100TH GENERAL ASSEMBLY
State of Illinois
2017 and 2018
HB0281

 

Introduced , by Rep. Mary E. Flowers

 

SYNOPSIS AS INTRODUCED:
 
20 ILCS 535/5
20 ILCS 535/7 new
225 ILCS 60/22  from Ch. 111, par. 4400-22

    Amends the Administration of Psychotropic Medications to Children Act. Provides that the Department of Children and Family Services shall adopt rules requiring the Department to distribute treatment guidelines on an annual basis to all persons licensed under the Medical Practice Act of 1987 to practice medicine in all of its branches. Provides that the Department shall prepare and submit an annual report to the General Assembly with specified information concerning the administration of psychotropic medication to persons for whom it is legally responsible. Amends the Medical Practice Act of 1987. Provides that the Department of Financial and Professional Regulation may revoke, suspend, place on probation, reprimand, refuse to issue or renew, or take any other disciplinary or non-disciplinary action as the Department may deem proper with regard to the license or permit of any person issued under the Act upon repeated acts of clearly excessive prescribing, furnishing, or administering psychotropic medications to a minor without a good faith prior examination of the patient and medical reason.


LRB100 00019 SMS 10020 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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1    AN ACT concerning State government.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Administration of Psychotropic Medications
5to Children Act is amended by changing Section 5 and by adding
6Section 7 as follows:
 
7    (20 ILCS 535/5)
8    Sec. 5. Administration of psychotropic medications. On or
9before October 1, 2011, the Department of Children and Family
10Services shall promulgate final rules, amending its current
11rules establishing and maintaining standards and procedures to
12govern the administration of psychotropic medications. Such
13amendments to its rules shall include, but are not limited to,
14the following:
15    (a) The role of the Department in the administration of
16psychotropic medications to youth for whom it is legally
17responsible and who are in facilities operated by the Illinois
18Department of Corrections or the Illinois Department of
19Juvenile Justice.
20    (b) Provisions regarding the administration of
21psychotropic medications for youth for whom the Department is
22legally responsible and who are in residential facilities,
23group homes, transitional living programs, or foster homes

 

 

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1where the youth is under the age of 18 or where the youth is 18
2or older and has provided the Department with appropriate
3consent.
4    (b-5) Provisions requiring the Department to distribute
5treatment guidelines on an annual basis to all persons licensed
6under the Medical Practice Act of 1987 to practice medicine in
7all of its branches.
8    (c) Provisions regarding the administration of
9psychotropic medications for youth for whom the Department is
10legally responsible and who are in psychiatric hospitals.
11    (d) Provisions concerning the emergency use of
12psychotropic medications, including appropriate and timely
13reporting.
14    (e) Provisions prohibiting the administration of
15psychotropic medications to persons for whom the Department is
16legally responsible as punishment for bad behavior, for the
17convenience of staff or caregivers, or as a substitute for
18adequate mental health care or other services.
19    (f) The creation of a committee to develop, post on a
20website, and periodically review materials listing which
21psychotropic medications are approved for use with youth for
22whom the Department has legal responsibility. The materials
23shall include guidelines for the use of psychotropic
24medications and may include the acceptable range of dosages,
25contraindications, and time limits, if any, and such other
26topics necessary to ensure the safe and appropriate use of

 

 

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1psychotropic medications.
2    (g) Provisions regarding the appointment, qualifications,
3and training of employees of the Department who are authorized
4to consent to the administration of psychotropic medications to
5youth for whom the Department has legal responsibility,
6including the scope of the authority of such persons.
7    (h) Provisions regarding training and materials for
8parents, foster parents, and relative caretakers concerning
9the rules governing the use of psychotropic medications with
10youth for whom the Department has legal responsibility.
11    (i) With respect to any youth under the age of 18 for whom
12the Department has legal responsibility and who does not assent
13to the administration of recommended psychotropic medication,
14provisions providing standards and procedures for reviewing
15the youth's concerns. With respect to any youth over the age of
1618 for whom the Department has legal responsibility and who
17does not consent to the administration of recommended
18psychotropic medication, provisions providing standards and
19procedures for reviewing the youth's concerns upon the youth's
20request and with the youth's consent. Standards and procedures
21developed under this subsection shall not be inconsistent with
22the Mental Health and Developmental Disabilities Code.
23    (j) Provisions ensuring that, subject to all relevant
24confidentiality laws, service plans for youth for whom the
25Department has legal responsibility include the following
26information:

 

 

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1        (1) Identification by name and dosage of the
2    psychotropic medication known by the Department to have
3    been administered to the youth since the last service plan.
4        (2) The benefits of the psychotropic medication.
5        (3) The negative side effects of the psychotropic
6    medication.
7(Source: P.A. 97-245, eff. 8-4-11.)
 
