Illinois General Assembly - Full Text of HB3933
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Full Text of HB3933  93rd General Assembly

HB3933 93rd General Assembly


093_HB3933

 
                                     LRB093 13632 AMC 19007 b

 1        AN ACT concerning midwives.

 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
11        enable   the   practice   of   midwifery   by   certified
12        professional  midwives  so  that  this  profession can be
13        recognized and regulated independently, according to  the
14        principles  recommended  by  the  Pew  Health Professions
15        Commission and the American Public Health Association, to
16        increase  the  availability  of  midwives  to  meet   the
17        maternal-child health 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
22        unregulated since 1963 and have participated in  national
23        credentialing 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
30        labor   and   delivery,  and  postpartum  support,  (iii)
31        minimizing   technological   interventions,   and    (iv)
 
                            -2-      LRB093 13632 AMC 19007 b
 1        identifying  and  referring women who require obstetrical
 2        attention. The application of this  woman-centered  model
 3        of  care has been proven to reduce the incidence of birth
 4        injury, trauma, and cesarean section.
 5             (5)  In recognition of major changes in health  care
 6        regulation  and  practice,  the  Pew  Health  Professions
 7        Commission,   through   its   Taskforce  on  Health  Care
 8        Workforce Regulation,  recommends  that  "until  national
 9        models  for  scopes  of  practice  can  be  developed and
10        adopted, states should explore and develop mechanisms for
11        existing professions to evolve their existing  scopes  of
12        practice   and   for   new   professions  (or  previously
13        unregulated  professions)   to   emerge",   and   further
14        recommends  that "a number of professions and disciplines
15        that use non-mainstream therapies safely and  effectively
16        should be recognized and regulated as appropriate".
17             (6)  In  its  April  1999  report,  the  Pew  Health
18        Professions  Commission,  in  conjunction with the Center
19        for the Health Professions,  recommended  that  "midwives
20        should  be  recognized  as  independent and collaborative
21        practitioners" and recommended "legislative  action  that
22        ensures: appropriate entry-to-practice standards" and the
23        "elimination of requirements that midwives be directed or
24        supervised by other health care professionals".
25             (7)  In   its   resolution,  "Increasing  access  to
26        out-of-hospital   maternity   care    services    through
27        state-regulated   and  nationally-certified  direct-entry
28        midwives", the American  Public  Health  Association  (i)
29        supports  efforts  to  increase access to out-of-hospital
30        maternity care services and increase the range of quality
31        maternity care choices available  to  consumers,  through
32        recognition   that   legally   regulated  and  nationally
33        certified  direct-entry  midwives   can   serve   clients
34        desiring  safe,  planned,  out-of-hospital maternity care
 
                            -3-      LRB093 13632 AMC 19007 b
 1        services,  and  (ii)  encourages  the   development   and
 2        implementation   of  guidelines  for  the  licensing  and
 3        certification of direct-entry midwives and  the  practice
 4        of  midwifery for use by state and local health agencies,
 5        health   planners,   maternity   care   providers,    and
 6        professional organizations.

 7        Section 10.  Definitions. As used in this Act:
 8        "Approved   program  of  midwifery  education"  means  an
 9    education  program  accredited   or   pre-accredited   by   a
10    direct-entry midwifery accreditation agency recognized by the
11    United  States  Department  of  Education, i.e. the Midwifery
12    Education Accreditation Council (MEAC) or its successor.
13        "Certified professional midwife" means a person  who  has
14    met the standards for certification set by the North American
15    Registry  of  Midwives  or its successor and has been awarded
16    this credential.
17        "Consultation"  means  the  process  whereby  a  licensed
18    midwife seeks the advice or opinion of a physician or another
19    member of a health care team.
20        "Council" means the Licensed Midwife Council.
21        "Department"  means  the   Department   of   Professional
22    Regulation.
23        "Director" means the Director of Professional Regulation.
24        "Informed consent" means a document that includes, but is
25    not  limited to, disclosure of the midwife's education, skill
26    level, liability insurance coverage,  and  written  plan  for
27    medical emergencies.
28        "Licensed  midwife"  means a person who is licensed under
29    this Act.
30        "Midwifery" means the provision, on  a  continuing  basis
31    and   within   a   health   care  system  that  provides  for
32    consultation and referral as needed, of  the  necessary  care
33    and  education  to  women  during  pregnancy,  labor, and the
 
