Illinois General Assembly - Full Text of Public Act 098-0990
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Public Act 098-0990




Public Act 098-0990
SB2958 EnrolledLRB098 19577 RPS 54767 b

    AN ACT concerning regulation.
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
    Section 1. Legislative findings. The General Assembly
finds that:
        (1) Many states have had successful medication
    aide-certified (MA-C) programs for many years.
        (2) A medication aide-certified assists with
    medication administration while under the supervision of a
    registered professional nurse (RN) in a long-term care
    Section 5. The Nursing Home Care Act is amended by adding
Section 3-305.5 as follows:
    (210 ILCS 45/3-305.5 new)
    Sec. 3-305.5. Violation of the Nurse Practice Act. A
facility that fails to submit any required report under Section
80-10 of the Nurse Practice Act is subject to discipline under
this Article.
    Section 10. The Nurse Practice Act is amended by adding
Article 80 as follows:
    (225 ILCS 65/Art. 80 heading new)

    (225 ILCS 65/80-5 new)
    Sec. 80-5. Definitions. For the purposes of this Article
    "Direct-care assignment" means an assignment as defined
for staffing requirements as direct care staff under 77 CFR
    "Medication aide" means a person who has met the
qualifications for licensure under this Article who assists
with medication administration while under the supervision of a
registered professional nurse (RN) in a long-term care
    "Qualified employer" means a long-term care facility
licensed by the Department of Public Health that meets the
qualifications set forth in Section 80-1o.
    (225 ILCS 65/80-10 new)
    Sec. 80-10. Pilot program.
    (a) The Department shall administer and enforce a Licensed
Medication Aide Pilot Program. The program shall last for a
period of 3 years, as determined by rule. During the 3-year
pilot program, the Department shall license and regulate
licensed medication aides. As part of the pilot program, no
more than 10 skilled nursing homes, which shall be
geographically located throughout the State, shall be
authorized to employ licensed medication aides, as approved by
the Department. The Department may consult with the Department
of Public Health as necessary to properly administer and
enforce this Article.
    (b) To be approved as a qualified facility for the duration
of the pilot program, a facility must:
        (1) be licensed in good standing as a skilled nursing
    facility by the Department of Public Health;
        (2) have an overall Five Star Quality Rating of 3, 4,
    or 5 from the most recent data available on the Centers for
    Medicare and Medicaid Services' website;
        (3) certify that the employment of a licensed
    medication aide will not replace or diminish the employment
    of a registered nurse or licensed practical nurse at the
        (4) certify that a registered nurse will be on-duty and
    present in the facility to delegate and supervise the
    medication administration by a licensed medication aide at
    all times;
        (5) certify that, with the exception of licensed health
    care professionals, only licensed medication aides will be
    employed in the capacity of administering medication; and
        (6) provide information regarding patient safety,
    efficiency, and errors as determined by the Department;
    failure to submit any required report may be grounds for
    discipline or sanctions under this Act, the Nursing Home
    Administrators Licensing and Disciplinary Act, or the
    Nursing Home Care Act.
    The Department shall submit a report regarding patient
safety, efficiency, and errors, as determined by rule, to the
General Assembly no later than 6 months after termination of
the pilot program.
    (225 ILCS 65/80-15 new)
    Sec. 80-15. Licensure requirement; exempt activities.
    (a) On and after January 1, 2015, no person shall practice
as a medication aide or hold himself or herself out as a
licensed medication aide in this State unless he or she is
licensed under this Article.
    (b) Nothing in this Article shall be construed as
preventing or restricting the practice, services, or
activities of:
        (1) any person licensed in this State by any other law
    from engaging in the profession or occupation for which he
    or she is licensed;
        (2) any person employed as a medication aide by the
    government of the United States, if such person practices
    as a medication aide solely under the direction or control
    of the organization by which he or she is employed; or
        (3) any person pursuing a course of study leading to a
    certificate in medication aide at an accredited or approved
    educational program if such activities and services
    constitute a part of a supervised course of study and if
    such person is designated by a title which clearly
    indicates his or her status as a student or trainee.
