94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
HB0645

 

Introduced 1/28/2005, by Rep. Mary E. Flowers

 

SYNOPSIS AS INTRODUCED:
 
New Act
5 ILCS 80/4.26 new
225 ILCS 60/4   from Ch. 111, par. 4400-4
225 ILCS 65/5-15

    Creates the Certified Professional Midwife Licensure Act. Provides for licensure of persons providing midwifery services. Amends the Regulatory Sunset Act to repeal the new Act on January 1, 2016. Amends the Medical Practice Act of 1987 and the Nursing and Advanced Practice Nursing Act to provide that those Acts do not prohibit the practice of midwifery by persons licensed under the Certified Professional Midwives Licensure Act. Effective immediately.


LRB094 06862 RAS 36969 b

CORRECTIONAL BUDGET AND IMPACT NOTE ACT MAY APPLY
FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB0645 LRB094 06862 RAS 36969 b

1     AN ACT concerning regulation.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4     Section 1. Short title. This Act may be cited as the
5 Certified Professional Midwife Licensure Act.
 
6     Section 5. Findings and purpose. This Act is intended to
7 establish a licensing procedure for certified professional
8 midwives in Illinois. The General Assembly finds and declares
9 the following:
10         (1) The intent of this Act is to encourage and enable
11     the practice of midwifery by certified professional
12     midwives so that this profession can be recognized and
13     regulated independently, according to the principles
14     recommended by the Pew Health Professions Commission and
15     the American Public Health Association, to increase the
16     availability of midwives to meet the maternal-child health
17     needs of Illinois families.
18         (2) Consumers continue to request the care of
19     direct-entry midwives.
20         (3) Direct-entry midwives have continued to provide
21     services to families in Illinois despite being unregulated
22     since 1963 and have participated in national credentialing
23     organized to meet professional standards.
24         (4) The Midwives Model of Care, as defined by the
25     Midwifery Task Force, includes (i) monitoring the
26     physical, psychological and social well-being of the
27     mother throughout the childbearing cycle, (ii) providing
28     the mother with individualized education, counseling, and
29     prenatal care, continuous hands-on assistance during labor
30     and delivery, and postpartum support, (iii) minimizing
31     technological interventions, and (iv) identifying and
32     referring women who require obstetrical attention. The

 

 

HB0645 - 2 - LRB094 06862 RAS 36969 b

1     application of this woman-centered model of care has been
2     proven to reduce the incidence of birth injury, trauma, and
3     cesarean section.
4         (5) In recognition of major changes in health care
5     regulation and practice, the Pew Health Professions
6     Commission, through its Taskforce on Health Care Workforce
7     Regulation, recommends that "until national models for
8     scopes of practice can be developed and adopted, states
9     should explore and develop mechanisms for existing
10     professions to evolve their existing scopes of practice and
11     for new professions (or previously unregulated
12     professions) to emerge", and further recommends that "a
13     number of professions and disciplines that use
14     non-mainstream therapies safely and effectively should be
15     recognized and regulated as appropriate".
16         (6) In its April 1999 report, the Pew Health
17     Professions Commission, in conjunction with the Center for
18     the Health Professions, recommended that "midwives should
19     be recognized as independent and collaborative
20     practitioners" and recommended "legislative action that
21     ensures: appropriate entry-to-practice standards" and the
22     "elimination of requirements that midwives be directed or
23     supervised by other health care professionals".
24         (7) In its resolution, "Increasing access to
25     out-of-hospital maternity care services through
26     state-regulated and nationally-certified direct-entry
27     midwives", the American Public Health Association (i)
28     supports efforts to increase access to out-of-hospital
29     maternity care services and increase the range of quality
30     maternity care choices available to consumers, through
31     recognition that legally regulated and nationally
32     certified direct-entry midwives can serve clients desiring
33     safe, planned, out-of-hospital maternity care services,
34     and (ii) encourages the development and implementation of
35     guidelines for the licensing and certification of
36     direct-entry midwives and the practice of midwifery for use

 

 

HB0645 - 3 - LRB094 06862 RAS 36969 b

1     by state and local health agencies, health planners,
2     maternity care providers, and professional organizations.
 