8    (20 ILCS 535/7 new)
9    Sec. 7. Annual reports on prescribing patterns.
10    (a) No later than December 31, 2018, and December 31 of
11each year thereafter, the Department shall prepare and submit
12an annual report, covering the previous fiscal year, to the
13General Assembly concerning the administration of psychotropic
14medication to persons for whom it is legally responsible. This
15report shall include, but is not limited to, pharmacy claims
16data for youth the Department is legally responsible for each
17of the following:
18        (1) Who are or have been on 3 or more psychotropic
19    medications for 60 days or more.
20        (2) Who are 5 years of age or younger and have been
21    prescribed one or more psychotropic medications.
22        (3) Who are or have been on 2 or more antipsychotic
23    medications for 60 days or more.
24    Prior to the release of this data, personal identifiers,
25such as name, date of birth, address, and Social Security

 

 

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1number, shall be removed and a unique identifier shall be
2submitted.
3    (b) For each person who falls into one of the categories
4described in subsection (a), the Department shall submit the
5following information to the General Assembly:
6        (1) a list of the psychotropic medications prescribed;
7        (2) the start and stop dates, if any, for each
8    psychotropic medication prescribed;
9        (3) the prescriber's name and contact information;
10        (4) the person's year of birth;
11        (5) the diagnoses received on non-pharmacy claims,
12    including all associated dates of claim and service and the
13    associated CPT code for the claim or service;
14        (6) the unit and quantity of the medication and the
15    number of days' supply of the medication; and
16        (7) the person's weight.
17    (c) The Department shall contract for consulting services
18from, if available, a psychiatrist who has expertise and
19specializes in pediatric care for the purpose of reviewing the
20data provided to the General Assembly in subsection (a).
21    (d) Using information gathered from subsection (a), the
22Department shall analyze prescribing patterns by population
23for youth for whom it is legally responsible and who are in
24facilities operated by the Department of Corrections or the
25Department of Juvenile Justice.
26        
 

 

 

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1    Section 10. The Medical Practice Act of 1987 is amended by
2changing Section 22 as follows:
 
3    (225 ILCS 60/22)  (from Ch. 111, par. 4400-22)
4    (Section scheduled to be repealed on December 31, 2017)
5    Sec. 22. Disciplinary action.
6    (A) The Department may revoke, suspend, place on probation,
7reprimand, refuse to issue or renew, or take any other
8disciplinary or non-disciplinary action as the Department may
9deem proper with regard to the license or permit of any person
10issued under this Act, including imposing fines not to exceed
11$10,000 for each violation, upon any of the following grounds:
12        (1) Performance of an elective abortion in any place,
13    locale, facility, or institution other than:
14            (a) a facility licensed pursuant to the Ambulatory
15        Surgical Treatment Center Act;
16            (b) an institution licensed under the Hospital
17        Licensing Act;
18            (c) an ambulatory surgical treatment center or
19        hospitalization or care facility maintained by the
20        State or any agency thereof, where such department or
21        agency has authority under law to establish and enforce
22        standards for the ambulatory surgical treatment
23        centers, hospitalization, or care facilities under its
24        management and control;

 

 

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1            (d) ambulatory surgical treatment centers,
2        hospitalization or care facilities maintained by the
3        Federal Government; or
4            (e) ambulatory surgical treatment centers,
5        hospitalization or care facilities maintained by any
6        university or college established under the laws of
7        this State and supported principally by public funds
8        raised by taxation.
9        (2) Performance of an abortion procedure in a wilful
10    and wanton manner on a woman who was not pregnant at the
11    time the abortion procedure was performed.
12        (3) A plea of guilty or nolo contendere, finding of
13    guilt, jury verdict, or entry of judgment or sentencing,
14    including, but not limited to, convictions, preceding
15    sentences of supervision, conditional discharge, or first
16    offender probation, under the laws of any jurisdiction of
17    the United States of any crime that is a felony.
18        (4) Gross negligence in practice under this Act.
19        (5) Engaging in dishonorable, unethical or
20    unprofessional conduct of a character likely to deceive,
21    defraud or harm the public.
22        (6) Obtaining any fee by fraud, deceit, or
23    misrepresentation.
24        (7) Habitual or excessive use or abuse of drugs defined
25    in law as controlled substances, of alcohol, or of any
26    other substances which results in the inability to practice

