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


Rep. Sara Feigenholtz

Filed: 5/13/2014





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2    AMENDMENT NO. ______. Amend Senate Bill 2958 by replacing
3everything after the enacting clause with the following:
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



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1facility that fails to submit any required report under Section
280-10 of the Nurse Practice Act is subject to discipline under
3this Article.
4    Section 10. The Nurse Practice Act is amended by adding
5Article 80 as follows:
6    (225 ILCS 65/Art. 80 heading new)

8    (225 ILCS 65/80-5 new)
9    Sec. 80-5. Definitions. For the purposes of this Article
11    "Direct-care assignment" means an assignment as defined
12for staffing requirements as direct care staff under 77 CFR
14    "Medication aide" means a person who has met the
15qualifications for licensure under this Article who assists
16with medication administration while under the supervision of a
17registered professional nurse (RN) in a long-term care
19    "Qualified employer" means a long-term care facility
20licensed by the Department of Public Health that meets the
21qualifications set forth in Section 80-1o.
22    (225 ILCS 65/80-10 new)



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1    Sec. 80-10. Pilot program.
2    (a) The Department shall administer and enforce a Licensed
3Medication Aide Pilot Program. The program shall last for a
4period of 3 years, as determined by rule. During the 3-year
5pilot program, the Department shall license and regulate
6licensed medication aides. As part of the pilot program, no
7more than 10 skilled nursing homes, which shall be
8geographically located throughout the State, shall be
9authorized to employ licensed medication aides, as approved by
10the Department. The Department may consult with the Department
11of Public Health as necessary to properly administer and
12enforce this Article.
13    (b) To be approved as a qualified facility for the duration
14of the pilot program, a facility must:
15        (1) be licensed in good standing as a skilled nursing
16    facility by the Department of Public Health;
17        (2) have an overall Five Star Quality Rating of 3, 4,
18    or 5 from the most recent data available on the Centers for
19    Medicare and Medicaid Services' website;
20        (3) certify that the employment of a licensed
21    medication aide will not replace or diminish the employment
22    of a registered nurse or licensed practical nurse at the
23    facility;
24        (4) certify that a registered nurse will be on-duty and
25    present in the facility to delegate and supervise the
26    medication administration by a licensed medication aide at



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1    all times;
2        (5) certify that, with the exception of licensed health
3    care professionals, only licensed medication aides will be
4    employed in the capacity of administering medication; and
5        (6) provide information regarding patient safety,
6    efficiency, and errors as determined by the Department;
7    failure to submit any required report may be grounds for
8    discipline or sanctions under this Act, the Nursing Home
9    Administrators Licensing and Disciplinary Act, or the
10    Nursing Home Care Act.
11    The Department shall submit a report regarding patient
12safety, efficiency, and errors, as determined by rule, to the
13General Assembly no later than 6 months after termination of
14the pilot program.
15    (225 ILCS 65/80-15 new)
16    Sec. 80-15. Licensure requirement; exempt activities.
17    (a) On and after January 1, 2015, no person shall practice
18as a medication aide or hold himself or herself out as a
19licensed medication aide in this State unless he or she is
20licensed under this Article.
21    (b) Nothing in this Article shall be construed as
22preventing or restricting the practice, services, or
23activities of:
24        (1) any person licensed in this State by any other law
25    from engaging in the profession or occupation for which he



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1    or she is licensed;
2        (2) any person employed as a medication aide by the
3    government of the United States, if such person practices
4    as a medication aide solely under the direction or control
5    of the organization by which he or she is employed; or
6        (3) any person pursuing a course of study leading to a
7    certificate in medication aide at an accredited or approved
8    educational program if such activities and services
9    constitute a part of a supervised course of study and if
10    such person is designated by a title which clearly
11    indicates his or her status as a student or trainee.
12    (c) Nothing in this Article shall be construed to limit the
13delegation of tasks or duties by a physician, dentist, advanced
14practice nurse, or podiatric physician as authorized by law.
15    (225 ILCS 65/80-20 new)
16    Sec. 80-20. Scope of practice.
17    (a) A licensed medication aide may only practice in a
18qualified facility.
19    (b) Licensed medication aides must be supervised by and
20receive delegation by a registered nurse that is on-duty and
21present in the facility at all times.
22    (c) Licensed medication aides shall not have a direct-care
23assignment when scheduled to work as a licensed medication
24aide, but may assist residents as needed.
25    (d) Licensed medication aides shall not administer any