3     Section 10. Definitions. As used in this Act:
4     "Approved program of midwifery education" means an
5 education program accredited or pre-accredited by a
6 direct-entry midwifery accreditation agency recognized by the
7 United States Department of Education, i.e. the Midwifery
8 Education Accreditation Council (MEAC) or its successor.
9     "Certified professional midwife" means a person who has met
10 the standards for certification set by the North American
11 Registry of Midwives or its successor and has been awarded this
12 credential.
13     "Consultation" means the process whereby a licensed
14 midwife seeks the advice or opinion of a physician or another
15 member of a health care team.
16     "Council" means the Licensed Midwife Council.
17     "Department" means the Department of Financial and
18 Professional Regulation.
19     "Secretary" means the Secretary of Financial and
20 Professional Regulation.
21     "Informed consent" means a document that includes, but is
22 not limited to, disclosure of the midwife's education, skill
23 level, liability insurance coverage, and written plan for
24 medical emergencies.
25     "Licensed midwife" means a person who is licensed under
26 this Act.
27     "Midwifery" means the provision, on a continuing basis and
28 within a health care system that provides for consultation and
29 referral as needed, of the necessary care and education to
30 women during pregnancy, labor, and the postpartum and
31 interpartum periods; attending deliveries that the individual
32 is responsible for; and caring for the newborn infant.
33 "Midwifery" also includes the provision of additional primary
34 health care services to women and their families, which
35 include, but are not limited to, well-woman gynecological

 

 

HB0645 - 4 - LRB094 06862 RAS 36969 b

1 services such as non-pharmacological family planning and
2 routine pap smears.
3     "North American Registry of Midwives" or "NARM" means the
4 international agency, or its successor, that has established
5 and has continued to administer certification for the
6 credentialing of certified professional midwives.
7     "Peer review" means an educational review process in
8 accordance with current NARM peer review standards that
9 includes a certificate of participation document.
10     "Referral" means the process whereby a licensed midwife
11 directs the client to a physician or other health care
12 professional for management of a particular problem or aspect
13 of the client's care.
 
14     Section 15. License required.
15     (a) Beginning July 1, 2007, no person shall practice
16 midwifery in this State without a license under this Act,
17 except as provided in Section 20.
18     (b) No person shall use in connection with the person's
19 name any letters, words, or insignia indicating or implying
20 that the person is a licensed midwife unless the person is
21 licensed in accordance with this Act. A person so licensed may
22 use the abbreviation "L.M." in connection with the person's
23 name.
 
24     Section 20. Exemptions. Nothing in this Act shall be
25 construed to prohibit or to require registration under this
26 Act, with regard to any of the following:
27         (1) The gratuitous rendering of services.
28         (2) The rendering of services by a person if such
29     attendance is in accordance with the person's religious
30     faith and is rendered to persons with a similar religious
31     faith.
32         (3) Certified nurse midwives authorized under the
33     Advanced Practice Nursing Board to practice in Illinois.
34         (4) Licensed physicians or other licensed health care

 

 

HB0645 - 5 - LRB094 06862 RAS 36969 b

1     providers authorized to provide maternity care.
2         (5) Midwifery that is included in the educational
3     programs of student midwives enrolled in approved programs
4     of midwifery education.
 
