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1 | AN ACT concerning regulation.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 1. Short title. This Act may be cited as the Home | ||||||||||||||||||||||||||||||||
5 | Birth Safety Act. | ||||||||||||||||||||||||||||||||
6 | Section 5. Purpose. The practice of midwifery in | ||||||||||||||||||||||||||||||||
7 | out-of-hospital settings is hereby declared to affect the | ||||||||||||||||||||||||||||||||
8 | public health, safety, and welfare and to be subject to | ||||||||||||||||||||||||||||||||
9 | regulation in the public interest. The purpose of this Act is | ||||||||||||||||||||||||||||||||
10 | to protect and benefit the public by setting standards for the | ||||||||||||||||||||||||||||||||
11 | qualifications, education, training, and experience of those | ||||||||||||||||||||||||||||||||
12 | who seek to obtain licensure as a licensed certified | ||||||||||||||||||||||||||||||||
13 | professional midwife, including a requirement to work | ||||||||||||||||||||||||||||||||
14 | collaboratively with hospital-based and privileged health care | ||||||||||||||||||||||||||||||||
15 | professionals to promote high standards of professional | ||||||||||||||||||||||||||||||||
16 | performance for those licensed to practice midwifery in | ||||||||||||||||||||||||||||||||
17 | out-of-hospital settings in this State, to promote a | ||||||||||||||||||||||||||||||||
18 | collaborative and integrated maternity care delivery system in | ||||||||||||||||||||||||||||||||
19 | Illinois with agreed-upon consulting, transfer and transport | ||||||||||||||||||||||||||||||||
20 | protocols in use by all health care professionals and licensed | ||||||||||||||||||||||||||||||||
21 | midwives across all health care settings to maximize patient | ||||||||||||||||||||||||||||||||
22 | safety and positive outcomes, to support accredited education | ||||||||||||||||||||||||||||||||
23 | and training as a prerequisite to licensure and to protect the |
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1 | public from unprofessional conduct by persons licensed to | ||||||
2 | practice midwifery, as defined in this Act. This Act shall be | ||||||
3 | liberally construed to best carry out these purposes. | ||||||
4 | Section 10. Exemptions. | ||||||
5 | (a) This Act does not prohibit a person licensed under any | ||||||
6 | other Act in this State from engaging in the practice for which | ||||||
7 | he or she is licensed or from delegating services as provided | ||||||
8 | for under that other Act. | ||||||
9 | (b) Nothing in this Act shall be construed to prohibit or | ||||||
10 | require licensing under this Act with regard to: | ||||||
11 | (1) the rendering of services by a birth attendant, if | ||||||
12 | such attendance is in accordance with the birth attendant's | ||||||
13 | cultural traditions or religious faith and is rendered only | ||||||
14 | to women and families in that distinct cultural or | ||||||
15 | religious group as an exercise and enjoyment of their | ||||||
16 | religious freedom; and | ||||||
17 | (2) a student midwife working under the direction of a | ||||||
18 | licensed certified professional midwife. | ||||||
19 | Section 15. Definitions. In this Act: | ||||||
20 | "Board" means the Illinois Midwifery Board, as specified in | ||||||
21 | this Act. | ||||||
22 | "Certified Professional Midwife" or "CPM" means a person | ||||||
23 | who has met the standards for certification as a Certified | ||||||
24 | Professional Midwife set by the North American Registry of |
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1 | Midwives or its successor, including successful completion of a | ||||||
2 | comprehensive written examination administered in a | ||||||
3 | computerized 0testing center contracted by the North American | ||||||
4 | Registry of Midwives. | ||||||
5 | "Department" means the Department of Financial and | ||||||
6 | Professional Regulation. | ||||||
7 | "Health care practitioner" means physician licensed to | ||||||
8 | practice medicine in all its branches or an advanced practice | ||||||
9 | nurse who is a certified nurse midwife. | ||||||
10 | "Licensed certified professional midwife" or "LCPM" means | ||||||
11 | a person who has successfully met the requirements under | ||||||
12 | Section 30 of this Act. | ||||||
13 | "Midwifery Bridge Certificate" means the certificate | ||||||
14 | issued by the North American Registry of Midwives that | ||||||
15 | documents completion of 50 hours of accredited continuing | ||||||
16 | education specific to content in emergency skills for | ||||||
17 | pregnancy, birth, and newborn care, along with other midwifery | ||||||
18 | topics addressing the core competencies established by the | ||||||
19 | International Confederation of Midwives or its successor. | ||||||
20 | Bridge topics shall include 14 hours of obstetric emergency | ||||||
21 | skills training, such as birth emergency skills training (BEST) | ||||||
22 | or an advanced life-saving in obstetrics (ALSO) course. The | ||||||
23 | remaining 36 hours shall be divided among and include hours in | ||||||