    (c) Nothing in this Article shall be construed to limit the
delegation of tasks or duties by a physician, dentist, advanced
practice nurse, or podiatric physician as authorized by law.
    (225 ILCS 65/80-20 new)
    Sec. 80-20. Scope of practice.
    (a) A licensed medication aide may only practice in a
qualified facility.
    (b) Licensed medication aides must be supervised by and
receive delegation by a registered nurse that is on-duty and
present in the facility at all times.
    (c) Licensed medication aides shall not have a direct-care
assignment when scheduled to work as a licensed medication
aide, but may assist residents as needed.
    (d) Licensed medication aides shall not administer any
medication until a physician has conducted an initial
assessment of the resident.
    (e) Licensed medication aides shall not administer any
Schedule II controlled substances as set forth in the Illinois
Controlled Substances Act, and may not administer any
subcutaneous, intramuscular, intradermal, or intravenous
    (225 ILCS 65/80-25 new)
    Sec. 80-25. Unlicensed practice; violation; civil penalty.
    (a) In addition to any other penalty provided by law, any
person who practices, offers to practice, attempts to practice,
or holds oneself out to practice as a medication aide without
being licensed under this Act shall, in addition to any other
penalty provided by law, pay a civil penalty to the Department
in an amount not to exceed $10,000 for each offense as
determined by the Department. The civil penalty shall be
assessed by the Department after a hearing is held in
accordance with the provisions set forth in this Act regarding
the provision of a hearing for the discipline of a licensee.
    (b) The Department has the authority and power to
investigate any and all unlicensed activity.
    (c) The civil penalty shall be paid within 60 days after
the effective date of the order imposing the civil penalty. The
order shall constitute a judgment and may be filed and
execution had thereon in the same manner as any judgment from
any court of record.
    (225 ILCS 65/80-30 new)
    Sec. 80-30. Applications for original licensure.
Applications for original licensure shall be made to the
Department in writing on forms prescribed by the Department and
shall be accompanied by the required fee, which shall not be
returnable. The application shall require such information as,
in the judgment of the Department, will enable the Department
to pass on the qualifications of the applicant for licensure.
Applicants have 3 years after the date of application to
complete the application process. If the process has not been
completed within 3 years, the application shall be denied, the
fee forfeited, and the applicant must reapply and meet the
requirements in effect at the time of reapplication.
    (225 ILCS 65/80-35 new)
    Sec. 80-35. Examinations. The Department shall authorize
examinations of applicants for a license under this Article at
the times and place as it may designate. The examination shall
be of a character to give a fair test of the qualifications of
the applicant to practice as a medication aide.
    Applicants for examination as a medication aide shall be
required to pay, either to the Department or the designated
testing service, a fee covering the cost of providing the
examination. Failure to appear for the examination on the
scheduled date, at the time and place specified, after the
applicant's application for examination has been received and
acknowledged by the Department or the designated testing
service, shall result in the forfeiture of the examination fee.