                            -4-      LRB093 13632 AMC 19007 b
 1    postpartum and interpartum periods; attending deliveries that
 2    the individual is responsible for; and caring for the newborn
 3    infant. "Midwifery" also includes the provision of additional
 4    primary health care services to  women  and  their  families,
 5    which   include,   but   are   not   limited  to,  well-woman
 6    gynecological services  such  as  non-pharmacological  family
 7    planning and routine pap smears.
 8        "North American Registry of Midwives" or "NARM" means the
 9    international  agency, or its successor, that has established
10    and  has  continued  to  administer  certification  for   the
11    credentialing of certified professional midwives.
12        "Peer  review"  means  an  educational  review process in
13    accordance with  current  NARM  peer  review  standards  that
14    includes a certificate of participation document.
15        "Referral"  means  the process whereby a licensed midwife
16    directs the client  to  a  physician  or  other  health  care
17    professional for management of a particular problem or aspect
18    of the client's care.

19        Section 15.  License required.
20        (a)  Beginning  July  1,  2005,  no person shall practice
21    midwifery in this State without a  license  under  this  Act,
22    except as provided in Section 20.
23        (b)  No  person shall use in connection with the person's
24    name any letters, words, or insignia indicating  or  implying
25    that  the  person  is a licensed midwife unless the person is
26    licensed in accordance with this Act. A  person  so  licensed
27    may  use  the  abbreviation  "L.M."  in  connection  with the
28    person's name.

29        Section 20.  Exemptions. Nothing in  this  Act  shall  be
30    construed  to  prohibit or to require registration under this
31    Act, with regard to any of the following:
32        (1)  The gratuitous rendering of services.
 
                            -5-      LRB093 13632 AMC 19007 b
 1        (2)  The rendering  of  services  by  a  person  if  such
 2    attendance is in accordance with the person's religious faith
 3    and is rendered to persons with a similar religious faith.
 4        (3)  Certified   nurse   midwives  authorized  under  the
 5    Advanced Practice Nursing Board to practice in Illinois.
 6        (4)  Licensed physicians or other  licensed  health  care
 7    providers authorized to provide maternity care.
 8        (5)  Midwifery   that  is  included  in  the  educational
 9    programs of student midwives enrolled in approved programs of
10    midwifery education.

11        Section 25.  Licensed Midwife  Council.  There  shall  be
12    established  within the Department of Professional Regulation
13    a Licensed Midwife Council composed of 7 members appointed by
14    the Director. The appointed  members  of  the  Council  shall
15    include 4 licensed midwives and 3 consumers.  A consumer is a
16    person  who  (i) has never been a midwife nor studied to be a
17    midwife, (ii) has no financial interest in  the  practice  of
18    midwifery or in any health care facility, agency, or insurer,
19    and  (iii)  has  engaged  a  provider  who  practices  or has
20    practiced as a midwife in an out-of-hospital  birth  setting.
21    Of  the  members  first  appointed  to the Council, 3 members
22    shall be appointed for a term of 3 years, 2 members shall  be
23    appointed  for  a  term  of  2  years, and 2 members shall be
24    appointed for a term of one  year.  Thereafter,  all  members
25    shall  serve  3-year  terms.  In  making  appointments to the
26    Council, the Director shall consider the  recommendations  of
27    individuals   and   organizations   directly   involved  with
28    midwifery in this State. A vacancy in an unexpired term shall
29    be filled in the same manner as the original appointment. The
30    Director  may  remove  a  Council  member   for   misconduct,
31    incapacity,  or  neglect of duty, but only after notice and a
32    public hearing, unless the notice and hearing are  waived  by
33    the  member  in  writing.  The  Council  shall elect from its
 
                            -6-      LRB093 13632 AMC 19007 b
 1    membership a chairperson. The Council may meet as needed, but
 2    shall meet at least twice a year.

