipment and devices.
4        (11) Obtaining appropriate screening and testing,
5    including laboratory tests, urinalysis, and ultrasound.
6        (12) Providing prenatal care during the antepartum
7    period, with consultation or referral as required.
8        (13) Providing care during the intra-partum period,
9    including:
10            (A) monitoring and evaluating the condition of the
11        patient and fetus;
12            (B) performing emergency procedures, including:
13                (i) administering approved medications;
14                (ii) administering intravenous fluids for
15            stabilization;
16                (iii) performing an emergency episiotomy; and
17                (iv) providing care while on the way to a
18            hospital under circumstances in which emergency
19            medical services have not been activated;
20            (C) activating emergency medical services for an
21        emergency; and
22            (D) delivering in an out-of-hospital setting.
23        (14) Participating in mandatory peer review in cases
24    involving transfers of patients in accordance with rules
25    adopted by the Department, and peer review of any patient's
26    care upon request.



HB0677- 31 -LRB100 06207 SMS 16241 b

1        (15) Providing care during the postpartum period,
2    including:
3            (A) suturing of first and second degree perineal or
4        labial lacerations, or suturing of an episiotomy with
5        the administration of a local anesthetic; and
6            (B) making further contact with the patient within
7        48 hours, within 2 weeks, and at 6 weeks after the
8        delivery to assess for hemorrhage, preeclampsia,
9        thrombo-embolism, infection, and emotional well-being.
10        (16) Providing routine care for the newborn for up to
11    72 hours after delivery, exclusive of administering
12    immunizations, including:
13            (A) immediate care at birth, including
14        resuscitating as needed, performing a newborn
15        examination, and administering intramuscular vitamin K
16        and eye ointment for prevention of ophthalmia
17        neonatorium;
18            (B) assessing newborn feeding and hydration;
19            (C) performing metabolic screening and reporting
20        on the screening in accordance with the regulations
21        related to newborn screenings that are adopted by the
22        Department;
23            (D) performing critical congenital heart disease
24        screening and reporting on the screening in accordance
25        with the regulations related to newborn screenings
26        that are adopted by the Department; and



HB0677- 32 -LRB100 06207 SMS 16241 b

1            (E) referring the infant to an audiologist for a
2        hearing screening in accordance with the regulations
3        related to newborn screenings that are adopted by the
4        Department.
5        (17) Within 24 hours after delivery notifying a
6    pediatric health care practitioner of the delivery.
7        (18) Within 72 hours after delivery:
8            (A) transferring health records to the pediatric
9        health care practitioner, including documentation of
10        the performance of the screenings required under
11        subparagraphs (C) and (D) of paragraph (16) of this
12        subsection (b); and
13            (B) referring the newborn to a pediatric health
14        care practitioner.
15        (19) Providing the following care of the newborn beyond
16    the first 72 hours after delivery:
17            (A) weight checks and general observation of the
18        newborn's activity, with abnormal findings
19        communicated to the newborn's pediatric health care
20        practitioner;
21            (B) assessment of newborn feeding and hydration;
22        and
23            (C) breastfeeding support and counseling.
24        (20) Providing limited services to the patient after
25    the postpartum period, including:
26            (A) breastfeeding support and counseling; and



HB0677- 33 -LRB100 06207 SMS 16241 b

1            (B) counseling and referral for all family
2        planning methods.
3        (21) Providing a copy of all newborn care records to
4    the designated health care provider after the birth of the
5    baby at time of transfer of care. The licensed certified
6    professional midwife shall obtain consent for the transfer
7    of records per the Health Insurance Portability and
8    Accountability Act of 1996.
9        (22) Distributing Illinois Department of Public Health
10    materials about metabolic and hearing screenings for
11    newborns if such materials are available.
12    (c) The practice of midwifery does not include:
13        (1) Out-of-hospital care to a woman who has had a
14    caesarean section.
15        (2) Out-of-hospital care in cases of multifetal
16    gestation.
17        (3) Out-of-hospital care in cases involving breech
18    delivery.
19        (4) Administering prescription pharmacological agents
20    intended to induce or augment labor or artificial rupture
21    of membranes prior to onset of labor.
22        (5) Administering prescription pharmacological agents
23    to provide pain management or anesthetic except for the
24    administration of a local anesthetic.
25        (6) Using vacuum extractors or forceps.
26        (7) Prescribing medications.



HB0677- 34 -LRB100 06207 SMS 16241 b

1        (8) Performing surgical procedures, including, but not
2    limited to, abortions, cesarean sections and
3    circumcisions, except for an emergency episiotomy.
4        (9) Knowingly accepting responsibility for prenatal or
5    intra-partum care of a patient with any of the following
6    risk factors:
7            (A) previous uterine surgery, including a cesarean
8        section or myomectomy;
9            (B) chronic significant maternal cardiac,
10        pulmonary, renal, or hepatic disease;
11            (C) malignant disease in an active phase;
12            (D) significant hematological disorders or
13        coagulopathies or pulmonary embolism;
14            (E) diabetes mellitus requiring insulin;
15            (F) known maternal congenital abnormalities
16        affecting childbirth;
17            (G) confirmed isoimmunization, Rh disease with
18        positive titer levels;
19            (H) active tuberculosis;
20            (I) active syphilis or gonorrhea;
21            (J) active genital herpes infection 2 weeks prior
22        to labor or during labor;
23            (K) pelvic or uterine abnormalities affecting
24        normal vaginal births, including tumors and
25        malformations;
26            (L) alcoholism or abuse;



HB0677- 35 -LRB100 06207 SMS 16241 b

1            (M) drug addiction or abuse;
2            (N) confirmed HIV or AIDS status;
3            (O) uncontrolled current serious psychiatric
4        illness;
5            (P) social or familial conditions unsatisfactory
6        for out-of-hospital maternity care services;
7            (Q) fetus with suspected or diagnosed congenital
8        abnormalities that may require immediate medical
9        intervention;
10            (R) indications that the fetus has died in utero;
11        or
12            (S) premature labor (gestation less than 37
13        weeks).
14        (10) Continuing to provide care for conditions for
15    which a transfer is required under subsection (c) of
16    Section 60.
17        (11) Administering drugs other than those listed in
18    Section 60 of this Act.
19    Section 50. Informed consent.
20    (a) A licensed certified professional midwife shall, at an
21initial consultation with a patient, disclose to the patient
22orally and in writing on a Department-specified uniform
23informed consent form all of the following:
24        (1) The licensed certified professional midwife's
25    experience and training.



HB0677- 36 -LRB100 06207 SMS 16241 b

1        (2) The general risk factors associated with the
2    services to be provided.
3        (3) The definition of the "practice of midwifery" in
4    this Act.
5        (4) That the client is retaining a licensed certified
6    professional midwife, not an advanced practice nurse who is
7    a certified nurse midwife, and that the licensed certified
8    professional midwife is not supervised by a physician or
9    nurse.
10        (5) The licensed certified professional midwife's
11    current licensure status and license number.
12        (6) The practice settings in which the licensed
13    certified professional midwife practices.
14        (7) A description of the procedures, benefits and risks
15    of home births, including those conditions that may arise
16    during delivery.
17        (8) That there are conditions that are outside of the
18    scope of practice of a licensed certified professional
19    midwife that will result in a referral for a consultation
20    from, or transfer of care to, a health care practitioner.
21        (9) That there may be benefits to pre-registration at
22    the nearest hospital.
23        (10) The specific arrangements for the referral of
24    complications to a health care practitioner for
25    consultation. The licensed certified professional midwife
26    shall not be required to identify a specific health care



HB0677- 37 -LRB100 06207 SMS 16241 b

1    practitioner.
2        (11) Instructions for filing a complaint with the
3    Department.
4        (12) That if, during the course of care, the client is
5    informed that she has or may have a condition indicating
6    the need for a mandatory transfer, the licensed certified
7    professional midwife shall initiate the transfer.
8        (13) A written protocol for the handling of both
9    patient's and newborn's medical emergencies, including
10    transportation to a hospital, particular to each client,
11    complete with identification of the appropriate hospital,
12    and the estimated travel time to the hospital. A verbal
13    report of the care provided must be provided to emergency
14    services providers and a copy of the client records shall
15    be sent with the client at the time of any transfer to a
16    hospital.
17    (b) A copy of the informed consent document, signed and
18dated by the patient, must be kept in each patient's chart. All
19patients' charts and records of services provided shall be
20maintained for a minimum of 10 years after the last patient
22    Section 55. Midwife requirements. A licensed certified
23professional midwife shall do all of the following:
24    (a) Prior to labor, develop a written plan of care specific
25to the patient, including specific risk factors pertaining to



HB0677- 38 -LRB100 06207 SMS 16241 b

1the individual health and circumstances of the patient, to
2ensure continuity of antepartum, intra-partum, and postpartum
3care. The plan shall include:
4        (1) twenty-four hour, on-call availability by a
5    licensed certified professional midwife, advanced practice
6    nurse who is a certified nurse midwife, or licensed
7    physician throughout pregnancy, intra-partum, and 6 weeks
8    postpartum;
9        (2) appropriate screening and testing, including
10    laboratory tests, urinalysis, and ultrasound; and
11        (3) labor support, fetal monitoring, and routine
12    assessment of vital signs once active labor is established.
13    (b) Perform emergency procedures including: administering
14approved medications; administering intravenous fluids for
15stabilization; performing an emergency episiotomy; providing
16care while on the way to a hospital under circumstances in
17which emergency medical services have not been activated; and
18activating emergency medical services for an emergency.
19    (c) Supervise delivery of infant and placenta, assess
20newborn and maternal well-being in immediate postpartum, and
21perform Apgar tests.
22    (d) Provide immediate care at birth, including
23resuscitating as needed, performing a newborn examination, and
24administering intramuscular vitamin K and eye ointment for the
25prevention of blindness.
26    (e) Perform routine cord management and inspect for the



HB0677- 39 -LRB100 06207 SMS 16241 b

1appropriate number of vessels.
2    (f) Inspect the placenta and membranes for completeness.
3    (g) Inspect the perineum and vagina postpartum for
4lacerations and stabilize suturing of first and second degree
5perineal or labial lacerations or suturing of an episiotomy
6with administration of a local anesthetic.
7    (h) Observe mother and newborn postpartum until stable
8condition is achieved, but in no event for less than 2 hours to
9assess for hemorrhage, preeclampsia, thromboembolism,
10infection, and emotional well-being.
11    (i) Instruct the mother, father, and other support persons,
12both verbally and in writing, of the special care and
13precautions for both mother and newborn in the immediate
14postpartum period.
15    (j) Reevaluate maternal and newborn well-being within 36
16hours of delivery.
17    (k) Use universal precautions with all biohazard
19    (l) Ensure that a birth certificate is accurately completed
20and filed in accordance with State law.
21    (m) Within 24 hours after delivery, notify a pediatric
22health care professional of the delivery including
23transferring health records to the pediatric health
24practitioner documenting performance of the required newborn
26    (n) Within 24 to 36 hours after delivery, submit a blood



HB0677- 40 -LRB100 06207 SMS 16241 b

1sample in accordance with metabolic screening requirements for
3    (o) Within one week after delivery, perform newborn weight
4checks and general observation of the newborn's activities with
5abnormal findings communicated to the newborn's pediatric
6health care practitioner, assessment of newborn feeding and
7hydration, offer a newborn hearing screening to every newborn
8or refer the parents to a facility with a newborn hearing
9screening program.
10    (p) Provide services to the patient after the post-partum
11period limited to breastfeeding support and counseling and
12counseling and referral for family planning.
13    (q) Maintain adequate antenatal and perinatal records of
14each client and provide records to consulting licensed
15physicians and advanced practice nurses who are certified nurse
16midwives in accordance with federal Health Insurance
17Portability and Accountability Act regulations and State law.
18    Section 60. Administration of drugs.
19    (a) A licensed certified professional midwife may
20administer the following agents during the practice of
22        (1) oxygen for the treatment of fetal distress;
23        (2) eye prophylactics - 0.5% erythromycin ophthalmic
24    ointment for the prevention of neonatal ophthalmia;
25        (3) oxytocin (Pitocin) as a postpartum antihemorrhagic



