Illinois General Assembly - Full Text of HB3401
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Full Text of HB3401  102nd General Assembly

HB3401 102ND GENERAL ASSEMBLY

  
  

 


 
102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB3401

 

Introduced 2/22/2021, by Rep. Robyn Gabel

 

SYNOPSIS AS INTRODUCED:
 
New Act
5 ILCS 80/4.41 new

    Creates the Licensed Certified Professional Midwife Practice Act. Provides for the licensure of certified professional midwives by the Department of Financial and Professional Regulation and for certain limitations on the activities of licensed certified professional midwives. Creates the Illinois Midwifery Board. Sets forth provisions concerning application; qualifications; exemptions; title protection; informed consent; consultation and referral; grounds for disciplinary action; reporting; and administrative procedures. Amends the Regulatory Sunset Act to set a repeal date for the new Act of January 1, 2032.


LRB102 14708 SPS 20061 b

FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB3401LRB102 14708 SPS 20061 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. Short title. This Act may be cited as the
5Licensed Certified Professional Midwife Practice Act.
 
6    Section 5. Purpose. The practice of midwifery in
7out-of-hospital settings is hereby declared to affect the
8public health, safety, and welfare and to be subject to
9regulation in the public interest. The purpose of the Act is to
10protect and benefit the public by setting standards for the
11qualifications, education, training, and experience of those
12who seek to obtain licensure as a licensed certified
13professional midwife, including requirements to work in
14consultation with hospital based and privileged health care
15professionals to promote high standards of professional
16performance for those licensed to practice midwifery in
17out-of-hospital settings in this State, to promote a
18consultative and integrated maternity care delivery system in
19Illinois with agreed-upon consulting, transfer, and transport
20protocols in use by all health care professionals and licensed
21certified professional midwives across all health care
22settings to maximize client safety and positive outcomes, to
23support accredited education and training as a prerequisite to

 

 

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1licensure, and to protect the public.
 
2    Section 10. Definitions. As used in this Act:
3    "Address of record" means the designated address recorded
4by the Department in the applicant's application file or the
5licensee's licensure file as maintained by the Department.
6    "Antepartum" means before labor or childbirth.
7    "Birth assistant" means a midwifery student or individual
8who has been educated to provide both basic and emergency care
9to newborns and mothers during labor, delivery, and
10immediately postpartum and who maintains Neonatal
11Resuscitation Program provider status and cardiopulmonary
12resuscitation certification.
13    "Board" means the Illinois Midwifery Board.
14    "Certified nurse midwife" means an individual licensed
15under the Nurse Practice Act as an advanced practice
16registered nurse and is certified as a nurse midwife.
17    "Client" means a childbearing individual or newborn for
18whom a licensed certified professional midwife provides
19services.
20    "Consultation" means the process by which a licensed
21certified professional midwife seeks the advice or opinion of
22another health care professional.
23    "Department" means the Department of Financial and
24Professional Regulation.
25    "Email address of record" means the designated email

 

 

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1address of record by the Department in the applicant's
2application file or the licensee's licensure file as
3maintained by the Department.
4    "Health care professional" means an advanced practice
5registered nurse or a physician licensed to practice medicine
6in all of its branches.
7    "Intrapartum" means during labor and delivery or
8childbirth.
9    "Licensed certified professional midwife" means a person
10who has successfully met the requirements under Section 40 of
11this Act.
12    "Low-risk" means a low-risk pregnancy where there is an
13absence of any preexisting maternal disease, significant
14disease arising from the pregnancy, or any condition likely to
15affect the pregnancy, including, but not limited to, those
16listed in subsection (b) of Section 60 of this Act.
17    "Midwifery Education and Accreditation Council" or "MEAC"
18means the nationally recognized accrediting agency, or its
19successor, that establishes standards for the education of
20direct-entry midwives in the United States.
21    "National Association of Certified Professional Midwives"
22or "NACPM" means the professional organization, or its
23successor, that promotes the growth and development of the
24profession of certified professional midwives.
25    "North American Registry of Midwives" or "NARM" means the
26accredited international agency, or its successor

 

 

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1organization, that has established and has continued to
2administer certification for the credentialing of licensed
3certified professional midwives.
4    "Onset of care" means the initial prenatal visit upon an
5agreement between a licensed certified professional midwife
6and prospective client to establish a midwife-client
7relationship, during which the licensed certified professional
8midwife may take a prospective client's medical history,
9complete an exam, establish a prospective client's record, or
10perform other services related to establishing care. "Onset of
11care" does not include an initial interview where information
12about the licensed certified professional midwife's practice
13is shared but no midwife-client relationship is established.
14    "Pediatric health care professional" means a licensed
15physician specializing in the care of children, a family
16practice physician, or an advanced practice registered nurse
17licensed under the Nurse Practice Act and certified as a
18Pediatric Nurse Practitioner or Family Nurse Practitioner.
19    "Physician" means a physician licensed under the Medical
20Practice Act of 1987 to practice medicine in all of its
21branches.
22    "Postpartum period" means the first 6 weeks after
23delivery.
24    "Practice of midwifery" means providing the necessary
25supervision, care, and advice to a client during a low-risk
26pregnancy, labor, and the postpartum period, including the

