Illinois General Assembly - Full Text of SB2958
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Full Text of SB2958  98th General Assembly



SB2958 EnrolledLRB098 19577 RPS 54767 b

1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 1. Legislative findings. The General Assembly
5finds that:
6        (1) Many states have had successful medication
7    aide-certified (MA-C) programs for many years.
8        (2) A medication aide-certified assists with
9    medication administration while under the supervision of a
10    registered professional nurse (RN) in a long-term care
11    facility.
12    Section 5. The Nursing Home Care Act is amended by adding
13Section 3-305.5 as follows:
14    (210 ILCS 45/3-305.5 new)
15    Sec. 3-305.5. Violation of the Nurse Practice Act. A
16facility that fails to submit any required report under Section
1780-10 of the Nurse Practice Act is subject to discipline under
18this Article.
19    Section 10. The Nurse Practice Act is amended by adding
20Article 80 as follows:



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1    (225 ILCS 65/Art. 80 heading new)

3    (225 ILCS 65/80-5 new)
4    Sec. 80-5. Definitions. For the purposes of this Article
6    "Direct-care assignment" means an assignment as defined
7for staffing requirements as direct care staff under 77 CFR
9    "Medication aide" means a person who has met the
10qualifications for licensure under this Article who assists
11with medication administration while under the supervision of a
12registered professional nurse (RN) in a long-term care
14    "Qualified employer" means a long-term care facility
15licensed by the Department of Public Health that meets the
16qualifications set forth in Section 80-1o.
17    (225 ILCS 65/80-10 new)
18    Sec. 80-10. Pilot program.
19    (a) The Department shall administer and enforce a Licensed
20Medication Aide Pilot Program. The program shall last for a
21period of 3 years, as determined by rule. During the 3-year
22pilot program, the Department shall license and regulate
23licensed medication aides. As part of the pilot program, no
24more than 10 skilled nursing homes, which shall be



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1geographically located throughout the State, shall be
2authorized to employ licensed medication aides, as approved by
3the Department. The Department may consult with the Department
4of Public Health as necessary to properly administer and
5enforce this Article.
6    (b) To be approved as a qualified facility for the duration
7of the pilot program, a facility must:
8        (1) be licensed in good standing as a skilled nursing
9    facility by the Department of Public Health;
10        (2) have an overall Five Star Quality Rating of 3, 4,
11    or 5 from the most recent data available on the Centers for
12    Medicare and Medicaid Services' website;
13        (3) certify that the employment of a licensed
14    medication aide will not replace or diminish the employment
15    of a registered nurse or licensed practical nurse at the
16    facility;
17        (4) certify that a registered nurse will be on-duty and
18    present in the facility to delegate and supervise the
19    medication administration by a licensed medication aide at
20    all times;
21        (5) certify that, with the exception of licensed health
22    care professionals, only licensed medication aides will be
23    employed in the capacity of administering medication; and
24        (6) provide information regarding patient safety,
25    efficiency, and errors as determined by the Department;
26    failure to submit any required report may be grounds for



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1    discipline or sanctions under this Act, the Nursing Home
2    Administrators Licensing and Disciplinary Act, or the
3    Nursing Home Care Act.
4    The Department shall submit a report regarding patient
5safety, efficiency, and errors, as determined by rule, to the
6General Assembly no later than 6 months after termination of
7the pilot program.
8    (225 ILCS 65/80-15 new)
9    Sec. 80-15. Licensure requirement; exempt activities.
10    (a) On and after January 1, 2015, no person shall practice
11as a medication aide or hold himself or herself out as a
12licensed medication aide in this State unless he or she is
13licensed under this Article.
14    (b) Nothing in this Article shall be construed as
15preventing or restricting the practice, services, or
16activities of:
17        (1) any person licensed in this State by any other law
18    from engaging in the profession or occupation for which he
19    or she is licensed;
20        (2) any person employed as a medication aide by the
21    government of the United States, if such person practices
22    as a medication aide solely under the direction or control
23    of the organization by which he or she is employed; or
24        (3) any person pursuing a course of study leading to a
25    certificate in medication aide at an accredited or approved