HB0677- 41 -LRB100 06207 SMS 16241 b

1    agent or as prophylaxis for hemorrhage;
2        (4) Methyl-ergonovine or Methergine for the treatment
3    of postpartum hemorrhage;
4        (5) Misoprostol (Cytotec) for the treatment of
5    postpartum hemorrhage;
6        (6) Vitamin K for the prophylaxis for hemorrhagic
7    disease of the newborn;
8        (7) RHo(D) immune globulin for the prevention for
9    RHo(D) sensitization in RHo(D) negative women;
10        (8) intravenous fluids for maternal stabilization,
11    including lactated Ringer's solution, or with 5% dextrose
12    (D5LR), unless unavailable or impractical, in which case
13    0.9% sodium chloride may be administered;
14        (9) Lidocaine injection as a local anesthetic for
15    perineal repair;
16        (10) sterile water subcutaneous injections as a
17    non-pharmacological form of pain relief during the first
18    and second stages of labor; and
19        (11) ibuprofen for postpartum pain relief.
20    (b) The medication indications, dose, route of
21administration, and duration of treatment relating to the
22administration of drugs and procedures identified under this
23Section shall be determined by rule as the Department deems
24necessary to be in keeping with current evidence-based practice
25standards. The Department may approve additional medications,
26agents, or procedures based upon updated evidence-based



HB0677- 42 -LRB100 06207 SMS 16241 b

1obstetrical guidelines or based upon limited availability of
2standard medications or agents.
3    (c) A licensed certified professional midwife shall not
4administer Schedule II-V drugs.
5    Section 65. Consultation, referral, and transfer.
6    (a) A licensed certified professional midwife shall
7consult with a licensed physician concentrating in obstetrics,
8a licensed physician concentrating in a family practice who
9performs deliveries, or an advanced practice nurse who is a
10certified nurse midwife providing obstetrical care whenever
11there are significant deviations, including abnormal
12laboratory results, relative to a patient's pregnancy or to a
13neonate. If a referral to a physician or advanced practice
14nurse who is a certified midwife is needed, the licensed
15certified professional midwife shall refer the patient to a
16physician concentrating in obstetrics or to a physician
17concentrating in family practice who performs deliveries, and,
18if possible, remain in consultation with the physician or nurse
19until resolution of the concern. Consultation does not preclude
20the possibility of an out-of-hospital birth. It is appropriate
21for the licensed certified professional midwife to maintain
22care of the patient to the greatest degree possible, in
23accordance with the patient's wishes, during the pregnancy and,
24if possible, during labor, birth, and the postpartum period.
25    (b) The midwife shall document during prenatal care the



HB0677- 43 -LRB100 06207 SMS 16241 b

1health care practitioner the parents have chosen to provide
2pediatric care for the newborn in the weeks immediately
3following the birth. If no pediatric health care practitioner
4has been chosen by 36 weeks of pregnancy, the licensed
5certified professional midwife shall provide a referral.
6    (c) A licensed certified professional midwife shall
7consult with a licensed physician concentrating in obstetrics,
8a licensed physician concentrating in family practice who
9performs deliveries, or an advanced practice nurse who is a
10certified nurse midwife with regard to any patient who presents
11with or develops the following risk factors, or presents with
12or develops other risk factors that, in the judgment of the
13licensed certified professional midwife, warrant consultation:
14        (1) Antepartum.
15            (A) Pregnancy-induced hypertension, as evidenced
16        by a blood pressure of 140/90 on 2 occasions greater
17        than 6 hours apart.
18            (B) Persistent, severe headaches, epigastric pain,
19        or visual disturbances.
20            (C) Persistent symptoms of urinary tract
21        infection.
22            (D) Significant vaginal bleeding before the onset
23        of labor not associated with uncomplicated spontaneous
24        abortion.
25            (E) Rupture of membranes prior to the 37th week of
26        gestation.



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1            (F) Noted abnormal decrease in or cessation of
2        fetal movement.
3            (G) Anemia resistant to supplemental therapy.
4            (H) Fever of 102 degrees Fahrenheit or 39 degrees
5        Celsius or greater for more than 24 hours.
6            (I) Non-vertex presentation after 36 weeks
7        gestation.
8            (J) Hyperemesis or significant dehydration.
9            (K) Isoimmunization, Rh-negative sensitized,
10        positive titers, or any other positive antibody titer,
11        which may have a detrimental effect on mother or fetus.
12            (L) Elevated blood glucose levels unresponsive to
13        dietary management.
14            (M) Positive HIV antibody test.
15            (N) Primary genital herpes infection in pregnancy
16        or active recurrent herpes infection within 2 weeks of
17        labor.
18            (O) Symptoms of malnutrition or anorexia or
19        protracted weight loss or failure to gain weight.
20            (P) Suspected deep vein thrombosis.
21            (Q) Documented placental anomaly or previa.
22            (R) Labor prior to the 37th week of gestation.
23            (S) Lie other than vertex at term.
24            (T) Known fetal anomalies that may be affected by
25        the site of birth.
26            (U) Marked abnormal fetal heart tones.



HB0677- 45 -LRB100 06207 SMS 16241 b

1            (V) Abnormal non-stress test or abnormal
2        biophysical profile.
3            (W) Marked or severe polyhydramnios or
4        oligohydramnios.
5            (X) Evidence of intrauterine growth restriction.
6            (Y) Significant abnormal ultrasound findings.
7            (Z) Gestation beyond 42 weeks by reliable
8        confirmed dates.
9            (AA) Controlled hypothyroidism, being treated with
10        thyroid replacement and euthyroid, and with thyroid
11        test numbers in the normal range.
12            (BB) Previous obstetrical problems, including
13        uterine abnormalities, placental abruption, placenta
14        accreta, obstetric hemorrhage, incompetent cervix, or
15        preterm delivery for any reason.
16            (CC) Unforeseen multifetal gestation.
17        (2) Intra-partum.
18            (A) Rise in blood pressure above baseline, more
19        than 30/15 points or greater than 140/90.
20            (B) Persistent, severe headaches, epigastric pain,
21        or visual disturbances.
22            (C) Significant proteinuria or ketonuria.
23            (D) Fever over 100.6 degrees Fahrenheit or 38
24        degrees Celsius in absence of environmental factors.
25            (E) Ruptured membranes without onset of
26        established labor after 18 hours.



HB0677- 46 -LRB100 06207 SMS 16241 b

1            (F) Significant bleeding prior to delivery or any
2        abnormal bleeding, with or without abdominal pain, or
3        evidence of placental abruption.
4            (G) Fetal lie not compatible with spontaneous
5        vaginal delivery or unstable fetal lie.
6            (H) Failure to progress after 5 hours of active
7        labor or following 2 hours of active second stage
8        labor.
9            (I) Signs or symptoms of maternal infection.
10            (J) Active genital herpes at onset of labor or
11        within 2 weeks of the onset of labor.
12            (K) Fetal heart tones with non-reassuring
13        patterns.
14            (L) Signs or symptoms of fetal distress.
15            (M) Thick meconium or frank bleeding with birth not
16        imminent.
17            (N) Patient or licensed certified professional
18        midwife desires physician or advanced practice nurse
19        consultation or transfer.
20        (3) Postpartum.
21            (A) Failure to void within 6 hours of birth.
22            (B) Signs or symptoms of maternal shock.
23            (C) Fever of 102 degrees Fahrenheit or 39 degrees
24        Celsius and unresponsive to therapy for 12 hours.
25            (D) Abnormal lochia or signs or symptoms of uterine
26        sepsis.



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1            (E) Suspected deep vein thrombosis.
2            (F) Signs of clinically significant depression.
3            (G) Retained placenta.
4            (H) Patient with a third or fourth degree
5        laceration or a laceration beyond the licensed
6        certified professional midwife's ability to repair.
7    (d) A licensed certified professional midwife shall
8consult with a licensed physician with a concentration in
9obstetrics, a licensed physician with a concentration in
10pediatrics, a licensed physician with a concentration in family
11practice who performs deliveries, or an advanced practice nurse
12who is a certified nurse midwife with regard to any neonate who
13is born with or develops the following risk factors:
14        (1) Apgar score of 6 or less at 5 minutes without
15    significant improvement by 10 minutes.
16        (2) Persistent grunting respirations or retractions.
17        (3) Persistent cardiac irregularities.
18        (4) Persistent central cyanosis or pallor.
19        (5) Persistent lethargy or poor muscle tone.
20        (6) Abnormal cry.
21        (7) Birth weight less than 2,300 grams.
22        (8) Jitteriness or seizures.
23        (9) Jaundice occurring before 24 hours or outside of
24    normal range.
25        (10) Failure to urinate within 24 hours of birth.
26        (11) Failure to pass meconium within 48 hours of birth.



HB0677- 48 -LRB100 06207 SMS 16241 b

1        (12) Edema.
2        (13) Prolonged temperature instability.
3        (14) Significant signs or symptoms of infection.
4        (15) Significant clinical evidence of glycemic
5    instability.
6        (16) Abnormal, bulging, or depressed fontanel.
7        (17) Significant clinical evidence of prematurity.
8        (18) Medically significant congenital anomalies.
9        (19) Significant or suspected birth injury.
10        (20) Persistent inability to suck.
11        (21) Diminished consciousness.
12        (22) Clinically significant abnormalities in vital
13    signs, muscle tone, or behavior.
14        (23) Clinically significant color abnormality,
15    cyanotic, or pale or abnormal perfusion.
16        (24) Abdominal distension or projectile vomiting.
17        (25) Signs of clinically significant dehydration or
18    failure to thrive.
19    Section 70. Transfer.
20    (a) Transport via private vehicle is an acceptable method
21of transport if it is the most expedient and safest method for
22accessing medical services. The licensed certified
23professional midwife shall initiate immediate transport
24according to the licensed certified professional midwife's
25emergency plan, provide emergency stabilization until



HB0677- 49 -LRB100 06207 SMS 16241 b

1emergency medical services arrive or transfer is completed,
2accompany the patient or follow the patient to a hospital in a
3timely fashion, provide pertinent information to the receiving
4facility, and complete an emergency transport record. The
5following conditions shall require immediate physician or
6advanced practice nurse notification and emergency transfer to
7a hospital:
8        (1) Seizures or unconsciousness.
9        (2) Respiratory distress or arrest.
10        (3) Evidence of shock.
11        (4) Psychosis.
12        (5) Symptomatic chest pain or cardiac arrhythmias.
13        (6) Prolapsed umbilical cord.
14        (7) Shoulder dystocia not resolved by Advanced Life
15    Support in Obstetrics (ALSO) protocol.
16        (8) Symptoms of uterine rupture.
17        (9) Preeclampsia or eclampsia.
18        (10) Severe abdominal pain inconsistent with normal
19    labor.
20        (11) Chorioamnionitis.
21        (12) Clinically significant fetal heart rate patterns
22    or other manifestation of fetal distress.
23        (13) Presentation not compatible with spontaneous
24    vaginal delivery.
25        (14) Laceration greater than second degree perineal or
26    any cervical.



HB0677- 50 -LRB100 06207 SMS 16241 b

1        (15) Hemorrhage non-responsive to therapy.
2        (16) Uterine prolapse or inversion.
3        (17) Persistent uterine atony.
4        (18) Anaphylaxis.
5        (19) Failure to deliver placenta after one hour if
6    there is no bleeding or fundus is firm.
7        (20) Sustained instability or persistent abnormal
8    vital signs.
9        (21) Other conditions or symptoms that could threaten
10    the life of the mother, fetus, or neonate.
11    (b) If birth is imminent and the patient refuses to be
12transferred after the licensed certified professional midwife
13determines that a transfer is necessary, the licensed certified
14professional midwife shall:
15        (1) call 9-1-1 and remain with the patient until
16    emergency services personnel arrive; and
17        (2) transfer care and give a verbal report of the care
18    provided to the emergency medical services providers.
19    (c) For each patient who is transported under this section,
20the licensed certified professional midwife shall complete a
21standard transport reporting form and submit the completed form
22to the Department.
23    (d) The Board shall develop and recommend to the Department
24for adoption in the rules implementing this Act a planned
25out-of-hospital birth transport protocol.



