State of Illinois
91st General Assembly

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 1        AN  ACT to create the Certified Surgical Technologist and
 2    Certified  Surgical  Technologist/Certified  First  Assistant
 3    Practice Act and to amend the Regulatory Sunset Act.

 4        Be it enacted by the People of  the  State  of  Illinois,
 5    represented in the General Assembly:

 6        Section  1.   Short  title.  This Act may be cited as the
 7    Certified  Surgical  Technologist  and   Certified   Surgical
 8    Technologist/Certified First Assistant Practice Act.

 9        Section  5.  Legislative  purpose.   The  practice  as  a
10    certified  surgical  technologist and as a certified surgical
11    technologist/certified first assistant is declared to  affect
12    the  public  health, safety, and welfare and to be subject to
13    regulation and control in the public interest.   The  purpose
14    of  this  Act  is to encourage and promote the more effective
15    utilization of the skills of operating physicians by enabling
16    them to delegate certain surgery-related tasks  to  certified
17    surgical     technologists     and     certified     surgical
18    technologist/certified  first  assistants  to  the extent the
19    delegations are consistent with the health and welfare of the
20    patient and are conducted at the direction of and  under  the
21    supervision of the operating physician.
22        It  is  further  declared to be a matter of public health
23    and  concern  that  the  practice  as  a  certified  surgical
24    technologist and  certified  surgical  technologist/certified
25    first  assistant  merit  and  receive  the  confidence of the
26    public and that  only  qualified  persons  be  authorized  to
27    practice  as  certified  surgical technologists and certified
28    surgical  technologist/certified  first  assistants  in  this
29    State. This Act shall be liberally construed  to  best  carry
30    out these objectives and purposes.
                            -2-                LRB9101986ACdv
 1        Section 10. Definitions. As used in this Act:
 2        "Board"  means  the Medical Licensing Board created under
 3    the Medical Practice Act of 1987.
 4        "Certified surgical technologist" or "CST" means a person
 5    who is not a physician licensed to practice medicine  in  all
 6    of  its  branches and who is certified by the Liaison Council
 7    on Certification for the Surgical Technologist  (LCC-ST)  and
 8    licensed  under this Act to facilitate the safe and effective
 9    conduct of  invasive  surgical  procedures.  This  individual
10    works  under  the supervision of a surgeon to ensure that the
11    operating room or environment is  safe,  that  the  equipment
12    functions  properly,  and  that  the  operative  procedure is
13    conducted under conditions that maximize  patient  safety.  A
14    "certified  surgical technologist" possesses expertise in the
15    theory and application of sterile and aseptic  technique  and
16    combines the knowledge of human anatomy, surgical procedures,
17    and  implementation  tools  and  technologies to facilitate a
18    physician's   performance   of   invasive   therapeutic   and
19    diagnostic procedures.
20        "Certified    surgical    technologist/certified    first
21    assistant" or "CST/CFA" means a person who is not a physician
22    licensed to practice medicine in all of its branches and  who
23    is  certified by the Liaison Council on Certification for the
24    Surgical Technologist (LCC-ST)  and is  licensed  under  this
25    Act  to  provide  aid  to  operating  physicians in exposure,
26    hemostasis, and other technical functions that will  help  an
27    operating  physician  perform  a  safe operation with optimal
28    results  for  the  patient.  In   addition,   the   "CST/CFA"
29    demonstrates  the  principles  of  safe  positioning  of  the
30    surgical  patient,  provides  visualization  of the operative
31    site during the operative procedure, demonstrates the  proper
32    techniques  to  assist  the  surgeon in providing hemostasis,
33    demonstrates the appropriate techniques to  assist  with  the
34    closure  of body planes, expedites the operative procedure by
                            -3-                LRB9101986ACdv
 1    anticipating the needs of the surgeon, demonstrates  advanced
 2    knowledge  of normal and pathological anatomy and physiology,
 3    and demonstrates knowledge of emergency situations.
 4        "Department"  means  the   Department   of   Professional
 5    Regulation.
 6        "Director" means the Director of Professional Regulation.
 7        "Direct supervision" means the supervision of a certified
 8    surgical  assistant  by  an  operating physician and requires
 9    that the operating physician authorize the procedure,  remain
10    in the facility while the procedure is performed, and approve
11    the  work  performed, but does not require that the operating
12    physician be present with the patient during the procedure.
13        "Disciplinary Board" means  the  Illinois  State  Medical
14    Disciplinary Board.
15        "Operating physician" means a person licensed to practice
16    medicine  in  all  of its branches under the Medical Practice
17    Act of 1987.

