Public Act 102-0641
 
SB2153 EnrolledLRB102 11387 HLH 16720 b


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


 
ARTICLE 1.   NURSE STAFFING IMPROVEMENT ACT

 
    Section 1-1. This Article may be referred to as the Nurse 
Staffing Improvement Act.
 
    Section 1-5. The Hospital Licensing Act is amended  by 
changing Sections 7, 10.10, and 14.5 as follows:
 
    (210 ILCS 85/7)  (from Ch. 111 1/2, par. 148)
    Sec. 7. (a) The Director after notice and opportunity for 
hearing to the
applicant or licensee may deny, suspend, or 
revoke a permit to establish a
hospital or deny, suspend, or 
revoke a license to open, conduct, operate,
and maintain a 
hospital in any case in which he finds that there has been a

substantial failure to comply with the provisions of this Act, 
the Hospital
Report Card Act, or the Illinois Adverse Health 
Care Events Reporting Law of 2005 or the standards, rules, and 
regulations established by
virtue of any of those Acts. The 
Department may impose fines on hospitals, not to exceed $500 
per occurrence, for failing to (1) initiate a criminal 
background check on a patient that meets the criteria for 
hospital-initiated background checks or (2) report the death 
of a person known to be a resident of a facility licensed under 
the ID/DD Community Care Act or the MC/DD Act to the coroner or 
medical examiner within 24 hours as required by Section 6.09a 
of this Act. In assessing whether to impose such a fine for 
failure to initiate a criminal background check, the 
Department shall consider various factors including, but not 
limited to, whether the hospital has engaged in a pattern or 
practice of failing to initiate criminal background checks. 
Money from fines shall be deposited into the Long Term Care 
Provider Fund. 
    (a-5) If a hospital demonstrates a pattern or practice of 
failing to substantially comply with the requirements of 
Section 10.10 or the hospital's written staffing plan, the 
hospital shall provide a plan of correction to the Department 
within 60 days. The Department may impose fines as follows: 
(i) if a hospital fails to implement a written staffing plan 
for nursing services, a fine not to exceed $500 per occurrence 
may be imposed; (ii) if a hospital demonstrates a pattern or 
practice of failing to substantially comply with a plan of 
correction within 60 days after the plan takes effect, a fine 
not to exceed $500 per occurrence may be imposed; and (iii) if 
a hospital demonstrates for a second or subsequent time a 
pattern or practice of failing to substantially comply with a 
plan of correction within 60 days after the plan takes effect, 
a fine not to exceed $1,000 per occurrence may be imposed. 
Reports of violations of Section 10.10 shall be subject to 
public disclosure under Section 6.14a. Money from fines within 
this subsection (a-5) shall be deposited into the Hospital 
Licensure Fund, and money from fines for violations of Section 
10.10 shall be used for scholarships under the Nursing 
Education Scholarship Law. 
    (b) Such notice shall be effected by registered mail or by 
personal
service setting forth the particular reasons for the 
proposed action and
fixing a date, not less than 15 days from 
the date of such mailing or
service, at which time the 
applicant or licensee shall be given an
opportunity for a 
hearing. Such hearing shall be conducted by the Director
or by 
an employee of the Department designated in writing by the 
Director
as Hearing Officer to conduct the hearing. On the 
basis of any such
hearing, or upon default of the applicant or 
licensee, the Director shall
make a determination specifying 
his findings and conclusions. In case of a
denial to an 
applicant of a permit to establish a hospital, such

determination shall specify the subsection of Section 6 under 
which the
permit was denied and shall contain findings of fact 
forming the basis of
such denial. A copy of such determination 
shall be sent by registered mail
or served personally upon the 
applicant or licensee. The decision denying,
suspending, or 
revoking a permit or a license shall become final 35 days
after 
it is so mailed or served, unless the applicant or licensee, 
within
such 35 day period, petitions for review pursuant to 
Section 13.
    (c) The procedure governing hearings authorized by this 
Section shall be
in accordance with rules promulgated by the 
Department and approved by the
Hospital Licensing Board. A 
full and complete record shall be kept of all
proceedings, 
including the notice of hearing, complaint, and all other

