State of Illinois
2019 and 2020


Introduced 2/14/2020, by Sen. Kimberly A. Lightford


210 ILCS 85/7  from Ch. 111 1/2, par. 148
210 ILCS 85/10.10
210 ILCS 85/14.5
110 ILCS 975/5  from Ch. 144, par. 2755
35 ILCS 5/232 new

    Amends the Hospital Licensing Act. Requires a hospital to provide a plan of correction to the Department of Public Health within 60 days if the hospital demonstrates a pattern or practice of failing to substantially comply with specified requirements or with the hospital's written staffing plan. Allows the Department to impose specified fines on a hospital for failing to comply with written staffing plans for nursing services or plans of correction. Requires money from fines to be deposited into the Hospital Licensure Fund (instead of the Long Term Care Provider Fund). Contains provisions concerning staffing plans. Amends the Nursing Education Scholarship Law. Provides that the Department of Public Health may award a total of $500,000 annually in nursing education scholarships. Amends the Illinois Income Tax Act. Creates an income tax credit for taxpayers who are employed during the taxable year as nurse educators. Provides that the credit shall be equal to 2.5% of the taxpayer's federal adjusted gross income for the taxable year. Effective immediately, except that provisions amending the Hospital Licensing Act take effect on the first day of the first full calendar month that begins 6 months after the Act becomes law.

LRB101 19846 HLH 69366 b






SB3636LRB101 19846 HLH 69366 b

1    AN ACT concerning nursing.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:

5    Section 1-1. This Article may be referred to as the Nurse
6Staffing Improvement Act.
7    Section 1-5. The Hospital Licensing Act is amended by
8changing Sections 7, 10.10, and 14.5 as follows:
9    (210 ILCS 85/7)  (from Ch. 111 1/2, par. 148)
10    Sec. 7. (a) The Director after notice and opportunity for
11hearing to the applicant or licensee may deny, suspend, or
12revoke a permit to establish a hospital or deny, suspend, or
13revoke a license to open, conduct, operate, and maintain a
14hospital in any case in which he finds that there has been a
15substantial failure to comply with the provisions of this Act,
16the Hospital Report Card Act, or the Illinois Adverse Health
17Care Events Reporting Law of 2005 or the standards, rules, and
18regulations established by virtue of any of those Acts. The
19Department may impose fines on hospitals, not to exceed $500
20per occurrence, for failing to: (1) initiate a criminal
21background check on a patient that meets the criteria for



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1hospital-initiated background checks; or (2) report the death
2of a person known to be a resident of a facility licensed under
3the ID/DD Community Care Act or the MC/DD Act to the coroner or
4medical examiner within 24 hours as required by Section 6.09a
5of this Act. In assessing whether to impose such a fine for
6failure to initiate a criminal background check, the Department
7shall consider various factors including, but not limited to,
8whether the hospital has engaged in a pattern or practice of
9failing to initiate criminal background checks. If a hospital
10demonstrates a pattern or practice of failing to substantially
11comply with the requirements of Section 10.10 or the hospital's
12written staffing plan, the hospital shall provide a plan of
13correction to the Department within 60 days. The Department may
14impose fines as follows: (i) if a hospital fails to implement a
15written staffing plan for nursing services, a fine not to
16exceed $500 per occurrence may be imposed; (ii) if a hospital
17demonstrates a pattern or practice of failing to substantially
18comply with a plan of correction within 60 days after the plan
19takes effect, a fine not to exceed $500 per occurrence may be
20imposed; and (iii) if a hospital demonstrates for a second or
21subsequent time a pattern or practice of failing to
22substantially comply with a plan of correction within 60 days
23after the plan takes effect, a fine not to exceed $1,000 per
24occurrence may be imposed. Reports of violations of Section
2510.10 shall be subject to public disclosure under Section
266.14a. Money from fines shall be deposited into the Hospital



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1Licensure Fund, and money from fines for violations of Section
210.10 shall be used for scholarships under the Nursing
3Education Scholarship Law. Long Term Care Provider Fund.
4    (b) Such notice shall be effected by registered mail or by
5personal service setting forth the particular reasons for the
6proposed action and fixing a date, not less than 15 days from
7the date of such mailing or service, at which time the
8applicant or licensee shall be given an opportunity for a
9hearing. Such hearing shall be conducted by the Director or by
10an employee of the Department designated in writing by the
11Director as Hearing Officer to conduct the hearing. On the
12basis of any such hearing, or upon default of the applicant or
13licensee, the Director shall make a determination specifying
14his findings and conclusions. In case of a denial to an
15applicant of a permit to establish a hospital, such
16determination shall specify the subsection of Section 6 under
17which the permit was denied and shall contain findings of fact
18forming the basis of such denial. A copy of such determination
19shall be sent by registered mail or served personally upon the
20applicant or licensee. The decision denying, suspending, or
21revoking a permit or a license shall become final 35 days after
22it is so mailed or served, unless the applicant or licensee,
23within such 35 day period, petitions for review pursuant to
24Section 13.
25    (c) The procedure governing hearings authorized by this
26Section shall be in accordance with rules promulgated by the