18        Section 15.  Application of Act.  This Act shall  not  be
19    construed to prohibit the any of the following:
20             (1)  A person licensed in this State under any other
21        Act  from engaging in the practice for which he or she is
22        licensed,  including  without  limitation   a   physician
23        assistant   or  nurse  performing  surgery-related  tasks
24        within the scope of his or her license.
25             (2)  A person from engaging in the practice as a CST
26        or CST/CFA in the discharge of his or her official duties
27        as an employee of the United States government.
28             (3)  One or more  licensed  CSTs  or  CST/CFAs  from
29        forming  a professional service corporation in accordance
30        with  the  Professional  Service  Corporation   Act   and
31        applying   for   licensure  as  a  corporation  providing
32        certified surgical assistant services.
33             (4)  A  student  engaging  in  the  practice  as   a
                            -4-                LRB9101986ACdv
 1        surgical  technologist  or surgical first assistant under
 2        the  direct  supervision  of  a  physician  licensed   to
 3        practice  medicine  in all of its branches as part of his
 4        or her program of study  at  a  school  approved  by  the
 5        Department   or   in   preparation  to  qualify  for  the
 6        examination as prescribed under Section 50 of this Act.
 7             (5)  A  person  from  assisting  in  surgery  at  an
 8        operating physician's discretion.

 9        Section 20.  Powers and duties of  the  Department.   The
10    Department shall exercise the powers and duties prescribed by
11    the   Civil   Administrative   Code   of   Illinois  for  the
12    administration of licensing Acts and shall exercise any other
13    powers and duties necessary for effectuating the purposes  of
14    this Act.
15        The  Department  may  adopt  rules  consistent  with  the
16    provisions of this Act for its administration and enforcement
17    and  may  prescribe  forms that shall be issued in connection
18    with this Act.  The rules may include, but  are  not  limited
19    to,   standards  and  criteria  for  licensure,  professional
20    conduct, and discipline.

21        Section 25.  Illinois Administrative Procedure Act.   The
22    Illinois  Administrative  Procedure  Act is expressly adopted
23    and incorporated in this Act as if all of the  provisions  of
24    that Act were included in this Act.  For the purposes of this
25    Act,  the notice required under Section 10-25 of the Illinois
26    Administrative Procedure Act is deemed sufficient when mailed
27    to the last known address of a party.

28        Section  30.   Role  of  Medical  Licensing  Board.   All
29    matters relating to CSTs and CST/CFAs shall  be  referred  to
30    the Medical Licensing Board, which shall make recommendations
31    to the Director.
                            -5-                LRB9101986ACdv
 1        Section  35.   Licensure  requirement.   No  person shall
 2    engage in the practice as a CST or CST/CFA or hold himself or
 3    herself out as a CST or  CST/CFA  in  this  State  without  a
 4    license issued by the Department under this Act.

 5        Section  40.   Scope of practice.  A CST or CST/CFA shall
 6    be  allowed  to  assist  the  operating  physician   in   the
 7    performance  of any surgical procedure when working under the
 8    operating physician's direction. However, nothing in this Act
 9    shall be construed to allow CSTs or  CST/CFAs  to  administer
10    any type of medication.

11        Section 45.  Application for license.  An application for
12    an initial license shall be made to the Department in writing
13    on   forms   prescribed   by  the  Department  and  shall  be
14    accompanied  by   the   required   nonrefundable   fee.    An
15    application  shall  require information that, in the judgment
16    of the Department, will enable the Department to evaluate the
17    qualifications of an applicant for licensure.
18        If an applicant fails to obtain a license under this  Act
19    within  3  years  after  filing  his  or her application, the
20    application shall be denied. The applicant  may  make  a  new
21    application,  which  shall  be  accompanied  by  the required
22    nonrefundable fee.

23        Section 50.  Qualifications for licensure.
24        (a)  A person shall qualify for a license under this  Act
25    if  he  or she has applied to the Department for licensure in
26    accordance with Section 45 of this Act, has  not  violated  a
27    provision of Section 70, and has done one of the following:
28             (1)  to  be  licensed  as  a  CST,  has successfully
29        completed    the    surgical    technologist     national
30        certification examination provided by the Liaison Council
31        on    Certification   for   the   Surgical   Technologist
                            -6-                LRB9101986ACdv
 1        (LCC-ST)  or  its  successor  agency  and  has  met   the
 2        requirements for certification set forth by the LCC-ST or
 3        its successor agency; or
 4             (2)  to  be  licensed as a CST/CFA, has successfully
 5        completed  the  first  assistant  national  certification
 6        examination  provided   by   the   Liaison   Council   on
 7        Certification  for the Surgical Technologist (LCC-ST)  or
 8        is successor agency and has met the requirements for  its
 9        certification  set  forth  by the LCC-ST or its successor
10        agency.
11        In addition, the Department may take  into  consideration
12    any  felony  conviction  of  the  applicant, but a conviction
13    shall not operate as an absolute bar to licensure.
14        (b)  The Department shall issue a license to a person who
15    has met the qualification requirements of this Section.