5     Section 25. Licensed Midwife Council. There shall be
6 established within the Department of Financial and
7 Professional Regulation a Licensed Midwife Council composed of
8 7 members appointed by the Secretary. The appointed members of
9 the Council shall include 4 licensed midwives and 3 consumers.
10 A consumer is a person who (i) has never been a midwife nor
11 studied to be a midwife, (ii) has no financial interest in the
12 practice of midwifery or in any health care facility, agency,
13 or insurer, and (iii) has engaged a provider who practices or
14 has practiced as a midwife in an out-of-hospital birth setting.
15 Of the members first appointed to the Council, 3 members shall
16 be appointed for a term of 3 years, 2 members shall be
17 appointed for a term of 2 years, and 2 members shall be
18 appointed for a term of one year. Thereafter, all members shall
19 serve 3-year terms. In making appointments to the Council, the
20 Secretary shall consider the recommendations of individuals
21 and organizations directly involved with midwifery in this
22 State. A vacancy in an unexpired term shall be filled in the
23 same manner as the original appointment. The Secretary may
24 remove a Council member for misconduct, incapacity, or neglect
25 of duty, but only after notice and a public hearing, unless the
26 notice and hearing are waived by the member in writing. The
27 Council shall elect from its membership a chairperson. The
28 Council may meet as needed, but shall meet at least twice a
29 year.
 
30     Section 30. Powers of the Council. The Licensed Midwife
31 Council is authorized to:
32         (1) Recommend and approve the adoption and revision of
33     any rules that may be necessary to carry out the provisions
34     of this Act that are designed to protect the health,

 

 

HB0645 - 6 - LRB094 06862 RAS 36969 b

1     safety, and welfare of the public. The rules shall include
2     the scope of practice and services provided regarding the
3     use of equipment, procedures, and medications.
4         (2) Conduct hearings and disciplinary conferences on
5     disciplinary charges of those licensed as provided in
6     Section 75 and those in violation of Section 15.
7         (3) Report to the Department, upon completion of a
8     hearing, the disciplinary actions recommended to be taken
9     against a person violating this Act.
10         (4) Approve, deny, or withdraw approval of required
11     education and continuing educational programs.
 
12     Section 35. Council members; immunity from suit. The
13 members of the Council are immune from suit in any action based
14 upon disciplinary proceedings or other acts performed as
15 members of the Council, except those involving willful or
16 wanton misconduct.
 
17     Section 40. Council members; compensation. Members of the
18 Council shall serve without compensation, but shall be
19 reimbursed for actual expenses necessarily incurred in the
20 discharge of their duties.
 
21     Section 45. Powers and duties of the Department.
22     (a) The Department shall exercise the powers and duties
23 necessary to effectuate the purposes of this Act. None of the
24 functions, powers, or duties of the Department with respect to
25 licensure shall be exercised by the Department except upon
26 review and approval by the Council.
27     (b) The Department shall have the authority and
28 responsibility to:
29         (1) license individuals who qualify for licensure;
30         (2) issue quarterly reports to the Council on the
31     status of all formal complaints filed by the Department and
32     on significant issues as determined by the Council; and
33         (3) promulgate rules for licensure of candidates

 

 

HB0645 - 7 - LRB094 06862 RAS 36969 b

1     authorized to practice under this Act.
 
2     Section 50. Eligibility.
3     (a) A person is eligible to be licensed as a midwife if
4 that person meets the following qualifications:
5         (1) holds the credential of certified professional
6     midwife;
7         (2) has completed an approved program of midwifery
8     education with a minimum of 1,800 contact hours or its
9     equivalent;
10         (3) is in good standing with the North American
11     Registry of Midwives;
12         (4) participates in peer review at least twice per
13     year; and
14         (5) provides the Department with an annually updated
15     informed consent document.
16     (b) For a period of 5 years following the effective date of
17 this Act, the Council shall have the authority and discretion
18 to license applicants who have practiced midwifery prior to the
19 effective date of this Act and have had an application accepted
20 by the North American Registry of Midwives for certification.
21 Such license shall terminate automatically 2 years after the
22 date of registration unless the applicant has, by such time,
23 successfully completed the examination provided by the North
24 American Registry of Midwives.
 