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1    educational program if such activities and services
2    constitute a part of a supervised course of study and if
3    such person is designated by a title which clearly
4    indicates his or her status as a student or trainee.
5    (c) Nothing in this Article shall be construed to limit the
6delegation of tasks or duties by a physician, dentist, advanced
7practice nurse, or podiatric physician as authorized by law.
8    (225 ILCS 65/80-20 new)
9    Sec. 80-20. Scope of practice.
10    (a) A licensed medication aide may only practice in a
11qualified facility.
12    (b) Licensed medication aides must be supervised by and
13receive delegation by a registered nurse that is on-duty and
14present in the facility at all times.
15    (c) Licensed medication aides shall not have a direct-care
16assignment when scheduled to work as a licensed medication
17aide, but may assist residents as needed.
18    (d) Licensed medication aides shall not administer any
19medication until a physician has conducted an initial
20assessment of the resident.
21    (e) Licensed medication aides shall not administer any
22Schedule II controlled substances as set forth in the Illinois
23Controlled Substances Act, and may not administer any
24subcutaneous, intramuscular, intradermal, or intravenous



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1    (225 ILCS 65/80-25 new)
2    Sec. 80-25. Unlicensed practice; violation; civil penalty.
3    (a) In addition to any other penalty provided by law, any
4person who practices, offers to practice, attempts to practice,
5or holds oneself out to practice as a medication aide without
6being licensed under this Act shall, in addition to any other
7penalty provided by law, pay a civil penalty to the Department
8in an amount not to exceed $10,000 for each offense as
9determined by the Department. The civil penalty shall be
10assessed by the Department after a hearing is held in
11accordance with the provisions set forth in this Act regarding
12the provision of a hearing for the discipline of a licensee.
13    (b) The Department has the authority and power to
14investigate any and all unlicensed activity.
15    (c) The civil penalty shall be paid within 60 days after
16the effective date of the order imposing the civil penalty. The
17order shall constitute a judgment and may be filed and
18execution had thereon in the same manner as any judgment from
19any court of record.
20    (225 ILCS 65/80-30 new)
21    Sec. 80-30. Applications for original licensure.
22Applications for original licensure shall be made to the
23Department in writing on forms prescribed by the Department and
24shall be accompanied by the required fee, which shall not be



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1returnable. The application shall require such information as,
2in the judgment of the Department, will enable the Department
3to pass on the qualifications of the applicant for licensure.
4Applicants have 3 years after the date of application to
5complete the application process. If the process has not been
6completed within 3 years, the application shall be denied, the
7fee forfeited, and the applicant must reapply and meet the
8requirements in effect at the time of reapplication.
9    (225 ILCS 65/80-35 new)
10    Sec. 80-35. Examinations. The Department shall authorize
11examinations of applicants for a license under this Article at
12the times and place as it may designate. The examination shall
13be of a character to give a fair test of the qualifications of
14the applicant to practice as a medication aide.
15    Applicants for examination as a medication aide shall be
16required to pay, either to the Department or the designated
17testing service, a fee covering the cost of providing the
18examination. Failure to appear for the examination on the
19scheduled date, at the time and place specified, after the
20applicant's application for examination has been received and
21acknowledged by the Department or the designated testing
22service, shall result in the forfeiture of the examination fee.
23    If an applicant fails to pass an examination for
24registration under this Act within 3 years after filing his or
25her application, the application shall be denied. The applicant



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1may thereafter make a new application accompanied by the
2required fee; however, the applicant shall meet all
3requirements in effect at the time of subsequent application
4before obtaining licensure. The Department may employ
5consultants for the purposes of preparing and conducting
7    (225 ILCS 65/80-40 new)
8    Sec. 80-40. Licensure by examination. An applicant for
9licensure by examination to practice as a licensed medication
10aide must:
11        (1) submit a completed written application on forms
12    provided by the Department and fees as established by the
13    Department;
14        (2) be age 18 or older;
15        (3) have a high school diploma or a certificate of
16    general education development (GED);
17        (4) demonstrate the able to speak, read, and write the
18    English language, as determined by rule;
19        (5) demonstrate competency in math, as determined by
20    rule;
21        (6) be currently certified in good standing as a
22    certified nursing assistant and provide proof of 2,000
23    hours of practice as a certified nursing assistant within 3
24    years before application for licensure;
25        (7) submit to the criminal history records check