16        Section 55.  Licensure by  endorsement.   The  Department
17    may,  in  its  discretion,  license  as  a  CST or CST/CFA an
18    applicant who is licensed as a CST or CST/CFA under the  laws
19    of  another  state,  territory,  or  jurisdiction if (i)  the
20    requirements for licensure in that jurisdiction in which  the
21    applicant  was  licensed  were,  at  the  date  of licensure,
22    substantially equivalent to the requirements then in force in
23    this  State  or  (ii)  the  applicant  possesses   individual
24    qualifications  and  skills  that  demonstrate equivalence to
25    current Illinois requirements.     Applicants  have  3  years
26    from  the  date  of  application  to complete the application
27    process.  If the process has  not  been  completed  within  3
28    years,  the  application  shall  be  denied, the fee shall be
29    forfeited, and  the  applicant  must  reapply  and  meet  the
30    requirements in effect at the time of reapplication.

31        Section 60.  Expiration; restoration; renewal.
32        (a)  The  expiration  date  and  renewal  period for each
                            -7-                LRB9101986ACdv
 1    license issued under this Act shall be set by the  Department
 2    by  rule. Renewal shall be conditioned on paying the required
 3    fee and meeting other requirements as may be  established  by
 4    rule.
 5        (b)  A  CST  or  CST/CFA  who  has  permitted  his or her
 6    license to expire or who  has  had  his  or  her  license  on
 7    inactive  status  may  have  the  license  restored by making
 8    application to the Department, by filing proof acceptable  to
 9    the  Department  of  his  or  her fitness to have the license
10    restored, and by paying the required fees.  Proof of  fitness
11    may  include  sworn  evidence  certifying  to  active  lawful
12    practice  in  another jurisdiction. If the CST or CST/CFA has
13    not maintained an active  practice  in  another  jurisdiction
14    satisfactory   to   the   Department,  the  Department  shall
15    determine, by an evaluation program established by rule,  his
16    or  her  fitness  for  restoration  of  the license and shall
17    establish procedures and requirements for restoration.
18        (c)  A CST or CST/CFA whose license expired while  he  or
19    she  was  (i)  on  active  duty  with the armed forces of the
20    United States, (ii)  called into service of training with the
21    State Militia, or (iii)  in training or education  under  the
22    supervision  of the United States government before induction
23    into the  military  service  may  have  his  or  her  license
24    restored  without paying any lapsed renewal fees if, within 2
25    years after honorable termination of the  service,  training,
26    or  education,  he  or  she  furnishes  the  Department  with
27    satisfactory  evidence that he or she has been so engaged and
28    that his or her service, training, or education has  been  so
29    terminated.

30        Section  65.   Inactive  status.   A  CST  or CST/CFA who
31    notifies the Department in writing on forms prescribed by the
32    Department may elect to place his or her license on  inactive
33    status  and  shall,  subject  to  rules of the Department, be
                            -8-                LRB9101986ACdv
 1    excused from payment of renewal fees until he or she notifies
 2    the Department in writing of his or her intention  to  resume
 3    active status.
 4        A  CST  or  CST/CFA  requesting restoration from inactive
 5    status shall pay the current renewal fee  and  shall  restore
 6    his or her license in accordance with Section 60 of this Act.
 7        A  CST  or  CST/CFA  whose  license is on inactive status
 8    shall not practice as a CST or  CST/CFA  in  this  State.   A
 9    licensee  who  engages  in practice as a CST or CST/CFA while
10    his or her license is lapsed or on inactive status  shall  be
11    considered to be practicing without a license, which shall be
12    grounds for discipline under Section 90 of this Act.

13        Section 70.  Fees; returned checks.
14        (a)  The  Department  shall  set  by  rule  fees  for the
15    administration of this Act, including but not limited to fees
16    for initial  and  renewal  licensure  and  restoration  of  a
17    license.
18        (b)  A  person  who  delivers a check or other payment to
19    the Department that is returned to the Department  unpaid  by
20    the financial institution upon which it is drawn shall pay to
21    the Department, in addition to the amount already owed to the
22    Department, a fine of $50.  If the check or other payment was
23    for  a  renewal  or  issuance  fee  and that person practices
24    without paying the renewal fee or issuance fee and  the  fine
25    due,  an additional fine of $100 shall be imposed.  The fines
26    imposed  by  this  Section  are  in  addition  to  any  other
27    discipline provided under this Act for unlicensed practice or
28    practice on  a  nonrenewed  license.   The  Department  shall
29    notify  the  person  that fees and fines shall be paid to the
30    Department by  certified  check  or  money  order  within  30
31    calendar   days   after  the  notification.   If,  after  the
32    expiration of 30 days from the date of the notification,  the
33    person  has  failed  to  submit the necessary remittance, the
                            -9-                LRB9101986ACdv
 1    Department shall automatically terminate the license or  deny
 2    the  application  without  a  hearing.  If the person seeks a
 3    license after termination or denial, he or she shall apply to
 4    the Department for restoration or issuance of the license and
 5    pay all fees and fines due to the Department.  The Department
 6    may establish a fee for the processing of an application  for
 7    restoration of a license to defray the expenses of processing
 8    the  application.  The Director may waive the fines due under
 9    this Section in individual cases if the Director  finds  that
10    the fines would be unreasonable or unnecessarily burdensome.