 3        Section 30.  Powers of the Council. The Licensed  Midwife
 4    Council is authorized to:
 5        (1)  Recommend  and  approve the adoption and revision of
 6    any rules that may be necessary to carry out  the  provisions
 7    of  this Act that are designed to protect the health, safety,
 8    and welfare of the public. The rules shall include the  scope
 9    of  practice  and  services  provided  regarding  the  use of
10    equipment, procedures, and medications.
11        (2)  Conduct hearings  and  disciplinary  conferences  on
12    disciplinary charges of those licensed as provided in Section
13    70 and those in violation of Section 15.
14        (3)  Report  to  the  Department,  upon  completion  of a
15    hearing, the disciplinary actions  recommended  to  be  taken
16    against a person violating this Act.
17        (4)    Approve,  deny,  or  withdraw approval of required
18    education and continuing educational programs.

19        Section 35.  Council members;  immunity  from  suit.  The
20    members  of  the  Council  are immune from suit in any action
21    based upon disciplinary proceedings or other  acts  performed
22    as  members of the Council, except those involving willful or
23    wanton misconduct.

24        Section 40.  Council members;  compensation.  Members  of
25    the  Council  shall  serve without compensation, but shall be
26    reimbursed for actual expenses necessarily  incurred  in  the
27    discharge of their duties.

28        Section 45.  Powers and duties of the Department.
29        (a)  The  Department shall exercise the powers and duties
30    necessary to effectuate the purposes of this Act. None of the

 
                            -7-      LRB093 13632 AMC 19007 b
 1    functions, powers, or duties of the Department  with  respect
 2    to licensure shall be exercised by the Department except upon
 3    review and approval by the Council.
 4        (b)  The   Department   shall   have  the  authority  and
 5    responsibility to:
 6             (1)  license individuals who qualify for licensure;
 7             (2)  issue quarterly reports to the Council  on  the
 8        status  of  all formal complaints filed by the Department
 9        and on significant issues as determined by  the  Council;
10        and
11             (3)  promulgate  rules  for  licensure of candidates
12        authorized to practice under this Act.

13        Section 50.  Eligibility.
14        (a)  A person is eligible to be licensed as a midwife  if
15    that person meets the following qualifications:
16             (1)  holds  the credential of certified professional
17        midwife;
18             (2)  has completed an approved program of  midwifery
19        education  with  a  minimum of 1,800 contact hours or its
20        equivalent;
21             (3)  is in good standing  with  the  North  American
22        Registry of Midwives;
23             (4)  participates  in peer review at least twice per
24        year; and
25             (5)  provides  the  Department  with   an   annually
26        updated informed consent document.
27        (b)  For a period of 5 years following the effective date
28    of  this  Act,  the  Council  shall  have  the  authority and
29    discretion to license applicants who have practiced midwifery
30    prior to the effective date of  this  Act  and  have  had  an
31    application  accepted  by  the  North  American  Registry  of
32    Midwives  for  certification.  Such  license  shall terminate
33    automatically 2 years after the date of  registration  unless
 
                            -8-      LRB093 13632 AMC 19007 b
 1    the  applicant  has, by such time, successfully completed the
 2    examination  provided  by  the  North  American  Registry  of
 3    Midwives.

 4        Section 55.  Scope of practice; informed consent.
 5        (a)  A licensed midwife may perform any of the  midwifery
 6    services   and  skills  established  by  the  North  American
 7    Registry  of  Midwives,  including,  but  not   limited   to,
 8    antepartum,   intrapartum,  and  postpartum  care  of  women;
 9    newborn assessment  and  care  of  newborns;  and  well-woman
10    gynecology  and  non-prescriptive  family planning.  However,
11    the midwife must practice within the standards  for  practice
12    and  code  of  ethics  of  the  North  American  Registry  of
13    Midwives.
14        (b)  A  copy of the informed consent document, signed and
15    dated by the client, must be kept in each client's chart.

16        Section 60.  Application  for  license.  A  person  shall
17    apply  for  licensure  as a midwife to the Director on a form
18    furnished  by  the  Department.  The  application  shall   be
19    accompanied by payment of the specified fee and evidence that
20    the person meets the eligibility requirements of this Act.