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1    required under Section 50-35 of this Act;
2        (8) have not engaged in conduct or behavior determined
3    to be grounds for discipline under this Act;
4        (9) be currently certified to perform cardiopulmonary
5    resuscitation by the American Heart Association or
6    American Red Cross;
7        (10) have successfully completed a course of study
8    approved by the Department as defined by rule; to be
9    approved, the program must include a minimum of 60 hours of
10    classroom-based medication aide education, a minimum of 10
11    hours of simulation laboratory study, and a minimum of 30
12    hours of registered nurse-supervised clinical practicum
13    with progressive responsibility of patient medication
14    assistance;
15        (11) have successfully completed the Medication Aide
16    Certification Examination or other examination authorized
17    by the Department; and
18        (12) submit proof of employment by a qualifying
19    facility.
20    (225 ILCS 65/80-45 new)
21    Sec. 80-45. Expiration of license. The expiration date for
22each license to practice as a licensed medication aide shall be
23set by the rule. Licenses under this Article may not be renewed
24or restored.



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1    (225 ILCS 65/80-50 new)
2    Sec. 80-50. Administration and enforcement. Licenses
3issued under this Article are subject to Article 70, including
4grounds for disciplinary action under Section 70-5.
5    (225 ILCS 65/80-55 new)
6    Sec. 80-55. Title. Any person who is issued a license as a
7medication aide under the terms of this Act shall use the words
8"licensed medication aide" in connection with his or her name
9to denote his or her licensure under this Act.
10    (225 ILCS 65/80-60 new)
11    Sec. 80-60. Rules. The Department shall file rules to
12administer this Article within 90 days of the effective date of
13this Act.
14    Section 15. The Nursing Home Administrators Licensing and
15Disciplinary Act is amended by changing Section 17 as follows:
16    (225 ILCS 70/17)  (from Ch. 111, par. 3667)
17    Sec. 17. Grounds for disciplinary action.
18    (a) The Department may impose fines not to exceed $10,000
19or may refuse to issue or to renew, or may revoke, suspend,
20place on probation, censure, reprimand or take other
21disciplinary or non-disciplinary action with regard to the
22license of any person, for any one or combination of the



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1following causes:
2        (1) Intentional material misstatement in furnishing
3    information to the Department.
4        (2) Conviction of or entry of a plea of guilty or nolo
5    contendere to any crime that is a felony under the laws of
6    the United States or any state or territory thereof or a
7    misdemeanor of which an essential element is dishonesty or
8    that is directly related to the practice of the profession
9    of nursing home administration.
10        (3) Making any misrepresentation for the purpose of
11    obtaining a license, or violating any provision of this
12    Act.
13        (4) Immoral conduct in the commission of any act, such
14    as sexual abuse or sexual misconduct, related to the
15    licensee's practice.
16        (5) Failing to respond within 30 days, to a written
17    request made by the Department for information.
18        (6) Engaging in dishonorable, unethical or
19    unprofessional conduct of a character likely to deceive,
20    defraud or harm the public.
21        (7) Habitual use or addiction to alcohol, narcotics,
22    stimulants, or any other chemical agent or drug which
23    results in the inability to practice with reasonable
24    judgment, skill or safety.
25        (8) Discipline by another U.S. jurisdiction if at least
26    one of the grounds for the discipline is the same or



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1    substantially equivalent to those set forth herein.
2        (9) A finding by the Department that the licensee,
3    after having his or her license placed on probationary
4    status has violated the terms of probation.
5        (10) Willfully making or filing false records or
6    reports in his or her practice, including but not limited
7    to false records filed with State agencies or departments.
8        (11) Physical illness, mental illness, or other
9    impairment or disability, including, but not limited to,
10    deterioration through the aging process, or loss of motor
11    skill that results in the inability to practice the
12    profession with reasonable judgment, skill or safety.
13        (12) Disregard or violation of this Act or of any rule
14    issued pursuant to this Act.
15        (13) Aiding or abetting another in the violation of
16    this Act or any rule or regulation issued pursuant to this
17    Act.
18        (14) Allowing one's license to be used by an unlicensed
19    person.
20        (15) (Blank).
21        (16) Professional incompetence in the practice of
22    nursing home administration.
23        (17) Conviction of a violation of Section 12-19 or
24    subsection (a) of Section 12-4.4a of the Criminal Code of
25    1961 or the Criminal Code of 2012 for the abuse and
26    criminal neglect of a long term care facility resident.