11        Section  75.  Supervision requirement.  A person licensed
12    under this Act shall practice as a CST or CST/CFA only  under
13    the direct supervision of an operating physician.

14        Section  80.   Billing patients.   A CST/CFA may directly
15    bill or otherwise charge patients for services rendered.

16        Section 85.  Identification.  No  person  shall  use  the
17    title   or   perform   the   duties  of  "certified  surgical
18    technologist" or "certified  surgical  technologist/certified
19    first  assistant" unless he or she is a qualified holder of a
20    license issued by the Department as provided in this Act.   A
21    CST  or  CST/CFA  shall  wear  on  his  or her person visible
22    identification indicating that he or she is licensed as a CST
23    or CST/CFA while acting in the course of his or her duties.

24        Section 90.  Grounds for disciplinary action.
25        (a)  The  Department  may  refuse  to  issue,  renew,  or
26    restore a license, may revoke or suspend a  license,  or  may
27    place   on  probation,  censure,  reprimand,  or  take  other
28    disciplinary action with regard to a  person  licensed  under
29    this  Act,  including  but  not  limited to the imposition of
30    fines not to exceed $5,000 for each violation for any one  or
                            -10-               LRB9101986ACdv
 1    combination of the following causes:
 2             (1)  Making  a  material  misstatement in furnishing
 3        information to the Department.
 4             (2)  Violating a provision of this Act or its rules.
 5             (3)  Conviction under the laws of  a  United  States
 6        jurisdiction   of   a   crime  that  is  a  felony  or  a
 7        misdemeanor, an essential element of which is dishonesty,
 8        or of a crime that is directly related to the practice as
 9        a CST or CST/CFA.
10             (4)  Making a misrepresentation for the  purpose  of
11        obtaining, renewing, or restoring a license.
12             (5)  Willfully aiding or assisting another person in
13        violating a provision of this Act or its rules.
14             (6)  Failing  to  provide information within 60 days
15        in response to a written request made by the Department.
16             (7)  Engaging   in   dishonorable,   unethical,   or
17        unprofessional conduct of a character likely to  deceive,
18        defraud,  or  harm  the public, as defined by rule of the
19        Department.
20             (8)  Discipline    by    another    United    States
21        jurisdiction or foreign nation, if at least  one  of  the
22        grounds  for  discipline  is  the  same  or substantially
23        equivalent to those set forth in this Section.
24             (9)  Directly or indirectly giving to  or  receiving
25        from   a   person,  firm,  corporation,  partnership,  or
26        association a fee, commission, rebate, or other  form  of
27        compensation  for  professional  services not actually or
28        personally rendered.
29             (10)  A finding by the Disciplinary Board  that  the
30        licensee,  after  having  his  or  her  license placed on
31        probationary status, has violated the terms of probation.
32             (11)  Willfully making or filing  false  records  or
33        reports in his or her practice, including but not limited
34        to false records or reports filed with State agencies.
                            -11-               LRB9101986ACdv
 1             (12)  Willfully making or signing a false statement,
 2        certificate, or affidavit to induce payment.
 3             (13)  Willfully  failing  to  report  an instance of
 4        suspected child abuse or neglect as  required  under  the
 5        Abused and Neglected Child Reporting Act.
 6             (14)  Being  named  as a perpetrator in an indicated
 7        report by the Department of Children and Family  Services
 8        under  the  Abused  and Neglected Child Reporting Act and
 9        upon proof by clear  and  convincing  evidence  that  the
10        licensee  has  caused  a  child  to be an abused child or
11        neglected child as defined in the  Abused  and  Neglected
12        Child Reporting Act.
13             (15)  Employment   of   fraud,   deception,  or  any
14        unlawful means in applying for or securing a license as a
15        CST or CST/CFA.
16             (16)  Allowing another person  to  use  his  or  her
17        license to practice.
18             (17)  Failure   to  report  to  the  Department  any
19        adverse  final  action  taken  against  the  licensee  by
20        another licensing jurisdiction,  government  agency,  law
21        enforcement  agency,  or  court  or liability for conduct
22        that would constitute grounds for action as set forth  in
23        this Section.
24             (18)  Habitual  intoxication or addiction to the use
25        of drugs.
26             (19)  Physical illness, including  but  not  limited
27        to,  deterioration  through  the aging process or loss of
28        motor skills that results in the  inability  to  practice
29        the  profession  for  which  he  or  she is licensed with
30        reasonable judgement, skill, or safety.
31             (20)  Gross  malpractice  resulting   in   permanent
32        injury or death of a patient.
33             (21)  Immoral  conduct  in  the commission of an act
34        related to the licensee's  practice,  including  but  not
                            -12-               LRB9101986ACdv
 1        limited  to  sexual  abuse,  sexual misconduct, or sexual
 2        exploitation.
 3             (22)  Violation   of   the   Health   Care    Worker
 4        Self-Referral Act.
 5        (b)  The  Department  may  refuse to issue or may suspend
 6    the license of a person who fails to file a  tax  return,  to
 7    pay the tax, penalty, or interest shown in a filed return, or
 8    to pay a final assessment of the tax, penalty, or interest as
 9    required  by  a  tax  Act  administered  by the Department of
10    Revenue, until the requirements of the tax Act are satisfied.
11        (c)  The determination by a circuit court that a licensee
12    is subject to involuntary admission or judicial admission  as
13    provided  in the Mental Health and Developmental Disabilities
14    Code operates as an automatic suspension. The suspension will
15    end only upon (i)  a finding by a court that the  patient  is
16    no  longer  subject  to  involuntary  admission  or  judicial
17    admission,   (ii)  issuance   of  an  order  so  finding  and
18    discharging the patient, and (iii)  the recommendation of the
19    Disciplinary Board to  the  Director  that  the  licensee  be
20    allowed to resume his or her practice.