25     Section 55. Scope of practice; informed consent.
26     (a) A licensed midwife may perform any of the midwifery
27 services and skills established by the North American Registry
28 of Midwives, including, but not limited to, antepartum,
29 intrapartum, and postpartum care of women; newborn assessment
30 and care of newborns; and well-woman gynecology and
31 non-prescriptive family planning. However, the midwife must
32 practice within the standards for practice and code of ethics
33 of the North American Registry of Midwives.
34     (b) A copy of the informed consent document, signed and

 

 

HB0645 - 8 - LRB094 06862 RAS 36969 b

1 dated by the client, must be kept in each client's chart.
 
2     Section 60. Application for license. A person shall apply
3 for licensure as a midwife to the Secretary on a form furnished
4 by the Department. The application shall be accompanied by
5 payment of the specified fee and evidence that the person meets
6 the eligibility requirements of this Act.
 
7     Section 65. Renewals. A midwife license must be renewed
8 every 3 years. An applicant for renewal shall submit to the
9 Department (i) a renewal application on the prescribed form
10 furnished by the Department and (ii) a renewal fee as
11 prescribed by the Department.
 
12     Section 70. Fees. The Department shall have the authority
13 to (i) charge each candidate for licensure a fee, which must be
14 submitted with his or her application and (ii) charge each
15 licensed midwife a fee for renewal of his or her license.
 
16     Section 75. Disciplinary action.
17     (a) A licensed midwife or applicant for licensure, renewal,
18 or reinstatement shall not engage in unprofessional conduct,
19 which includes:
20         (1) fraudulently procuring or using a license;
21         (2) willfully making or filing false reports or
22     records, willfully impeding or obstructing the filing of
23     reports or records, or willfully failing to file required
24     reports or records in the practice of midwifery;
25         (3) using dishonest or misleading advertising;
26         (4) failing to comply with any statutes related to the
27     practice of midwifery;
28         (5) conviction of a crime related to the practice of
29     midwifery as described in this Act;
30         (6) failing to provide, in a timely manner, copies of
31     all records of the care provided to a person after a
32     written request is received from the person who received

 

 

HB0645 - 9 - LRB094 06862 RAS 36969 b

1     care; and
2         (7) engaging in gross or repeated malpractice.
3     (b) After a hearing, and upon making a finding of
4 unprofessional conduct, the Licensed Midwife Council shall (i)
5 reprimand the licensed midwife or applicant, (ii) revoke the
6 license or refuse to issue or renew a license, or (iii) seek an
7 injunction against the continuation of the conduct.
 
8     Section 80. Penalties. A person who knowingly violates any
9 of the provisions of this Act is guilty of a Class A
10 misdemeanor.
 
11     Section 85. Reimbursement. A midwife licensed to practice
12 midwifery is eligible for compensation as a provider under the
13 Illinois Medicaid program and any other third party
14 reimbursement plan, including Medicare, subject to the laws of
15 this State and applicable federal law.
 
16     Section 90. Advertising. A person licensed under this Act
17 may advertise the availability of professional services in the
18 public media or on the premises where such professional
19 services are rendered, provided that the advertising is
20 truthful and not misleading.
 
21     Section 95. Women's rights regarding the birth of the baby.
22 Women have a right to give birth where and with whom they
23 choose. This Act does not prohibit the attendance at birth of
24 the mother's choice of family, friends, and other persons.
 
25     Section 100. Liability of licensed midwives. Licensed
26 midwives shall be liable for their acts or omissions in the
27 performance of the services that they provide, and no
28 physician, nurse, pre-hospital emergency personnel, or health
29 care institution shall be liable for any act or omission
30 resulting from the administration of services by any licensed
31 midwife. The provisions of this Section shall not relieve any

 

 

HB0645 - 10 - LRB094 06862 RAS 36969 b

1 other licensed midwife, physician, nurse, pre-hospital
2 emergency personnel, or health care institution from liability
3 for any willful or wanton act or omission or any act or
4 omission constituting gross negligence, or under circumstances
5 where a licensed midwife has a business relationship with any
6 such licensed midwife, physician, nurse, pre-hospital
7 emergency personnel, or health care institution. A physician,
8 nurse, pre-hospital emergency personnel, or health care
9 institution shall not be deemed to have established a business
10 relationship solely by providing consultation or accepting a
11 referral from the midwife in accordance with this Act.
 