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1        (18) Violation of the Nursing Home Care Act, the
2    Specialized Mental Health Rehabilitation Act of 2013, or
3    the ID/DD Community Care Act or of any rule issued under
4    the Nursing Home Care Act, the Specialized Mental Health
5    Rehabilitation Act of 2013, or the ID/DD Community Care
6    Act. A final adjudication of a Type "AA" violation of the
7    Nursing Home Care Act made by the Illinois Department of
8    Public Health, as identified by rule, relating to the
9    hiring, training, planning, organizing, directing, or
10    supervising the operation of a nursing home and a
11    licensee's failure to comply with this Act or the rules
12    adopted under this Act, shall create a rebuttable
13    presumption of a violation of this subsection.
14        (19) Failure to report to the Department any adverse
15    final action taken against the licensee by a licensing
16    authority of another state, territory of the United States,
17    or foreign country; or by any governmental or law
18    enforcement agency; or by any court for acts or conduct
19    similar to acts or conduct that would constitute grounds
20    for disciplinary action under this Section.
21        (20) Failure to report to the Department the surrender
22    of a license or authorization to practice as a nursing home
23    administrator in another state or jurisdiction for acts or
24    conduct similar to acts or conduct that would constitute
25    grounds for disciplinary action under this Section.
26        (21) Failure to report to the Department any adverse



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1    judgment, settlement, or award arising from a liability
2    claim related to acts or conduct similar to acts or conduct
3    that would constitute grounds for disciplinary action
4    under this Section.
5        (22) Failure to submit any required report under
6    Section 80-10 of the Nurse Practice Act.
7    All proceedings to suspend, revoke, place on probationary
8status, or take any other disciplinary action as the Department
9may deem proper, with regard to a license on any of the
10foregoing grounds, must be commenced within 5 years next after
11receipt by the Department of (i) a complaint alleging the
12commission of or notice of the conviction order for any of the
13acts described herein or (ii) a referral for investigation
14under Section 3-108 of the Nursing Home Care Act.
15    The entry of an order or judgment by any circuit court
16establishing that any person holding a license under this Act
17is a person in need of mental treatment operates as a
18suspension of that license. That person may resume their
19practice only upon the entry of a Department order based upon a
20finding by the Board that they have been determined to be
21recovered from mental illness by the court and upon the Board's
22recommendation that they be permitted to resume their practice.
23    The Department, upon the recommendation of the Board, may
24adopt rules which set forth standards to be used in determining
25what constitutes:
26        (i) when a person will be deemed sufficiently



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1    rehabilitated to warrant the public trust;
2        (ii) dishonorable, unethical or unprofessional conduct
3    of a character likely to deceive, defraud, or harm the
4    public;
5        (iii) immoral conduct in the commission of any act
6    related to the licensee's practice; and
7        (iv) professional incompetence in the practice of
8    nursing home administration.
9    However, no such rule shall be admissible into evidence in
10any civil action except for review of a licensing or other
11disciplinary action under this Act.
12    In enforcing this Section, the Department or Board, upon a
13showing of a possible violation, may compel any individual
14licensed to practice under this Act, or who has applied for
15licensure pursuant to this Act, to submit to a mental or
16physical examination, or both, as required by and at the
17expense of the Department. The examining physician or
18physicians shall be those specifically designated by the
19Department or Board. The Department or Board may order the
20examining physician to present testimony concerning this
21mental or physical examination of the licensee or applicant. No
22information shall be excluded by reason of any common law or
23statutory privilege relating to communications between the
24licensee or applicant and the examining physician. The
25individual to be examined may have, at his or her own expense,
26another physician of his or her choice present during all



