HB0822 Engrossed

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    AN ACT concerning regulation.

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

 
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    Section 5. The Assisted Living and Shared Housing Act is 
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amended  by changing Section 70 as follows:
 



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    (210 ILCS 9/70)



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    Sec. 70. Service requirements. An
establishment must

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provide all mandatory services and may provide optional 
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services, including
medication reminders, supervision of 
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self-administered medication and
medication administration as

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defined by this Section
and nonmedical services defined by 
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rule, whether provided directly by the
establishment or by 
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another
entity arranged for by the establishment with the 
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consent of the resident or
the resident's
representative.

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    For the purposes of this Section, "medication reminders" 
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means reminding
residents to take pre-dispensed, 
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self-administered medication, observing the
resident, and 
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documenting whether or not the resident took the medication.

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    For the purposes of this Section, "supervision of 
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self-administered
medication" means assisting the resident 
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with self-administered medication
using any combination of the 
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following: reminding residents to take medication,
reading the 
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medication label to residents, checking the self-administered

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medication dosage against the label of the medication, 
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confirming that
residents have obtained and are taking the 
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dosage as prescribed, and
documenting in writing that the 
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resident has taken (or refused to take) the
medication.  If 
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residents are physically unable to open the container, the

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container may be opened for them.  Supervision of 
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self-administered medication
shall be under the direction of a 
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licensed health care professional.

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    For the purposes of this Section, "medication 
 


 






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administration" refers to a
licensed health care professional 
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employed by an establishment engaging in
administering routine 
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insulin and vitamin B-12 injections,
oral medications,
topical 
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treatments, eye and ear drops, or
nitroglycerin patches.

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Non-licensed staff may not administer any medication, except 
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that a certified medication aide may administer all medications 
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allowed under Department of Public Health rules adopted to 
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implement Section 3-206.05 of the Nursing Home Care Act. A 
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certified medication aide is prohibited from administering 
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medication to a resident until the required comprehensive 
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assessment by a physician is completed.  A certified medication 
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aide is prohibited from administering medication to a resident 
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whose medical condition is determined to be unstable.


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    The Department shall specify by rule procedures for 
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medication reminders,
supervision of self-administered 
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medication, and medication administration.

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    Nothing in this Act shall preclude a physician licensed to 
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practice medicine
in all its branches from providing services 
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to any resident.

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(Source: P.A. 91-656, eff. 1-1-01.)

 
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    Section 10. The Nursing Home Care Act is amended  by adding 
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Section 3-206.05 as follows:
 
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    (210 ILCS 45/3-206.05  new)
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    Sec. 3-206.05. Certified medication aide.
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    (a) The General Assembly finds that 30 other states have 
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had  successful medication aide programs for many years.  
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Further, the addition of certified medication aides would 
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increase the amount of skilled nursing care available by 
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enabling licensed nurses to devote even more time to the 
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assessment and monitoring of patient conditions.  The certified 
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medication aide will assist a licensed nurse in the 
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administration of routine medications.
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    (b) The Director shall appoint a Planning and Certification 
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Committee to develop the training curriculum, certification 
 


 






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test, certification requirements, continuing education 
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standards, regulations, and ongoing evaluation process for 
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medication aides.  The committee shall review any reports of 
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gross negligence on the part of any medication aide and shall 
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monitor the overall effectiveness of the medication aide 
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program. The committee shall be composed of one representative 
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from a nursing association, one representative from a nursing 
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school, one representative from the community colleges, one 
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representative from an organization advocating for seniors, 
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and 3 representatives from associations representing long-term 
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care providers.  The committee shall submit an annual progress 
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report to the General Assembly beginning July 1, 2006.  The 
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report shall  include a progress report on medication aide 
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program implementation and recommendations for legislative 
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changes necessary for program improvement.
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    (c)  Based on the recommendations of the Planning and 
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Certification Committee, the Department shall adopt and 
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implement rules for the
training, certification, and 
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employment of certified
medication aides in facilities 
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licensed under this Act.
Certified medication aides shall be 
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allowed to
administer medications to facility residents under 
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the
supervision of a duly licensed health care professional in 
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accordance
with rules adopted by the Department under this 
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Section.
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    (d) Unless an individual is certified under this Section:
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        (1) The individual may not practice as a certified
    
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    medication aide.
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        (2) A facility may not employ the individual as a
    
