97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB1665

 

Introduced 2/15/2011, by Rep. Robyn Gabel

 

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

    Creates the Home Birth Integration Act. Provides that beginning January 1 2013, Illinois hospitals shall implement emergency transfer protocols for home birth patients developed in collaboration with community midwives or their agent. Sets forth the requirements for the protocols. Provides that the Department of Public Health and the Illinois Council of Certified Professional Midwives or their agent shall jointly develop guidelines for the implementation of the Act. Provides that the guidelines shall be communicated to the trauma center medical directors committees and the medical directors committees of each EMS region in this State within 6 months after the effective date of the Act. Sets forth a provision concerning the powers and duties of the Department and rules and vicarious liability. Amends the Medical Practice Act of 1987 and the Nurse Practice Act to exempt community midwives engaged in the transport and transfer of care of home birth mothers or infants in a case of emergency. Makes other changes.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning home birth integration.
 
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 Integration Act.
 
6    Section 5. Purpose. The General Assembly finds that due to
7an extreme shortage of licensed home birth providers, a
8significant percentage of Illinois home birth families engage
9the services of unregulated, underground, community midwives
10to attend their planned home births. It further finds that the
11recent Publication #476 of the American College of
12Obstetricians and Gynecologists emphasizes the importance of
13providing home birth families with an integrated and regulated
14health system that ensures a plan for safe and quick
15transportation to a nearby hospital in the event of an
16emergency. It is hereby declared that the lack of integration
17of community home birth midwives into the Illinois Emergency
18Medical System creates a serious gap in care that negatively
19affects the health, safety, and welfare of hundreds of Illinois
20mothers annually who choose to give birth at home as well as
21the health, safety, and welfare of their infants. The purpose
22of this Act is to require the Department of Public Health,
23Illinois community home birth midwives, and Illinois hospitals

 

 

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1to work together to create protocols for receiving transports
2of home birth mothers, infants, or both, which include methods
3of transferring medical charts and methods of communication
4that maintain the underground midwife's anonymity and
5therefore do not discourage midwives from transporting in a
6situation where the health and welfare of mother or baby
7requires it. This Act shall be liberally construed to best
8carry out these purposes.
 
9    Section 10. Definitions. As used in this Act:
10    "Department" means the Department of Public Health.
11    "Director" means the Director of Public Health.
12    "Emergency" means a medical condition of recent onset and
13severity that would lead a prudent layperson, possessing an
14average knowledge of medicine and health, to believe that
15urgent or unscheduled medical care is required.
16    "Hospital" has the meaning ascribed to that term in the
17Hospital Licensing Act.
18    "Community midwife" means any midwife serving the home
19birth community in this State who is not licensed under the
20Nurse Practice Act.
21    "Emergency medical services system" or "EMS system" means
22an organization of hospitals, vehicle service providers, and
23personnel approved by the Department in a specific geographic
24area that coordinates and provides pre-hospital and
25inter-hospital emergency care and non-emergency medical

 

 

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1transports at a BLS, ILS, or ALS level pursuant to a System
2program plan submitted to and approved by the Department, and
3pursuant to the EMS Region Plan adopted for the EMS Region in
4which the System is located.
5    "Patient" means the mother or infant receiving or planning
6to receive home birth services from the community midwife.
7    "EMS medical directors committee" is a committee comprised
8of EMS medical directors and fire personnel within the regional
9emergency medical system.
10    "Trauma center medical directors committee" is a committee
11comprised of the region's trauma center medical directors.
12    "Certified professional midwives" or "CPMs" are community
13midwives who have earned a national certification in midwifery.
 
14    Section 15. Home birth emergency transfer protocols.
15    (a) Beginning January 1 2013, Illinois hospitals shall
16implement emergency transfer protocols for home birth patients
17developed in collaboration with community midwives or their
18agent. These protocols must do all of the following:
19        (1) Allow rapid transfer of patient and patient medical
20    records when an emergency arises during the course of,
21    immediately after, or in the 6 weeks following a planned
22    home birth.
23        (2) Allow professional communication between the
24    midwife and transport and hospital personnel before,
25    during, and after transport.

 

 

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1        (3) Prohibit the receiving hospital or personnel and
2    the EMS responders or other transport agency personnel from
3    filing a report with the Department of Children and Family
4    Services merely for the fact of a planned home birth.
5        (4) Prohibit the receiving hospital or personnel and
6    the EMS responders or other transport agency personnel from
7    filing a report with the Department of Financial and
8    Professional Regulation or local authorities solely for
9    the fact of attending a home birth.
10    (b) The protocols described in subsection (a) of this
11Section may not do any of the following:
12        (1) Require the midwife to reveal her identity or
13    location.
14        (2) Require the family to reveal the midwife's identity
15    or location.
 
