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 
    facility.
 
    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)
ARTICLE 80.  MEDICATION AIDE PILOT PROGRAM

 
    (225 ILCS 65/80-5 new)
    Sec. 80-5. Definitions. For the purposes of this Article 
only:
    "Direct-care assignment" means an assignment as defined 
for staffing requirements as
direct care staff under 77 CFR 
300.1230. 
    "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 
facility.
    "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 
    facility;
        (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 
medication. 
 
    (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 
examinations.
 
    (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 
    Department;
        (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 
    rule;
        (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 
    assistance;
        (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 
    facility.
 
    (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 
    Act.
        (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 
    Act.
        (14) Allowing one's license to be used by an unlicensed

    person.
        (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 
    public;
        (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 
records.
    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 
indemnification.
    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 
Section.
    (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 
satisfied.
    (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 
Act.
(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. 
7-22-13.)
 
    Section 99. Effective date. This Act takes effect upon 
becoming law.