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Public Act 102-0641


 

Public Act 0641 102ND GENERAL ASSEMBLY

  
  
  

 


 
Public Act 102-0641
 
SB2153 EnrolledLRB102 11387 HLH 16720 b

    AN ACT concerning nursing.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
ARTICLE 1. NURSE STAFFING IMPROVEMENT ACT

 
    Section 1-1. This Article may be referred to as the Nurse
Staffing Improvement Act.
 
    Section 1-5. The Hospital Licensing Act is amended by
changing Sections 7, 10.10, and 14.5 as follows:
 
    (210 ILCS 85/7)  (from Ch. 111 1/2, par. 148)
    Sec. 7. (a) The Director after notice and opportunity for
hearing to the applicant or licensee may deny, suspend, or
revoke a permit to establish a hospital or deny, suspend, or
revoke a license to open, conduct, operate, and maintain a
hospital in any case in which he finds that there has been a
substantial failure to comply with the provisions of this Act,
the Hospital Report Card Act, or the Illinois Adverse Health
Care Events Reporting Law of 2005 or the standards, rules, and
regulations established by virtue of any of those Acts. The
Department may impose fines on hospitals, not to exceed $500
per occurrence, for failing to (1) initiate a criminal
background check on a patient that meets the criteria for
hospital-initiated background checks or (2) report the death
of a person known to be a resident of a facility licensed under
the ID/DD Community Care Act or the MC/DD Act to the coroner or
medical examiner within 24 hours as required by Section 6.09a
of this Act. In assessing whether to impose such a fine for
failure to initiate a criminal background check, the
Department shall consider various factors including, but not
limited to, whether the hospital has engaged in a pattern or
practice of failing to initiate criminal background checks.
Money from fines shall be deposited into the Long Term Care
Provider Fund.
    (a-5) If a hospital demonstrates a pattern or practice of
failing to substantially comply with the requirements of
Section 10.10 or the hospital's written staffing plan, the
hospital shall provide a plan of correction to the Department
within 60 days. The Department may impose fines as follows:
(i) if a hospital fails to implement a written staffing plan
for nursing services, a fine not to exceed $500 per occurrence
may be imposed; (ii) if a hospital demonstrates a pattern or
practice of failing to substantially comply with a plan of
correction within 60 days after the plan takes effect, a fine
not to exceed $500 per occurrence may be imposed; and (iii) if
a hospital demonstrates for a second or subsequent time a
pattern or practice of failing to substantially comply with a
plan of correction within 60 days after the plan takes effect,
a fine not to exceed $1,000 per occurrence may be imposed.
Reports of violations of Section 10.10 shall be subject to
public disclosure under Section 6.14a. Money from fines within
this subsection (a-5) shall be deposited into the Hospital
Licensure Fund, and money from fines for violations of Section
10.10 shall be used for scholarships under the Nursing
Education Scholarship Law.
    (b) Such notice shall be effected by registered mail or by
personal service setting forth the particular reasons for the
proposed action and fixing a date, not less than 15 days from
the date of such mailing or service, at which time the
applicant or licensee shall be given an opportunity for a
hearing. Such hearing shall be conducted by the Director or by
an employee of the Department designated in writing by the
Director as Hearing Officer to conduct the hearing. On the
basis of any such hearing, or upon default of the applicant or
licensee, the Director shall make a determination specifying
his findings and conclusions. In case of a denial to an
applicant of a permit to establish a hospital, such
determination shall specify the subsection of Section 6 under
which the permit was denied and shall contain findings of fact
forming the basis of such denial. A copy of such determination
shall be sent by registered mail or served personally upon the
applicant or licensee. The decision denying, suspending, or
revoking a permit or a license shall become final 35 days after
it is so mailed or served, unless the applicant or licensee,
within such 35 day period, petitions for review pursuant to
Section 13.
    (c) The procedure governing hearings authorized by this
Section shall be in accordance with rules promulgated by the
Department and approved by the Hospital Licensing Board. A
full and complete record shall be kept of all proceedings,
including the notice of hearing, complaint, and all other
documents in the nature of pleadings, written motions filed in
the proceedings, and the report and orders of the Director and
Hearing Officer. All testimony shall be reported but need not
be transcribed unless the decision is appealed pursuant to
Section 13. A copy or copies of the transcript may be obtained
by any interested party on payment of the cost of preparing
such copy or copies.
    (d) The Director or Hearing Officer shall upon his own
motion, or on the written request of any party to the
proceeding, issue subpoenas requiring the attendance and the
giving of testimony by witnesses, and subpoenas duces tecum
requiring the production of books, papers, records, or
memoranda. All subpoenas and subpoenas duces tecum issued
under the terms of this Act may be served by any person of full
age. The fees of witnesses for attendance and travel shall be
the same as the fees of witnesses before the Circuit Court of
this State, such fees to be paid when the witness is excused
from further attendance. When the witness is subpoenaed at the
instance of the Director, or Hearing Officer, such fees shall
be paid in the same manner as other expenses of the Department,
and when the witness is subpoenaed at the instance of any other
party to any such proceeding the Department may require that
the cost of service of the subpoena or subpoena duces tecum and
the fee of the witness be borne by the party at whose instance
the witness is summoned. In such case, the Department in its
discretion, may require a deposit to cover the cost of such
service and witness fees. A subpoena or subpoena duces tecum
issued as aforesaid shall be served in the same manner as a
subpoena issued out of a court.
    (e) Any Circuit Court of this State upon the application
of the Director, or upon the application of any other party to
the proceeding, may, in its discretion, compel the attendance
of witnesses, the production of books, papers, records, or
memoranda and the giving of testimony before the Director or
Hearing Officer conducting an investigation or holding a
hearing authorized by this Act, by an attachment for contempt,
or otherwise, in the same manner as production of evidence may
be compelled before the court.
    (f) The Director or Hearing Officer, or any party in an
investigation or hearing before the Department, may cause the
depositions of witnesses within the State to be taken in the
manner prescribed by law for like depositions in civil actions
in courts of this State, and to that end compel the attendance
of witnesses and the production of books, papers, records, or
memoranda.
(Source: P.A. 99-180, eff. 7-29-15.)
 