16    Section 20. Development. Upon the effective date of this
17Act, the Department and the Illinois Council of Certified
18Professional Midwives or their agent shall jointly develop
19guidelines for the implementation of this Act. These guidelines
20shall be communicated to the trauma center medical directors
21committees and the medical directors committees of each EMS
22region in this State within 6 months after the effective date
23of this Act.
24    Within 6 months after receipt of these guidelines, the
25trauma center medical directors committees and EMS medical

 

 

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1directors committee of each EMS region in this State shall, in
2collaboration with local community midwives or their agents,
3develop protocols to carry out the provisions of this Act and
4the regional medical directors committee shall submit these
5protocols to the Department for approval.
6    If the Department suggest changes to the plan or protocols,
7then the committee shall implement the changes or engage in
8further dialogue with the Department.
 
9    Section 25. Powers and duties of the Department; rules. The
10Department shall have the authority and responsibility to:
11        (1) Approve or deny plans submitted by regional medical
12    directors committees within 3 months after their
13    submission. For any plans not meeting approval, the
14    Department shall suggest changes.
15        (2) Ensure that all negotiations shall be completed and
16    plans and protocols shall be in place across all regions by
17    January 1, 2013.
18        (3) Monitor the ongoing regional programs.
19        (4) Keep such records that the Department determines
20    are necessary, however in no circumstances can such records
21    be used to criminally implicate midwives or parents solely
22    for the act of participating in a home birth, nor for
23    parents exercising their legal right to informed consent or
24    informed denial of treatment.
 

 

 

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1    Section 30. Vicarious liability. No physician licensed to
2practice medicine in all its branches or physician's assistant,
3nurse, advanced practice nurse, medical assistant or
4technician, or first responder shall be held liable for an
5injury solely resulting from an act or omission by a midwife
6occurring outside of a hospital, doctor's office, or health
7care facility. Except as may otherwise be provided by law,
8nothing in this Section shall exempt any physician licensed to
9practice medicine in all its branches, physician's assistant,
10nurse, advanced practice nurse, medical assistant or
11technician, or first responder from liability for his or her
12own negligent, grossly negligent, or willful or wanton acts or
13omissions.
 
14    Section 900. The Medical Practice Act of 1987 is amended by
15changing Section 4 as follows:
 
16    (225 ILCS 60/4)  (from Ch. 111, par. 4400-4)
17    (Section scheduled to be repealed on November 30, 2011)
18    Sec. 4. Exemptions.
19    (a) This Act does not apply to the following:
20        (1) persons lawfully carrying on their particular
21    profession or business under any valid existing regulatory
22    Act of this State;
23        (2) persons rendering gratuitous services in cases of
24    emergency;

 

 

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1        (3) persons treating human ailments by prayer or
2    spiritual means as an exercise or enjoyment of religious
3    freedom; or
4        (4) persons practicing the specified occupations set
5    forth in in subsection (a) of, and pursuant to a licensing
6    exemption granted in subsection (b) or (d) of, Section
7    2105-350 of the Department of Professional Regulation Law
8    of the Civil Administrative Code of Illinois, but only for
9    so long as the 2016 Olympic and Paralympic Games
10    Professional Licensure Exemption Law is operable; or
11        (5) community midwives engaged in the transport and
12    transfer of care of home birth mothers or infants in a case
13    of emergency.
14    (b) (Blank).
15(Source: P.A. 96-7, eff. 4-3-09.)
 
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.
22        (12) Delegation to authorized direct care staff
23    trained under Section 15.4 of the Mental Health and
24    Developmental Disabilities Administrative Act consistent
25    with the policies of the Department.
26        (13) The practice, services, or activities of persons

 

 

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1    practicing the specified occupations set forth in
2    subsection (a) of, and pursuant to a licensing exemption
3    granted in subsection (b) or (d) of, Section 2105-350 of
4    the Department of Professional Regulation Law of the Civil
5    Administrative Code of Illinois, but only for so long as
6    the 2016 Olympic and Paralympic Games Professional
7    Licensure Exemption Law is operable.
8        (14) County correctional personnel from delivering
9    prepackaged medication for self-administration to an
10    individual detainee in a correctional facility.
11        (15) Community midwives engaged in the transport and
12    transfer of care of home birth mothers or infants in a case
13    of emergency.
14    Nothing in this Act shall be construed to limit the
15delegation of tasks or duties by a physician, dentist, or
16podiatrist to a licensed practical nurse, a registered
17professional nurse, or other persons.
18(Source: P.A. 95-639, eff. 10-5-07; 95-876, eff. 8-21-08; 96-7,
19eff. 4-3-09; 96-516, eff. 8-14-09; 96-1000, eff. 7-2-10.)