Illinois General Assembly - Full Text of HB4096
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Full Text of HB4096  103rd General Assembly




State of Illinois
2023 and 2024


Introduced 5/17/2023, by Rep. Tom Weber


5 ILCS 100/5-45.35 new
210 ILCS 5/10f  from Ch. 111 1/2, par. 157-8.10f
210 ILCS 85/7  from Ch. 111 1/2, par. 148
225 ILCS 60/67 new

    Amends the Medical Practice Act of 1987. Provides that sex-reassignment procedures are prohibited for patients younger than 18 years of age. Provides that if sex-reassignment procedures are administered or performed on patients 18 years of age or older, consent must be provided as specified. Provides that the Department of Financial and Professional Regulation shall revoke the license of any physician who willfully or actively violates the prohibition on sex-reassignment procedures for patients younger than 18 years of age. Amends the Hospital Licensing Act and the Ambulatory Surgical Treatment Center Act. Adds a failure to comply with the provisions as grounds for fines, license denial, license suspension or revocation, or refusal to renew a hospital or facility's license. Amends the Illinois Administrative Procedure Act to provide for emergency rulemaking.

LRB103 32558 SPS 62147 b





HB4096LRB103 32558 SPS 62147 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 5. The Illinois Administrative Procedure Act is
5amended by adding Section 5-45.35 as follows:
6    (5 ILCS 100/5-45.35 new)
7    Sec. 5-45.35. Emergency rulemaking; Department of
8Financial and Professional Regulation. To provide for the
9expeditious and timely implementation of this amendatory Act
10of the 103rd General Assembly, emergency rules implementing
11Section 67 of the Medical Practice Act of 1987 may be adopted
12in accordance with Section 5-45 by the Department of Financial
13and Professional Regulation and the Department of Public
14Health. The adoption of emergency rules authorized by Section
155-45 and this Section is deemed to be necessary for the public
16interest, safety, and welfare.
17    This Section is repealed one year after the effective date
18of this amendatory Act of the 103rd General Assembly.
19    Section 10. The Ambulatory Surgical Treatment Center Act
20is amended by changing Section 10f as follows:
21    (210 ILCS 5/10f)  (from Ch. 111 1/2, par. 157-8.10f)



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1    Sec. 10f. Denial, suspension, revocation or refusal to
2renew a license; suspension of a service.
3    (a) When the Director determines that there is or has been
4a substantial or continued failure to comply with this Act or
5any rule promulgated hereunder, or Section 67 of the Medical
6Practice Act of 1987, the Department may issue an order of
7license denial, suspension or revocation, or refusal to renew
8a license, in accordance with subsection (a) of Section 10g of
9this Act.
10    (b) When the Director determines that a facility has
11failed to demonstrate the capacity to safely provide one or
12more of its services to patients, the Department may issue an
13order of service suspension in accordance with subsection (a)
14of Section 10g of this Act.
15    (c) If, however, the Department finds that the public
16interest, health, safety, or welfare imperatively requires
17emergency action, and if the Director incorporates a finding
18to that effect in the order, summary suspension of a service or
19a license to open, conduct, operate, and maintain an
20ambulatory surgical treatment center or any part thereof may
21be ordered pending proceedings for license revocation or other
22action, which shall be promptly instituted and determined.
23(Source: P.A. 86-1292.)
24    Section 15. The Hospital Licensing Act is amended by
25changing Section 7 as follows:



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1    (210 ILCS 85/7)  (from Ch. 111 1/2, par. 148)
2    Sec. 7. (a) The Director after notice and opportunity for
3hearing to the applicant or licensee may deny, suspend, or
4revoke a permit to establish a hospital or deny, suspend, or
5revoke a license to open, conduct, operate, and maintain a
6hospital in any case in which he finds that there has been a
7substantial failure to comply with the provisions of this Act,
8the Hospital Report Card Act, or the Illinois Adverse Health
9Care Events Reporting Law of 2005, or Section 67 of the Medical
10Practice Act of 1987 or the standards, rules, and regulations
11established by virtue of any of those Acts. The Department may
12impose fines on hospitals, not to exceed $500 per occurrence,
13for failing to (1) initiate a criminal background check on a
14patient that meets the criteria for hospital-initiated
15background checks or (2) report the death of a person known to
16be a resident of a facility licensed under the ID/DD Community
17Care Act or the MC/DD Act to the coroner or medical examiner
18within 24 hours as required by Section 6.09a of this Act. In
19assessing whether to impose such a fine for failure to
20initiate a criminal background check, the Department shall
21consider various factors including, but not limited to,
22whether the hospital has engaged in a pattern or practice of
23failing to initiate criminal background checks. Money from
24fines shall be deposited into the Long Term Care Provider