HB0677- 51 -LRB100 06207 SMS 16241 b

1    Section 75. Annual reports.
2    (a) A licensed certified professional midwife shall
3annually report to the Department by no later than March 31st
4of each year beginning in 2020, in a form specified by the
5Department, the following information regarding cases in which
6the licensed certified professional midwife assisted during
7the previous calendar year when the intended place of birth at
8the onset of care was an out-of-hospital setting:
9        (1) the total number of patients served at the onset of
10    care;
11        (2) the number, by county, of live births attended;
12        (3) the number, by county, of cases of fetal demise,
13    infant deaths, and maternal deaths attended at the
14    discovery of the demise or death;
15        (4) the number of women whose care was transferred to
16    another health care practitioner during the antepartum
17    period and the reason for transfer;
18        (5) the number, reason for, and outcome of each
19    nonemergency hospital transfer during the intra-partum or
20    postpartum period;
21        (6) the number, reason for, and outcome of each urgent
22    or emergency transport of an expectant mother in the
23    antepartum period;
24        (7) the number, reason for, and outcome of each urgent
25    or emergency transport of an infant or mother during the
26    intra-partum or immediate postpartum period;



HB0677- 52 -LRB100 06207 SMS 16241 b

1        (8) the number of planned out-of-hospital births at the
2    onset of labor and the number of births completed in an
3    out-of-hospital setting;
4        (9) a brief description of any complications resulting
5    in the morbidity or mortality of a mother or a neonate; and
6        (10) any other information required by rule by the
7    Department.
8    (b) The Department shall send a written notice of
9noncompliance to each licensee who fails to meet the reporting
10requirements under subsection (a) of this Section.
11    (c) A licensed certified professional midwife who fails to
12comply with the reporting requirements under this Section shall
13be prohibited from license renewal until the information
14required under subsection (a) of this Section is reported.
15    (d) The Committee shall maintain the confidentiality of any
16report under subsection (f) of this Section.
17    (e) Notwithstanding any other provision of law, a licensed
18certified professional midwife shall be subject to the same
19reporting requirements as other health care practitioners who
20provide care to individuals.
21    (f) All reports required shall be submitted to the
22Department in a timely fashion. Unless otherwise provided in
23this Section, the reports shall be filed in writing within 60
24days after a determination that a report is required under this
26    The Department may also exercise the power under Section



HB0677- 53 -LRB100 06207 SMS 16241 b

1165 of this Act to subpoena copies of hospital or medical
2records in cases concerning death or permanent bodily injury.
3Rules shall be adopted by the Department to implement this
5    Nothing contained in this Section shall act to in any way
6waive or modify the confidentiality of reports and committee
7reports to the extent provided by law. Any information reported
8or disclosed shall be kept for the confidential use of the
9Department, its attorneys, the investigative staff, and
10authorized clerical staff, as provided in this Act, and shall
11be afforded the same status as is provided information
12concerning medical studies in Part 21 of Article VIII of the
13Code of Civil Procedure, except that the Department may
14disclose information and documents to a federal, state, or
15local law enforcement agency pursuant to a subpoena in an
16ongoing criminal investigation or to a health care licensing
17body or midwifery licensing authority of another state or
18jurisdiction pursuant to an official request made by that
19licensing body or authority. Furthermore, information and
20documents disclosed to a federal, state, or local law
21enforcement agency may be used by that agency only for the
22investigation and prosecution of a criminal offense, or, in the
23case of disclosure to a health care licensing body or medical
24licensing authority, only for investigations and disciplinary
25action proceedings with regard to a license. Information and
26documents disclosed to the Department of Public Health may be



HB0677- 54 -LRB100 06207 SMS 16241 b

1used by that Department only for investigation and disciplinary
2action regarding the license of a health care institution
3licensed by the Department of Public Health.
4    Section 80. Illinois Certified Professional Midwifery
6    (a) There is created under the authority of the Department
7the Illinois Certified Professional Midwifery Board, which
8shall consist of the following 9 members appointed by the
10        Three of whom shall be licensed certified professional
11    midwives who currently practice midwifery; except that the
12    initial appointees shall be Certified Professional
13    Midwives who have at least 3 years of experience in the
14    practice of midwifery in an out-of-hospital setting, and
15    otherwise meet the qualifications for licensure set forth
16    in this Act.
17        One of whom shall be a licensed physician concentrating
18    in obstetrics.
19        One of whom shall be a licensed physician concentrating
20    in a family practice who performs deliveries.
21        One of whom shall be a licensed physician who
22    concentrates in pediatrics.
23        Two of whom shall be advanced practice nurses who are
24    certified nurse midwives.
25        One of whom shall be a knowledgeable public member who



HB0677- 55 -LRB100 06207 SMS 16241 b

1    has given birth with the assistance of a licensed certified
2    professional midwife or a Certified Professional Midwife
3    in an out-of-hospital birth setting.
4    Board members shall serve 4-year terms, except that in the
5case of initial appointments, terms shall be staggered as
6follows: 4 members shall serve for 4 years, and 5 members shall
7serve for 2 years. The Board shall annually elect a chairperson
8and vice chairperson.
9    (b) Any appointment made to fill a vacancy shall be for the
10unexpired portion of the term. Appointments to fill vacancies
11shall be made in the same manner as original appointments. No
12Board member may be reappointed for a term that would cause his
13or her continuous service on the Board to exceed 9 years.
14    (c) Board membership must have reasonable representation
15from different geographic areas of this State.
16    (d) The members of the Board shall serve without
17compensation but may be reimbursed for all legitimate,
18necessary, and authorized expenses incurred in attending the
19meetings of the Board if funds are available for such purposes.
20    (e) The Secretary may remove any member of the Board for
21misconduct, incapacity, or neglect of duty at any time prior to
22the expiration of his or her term.
23    (f) Five Board members shall constitute a quorum. A vacancy
24in the membership of the Board shall not impair the right of a
25quorum to perform all of the duties of the Board.
26    (g) The Board shall provide the Department with



HB0677- 56 -LRB100 06207 SMS 16241 b

1recommendations concerning the administration of this Act and
2may perform each of the following duties:
3        (1) Recommend to the Department from time to time
4    revisions to any rules that may be necessary to carry out
5    the provisions of this Act, including those that are
6    designed to protect the health, safety, and welfare of the
7    public.
8        (2) Conduct hearings and disciplinary conferences on
9    disciplinary charges of licensees.
10        (3) Report to the Department, upon completion of a
11    hearing, the disciplinary actions recommended to be taken
12    against a person found in violation of this Act.
13        (4) Recommend the approval, denial of approval, or
14    withdrawal of approval of required education and
15    continuing educational programs.
16    (h) The Secretary shall give due consideration to all
17recommendations of the Board. If the Secretary takes action
18contrary to a recommendation of the Board, the Secretary must
19promptly provide a written explanation of that action.
20    (i) The Board may recommend to the Secretary that one or
21more licensed certified professional midwives be selected by
22the Secretary to assist in any investigation under this Act.
23Travel expenses shall be provided to any licensee who provides
24assistance under this subsection (i), in an amount determined
25by the Secretary, if funds are available for such purposes.
26    (j) Members of the Board shall be immune from suit in an



HB0677- 57 -LRB100 06207 SMS 16241 b

1action based upon a disciplinary proceeding or other activity
2performed in good faith as a member of the Board, except for
3willful or wanton misconduct.
4    (k) Members of the Board may participate in and act at any
5meeting of the Illinois Midwifery Board through the use of any
6real-time Internet or telephone communication media, by means
7of which all persons participating in the meeting can
8communicate with each other. Participation in such meeting
9shall constitute attendance and presence in person at the
10meeting of the person or persons so participating.
11    Section 85. Continuing education for certified
12professional midwife licensees.
13    The Department shall adopt rules of continuing education
14for licensed certified professional midwives that require a
15total of 24 hours of continuing education per 2-year license
16renewal cycle. Four hours of continuing education shall consist
17of successful completion of peer review in accordance with NARM
18standards for official peer review. The rules shall address
19variances in part or in whole for good cause, including without
20limitation illness or hardship. The continuing education rules
21must ensure that licensees are given the opportunity to
22participate in programs sponsored by or through their State or
23national professional associations, hospitals, or other
24providers of continuing education. Each licensee is
25responsible for maintaining records of completion of



HB0677- 58 -LRB100 06207 SMS 16241 b

1continuing education and shall produce the records when
2requested by the Department.
3    Section 90. Vicarious liability.
4    (a) No physician, advanced practice nurse, nurse,
5hospital, emergency room personnel, emergency medical
6technician, or ambulance personnel shall be liable in any civil
7action arising out of any injury resulting from an act or
8omission of a licensed certified professional midwife, even if
9the health care practitioner has consulted with or accepted a
10referral from the licensed certified professional midwife. A
11physician or advanced practice nurse who consults with a
12licensed certified professional midwife but who does not
13examine or treat a client of the licensed certified
14professional midwife shall not be deemed to have created a
15physician-patient or advanced practice nurse-patient
16relationship with such client.
17    (b) Consultation with a physician or advanced practice
18nurse does not alone create a physician-patient or advanced
19practice nurse-patient relationship or any other relationship
20with the physician or advanced practice nurse. The informed
21consent shall specifically state that the licensed certified
22professional midwife and any consulting physician or advanced
23practice nurse are not employees, partners, associates,
24agents, or principals of one another. The licensed certified
25professional midwife shall inform the patient that he or she is



HB0677- 59 -LRB100 06207 SMS 16241 b

1independently licensed and practicing midwifery and in that
2regard is solely responsible for the services he or she
4    Section 95. Advertising.
5    (a) Any person licensed under this Act may advertise the
6availability of midwifery services in the public media or on
7premises where services are rendered, if the advertising is
8truthful and not misleading and is in conformity with any rules
9regarding the practice of a licensed certified professional
11    (b) A licensee must include in every advertisement for
12midwifery services regulated under this Act his or her title as
13it appears on the license or the initials authorized under this
15    Section 100. Social Security Number on application. In
16addition to any other information required to be contained in
17the application, every application for an original, renewal,
18reinstated, or restored license under this Act shall include
19the applicant's Social Security Number.
20    Section 105. Renewal of licensure.
21    (a) Licensed certified professional midwives shall renew
22their license biannually at the discretion of the Department.
23    (b) Rules adopted under this Act shall require the licensed



HB0677- 60 -LRB100 06207 SMS 16241 b

1certified professional midwife to maintain CPM certification
2by meeting all the continuing education requirements and other
3requirements set forth by the North American Registry of
5    Section 110. Inactive status.
6    (a) A licensed certified professional midwife who notifies
7the Department in writing on forms prescribed by the Department
8may elect to place his or her license on an inactive status and
9shall be excused from payment of renewal fees until he or she
10notifies the Department in writing of his or her intent to
11restore the license.
12    (b) A licensed certified professional midwife whose
13license is on inactive status may not practice licensed
14certified professional midwifery in the State of Illinois.
15    (c) A licensed certified professional midwife requesting
16restoration from inactive status shall be required to pay the
17current renewal fee and to restore his or her license, as
18provided by the Department.
19    (d) Any licensee who engages in the practice of midwifery
20while his or her license is lapsed or on inactive status shall
21be considered to be practicing without a license, which shall
22be grounds for discipline.
23    Section 115. Renewal, reinstatement, or restoration of
24licensure; military service.