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    certified medication aide.
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    (e) A certified medication aide must comply with all of the 
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following:
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        (1) He or she must be a duly certified nursing 
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    assistant under this



    Act for at least one year.
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        (2) He or she must satisfactorily complete the 
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    medication aide
    training program involving at least 60 
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    hours of classroom training and 40 hours of clinical 
 


 






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    training prescribed by the Department.
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        (3) He or she must satisfactorily meet all continuing 
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    education and
    recertification requirements prescribed by 
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    the Department.
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        (4) He or she may not administer any schedule II 
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    controlled substances, any medication by sub-cutaneous, 
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    intramuscular, intradermal, or intravenous route, or any 
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    medications injected into a tube.
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        (5) He or she may not pass medications in a sub-acute 
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    section of a nursing home.

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        (6) He or she is prohibited from administering 
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    medication to a resident of a long-term care facility until 
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    the initial comprehensive assessment is completed and 
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    reviewed by a licensed health care professional.
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        (7) He or she is prohibited from administering 
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    medication to a resident whose comprehensive assessment 
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    indicated an unstable medical condition.
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    (f) A facility must comply with the following staffing 
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requirements:
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        (1) Only a certified medication aide may be employed in 
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    the capacity of a medication aide.
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        (2) A certified medication aide may not be assigned 
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    other duties when employed in the capacity of a medication 
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    aide.
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        (3) A certified medication aide may not be used to 
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    achieve minimum staffing requirements under this Act.

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    (g) The Department shall do all of the following:
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        (1) Prescribe education and training programs for
    
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    certified medication aides.
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        (2) Prescribe requirements for re-certification,
    
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    including continuing education and in-service
    
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    requirements.
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        (3) Develop standards concerning the functions that
    
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    may be performed by certified medication aides,
    including 
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    standards for oversight by a
    licensed healthcare 
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    professional.

 
 


 






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    Section 15. The Nursing and Advanced Practice Nursing Act 
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is amended  by changing Section 5-15 as follows:
 



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    (225 ILCS 65/5-15)



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    (Section scheduled to be repealed on January 1, 2008)

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    Sec. 5-15. Policy; application of Act. For the protection 
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of life and the
promotion of health, and the prevention of 
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illness and communicable diseases,
any person practicing or 
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offering to practice professional and practical
nursing in 
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Illinois shall submit evidence that he or she is qualified to

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practice, and shall be licensed as provided under this Act.  No 
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person shall
practice or offer to practice professional or 
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practical nursing in Illinois or
use any title, sign, card or 
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device to indicate that such a person is
practicing 
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professional or practical nursing unless such person has been

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licensed under the provisions of this Act.

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    This Act does not prohibit the following:


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        (a) The practice of nursing in Federal employment in 
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    the discharge of the
employee's duties by a person who is 
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    employed by the United States
government or any bureau, 
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    division or agency thereof and is a legally
qualified and 
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    licensed nurse of another state or territory and not in

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    conflict with Sections 10-5, 10-30, and 10-45 of this
Act.


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        (b) Nursing that is included in their program of study 
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    by
students
enrolled in programs of nursing or in current 
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    nurse practice update courses
approved by the Department.


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        (c) The furnishing of nursing assistance in an 
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    emergency.


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        (d) The practice of nursing by a nurse who holds an 
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    active license in
another state when providing services to 
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    patients in Illinois during a bonafide
emergency or in 
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    immediate preparation for or during interstate
transit.


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        (e) The incidental care of the sick by members of the 
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    family, domestic
servants or housekeepers, or care of the 
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    sick where treatment is by prayer
or spiritual means.


 


 






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        (f) Persons from being employed as nursing aides, 
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    attendants, orderlies,
and
other auxiliary workers in 
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    private homes, long term care facilities,
nurseries, 
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    hospitals or other institutions.