24 | the areas of pharmacology, lab interpretations of pregnancy, | ||||||
25 | antepartum complications, intra-partum complications, | ||||||
26 | postpartum complications, and neonatal care or any additional |
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1 | requirements subsequently required by the North American | ||||||
2 | Registry of Midwives or its successor. | ||||||
3 | "MEAC" means the Midwifery Education and Accreditation | ||||||
4 | Council, or its successor. | ||||||
5 | "NARM" means the North American Registry of Midwives, or | ||||||
6 | any successor organization, that has established and has | ||||||
7 | continued to administer certification for the credentialing of | ||||||
8 | Certified Professional Midwives. | ||||||
9 | "Patient" means a woman or newborn for whom a licensed | ||||||
10 | certified professional midwife provides services. | ||||||
11 | "Postpartum period" means the first 6 weeks after delivery. | ||||||
12 | "Practice of midwifery" means, consistent with current | ||||||
13 | national standards, this Act, and rules adopted by the | ||||||
14 | Department, providing the necessary supervision, care, | ||||||
15 | education, and advice to people with low-risk pregnancies | ||||||
16 | during the antepartum, intra-partum, and postpartum period, | ||||||
17 | conducting deliveries, and caring for the newborn, with such | ||||||
18 | care including preventative measures, the detection of | ||||||
19 | abnormal conditions in the mother and the child, the | ||||||
20 | identification, referral and procurement of medical assistance | ||||||
21 | when necessary care is beyond the scope of certified | ||||||
22 | professional midwifery practice, and the execution of | ||||||
23 | emergency measures in the absence of medical help. "Practice of | ||||||
24 | midwifery" includes breastfeeding assistance and education, | ||||||
25 | non-prescriptive family planning, and basic well-woman care | ||||||
26 | limited to screenings for sexually transmitted infection. |
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1 | "Secretary" means the Secretary of Financial and | ||||||
2 | Professional Regulation. | ||||||
3 | Section 20. Unlicensed practice. Beginning on January 1, | ||||||
4 | 2019, no person may practice, attempt to practice, or hold | ||||||
5 | himself or herself out to practice as a licensed certified | ||||||
6 | professional midwife unless he or she is licensed under this | ||||||
7 | Act. | ||||||
8 | Section 25. Powers and duties of the Department; rules. | ||||||
9 | (a) The Department shall exercise the powers and duties | ||||||
10 | prescribed by the Civil Administrative Code of Illinois for the | ||||||
11 | administration of licensing Acts and shall exercise such other | ||||||
12 | powers and duties necessary for effectuating the purposes of | ||||||
13 | this Act. | ||||||
14 | (b) The Department shall adopt rules under the Illinois | ||||||
15 | Administrative Procedure Act for the administration and | ||||||
16 | enforcement of the Act and for the payment of fees connected to | ||||||
17 | the Act and may prescribe forms that shall be issued in | ||||||
18 | connection with the Act. In addition, the Department shall | ||||||
19 | adopt rules establishing uniform State forms that licensed | ||||||
20 | certified professional midwives must (1) provide to clients | ||||||
21 | consistent with the Act, including informed consent forms, (2) | ||||||
22 | complete and submit to the Board in each case in which the | ||||||
23 | transport of a patient occurs in accordance with transport | ||||||
24 | protocols recommended by the Board and adopted by the |
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1 | Department by rule, and (3) complete to report patient outcomes | ||||||
2 | to the Board. | ||||||
3 | (c) The rules adopted by the Department under this Section | ||||||
4 | may not authorize a licensed certified professional midwife to | ||||||
5 | practice beyond the scope of practice set forth in Section 45. | ||||||
6 | (d) The Department shall consult with the Board in adopting | ||||||
7 | rules. Notice of proposed rulemaking shall be transmitted to | ||||||
8 | the Board and the Department shall review the Board's response | ||||||
9 | and any recommendations made. The Department shall notify the | ||||||
10 | Board in writing of deviations from the Board's recommendations | ||||||
11 | and responses. | ||||||
12 | (e) The Department may at any time seek the advice and the | ||||||
13 | expert knowledge of the Board on any matter relating to the | ||||||
14 | administration of this Act. | ||||||
15 | (f) The Department shall issue quarterly a report to the | ||||||
16 | Board of the status of all complaints related to the profession | ||||||
17 | filed with the Department. | ||||||
18 | (g) Administration by the Department of this Act must be | ||||||
19 | consistent with standards regarding the practice of midwifery | ||||||
20 | established by the National Association of Certified | ||||||
21 | Professional Midwives or a successor organization, this Act and | ||||||
22 | rules adopted pursuant to this Act. | ||||||