21        Section 95.  Injunctions; cease and desist order.
22        (a)  If  a  person  violates a provision of this Act, the
23    Director, in the name of the People of the State of Illinois,
24    through the Attorney General of the State of Illinois or  the
25    State's  Attorney  of a county in which the violation occurs,
26    may petition for an order enjoining the violation or  for  an
27    order enforcing compliance with this Act.  Upon the filing of
28    a verified petition in court, the court may issue a temporary
29    restraining   order   without   notice   or   bond   and  may
30    preliminarily and permanently enjoin the violation. If it  is
31    established  that  the  licensee has violated or is violating
32    the  injunction,  the  court  may  punish  the  offender  for
33    contempt of court.  Proceedings under this Section  shall  be
                            -13-               LRB9101986ACdv
 1    in  addition  to,  and not in lieu of, all other remedies and
 2    penalties provided by this Act.
 3        (b)  If a person practices or holds  himself  or  herself
 4    out  as  a  CST  or CST/CFA without being licensed under this
 5    Act, then any licensed CST or CST/CFA, interested  party,  or
 6    person  injured  thereby,  in  addition  to  the  Director or
 7    State's Attorney, may petition  for  relief  as  provided  in
 8    subsection (a)  of this Section.
 9        (c)  If  the Department determines that a person violated
10    a provision of this Act, the Department may issue a  rule  to
11    show  cause  why  an  order to cease and desist should not be
12    entered against him or her.  The rule shall clearly set forth
13    the grounds relied upon by the Department and shall provide a
14    period of 7 days after the date of the rule to file an answer
15    to the satisfaction of the Department.  Failure to answer  to
16    the  satisfaction  of  the Department shall cause an order to
17    cease and desist to be issued immediately.