SB3636- 4 -LRB101 19846 HLH 69366 b

1Department and approved by the Hospital Licensing Board. A full
2and complete record shall be kept of all proceedings, including
3the notice of hearing, complaint, and all other documents in
4the nature of pleadings, written motions filed in the
5proceedings, and the report and orders of the Director and
6Hearing Officer. All testimony shall be reported but need not
7be transcribed unless the decision is appealed pursuant to
8Section 13. A copy or copies of the transcript may be obtained
9by any interested party on payment of the cost of preparing
10such copy or copies.
11    (d) The Director or Hearing Officer shall upon his own
12motion, or on the written request of any party to the
13proceeding, issue subpoenas requiring the attendance and the
14giving of testimony by witnesses, and subpoenas duces tecum
15requiring the production of books, papers, records, or
16memoranda. All subpoenas and subpoenas duces tecum issued under
17the terms of this Act may be served by any person of full age.
18The fees of witnesses for attendance and travel shall be the
19same as the fees of witnesses before the Circuit Court of this
20State, such fees to be paid when the witness is excused from
21further attendance. When the witness is subpoenaed at the
22instance of the Director, or Hearing Officer, such fees shall
23be paid in the same manner as other expenses of the Department,
24and when the witness is subpoenaed at the instance of any other
25party to any such proceeding the Department may require that
26the cost of service of the subpoena or subpoena duces tecum and



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1the fee of the witness be borne by the party at whose instance
2the witness is summoned. In such case, the Department in its
3discretion, may require a deposit to cover the cost of such
4service and witness fees. A subpoena or subpoena duces tecum
5issued as aforesaid shall be served in the same manner as a
6subpoena issued out of a court.
7    (e) Any Circuit Court of this State upon the application of
8the Director, or upon the application of any other party to the
9proceeding, may, in its discretion, compel the attendance of
10witnesses, the production of books, papers, records, or
11memoranda and the giving of testimony before the Director or
12Hearing Officer conducting an investigation or holding a
13hearing authorized by this Act, by an attachment for contempt,
14or otherwise, in the same manner as production of evidence may
15be compelled before the court.
16    (f) The Director or Hearing Officer, or any party in an
17investigation or hearing before the Department, may cause the
18depositions of witnesses within the State to be taken in the
19manner prescribed by law for like depositions in civil actions
20in courts of this State, and to that end compel the attendance
21of witnesses and the production of books, papers, records, or
23(Source: P.A. 99-180, eff. 7-29-15.)
24    (210 ILCS 85/10.10)
25    Sec. 10.10. Nurse Staffing by Patient Acuity.



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1    (a) Findings. The Legislature finds and declares all of the
3        (1) The State of Illinois has a substantial interest in
4    promoting quality care and improving the delivery of health
5    care services.
6        (2) Evidence-based studies have shown that the basic
7    principles of staffing in the acute care setting should be
8    based on the complexity of patients' care needs aligned
9    with available nursing skills to promote quality patient
10    care consistent with professional nursing standards.
11        (3) Compliance with this Section promotes an
12    organizational climate that values registered nurses'
13    input in meeting the health care needs of hospital
14    patients.
15    (b) Definitions. As used in this Section:
16    "Acuity model" means an assessment tool selected and
17implemented by a hospital, as recommended by a nursing care
18committee, that assesses the complexity of patient care needs
19requiring professional nursing care and skills and aligns
20patient care needs and nursing skills consistent with
21professional nursing standards.
22    "Department" means the Department of Public Health.
23    "Direct patient care" means care provided by a registered
24professional nurse with direct responsibility to oversee or
25carry out medical regimens or nursing care for one or more