21        Section  65.  Renewals. A midwife license must be renewed
22    every 3 years. An applicant for renewal shall submit  to  the
23    Department  (i)  a renewal application on the prescribed form
24    furnished by  the  Department  and  (ii)  a  renewal  fee  as
25    prescribed by the Department.

26        Section   70.  Fees.   The   Department  shall  have  the
27    authority to (i) charge each candidate for licensure  a  fee,
28    which must be submitted with his or her  application and (ii)
29    charge  each licensed midwife a fee for renewal of his or her
30    license.
 
                            -9-      LRB093 13632 AMC 19007 b
 1        Section 75.  Disciplinary action.
 2        (a)  A  licensed  midwife  or  applicant  for  licensure,
 3    renewal, or reinstatement shall not engage in  unprofessional
 4    conduct, which includes:
 5             (1)  fraudulently procuring or using a license;
 6             (2)  willfully  making  or  filing  false reports or
 7        records, willfully impeding or obstructing the filing  of
 8        reports or records, or willfully failing to file required
 9        reports or records in the practice of midwifery;
10             (3)  using dishonest or misleading advertising;
11             (4)  failing  to comply with any statutes related to
12        the practice of midwifery;
13             (5)  conviction of a crime related to  the  practice
14        of midwifery as described in this Act;
15             (6)  failing  to provide, in a timely manner, copies
16        of all records of the care provided to a person  after  a
17        written  request is received from the person who received
18        care; and
19             (7)  engaging in gross or repeated malpractice.
20        (b)  After a  hearing,  and  upon  making  a  finding  of
21    unprofessional  conduct,  the  Licensed Midwife Council shall
22    (i) reprimand the licensed midwife or applicant, (ii)  revoke
23    the  license  or refuse to issue or renew a license, or (iii)
24    seek an injunction against the continuation of the conduct.

25        Section 80.  Penalties. A person who  knowingly  violates
26    any  of  the  provisions  of  this Act is guilty of a Class A
27    misdemeanor.

28        Section  85.  Reimbursement.  A   midwife   licensed   to
29    practice midwifery is eligible for compensation as a provider
30    under the Illinois Medicaid program and any other third party
31    reimbursement  plan,  including Medicare, subject to the laws
32    of this State and applicable federal law.
 
                            -10-     LRB093 13632 AMC 19007 b
 1        Section 90.  Advertising. A person  licensed  under  this
 2    Act  may  advertise the availability of professional services
 3    in  the  public  media  or  on  the   premises   where   such
 4    professional   services   are  rendered,  provided  that  the
 5    advertising is truthful and not misleading.

 6        Section 95.  Women's rights regarding the  birth  of  the
 7    baby.  Women  have  a right to give birth where and with whom
 8    they choose. This Act does not  prohibit  the  attendance  at
 9    birth  of  the  mother's choice of family, friends, and other
10    persons.

11        Section 100.  Liability of  licensed  midwives.  Licensed
12    midwives  shall  be liable for their acts or omissions in the
13    performance  of  the  services  that  they  provide,  and  no
14    physician, nurse, pre-hospital emergency personnel, or health
15    care institution shall be liable  for  any  act  or  omission
16    resulting from the administration of services by any licensed
17    midwife. The provisions of this Section shall not relieve any
18    other   licensed   midwife,  physician,  nurse,  pre-hospital
19    emergency  personnel,  or  health   care   institution   from
20    liability  for  any  willful or wanton act or omission or any
21    act or  omission  constituting  gross  negligence,  or  under
22    circumstances   where  a  licensed  midwife  has  a  business
23    relationship  with  any  such  licensed  midwife,  physician,
24    nurse,  pre-hospital  emergency  personnel,  or  health  care
25    institution.  A  physician,  nurse,  pre-hospital   emergency
26    personnel,  or health care institution shall not be deemed to
27    have established a business relationship solely by  providing
28    consultation  or  accepting  a  referral  from the midwife in
29    accordance with this Act.

30        Section 105.  Promulgation of rules  by  the  Department.
31    The  Department  shall  promulgate rules for the licensure of
 
                            -11-     LRB093 13632 AMC 19007 b
 1    midwives under this Act by January 1, 2004.