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1aspects of the examination. Failure of any individual to submit
2to mental or physical examination, when directed, shall be
3grounds for suspension of his or her license until such time as
4the individual submits to the examination if the Department
5finds, after notice and hearing, that the refusal to submit to
6the examination was without reasonable cause.
7    If the Department or Board finds an individual unable to
8practice because of the reasons set forth in this Section, the
9Department or Board shall require such individual to submit to
10care, counseling, or treatment by physicians approved or
11designated by the Department or Board, as a condition, term, or
12restriction for continued, reinstated, or renewed licensure to
13practice; or in lieu of care, counseling, or treatment, the
14Department may file, or the Board may recommend to the
15Department to file, a complaint to immediately suspend, revoke,
16or otherwise discipline the license of the individual. Any
17individual whose license was granted pursuant to this Act or
18continued, reinstated, renewed, disciplined or supervised,
19subject to such terms, conditions or restrictions who shall
20fail to comply with such terms, conditions or restrictions
21shall be referred to the Secretary for a determination as to
22whether the licensee shall have his or her license suspended
23immediately, pending a hearing by the Department. In instances
24in which the Secretary immediately suspends a license under
25this Section, a hearing upon such person's license must be
26convened by the Board within 30 days after such suspension and



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1completed without appreciable delay. The Department and Board
2shall have the authority to review the subject administrator's
3record of treatment and counseling regarding the impairment, to
4the extent permitted by applicable federal statutes and
5regulations safeguarding the confidentiality of medical
7    An individual licensed under this Act, affected under this
8Section, shall be afforded an opportunity to demonstrate to the
9Department or Board that he or she can resume practice in
10compliance with acceptable and prevailing standards under the
11provisions of his or her license.
12    (b) Any individual or organization acting in good faith,
13and not in a wilful and wanton manner, in complying with this
14Act by providing any report or other information to the
15Department, or assisting in the investigation or preparation of
16such information, or by participating in proceedings of the
17Department, or by serving as a member of the Board, shall not,
18as a result of such actions, be subject to criminal prosecution
19or civil damages.
20    (c) Members of the Board, and persons retained under
21contract to assist and advise in an investigation, shall be
22indemnified by the State for any actions occurring within the
23scope of services on or for the Board, done in good faith and
24not wilful and wanton in nature. The Attorney General shall
25defend all such actions unless he or she determines either that
26there would be a conflict of interest in such representation or



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1that the actions complained of were not in good faith or were
2wilful and wanton.
3    Should the Attorney General decline representation, a
4person entitled to indemnification under this Section shall
5have the right to employ counsel of his or her choice, whose
6fees shall be provided by the State, after approval by the
7Attorney General, unless there is a determination by a court
8that the member's actions were not in good faith or were wilful
9and wanton.
10    A person entitled to indemnification under this Section
11must notify the Attorney General within 7 days of receipt of
12notice of the initiation of any action involving services of
13the Board. Failure to so notify the Attorney General shall
14constitute an absolute waiver of the right to a defense and
16    The Attorney General shall determine within 7 days after
17receiving such notice, whether he or she will undertake to
18represent a person entitled to indemnification under this
20    (d) The determination by a circuit court that a licensee is
21subject to involuntary admission or judicial admission as
22provided in the Mental Health and Developmental Disabilities
23Code, as amended, operates as an automatic suspension. Such
24suspension will end only upon a finding by a court that the
25patient is no longer subject to involuntary admission or
26judicial admission and issues an order so finding and



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1discharging the patient; and upon the recommendation of the
2Board to the Secretary that the licensee be allowed to resume
3his or her practice.
4    (e) The Department may refuse to issue or may suspend the
5license of any person who fails to file a return, or to pay the
6tax, penalty or interest shown in a filed return, or to pay any
7final assessment of tax, penalty or interest, as required by
8any tax Act administered by the Department of Revenue, until
9such time as the requirements of any such tax Act are
11    (f) The Department of Public Health shall transmit to the
12Department a list of those facilities which receive an "A"
13violation as defined in Section 1-129 of the Nursing Home Care
15(Source: P.A. 97-38, eff. 6-28-11; 97-227, eff. 1-1-12;
1697-1109, eff. 1-1-13; 97-1150, eff. 1-25-13; 98-104, eff.
18    Section 99. Effective date. This Act takes effect upon
19becoming law.