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1    "Nursing care committee" means a an existing or newly
2created hospital-wide committee or committees of nurses whose
3functions, in part or in whole, contribute to the development,
4recommendation, and review of the hospital's nurse staffing
5plan established pursuant to subsection (d).
6    "Registered professional nurse" means a person licensed as
7a Registered Nurse under the Nurse Practice Act.
8    "Written staffing plan for nursing care services" means a
9written plan for guiding the assignment of patient care nursing
10staff based on multiple nurse and patient considerations that
11yield minimum staffing levels for inpatient care units and the
12adopted acuity model aligning patient care needs with nursing
13skills required for quality patient care consistent with
14professional nursing standards.
15    (c) Written staffing plan.
16        (1) Every hospital shall implement a written
17    hospital-wide staffing plan, prepared recommended by a
18    nursing care committee or committees, that provides for
19    minimum direct care professional registered
20    nurse-to-patient staffing needs for each inpatient care
21    unit, including inpatient emergency departments. If the
22    staffing plan prepared by the nursing care committee is not
23    adopted by the hospital, or if substantial changes are
24    proposed to it, the chief nursing officer shall either: (i)
25    provide a written explanation to the committee of the
26    reasons the plan was not adopted; or (ii) provide a written



SB3636- 8 -LRB101 19846 HLH 69366 b

1    explanation of any substantial changes made to the proposed
2    plan prior to it being adopted by the hospital. The written
3    hospital-wide staffing plan shall include, but need not be
4    limited to, the following considerations:
5            (A) The complexity of complete care, assessment on
6        patient admission, volume of patient admissions,
7        discharges and transfers, evaluation of the progress
8        of a patient's problems, ongoing physical assessments,
9        planning for a patient's discharge, assessment after a
10        change in patient condition, and assessment of the need
11        for patient referrals.
12            (B) The complexity of clinical professional
13        nursing judgment needed to design and implement a
14        patient's nursing care plan, the need for specialized
15        equipment and technology, the skill mix of other
16        personnel providing or supporting direct patient care,
17        and involvement in quality improvement activities,
18        professional preparation, and experience.
19            (C) Patient acuity and the number of patients for
20        whom care is being provided.
21            (D) The ongoing assessments of a unit's patient
22        acuity levels and nursing staff needed shall be
23        routinely made by the unit nurse manager or his or her
24        designee.
25            (E) The identification of additional registered
26        nurses available for direct patient care when



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1        patients' unexpected needs exceed the planned workload
2        for direct care staff.
3        (2) In order to provide staffing flexibility to meet
4    patient needs, every hospital shall identify an acuity
5    model for adjusting the staffing plan for each inpatient
6    care unit.
7        (2.5) Each hospital shall implement the staffing plan
8    and assign nursing personnel to each inpatient care unit,
9    including inpatient emergency departments, in accordance
10    with the staffing plan.
11            (A) A registered nurse may report to the nursing
12        care committee any variations where the nurse
13        personnel assignment in an inpatient care unit is not
14        in accordance with the adopted staffing plan and may
15        make a written report to the nursing care committee
16        based on the variations.
17            (B) Shift-to-shift adjustments in staffing levels
18        required by the staffing plan may be made by the
19        appropriate hospital personnel overseeing inpatient
20        care operations. If a registered nurse in an inpatient
21        care unit objects to a shift-to-shift adjustment, the
22        registered nurse may submit a written report to the
23        nursing care committee.
24            (C) The nursing care committee shall develop a
25        process to examine and respond to written reports
26        submitted under subparagraphs (A) and (B) of this



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1        paragraph (2.5), including the ability to determine if
2        a specific written report is resolved or should be
3        dismissed.
4        (3) The written staffing plan shall be posted in a
5    conspicuous and accessible location for both patients and
6    direct care staff, as required under the Hospital Report
7    Card Act. A copy of the written staffing plan shall be
8    provided to any member of the general public upon request.
9    (d) Nursing care committee.
10        (1) Every hospital shall have a nursing care committee
11    that meets at least twice per year. A hospital shall
12    appoint members of a committee whereby at least 55% 50% of
13    the members are registered professional nurses providing
14    direct inpatient patient care, one of whom shall be
15    selected annually by the direct inpatient care nurses to
16    serve as co-chair of the committee.
17        (2) (Blank). A nursing care committee's
18    recommendations must be given significant regard and
19    weight in the hospital's adoption and implementation of a
20    written staffing plan.
21        (2.5) A nursing care committee shall prepare and
22    recommend to hospital administration the hospital's
23    written hospital-wide staffing plan. If the staffing plan
24    is not adopted by the hospital, the chief nursing officer
25    shall provide a written statement to the committee prior to
26    a staffing plan being adopted by the hospital that: (A)