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1    (a-5) If a hospital demonstrates a pattern or practice of
2failing to substantially comply with the requirements of
3Section 10.10 or the hospital's written staffing plan, the
4hospital shall provide a plan of correction to the Department
5within 60 days. The Department may impose fines as follows:
6(i) if a hospital fails to implement a written staffing plan
7for nursing services, a fine not to exceed $500 per occurrence
8may be imposed; (ii) if a hospital demonstrates a pattern or
9practice of failing to substantially comply with a plan of
10correction within 60 days after the plan takes effect, a fine
11not to exceed $500 per occurrence may be imposed; and (iii) if
12a hospital demonstrates for a second or subsequent time a
13pattern or practice of failing to substantially comply with a
14plan of correction within 60 days after the plan takes effect,
15a fine not to exceed $1,000 per occurrence may be imposed.
16Reports of violations of Section 10.10 shall be subject to
17public disclosure under Section 6.14a. Money from fines within
18this subsection (a-5) shall be deposited into the Hospital
19Licensure Fund, and money from fines for violations of Section
2010.10 shall be used for scholarships under the Nursing
21Education Scholarship Law.
22    (b) Such notice shall be effected by registered mail or by
23personal service setting forth the particular reasons for the
24proposed action and fixing a date, not less than 15 days from
25the date of such mailing or service, at which time the
26applicant or licensee shall be given an opportunity for a



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1hearing. Such hearing shall be conducted by the Director or by
2an employee of the Department designated in writing by the
3Director as Hearing Officer to conduct the hearing. On the
4basis of any such hearing, or upon default of the applicant or
5licensee, the Director shall make a determination specifying
6his findings and conclusions. In case of a denial to an
7applicant of a permit to establish a hospital, such
8determination shall specify the subsection of Section 6 under
9which the permit was denied and shall contain findings of fact
10forming the basis of such denial. A copy of such determination
11shall be sent by registered mail or served personally upon the
12applicant or licensee. The decision denying, suspending, or
13revoking a permit or a license shall become final 35 days after
14it is so mailed or served, unless the applicant or licensee,
15within such 35 day period, petitions for review pursuant to
16Section 13.
17    (c) The procedure governing hearings authorized by this
18Section shall be in accordance with rules promulgated by the
19Department and approved by the Hospital Licensing Board. A
20full and complete record shall be kept of all proceedings,
21including the notice of hearing, complaint, and all other
22documents in the nature of pleadings, written motions filed in
23the proceedings, and the report and orders of the Director and
24Hearing Officer. All testimony shall be reported but need not
25be transcribed unless the decision is appealed pursuant to
26Section 13. A copy or copies of the transcript may be obtained



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1by any interested party on payment of the cost of preparing
2such copy or copies.
3    (d) The Director or Hearing Officer shall upon his own
4motion, or on the written request of any party to the
5proceeding, issue subpoenas requiring the attendance and the
6giving of testimony by witnesses, and subpoenas duces tecum
7requiring the production of books, papers, records, or
8memoranda. All subpoenas and subpoenas duces tecum issued
9under the terms of this Act may be served by any person of full
10age. The fees of witnesses for attendance and travel shall be
11the same as the fees of witnesses before the Circuit Court of
12this State, such fees to be paid when the witness is excused
13from further attendance. When the witness is subpoenaed at the
14instance of the Director, or Hearing Officer, such fees shall
15be paid in the same manner as other expenses of the Department,
16and when the witness is subpoenaed at the instance of any other
17party to any such proceeding the Department may require that
18the cost of service of the subpoena or subpoena duces tecum and
19the fee of the witness be borne by the party at whose instance
20the witness is summoned. In such case, the Department in its
21discretion, may require a deposit to cover the cost of such
22service and witness fees. A subpoena or subpoena duces tecum
23issued as aforesaid shall be served in the same manner as a
24subpoena issued out of a court.
25    (e) Any Circuit Court of this State upon the application
26of the Director, or upon the application of any other party to