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1medication until a physician has conducted an initial
2assessment of the resident.
3    (e) Licensed medication aides shall not administer any
4Schedule II controlled substances as set forth in the Illinois
5Controlled Substances Act, and may not administer any
6subcutaneous, intramuscular, intradermal, or intravenous
8    (225 ILCS 65/80-25 new)
9    Sec. 80-25. Unlicensed practice; violation; civil penalty.
10    (a) In addition to any other penalty provided by law, any
11person who practices, offers to practice, attempts to practice,
12or holds oneself out to practice as a medication aide without
13being licensed under this Act shall, in addition to any other
14penalty provided by law, pay a civil penalty to the Department
15in an amount not to exceed $10,000 for each offense as
16determined by the Department. The civil penalty shall be
17assessed by the Department after a hearing is held in
18accordance with the provisions set forth in this Act regarding
19the provision of a hearing for the discipline of a licensee.
20    (b) The Department has the authority and power to
21investigate any and all unlicensed activity.
22    (c) The civil penalty shall be paid within 60 days after
23the effective date of the order imposing the civil penalty. The
24order shall constitute a judgment and may be filed and
25execution had thereon in the same manner as any judgment from



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1any court of record.
2    (225 ILCS 65/80-30 new)
3    Sec. 80-30. Applications for original licensure.
4Applications for original licensure shall be made to the
5Department in writing on forms prescribed by the Department and
6shall be accompanied by the required fee, which shall not be
7returnable. The application shall require such information as,
8in the judgment of the Department, will enable the Department
9to pass on the qualifications of the applicant for licensure.
10Applicants have 3 years after the date of application to
11complete the application process. If the process has not been
12completed within 3 years, the application shall be denied, the
13fee forfeited, and the applicant must reapply and meet the
14requirements in effect at the time of reapplication.
15    (225 ILCS 65/80-35 new)
16    Sec. 80-35. Examinations. The Department shall authorize
17examinations of applicants for a license under this Article at
18the times and place as it may designate. The examination shall
19be of a character to give a fair test of the qualifications of
20the applicant to practice as a medication aide.
21    Applicants for examination as a medication aide shall be
22required to pay, either to the Department or the designated
23testing service, a fee covering the cost of providing the
24examination. Failure to appear for the examination on the



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1scheduled date, at the time and place specified, after the
2applicant's application for examination has been received and
3acknowledged by the Department or the designated testing
4service, shall result in the forfeiture of the examination fee.
5    If an applicant fails to pass an examination for
6registration under this Act within 3 years after filing his or
7her application, the application shall be denied. The applicant
8may thereafter make a new application accompanied by the
9required fee; however, the applicant shall meet all
10requirements in effect at the time of subsequent application
11before obtaining licensure. The Department may employ
12consultants for the purposes of preparing and conducting
14    (225 ILCS 65/80-40 new)
15    Sec. 80-40. Licensure by examination. An applicant for
16licensure by examination to practice as a licensed medication
17aide must:
18        (1) submit a completed written application on forms
19    provided by the Department and fees as established by the
20    Department;
21        (2) be age 18 or older;
22        (3) have a high school diploma or a certificate of
23    general education development (GED);
24        (4) demonstrate the able to speak, read, and write the
25    English language, as determined by rule;