HB0677- 61 -LRB100 06207 SMS 16241 b

1    (a) The expiration date and renewal period for each license
2issued under this Act shall be set by the Department.
3    (b) All renewal applicants shall provide proof of having
4maintained CPM certification by meeting continuing education
5requirements and other requirements set forth by the North
6American Registry of Midwives and current CPR certification
7required under Section 30.
8    (c) Any licensed certified professional midwife who has
9permitted his or her license to expire or who has had his or
10her license on inactive status may have his or her license
11restored by making application to the Department and filing
12proof acceptable to the Department of fitness to have the
13license restored and by paying the required fees. Proof of
14fitness may include evidence attesting to active lawful
15practice in another jurisdiction.
16    (d) The Department shall determine, by an evaluation
17program, fitness for restoration of a license under this
18Section and shall establish procedures and requirements for
20    (e) Any licensed certified professional midwife whose
21license expired while he or she was (i) in federal service on
22active duty with the Armed Forces of the United States or the
23State Militia and called into service or training or (ii)
24received education under the supervision of the United States
25preliminary to induction into the military service may have his
26or her license restored without paying any lapsed renewal fees,



HB0677- 62 -LRB100 06207 SMS 16241 b

1if, within 2 years after honorable termination of service,
2training, or education, he or she furnishes the Department with
3satisfactory evidence to the effect that he or she has been so
5    Section 120. Roster. The Department shall maintain a roster
6of the names and addresses of all licensees and of all persons
7whose licenses have been suspended or revoked. This roster
8shall be available upon written request and payment of the
9required fee.
10    Section 125. Fees.
11    (a) The Department shall provide for a schedule of fees for
12the administration and enforcement of this Act, including
13without limitation original licensure, renewal, and
14restoration, which fees shall be nonrefundable.
15    (b) All fees collected under this Act shall be deposited
16into the General Professions Dedicated Fund and appropriated to
17the Department for the ordinary and contingent expenses of the
18Department in the administration of this Act.
19    Section 130. Returned checks; fines. Any person who
20delivers a check or other payment to the Department that is
21returned to the Department unpaid by the financial institution
22upon which it is drawn shall pay to the Department, in addition
23to the amount already owed to the Department, a fine of $50.



HB0677- 63 -LRB100 06207 SMS 16241 b

1The fines imposed by this Section are in addition to any other
2discipline provided under this Act for unlicensed practice or
3practice on a non-renewed license. The Department shall notify
4the person that fees and fines shall be paid to the Department
5by certified check or money order within 30 calendar days after
6the notification. If, after the expiration of 30 days from the
7date of the notification, the person has failed to submit the
8necessary remittance, the Department shall automatically
9terminate the license or deny the application, without hearing.
10If, after termination or denial, the person seeks a license, he
11or she shall apply to the Department for restoration or
12issuance of the license and pay all fees and fines due to the
13Department. The Department may establish a fee for the
14processing of an application for restoration of a license to
15defray all expenses of processing the application. The
16Secretary may waive the fines due under this Section in
17individual cases where the Secretary finds that the fines would
18be unreasonable or unnecessarily burdensome.
19    Section 135. Unlicensed practice; civil penalty. Any
20person who practices, offers to practice, attempts to practice,
21or holds himself or herself out to practice certified
22professional midwifery or as a midwife without being licensed
23under this Act shall, in addition to any other penalty provided
24by law, pay a civil penalty to the Department in an amount not
25to exceed $5,000 for each offense, as determined by the



HB0677- 64 -LRB100 06207 SMS 16241 b

1Department. The civil penalty shall be assessed by the
2Department after a hearing is held in accordance with the
3provisions set forth in this Act regarding the provision of a
4hearing for the discipline of a licensee. The civil penalty
5shall be paid within 60 days after the effective date of the
6order imposing the civil penalty. The order shall constitute a
7judgment and may be filed and execution had thereon in the same
8manner as any judgment from any court of record. The Department
9may investigate any unlicensed activity.
10    Section 140. Grounds for disciplinary action.
11    (a) The Department may refuse to issue or to renew or may
12revoke, suspend, place on probation, reprimand, or take other
13disciplinary action as the Department may deem proper,
14including fines not to exceed $5,000 for each violation, with
15regard to any licensee or license for any one or combination of
16the following causes:
17        (1) Violations of this Act or its rules.
18        (2) Material misstatement in furnishing information to
19    the Department.
20        (3) Conviction of any crime under the laws of any U.S.
21    jurisdiction that is (i) a felony, (ii) a misdemeanor, an
22    essential element of which is dishonesty, or (iii) directly
23    related to the practice of the profession.
24        (4) Making any misrepresentation for the purpose of
25    obtaining a license.



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1        (5) Professional incompetence or gross negligence.
2        (6) Gross malpractice.
3        (7) Aiding or assisting another person in violating any
4    provision of this Act or its rules.
5        (8) Failing to provide information within 60 days in
6    response to a written request made by the Department.
7        (9) Engaging in dishonorable, unethical, or
8    unprofessional conduct of a character likely to deceive,
9    defraud, or harm the public.
10        (10) Habitual or excessive use or addiction to alcohol,
11    narcotics, stimulants, or any other chemical agent or drug
12    that results in the inability to practice with reasonable
13    judgment, skill, or safety.
14        (11) Discipline by another U.S. jurisdiction or
15    foreign nation if at least one of the grounds for the
16    discipline is the same or substantially equivalent to those
17    set forth in this Act.
18        (12) Directly or indirectly giving to or receiving from
19    any person, firm, corporation, partnership, or association
20    any fee, commission, rebate, or other form of compensation
21    for any professional services not actually or personally
22    rendered. This shall not be deemed to include rent or other
23    remunerations paid to an individual, partnership, or
24    corporation by a licensed certified professional midwife
25    for the lease, rental, or use of space, owned or controlled
26    by the individual, partnership, corporation, or



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1    association.
2        (13) A finding by the Department that the licensee,
3    after having his or her license placed on probationary
4    status, has violated the terms of probation.
5        (14) Abandonment of a patient.
6        (15) Willfully making or filing false records or
7    reports relating to a licensee's practice, including, but
8    not limited to, false records filed with State agencies or
9    departments.
10        (16) Physical illness or mental illness, including,
11    but not limited to, deterioration through the aging process
12    or loss of motor skill that results in the inability to
13    practice the profession with reasonable judgment, skill,
14    or safety.
15        (17) Failure to provide a patient with a copy of his or
16    her record upon the written request of the patient.
17        (18) Conviction by any court of competent
18    jurisdiction, either within or without this State, of any
19    violation of any law governing the practice of licensed
20    certified professional midwifery or conviction in this or
21    another state of any crime that is a felony under the laws
22    of this State or conviction of a felony in a federal court,
23    if the Department determines, after investigation, that
24    the person has not been sufficiently rehabilitated to
25    warrant the public trust.
26        (19) A finding that licensure has been applied for or



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1    obtained by fraudulent means.
2        (20) Being named as a perpetrator in an indicated
3    report by the Department of Children and Family Services
4    under the Abused and Neglected Child Reporting Act and upon
5    proof by clear and convincing evidence that the licensee
6    has caused a child to be an abused child or a neglected
7    child, as defined in Section 3 of the Abused and Neglected
8    Child Reporting Act.
9        (21) Practicing or attempting to practice under a name
10    other than the full name shown on a license issued under
11    this Act.
12        (22) Immoral conduct in the commission of any act, such
13    as sexual abuse, sexual misconduct, or sexual
14    exploitation, related to the licensee's practice.
15        (23) Maintaining a professional relationship with any
16    person, firm, or corporation when the licensed certified
17    professional midwife knows or should know that a person,
18    firm, or corporation is violating this Act.
19        (24) Failure to provide satisfactory proof of having
20    participated in approved continuing education programs as
21    determined by the Board and approved by the Secretary.
22    Exceptions for extreme hardships are to be defined by the
23    Department.
24    (b) The Department may refuse to issue or may suspend the
25license of any person who fails to (i) file a tax return or to
26pay the tax, penalty, or interest shown in a filed return or



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1(ii) pay any final assessment of the tax, penalty, or interest,
2as required by any tax Act administered by the Illinois
3Department of Revenue, until the time that the requirements of
4that tax Act are satisfied.
5    (c) The determination by a circuit court that a licensee is
6subject to involuntary admission or judicial admission as
7provided in the Mental Health and Developmental Disabilities
8Code operates as an automatic suspension. The suspension shall
9end only upon a finding by a court that the patient is no
10longer subject to involuntary admission or judicial admission,
11the issuance of an order so finding and discharging the
12patient, and the recommendation of the Board to the Secretary
13that the licensee be allowed to resume his or her practice.
14    (d) In enforcing this Section, the Department, upon a
15showing of a possible violation, may compel any person licensed
16to practice under this Act or who has applied for licensure or
17certification pursuant to this Act to submit to a mental or
18physical examination, or both, as required by and at the
19expense of the Department. The examining physicians shall be
20those specifically designated by the Department. The
21Department may order an examining physician to present
22testimony concerning the mental or physical examination of the
23licensee or applicant. No information shall be excluded by
24reason of any common law or statutory privilege relating to
25communications between the licensee or applicant and the
26examining physician. The person to be examined may have, at his



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1or her own expense, another physician of his or her choice
2present during all aspects of the examination. Failure of any
3person to submit to a mental or physical examination when
4directed shall be grounds for suspension of a license until the
5person submits to the examination if the Department finds,
6after notice and hearing, that the refusal to submit to the
7examination was without reasonable cause.
8    If the Department finds an individual unable to practice
9because of the reasons set forth in this subsection (d), the
10Department may require that individual to submit to care,
11counseling, or treatment by physicians approved or designated
12by the Department, as a condition, term, or restriction for
13continued, reinstated, or renewed licensure to practice or, in
14lieu of care, counseling, or treatment, the Department may file
15a complaint to immediately suspend, revoke, or otherwise
16discipline the license of the individual. Any person whose
17license was granted, reinstated, renewed, disciplined, or
18supervised subject to such terms, conditions, or restrictions
19and who fails to comply with such terms, conditions, or
20restrictions shall be referred to the Secretary for a
21determination as to whether or not the person shall have his or
22her license suspended immediately, pending a hearing by the
24    In instances in which the Secretary immediately suspends a
25person's license under this Section, a hearing on that person's
26license must be convened by the Department within 15 days after



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1the suspension and completed without appreciable delay. The
2Department may review the person's record of treatment and
3counseling regarding the impairment, to the extent permitted by
4applicable federal statutes and regulations safeguarding the
5confidentiality of medical records.
6    A person licensed under this Act and affected under this
7subsection (d) shall be afforded an opportunity to demonstrate
8to the Department that he or she can resume practice in
9compliance with acceptable and prevailing standards under the
10provisions of his or her license.
11    Section 145. Failure to pay restitution. The Department,
12without further process or hearing, shall suspend the license
13or other authorization to practice of any person issued under
14this Act who has been certified by court order as not having
15paid restitution to a person under Section 8A-3.5 of the
16Illinois Public Aid Code, under Section 46-1 of the Criminal
17Code of 1961, or under Sections 17-8.5 or 17-10.5 of the
18Criminal Code of 2012. A person whose license or other
19authorization to practice is suspended under this Section is
20prohibited from practicing until restitution is paid in full.
21    Section 150. Injunction; cease and desist order.
22    (a) If a person violates any provision of this Act, the
23Secretary may, in the name of the People of the State of
24Illinois, through the Attorney General or the State's Attorney



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1of any county in which the action is brought, petition for an
2order enjoining the violation or enforcing compliance with this
3Act. Upon the filing of a verified petition in court, the court
4may issue a temporary restraining order, without notice or
5bond, and may preliminarily and permanently enjoin the
6violation. If it is established that the person has violated or
7is violating the injunction, the court may punish the offender
8for contempt of court. Proceedings under this Section shall be
9in addition to, and not in lieu of, all other remedies and
10penalties provided by this Act.
11    (b) If any person practices as a licensed certified
12professional midwife or holds himself or herself out as a
13licensed certified professional midwife without being licensed
14under the provisions of this Act, then any licensed certified
15professional midwife, any interested party, or any person
16injured thereby may, in addition to the Secretary, petition for
17relief as provided in subsection (a) of this Section.
18    (c) Whenever, in the opinion of the Department, any person
19violates any provision of this Act, the Department may issue a
20rule to show cause why an order to cease and desist should not
21be entered against that person. The rule shall clearly set
22forth the grounds relied upon by the Department and shall
23provide a period of 7 days after the date of the rule to file an
24answer to the satisfaction of the Department. Failure to answer
25to the satisfaction of the Department shall cause an order to
26cease and desist to be issued immediately.