    If an applicant fails to pass an examination for
registration under this Act within 3 years after filing his or
her application, the application shall be denied. The applicant
may thereafter make a new application accompanied by the
required fee; however, the applicant shall meet all
requirements in effect at the time of subsequent application
before obtaining licensure. The Department may employ
consultants for the purposes of preparing and conducting
    (225 ILCS 65/80-40 new)
    Sec. 80-40. Licensure by examination. An applicant for
licensure by examination to practice as a licensed medication
aide must:
        (1) submit a completed written application on forms
    provided by the Department and fees as established by the
        (2) be age 18 or older;
        (3) have a high school diploma or a certificate of
    general education development (GED);
        (4) demonstrate the able to speak, read, and write the
    English language, as determined by rule;
        (5) demonstrate competency in math, as determined by
        (6) be currently certified in good standing as a
    certified nursing assistant and provide proof of 2,000
    hours of practice as a certified nursing assistant within 3
    years before application for licensure;
        (7) submit to the criminal history records check
    required under Section 50-35 of this Act;
        (8) have not engaged in conduct or behavior determined
    to be grounds for discipline under this Act;
        (9) be currently certified to perform cardiopulmonary
    resuscitation by the American Heart Association or
    American Red Cross;
        (10) have successfully completed a course of study
    approved by the Department as defined by rule; to be
    approved, the program must include a minimum of 60 hours of
    classroom-based medication aide education, a minimum of 10
    hours of simulation laboratory study, and a minimum of 30
    hours of registered nurse-supervised clinical practicum
    with progressive responsibility of patient medication
        (11) have successfully completed the Medication Aide
    Certification Examination or other examination authorized
    by the Department; and
        (12) submit proof of employment by a qualifying
    (225 ILCS 65/80-45 new)
    Sec. 80-45. Expiration of license. The expiration date for
each license to practice as a licensed medication aide shall be
set by the rule. Licenses under this Article may not be renewed
or restored.
    (225 ILCS 65/80-50 new)
    Sec. 80-50. Administration and enforcement. Licenses
issued under this Article are subject to Article 70, including
grounds for disciplinary action under Section 70-5.
    (225 ILCS 65/80-55 new)
    Sec. 80-55. Title. Any person who is issued a license as a
medication aide under the terms of this Act shall use the words
"licensed medication aide" in connection with his or her name
to denote his or her licensure under this Act.
    (225 ILCS 65/80-60 new)
    Sec. 80-60. Rules. The Department shall file rules to
administer this Article within 90 days of the effective date of
this Act.
    Section 15. The Nursing Home Administrators Licensing and
Disciplinary Act is amended by changing Section 17 as follows:
    (225 ILCS 70/17)  (from Ch. 111, par. 3667)
    Sec. 17. Grounds for disciplinary action.
    (a) The Department may impose fines not to exceed $10,000
or may refuse to issue or to renew, or may revoke, suspend,
place on probation, censure, reprimand or take other
disciplinary or non-disciplinary action with regard to the
license of any person, for any one or combination of the
following causes:
        (1) Intentional material misstatement in furnishing
    information to the Department.
        (2) Conviction of or entry of a plea of guilty or nolo
    contendere to any crime that is a felony under the laws of
    the United States or any state or territory thereof or a
    misdemeanor of which an essential element is dishonesty or
    that is directly related to the practice of the profession
    of nursing home administration.
        (3) Making any misrepresentation for the purpose of
    obtaining a license, or violating any provision of this
        (4) Immoral conduct in the commission of any act, such
    as sexual abuse or sexual misconduct, related to the
    licensee's practice.
        (5) Failing to respond within 30 days, to a written
    request made by the Department for information.
        (6) Engaging in dishonorable, unethical or
    unprofessional conduct of a character likely to deceive,
    defraud or harm the public.
        (7) Habitual use or addiction to alcohol, narcotics,
    stimulants, or any other chemical agent or drug which
    results in the inability to practice with reasonable
    judgment, skill or safety.
        (8) Discipline by another U.S. jurisdiction if at least
    one of the grounds for the discipline is the same or
    substantially equivalent to those set forth herein.
        (9) A finding by the Department that the licensee,
    after having his or her license placed on probationary
    status has violated the terms of probation.
        (10) Willfully making or filing false records or
    reports in his or her practice, including but not limited
    to false records filed with State agencies or departments.
        (11) Physical illness, mental illness, or other
    impairment or disability, including, but not limited to,
    deterioration through the aging process, or loss of motor
    skill that results in the inability to practice the
    profession with reasonable judgment, skill or safety.
        (12) Disregard or violation of this Act or of any rule
    issued pursuant to this Act.
        (13) Aiding or abetting another in the violation of
    this Act or any rule or regulation issued pursuant to this
        (14) Allowing one's license to be used by an unlicensed
        (15) (Blank).