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1        (5) demonstrate competency in math, as determined by
2    rule;
3        (6) be currently certified in good standing as a
4    certified nursing assistant and provide proof of 2,000
5    hours of practice as a certified nursing assistant within 3
6    years before application for licensure;
7        (7) submit to the criminal history records check
8    required under Section 50-35 of this Act;
9        (8) have not engaged in conduct or behavior determined
10    to be grounds for discipline under this Act;
11        (9) be currently certified to perform cardiopulmonary
12    resuscitation by the American Heart Association or
13    American Red Cross;
14        (10) have successfully completed a course of study
15    approved by the Department as defined by rule; to be
16    approved, the program must include a minimum of 60 hours of
17    classroom-based medication aide education, a minimum of 10
18    hours of simulation laboratory study, and a minimum of 30
19    hours of registered nurse-supervised clinical practicum
20    with progressive responsibility of patient medication
21    assistance;
22        (11) have successfully completed the Medication Aide
23    Certification Examination or other examination authorized
24    by the Department; and
25        (12) submit proof of employment by a qualifying
26    facility.



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1    (225 ILCS 65/80-45 new)
2    Sec. 80-45. Expiration of license. The expiration date for
3each license to practice as a licensed medication aide shall be
4set by the rule. Licenses under this Article may not be renewed
5or restored.
6    (225 ILCS 65/80-50 new)
7    Sec. 80-50. Administration and enforcement. Licenses
8issued under this Article are subject to Article 70, including
9grounds for disciplinary action under Section 70-5.
10    (225 ILCS 65/80-55 new)
11    Sec. 80-55. Title. Any person who is issued a license as a
12medication aide under the terms of this Act shall use the words
13"licensed medication aide" in connection with his or her name
14to denote his or her licensure under this Act.
15    (225 ILCS 65/80-60 new)
16    Sec. 80-60. Rules. The Department shall files rules to
17administer this Article within 90 days of the effective date of
18this Act.
19    Section 15. The Nursing Home Administrators Licensing and
20Disciplinary Act is amended by changing Section 17 as follows:



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1    (225 ILCS 70/17)  (from Ch. 111, par. 3667)
2    Sec. 17. Grounds for disciplinary action.
3    (a) The Department may impose fines not to exceed $10,000
4or may refuse to issue or to renew, or may revoke, suspend,
5place on probation, censure, reprimand or take other
6disciplinary or non-disciplinary action with regard to the
7license of any person, for any one or combination of the
8following causes:
9        (1) Intentional material misstatement in furnishing
10    information to the Department.
11        (2) Conviction of or entry of a plea of guilty or nolo
12    contendere to any crime that is a felony under the laws of
13    the United States or any state or territory thereof or a
14    misdemeanor of which an essential element is dishonesty or
15    that is directly related to the practice of the profession
16    of nursing home administration.
17        (3) Making any misrepresentation for the purpose of
18    obtaining a license, or violating any provision of this
19    Act.
20        (4) Immoral conduct in the commission of any act, such
21    as sexual abuse or sexual misconduct, related to the
22    licensee's practice.
23        (5) Failing to respond within 30 days, to a written
24    request made by the Department for information.
25        (6) Engaging in dishonorable, unethical or
26    unprofessional conduct of a character likely to deceive,



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1    defraud or harm the public.
2        (7) Habitual use or addiction to alcohol, narcotics,
3    stimulants, or any other chemical agent or drug which
4    results in the inability to practice with reasonable
5    judgment, skill or safety.
6        (8) Discipline by another U.S. jurisdiction if at least
7    one of the grounds for the discipline is the same or
8    substantially equivalent to those set forth herein.
9        (9) A finding by the Department that the licensee,
10    after having his or her license placed on probationary
11    status has violated the terms of probation.
12        (10) Willfully making or filing false records or
13    reports in his or her practice, including but not limited
14    to false records filed with State agencies or departments.
15        (11) Physical illness, mental illness, or other
16    impairment or disability, including, but not limited to,
17    deterioration through the aging process, or loss of motor
18    skill that results in the inability to practice the
19    profession with reasonable judgment, skill or safety.
20        (12) Disregard or violation of this Act or of any rule
21    issued pursuant to this Act.
22        (13) Aiding or abetting another in the violation of
23    this Act or any rule or regulation issued pursuant to this
24    Act.
25        (14) Allowing one's license to be used by an unlicensed
26    person.