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1    Section 155. Violation; criminal penalty.
2    (a) Whoever knowingly practices or offers to practice
3midwifery in this State without being licensed for that purpose
4or exempt under this Act shall be guilty of a Class A
5misdemeanor; and shall be guilty of a Class 4 felony for a
6second or subsequent violation.
7    (b) Notwithstanding any other provision of this Act, all
8criminal fines, moneys, or other property collected or received
9by the Department under this Section or any other State or
10federal statute, including, but not limited to, property
11forfeited to the Department under Section 505 of the Illinois
12Controlled Substances Act or Section 85 of the Methamphetamine
13Control and Community Protection Act, shall be deposited into
14the Professional Regulation Evidence Fund.
15    Section 160. Investigation; notice; hearing. The
16Department may investigate the actions of any applicant or of
17any person or persons holding or claiming to hold a license
18under this Act. Before refusing to issue or to renew or taking
19any disciplinary action regarding a license, the Department
20shall, at least 30 days prior to the date set for the hearing,
21notify in writing the applicant or licensee of the nature of
22any charges and that a hearing shall be held on a date
23designated. The Department shall direct the applicant or
24licensee to file a written answer with the Board under oath



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1within 20 days after the service of the notice and inform the
2applicant or licensee that failure to file an answer shall
3result in default being taken against the applicant or licensee
4and that the license may be suspended, revoked, or placed on
5probationary status or that other disciplinary action may be
6taken, including limiting the scope, nature, or extent of
7practice, as the Secretary may deem proper. Written notice may
8be served by personal delivery or certified or registered mail
9to the respondent at the address of his or her last
10notification to the Department. If the person fails to file an
11answer after receiving notice, his or her license may, in the
12discretion of the Department, be suspended, revoked, or placed
13on probationary status, or the Department may take any
14disciplinary action deemed proper, including limiting the
15scope, nature, or extent of the person's practice or the
16imposition of a fine, without a hearing, if the act or acts
17charged constitute sufficient grounds for such action under
18this Act. At the time and place fixed in the notice, the Board
19shall proceed to hear the charges and the parties or their
20counsel shall be accorded ample opportunity to present such
21statements, testimony, evidence, and argument as may be
22pertinent to the charges or to their defense. The Board may
23continue a hearing from time to time.
24    Section 165. Formal hearing; preservation of record. The
25Department, at its expense, shall preserve a record of all



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1proceedings at the formal hearing of any case. The notice of
2hearing, complaint, and all other documents in the nature of
3pleadings and written motions filed in the proceedings, the
4transcript of testimony, the report of the Board or hearing
5officer, and order of the Department shall be the record of the
6proceeding. The Department shall furnish a transcript of the
7record to any person interested in the hearing upon payment of
8the fee required under Section 2105-115 of the Department of
9Professional Regulation Law.
10    Section 170. Witnesses; production of documents; contempt.
11Any circuit court may upon application of the Department or its
12designee or of the applicant or licensee against whom
13proceedings under Section 95 of this Act are pending, enter an
14order requiring the attendance of witnesses and their testimony
15and the production of documents, papers, files, books, and
16records in connection with any hearing or investigation. The
17court may compel obedience to its order by proceedings for
19    Section 175. Subpoena; oaths. The Department shall have the
20power to subpoena and bring before it any person in this State
21and to take testimony either orally or by deposition or both
22with the same fees and mileage and in the same manner as
23prescribed in civil cases in circuit courts of this State. The
24Secretary, the designated hearing officer, and every member of



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1the Board has the power to administer oaths to witnesses at any
2hearing that the Department is authorized to conduct and any
3other oaths authorized in any Act administered by the
4Department. Any circuit court may, upon application of the
5Department or its designee or upon application of the person
6against whom proceedings under this Act are pending, enter an
7order requiring the attendance of witnesses and their
8testimony, and the production of documents, papers, files,
9books, and records in connection with any hearing or
10investigation. The court may compel obedience to its order by
11proceedings for contempt.
12    Section 180. Findings of fact, conclusions of law, and
13recommendations. At the conclusion of the hearing the Board
14shall present to the Secretary a written report of its findings
15of fact, conclusions of law, and recommendations. The report
16shall contain a finding as to whether or not the accused person
17violated this Act or failed to comply with the conditions
18required under this Act. The Board shall specify the nature of
19the violation or failure to comply and shall make its
20recommendations to the Secretary.
21    The report of findings of fact, conclusions of law, and
22recommendations of the Board shall be the basis for the
23Department's order. If the Secretary disagrees in any regard
24with the report of the Board, the Secretary may issue an order
25in contravention of the report. The finding is not admissible



HB0677- 76 -LRB100 06207 SMS 16241 b

1in evidence against the person in a criminal prosecution
2brought for the violation of this Act, but the hearing and
3findings are not a bar to a criminal prosecution brought for
4the violation of this Act.
5    Section 185. Hearing officer. The Secretary may appoint any
6attorney duly licensed to practice law in the State of Illinois
7to serve as the hearing officer in any action for departmental
8refusal to issue, renew, or license an applicant or for
9disciplinary action against a licensee. The hearing officer
10shall have full authority to conduct the hearing. The hearing
11officer shall report his or her findings of fact, conclusions
12of law, and recommendations to the Board and the Secretary. The
13Board shall have 60 calendar days after receipt of the report
14to review the report of the hearing officer and present its
15findings of fact, conclusions of law, and recommendations to
16the Secretary. If the Board fails to present its report within
17the 60-day period, the Secretary may issue an order based on
18the report of the hearing officer. If the Secretary disagrees
19with the recommendation of the Board or the hearing officer, he
20or she may issue an order in contravention of that
22    Section 190. Service of report; motion for rehearing. In
23any case involving the discipline of a license, a copy of the
24Board's report shall be served upon the respondent by the



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1Department, either personally or as provided in this Act for
2the service of the notice of hearing. Within 20 days after the
3service, the respondent may present to the Department a motion
4in writing for a rehearing that shall specify the particular
5grounds for rehearing. If no motion for rehearing is filed,
6then upon the expiration of the time specified for filing a
7motion, or if a motion for rehearing is denied, then upon the
8denial, the Secretary may enter an order in accordance with
9this Act. If the respondent orders from the reporting service
10and pays for a transcript of the record within the time for
11filing a motion for rehearing, the 20-day period within which
12the motion may be filed shall commence upon the delivery of the
13transcript to the respondent.
14    Section 195. Rehearing. Whenever the Secretary is
15satisfied that substantial justice has not been done in the
16revocation, suspension, or refusal to issue or renew a license,
17the Secretary may order a rehearing by the same or another
18hearing officer or by the Board.
19    Section 200. Prima facie proof. An order or a certified
20copy thereof, over the seal of the Department and purporting to
21be signed by the Secretary, shall be prima facie proof of the
23    (1) that the signature is the genuine signature of the



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1    (2) that such Secretary is duly appointed and qualified;
2    (3) that the Board and its members are qualified to act;
4    (4) that the findings and conclusions set forth therein are
5prima facie true and correct.
6    Section 205. Restoration of license. At any time after the
7suspension or revocation of any license, the Department may
8restore the license to the accused person, unless after an
9investigation and a hearing the Department determines that
10restoration is not in the public interest.
11    Section 210. Surrender of license. Upon the revocation or
12suspension of any license, the licensee shall immediately
13surrender the license to the Department. If the licensee fails
14to do so, the Department shall have the right to seize the
16    Section 215. Summary suspension. The Secretary may
17summarily suspend the license of a licensee under this Act
18without a hearing, simultaneously with the institution of
19proceedings for a hearing provided for in this Act, if the
20Secretary finds that evidence in his or her possession
21indicates that continuation in practice would constitute an
22imminent danger to the public. In the event that the Secretary
23summarily suspends a license without a hearing, a hearing by



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1the Department must be held within 30 days after the suspension
2has occurred.
3    Section 220. Certificate of record. The Department shall
4not be required to certify any record to the court or file any
5answer in court or otherwise appear in any court in a judicial
6review proceeding, unless there is filed in the court, with the
7complaint, a receipt from the Department acknowledging payment
8of the costs of furnishing and certifying the record. Failure
9on the part of the plaintiff to file a receipt in court shall
10be grounds for dismissal of the action.
11    Section 225. Administrative Review Law. All final
12administrative decisions of the Department are subject to
13judicial review under the Administrative Review Law and its
14rules. The term "administrative decision" is defined as in
15Section 3-101 of the Code of Civil Procedure.
16    Section 230. Illinois Administrative Procedure Act. The
17Illinois Administrative Procedure Act is hereby expressly
18adopted and incorporated in this Act as if all of the
19provisions of such Act were included in this Act, except that
20the provision of subsection (d) of Section 10-65 of the
21Illinois Administrative Procedure Act that provides that at
22hearings the licensee has the right to show compliance with all
23lawful requirements for retention, continuation, or renewal of



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1the license is specifically excluded. For purposes of this Act,
2the notice required under Section 10-25 of the Illinois
3Administrative Procedure Act is deemed sufficient when mailed
4to the last known address of a party.
5    Section 235. Home rule. The regulation and licensing of
6midwives are exclusive powers and functions of the State. A
7home rule unit may not regulate or license midwives. This
8Section is a denial and limitation of home rule powers and
9functions under subsection (h) of Section 6 of Article VII of
10the Illinois Constitution.
11    Section 240. Severability. The provisions of this Act are
12severable under Section 1.31 of the Statute on Statutes.
13    Section 900. The Regulatory Sunset Act is amended by adding
14Section 4.38 as follows:
15    (5 ILCS 80/4.38 new)
16    Sec. 4.38. Act repealed on January 1, 2028. The following
17Act is repealed on January 1, 2028:
18    The Home Birth Safety Act.
19    Section 905. The Medical Practice Act of 1987 is amended by
20changing Section 4 as follows:



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1    (225 ILCS 60/4)  (from Ch. 111, par. 4400-4)
2    (Section scheduled to be repealed on December 31, 2017)
3    Sec. 4. Exemptions. This Act does not apply to the
5        (1) persons lawfully carrying on their particular
6    profession or business under any valid existing regulatory
7    Act of this State, including without limitation persons
8    engaged in the practice of midwifery who are licensed under
9    the Home Birth Safety Act;
10        (2) persons rendering gratuitous services in cases of
11    emergency; or
12        (3) persons treating human ailments by prayer or
13    spiritual means as an exercise or enjoyment of religious
14    freedom.
15(Source: P.A. 96-7, eff. 4-3-09; 97-622, eff. 11-23-11.)
16    Section 910. The Nurse Practice Act is amended by changing
17Section 50-15 as follows:
18    (225 ILCS 65/50-15)   (was 225 ILCS 65/5-15)
19    (Section scheduled to be repealed on January 1, 2018)
20    Sec. 50-15. Policy; application of Act.
21    (a) For the protection of life and the promotion of health,
22and the prevention of illness and communicable diseases, any
23person practicing or offering to practice advanced,
24professional, or practical nursing in Illinois shall submit



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1evidence that he or she is qualified to practice, and shall be
2licensed as provided under this Act. No person shall practice
3or offer to practice advanced, professional, or practical
4nursing in Illinois or use any title, sign, card or device to
5indicate that such a person is practicing professional or
6practical nursing unless such person has been licensed under
7the provisions of this Act.
8    (b) This Act does not prohibit the following:
9        (1) The practice of nursing in Federal employment in
10    the discharge of the employee's duties by a person who is
11    employed by the United States government or any bureau,
12    division or agency thereof and is a legally qualified and
13    licensed nurse of another state or territory and not in
14    conflict with Sections 50-50, 55-10, 60-10, and 70-5 of
15    this Act.
16        (2) Nursing that is included in the program of study by
17    students enrolled in programs of nursing or in current
18    nurse practice update courses approved by the Department.
19        (3) The furnishing of nursing assistance in an
20    emergency.
21        (4) The practice of nursing by a nurse who holds an
22    active license in another state when providing services to
23    patients in Illinois during a bonafide emergency or in
24    immediate preparation for or during interstate transit.
25        (5) The incidental care of the sick by members of the
26    family, domestic servants or housekeepers, or care of the