        (16) Professional incompetence in the practice of
    nursing home administration.
        (17) Conviction of a violation of Section 12-19 or
    subsection (a) of Section 12-4.4a of the Criminal Code of
    1961 or the Criminal Code of 2012 for the abuse and
    criminal neglect of a long term care facility resident.
        (18) Violation of the Nursing Home Care Act, the
    Specialized Mental Health Rehabilitation Act of 2013, or
    the ID/DD Community Care Act or of any rule issued under
    the Nursing Home Care Act, the Specialized Mental Health
    Rehabilitation Act of 2013, or the ID/DD Community Care
    Act. A final adjudication of a Type "AA" violation of the
    Nursing Home Care Act made by the Illinois Department of
    Public Health, as identified by rule, relating to the
    hiring, training, planning, organizing, directing, or
    supervising the operation of a nursing home and a
    licensee's failure to comply with this Act or the rules
    adopted under this Act, shall create a rebuttable
    presumption of a violation of this subsection.
        (19) Failure to report to the Department any adverse
    final action taken against the licensee by a licensing
    authority of another state, territory of the United States,
    or foreign country; or by any governmental or law
    enforcement agency; or by any court for acts or conduct
    similar to acts or conduct that would constitute grounds
    for disciplinary action under this Section.
        (20) Failure to report to the Department the surrender
    of a license or authorization to practice as a nursing home
    administrator in another state or jurisdiction for acts or
    conduct similar to acts or conduct that would constitute
    grounds for disciplinary action under this Section.
        (21) Failure to report to the Department any adverse
    judgment, settlement, or award arising from a liability
    claim related to acts or conduct similar to acts or conduct
    that would constitute grounds for disciplinary action
    under this Section.
        (22) Failure to submit any required report under
    Section 80-10 of the Nurse Practice Act.
    All proceedings to suspend, revoke, place on probationary
status, or take any other disciplinary action as the Department
may deem proper, with regard to a license on any of the
foregoing grounds, must be commenced within 5 years next after
receipt by the Department of (i) a complaint alleging the
commission of or notice of the conviction order for any of the
acts described herein or (ii) a referral for investigation
under Section 3-108 of the Nursing Home Care Act.
    The entry of an order or judgment by any circuit court
establishing that any person holding a license under this Act
is a person in need of mental treatment operates as a
suspension of that license. That person may resume their
practice only upon the entry of a Department order based upon a
finding by the Board that they have been determined to be
recovered from mental illness by the court and upon the Board's
recommendation that they be permitted to resume their practice.
    The Department, upon the recommendation of the Board, may
adopt rules which set forth standards to be used in determining
what constitutes:
        (i) when a person will be deemed sufficiently
    rehabilitated to warrant the public trust;
        (ii) dishonorable, unethical or unprofessional conduct
    of a character likely to deceive, defraud, or harm the
        (iii) immoral conduct in the commission of any act
    related to the licensee's practice; and
        (iv) professional incompetence in the practice of
    nursing home administration.
    However, no such rule shall be admissible into evidence in
any civil action except for review of a licensing or other
disciplinary action under this Act.
    In enforcing this Section, the Department or Board, upon a
showing of a possible violation, may compel any individual
licensed to practice under this Act, or who has applied for
licensure pursuant to this Act, to submit to a mental or
physical examination, or both, as required by and at the
expense of the Department. The examining physician or
physicians shall be those specifically designated by the
Department or Board. The Department or Board may order the
examining physician to present testimony concerning this
mental or physical examination of the licensee or applicant. No
information shall be excluded by reason of any common law or
statutory privilege relating to communications between the
licensee or applicant and the examining physician. The
individual to be examined may have, at his or her own expense,
another physician of his or her choice present during all
aspects of the examination. Failure of any individual to submit
to mental or physical examination, when directed, shall be
grounds for suspension of his or her license until such time as
the individual submits to the examination if the Department
finds, after notice and hearing, that the refusal to submit to
the examination was without reasonable cause.