 

 

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1    with reasonable judgment, skill or safety.
2        (8) Practicing under a false or, except as provided by
3    law, an assumed name.
4        (9) Fraud or misrepresentation in applying for, or
5    procuring, a license under this Act or in connection with
6    applying for renewal of a license under this Act.
7        (10) Making a false or misleading statement regarding
8    their skill or the efficacy or value of the medicine,
9    treatment, or remedy prescribed by them at their direction
10    in the treatment of any disease or other condition of the
11    body or mind.
12        (11) Allowing another person or organization to use
13    their license, procured under this Act, to practice.
14        (12) Adverse action taken by another state or
15    jurisdiction against a license or other authorization to
16    practice as a medical doctor, doctor of osteopathy, doctor
17    of osteopathic medicine or doctor of chiropractic, a
18    certified copy of the record of the action taken by the
19    other state or jurisdiction being prima facie evidence
20    thereof. This includes any adverse action taken by a State
21    or federal agency that prohibits a medical doctor, doctor
22    of osteopathy, doctor of osteopathic medicine, or doctor of
23    chiropractic from providing services to the agency's
24    participants.
25        (13) Violation of any provision of this Act or of the
26    Medical Practice Act prior to the repeal of that Act, or

 

 

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1    violation of the rules, or a final administrative action of
2    the Secretary, after consideration of the recommendation
3    of the Disciplinary Board.
4        (14) Violation of the prohibition against fee
5    splitting in Section 22.2 of this Act.
6        (15) A finding by the Disciplinary Board that the
7    registrant after having his or her license placed on
8    probationary status or subjected to conditions or
9    restrictions violated the terms of the probation or failed
10    to comply with such terms or conditions.
11        (16) Abandonment of a patient.
12        (17) Prescribing, selling, administering,
13    distributing, giving or self-administering any drug
14    classified as a controlled substance (designated product)
15    or narcotic for other than medically accepted therapeutic
16    purposes.
17        (18) Promotion of the sale of drugs, devices,
18    appliances or goods provided for a patient in such manner
19    as to exploit the patient for financial gain of the
20    physician.
21        (19) Offering, undertaking or agreeing to cure or treat
22    disease by a secret method, procedure, treatment or
23    medicine, or the treating, operating or prescribing for any
24    human condition by a method, means or procedure which the
25    licensee refuses to divulge upon demand of the Department.
26        (20) Immoral conduct in the commission of any act

 

 

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1    including, but not limited to, commission of an act of
2    sexual misconduct related to the licensee's practice.
3        (21) Wilfully making or filing false records or reports
4    in his or her practice as a physician, including, but not
5    limited to, false records to support claims against the
6    medical assistance program of the Department of Healthcare
7    and Family Services (formerly Department of Public Aid)
8    under the Illinois Public Aid Code.
9        (22) Wilful omission to file or record, or wilfully
10    impeding the filing or recording, or inducing another
11    person to omit to file or record, medical reports as
12    required by law, or wilfully failing to report an instance
13    of suspected abuse or neglect as required by law.
14        (23) Being named as a perpetrator in an indicated
15    report by the Department of Children and Family Services
16    under the Abused and Neglected Child Reporting Act, and
17    upon proof by clear and convincing evidence that the
18    licensee has caused a child to be an abused child or
19    neglected child as defined in the Abused and Neglected
20    Child Reporting Act.
21        (24) Solicitation of professional patronage by any
22    corporation, agents or persons, or profiting from those
23    representing themselves to be agents of the licensee.
24        (25) Gross and wilful and continued overcharging for
25    professional services, including filing false statements
26    for collection of fees for which services are not rendered,

 

 