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1        (15) (Blank).
2        (16) Professional incompetence in the practice of
3    nursing home administration.
4        (17) Conviction of a violation of Section 12-19 or
5    subsection (a) of Section 12-4.4a of the Criminal Code of
6    1961 or the Criminal Code of 2012 for the abuse and
7    criminal neglect of a long term care facility resident.
8        (18) Violation of the Nursing Home Care Act, the
9    Specialized Mental Health Rehabilitation Act of 2013, or
10    the ID/DD Community Care Act or of any rule issued under
11    the Nursing Home Care Act, the Specialized Mental Health
12    Rehabilitation Act of 2013, or the ID/DD Community Care
13    Act. A final adjudication of a Type "AA" violation of the
14    Nursing Home Care Act made by the Illinois Department of
15    Public Health, as identified by rule, relating to the
16    hiring, training, planning, organizing, directing, or
17    supervising the operation of a nursing home and a
18    licensee's failure to comply with this Act or the rules
19    adopted under this Act, shall create a rebuttable
20    presumption of a violation of this subsection.
21        (19) Failure to report to the Department any adverse
22    final action taken against the licensee by a licensing
23    authority of another state, territory of the United States,
24    or foreign country; or by any governmental or law
25    enforcement agency; or by any court for acts or conduct
26    similar to acts or conduct that would constitute grounds



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1    for disciplinary action under this Section.
2        (20) Failure to report to the Department the surrender
3    of a license or authorization to practice as a nursing home
4    administrator in another state or jurisdiction for acts or
5    conduct similar to acts or conduct that would constitute
6    grounds for disciplinary action under this Section.
7        (21) Failure to report to the Department any adverse
8    judgment, settlement, or award arising from a liability
9    claim related to acts or conduct similar to acts or conduct
10    that would constitute grounds for disciplinary action
11    under this Section.
12        (22) Failure to submit any required report under
13    Section 80-10 of the Nurse Practice Act.
14    All proceedings to suspend, revoke, place on probationary
15status, or take any other disciplinary action as the Department
16may deem proper, with regard to a license on any of the
17foregoing grounds, must be commenced within 5 years next after
18receipt by the Department of (i) a complaint alleging the
19commission of or notice of the conviction order for any of the
20acts described herein or (ii) a referral for investigation
21under Section 3-108 of the Nursing Home Care Act.
22    The entry of an order or judgment by any circuit court
23establishing that any person holding a license under this Act
24is a person in need of mental treatment operates as a
25suspension of that license. That person may resume their
26practice only upon the entry of a Department order based upon a



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1finding by the Board that they have been determined to be
2recovered from mental illness by the court and upon the Board's
3recommendation that they be permitted to resume their practice.
4    The Department, upon the recommendation of the Board, may
5adopt rules which set forth standards to be used in determining
6what constitutes:
7        (i) when a person will be deemed sufficiently
8    rehabilitated to warrant the public trust;
9        (ii) dishonorable, unethical or unprofessional conduct
10    of a character likely to deceive, defraud, or harm the
11    public;
12        (iii) immoral conduct in the commission of any act
13    related to the licensee's practice; and
14        (iv) professional incompetence in the practice of
15    nursing home administration.
16    However, no such rule shall be admissible into evidence in
17any civil action except for review of a licensing or other
18disciplinary action under this Act.
19    In enforcing this Section, the Department or Board, upon a
20showing of a possible violation, may compel any individual
21licensed to practice under this Act, or who has applied for
22licensure pursuant to this Act, to submit to a mental or
23physical examination, or both, as required by and at the
24expense of the Department. The examining physician or
25physicians shall be those specifically designated by the
26Department or Board. The Department or Board may order the