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1the proceeding, may, in its discretion, compel the attendance
2of witnesses, the production of books, papers, records, or
3memoranda and the giving of testimony before the Director or
4Hearing Officer conducting an investigation or holding a
5hearing authorized by this Act, by an attachment for contempt,
6or otherwise, in the same manner as production of evidence may
7be compelled before the court.
8    (f) The Director or Hearing Officer, or any party in an
9investigation or hearing before the Department, may cause the
10depositions of witnesses within the State to be taken in the
11manner prescribed by law for like depositions in civil actions
12in courts of this State, and to that end compel the attendance
13of witnesses and the production of books, papers, records, or
15(Source: P.A. 102-641, eff. 8-27-21.)
16    Section 20. The Medical Practice Act of 1987 is amended by
17adding Section 67 as follows:
18    (225 ILCS 60/67 new)
19    Sec. 67. Prohibition on sex-reassignment procedures.
20    (a) As used in this Section:
21    "Sex" means the classification of a person as either male
22or female based on the organization of the human body of such
23person for a specific reproductive role, as indicated by the
24person's sex chromosomes, naturally occurring sex hormones,



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1and internal and external genitalia present at birth.
2    "Sex-reassignment procedures" means any medical procedure,
3including a surgical procedure, to affirm a person's
4perception of his or her sex if that perception is
5inconsistent with the person's sex.
6    "Sex-reassignment procedures" does not include:
7        (1) treatment provided by a physician who, in his or
8    her good faith clinical judgment, performs procedures upon
9    or provides therapies to a minor born with a medically
10    verifiable genetic disorder of sexual development,
11    including any of the following:
12            (A) external biological sex characteristics that
13        are unresolvably ambiguous; and
14            (B) a disorder of sexual development in which the
15        physician has determined through genetic or
16        biochemical testing that the patient does not have a
17        normal sex chromosome structure, sex steroid hormone
18        production, or sex steroid hormone action for a male
19        or female, as applicable;
20        (2) procedures to treat an infection, an injury, a
21    disease, or a disorder that has been caused or exacerbated
22    by the performance of any sex-reassignment procedure,
23    regardless of whether such procedure was performed in
24    accordance with state or federal law; and
25        (3) procedures provided to a patient for the treatment
26    of a physical disorder, physical injury, or physical



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1    illness that would, as certified by a licensed physician,
2    place the individual in imminent danger of death or
3    impairment of a major bodily function without the
4    procedure.
5    (b) Sex-reassignment procedures are prohibited for
6patients younger than 18 years of age.
7    (c) If sex-reassignment procedures are prescribed for or
8administered or performed on patients 18 years of age or
9older, consent must be voluntary, informed, and in writing on
10forms adopted by rule of the Department. Consent to
11sex-reassignment procedures is voluntary and informed only if
12the physician who is to prescribe or administer the
13pharmaceutical product or perform the procedure has, at a
14minimum, while physically present in the same room:
15        (1) informed the patient of the nature and risks of
16    the procedure in order for the patient to make a prudent
17    decision;
18        (2) provided the informed consent form, as adopted in
19    rule by the Department, to the patient; and
20        (3) received the patient's written acknowledgment,
21    before the procedure is administered or performed, that
22    the information required to be provided under this
23    subsection has been provided.
24    (c) Sex-reassignment procedures may not be administered or
25performed except by a physician.
26    (d) The Department shall revoke the license of any



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1physician who willfully or actively participates in a
2violation of subsection (b).
3    (e) The Department shall adopt emergency rules to
4implement this Section.