 2        Section 900.  The Regulatory Sunset  Act  is  amended  by
 3    adding Section 4.25 as follows:

 4        (5 ILCS 80/4.25 new)
 5        Sec.   4.25.  Act  repealed  on  January  1,  2015.   The
 6    following Act is repealed on January 1, 2015:
 7        The Certified Professional Midwife Licensure Act.

 8        Section   905.  The  Medical  Practice  Act  of  1987  is
 9    amended by changing Section 4 as follows:

10        (225 ILCS 60/4) (from Ch. 111, par. 4400-4)
11        Sec. 4.  Exemptions.
12        (a)  This Act does not apply to the following:
13             (1)  persons lawfully carrying on  their  particular
14        profession   or   business   under   any  valid  existing
15        regulatory Act of this State;
16             (2)  persons rendering gratuitous services in  cases
17        of emergency; or
18             (3)  persons  treating  human  ailments by prayer or
19        spiritual means as an exercise or enjoyment of  religious
20        freedom.
21        (b)  (Blank).
22        (c)  Nothing   in   this   Act   shall  be  construed  as
23    prohibiting the practice of  midwifery  by  persons  licensed
24    under the Certified Professional Midwife Licensure Act.
25    (Source: P.A. 93-379, eff. 7-24-03.)

26        (225 ILCS 65/5-15)
27        (Section scheduled to be repealed on January 1, 2008)
28        Sec. 5-15. Policy; application of Act. For the protection
29    of  life  and  the promotion of health, and the prevention of
 
                            -12-     LRB093 13632 AMC 19007 b
 1    illness and communicable diseases, any person  practicing  or
 2    offering  to  practice  professional and practical nursing in
 3    Illinois shall submit evidence that he or she is qualified to
 4    practice, and shall be licensed as provided under  this  Act.
 5    No person shall practice or offer to practice professional or
 6    practical nursing in Illinois or use any title, sign, card or
 7    device   to   indicate  that  such  a  person  is  practicing
 8    professional or practical nursing unless such person has been
 9    licensed under the provisions of this Act.
10        This Act does not prohibit the following:
11             (a)  The practice of nursing in  Federal  employment
12        in the discharge of the employee's duties by a person who
13        is  employed  by  the  United  States  government  or any
14        bureau, division or  agency  thereof  and  is  a  legally
15        qualified   and   licensed  nurse  of  another  state  or
16        territory and not in conflict with Sections 10-5,  10-30,
17        and 10-45 of this Act.
18             (b)  Nursing  that  is  included in their program of
19        study by students enrolled in programs of nursing  or  in
20        current  nurse  practice  update  courses approved by the
21        Department.
22             (c)  The furnishing  of  nursing  assistance  in  an
23        emergency.
24             (d)  The practice of nursing by a nurse who holds an
25        active  license  in another state when providing services
26        to patients in Illinois during a bonafide emergency or in
27        immediate preparation for or during interstate transit.
28             (e)  The incidental care of the sick by  members  of
29        the family, domestic servants or housekeepers, or care of
30        the sick where treatment is by prayer or spiritual means.
31             (f)  Persons  from  being employed as nursing aides,
32        attendants, orderlies, and  other  auxiliary  workers  in
33        private  homes,  long  term  care  facilities, nurseries,
34        hospitals or other institutions.
 
                            -13-     LRB093 13632 AMC 19007 b
 1             (g)  The practice of practical nursing  by  one  who
 2        has  applied  in  writing  to  the Department in form and
 3        substance satisfactory to the Department, for  a  license
 4        as  a  licensed practical nurse and who has complied with
 5        all  the  provisions  under  Section  10-30,  except  the
 6        passing of an examination to be eligible to receive  such
 7        license,  until:  the decision of the Department that the
 8        applicant  has  failed  to  pass   the   next   available
 9        examination  authorized  by the Department or has failed,
10        without an approved excuse, to take  the  next  available
11        examination  authorized  by  the  Department or until the
12        withdrawal of  the  application,  but  not  to  exceed  3
13        months.  An  applicant practicing practical nursing under
14        this Section who passes  the  examination,  however,  may
15        continue  to  practice under this Section until such time
16        as he or she receives his or her license to  practice  or
17        until the Department notifies him or her that the license
18        has  been  denied.  No applicant for licensure practicing
19        under the provisions of  this  paragraph  shall  practice
20        practical  nursing except under the direct supervision of
21        a registered professional nurse licensed under  this  Act
22        or  a  licensed  physician, dentist or podiatrist.  In no
23        instance shall any such applicant practice or be employed
24        in any supervisory capacity.
25             (h)  The practice of practical nursing by one who is
26        a licensed practical nurse under the laws of another U.S.
27        jurisdiction  and  has  applied   in   writing   to   the
28        Department,  in  form  and  substance satisfactory to the
29        Department, for a license as a licensed  practical  nurse
30        and  who  is  qualified  to  receive  such  license under
31        Section 10-30, until (1) the expiration of 6 months after
32        the  filing  of  such  written   application,   (2)   the
33        withdrawal of such application, or (3) the denial of such
34        application by the Department.
 