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1    sick where treatment is by prayer or spiritual means.
2        (6) Persons from being employed as unlicensed
3    assistive personnel in private homes, long term care
4    facilities, nurseries, hospitals or other institutions.
5        (7) The practice of practical nursing by one who is a
6    licensed practical nurse under the laws of another U.S.
7    jurisdiction and has applied in writing to the Department,
8    in form and substance satisfactory to the Department, for a
9    license as a licensed practical nurse and who is qualified
10    to receive such license under this Act, until (i) the
11    expiration of 6 months after the filing of such written
12    application, (ii) the withdrawal of such application, or
13    (iii) the denial of such application by the Department.
14        (8) The practice of advanced practice nursing by one
15    who is an advanced practice 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 an
19    advanced practice nurse and who is qualified to receive
20    such license under this Act, until (i) the expiration of 6
21    months after the filing of such written application, (ii)
22    the withdrawal of such application, or (iii) the denial of
23    such application by the Department.
24        (9) The practice of professional nursing by one who is
25    a registered professional nurse under the laws of another
26    state, territory of the United States or country and has



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1    applied in writing to the Department, in form and substance
2    satisfactory to the Department, for a license as a
3    registered professional nurse and who is qualified to
4    receive such license under Section 55-10, until (1) the
5    expiration of 6 months after the filing of such written
6    application, (2) the withdrawal of such application, or (3)
7    the denial of such application by the Department.
8        (10) The practice of professional nursing that is
9    included in a program of study by one who is a registered
10    professional nurse under the laws of another state or
11    territory of the United States or foreign country,
12    territory or province and who is enrolled in a graduate
13    nursing education program or a program for the completion
14    of a baccalaureate nursing degree in this State, which
15    includes clinical supervision by faculty as determined by
16    the educational institution offering the program and the
17    health care organization where the practice of nursing
18    occurs.
19        (11) Any person licensed in this State under any other
20    Act from engaging in the practice for which she or he is
21    licensed, including without limitation any person engaged
22    in the practice of midwifery who is licensed under the Home
23    Birth Safety Act.
24        (12) Delegation to authorized direct care staff
25    trained under Section 15.4 of the Mental Health and
26    Developmental Disabilities Administrative Act consistent



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1    with the policies of the Department.
2        (13) The practice, services, or activities of persons
3    practicing the specified occupations set forth in
4    subsection (a) of, and pursuant to a licensing exemption
5    granted in subsection (b) or (d) of, Section 2105-350 of
6    the Department of Professional Regulation Law of the Civil
7    Administrative Code of Illinois, but only for so long as
8    the 2016 Olympic and Paralympic Games Professional
9    Licensure Exemption Law is operable.
10        (14) County correctional personnel from delivering
11    prepackaged medication for self-administration to an
12    individual detainee in a correctional facility.
13    Nothing in this Act shall be construed to limit the
14delegation of tasks or duties by a physician, dentist, or
15podiatric physician to a licensed practical nurse, a registered
16professional nurse, or other persons.
17(Source: P.A. 98-214, eff. 8-9-13.)
18    Section 915. The Illinois Public Aid Code is amended by
19changing Section 5-5 as follows:
20    (305 ILCS 5/5-5)  (from Ch. 23, par. 5-5)
21    Sec. 5-5. Medical services. The Illinois Department, by
22rule, shall determine the quantity and quality of and the rate
23of reimbursement for the medical assistance for which payment
24will be authorized, and the medical services to be provided,



HB0677- 86 -LRB100 06207 SMS 16241 b

1which may include all or part of the following: (1) inpatient
2hospital services; (2) outpatient hospital services; (3) other
3laboratory and X-ray services; (4) skilled nursing home
4services; (5) physicians' services whether furnished in the
5office, the patient's home, a hospital, a skilled nursing home,
6or elsewhere; (6) medical care, or any other type of remedial
7care furnished by licensed practitioners, including the
8services of licensed certified professional midwives pursuant
9to the Home Birth Safety Act; (7) home health care services;
10(8) private duty nursing service; (9) clinic services; (10)
11dental services, including prevention and treatment of
12periodontal disease and dental caries disease for pregnant
13women, provided by an individual licensed to practice dentistry
14or dental surgery; for purposes of this item (10), "dental
15services" means diagnostic, preventive, or corrective
16procedures provided by or under the supervision of a dentist in
17the practice of his or her profession; (11) physical therapy
18and related services; (12) prescribed drugs, dentures, and
19prosthetic devices; and eyeglasses prescribed by a physician
20skilled in the diseases of the eye, or by an optometrist,
21whichever the person may select; (13) other diagnostic,
22screening, preventive, and rehabilitative services, including
23to ensure that the individual's need for intervention or
24treatment of mental disorders or substance use disorders or
25co-occurring mental health and substance use disorders is
26determined using a uniform screening, assessment, and



HB0677- 87 -LRB100 06207 SMS 16241 b

1evaluation process inclusive of criteria, for children and
2adults; for purposes of this item (13), a uniform screening,
3assessment, and evaluation process refers to a process that
4includes an appropriate evaluation and, as warranted, a
5referral; "uniform" does not mean the use of a singular
6instrument, tool, or process that all must utilize; (14)
7transportation and such other expenses as may be necessary;
8(15) medical treatment of sexual assault survivors, as defined
9in Section 1a of the Sexual Assault Survivors Emergency
10Treatment Act, for injuries sustained as a result of the sexual
11assault, including examinations and laboratory tests to
12discover evidence which may be used in criminal proceedings
13arising from the sexual assault; (16) the diagnosis and
14treatment of sickle cell anemia; and (17) any other medical
15care, and any other type of remedial care recognized under the
16laws of this State, but not including abortions, or induced
17miscarriages or premature births, unless, in the opinion of a
18physician, such procedures are necessary for the preservation
19of the life of the woman seeking such treatment, or except an
20induced premature birth intended to produce a live viable child
21and such procedure is necessary for the health of the mother or
22her unborn child. The Illinois Department, by rule, shall
23prohibit any physician from providing medical assistance to
24anyone eligible therefor under this Code where such physician
25has been found guilty of performing an abortion procedure in a
26wilful and wanton manner upon a woman who was not pregnant at



HB0677- 88 -LRB100 06207 SMS 16241 b

1the time such abortion procedure was performed. The term "any
2other type of remedial care" shall include nursing care and
3nursing home service for persons who rely on treatment by
4spiritual means alone through prayer for healing.
5    Notwithstanding any other provision of this Section, a
6comprehensive tobacco use cessation program that includes
7purchasing prescription drugs or prescription medical devices
8approved by the Food and Drug Administration shall be covered
9under the medical assistance program under this Article for
10persons who are otherwise eligible for assistance under this
12    Notwithstanding any other provision of this Code, the
13Illinois Department may not require, as a condition of payment
14for any laboratory test authorized under this Article, that a
15physician's handwritten signature appear on the laboratory
16test order form. The Illinois Department may, however, impose
17other appropriate requirements regarding laboratory test order
19    Upon receipt of federal approval of an amendment to the
20Illinois Title XIX State Plan for this purpose, the Department
21shall authorize the Chicago Public Schools (CPS) to procure a
22vendor or vendors to manufacture eyeglasses for individuals
23enrolled in a school within the CPS system. CPS shall ensure
24that its vendor or vendors are enrolled as providers in the
25medical assistance program and in any capitated Medicaid
26managed care entity (MCE) serving individuals enrolled in a



HB0677- 89 -LRB100 06207 SMS 16241 b

1school within the CPS system. Under any contract procured under
2this provision, the vendor or vendors must serve only
3individuals enrolled in a school within the CPS system. Claims
4for services provided by CPS's vendor or vendors to recipients
5of benefits in the medical assistance program under this Code,
6the Children's Health Insurance Program, or the Covering ALL
7KIDS Health Insurance Program shall be submitted to the
8Department or the MCE in which the individual is enrolled for
9payment and shall be reimbursed at the Department's or the
10MCE's established rates or rate methodologies for eyeglasses.
11    On and after July 1, 2012, the Department of Healthcare and
12Family Services may provide the following services to persons
13eligible for assistance under this Article who are
14participating in education, training or employment programs
15operated by the Department of Human Services as successor to
16the Department of Public Aid:
17        (1) dental services provided by or under the
18    supervision of a dentist; and
19        (2) eyeglasses prescribed by a physician skilled in the
20    diseases of the eye, or by an optometrist, whichever the
21    person may select.
22    Notwithstanding any other provision of this Code and
23subject to federal approval, the Department may adopt rules to
24allow a dentist who is volunteering his or her service at no
25cost to render dental services through an enrolled
26not-for-profit health clinic without the dentist personally



HB0677- 90 -LRB100 06207 SMS 16241 b

1enrolling as a participating provider in the medical assistance
2program. A not-for-profit health clinic shall include a public
3health clinic or Federally Qualified Health Center or other
4enrolled provider, as determined by the Department, through
5which dental services covered under this Section are performed.
6The Department shall establish a process for payment of claims
7for reimbursement for covered dental services rendered under
8this provision.
9    The Illinois Department, by rule, may distinguish and
10classify the medical services to be provided only in accordance
11with the classes of persons designated in Section 5-2.
12    The Department of Healthcare and Family Services must
13provide coverage and reimbursement for amino acid-based
14elemental formulas, regardless of delivery method, for the
15diagnosis and treatment of (i) eosinophilic disorders and (ii)
16short bowel syndrome when the prescribing physician has issued
17a written order stating that the amino acid-based elemental
18formula is medically necessary.
19    The Illinois Department shall authorize the provision of,
20and shall authorize payment for, screening by low-dose
21mammography for the presence of occult breast cancer for women
2235 years of age or older who are eligible for medical
23assistance under this Article, as follows:
24        (A) A baseline mammogram for women 35 to 39 years of
25    age.
26        (B) An annual mammogram for women 40 years of age or



HB0677- 91 -LRB100 06207 SMS 16241 b

1    older.
2        (C) A mammogram at the age and intervals considered
3    medically necessary by the woman's health care provider for
4    women under 40 years of age and having a family history of
5    breast cancer, prior personal history of breast cancer,
6    positive genetic testing, or other risk factors.
7        (D) A comprehensive ultrasound screening of an entire
8    breast or breasts if a mammogram demonstrates
9    heterogeneous or dense breast tissue, when medically
10    necessary as determined by a physician licensed to practice
11    medicine in all of its branches.
12        (E) A screening MRI when medically necessary, as
13    determined by a physician licensed to practice medicine in
14    all of its branches.
15    All screenings shall include a physical breast exam,
16instruction on self-examination and information regarding the
17frequency of self-examination and its value as a preventative
18tool. For purposes of this Section, "low-dose mammography"
19means the x-ray examination of the breast using equipment
20dedicated specifically for mammography, including the x-ray
21tube, filter, compression device, and image receptor, with an
22average radiation exposure delivery of less than one rad per
23breast for 2 views of an average size breast. The term also
24includes digital mammography and includes breast
25tomosynthesis. As used in this Section, the term "breast
26tomosynthesis" means a radiologic procedure that involves the



HB0677- 92 -LRB100 06207 SMS 16241 b

1acquisition of projection images over the stationary breast to
2produce cross-sectional digital three-dimensional images of
3the breast. If, at any time, the Secretary of the United States
4Department of Health and Human Services, or its successor
5agency, promulgates rules or regulations to be published in the
6Federal Register or publishes a comment in the Federal Register
7or issues an opinion, guidance, or other action that would
8require the State, pursuant to any provision of the Patient
9Protection and Affordable Care Act (Public Law 111-148),
10including, but not limited to, 42 U.S.C. 18031(d)(3)(B) or any
11successor provision, to defray the cost of any coverage for
12breast tomosynthesis outlined in this paragraph, then the
13requirement that an insurer cover breast tomosynthesis is
14inoperative other than any such coverage authorized under
15Section 1902 of the Social Security Act, 42 U.S.C. 1396a, and
16the State shall not assume any obligation for the cost of
17coverage for breast tomosynthesis set forth in this paragraph.
18    On and after January 1, 2016, the Department shall ensure
19that all networks of care for adult clients of the Department
20include access to at least one breast imaging Center of Imaging
21Excellence as certified by the American College of Radiology.
22    On and after January 1, 2012, providers participating in a
23quality improvement program approved by the Department shall be
24reimbursed for screening and diagnostic mammography at the same
25rate as the Medicare program's rates, including the increased
26reimbursement for digital mammography.