 

 

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1intended low-risk delivery of a child, and providing normal
2newborn care. "Practice of midwifery" does not include the
3practice of medicine or nursing.
4    "Secretary" means the Secretary of Financial and
5Professional Regulation.
 
6    Section 15. Address of record; email address of record.
7All applicants and licensees shall:
8        (1) provide a valid address and email address to the
9    Department, which shall serve as the address of record and
10    email address of record, respectively, at the time of
11    application for licensure or renewal of licensure; and
12        (2) inform the Department of any change of address of
13    record or email address of record within 14 days after
14    such change either through the Department's website or by
15    contacting the Department.
 
16    Section 20. Exemptions.
17    (a) This Act does not prohibit a person licensed under any
18other Act in this State from engaging in the practice for which
19he or she is licensed or from delegating services as provided
20for under the Act.
21    (b) Nothing in this Act shall be construed to prohibit or
22require licensing under this Act with regard to:
23        (1) the gratuitous rendering of services;
24        (2) the rendering of services by a birth attendant if

 

 

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1    such attendance is in accordance with the birth
2    attendant's religious faith or cultural group and is
3    rendered only to childbearing individuals and families in
4    a distinct cultural or religious group as an exercise and
5    enjoyment of religious or cultural freedom; and
6        (3) a student midwife or midwife's assistant working
7    under the supervision of a licensed certified professional
8    midwife.
9    (c) Nothing in this Act prevents a licensed certified
10professional midwife from assisting a health care
11professional, practicing within his or her scope of practice
12while providing antepartum, intrapartum, or postpartum care.
13    (d) Nothing in this Act abridges, limits, or changes in
14any way the rights of parents to deliver their baby where,
15when, how, and with whom they choose, regardless of licensure
16under this Act.
 
17    Section 25. Illinois Midwifery Board.
18    (a) There is created under the authority of the Department
19the Illinois Midwifery Board, which shall consist of 9 members
20appointed by the Secretary: 5 of whom shall be licensed
21certified professional midwives, except that initial
22appointees must have at least 3 years of experience in the
23practice of midwifery in an out-of-hospital setting, be
24certified by the North American Registry of Midwives, and meet
25the qualifications for licensure set forth in this Act; one of

 

 

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1whom shall be a licensed obstetrician; one of whom shall be a
2certified nurse midwife who provides home birth services; one
3of whom shall be a pediatric health care professional; and one
4of whom shall be a knowledgeable public member who has given
5birth in an out-of-hospital birth setting. Board members shall
6serve 4-year terms, except that in the case of initial
7appointments, terms shall be staggered as follows: 4 members
8shall serve for 4 years, 3 members shall serve for 3 years, and
92 members shall serve for 2 years. The Board shall annually
10elect a chairperson and vice chairperson.
11    (b) Any appointment made to fill a vacancy shall be for the
12unexpired portion of the term. Appointments to fill vacancies
13shall be made in the same manner as original appointments. No
14Board member may be reappointed for a term that would cause his
15or her continuous service on the Board to exceed 9 years.
16    (c) Board membership must have a reasonable representation
17from different geographic areas of this State, if possible.
18    (d) Board membership appointments should give preference
19to members who have experience providing out-of-hospital birth
20services or consulting with licensed certified professional
21midwives or certified nurse midwives.
22    (e) The members of the Board may be reimbursed for all
23legitimate, necessary, and authorized expenses incurred in
24attending the meetings of the Board.
25    (f) The Secretary may remove any member of the Board for
26misconduct, incapacity, or neglect of duty at any time prior

 

 

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1to the expiration of his or her term.
2    (g) Five Board members shall constitute a quorum. A
3vacancy in the membership of the Board shall not impair the
4right of a quorum to perform all of the duties of the Board.
5    (h) The Board shall provide the Department with
6recommendations concerning the administration of this Act and
7may perform each of the following duties:
8        (1) Recommend to the Department the prescription and,
9    from time to time, the revision of any rules that may be
10    necessary to carry out the provisions of this Act,
11    including those that are designed to protect the health,
12    safety, and welfare of the public.
13        (2) Recommend changes to the medication formulary list
14    as standards and drug availability change.
15        (3) Conduct hearing and disciplinary conferences on
16    disciplinary charges of licensees.
17        (4) Report to the Department, upon completion of a
18    hearing, the disciplinary actions recommended to be taken
19    against a person found in violation of this Act.
20        (5) Recommend the approval, denial of approval, and
21    withdrawal of approval of required education and
22    continuing educational programs.
23        (6) Assist the Department in drafting forms and
24    informational handouts relative to this Act.
25    (i) The Secretary shall give due consideration to all
26recommendations of the Board. If the Secretary takes action