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        (g) The practice of practical nursing by one who has 
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    applied in writing to
the Department in form and substance 
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    satisfactory to the Department, for a
license as a licensed 
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    practical nurse and who has complied with all the

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    provisions under Section 10-30, except the passing of an 
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    examination
to be eligible to receive such license, until:  
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    the decision of the Department
that the applicant has 
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    failed to pass the next available examination
authorized by 
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    the Department or has failed, without an approved excuse, 
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    to
take the next available examination authorized by the 
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    Department or until the
withdrawal of the application, but 
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    not to exceed 3 months.
An applicant practicing practical 
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    nursing under this Section who passes the
examination, 
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    however, may continue to practice under this Section until 
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    such
time as he or she receives his or her license to 
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    practice or until the
Department notifies him or her that 
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    the license has been denied.
 No applicant
for licensure 
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    practicing under
the provisions of this paragraph shall 
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    practice practical nursing except
under the direct 
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    supervision of a registered professional nurse licensed

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    under this Act or a licensed physician, dentist or 
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    podiatrist.  In no
instance shall any such applicant 
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    practice or be
employed in any supervisory capacity.


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        (h) The practice of practical nursing by one who is a 
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    licensed practical
nurse under the laws of another U.S. 
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    jurisdiction and has applied in writing
to the Department, 
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    in form and substance satisfactory to the Department,
for a 
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    license as a licensed practical nurse and who is qualified 
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    to receive
such license under Section 10-30, until (1) the 
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    expiration of 6 months after
the filing of such written 
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    application, (2) the withdrawal of such application,
or (3) 
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    the denial of such application by the Department.


 


 






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        (i) The practice of professional nursing by one who has 
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    applied in writing
to the Department in form and substance 
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    satisfactory to the Department for
a license as a 
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    registered professional nurse and has complied with all the

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    provisions under Section 10-30 except the passing of an 
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    examination to be
eligible to receive such license, until  
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    the decision of the Department
that the applicant has 
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    failed to pass the next available examination
authorized by 
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    the Department or has failed, without an approved excuse, 
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    to
take the next available examination authorized by the 
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    Department or until
the withdrawal of the application, but 
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    not to exceed 3 months.
An applicant practicing 
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    professional nursing under this Section who passes
the

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    examination, however, may continue to practice under this 
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    Section until such
time as he or she receives his or her 
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    license to practice or until the
Department notifies him or 
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    her that the license has been denied.
 No applicant
for 
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    licensure practicing under
the provisions of this 
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    paragraph shall practice professional nursing except
under 
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    the direct supervision of a registered professional nurse 
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    licensed
under this Act.  In no instance shall any such 
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    applicant practice or be
employed in any supervisory 
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    capacity.


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        (j) The practice of professional nursing by one who is 
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    a registered
professional nurse under the laws of another 
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    state, territory of the United
States or country and has 
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    applied in writing to the Department, in form and
substance 
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    satisfactory to the Department, for a license as a 
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    registered
professional nurse and who is qualified to 
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    receive such license under
Section 10-30, until  (1)  the 
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    expiration of 6 months after the filing of
such written 
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    application, (2) the withdrawal of such application, or (3)

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    the denial of such application by the Department.


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        (k) The practice of professional nursing that is 
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    included in a program of
study by one who is a registered 
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    professional nurse under the laws of
another state or 
 


 






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    territory of the United States or foreign country,

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    territory or province and who is enrolled in a graduate 
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    nursing education
program or a program for the completion 
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    of a baccalaureate nursing degree in
this State, which 
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    includes clinical supervision by faculty as
determined by 
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    the educational institution offering the program and the

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    health care organization where the practice of nursing 
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    occurs.  The
educational institution will file with the 
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    Department each academic term a
list of the names and 
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    origin of license of all professional nurses
practicing 
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    nursing as part of their programs under this provision.


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        (l) Any person licensed in this State under any other 
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    Act from engaging
in the practice for which she or he is 
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    licensed.


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        (m) Delegation to authorized direct care staff trained 
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    under Section 15.4
of the Mental Health and
Developmental 
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    Disabilities Administrative Act.

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        (n) Administration of medications by a certified 
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    medication aide certified under Section 3-206.05 of the 
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    Nursing Home Care Act.  Any nurse providing supervision to a 
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    certified medication aide is not liable under this Act for 
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    the actions of the medication aide. Nothing in this Section 
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    shall be construed to grant a facility immunity from 
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    liability based upon the actions of the medication aide.

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    An applicant for license practicing under the exceptions 
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set forth in
subparagraphs (g), (h), (i), and (j) of this 
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Section shall use the title
R.N. Lic. Pend. or L.P.N. Lic. 
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Pend. respectively and no other.

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(Source: P.A. 93-265, eff. 7-22-03.)