    If the Department or Board finds an individual unable to
practice because of the reasons set forth in this Section, the
Department or Board shall require such individual to submit to
care, counseling, or treatment by physicians approved or
designated by the Department or Board, as a condition, term, or
restriction for continued, reinstated, or renewed licensure to
practice; or in lieu of care, counseling, or treatment, the
Department may file, or the Board may recommend to the
Department to file, a complaint to immediately suspend, revoke,
or otherwise discipline the license of the individual. Any
individual whose license was granted pursuant to this Act or
continued, reinstated, renewed, disciplined or supervised,
subject to such terms, conditions or restrictions who shall
fail to comply with such terms, conditions or restrictions
shall be referred to the Secretary for a determination as to
whether the licensee shall have his or her license suspended
immediately, pending a hearing by the Department. In instances
in which the Secretary immediately suspends a license under
this Section, a hearing upon such person's license must be
convened by the Board within 30 days after such suspension and
completed without appreciable delay. The Department and Board
shall have the authority to review the subject administrator's
record of treatment and counseling regarding the impairment, to
the extent permitted by applicable federal statutes and
regulations safeguarding the confidentiality of medical
    An individual licensed under this Act, affected under this
Section, shall be afforded an opportunity to demonstrate to the
Department or Board that he or she can resume practice in
compliance with acceptable and prevailing standards under the
provisions of his or her license.
    (b) Any individual or organization acting in good faith,
and not in a wilful and wanton manner, in complying with this
Act by providing any report or other information to the
Department, or assisting in the investigation or preparation of
such information, or by participating in proceedings of the
Department, or by serving as a member of the Board, shall not,
as a result of such actions, be subject to criminal prosecution
or civil damages.
    (c) Members of the Board, and persons retained under
contract to assist and advise in an investigation, shall be
indemnified by the State for any actions occurring within the
scope of services on or for the Board, done in good faith and
not wilful and wanton in nature. The Attorney General shall
defend all such actions unless he or she determines either that
there would be a conflict of interest in such representation or
that the actions complained of were not in good faith or were
wilful and wanton.
    Should the Attorney General decline representation, a
person entitled to indemnification under this Section shall
have the right to employ counsel of his or her choice, whose
fees shall be provided by the State, after approval by the
Attorney General, unless there is a determination by a court
that the member's actions were not in good faith or were wilful
and wanton.
    A person entitled to indemnification under this Section
must notify the Attorney General within 7 days of receipt of
notice of the initiation of any action involving services of
the Board. Failure to so notify the Attorney General shall
constitute an absolute waiver of the right to a defense and
    The Attorney General shall determine within 7 days after
receiving such notice, whether he or she will undertake to
represent a person entitled to indemnification under this
    (d) The determination by a circuit court that a licensee is
subject to involuntary admission or judicial admission as
provided in the Mental Health and Developmental Disabilities
Code, as amended, operates as an automatic suspension. Such
suspension will end only upon a finding by a court that the
patient is no longer subject to involuntary admission or
judicial admission and issues an order so finding and
discharging the patient; and upon the recommendation of the
Board to the Secretary that the licensee be allowed to resume
his or her practice.
    (e) The Department may refuse to issue or may suspend the
license of any person who fails to file a return, or to pay the
tax, penalty or interest shown in a filed return, or to pay any
final assessment of tax, penalty or interest, as required by
any tax Act administered by the Department of Revenue, until
such time as the requirements of any such tax Act are
    (f) The Department of Public Health shall transmit to the
Department a list of those facilities which receive an "A"
violation as defined in Section 1-129 of the Nursing Home Care
(Source: P.A. 97-38, eff. 6-28-11; 97-227, eff. 1-1-12;
97-1109, eff. 1-1-13; 97-1150, eff. 1-25-13; 98-104, eff.
    Section 99. Effective date. This Act takes effect upon
becoming law.

Effective Date: 8/18/2014