documents in the nature of pleadings, written motions filed in 
the
proceedings, and the report and orders of the Director and 
Hearing Officer.
All testimony shall be reported but need not 
be transcribed unless the
decision is appealed pursuant to 
Section 13. A copy or copies of the
transcript may be obtained 
by any interested party on payment of the cost
of preparing 
such copy or copies.
    (d) The Director or Hearing Officer shall upon his own 
motion, or on the
written request of any party to the 
proceeding, issue subpoenas requiring
the attendance and the 
giving of testimony by witnesses, and subpoenas
duces tecum 
requiring the production of books, papers, records, or

memoranda. All subpoenas and subpoenas duces tecum issued 
under the terms
of this Act may be served by any person of full 
age. The fees of witnesses
for attendance and travel shall be 
the same as the fees of witnesses before
the Circuit Court of 
this State, such fees to be paid when the witness is
excused 
from further attendance. When the witness is subpoenaed at the

instance of the Director, or Hearing Officer, such fees shall 
be paid in
the same manner as other expenses of the Department, 
and when the witness
is subpoenaed at the instance of any other 
party to any such proceeding the
Department may require that 
the cost of service of the subpoena or subpoena
duces tecum and 
the fee of the witness be borne by the party at whose
instance 
the witness is summoned. In such case, the Department in its

discretion, may require a deposit to cover the cost of such 
service and
witness fees. A subpoena or subpoena duces tecum 
issued as aforesaid shall
be served in the same manner as a 
subpoena issued out of a court.
    (e) Any Circuit Court of this State upon the application 
of the
Director, or upon the application of any other party to 
the proceeding,
may, in its discretion, compel the attendance 
of witnesses, the production
of books, papers, records, or 
memoranda and the giving of testimony before
the Director or 
Hearing Officer conducting an investigation or holding a

hearing authorized by this Act, by an attachment for contempt, 
or
otherwise, in the same manner as production of evidence may 
be compelled
before the court.
    (f) The Director or Hearing Officer, or any party in an 
investigation or
hearing before the Department, may cause the 
depositions of witnesses
within the State to be taken in the 
manner prescribed by law for like
depositions in civil actions 
in courts of this State, and to that end
compel the attendance 
of witnesses and the production of books, papers,
records, or 
memoranda.
(Source: P.A. 99-180, eff. 7-29-15.)
 
    (210 ILCS 85/10.10)
    Sec. 10.10. Nurse Staffing by Patient Acuity.