 

 

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1contrary to a recommendation of the Board, the Secretary must
2promptly provide a written explanation of that action.
3    (j) The Board may recommend to the Secretary that one or
4more licensed certified professional midwives be selected by
5the Secretary to assist in any investigation under this Act.
6Compensation shall be provided to any licensee who provides
7assistance under this subsection in an amount determined by
8the Secretary.
9    (k) Members of the Board shall be immune from suit in an
10action based upon a disciplinary proceeding or other activity
11performed in good faith as a member of the Board, except for
12willful or wanton misconduct.
13    (l) Members of the Board may participate in and act at any
14meeting of the Illinois Midwifery Board through the use of any
15real-time Internet or telephone communications media, by means
16of which all persons participating in the meeting can
17communicate with each other. Participation in such meeting
18shall constitute attendance and presence in person at the
19meetings of the person or persons so participating.
 
20    Section 30. Powers and duties of the Department; rules.
21    (a) The Department shall exercise the powers and duties
22prescribed by the Civil Administrative Code of Illinois for
23the administration of licensing Acts and shall exercise such
24other powers and duties necessary for effectuating the
25purposes of this Act.

 

 

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1    (b) The Secretary shall adopt rules consistent with the
2provisions of this Act for the administration and enforcement
3of this Act and for the payment of fees connected to this Ac
4and may prescribe forms that shall be issued in connection
5with this Act.
6    (c) Administration by the Department of this Act must be
7consistent with standards regarding the practice of midwifery
8established by the National Association of Certified
9Professional Midwives or a successor organization, this Act,
10and rules adopted pursuant to this Act.
 
11    Section 35. Use of title. No person may use the title
12"licensed midwife", describe or imply that he or she is a
13licensed midwife, or represent himself or herself as a
14licensed midwife unless the person is granted a license under
15this Act or is licensed as an advanced practice registered
16nurse with certification as a nurse midwife.
 
17    Section 40. Licensure.
18    (a) Each applicant who successfully meets the requirements
19of this Section shall be licensed as a certified professional
20midwife if the applicant:
21        (1) submits forms prescribed by the Department and
22    accompanied by the required fee;
23        (2) is at least 21 years of age;
24        (3) is a high school graduate or have completed an

 

 

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1    equivalent education;
2        (4) holds and maintains valid certified professional
3    midwife certification granted by NARM or its successor
4    organization;
5        (5) holds and maintains cardiopulmonary resuscitation
6    certification;
7        (6) holds and maintains neonatal resuscitation
8    provider status; and
9        (7) successfully completed a postsecondary midwifery
10    education program through an institution, program, or
11    pathway accredited by the Midwife Education and
12    Accreditation Council, that has both academic and clinical
13    practice incorporated throughout the curriculum.
14    (b) Midwives who are certified by NARM, but who have not
15completed a MEAC program, may apply for licensure for up to 3
16years after the adoption of rules if they meet the following
17requirements:
18        (1) provide proof as a citizen residing in Illinois;
19        (2) provide proof of practicing as a certified
20    professional midwife in Illinois for at least 3 years
21    prior to when rules are adopted; and
22        (3) provide proof of items (1) through (6) of
23    subsection (a).
 
24    Section 45. Renewal of licensure.
25    (a) A licensed certified professional midwife shall renew

 

 

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1his or her license every 3 years at the discretion of the
2Department.
3    (b) Rules adopted under this Act shall require a licensed
4certified professional midwife to maintain certified
5professional midwife certification by meeting all continuing
6education requirements and other requirements set forth in
7this Section and to maintain current cardiopulmonary
8resuscitation or basic life support certification as required
9under Section 40.
10    (c) A licensed certified professional midwife must
11complete at least 10 hours of continuing education credits
12annually, such that each licensure renewal requires a total 30
13hours of continuing education credits.
 