SB3636- 11 -LRB101 19846 HLH 69366 b

1    explains the reasons the committee's proposed staffing
2    plan was not adopted; and (B) describes the changes to the
3    committee's proposed staffing or any alternative to the
4    committee's proposed staffing plan.
5        (3) A nursing care committee's committee or
6    committees' committees shall recommend a written staffing
7    plan for the hospital shall be based on the principles from
8    the staffing components set forth in subsection (c). In
9    particular, a committee or committees shall provide input
10    and feedback on the following:
11            (A) Selection, implementation, and evaluation of
12        minimum staffing levels for inpatient care units.
13            (B) Selection, implementation, and evaluation of
14        an acuity model to provide staffing flexibility that
15        aligns changing patient acuity with nursing skills
16        required.
17            (C) Selection, implementation, and evaluation of a
18        written staffing plan incorporating the items
19        described in subdivisions (c)(1) and (c)(2) of this
20        Section.
21            (D) Review the nurse following: nurse-to-patient
22        staffing plans guidelines for all inpatient areas; and
23        current acuity tools and measures in use. The nursing
24        care committee's review shall consider:
25                (i) patient outcomes;
26                (ii) complaints regarding staffing, including



SB3636- 12 -LRB101 19846 HLH 69366 b

1            complaints about a delay in direct care nursing or
2            an absence of direct care nursing;
3                (iii) the number of hours of nursing care
4            provided through an inpatient hospital unit
5            compared with the number of inpatients served by
6            the hospital unit during a 24-hour period;
7                (iv) the aggregate hours of overtime worked by
8            the nursing staff;
9                (v) the extent to which actual nurse staffing
10            for each hospital inpatient unit differs from the
11            staffing specified by the staffing plan; and
12                (vi) any other matter or change to the staffing
13            plan determined by the committee to ensure that the
14            hospital is staffed to meet the health care needs
15            of patients.
16        (4) A nursing care committee must issue a written
17    report addressing address the items described in
18    subparagraphs (A) through (D) of paragraph (3)
19    semi-annually. A written copy of this report shall be made
20    available to direct inpatient care nurses by making
21    available a paper copy of the report, distributing it
22    electronically, or posting it on the hospital's website.
23        (5) A nursing care committee must issue a written
24    report at least annually to the hospital governing board
25    that addresses items including, but not limited to: the
26    items described in paragraph (3); changes made based on



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1    committee recommendations and the impact of such changes;
2    and recommendations for future changes related to nurse
3    staffing.
4    (e) Nothing in this Section 10.10 shall be construed to
5limit, alter, or modify any of the terms, conditions, or
6provisions of a collective bargaining agreement entered into by
7the hospital.
8    (f) No hospital may discipline, discharge, or take any
9other adverse employment action against an employee solely
10because the employee expresses a concern or complaint regarding
11an alleged violation of this Section or concerns related to
12nurse staffing.
13    (g) Any employee of a hospital may file a complaint with
14the Department regarding an alleged violation of this Section.
15The Department must forward notification of the alleged
16violation to the hospital in question within 10 business days
17after the complaint is filed. Upon receiving a complaint of a
18violation of this Section, the Department may take any action
19authorized under Sections 7 or 9 of this Act.
20(Source: P.A. 96-328, eff. 8-11-09; 97-423, eff. 1-1-12;
2197-813, eff. 7-13-12.)
22    (210 ILCS 85/14.5)
23    Sec. 14.5. Hospital Licensure Fund.
24    (a) There is created in the State treasury the Hospital
25Licensure Fund. The Fund is created for the purpose of



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1providing funding for the administration of the licensure
2program and patient safety and quality initiatives for
3hospitals, including, without limitation, the implementation
4of the Illinois Adverse Health Care Events Reporting Law of
6    (b) The Fund shall consist of the following:
7        (1) fees collected pursuant to Sections Section 5 and 7
8    of the Hospital Licensing Act;
9        (2) federal matching funds received by the State as a
10    result of expenditures made by the Department that are
11    attributable to moneys deposited in the Fund;
12        (3) interest earned on moneys deposited in the Fund;
13    and
14        (4) other moneys received for the Fund from any other
15    source, including interest earned thereon.
16    (c) Disbursements from the Fund shall be made only for:
17        (1) initially, the implementation of the Illinois
18    Adverse Health Care Events Reporting Law of 2005;
19        (2) subsequently, programs, information, or
20    assistance, including measures to address public
21    complaints, designed to measurably improve quality and
22    patient safety; and
23        (2.5) from fines for violations of Section 10.10,
24    scholarships under the Nursing Education Scholarship Law;
25    and
26        (3) the reimbursement of moneys collected by the



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1    Department through error or mistake.
2    (d) The uses described in paragraph (2) of subsection (c)
3shall be developed in conjunction with a statewide organization
4representing a majority of hospitals.
5(Source: P.A. 98-683, eff. 6-30-14.)