    (a) Findings. The Legislature finds and declares all of 
the following:
        (1) The State of Illinois has a substantial interest 
    in promoting quality care and improving the delivery of 
    health care services.
        (2) Evidence-based studies have shown that the basic 
    principles of staffing in the acute care setting should be 
    based on the complexity of patients' care needs aligned 
    with available nursing skills to promote quality patient 
    care consistent with professional nursing standards.
        (3) Compliance with this Section promotes an 
    organizational climate that values registered nurses' 
    input in meeting the health care needs of hospital 
    patients.
    (b) Definitions. As used in this Section:
    "Acuity model" means an assessment tool selected and 
implemented by a hospital, as recommended by a nursing care 
committee, that assesses the complexity of patient care needs 
requiring professional nursing care and skills and aligns 
patient care needs and nursing skills consistent with 
professional nursing standards.
    "Department" means the Department of Public Health.
    "Direct patient care" means care provided by a registered 
professional nurse with direct responsibility to oversee or 
carry out medical regimens or nursing care for one or more 
patients.
    "Nursing care committee" means a an existing or newly 
created hospital-wide committee or committees of nurses whose 
functions, in part or in whole, contribute to the development, 
recommendation,  and review of the hospital's nurse staffing 
plan established pursuant to subsection (d).
    "Registered professional nurse" means a person licensed as 
a Registered Nurse under the Nurse
 Practice Act.
    "Written staffing plan for nursing care services" means a 
written plan for guiding the assignment of patient care 
nursing staff based on multiple nurse and patient 
considerations that yield minimum staffing levels for 
inpatient care units and the adopted acuity model aligning 
patient care needs with nursing skills required for quality 
patient care consistent with professional nursing standards.
    (c) Written staffing plan.
        (1) Every hospital shall implement a written 
    hospital-wide staffing plan, prepared recommended by a 
    nursing care committee or committees, that provides for 
    minimum direct care professional registered 
    nurse-to-patient staffing needs for each inpatient care 
    unit, including inpatient emergency departments. If the 
    staffing plan prepared by the nursing care committee is 
    not adopted by the hospital, or if substantial changes are 
    proposed to it, the chief nursing officer shall either: 
    (i) provide a written explanation  to the committee of the 
    reasons the plan was not adopted; or (ii) provide a 
    written explanation of any substantial changes made to the 
    proposed plan prior to it being adopted by the hospital. 
    The written hospital-wide staffing plan shall include, but 
    need not be limited to, the following considerations:
            (A) The complexity of complete care, assessment on 
        patient admission, volume of patient admissions, 
        discharges and transfers, evaluation of the progress 
        of a patient's problems, ongoing physical assessments, 
        planning for a patient's discharge, assessment after a 
        change in patient condition, and assessment of the 
        need for patient referrals.
            (B) The complexity of clinical professional 
        nursing judgment needed to design and implement a 
        patient's nursing care plan, the need for specialized 
        equipment and technology, the skill mix of other 
        personnel providing or supporting direct patient care, 
        and involvement in quality improvement activities, 
        professional preparation, and experience.
            (C) Patient acuity and the number of patients for 
        whom care is being provided.
            (D) The ongoing assessments of a unit's patient 
        acuity levels and nursing staff needed shall be 
        routinely made by the unit nurse manager or his or her 
        designee.
            (E) The identification of additional registered 
        nurses available for direct patient care when 
        patients' unexpected needs exceed the planned workload 
        for direct care staff.
        (2) In order to provide staffing flexibility to meet 
    patient needs, every hospital shall identify an acuity 
    model for adjusting the staffing plan for each inpatient 
    care unit.
        (2.5) Each hospital shall implement the staffing plan 
    and assign nursing personnel to each inpatient care unit, 
    including inpatient emergency departments, in accordance 
    with the staffing plan.
            (A) A registered nurse may report to the nursing 
        care committee any variations where the nurse 
        personnel assignment in an inpatient care unit is not 
        in accordance with the adopted staffing plan and may 
        make a written report to the nursing care committee 
        based on the variations.
            (B)  Shift-to-shift adjustments in staffing levels 
        required by the staffing plan may be made by the 
        appropriate hospital personnel overseeing inpatient 
        care operations. If a registered nurse in an inpatient 
        care unit objects to a shift-to-shift adjustment, the 
        registered nurse may submit a written report to the 
        nursing care committee.
            (C)  The nursing care committee shall develop a 
        process to examine and respond to written reports 
        submitted under subparagraphs (A) and (B) of this 
        paragraph (2.5), including the ability to determine if 
        a specific written report is resolved or should be 
        dismissed. 
        (3) The written staffing plan shall be posted in a 
    conspicuous and accessible location for both patients and 
    direct care staff, as required under the Hospital Report 
    Card Act. A copy of the written staffing plan shall be 
    provided to any member of the general public upon request. 
    (d) Nursing care committee.
        (1) Every hospital shall have a nursing care committee 
    that meets at least 6 times per year. A hospital shall 
    appoint members of a committee whereby at least 55% 50% of 
    the members are registered professional nurses providing 
    direct inpatient patient care, one of whom shall be 
    selected annually by the direct inpatient care nurses to 
    serve as co-chair of the committee.
        (2) (Blank).  A nursing care committee's 
    recommendations must be given significant regard and 
    weight in the hospital's adoption and implementation of a 
    written staffing plan.