14    Section 50. Informed consent.
15    (a) A licensed certified professional midwife shall, at an
16initial prenatal visit with a client, provide and disclose to
17the client orally and in writing on a form provided by the
18Department all of the following information:
19        (1) the licensed certified professional midwife's
20    experience and training;
21        (2) whether the licensed certified professional
22    midwife has malpractice liability insurance coverage and
23    the policy limits of the coverage;
24        (3) a protocol for the handling of both the patient's
25    and the newborn's medical emergencies; this shall include,

 

 

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1    but not be limited to, obtaining transportation to a
2    hospital particular to each client with identification of
3    the appropriate hospital, providing a verbal report of the
4    care provided to emergency services providers, and sending
5    a copy of the client records with the client at the time of
6    any transfer to a hospital, including obtaining a signed
7    authorization to release the client's medical records to a
8    health care professional or hospital in the event of such
9    emergency transport;
10        (4) a statement informing the client that, in the
11    event of an emergency or voluntary transfer or if
12    subsequent care is required resulting from the acts or
13    omissions of the licensed certified professional midwife,
14    no liability for the acts or omissions of the licensed
15    certified professional midwife are assignable to the
16    receiving hospital, health care facility, physician,
17    nurse, emergency personnel, or other medical professional
18    rendering such care; the receiving hospital, health care
19    facility, physician, nurse, emergency medical personnel,
20    hospital, or other medical professional rendering care are
21    responsible for their own acts and omissions;
22        (5) a statement outlining the emergency equipment,
23    drugs, and personnel available to necessary to provide
24    appropriate care in the home;
25        (6) the intent to provide at least one birth assistant
26    during intrapartum and immediate postpartum care; and

 

 

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1        (7) a recommendation that the client preregister with
2    the nearest hospital and explain the benefits of
3    preregistration.
4    (b) A licensed certified professional midwife shall, at an
5initial prenatal visit with a client, provide a copy of the
6written disclosures required under this Section to the client
7and obtain the client's signature acknowledging that the
8client has been informed, orally and in writing, of the
9disclosures required.
 
10    Section 55. Scope of practice.
11    (a) A licensed certified professional midwife shall:
12        (1) offer each client routine prenatal care and
13    testing in accordance with current American College of
14    Obstetricians and Gynecologists guidelines;
15        (2) provide all clients with a plan for 24 hour
16    on-call availability by a licensed certified professional
17    midwife, certified nurse midwife, or licensed physician
18    throughout pregnancy, intrapartum, and 6 weeks postpartum;
19        (3) provide clients with labor support, fetal
20    monitoring, and routine assessment of vital signs once
21    active labor is established;
22        (4) supervise delivery of infant and placenta, assess
23    newborn and maternal well-being in immediate postpartum,
24    and perform an Apgar score assessment;
25        (5) perform routine cord management and inspect for an

 

 

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1    appropriate number of vessels;
2        (6) inspect the placenta and membranes for
3    completeness;
4        (7) inspect the perineum and vagina postpartum for
5    lacerations and stabilize if necessary;
6        (8) observe the childbearing individual and newborn
7    postpartum until stable condition is achieved, but in no
8    event for less than 2 hours;
9        (9) instruct the childbearing individual, spouse, and
10    other support persons, both verbally and in writing, of
11    the special care and precautions for both the childbearing
12    individual and newborn in the immediate postpartum period;
13        (10) reevaluate maternal and newborn well-being within
14    36 hours of delivery;
15        (11) notify a pediatric health care professional
16    within 72 hours after delivery;
17        (12) use universal precautions with all biohazard
18    materials;
19        (13) ensure that a birth certificate is accurately
20    completed and filed in accordance with the Department of
21    Public Health;
22        (14) offer to obtain and submit a blood sample in
23    accordance with the recommendations for metabolic
24    screening of the newborn;
25        (15) offer an injection of vitamin K for the newborn
26    in accordance with the indication, dose, and

 

 

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1    administration route as authorized in subsection (b);
2        (16) within one week of delivery, offer a newborn
3    hearing screening to every newborn or refer the parents to
4    a facility with a newborn hearing screening program;
5        (17) within 2 hours of the birth, offer the
6    administration of antibiotic ointment into the eyes of the
7    newborn, in accordance with the Infant Eye Disease Act;
8    and
9        (18) maintain adequate antenatal and perinatal records
10    of each client and provide records to consulting licensed
11    physicians and licensed certified nurse midwives, in
12    accordance with regulations promulgated under the Health
13    Insurance Portability and Accountability Act of 1996.
14    (b) A licensed certified professional midwife may
15administer the following during the practice of midwifery:
16        (1) oxygen for the treatment of fetal distress;
17        (2) eye prophylactics, either 0.5% erythromycin
18    ophthalmic ointment or 1% tetracycline ophthalmic ointment
19    for the prevention of neonatal ophthalmia;
20        (3) oxytocin, pitocin, or misoprostol as a postpartum
21    antihemorrhagic agent;
22        (4) methylergonovine or methergine for the treatment
23    of postpartum hemorrhage;
24        (5) vitamin K for the prophylaxis of hemorrhagic
25    disease of the newborn;
26        (6) Rho (D) immune globulin for the prevention of Rho