    (210 ILCS 85/10.10)
    Sec. 10.10. Nurse Staffing by Patient Acuity.
    (a) Findings. The Legislature finds and declares all of
the following:
        (1) The State of Illinois has a substantial interest
    in promoting quality care and improving the delivery of
    health care services.
        (2) Evidence-based studies have shown that the basic
    principles of staffing in the acute care setting should be
    based on the complexity of patients' care needs aligned
    with available nursing skills to promote quality patient
    care consistent with professional nursing standards.
        (3) Compliance with this Section promotes an
    organizational climate that values registered nurses'
    input in meeting the health care needs of hospital
    patients.
    (b) Definitions. As used in this Section:
    "Acuity model" means an assessment tool selected and
implemented by a hospital, as recommended by a nursing care
committee, that assesses the complexity of patient care needs
requiring professional nursing care and skills and aligns
patient care needs and nursing skills consistent with
professional nursing standards.
    "Department" means the Department of Public Health.
    "Direct patient care" means care provided by a registered
professional nurse with direct responsibility to oversee or
carry out medical regimens or nursing care for one or more
patients.
    "Nursing care committee" means a an existing or newly
created hospital-wide committee or committees of nurses whose
functions, in part or in whole, contribute to the development,
recommendation, and review of the hospital's nurse staffing
plan established pursuant to subsection (d).
    "Registered professional nurse" means a person licensed as
a Registered Nurse under the Nurse Practice Act.
    "Written staffing plan for nursing care services" means a
written plan for guiding the assignment of patient care
nursing staff based on multiple nurse and patient
considerations that yield minimum staffing levels for
inpatient care units and the adopted acuity model aligning
patient care needs with nursing skills required for quality
patient care consistent with professional nursing standards.
    (c) Written staffing plan.
        (1) Every hospital shall implement a written
    hospital-wide staffing plan, prepared recommended by a
    nursing care committee or committees, that provides for
    minimum direct care professional registered
    nurse-to-patient staffing needs for each inpatient care
    unit, including inpatient emergency departments. If the
    staffing plan prepared by the nursing care committee is
    not adopted by the hospital, or if substantial changes are
    proposed to it, the chief nursing officer shall either:
    (i) provide a written explanation to the committee of the
    reasons the plan was not adopted; or (ii) provide a
    written explanation of any substantial changes made to the
    proposed plan prior to it being adopted by the hospital.
    The written hospital-wide staffing plan shall include, but
    need not be limited to, the following considerations:
            (A) The complexity of complete care, assessment on
        patient admission, volume of patient admissions,
        discharges and transfers, evaluation of the progress
        of a patient's problems, ongoing physical assessments,
        planning for a patient's discharge, assessment after a
        change in patient condition, and assessment of the
        need for patient referrals.
            (B) The complexity of clinical professional
        nursing judgment needed to design and implement a
        patient's nursing care plan, the need for specialized
        equipment and technology, the skill mix of other
        personnel providing or supporting direct patient care,
        and involvement in quality improvement activities,
        professional preparation, and experience.
            (C) Patient acuity and the number of patients for
        whom care is being provided.
            (D) The ongoing assessments of a unit's patient
        acuity levels and nursing staff needed shall be
        routinely made by the unit nurse manager or his or her
        designee.
            (E) The identification of additional registered
        nurses available for direct patient care when
        patients' unexpected needs exceed the planned workload
        for direct care staff.
        (2) In order to provide staffing flexibility to meet
    patient needs, every hospital shall identify an acuity
    model for adjusting the staffing plan for each inpatient
    care unit.
        (2.5) Each hospital shall implement the staffing plan
    and assign nursing personnel to each inpatient care unit,
    including inpatient emergency departments, in accordance
    with the staffing plan.
            (A) A registered nurse may report to the nursing
        care committee any variations where the nurse
        personnel assignment in an inpatient care unit is not
        in accordance with the adopted staffing plan and may
        make a written report to the nursing care committee
        based on the variations.
            (B) Shift-to-shift adjustments in staffing levels
        required by the staffing plan may be made by the
        appropriate hospital personnel overseeing inpatient
        care operations. If a registered nurse in an inpatient
        care unit objects to a shift-to-shift adjustment, the
        registered nurse may submit a written report to the
        nursing care committee.