18        Section 100. Investigation; notice;  hearing.    Licenses
19    may  be refused, revoked, suspended, or otherwise disciplined
20    in the manner provided by this Act and  not  otherwise.   The
21    Department  may  upon  its  own  motion  and  shall  upon the
22    verified complaint in writing of  any  person  setting  forth
23    facts  that if proven would constitute grounds for refusal to
24    issue  or  for  suspension  or  revocation  under  this  Act,
25    investigate the actions of a person applying for, holding, or
26    claiming to hold a license.   The  Department  shall,  before
27    refusing to issue or renew, suspending, or revoking a license
28    or  taking  other  discipline  pursuant to Section 90 of this
29    Act, at least 30 days prior to the date set for the  hearing,
30    (i)  notify  in  writing  the  applicant  or  licensee of any
31    charges made, (ii)  direct the applicant or licensee to  file
32    a  written answer to the Department under oath within 20 days
33    after the  service  of  the  notice,  and  (iii)  inform  the
                            -14-               LRB9101986ACdv
 1    applicant  or  licensee  that  failure to file an answer will
 2    result in  default  being  taken  against  the  applicant  or
 3    licensee  and  that  the  license  may be suspended, revoked,
 4    placed on probationary status, or other  disciplinary  action
 5    may be taken, including limiting the scope, nature, or extent
 6    of practice, as the Director may deem proper.  Written notice
 7    may  be  served  by  personal  delivery  to  the applicant or
 8    licensee or by mailing the notice by certified mail to his or
 9    her last known place of residence or to the place of business
10    last specified by the applicant or licensee  in  his  or  her
11    last  notification to the Department.  If the person fails to
12    file an answer after receiving notice,  his  or  her  license
13    may,  in  the  discretion  of  the  Department, be suspended,
14    revoked, or placed on probationary status or  the  Department
15    may   take   whatever   disciplinary  action  deemed  proper,
16    including limiting  the  scope,  nature,  or  extent  of  the
17    person's  practice  or  the  imposition  of  a fine without a
18    hearing if the act  or  acts  charged  constitute  sufficient
19    grounds  for  such  action  under  this Act.  At the time and
20    place fixed in the notice, the Department  shall  proceed  to
21    hearing of the charges and both the applicant or licensee and
22    the  complainant  shall  be  afforded  ample  opportunity  to
23    present,  in person or by counsel, any statements, testimony,
24    evidence, and arguments that may be pertinent to the  charges
25    or  to  their defense.  The Department may continue a hearing
26    from time to time.  If the Board is not sitting at  the  time
27    and  place  fixed  in  the notice or at the time and place to
28    which the hearing shall have been continued,  the  Department
29    may continue the hearing for a period not to exceed 30 days.

30        Section  105.  Record of proceedings.  The Department, at
31    its expense, shall preserve a record of all proceedings at  a
32    formal hearing conducted pursuant to Section 100.  The notice
33    of  hearing,  complaint, all other documents in the nature of
                            -15-               LRB9101986ACdv
 1    pleadings and written motions filed in the  proceedings,  the
 2    transcript of testimony, the report of the Disciplinary Board
 3    or hearing officer, and orders of the Department shall be the
 4    record  of  the  proceeding.   The  Department shall supply a
 5    transcript of the record to  any  person  interested  in  the
 6    hearing upon payment of the fee required under Section 60f of
 7    the Civil Administrative Code of Illinois.

 8        Section  110.   Witnesses;  production  of  documents.  A
 9    circuit court, upon application  of  the  Department  or  its
10    designee,  applicant,  or  licensee  against whom proceedings
11    pursuant to Section 100 of this Act  are  pending,  enter  an
12    order   requiring  the  attendance  of  witnesses  and  their
13    testimony and the production  of  documents,  papers,  files,
14    books,   and   records   in  connection  with  a  hearing  or
15    investigation authorized by this Act. The  court  may  compel
16    obedience to its order through contempt proceedings.

17        Section  115.   Subpoena  power.   The Department has the
18    power to subpoena and bring before  it  any  person  in  this
19    State  and  to  take testimony, orally or by deposition, with
20    the  same  fees  and  mileage  and  in  the  same  manner  as
21    prescribed by law in judicial proceedings in civil  cases  in
22    circuit   courts   of   this  State.  The  Director  and  any
23    Disciplinary Board member designated by  the  Director  shall
24    each  have  the  authority to administer, at any hearing that
25    the Department is authorized to conduct under this Act, oaths
26    to  witnesses  and  any  other   oaths   authorized   to   be
27    administered by the Department under this Act.

28        Section  120.   Board  report.   At the conclusion of the
29    hearing, the Disciplinary Board shall present to the Director
30    a written report of its findings of fact, conclusions of law,
31    and recommendations. In the report,  the  Disciplinary  Board
                            -16-               LRB9101986ACdv
 1    shall  make  a finding of whether or not the charged licensee
 2    or applicant has violated a provision  of  this  Act  or  its
 3    rules  and  shall  specify  the  nature of the violation.  In
 4    making its recommendations for discipline,  the  Disciplinary
 5    Board may take into consideration all facts and circumstances
 6    bearing  upon  the  reasonableness  of  the  conduct  of  the
 7    respondent  and  the potential for future harm to the public,
 8    including but not limited  to  previous  discipline  of  that
 9    respondent  by  the Department, intent, degree of harm to the
10    public, likelihood of harm in  the  future,  any  restitution
11    made,  and  whether  the  incident or incidents complained of
12    appear to be isolated or a pattern of conduct.  In making its
13    recommendations for discipline, the Disciplinary Board  shall
14    seek   to   ensure   that  the  severity  of  the  discipline
15    recommended  bears  some  reasonable  relationship   to   the
16    severity of the violation.