12     Section 105. Rules. The Department shall adopt rules for
13 the licensure of midwives under this Act by January 1, 2006.
 
14     Section 900. The Regulatory Sunset Act is amended by adding
15 Section 4.26 as follows:
 
16     (5 ILCS 80/4.26 new)
17     Sec. 4.26. Act repealed on January 1, 2016. The following
18 Act is repealed on January 1, 2016:
19     The Certified Professional Midwife Licensure Act.
 
20     Section 905. The Medical Practice Act of 1987 is amended by
21 changing Section 4 as follows:
 
22     (225 ILCS 60/4)  (from Ch. 111, par. 4400-4)
23     Sec. 4. Exemptions.
24     (a) This Act does not apply to the following:
25         (1) persons lawfully carrying on their particular
26     profession or business under any valid existing regulatory
27     Act of this State;
28         (2) persons rendering gratuitous services in cases of
29     emergency; or
30         (3) persons treating human ailments by prayer or
31     spiritual means as an exercise or enjoyment of religious

 

 

HB0645 - 11 - LRB094 06862 RAS 36969 b

1     freedom.
2     (b) (Blank).
3     (c) Nothing in this Act shall be construed as prohibiting
4 the practice of midwifery by persons licensed under the
5 Certified Professional Midwife Licensure Act.
6 (Source: P.A. 93-379, eff. 7-24-03.)
 
7     Section 910. The Nursing and Advanced Practice Nursing Act
8 is amended by changing Section 5-15 as follows:
 
9     (225 ILCS 65/5-15)
10     (Section scheduled to be repealed on January 1, 2008)
11     Sec. 5-15. Policy; application of Act. For the protection
12 of life and the promotion of health, and the prevention of
13 illness and communicable diseases, any person practicing or
14 offering to practice professional and practical nursing in
15 Illinois shall submit evidence that he or she is qualified to
16 practice, and shall be licensed as provided under this Act. No
17 person shall practice or offer to practice professional or
18 practical nursing in Illinois or use any title, sign, card or
19 device to indicate that such a person is practicing
20 professional or practical nursing unless such person has been
21 licensed under the provisions of this Act.
22     This Act does not prohibit the following:
23         (a) The practice of nursing in Federal employment in
24     the discharge of the employee's duties by a person who is
25     employed by the United States government or any bureau,
26     division or agency thereof and is a legally qualified and
27     licensed nurse of another state or territory and not in
28     conflict with Sections 10-5, 10-30, and 10-45 of this Act.
29         (b) Nursing that is included in their program of study
30     by students enrolled in programs of nursing or in current
31     nurse practice update courses approved by the Department.
32         (c) The furnishing of nursing assistance in an
33     emergency.
34         (d) The practice of nursing by a nurse who holds an

 

 

HB0645 - 12 - LRB094 06862 RAS 36969 b

1     active license in another state when providing services to
2     patients in Illinois during a bonafide emergency or in
3     immediate preparation for or during interstate transit.
4         (e) The incidental care of the sick by members of the
5     family, domestic servants or housekeepers, or care of the
6     sick where treatment is by prayer or spiritual means.
7         (f) Persons from being employed as nursing aides,
8     attendants, orderlies, and other auxiliary workers in
9     private homes, long term care facilities, nurseries,
10     hospitals or other institutions.
11         (g) The practice of practical nursing by one who has
12     applied in writing to the Department in form and substance
13     satisfactory to the Department, for a license as a licensed
14     practical nurse and who has complied with all the
15     provisions under Section 10-30, except the passing of an
16     examination to be eligible to receive such license, until:
17     the decision of the Department that the applicant has
18     failed to pass the next available examination authorized by
19     the Department or has failed, without an approved excuse,
20     to take the next available examination authorized by the
21     Department or until the withdrawal of the application, but
22     not to exceed 3 months. An applicant practicing practical
23     nursing under this Section who passes the examination,
24     however, may continue to practice under this Section until
25     such time as he or she receives his or her license to
26     practice or until the Department notifies him or her that
27     the license has been denied. No applicant for licensure
28     practicing under the provisions of this paragraph shall
29     practice practical nursing except under the direct
30     supervision of a registered professional nurse licensed
31     under this Act or a licensed physician, dentist or
32     podiatrist. In no instance shall any such applicant
33     practice or be employed in any supervisory capacity.
34         (h) The practice of practical nursing by one who is a
35     licensed practical nurse under the laws of another U.S.
36     jurisdiction and has applied in writing to the Department,