            (C) The nursing care committee shall develop a
        process to examine and respond to written reports
        submitted under subparagraphs (A) and (B) of this
        paragraph (2.5), including the ability to determine if
        a specific written report is resolved or should be
        dismissed.
        (3) The written staffing plan shall be posted in a
    conspicuous and accessible location for both patients and
    direct care staff, as required under the Hospital Report
    Card Act. A copy of the written staffing plan shall be
    provided to any member of the general public upon request.
    (d) Nursing care committee.
        (1) Every hospital shall have a nursing care committee
    that meets at least 6 times per year. A hospital shall
    appoint members of a committee whereby at least 55% 50% of
    the members are registered professional nurses providing
    direct inpatient patient care, one of whom shall be
    selected annually by the direct inpatient care nurses to
    serve as co-chair of the committee.
        (2) (Blank). A nursing care committee's
    recommendations must be given significant regard and
    weight in the hospital's adoption and implementation of a
    written staffing plan.
        (2.5) A nursing care committee shall prepare and
    recommend to hospital administration the hospital's
    written hospital-wide staffing plan. If the staffing plan
    is not adopted by the hospital, the chief nursing officer
    shall provide a written statement to the committee prior
    to a staffing plan being adopted by the hospital that: (A)
    explains the reasons the committee's proposed staffing
    plan was not adopted; and (B) describes the changes to the
    committee's proposed staffing or any alternative to the
    committee's proposed staffing plan.
        (3) A nursing care committee's committee or
    committees' committees shall recommend a written staffing
    plan for the hospital shall be based on the principles
    from the staffing components set forth in subsection (c).
    In particular, a committee or committees shall provide
    input and feedback on the following:
            (A) Selection, implementation, and evaluation of
        minimum staffing levels for inpatient care units.
            (B) Selection, implementation, and evaluation of
        an acuity model to provide staffing flexibility that
        aligns changing patient acuity with nursing skills
        required.
            (C) Selection, implementation, and evaluation of a
        written staffing plan incorporating the items
        described in subdivisions (c)(1) and (c)(2) of this
        Section.
            (D) Review the nurse following: nurse-to-patient
        staffing plans guidelines for all inpatient areas; and
        current acuity tools and measures in use. The nursing
        care committee's review shall consider:
                (i) patient outcomes;
                (ii) complaints regarding staffing, including
            complaints about a delay in direct care nursing or
            an absence of direct care nursing;
                (iii) the number of hours of nursing care
            provided through an inpatient hospital unit
            compared with the number of inpatients served by
            the hospital unit during a 24-hour period;
                (iv) the aggregate hours of overtime worked by
            the nursing staff;
                (v) the extent to which actual nurse staffing
            for each hospital inpatient unit differs from the
            staffing specified by the staffing plan; and
                (vi) any other matter or change to the
            staffing plan determined by the committee to
            ensure that the hospital is staffed to meet the
            health care needs of patients.
        (4) A nursing care committee must issue a written
    report addressing address the items described in
    subparagraphs (A) through (D) of paragraph (3)
    semi-annually. A written copy of this report shall be made
    available to direct inpatient care nurses by making
    available a paper copy of the report, distributing it
    electronically, or posting it on the hospital's website.
        (5) A nursing care committee must issue a written
    report at least annually to the hospital governing board
    that addresses items including, but not limited to: the
    items described in paragraph (3); changes made based on
    committee recommendations and the impact of such changes;
    and recommendations for future changes related to nurse
    staffing.
    (e) Nothing in this Section 10.10 shall be construed to
limit, alter, or modify any of the terms, conditions, or
provisions of a collective bargaining agreement entered into
by the hospital.
    (f) No hospital may discipline, discharge, or take any
other adverse employment action against an employee solely
because the employee expresses a concern or complaint
regarding an alleged violation of this Section or concerns
related to nurse staffing.
    (g) Any employee of a hospital may file a complaint with
the Department regarding an alleged violation of this Section.
The Department must forward notification of the alleged
violation to the hospital in question within 10 business days
after the complaint is filed. Upon receiving a complaint of a
violation of this Section, the Department may take any action
authorized under Sections 7 or 9 of this Act.
(Source: P.A. 96-328, eff. 8-11-09; 97-423, eff. 1-1-12;
97-813, eff. 7-13-12.)
 