17        Section  125.  Motion for rehearing.  In a case involving
18    the refusal to issue or renew a license or the discipline  of
19    a  licensee,  a copy of the Disciplinary Board's report shall
20    be served upon  the  respondent  by  the  Department,  either
21    personally  or  as provided under Section 100 of this Act for
22    the service of the notice of hearing.  Within 20  days  after
23    service,  the  respondent  may  present  to  the Department a
24    motion in writing for a rehearing, which  shall  specify  the
25    particular  grounds  for  a  rehearing.   If  no  motion  for
26    rehearing  is  filed,  then  upon  the expiration of the time
27    specified for filing the motion, or if a motion for rehearing
28    is denied, then upon the denial the  Director  may  enter  an
29    order  in accordance with recommendations of the Disciplinary
30    Board except as provided in Section 130 or 135 of  this  Act.
31    If  the respondent orders a transcript of the record from the
32    reporting service and pays for the transcript within the time
33    for filing a motion for rehearing, the 20-day  period  within
                            -17-               LRB9101986ACdv
 1    which  such  a  motion  may  be filed shall commence upon the
 2    delivery of the transcript to the respondent.

 3        Section 130.  Director's order.
 4        (a)  The Director shall issue  an  order  concerning  the
 5    disposition  of  the  charges (i) following the expiration of
 6    the filing period granted under Section 125 if no motion  for
 7    rehearing  is  filed  or (ii)  following a denial of a timely
 8    motion for rehearing.
 9        (b)  The  Director's  order  shall  be   based   on   the
10    recommendations  contained in the Disciplinary Board's report
11    unless, after giving due consideration  to  the  Disciplinary
12    Board's report, the Director disagrees in any regard with the
13    report of the Disciplinary Board, in which case he or she may
14    issue  an  order in contravention of the report. The Director
15    shall provide a written report to the Disciplinary  Board  on
16    any  deviation from the Board's report and shall specify with
17    particularity the reasons for his or  her  deviation  in  the
18    final  order.  The Disciplinary Board's report and Director's
19    order are not admissible as evidence against the person in  a
20    criminal prosecution brought for a violation of this Act, but
21    the  hearing,  report,  and order are not a bar to a criminal
22    prosecution brought for the violation of this Act.

23        Section  135.   Hearing  officer.   Notwithstanding   the
24    provisions  of  Section  100  of this Act, the Director shall
25    have  the  authority  to  appoint  an  attorney  licensed  to
26    practice law in this State to serve as the hearing officer in
27    a hearing authorized under Section 100.  The  Director  shall
28    notify  the  Disciplinary  Board  of  the  appointment.   The
29    hearing  officer  shall  have  full  authority to conduct the
30    hearing.  The Disciplinary Board has the  right  to  have  at
31    least  one member present at a hearing conducted by a hearing
32    officer appointed under this Section.   The  hearing  officer
                            -18-               LRB9101986ACdv
 1    shall report his or her findings of fact, conclusions of law,
 2    and   recommendations  to  the  Disciplinary  Board  and  the
 3    Director.  The Disciplinary Board shall have  60  days  after
 4    receipt  of  the  report  to review the report of the hearing
 5    officer and to present its findings of fact,  conclusions  of
 6    law,   and   recommendations   to   the   Director.   If  the
 7    Disciplinary Board fails to present  its  report  within  the
 8    60-day period, the Director shall issue an order based on the
 9    report  of the hearing officer.  If the Director disagrees in
10    any regard with the  report  of  the  Disciplinary  Board  or
11    hearing   officer,   he   or   she  may  issue  an  order  in
12    contravention of the report.  The Director  shall  provide  a
13    written  explanation to the Disciplinary Board of a deviation
14    from the Disciplinary Board's report and shall  specify  with
15    particularity  the  reasons  for  his or her deviation in the
16    final order.

17        Section 140.  Rehearing on order of  Director.   Whenever
18    the  Director  is  not satisfied that substantial justice has
19    been achieved in the discipline of a licensee,  the  Director
20    may  order a rehearing by the same or another hearing officer
21    or by the Disciplinary Board.

22        Section 145.  Order; prima facie proof.  An  order  or  a
23    certified  copy  of an order, over the seal of the Department
24    and purporting to be signed by the Director, shall  be  prima
25    facie proof that:
26             (1)  the  signature  is the genuine signature of the
27        Director;
28             (2)  the Director is duly appointed  and  qualified;
29        and
30             (3)  the  Disciplinary  Board  and  its  members are
31        qualified to act.
                            -19-               LRB9101986ACdv
 1        Section 150.  Restoration of license.  At any time  after
 2    the suspension or revocation of a license, the Department may
 3    restore it to the licensee unless, after an investigation and
 4    a  hearing, the Department determines that restoration is not
 5    in the public interest.  Where circumstances of suspension or
 6    revocation so indicate,  or  on  the  recommendation  of  the
 7    Disciplinary Board, the Department may require an examination
 8    of the licensee before restoring his or her license.

 9        Section  155.  Surrender of license.  Upon the revocation
10    or suspension of a license, the  licensee  shall  immediately
11    surrender  the  license  to  the Department.  If the licensee
12    fails to do so, the Department shall have the right to  seize
13    the license.