 

 

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1    (D) sensitization in Rho (D) negative individuals;
2        (7) intravenous fluids for maternal stabilization,
3    including lactated Ringer's solution or 5% dextrose,
4    unless unavailable or impractical, in which case 0.9%
5    sodium chloride may be administered;
6        (8) antibiotics, prescribed by a health care
7    professional, to prevent group B strep disease;
8        (9) ibuprofen for postpartum pain relief;
9        (10) lidocaine injection as a local anesthetic for
10    perineal repair; and
11        (11) sterile water subcutaneous injections as a
12    non-pharmaceutical form of pain relief during the first
13    and second stages of labor.
14    The medication indications, dose, route of administration,
15and duration of treatment relating to the administration of
16drugs and procedures identified under this Section shall be
17determined by rule as the Department deems necessary to be in
18keeping with current evidence-based practice and standards.
19The Department may approve additional medications, agents, or
20procedures based upon updated evidence-based obstetrical
21guidelines or based upon limited availability of standard
22medications or agents.
23    (c) A licensed certified professional midwife shall plan
24for at least 2 licensed certified professional midwives or a
25licensed certified professional midwife and a birth assistant
26to be present at all out-of-hospital births.
 

 

 

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1    Section 60. Consultation and referral.
2    (a) A licensed certified professional midwife shall
3consult with a licensed physician or a certified nurse midwife
4providing obstetrical care whenever there are significant
5deviations, including abnormal laboratory results, relative to
6a client's pregnancy or to a neonate. If a referral to a
7physician or certified nurse midwife is needed, the licensed
8certified professional midwife shall refer the client to a
9physician or certified nurse midwife and, if possible, remain
10in consultation with the physician until resolution of the
11concern. Consultation does not preclude the possibility of an
12out-of-hospital birth. It is appropriate for the licensed
13certified professional midwife to maintain care of the client
14to the greatest degree possible, in accordance with the
15client's wishes, during the pregnancy and, if possible, during
16labor, birth, and the postpartum period.
17    (b) A licensed certified professional midwife shall
18consult with a licensed physician or a certified nurse midwife
19with regard to any childbearing individual who presents with
20or develops the following risk factors or presents with or
21develops other risk factors that, in the judgment of the
22licensed certified professional midwife, warrant consultation:
23        (1) Antepartum:
24            (A) pregnancy induced hypertension, as evidenced
25        by a blood pressure of 140/90 on 2 occasions greater

 

 

HB3401- 19 -LRB102 14708 SPS 20061 b

1        than 6 hours apart;
2            (B) persistent, severe headaches, epigastric pain,
3        or visual disturbances;
4            (C) persistent symptoms of urinary tract
5        infection;
6            (D) significant vaginal bleeding before the onset
7        of labor not associated with uncomplicated spontaneous
8        abortion;
9            (E) rupture of membranes prior to the 37th week
10        gestation;
11            (F) noted abnormal decrease in or cessation of
12        fetal movement;
13            (G) anemia resistant to supplemental therapy;
14            (H) fever of 102 degrees Fahrenheit or 39 degrees
15        Celsius or greater for more than 24 hours;
16            (I) non-vertex presentation after 38 weeks
17        gestation;
18            (J) hyperemesis or significant dehydration;
19            (K) isoimmunization, Rh-negative sensitized,
20        positive titers, or any other positive antibody titer,
21        which may have a detrimental effect on the
22        childbearing individual or fetus;
23            (L) elevated blood glucose levels unresponsive to
24        dietary management;
25            (M) positive HIV antibody test;
26            (N) primary genital herpes infection in pregnancy;

 

 

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1            (O) symptoms of malnutrition or anorexia or
2        protracted weight loss or failure to gain weight;
3            (P) suspected deep vein thrombosis;
4            (Q) documented placental anomaly or previa;
5            (R) documented low-lying placenta in a
6        childbearing individual with history of previous
7        cesarean delivery;
8            (S) labor prior to the 37th week of gestation;
9            (T) history of prior uterine incision;
10            (U) lie other than vertex at term;
11            (V) multiple gestation;
12            (W) known fetal anomalies that may be affected by
13        the site of birth;
14            (X) marked abnormal fetal heart tones;
15            (Y) abnormal non-stress test or abnormal
16        biophysical profile;
17            (Z) marked or severe polyhydramnios or
18        oligohydramnios;
19            (AA) evidence of intrauterine growth restriction;
20            (BB) significant abnormal ultrasound findings; or
21            (CC) gestation beyond 42 weeks by reliable
22        confirmed dates;
23        (2) Intrapartum:
24            (A) rise in blood pressure above baseline, more
25        than 30/15 points or greater than 140/90;
26            (B) persistent, severe headaches, epigastric pain