    (210 ILCS 85/14.5)
    Sec. 14.5. Hospital Licensure Fund.
    (a) There is created in the State treasury the Hospital
Licensure Fund. The Fund is created for the purpose of
providing funding for the administration of the licensure
program and patient safety and quality initiatives for
hospitals, including, without limitation, the implementation
of the Illinois Adverse Health Care Events Reporting Law of
2005.
    (b) The Fund shall consist of the following:
        (1) fees collected pursuant to Sections Section 5 and
    7 of the Hospital Licensing Act;
        (2) federal matching funds received by the State as a
    result of expenditures made by the Department that are
    attributable to moneys deposited in the Fund;
        (3) interest earned on moneys deposited in the Fund;
    and
        (4) other moneys received for the Fund from any other
    source, including interest earned thereon.
    (c) Disbursements from the Fund shall be made only for:
        (1) initially, the implementation of the Illinois
    Adverse Health Care Events Reporting Law of 2005;
        (2) subsequently, programs, information, or
    assistance, including measures to address public
    complaints, designed to measurably improve quality and
    patient safety; and
        (2.5) from fines for violations of Section 10.10,
    scholarships under the Nursing Education Scholarship Law;
    and
        (3) the reimbursement of moneys collected by the
    Department through error or mistake.
    (d) The uses described in paragraph (2) of subsection (c)
shall be developed in conjunction with a statewide
organization representing a majority of hospitals.
(Source: P.A. 98-683, eff. 6-30-14.)
 