14        Section  160.   Temporary  suspension.   The Director may
15    temporarily suspend the license of a CST or CST/CFA without a
16    hearing, simultaneously with the institution  of  proceedings
17    for a hearing provided for in Section 100 of this Act, if the
18    Director  finds  that  evidence  in  his  or  her  possession
19    indicates  that  continuation in practice would constitute an
20    imminent danger to the public.  If the  Director  temporarily
21    suspends  a  license  without  a  hearing,  a  hearing by the
22    Department shall be held within 30 days after the  suspension
23    has  occurred  and  shall  be  concluded  without appreciable
24    delay.

25        Section 165.   Certificate  of  record.   The  Department
26    shall  not  be  required  to certify any record to a court or
27    file an answer in court or otherwise appear in a court  in  a
28    judicial  review  proceeding  unless  there  is  filed in the
29    court, with the complaint,  a  receipt  from  the  Department
30    acknowledging   payment   of  the  costs  of  furnishing  and
31    certifying the record.  Failure on the part of the  plaintiff
                            -20-               LRB9101986ACdv
 1    to  file a receipt in court shall be grounds for dismissal of
 2    the action.

 3        Section  170.   Administrative  Review  Law.   All  final
 4    administrative decisions of the  Department  are  subject  to
 5    judicial  review  under the Administrative Review Law and its
 6    rules. The term "administrative decision" is  defined  as  in
 7    Section 3-101 of the Code of Civil Procedure.
 8        Proceedings for judicial review shall be commenced in the
 9    circuit court of the county in which the party seeking review
10    resides.  If  the  party  seeking review is not a resident of
11    this State, venue shall be in Sangamon County.

12        Section 175.  Criminal penalties.  A person who is  found
13    to  have  knowingly  violated Sections 35 or 75 or subsection
14    (a)  of Section 180 of this  Act  is  guilty  of  a  Class  A
15    misdemeanor  for  a  first offense and is guilty of a Class 4
16    felony for a second or subsequent offense.

17        Section 180.  Unlicensed practice; civil penalties.
18        (a)  No person shall practice, offer to practice, attempt
19    to practice, or hold himself or herself out to practice as  a
20    CST  or CST/CFA without a license issued by the Department to
21    that person under this Act.
22        (b)  In addition to any other penalty provided by law,  a
23    person who violates subsection (a)  of this Section shall pay
24    a  civil penalty to the Department in an amount not to exceed
25    $5,000 for each offense, as  determined  by  the  Department.
26    The civil penalty shall be assessed by the Department after a
27    hearing  is  held in accordance with the provisions set forth
28    in this Act regarding a  hearing  for  the  discipline  of  a
29    licensee.
30        (c)  The  Department  has  the  authority  and  power  to
31    investigate any and all unlicensed activity.
                            -21-               LRB9101986ACdv
 1        (d)  The  civil  penalty assessed under this Act shall be
 2    paid within 60 days after the effective  date  of  the  order
 3    imposing  the  civil  penalty.   The order shall constitute a
 4    judgment and may be filed and execution had on  the  judgment
 5    in the same manner as a judgment from a court of record.

 6        Section 170.  Deposit of moneys.  All moneys collected by
 7    the  Department  under  this  Act shall be deposited into the
 8    Illinois  State  Medical  Disciplinary  Fund  in  the   State
 9    Treasury and shall be used for the following purposes:
10             (1)  by  the  Illinois  State  Medical  Disciplinary
11        Board  in  the exercise of its powers and the performance
12        of its duties under this Act;
13             (2)  for costs  directly  related  to  licensing  of
14        persons under this Act; and
15             (3)  for  costs  incurred  by  the Medical Licensing
16        Board in the exercise of its powers and  the  performance
17        of its duties under this Act.

18        Section  175.   Home  rule  powers.   The  regulation and
19    licensing of CSTs  and  CST/CFAs  are  exclusive  powers  and
20    functions  of the State.  A home rule unit shall not regulate
21    or license CSTs and CST/CFAs. This Section  is  a  limitation
22    under  subsection  (h)  of  Section  6  of Article VII of the
23    Illinois Constitution.

24        Section 950. The Regulatory  Sunset  Act  is  amended  by
25    adding Section 4.20 as follows:

26        (5 ILCS 80/4.20 new)
27        Sec. 4.20. Act repealed on January 1, 2010. The following
28    Act is repealed on January 1, 2010:
29        The   Certified   Surgical   Technologist  and  Certified
30    Surgical Technologist/Certified First Assistant Practice Act.
                            -22-               LRB9101986ACdv

 2        Section  999.  Effective  date.  This  Act  takes  effect
 3    January 1, 2000.

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