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1    including, but not limited to, filing such false statements
2    for collection of monies for services not rendered from the
3    medical assistance program of the Department of Healthcare
4    and Family Services (formerly Department of Public Aid)
5    under the Illinois Public Aid Code.
6        (26) A pattern of practice or other behavior which
7    demonstrates incapacity or incompetence to practice under
8    this Act.
9        (27) Mental illness or disability which results in the
10    inability to practice under this Act with reasonable
11    judgment, skill or safety.
12        (28) Physical illness, including, but not limited to,
13    deterioration through the aging process, or loss of motor
14    skill which results in a physician's inability to practice
15    under this Act with reasonable judgment, skill or safety.
16        (29) Cheating on or attempt to subvert the licensing
17    examinations administered under this Act.
18        (30) Wilfully or negligently violating the
19    confidentiality between physician and patient except as
20    required by law.
21        (31) The use of any false, fraudulent, or deceptive
22    statement in any document connected with practice under
23    this Act.
24        (32) Aiding and abetting an individual not licensed
25    under this Act in the practice of a profession licensed
26    under this Act.

 

 

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1        (33) Violating state or federal laws or regulations
2    relating to controlled substances, legend drugs, or
3    ephedra as defined in the Ephedra Prohibition Act.
4        (34) Failure to report to the Department any adverse
5    final action taken against them by another licensing
6    jurisdiction (any other state or any territory of the
7    United States or any foreign state or country), by any peer
8    review body, by any health care institution, by any
9    professional society or association related to practice
10    under this Act, by any governmental agency, by any law
11    enforcement agency, or by any court for acts or conduct
12    similar to acts or conduct which would constitute grounds
13    for action as defined in this Section.
14        (35) Failure to report to the Department surrender of a
15    license or authorization to practice as a medical doctor, a
16    doctor of osteopathy, a doctor of osteopathic medicine, or
17    doctor of chiropractic in another state or jurisdiction, or
18    surrender of membership on any medical staff or in any
19    medical or professional association or society, while
20    under disciplinary investigation by any of those
21    authorities or bodies, for acts or conduct similar to acts
22    or conduct which would constitute grounds for action as
23    defined in this Section.
24        (36) Failure to report to the Department any adverse
25    judgment, settlement, or award arising from a liability
26    claim related to acts or conduct similar to acts or conduct

 

 

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1    which would constitute grounds for action as defined in
2    this Section.
3        (37) Failure to provide copies of medical records as
4    required by law.
5        (38) Failure to furnish the Department, its
6    investigators or representatives, relevant information,
7    legally requested by the Department after consultation
8    with the Chief Medical Coordinator or the Deputy Medical
9    Coordinator.
10        (39) Violating the Health Care Worker Self-Referral
11    Act.
12        (40) Willful failure to provide notice when notice is
13    required under the Parental Notice of Abortion Act of 1995.
14        (41) Failure to establish and maintain records of
15    patient care and treatment as required by this law.
16        (42) Entering into an excessive number of written
17    collaborative agreements with licensed advanced practice
18    nurses resulting in an inability to adequately
19    collaborate.
20        (43) Repeated failure to adequately collaborate with a
21    licensed advanced practice nurse.
22        (44) Violating the Compassionate Use of Medical
23    Cannabis Pilot Program Act.
24        (45) Entering into an excessive number of written
25    collaborative agreements with licensed prescribing
26    psychologists resulting in an inability to adequately

 

 

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1    collaborate.
2        (46) Repeated failure to adequately collaborate with a
3    licensed prescribing psychologist.
4        (47) Repeated acts of clearly excessive prescribing,
5    furnishing, or administering psychotropic medications to a
6    minor without a good faith prior examination of the patient
7    and medical reason therefor.
8    Except for actions involving the ground numbered (26), all
9proceedings to suspend, revoke, place on probationary status,
10or take any other disciplinary action as the Department may
11deem proper, with regard to a license on any of the foregoing
12grounds, must be commenced within 5 years next after receipt by
13the Department of a complaint alleging the commission of or
14notice of the conviction order for any of the acts described
15herein. Except for the grounds numbered (8), (9), (26), and
16(29), no action shall be commenced more than 10 years after the
17date of the incident or act alleged to have violated this
18Section. For actions involving the ground numbered (26), a
19pattern of practice or other behavior includes all incidents
20alleged to be part of the pattern of practice or other behavior
21that occurred, or a report pursuant to Section 23 of this Act
22received, within the 10-year period preceding the filing of the
23complaint. In the event of the settlement of any claim or cause
24of action in favor of the claimant or the reduction to final
25judgment of any civil action in favor of the plaintiff, such
26claim, cause of action or civil action being grounded on the