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1examining physician to present testimony concerning this
2mental or physical examination of the licensee or applicant. No
3information shall be excluded by reason of any common law or
4statutory privilege relating to communications between the
5licensee or applicant and the examining physician. The
6individual to be examined may have, at his or her own expense,
7another physician of his or her choice present during all
8aspects of the examination. Failure of any individual to submit
9to mental or physical examination, when directed, shall be
10grounds for suspension of his or her license until such time as
11the individual submits to the examination if the Department
12finds, after notice and hearing, that the refusal to submit to
13the examination was without reasonable cause.
14    If the Department or Board finds an individual unable to
15practice because of the reasons set forth in this Section, the
16Department or Board shall require such individual to submit to
17care, counseling, or treatment by physicians approved or
18designated by the Department or Board, as a condition, term, or
19restriction for continued, reinstated, or renewed licensure to
20practice; or in lieu of care, counseling, or treatment, the
21Department may file, or the Board may recommend to the
22Department to file, a complaint to immediately suspend, revoke,
23or otherwise discipline the license of the individual. Any
24individual whose license was granted pursuant to this Act or
25continued, reinstated, renewed, disciplined or supervised,
26subject to such terms, conditions or restrictions who shall



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1fail to comply with such terms, conditions or restrictions
2shall be referred to the Secretary for a determination as to
3whether the licensee shall have his or her license suspended
4immediately, pending a hearing by the Department. In instances
5in which the Secretary immediately suspends a license under
6this Section, a hearing upon such person's license must be
7convened by the Board within 30 days after such suspension and
8completed without appreciable delay. The Department and Board
9shall have the authority to review the subject administrator's
10record of treatment and counseling regarding the impairment, to
11the extent permitted by applicable federal statutes and
12regulations safeguarding the confidentiality of medical
14    An individual licensed under this Act, affected under this
15Section, shall be afforded an opportunity to demonstrate to the
16Department or Board that he or she can resume practice in
17compliance with acceptable and prevailing standards under the
18provisions of his or her license.
19    (b) Any individual or organization acting in good faith,
20and not in a wilful and wanton manner, in complying with this
21Act by providing any report or other information to the
22Department, or assisting in the investigation or preparation of
23such information, or by participating in proceedings of the
24Department, or by serving as a member of the Board, shall not,
25as a result of such actions, be subject to criminal prosecution
26or civil damages.



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1    (c) Members of the Board, and persons retained under
2contract to assist and advise in an investigation, shall be
3indemnified by the State for any actions occurring within the
4scope of services on or for the Board, done in good faith and
5not wilful and wanton in nature. The Attorney General shall
6defend all such actions unless he or she determines either that
7there would be a conflict of interest in such representation or
8that the actions complained of were not in good faith or were
9wilful and wanton.
10    Should the Attorney General decline representation, a
11person entitled to indemnification under this Section shall
12have the right to employ counsel of his or her choice, whose
13fees shall be provided by the State, after approval by the
14Attorney General, unless there is a determination by a court
15that the member's actions were not in good faith or were wilful
16and wanton.
17    A person entitled to indemnification under this Section
18must notify the Attorney General within 7 days of receipt of
19notice of the initiation of any action involving services of
20the Board. Failure to so notify the Attorney General shall
21constitute an absolute waiver of the right to a defense and
23    The Attorney General shall determine within 7 days after
24receiving such notice, whether he or she will undertake to
25represent a person entitled to indemnification under this



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1    (d) The determination by a circuit court that a licensee is
2subject to involuntary admission or judicial admission as
3provided in the Mental Health and Developmental Disabilities
4Code, as amended, operates as an automatic suspension. Such
5suspension will end only upon a finding by a court that the
6patient is no longer subject to involuntary admission or
7judicial admission and issues an order so finding and
8discharging the patient; and upon the recommendation of the
9Board to the Secretary that the licensee be allowed to resume
10his or her practice.
11    (e) The Department may refuse to issue or may suspend the
12license of any person who fails to file a return, or to pay the
13tax, penalty or interest shown in a filed return, or to pay any
14final assessment of tax, penalty or interest, as required by
15any tax Act administered by the Department of Revenue, until
16such time as the requirements of any such tax Act are
18    (f) The Department of Public Health shall transmit to the
19Department a list of those facilities which receive an "A"
20violation as defined in Section 1-129 of the Nursing Home Care
22(Source: P.A. 97-38, eff. 6-28-11; 97-227, eff. 1-1-12;
2397-1109, eff. 1-1-13; 97-1150, eff. 1-25-13; 98-104, eff.
25    Section 99. Effective date. This Act takes effect upon



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1becoming law.".