 

 

HB0645 - 13 - LRB094 06862 RAS 36969 b

1     in form and substance satisfactory to the Department, for a
2     license as a licensed practical nurse and who is qualified
3     to receive such license under Section 10-30, until (1) the
4     expiration of 6 months after the filing of such written
5     application, (2) the withdrawal of such application, or (3)
6     the denial of such application by the Department.
7         (i) The practice of professional nursing by one who has
8     applied in writing to the Department in form and substance
9     satisfactory to the Department for a license as a
10     registered professional nurse and has complied with all the
11     provisions under Section 10-30 except the passing of an
12     examination to be eligible to receive such license, until
13     the decision of the Department that the applicant has
14     failed to pass the next available examination authorized by
15     the Department or has failed, without an approved excuse,
16     to take the next available examination authorized by the
17     Department or until the withdrawal of the application, but
18     not to exceed 3 months. An applicant practicing
19     professional nursing under this Section who passes the
20     examination, however, may continue to practice under this
21     Section until such time as he or she receives his or her
22     license to practice or until the Department notifies him or
23     her that the license has been denied. No applicant for
24     licensure practicing under the provisions of this
25     paragraph shall practice professional nursing except under
26     the direct supervision of a registered professional nurse
27     licensed under this Act. In no instance shall any such
28     applicant practice or be employed in any supervisory
29     capacity.
30         (j) The practice of professional nursing by one who is
31     a registered professional nurse under the laws of another
32     state, territory of the United States or country and has
33     applied in writing to the Department, in form and substance
34     satisfactory to the Department, for a license as a
35     registered professional nurse and who is qualified to
36     receive such license under Section 10-30, until (1) the

 

 

HB0645 - 14 - LRB094 06862 RAS 36969 b

1     expiration of 6 months after the filing of such written
2     application, (2) the withdrawal of such application, or (3)
3     the denial of such application by the Department.
4         (k) The practice of professional nursing that is
5     included in a program of study by one who is a registered
6     professional nurse under the laws of another state or
7     territory of the United States or foreign country,
8     territory or province and who is enrolled in a graduate
9     nursing education program or a program for the completion
10     of a baccalaureate nursing degree in this State, which
11     includes clinical supervision by faculty as determined by
12     the educational institution offering the program and the
13     health care organization where the practice of nursing
14     occurs. The educational institution will file with the
15     Department each academic term a list of the names and
16     origin of license of all professional nurses practicing
17     nursing as part of their programs under this provision.
18         (l) Any person licensed in this State under any other
19     Act from engaging in the practice for which she or he is
20     licensed.
21         (m) Delegation to authorized direct care staff trained
22     under Section 15.4 of the Mental Health and Developmental
23     Disabilities Administrative Act.
24         (n) The practice of midwifery by persons licensed under
25     the Certified Professional Midwife Licensure Act.
26     An applicant for license practicing under the exceptions
27 set forth in subparagraphs (g), (h), (i), and (j) of this
28 Section shall use the title R.N. Lic. Pend. or L.P.N. Lic.
29 Pend. respectively and no other.
30 (Source: P.A. 93-265, eff. 7-22-03.)
 
31     Section 999. Effective date. This Act takes effect upon
32 becoming law.