 

 

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1        or visual disturbances;
2            (C) significant proteinuria or ketonuria;
3            (D) fever over 100.6 degrees Fahrenheit or 38
4        degrees Celsius in absence of environmental factors;
5            (E) ruptured membranes without onset of
6        established labor after 18 hours;
7            (F) significant bleeding prior to delivery or any
8        abnormal bleeding, with or without abdominal pain or
9        evidence of placental abruption;
10            (G) lie not compatible with spontaneous vaginal
11        delivery or unstable fetal lie;
12            (H) failure to progress after 5 hours of active
13        labor or following 2 hours of active second stage
14        labor;
15            (I) signs or symptoms of maternal infection;
16            (J) active genital herpes at onset of labor;
17            (K) fetal heart tones with non-reassuring
18        patterns;
19            (L) signs or symptoms of fetal distress;
20            (M) thick meconium or frank bleeding with birth
21        not imminent; or
22            (N) client or licensed certified professional
23        midwife desires physician consultation or transfer;
24        (3) Postpartum:
25            (A) failure to void within 6 hours of birth;
26            (B) signs or symptoms of maternal shock;

 

 

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1            (C) fever of 102 degrees Fahrenheit or 39 degrees
2        Celsius and unresponsive to therapy for 12 hours;
3            (D) abnormal lochia or signs or symptoms of
4        uterine sepsis;
5            (E) suspected deep vein thrombosis; or
6            (F) signs of clinically significant depression.
7    (c) A licensed certified professional midwife shall
8consult with a licensed physician or certified nurse midwife
9with regard to any neonate who is born with or develops the
10following risk factors:
11        (1) Apgar score of 6 or less at 5 minutes without
12    significant improvement by 10 minutes;
13        (2) persistent grunting respirations or retractions;
14        (3) persistent cardiac irregularities;
15        (4) persistent central cyanosis or pallor;
16        (5) persistent lethargy or poor muscle tone;
17        (6) abnormal cry;
18        (7) birth weight less than 2,300 grams;
19        (8) jitteriness or seizures;
20        (9) jaundice occurring before 24 hours or outside of
21    normal range;
22        (10) failure to urinate within 24 hours of birth;
23        (11) failure to pass meconium within 48 hours of
24    birth;
25        (12) edema;
26        (13) prolonged temperature instability;

 

 

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1        (14) significant signs or symptoms of infection;
2        (15) significant clinical evidence of glycemic
3    instability;
4        (16) abnormal, bulging, or depressed fontanel;
5        (17) significant clinical evidence of prematurity;
6        (18) medically significant congenital anomalies;
7        (19) significant or suspected birth injury;
8        (20) persistent inability to suck;
9        (21) diminished consciousness;
10        (22) clinically significant abnormalities in vital
11    signs, muscle tone, or behavior;
12        (23) clinically significant color abnormality,
13    cyanotic, or pale or abnormal perfusion;
14        (24) abdominal distension or projectile vomiting; or
15        (25) signs of clinically significant dehydration or
16    failure to thrive.
17    (d) Consultation with a health care professional does not
18establish a formal relationship with the client. Consultation
19does not establish a formal relationship between a licensed
20certified professional midwife and another health care
21professional.
 
22    Section 65. Transfer.
23    (a) Transport via private vehicle is an acceptable method
24of transport if it is the most expedient and safest method for
25accessing medical services. The licensed certified

 

 

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1professional midwife shall initiate immediate transport
2according to the licensed certified professional midwife's
3emergency plan, provide emergency stabilization until
4emergency medical services arrive or transfer is completed,
5accompany the client or follow the client to a hospital in a
6timely fashion, and provide pertinent information to the
7receiving facility and complete an emergency.
8    (b) A licensed certified professional midwife must
9establish a protocol for the handling of both the patient's
10and newborn's medical emergencies, including transportation to
11a hospital, particular to each client, with identification of
12the appropriate hospital. A verbal report of the care provided
13must be provided to emergency services providers and a copy of
14the client records shall be sent with the client at the time of
15any transfer to a hospital, including obtaining a signed
16authorization to release the client's medical records to a
17health care professional or hospital in the event of such
18emergency transport.
 