        (2.5) A nursing care committee shall prepare and 
    recommend to hospital administration the hospital's 
    written hospital-wide staffing plan. If the staffing plan 
    is not adopted by the hospital, the chief nursing officer 
    shall provide a written statement to the committee prior 
    to a staffing plan being adopted by the hospital that: (A) 
    explains the reasons the committee's proposed staffing 
    plan was not adopted; and (B) describes the changes to the 
    committee's proposed staffing or any alternative to the 
    committee's proposed staffing plan. 
        (3) A nursing care committee's committee or 
    committees' committees shall recommend a written staffing 
    plan for the hospital  shall be based on the principles 
    from the staffing components set forth in subsection  (c). 
    In particular, a committee or committees shall provide 
    input and feedback on the following:
            (A) Selection, implementation, and evaluation of 
        minimum staffing levels for inpatient care units.
            (B) Selection, implementation, and evaluation of 
        an acuity model to provide staffing flexibility that 
        aligns changing patient acuity with nursing skills 
        required.
            (C) Selection, implementation, and evaluation of a 
        written staffing plan incorporating the items 
        described in subdivisions (c)(1) and (c)(2) of this 
        Section.
            (D) Review the nurse following: nurse-to-patient 
        staffing plans guidelines for all inpatient areas; and 
        current acuity tools and measures in use. The nursing 
        care committee's review shall consider: 
                (i) patient outcomes;
                (ii) complaints regarding staffing, including 
            complaints about a delay in direct care nursing or 
            an absence of direct care nursing;
                (iii) the number of hours of nursing care 
            provided through an inpatient hospital unit 
            compared with the number of inpatients served by 
            the hospital unit during a 24-hour period;
                (iv) the aggregate hours of overtime worked by 
            the nursing staff;
                (v) the extent to which actual nurse staffing 
            for each hospital inpatient unit differs from the 
            staffing specified by the staffing plan; and
                (vi) any other matter or change to the 
            staffing plan determined by the committee to 
            ensure that the hospital is staffed to meet the 
            health care needs of patients. 
        (4) A nursing care committee must issue a written 
    report addressing address the items described in 
    subparagraphs (A) through (D) of paragraph (3) 
    semi-annually. A written copy of this report shall be made 
    available to direct inpatient care nurses by making 
    available a paper copy of the report, distributing it 
    electronically, or posting it on the hospital's website. 
        (5)  A nursing care committee must issue a written 
    report at least annually to the hospital governing board 
    that addresses items including, but not limited to: the 
    items described in paragraph (3); changes made based on 
    committee recommendations and the impact of such changes; 
    and recommendations for future changes related to nurse 
    staffing. 
    (e) Nothing in this Section 10.10 shall be construed to 
limit, alter, or modify any of the terms, conditions, or 
provisions of a collective bargaining agreement entered into 
by the hospital.


    (f) No hospital may discipline, discharge, or take any 
other adverse employment action against an employee solely 
because the employee expresses a concern or complaint 
regarding an alleged violation of this Section or concerns 
related to nurse staffing.
    (g) Any employee of a hospital may file a complaint with 
the Department regarding an alleged violation of this Section.   
The Department must forward notification of the alleged 
violation to the hospital in question within 10 business days 
after the complaint is filed. Upon receiving a complaint of a 
violation of this Section, the Department may take any action 
authorized under Sections 7 or 9 of this Act.
(Source: P.A. 96-328, eff. 8-11-09; 97-423, eff. 1-1-12; 
97-813, eff. 7-13-12.)
 
    (210 ILCS 85/14.5)
    Sec. 14.5. Hospital Licensure Fund. 
    (a) There is created in the State treasury the Hospital 
Licensure Fund. The Fund is created for the purpose of 
providing funding for the administration of the licensure 
program and patient safety and quality initiatives for 
hospitals, including, without limitation, the implementation 
of the Illinois Adverse Health Care Events Reporting Law of 
2005.
    (b) The Fund shall consist of the following: 
        (1) fees collected pursuant to Sections Section 5 and 
    7 of the Hospital Licensing Act; 
        (2) federal matching funds received by the State as a 
    result of expenditures made by the Department that are 
    attributable to moneys deposited in the Fund; 
        (3) interest earned on moneys deposited in the Fund; 
    and 
        (4) other moneys received for the Fund from any other 
    source, including interest earned thereon. 
    (c) Disbursements from the Fund shall be made only for: 
        (1) initially, the implementation of the Illinois 
    Adverse Health Care Events Reporting Law of 2005; 
        (2) subsequently, programs, information, or 
    assistance, including measures to address public 
    complaints, designed to measurably improve quality and 
    patient safety; and 
        (2.5) from fines for violations of Section 10.10, 
    scholarships under the Nursing Education Scholarship Law; 
    and 
        (3)  the reimbursement of moneys collected by the 
    Department through error or mistake. 
    (d)   The uses described in paragraph (2) of subsection (c) 
shall be developed in conjunction with a statewide 
organization representing a majority of hospitals. 