ARTICLE 5. NURSING EDUCATION SCHOLARSHIP

 
    Section 5-5. The Nursing Education Scholarship Law is
amended by changing Section 5 as follows:
 
    (110 ILCS 975/5)  (from Ch. 144, par. 2755)
    Sec. 5. Nursing education scholarships. Beginning with the
fall term of the 2004-2005 academic year, the Department, in
accordance with rules and regulations promulgated by it for
this program, shall provide scholarships to individuals
selected from among those applicants who qualify for
consideration by showing:
        (1) that he or she has been a resident of this State
    for at least one year prior to application, and is a
    citizen or a lawful permanent resident alien of the United
    States;
        (2) that he or she is enrolled in or accepted for
    admission to an associate degree in nursing program,
    hospital-based diploma in nursing program, baccalaureate
    degree in nursing program, graduate degree in nursing
    program, or practical nursing program at an approved
    institution; and
        (3) that he or she agrees to meet the nursing
    employment obligation.
    If in any year the number of qualified applicants exceeds
the number of scholarships to be awarded, the Department
shall, in consultation with the Illinois Nursing Workforce
Center Advisory Board, consider the following factors in
granting priority in awarding scholarships:
            (A) Financial need, as shown on a standardized
        financial needs assessment form used by an approved
        institution, of students who will pursue their
        education on a full-time or close to full-time basis
        and who already have a certificate in practical
        nursing, a diploma in nursing, or an associate degree
        in nursing and are pursuing a higher degree.
            (B) A student's status as a registered nurse who
        is pursuing a graduate degree in nursing to pursue
        employment in an approved institution that educates
        licensed practical nurses and that educates registered
        nurses in undergraduate and graduate nursing programs.
            (C) A student's merit, as shown through his or her
        grade point average, class rank, and other academic
        and extracurricular activities. The Department may add
        to and further define these merit criteria by rule.
    Unless otherwise indicated, scholarships shall be awarded
to recipients at approved institutions for a period of up to 2
years if the recipient is enrolled in an associate degree in
nursing program, up to 3 years if the recipient is enrolled in
a hospital-based diploma in nursing program, up to 4 years if
the recipient is enrolled in a baccalaureate degree in nursing
program, up to 5 years if the recipient is enrolled in a
graduate degree in nursing program, and up to one year if the
recipient is enrolled in a certificate in practical nursing
program. At least 40% of the scholarships awarded shall be for
recipients who are pursuing baccalaureate degrees in nursing,
30% of the scholarships awarded shall be for recipients who
are pursuing associate degrees in nursing or a diploma in
nursing, 10% of the scholarships awarded shall be for
recipients who are pursuing a certificate in practical
nursing, and 20% of the scholarships awarded shall be for
recipients who are pursuing a graduate degree in nursing.
    Beginning with the fall term of the 2021-2022 academic
year and continuing through the 2024-2025 academic year,
subject to appropriation from the Hospital Licensure Fund, in
addition to any other funds available to the Department for
such scholarships, the Department may award a total of
$500,000 annually in scholarships under this Section.
(Source: P.A. 100-513, eff. 1-1-18.)
 
ARTICLE 99. EFFECTIVE DATE

 
    Section 99-99. Effective date. This Act takes effect upon
becoming law.

Effective Date: 8/27/2021