HB0677- 93 -LRB100 06207 SMS 16241 b

1    The Department shall convene an expert panel including
2representatives of hospitals, free-standing mammography
3facilities, and doctors, including radiologists, to establish
4quality standards for mammography.
5    On and after January 1, 2017, providers participating in a
6breast cancer treatment quality improvement program approved
7by the Department shall be reimbursed for breast cancer
8treatment at a rate that is no lower than 95% of the Medicare
9program's rates for the data elements included in the breast
10cancer treatment quality program.
11    The Department shall convene an expert panel, including
12representatives of hospitals, free standing breast cancer
13treatment centers, breast cancer quality organizations, and
14doctors, including breast surgeons, reconstructive breast
15surgeons, oncologists, and primary care providers to establish
16quality standards for breast cancer treatment.
17    Subject to federal approval, the Department shall
18establish a rate methodology for mammography at federally
19qualified health centers and other encounter-rate clinics.
20These clinics or centers may also collaborate with other
21hospital-based mammography facilities. By January 1, 2016, the
22Department shall report to the General Assembly on the status
23of the provision set forth in this paragraph.
24    The Department shall establish a methodology to remind
25women who are age-appropriate for screening mammography, but
26who have not received a mammogram within the previous 18



HB0677- 94 -LRB100 06207 SMS 16241 b

1months, of the importance and benefit of screening mammography.
2The Department shall work with experts in breast cancer
3outreach and patient navigation to optimize these reminders and
4shall establish a methodology for evaluating their
5effectiveness and modifying the methodology based on the
7    The Department shall establish a performance goal for
8primary care providers with respect to their female patients
9over age 40 receiving an annual mammogram. This performance
10goal shall be used to provide additional reimbursement in the
11form of a quality performance bonus to primary care providers
12who meet that goal.
13    The Department shall devise a means of case-managing or
14patient navigation for beneficiaries diagnosed with breast
15cancer. This program shall initially operate as a pilot program
16in areas of the State with the highest incidence of mortality
17related to breast cancer. At least one pilot program site shall
18be in the metropolitan Chicago area and at least one site shall
19be outside the metropolitan Chicago area. On or after July 1,
202016, the pilot program shall be expanded to include one site
21in western Illinois, one site in southern Illinois, one site in
22central Illinois, and 4 sites within metropolitan Chicago. An
23evaluation of the pilot program shall be carried out measuring
24health outcomes and cost of care for those served by the pilot
25program compared to similarly situated patients who are not
26served by the pilot program.



HB0677- 95 -LRB100 06207 SMS 16241 b

1    The Department shall require all networks of care to
2develop a means either internally or by contract with experts
3in navigation and community outreach to navigate cancer
4patients to comprehensive care in a timely fashion. The
5Department shall require all networks of care to include access
6for patients diagnosed with cancer to at least one academic
7commission on cancer-accredited cancer program as an
8in-network covered benefit.
9    Any medical or health care provider shall immediately
10recommend, to any pregnant woman who is being provided prenatal
11services and is suspected of drug abuse or is addicted as
12defined in the Alcoholism and Other Drug Abuse and Dependency
13Act, referral to a local substance abuse treatment provider
14licensed by the Department of Human Services or to a licensed
15hospital which provides substance abuse treatment services.
16The Department of Healthcare and Family Services shall assure
17coverage for the cost of treatment of the drug abuse or
18addiction for pregnant recipients in accordance with the
19Illinois Medicaid Program in conjunction with the Department of
20Human Services.
21    All medical providers providing medical assistance to
22pregnant women under this Code shall receive information from
23the Department on the availability of services under the Drug
24Free Families with a Future or any comparable program providing
25case management services for addicted women, including
26information on appropriate referrals for other social services



HB0677- 96 -LRB100 06207 SMS 16241 b

1that may be needed by addicted women in addition to treatment
2for addiction.
3    The Illinois Department, in cooperation with the
4Departments of Human Services (as successor to the Department
5of Alcoholism and Substance Abuse) and Public Health, through a
6public awareness campaign, may provide information concerning
7treatment for alcoholism and drug abuse and addiction, prenatal
8health care, and other pertinent programs directed at reducing
9the number of drug-affected infants born to recipients of
10medical assistance.
11    Neither the Department of Healthcare and Family Services
12nor the Department of Human Services shall sanction the
13recipient solely on the basis of her substance abuse.
14    The Illinois Department shall establish such regulations
15governing the dispensing of health services under this Article
16as it shall deem appropriate. The Department should seek the
17advice of formal professional advisory committees appointed by
18the Director of the Illinois Department for the purpose of
19providing regular advice on policy and administrative matters,
20information dissemination and educational activities for
21medical and health care providers, and consistency in
22procedures to the Illinois Department.
23    The Illinois Department may develop and contract with
24Partnerships of medical providers to arrange medical services
25for persons eligible under Section 5-2 of this Code.
26Implementation of this Section may be by demonstration projects



HB0677- 97 -LRB100 06207 SMS 16241 b

1in certain geographic areas. The Partnership shall be
2represented by a sponsor organization. The Department, by rule,
3shall develop qualifications for sponsors of Partnerships.
4Nothing in this Section shall be construed to require that the
5sponsor organization be a medical organization.
6    The sponsor must negotiate formal written contracts with
7medical providers for physician services, inpatient and
8outpatient hospital care, home health services, treatment for
9alcoholism and substance abuse, and other services determined
10necessary by the Illinois Department by rule for delivery by
11Partnerships. Physician services must include prenatal and
12obstetrical care. The Illinois Department shall reimburse
13medical services delivered by Partnership providers to clients
14in target areas according to provisions of this Article and the
15Illinois Health Finance Reform Act, except that:
16        (1) Physicians participating in a Partnership and
17    providing certain services, which shall be determined by
18    the Illinois Department, to persons in areas covered by the
19    Partnership may receive an additional surcharge for such
20    services.
21        (2) The Department may elect to consider and negotiate
22    financial incentives to encourage the development of
23    Partnerships and the efficient delivery of medical care.
24        (3) Persons receiving medical services through
25    Partnerships may receive medical and case management
26    services above the level usually offered through the



HB0677- 98 -LRB100 06207 SMS 16241 b

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



HB0677- 99 -LRB100 06207 SMS 16241 b

1less than 6 years from the date of service or as provided by
2applicable State law, whichever period is longer, except that
3if an audit is initiated within the required retention period
4then the records must be retained until the audit is completed
5and every exception is resolved. The Illinois Department shall
6require health care providers to make available, when
7authorized by the patient, in writing, the medical records in a
8timely fashion to other health care providers who are treating
9or serving persons eligible for Medical Assistance under this
10Article. All dispensers of medical services shall be required
11to maintain and retain business and professional records
12sufficient to fully and accurately document the nature, scope,
13details and receipt of the health care provided to persons
14eligible for medical assistance under this Code, in accordance
15with regulations promulgated by the Illinois Department. The
16rules and regulations shall require that proof of the receipt
17of prescription drugs, dentures, prosthetic devices and
18eyeglasses by eligible persons under this Section accompany
19each claim for reimbursement submitted by the dispenser of such
20medical services. No such claims for reimbursement shall be
21approved for payment by the Illinois Department without such
22proof of receipt, unless the Illinois Department shall have put
23into effect and shall be operating a system of post-payment
24audit and review which shall, on a sampling basis, be deemed
25adequate by the Illinois Department to assure that such drugs,
26dentures, prosthetic devices and eyeglasses for which payment



HB0677- 100 -LRB100 06207 SMS 16241 b

1is being made are actually being received by eligible
2recipients. Within 90 days after September 16, 1984 (the
3effective date of Public Act 83-1439), the Illinois Department
4shall establish a current list of acquisition costs for all
5prosthetic devices and any other items recognized as medical
6equipment and supplies reimbursable under this Article and
7shall update such list on a quarterly basis, except that the
8acquisition costs of all prescription drugs shall be updated no
9less frequently than every 30 days as required by Section
11    The rules and regulations of the Illinois Department shall
12require that a written statement including the required opinion
13of a physician shall accompany any claim for reimbursement for
14abortions, or induced miscarriages or premature births. This
15statement shall indicate what procedures were used in providing
16such medical services.
17    Notwithstanding any other law to the contrary, the Illinois
18Department shall, within 365 days after July 22, 2013 (the
19effective date of Public Act 98-104), establish procedures to
20permit skilled care facilities licensed under the Nursing Home
21Care Act to submit monthly billing claims for reimbursement
22purposes. Following development of these procedures, the
23Department shall, by July 1, 2016, test the viability of the
24new system and implement any necessary operational or
25structural changes to its information technology platforms in
26order to allow for the direct acceptance and payment of nursing



HB0677- 101 -LRB100 06207 SMS 16241 b

1home claims.
2    Notwithstanding any other law to the contrary, the Illinois
3Department shall, within 365 days after August 15, 2014 (the
4effective date of Public Act 98-963), establish procedures to
5permit ID/DD facilities licensed under the ID/DD Community Care
6Act and MC/DD facilities licensed under the MC/DD Act to submit
7monthly billing claims for reimbursement purposes. Following
8development of these procedures, the Department shall have an
9additional 365 days to test the viability of the new system and
10to ensure that any necessary operational or structural changes
11to its information technology platforms are implemented.
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



HB0677- 102 -LRB100 06207 SMS 16241 b

1inquiries could indicate potential existence of claims or liens
2for the Illinois Department.
3    Enrollment of a vendor shall be subject to a provisional
4period and shall be conditional for one year. During the period
5of conditional enrollment, the Department may terminate the
6vendor's eligibility to participate in, or may disenroll the
7vendor from, the medical assistance program without cause.
8Unless otherwise specified, such termination of eligibility or
9disenrollment is not subject to the Department's hearing
10process. However, a disenrolled vendor may reapply without
12    The Department has the discretion to limit the conditional
13enrollment period for vendors based upon category of risk of
14the vendor.
15    Prior to enrollment and during the conditional enrollment
16period in the medical assistance program, all vendors shall be
17subject to enhanced oversight, screening, and review based on
18the risk of fraud, waste, and abuse that is posed by the
19category of risk of the vendor. The Illinois Department shall
20establish the procedures for oversight, screening, and review,
21which may include, but need not be limited to: criminal and
22financial background checks; fingerprinting; license,
23certification, and authorization verifications; unscheduled or
24unannounced site visits; database checks; prepayment audit
25reviews; audits; payment caps; payment suspensions; and other
26screening as required by federal or State law.