 

 

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1allegation that a person licensed under this Act was negligent
2in providing care, the Department shall have an additional
3period of 2 years from the date of notification to the
4Department under Section 23 of this Act of such settlement or
5final judgment in which to investigate and commence formal
6disciplinary proceedings under Section 36 of this Act, except
7as otherwise provided by law. The time during which the holder
8of the license was outside the State of Illinois shall not be
9included within any period of time limiting the commencement of
10disciplinary action by the Department.
11    The entry of an order or judgment by any circuit court
12establishing that any person holding a license under this Act
13is a person in need of mental treatment operates as a
14suspension of that license. That person may resume their
15practice only upon the entry of a Departmental order based upon
16a finding by the Disciplinary Board that they have been
17determined to be recovered from mental illness by the court and
18upon the Disciplinary Board's recommendation that they be
19permitted to resume their practice.
20    The Department may refuse to issue or take disciplinary
21action concerning the license of any person who fails to file a
22return, or to pay the tax, penalty or interest shown in a filed
23return, or to pay any final assessment of tax, penalty or
24interest, as required by any tax Act administered by the
25Illinois Department of Revenue, until such time as the
26requirements of any such tax Act are satisfied as determined by

 

 

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1the Illinois Department of Revenue.
2    The Department, upon the recommendation of the
3Disciplinary Board, shall adopt rules which set forth standards
4to be used in determining:
5        (a) when a person will be deemed sufficiently
6    rehabilitated to warrant the public trust;
7        (b) what constitutes dishonorable, unethical or
8    unprofessional conduct of a character likely to deceive,
9    defraud, or harm the public;
10        (c) what constitutes immoral conduct in the commission
11    of any act, including, but not limited to, commission of an
12    act of sexual misconduct related to the licensee's
13    practice; and
14        (d) what constitutes gross negligence in the practice
15    of medicine.
16    However, no such rule shall be admissible into evidence in
17any civil action except for review of a licensing or other
18disciplinary action under this Act.
19    In enforcing this Section, the Disciplinary Board or the
20Licensing Board, upon a showing of a possible violation, may
21compel, in the case of the Disciplinary Board, any individual
22who is licensed to practice under this Act or holds a permit to
23practice under this Act, or, in the case of the Licensing
24Board, any individual who has applied for licensure or a permit
25pursuant to this Act, to submit to a mental or physical
26examination and evaluation, or both, which may include a

 

 

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1substance abuse or sexual offender evaluation, as required by
2the Licensing Board or Disciplinary Board and at the expense of
3the Department. The Disciplinary Board or Licensing Board shall
4specifically designate the examining physician licensed to
5practice medicine in all of its branches or, if applicable, the
6multidisciplinary team involved in providing the mental or
7physical examination and evaluation, or both. The
8multidisciplinary team shall be led by a physician licensed to
9practice medicine in all of its branches and may consist of one
10or more or a combination of physicians licensed to practice
11medicine in all of its branches, licensed chiropractic
12physicians, licensed clinical psychologists, licensed clinical
13social workers, licensed clinical professional counselors, and
14other professional and administrative staff. Any examining
15physician or member of the multidisciplinary team may require
16any person ordered to submit to an examination and evaluation
17pursuant to this Section to submit to any additional
18supplemental testing deemed necessary to complete any
19examination or evaluation process, including, but not limited
20to, blood testing, urinalysis, psychological testing, or
21neuropsychological testing. The Disciplinary Board, the
22Licensing Board, or the Department may order the examining
23physician or any member of the multidisciplinary team to
24provide to the Department, the Disciplinary Board, or the
25Licensing Board any and all records, including business
26records, that relate to the examination and evaluation,

 

 

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1including any supplemental testing performed. The Disciplinary
2Board, the Licensing Board, or the Department may order the
3examining physician or any member of the multidisciplinary team
4to present testimony concerning this examination and
5evaluation of the licensee, permit holder, or applicant,
6including testimony concerning any supplemental testing or
7documents relating to the examination and evaluation. No
8information, report, record, or other documents in any way
9related to the examination and evaluation shall be excluded by
10reason of any common law or statutory privilege relating to
11communication between the licensee, permit holder, or
12applicant and the examining physician or any member of the
13multidisciplinary team. No authorization is necessary from the
14licensee, permit holder, or applicant ordered to undergo an
15evaluation and examination for the examining physician or any
16member of the multidisciplinary team to provide information,
17reports, records, or other documents or to provide any
18testimony regarding the examination and evaluation. The
19individual to be examined may have, at his or her own expense,
20another physician of his or her choice present during all
21aspects of the examination. Failure of any individual to submit
22to mental or physical examination and evaluation, or both, when
23directed, shall result in an automatic suspension, without
24hearing, until such time as the individual submits to the
25examination. If the Disciplinary Board or Licensing Board finds
26a physician unable to practice following an examination and