(Source: P.A. 98-683, eff. 6-30-14.)
 
ARTICLE 5.   NURSING EDUCATION SCHOLARSHIP

 
    Section 5-5. The Nursing Education Scholarship Law is 
amended  by changing Section 5  as follows:
 


    (110 ILCS 975/5)  (from Ch. 144, par. 2755)



    Sec. 5. Nursing education scholarships. Beginning with the 
fall term of the 2004-2005

academic year, the
Department, in 
accordance with rules and regulations promulgated by it for 
this
program, shall provide scholarships to individuals 
selected
from among those applicants who qualify for 
consideration by showing:

        (1) that he or she has been a resident of this State 
    for at least one
year prior to application, and is a 
    citizen or a lawful permanent resident
alien of the United 
    States;

        (2) that he or she is enrolled in or accepted for 
    admission to an associate degree in
nursing program, 
    hospital-based
diploma in nursing program, baccalaureate 
    degree
in nursing program, graduate degree in nursing 
    program, or practical nursing program at an approved

    institution; and

        (3) that he or she agrees to meet the nursing 
    employment obligation.

    If in any year the number of qualified applicants exceeds 
the number of
scholarships to be awarded, the Department 
shall, in consultation with the Illinois Nursing Workforce 
Center Advisory Board, consider the following factors in 
granting priority in awarding
scholarships:
            (A) Financial need, as shown on a
standardized 
        financial needs assessment form used by an approved

        institution, of students who will pursue their 
        education on a full-time or close to
full-time
basis 
        and who already have a certificate in practical 
        nursing, a diploma
in nursing, or an associate degree 
        in nursing and are pursuing a higher
degree.

            (B) A student's status as a registered nurse who 
        is pursuing a graduate degree in nursing to pursue 
        employment in an approved institution that educates 
        licensed practical nurses and that educates registered 
        nurses in undergraduate and graduate nursing programs.

            (C) A student's merit, as shown through his or her 
        grade point average, class rank, and other academic 
        and extracurricular activities.  The Department may add 
        to and further define these merit criteria by rule.

    Unless otherwise indicated, scholarships shall be awarded 
to
recipients at approved institutions for a period
of up to 2 
years if the recipient is enrolled in an
associate degree in

nursing
program, up to 3 years if the recipient is enrolled in 
a hospital-based
diploma in nursing program, up to 4 years if 
the recipient is enrolled in a
baccalaureate degree in nursing 
program, up to 5 years if the recipient is enrolled in a 
graduate degree in nursing program, and up to one year if the

recipient is enrolled in a certificate in practical nursing 
program.  At least
40% of the scholarships awarded shall be for 
recipients who are
pursuing baccalaureate degrees in nursing, 
30% of the scholarships
awarded shall be for recipients who 
are pursuing associate degrees in
nursing
or a diploma in 
nursing, 10% of the scholarships awarded
shall be for 
recipients who are pursuing a certificate in practical 
nursing, and 20% of the scholarships awarded shall be for 
recipients who are pursuing a graduate degree in nursing.

    Beginning with the fall term of the 2021-2022 academic 
year and continuing through the 2024-2025 academic year, 
subject to appropriation from the Hospital Licensure Fund, in 
addition to any other funds available to the Department for 
such scholarships, the Department may award a total of 
$500,000 annually in scholarships under this Section. 
(Source: P.A. 100-513, eff. 1-1-18.)

 
ARTICLE 99.  EFFECTIVE DATE

 
    Section 99-99. Effective date. This Act takes effect upon 
becoming law.