HB0677- 103 -LRB100 06207 SMS 16241 b

1    The Department shall define or specify the following: (i)
2by provider notice, the "category of risk of the vendor" for
3each type of vendor, which shall take into account the level of
4screening applicable to a particular category of vendor under
5federal law and regulations; (ii) by rule or provider notice,
6the maximum length of the conditional enrollment period for
7each category of risk of the vendor; and (iii) by rule, the
8hearing rights, if any, afforded to a vendor in each category
9of risk of the vendor that is terminated or disenrolled during
10the conditional enrollment period.
11    To be eligible for payment consideration, a vendor's
12payment claim or bill, either as an initial claim or as a
13resubmitted claim following prior rejection, must be received
14by the Illinois Department, or its fiscal intermediary, no
15later than 180 days after the latest date on the claim on which
16medical goods or services were provided, with the following
18        (1) In the case of a provider whose enrollment is in
19    process by the Illinois Department, the 180-day period
20    shall not begin until the date on the written notice from
21    the Illinois Department that the provider enrollment is
22    complete.
23        (2) In the case of errors attributable to the Illinois
24    Department or any of its claims processing intermediaries
25    which result in an inability to receive, process, or
26    adjudicate a claim, the 180-day period shall not begin



HB0677- 104 -LRB100 06207 SMS 16241 b

1    until the provider has been notified of the error.
2        (3) In the case of a provider for whom the Illinois
3    Department initiates the monthly billing process.
4        (4) In the case of a provider operated by a unit of
5    local government with a population exceeding 3,000,000
6    when local government funds finance federal participation
7    for claims payments.
8    For claims for services rendered during a period for which
9a recipient received retroactive eligibility, claims must be
10filed within 180 days after the Department determines the
11applicant is eligible. For claims for which the Illinois
12Department is not the primary payer, claims must be submitted
13to the Illinois Department within 180 days after the final
14adjudication by the primary payer.
15    In the case of long term care facilities, within 5 days of
16receipt by the facility of required prescreening information,
17data for new admissions shall be entered into the Medical
18Electronic Data Interchange (MEDI) or the Recipient
19Eligibility Verification (REV) System or successor system, and
20within 15 days of receipt by the facility of required
21prescreening information, admission documents shall be
22submitted through MEDI or REV or shall be submitted directly to
23the Department of Human Services using required admission
24forms. Effective September 1, 2014, admission documents,
25including all prescreening information, must be submitted
26through MEDI or REV. Confirmation numbers assigned to an



HB0677- 105 -LRB100 06207 SMS 16241 b

1accepted transaction shall be retained by a facility to verify
2timely submittal. Once an admission transaction has been
3completed, all resubmitted claims following prior rejection
4are subject to receipt no later than 180 days after the
5admission transaction has been completed.
6    Claims that are not submitted and received in compliance
7with the foregoing requirements shall not be eligible for
8payment under the medical assistance program, and the State
9shall have no liability for payment of those claims.
10    To the extent consistent with applicable information and
11privacy, security, and disclosure laws, State and federal
12agencies and departments shall provide the Illinois Department
13access to confidential and other information and data necessary
14to perform eligibility and payment verifications and other
15Illinois Department functions. This includes, but is not
16limited to: information pertaining to licensure;
17certification; earnings; immigration status; citizenship; wage
18reporting; unearned and earned income; pension income;
19employment; supplemental security income; social security
20numbers; National Provider Identifier (NPI) numbers; the
21National Practitioner Data Bank (NPDB); program and agency
22exclusions; taxpayer identification numbers; tax delinquency;
23corporate information; and death records.
24    The Illinois Department shall enter into agreements with
25State agencies and departments, and is authorized to enter into
26agreements with federal agencies and departments, under which



HB0677- 106 -LRB100 06207 SMS 16241 b

1such agencies and departments shall share data necessary for
2medical assistance program integrity functions and oversight.
3The Illinois Department shall develop, in cooperation with
4other State departments and agencies, and in compliance with
5applicable federal laws and regulations, appropriate and
6effective methods to share such data. At a minimum, and to the
7extent necessary to provide data sharing, the Illinois
8Department shall enter into agreements with State agencies and
9departments, and is authorized to enter into agreements with
10federal agencies and departments, including but not limited to:
11the Secretary of State; the Department of Revenue; the
12Department of Public Health; the Department of Human Services;
13and the Department of Financial and Professional Regulation.
14    Beginning in fiscal year 2013, the Illinois Department
15shall set forth a request for information to identify the
16benefits of a pre-payment, post-adjudication, and post-edit
17claims system with the goals of streamlining claims processing
18and provider reimbursement, reducing the number of pending or
19rejected claims, and helping to ensure a more transparent
20adjudication process through the utilization of: (i) provider
21data verification and provider screening technology; and (ii)
22clinical code editing; and (iii) pre-pay, pre- or
23post-adjudicated predictive modeling with an integrated case
24management system with link analysis. Such a request for
25information shall not be considered as a request for proposal
26or as an obligation on the part of the Illinois Department to



HB0677- 107 -LRB100 06207 SMS 16241 b

1take any action or acquire any products or services.
2    The Illinois Department shall establish policies,
3procedures, standards and criteria by rule for the acquisition,
4repair and replacement of orthotic and prosthetic devices and
5durable medical equipment. Such rules shall provide, but not be
6limited to, the following services: (1) immediate repair or
7replacement of such devices by recipients; and (2) rental,
8lease, purchase or lease-purchase of durable medical equipment
9in a cost-effective manner, taking into consideration the
10recipient's medical prognosis, the extent of the recipient's
11needs, and the requirements and costs for maintaining such
12equipment. Subject to prior approval, such rules shall enable a
13recipient to temporarily acquire and use alternative or
14substitute devices or equipment pending repairs or
15replacements of any device or equipment previously authorized
16for such recipient by the Department. Notwithstanding any
17provision of Section 5-5f to the contrary, the Department may,
18by rule, exempt certain replacement wheelchair parts from prior
19approval and, for wheelchairs, wheelchair parts, wheelchair
20accessories, and related seating and positioning items,
21determine the wholesale price by methods other than actual
22acquisition costs.
23    The Department shall require, by rule, all providers of
24durable medical equipment to be accredited by an accreditation
25organization approved by the federal Centers for Medicare and
26Medicaid Services and recognized by the Department in order to



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1bill the Department for providing durable medical equipment to
2recipients. No later than 15 months after the effective date of
3the rule adopted pursuant to this paragraph, all providers must
4meet the accreditation requirement.
5    The Department shall execute, relative to the nursing home
6prescreening project, written inter-agency agreements with the
7Department of Human Services and the Department on Aging, to
8effect the following: (i) intake procedures and common
9eligibility criteria for those persons who are receiving
10non-institutional services; and (ii) the establishment and
11development of non-institutional services in areas of the State
12where they are not currently available or are undeveloped; and
13(iii) notwithstanding any other provision of law, subject to
14federal approval, on and after July 1, 2012, an increase in the
15determination of need (DON) scores from 29 to 37 for applicants
16for institutional and home and community-based long term care;
17if and only if federal approval is not granted, the Department
18may, in conjunction with other affected agencies, implement
19utilization controls or changes in benefit packages to
20effectuate a similar savings amount for this population; and
21(iv) no later than July 1, 2013, minimum level of care
22eligibility criteria for institutional and home and
23community-based long term care; and (v) no later than October
241, 2013, establish procedures to permit long term care
25providers access to eligibility scores for individuals with an
26admission date who are seeking or receiving services from the



HB0677- 109 -LRB100 06207 SMS 16241 b

1long term care provider. In order to select the minimum level
2of care eligibility criteria, the Governor shall establish a
3workgroup that includes affected agency representatives and
4stakeholders representing the institutional and home and
5community-based long term care interests. This Section shall
6not restrict the Department from implementing lower level of
7care eligibility criteria for community-based services in
8circumstances where federal approval has been granted.
9    The Illinois Department shall develop and operate, in
10cooperation with other State Departments and agencies and in
11compliance with applicable federal laws and regulations,
12appropriate and effective systems of health care evaluation and
13programs for monitoring of utilization of health care services
14and facilities, as it affects persons eligible for medical
15assistance under this Code.
16    The Illinois Department shall report annually to the
17General Assembly, no later than the second Friday in April of
181979 and each year thereafter, in regard to:
19        (a) actual statistics and trends in utilization of
20    medical services by public aid recipients;
21        (b) actual statistics and trends in the provision of
22    the various medical services by medical vendors;
23        (c) current rate structures and proposed changes in
24    those rate structures for the various medical vendors; and
25        (d) efforts at utilization review and control by the
26    Illinois Department.



HB0677- 110 -LRB100 06207 SMS 16241 b

1    The period covered by each report shall be the 3 years
2ending on the June 30 prior to the report. The report shall
3include suggested legislation for consideration by the General
4Assembly. The filing of one copy of the report with the
5Speaker, one copy with the Minority Leader and one copy with
6the Clerk of the House of Representatives, one copy with the
7President, one copy with the Minority Leader and one copy with
8the Secretary of the Senate, one copy with the Legislative
9Research Unit, and such additional copies with the State
10Government Report Distribution Center for the General Assembly
11as is required under paragraph (t) of Section 7 of the State
12Library Act shall be deemed sufficient to comply with this
14    Rulemaking authority to implement Public Act 95-1045, if
15any, is conditioned on the rules being adopted in accordance
16with all provisions of the Illinois Administrative Procedure
17Act and all rules and procedures of the Joint Committee on
18Administrative Rules; any purported rule not so adopted, for
19whatever reason, is unauthorized.
20    On and after July 1, 2012, the Department shall reduce any
21rate of reimbursement for services or other payments or alter
22any methodologies authorized by this Code to reduce any rate of
23reimbursement for services or other payments in accordance with
24Section 5-5e.
25    Because kidney transplantation can be an appropriate, cost
26effective alternative to renal dialysis when medically



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1necessary and notwithstanding the provisions of Section 1-11 of
2this Code, beginning October 1, 2014, the Department shall
3cover kidney transplantation for noncitizens with end-stage
4renal disease who are not eligible for comprehensive medical
5benefits, who meet the residency requirements of Section 5-3 of
6this Code, and who would otherwise meet the financial
7requirements of the appropriate class of eligible persons under
8Section 5-2 of this Code. To qualify for coverage of kidney
9transplantation, such person must be receiving emergency renal
10dialysis services covered by the Department. Providers under
11this Section shall be prior approved and certified by the
12Department to perform kidney transplantation and the services
13under this Section shall be limited to services associated with
14kidney transplantation.
15    Notwithstanding any other provision of this Code to the
16contrary, on or after July 1, 2015, all FDA approved forms of
17medication assisted treatment prescribed for the treatment of
18alcohol dependence or treatment of opioid dependence shall be
19covered under both fee for service and managed care medical
20assistance programs for persons who are otherwise eligible for
21medical assistance under this Article and shall not be subject
22to any (1) utilization control, other than those established
23under the American Society of Addiction Medicine patient
24placement criteria, (2) prior authorization mandate, or (3)
25lifetime restriction limit mandate.
26    On or after July 1, 2015, opioid antagonists prescribed for



HB0677- 112 -LRB100 06207 SMS 16241 b

1the treatment of an opioid overdose, including the medication
2product, administration devices, and any pharmacy fees related
3to the dispensing and administration of the opioid antagonist,
4shall be covered under the medical assistance program for
5persons who are otherwise eligible for medical assistance under
6this Article. As used in this Section, "opioid antagonist"
7means a drug that binds to opioid receptors and blocks or
8inhibits the effect of opioids acting on those receptors,
9including, but not limited to, naloxone hydrochloride or any
10other similarly acting drug approved by the U.S. Food and Drug
12    Upon federal approval, the Department shall provide
13coverage and reimbursement for all drugs that are approved for
14marketing by the federal Food and Drug Administration and that
15are recommended by the federal Public Health Service or the
16United States Centers for Disease Control and Prevention for
17pre-exposure prophylaxis and related pre-exposure prophylaxis
18services, including, but not limited to, HIV and sexually
19transmitted infection screening, treatment for sexually
20transmitted infections, medical monitoring, assorted labs, and
21counseling to reduce the likelihood of HIV infection among
22individuals who are not infected with HIV but who are at high
23risk of HIV infection.
24(Source: P.A. 98-104, Article 9, Section 9-5, eff. 7-22-13;
2598-104, Article 12, Section 12-20, eff. 7-22-13; 98-303, eff.
268-9-13; 98-463, eff. 8-16-13; 98-651, eff. 6-16-14; 98-756,



HB0677- 113 -LRB100 06207 SMS 16241 b

1eff. 7-16-14; 98-963, eff. 8-15-14; 99-78, eff. 7-20-15;
299-180, eff. 7-29-15; 99-236, eff. 8-3-15; 99-407 (see Section
320 of P.A. 99-588 for the effective date of P.A. 99-407);
499-433, eff. 8-21-15; 99-480, eff. 9-9-15; 99-588, eff.
57-20-16; 99-642, eff. 7-28-16; 99-772, eff. 1-1-17; 99-895,
6eff. 1-1-17; revised 9-20-16.)