                            -14-     LRB093 13632 AMC 19007 b
 1             (i)  The practice of professional nursing by one who
 2        has  applied  in  writing  to  the Department in form and
 3        substance satisfactory to the Department for a license as
 4        a registered professional nurse and has complied with all
 5        the provisions under Section 10-30 except the passing  of
 6        an  examination  to  be eligible to receive such license,
 7        until  the decision of the Department that the  applicant
 8        has   failed  to  pass  the  next  available  examination
 9        authorized by the Department or has  failed,  without  an
10        approved  excuse,  to take the next available examination
11        authorized by the Department or until the  withdrawal  of
12        the application, but not to exceed 3 months. An applicant
13        practicing  professional  nursing  under this Section who
14        passes the examination, however, may continue to practice
15        under this Section until such time as he or she  receives
16        his  or  her  license to practice or until the Department
17        notifies him or her that the license has been denied.  No
18        applicant for licensure practicing under  the  provisions
19        of  this  paragraph  shall  practice professional nursing
20        except under  the  direct  supervision  of  a  registered
21        professional  nurse  licensed  under  this  Act.   In  no
22        instance shall any such applicant practice or be employed
23        in any supervisory capacity.
24             (j)  The practice of professional nursing by one who
25        is  a  registered  professional  nurse  under the laws of
26        another state, territory of the United States or  country
27        and has applied in writing to the Department, in form and
28        substance  satisfactory  to the Department, for a license
29        as a registered professional nurse and who  is  qualified
30        to  receive  such license under Section 10-30, until  (1)
31        the expiration of 6  months  after  the  filing  of  such
32        written   application,   (2)   the   withdrawal  of  such
33        application, or (3) the denial of such application by the
34        Department.
 
                            -15-     LRB093 13632 AMC 19007 b
 1             (k)  The practice of professional  nursing  that  is
 2        included in a program of study by one who is a registered
 3        professional  nurse  under  the  laws of another state or
 4        territory  of  the  United  States  or  foreign  country,
 5        territory or province and who is enrolled in  a  graduate
 6        nursing education program or a program for the completion
 7        of  a  baccalaureate  nursing degree in this State, which
 8        includes clinical supervision by faculty as determined by
 9        the educational institution offering the program and  the
10        health  care  organization  where the practice of nursing
11        occurs.  The educational institution will file  with  the
12        Department  each  academic  term  a list of the names and
13        origin of license of all professional  nurses  practicing
14        nursing as part of their programs under this provision.
15             (l)  Any  person  licensed  in  this State under any
16        other Act from engaging in the practice for which she  or
17        he is licensed.
18             (m)  Delegation  to  authorized  direct  care  staff
19        trained  under  Section  15.4  of  the  Mental Health and
20        Developmental Disabilities Administrative Act.
21             (n)  The practice of midwifery by  persons  licensed
22        under the Certified Professional Midwife Licensure Act.
23        An  applicant for license practicing under the exceptions
24    set forth in subparagraphs (g), (h), (i),  and  (j)  of  this
25    Section  shall  use  the title R.N. Lic. Pend. or L.P.N. Lic.
26    Pend. respectively and no other.
27    (Source: P.A. 93-265, eff. 7-22-03.)

28        Section 999.  Effective date. This Act takes effect  upon
29    becoming law.