7    Section 5-5. The Nursing Education Scholarship Law is
8amended by changing Section 5 as follows:
9    (110 ILCS 975/5)  (from Ch. 144, par. 2755)
10    Sec. 5. Nursing education scholarships. Beginning with the
11fall term of the 2004-2005 academic year, the Department, in
12accordance with rules and regulations promulgated by it for
13this program, shall provide scholarships to individuals
14selected from among those applicants who qualify for
15consideration by showing:
16        (1) that he or she has been a resident of this State
17    for at least one year prior to application, and is a
18    citizen or a lawful permanent resident alien of the United
19    States;
20        (2) that he or she is enrolled in or accepted for
21    admission to an associate degree in nursing program,
22    hospital-based diploma in nursing program, baccalaureate
23    degree in nursing program, graduate degree in nursing



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1    program, or practical nursing program at an approved
2    institution; and
3        (3) that he or she agrees to meet the nursing
4    employment obligation.
5    If in any year the number of qualified applicants exceeds
6the number of scholarships to be awarded, the Department shall,
7in consultation with the Illinois Nursing Workforce Center
8Advisory Board, consider the following factors in granting
9priority in awarding scholarships:
10            (A) Financial need, as shown on a standardized
11        financial needs assessment form used by an approved
12        institution, of students who will pursue their
13        education on a full-time or close to full-time basis
14        and who already have a certificate in practical
15        nursing, a diploma in nursing, or an associate degree
16        in nursing and are pursuing a higher degree.
17            (B) A student's status as a registered nurse who is
18        pursuing a graduate degree in nursing to pursue
19        employment in an approved institution that educates
20        licensed practical nurses and that educates registered
21        nurses in undergraduate and graduate nursing programs.
22            (C) A student's merit, as shown through his or her
23        grade point average, class rank, and other academic and
24        extracurricular activities. The Department may add to
25        and further define these merit criteria by rule.
26    Unless otherwise indicated, scholarships shall be awarded



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1to recipients at approved institutions for a period of up to 2
2years if the recipient is enrolled in an associate degree in
3nursing program, up to 3 years if the recipient is enrolled in
4a hospital-based diploma in nursing program, up to 4 years if
5the recipient is enrolled in a baccalaureate degree in nursing
6program, up to 5 years if the recipient is enrolled in a
7graduate degree in nursing program, and up to one year if the
8recipient is enrolled in a certificate in practical nursing
9program. At least 40% of the scholarships awarded shall be for
10recipients who are pursuing baccalaureate degrees in nursing,
1130% of the scholarships awarded shall be for recipients who are
12pursuing associate degrees in nursing or a diploma in nursing,
1310% of the scholarships awarded shall be for recipients who are
14pursuing a certificate in practical nursing, and 20% of the
15scholarships awarded shall be for recipients who are pursuing a
16graduate degree in nursing.
17    Beginning with the fall term of the 2020-2021 academic year
18and continuing through the 2023-2024 academic year, subject to
19appropriation from the Hospital Licensure Fund, in addition to
20any other funds available to the Department for such
21scholarships, the Department may award a total of $500,000
22annually in scholarships under this Section.
23(Source: P.A. 100-513, eff. 1-1-18.)




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1    Section 10-5. The Illinois Income Tax Act is amended by
2adding Section 232 as follows:
3    (35 ILCS 5/232 new)
4    Sec. 232. Credit for nurse educators.
5    (a) For taxable years beginning on or after January 1,
62020, any taxpayer who is employed during the taxable year as a
7nurse educator is entitled to a credit against the tax imposed
8by subsections (a) and (b) of Section 201 in an amount equal to
92.5% of the taxpayer's federal adjusted gross income for the
10taxable year. As used in this Section "nurse educator" has the
11meaning given to that term in Section 3 of the Nursing
12Education Scholarship Law.
13    (b) In no event shall a credit under this Section reduce a
14taxpayer's liability to less than zero. If the amount of credit
15exceeds the tax liability for the year, the excess may be
16carried forward and applied to the tax liability for the 5
17taxable years following the excess credit year. The tax credit
18shall be applied to the earliest year for which there is a tax
19liability. If there are credits for more than one year that are
20available to offset liability, the earlier credit shall be
21applied first.
22    (c) This Section is exempt from the provisions of Section




SB3636- 19 -LRB101 19846 HLH 69366 b

1    Section 99-99. Effective date. This Act takes effect upon
2becoming law, except that Article 1 takes effect on the first
3day of the first full calendar month that begins 6 months after
4this Act becomes law.