19    Section 70. Prohibited practices.
20    (a) A licensed certified professional midwife may not do
21any of the following:
22        (1) administer prescription pharmacological agents
23    intended to induce or augment labor;
24        (2) administer prescription pharmacological agents to
25    provide pain management;

 

 

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1        (3) use vacuum extractors or forceps;
2        (4) prescribe medications;
3        (5) provide out-of-hospital care to a childbearing
4    individual who has had a previous cesarean section;
5        (6) perform surgical procedures, including, but not
6    limited to, abortions, cesarean sections, and
7    circumcisions, except for an emergency episiotomy;
8        (7) knowingly accept responsibility for prenatal or
9    intrapartum care of a client with any of the following
10    risk factors:
11            (A) chronic significant maternal cardiac,
12        pulmonary, renal, or hepatic disease;
13            (B) malignant disease in an active phase;
14            (C) significant hematological disorders,
15        coagulopathies, or pulmonary embolism;
16            (D) insulin requiring diabetes mellitus;
17            (E) known maternal congenital abnormalities
18        affecting childbirth;
19            (F) confirmed isoimmunization, Rh disease with
20        positive titer;
21            (G) active tuberculosis;
22            (H) active syphilis or gonorrhea;
23            (I) active genital herpes infection 2 weeks prior
24        to labor or in labor;
25            (J) pelvic or uterine abnormalities affecting
26        normal vaginal births, including tumors and

 

 

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1        malformations;
2            (K) alcoholism or alcohol abuse;
3            (L) drug addiction or abuse; or
4            (M) confirmed AIDS status.
5    (b) A licensed certified professional midwife shall not
6administer Schedule II through IV controlled substances.
7Subject to a prescription by a health care professional,
8Schedule V controlled substances may be administered by
9licensed certified professional midwives.
 
10    Section 75. Annual Reports.
11    (a) Beginning in 2023, a licensed certified professional
12midwife shall annually report to the Department, by no later
13than March 31 of each year, in a form specified by the
14Department, the following information regarding cases in which
15the licensed certified professional midwife assisted during
16the previous calendar year when the intended place of birth at
17the onset of care was an out-of-hospital setting:
18        (1) the total number of patients served at the onset
19    of care;
20        (2) the number, by county, of live births attended;
21        (3) the number, by county, of cases of fetal demise,
22    infant deaths, and maternal deaths attended at the
23    discovery of the demise or death;
24        (4) the number of women whose care was transferred to
25    another health care professional during the antepartum

 

 

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1    period and the reason for transfer;
2        (5) the number, reason for, and outcome of each
3    nonemergency hospital transfer during the intrapartum or
4    postpartum period;
5        (6) the number, reason for, and outcome of each urgent
6    or emergency transport of an expectant childbearing
7    individual in the antepartum period;
8        (7) the number, reason for, and outcome of each urgent
9    or emergency transport of an infant or childbearing
10    individual during the intrapartum or immediate postpartum
11    period;
12        (8) the number of planned out-of-hospital births at
13    the onset of labor and the number of births completed in an
14    out-of-hospital setting;
15        (9) a brief description of any complications resulting
16    in the morbidity or mortality of a childbearing individual
17    or a neonate; and
18        (10) any other information required by rule by the
19    Department.
20    (b) The Department shall send a written notice of
21noncompliance to each licensee who fails to meet the reporting
22requirements under subsection (a) of this Section.
23    (c) A licensed certified professional midwife who fails to
24comply with the reporting requirements under this Section
25shall be prohibited from license renewal until the information
26required under subsection (a) of this Section is reported.

 

 

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1    (d) The Board shall maintain the confidentiality of any
2report under subsection (f) of this Section.
3    (e) Notwithstanding any other provision of law, a licensed
4certified professional midwife shall be subject to the same
5reporting requirements as other health care professionals who
6provide care to individuals.
7    (f) All reports required shall be submitted to the
8Department in a timely fashion. Unless otherwise provided in
9this Section, the reports shall be filed in writing within 60
10days after a determination that a report is required under
11this Act. The Department may also exercise the power under
12Section 30 of this Act to subpoena copies of hospital or
13medical records in cases concerning death or permanent bodily
14injury. Rules shall be adopted by the Department to implement
15this Section. Nothing contained in this Section shall act to
16in any way waive or modify the confidentiality of reports and
17committee reports to the extent provided by law. Any
18information reported or disclosed shall be kept for the
19confidential use of the Department, its attorneys, the
20investigative staff, and authorized clerical staff, as
21provided in this Act, and shall be afforded the same status as
22is provided information concerning medical studies in Part 21
23of Article VIII of the Code of Civil Procedure, except that the
24Department may disclose information and documents to a
25federal, state, or local law enforcement agency pursuant to a
26subpoena in an ongoing criminal investigation or to a health

 

 

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1care licensing body or midwifery licensing authority of
2another state or jurisdiction pursuant to an official request
3made by that licensing body or authority. Furthermore,
4information and documents disclosed to a federal, state, or
5local law enforcement agency may be used by that agency only
6for the investigation and prosecution of a criminal offense,
7or, in the case of disclosure to a health care licensing body
8or medical licensing authority, only for investigations and
9disciplinary action proceedings with regard to a license.
10Information and documents disclosed to the Department of
11Public Health may be used by that Department only for
12investigation and disciplinary action regarding the license of
13a health care institution licensed by the Department of Public
14Health.
 