 

 

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1evaluation because of the reasons set forth in this Section,
2the Disciplinary Board or Licensing Board shall require such
3physician to submit to care, counseling, or treatment by
4physicians, or other health care professionals, approved or
5designated by the Disciplinary Board, as a condition for
6issued, continued, reinstated, or renewed licensure to
7practice. Any physician, whose license was granted pursuant to
8Sections 9, 17, or 19 of this Act, or, continued, reinstated,
9renewed, disciplined or supervised, subject to such terms,
10conditions or restrictions who shall fail to comply with such
11terms, conditions or restrictions, or to complete a required
12program of care, counseling, or treatment, as determined by the
13Chief Medical Coordinator or Deputy Medical Coordinators,
14shall be referred to the Secretary for a determination as to
15whether the licensee shall have their license suspended
16immediately, pending a hearing by the Disciplinary Board. In
17instances in which the Secretary immediately suspends a license
18under this Section, a hearing upon such person's license must
19be convened by the Disciplinary Board within 15 days after such
20suspension and completed without appreciable delay. The
21Disciplinary Board shall have the authority to review the
22subject physician's record of treatment and counseling
23regarding the impairment, to the extent permitted by applicable
24federal statutes and regulations safeguarding the
25confidentiality of medical records.
26    An individual licensed under this Act, affected under this

 

 

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1Section, shall be afforded an opportunity to demonstrate to the
2Disciplinary Board that they can resume practice in compliance
3with acceptable and prevailing standards under the provisions
4of their license.
5    The Department may promulgate rules for the imposition of
6fines in disciplinary cases, not to exceed $10,000 for each
7violation of this Act. Fines may be imposed in conjunction with
8other forms of disciplinary action, but shall not be the
9exclusive disposition of any disciplinary action arising out of
10conduct resulting in death or injury to a patient. Any funds
11collected from such fines shall be deposited in the Medical
12Disciplinary Fund.
13    All fines imposed under this Section shall be paid within
1460 days after the effective date of the order imposing the fine
15or in accordance with the terms set forth in the order imposing
16the fine.
17    (B) The Department shall revoke the license or permit
18issued under this Act to practice medicine or a chiropractic
19physician who has been convicted a second time of committing
20any felony under the Illinois Controlled Substances Act or the
21Methamphetamine Control and Community Protection Act, or who
22has been convicted a second time of committing a Class 1 felony
23under Sections 8A-3 and 8A-6 of the Illinois Public Aid Code. A
24person whose license or permit is revoked under this subsection
25B shall be prohibited from practicing medicine or treating
26human ailments without the use of drugs and without operative

 

 

HB0281- 21 -LRB100 00019 SMS 10020 b

1surgery.
2    (C) The Department shall not revoke, suspend, place on
3probation, reprimand, refuse to issue or renew, or take any
4other disciplinary or non-disciplinary action against the
5license or permit issued under this Act to practice medicine to
6a physician based solely upon the recommendation of the
7physician to an eligible patient regarding, or prescription
8for, or treatment with, an investigational drug, biological
9product, or device.
10    (D) The Disciplinary Board shall recommend to the
11Department civil penalties and any other appropriate
12discipline in disciplinary cases when the Board finds that a
13physician willfully performed an abortion with actual
14knowledge that the person upon whom the abortion has been
15performed is a minor or an incompetent person without notice as
16required under the Parental Notice of Abortion Act of 1995.
17Upon the Board's recommendation, the Department shall impose,
18for the first violation, a civil penalty of $1,000 and for a
19second or subsequent violation, a civil penalty of $5,000.
20(Source: P.A. 98-601, eff. 12-30-13; 98-668, eff. 6-25-14;
2198-1140, eff. 12-30-14; 99-270, eff. 1-1-16.)