15    Section 80. Disclosure of information to client.
16    (a) A licensed certified professional midwife shall, at an
17initial prenatal visit with a client, provide and disclose to
18the client orally and in writing on a form provided by the
19department all of the following:
20        (1) The licensed certified professional midwife's
21    experience and training.
22        (2) Whether the licensed certified professional
23    midwife has malpractice liability insurance coverage and
24    the policy limits of the coverage.
25        (3) A protocol for the handling of both the patient's

 

 

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1    and newborn's medical emergencies, including
2    transportation to a hospital, particular to each client,
3    with identification of the appropriate hospital. A verbal
4    report of the care provided must be provided to emergency
5    services providers and a copy of the client records shall
6    be sent with the client at the time of any transfer to a
7    hospital, including obtaining a signed authorization to
8    release the client's medical records to a health care
9    professional or hospital in the event of such emergency
10    transport.
11        (4) A statement informing the client that, in the
12    event of an emergency or voluntary transfer or if
13    subsequent care is required resulting from the acts or
14    omissions of the licensed certified professional midwife,
15    no liability for the acts or omissions of the licensed
16    certified professional midwife are assignable to the
17    receiving hospital, health care facility, physician,
18    nurse, emergency personnel or other medical professional
19    rendering such care. The receiving hospital, health care
20    facility, physician, nurse, emergency medical personnel,
21    hospital, or other medical professional rendering care are
22    responsible for their own acts and omissions.
23        (5) A statement outlining the emergency equipment,
24    drugs and personnel necessary to provide appropriate care
25    in the home.
26        (6) The intent to provide at least one birth assistant

 

 

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1    during intrapartum and postpartum care.
2    (b) A licensed certified professional midwife shall, at an
3initial prenatal visit with a client, provide a copy of the
4written disclosures required under this Section to the client
5and obtain the client's signature acknowledging that she has
6been informed, orally and in writing, of the disclosures
7required.
 
8    Section 85. Vicarious liability.
9    (a) No physician, advanced practice registered nurse,
10nurse, hospital, emergency room personnel, emergency medical
11technician, or ambulance personnel shall be liable in any
12civil action arising out of any injury resulting from an act or
13omission of a licensed certified professional midwife, even if
14the health care professional has consulted with or accepted a
15referral from the licensed certified professional midwife. A
16physician or advanced practice registered nurse who consults
17with a licensed certified professional midwife but who does
18not examine or treat a client of the licensed certified
19professional midwife shall not be deemed to have created a
20physician-patient or advanced practice registered
21nurse-patient relationship with such client.
22    (b) Consultation with a physician or advanced practice
23registered nurse does not alone create a physician-patient or
24advanced practice registered nurse-patient relationship or any
25other relationship with the physician or advanced practice

 

 

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1registered nurse. The informed consent shall specifically
2state that the licensed certified professional midwife and any
3consulting physician or advanced practice registered nurse are
4not employees, partners, associates, agents, or principals of
5one another. The licensed certified professional midwife shall
6inform the patient that he or she is independently licensed
7and practicing midwifery and in that regard is solely
8responsible for the services he or she provides.
9    (c) Nothing in this Act is intended to expand the
10malpractice liability of physicians, advanced practice
11registered nurses, licensed certified professional midwives,
12or other health care professionals, hospitals, or other health
13care institutions beyond the limits existing in current
14Illinois statutory and common law; however, no physician,
15nurse, emergency medical personnel, hospital, or other health
16care institution shall be liable for any act or omission
17resulting from the provision of services by any licensed
18certified professional midwife, even if the physician, nurse,
19emergency medical personnel, hospital or other health care
20institution has consulted with or accepted a referral from the
21licensed certified professional midwife. The physician, nurse,
22licensed certified professional midwife, emergency medical
23personnel, hospital, or other health care institution
24providing care are responsible for their own acts and
25omissions.
 

 

 

HB3401- 33 -LRB102 14708 SPS 20061 b

1    Section 90. The Regulatory Sunset Act is amended by adding
2Section 4.41 as follows:
 
3    (5 ILCS 80/4.41 new)
4    Sec. 4.41. Act repealed on January 1, 2032. The following
5Act is repealed on January 1, 2032:
6    The Licensed Certified Professional Midwife Practice Act.