23 | Section 27. Requirements for schools. Schools providing | ||||||
24 | education for licensed certified professional midwives shall | ||||||
25 | provide a program of education that is accredited by the |
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1 | Midwifery Education and Accreditation Council and that | ||||||
2 | includes, but is not limited to, classes on the following | ||||||
3 | topics: | ||||||
4 | (1) the community and social determinants of health, | ||||||
5 | including income, literacy, education, water supply and | ||||||
6 | sanitation, housing, environmental hazards, food security, | ||||||
7 | disease patterns, and common threats to health; | ||||||
8 | (2) principles of community-based primary care using | ||||||
9 | health promotion and disease prevention and control | ||||||
10 | strategies; | ||||||
11 | (3) direct and indirect causes of maternal and neonatal | ||||||
12 | mortality and morbidity and strategies for reducing them; | ||||||
13 | (4) methodology for conducting maternal death review | ||||||
14 | and near-miss audits; | ||||||
15 | (5) principles of epidemiology and community | ||||||
16 | diagnosis, including water and sanitation, and how to use | ||||||
17 | these in care provision; | ||||||
18 | (6) methods of infection prevention and control | ||||||
19 | appropriate to the service being provided; | ||||||
20 | (7) principles of research, evidenced-based practice, | ||||||
21 | critical interpretation of professional literature, and | ||||||
22 | the interpretation of vital statistics and research | ||||||
23 | findings; | ||||||
24 | (8) indicators of quality health care services; | ||||||
25 | (9) principles of health education; | ||||||
26 | (10) national and local health services and |
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1 | infrastructures supporting the continuum of care through | ||||||
2 | organizations and referral systems, and how to access | ||||||
3 | needed resources for midwifery care; | ||||||
4 | (11) relevant national or local programs or | ||||||
5 | initiatives that provide services or knowledge of how to | ||||||
6 | assist community members to access services, such as | ||||||
7 | immunization and prevention or treatment of health | ||||||
8 | conditions prevalent in the country or locality; | ||||||
9 | (12) the concept of alarm or preparedness, the protocol | ||||||
10 | for referral to higher health facility levels, and | ||||||
11 | appropriate communication during transport and emergency | ||||||
12 | care; | ||||||
13 | (13) the legal and regulatory framework governing | ||||||
14 | reproductive health for women of all ages, including laws, | ||||||
15 | policies, protocols, and professional guidelines; | ||||||
16 | (14) human rights and their effects on the health of | ||||||
17 | individuals, including, but not limited to, health | ||||||
18 | disparities, domestic partner violence, and female genital | ||||||
19 | mutilation or cutting; | ||||||
20 | (15) advocacy and empowerment strategies for women; | ||||||
21 | (16) the history of childbirth practices and the | ||||||
22 | midwifery profession; | ||||||
23 | (17) unique healthcare needs of women from distinct | ||||||
24 | ethnic or cultural backgrounds or a variety of family | ||||||
25 | structures and sexual orientations; | ||||||
26 | (18) culturally sensitive care; |
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1 | (19) traditional and modern health practices that are | ||||||
2 | beneficial, neutral, or harmful; | ||||||
3 | (20) benefits and risks of available birth settings; | ||||||
4 | (21) strategies for advocating with women for a variety | ||||||
5 | of safe birth settings; | ||||||
6 | (22) the purpose and role of national and local | ||||||
7 | midwifery organizations that provide guidelines for | ||||||
8 | professional behaviors, which include that the midwife: | ||||||
9 | (A) is responsible and accountable for clinical | ||||||
10 | decisions and actions; | ||||||
11 | (B) acts consistently in accordance with | ||||||
12 | professional ethics, values, and human rights as | ||||||
13 | defined by national and local professional midwifery | ||||||
14 | organizations; | ||||||
15 | (C) acts consistently in accordance with standards | ||||||
16 | of practice as defined by national and local | ||||||
17 | professional midwifery organizations; | ||||||
18 | (D) maintains and updates knowledge and skills in | ||||||
19 | order to remain current in practice; | ||||||
20 | (E) uses standard or universal precautions, | ||||||
21 | infection prevention and control strategies, and clean | ||||||
22 | technique; | ||||||
23 | (F) behaves in a courteous, non-judgmental, | ||||||
24 | non-discriminatory, and culturally appropriate manner | ||||||
25 | with all clients; | ||||||
26 | (G) is respectful of individuals and their culture |
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1 | and customs, regardless of socioeconomic status, race, | ||||||
2 | ethnic origin, sexual orientation, gender, physical | ||||||
3 | ability, cognitive ability, or religious belief; | ||||||
4 | (H) maintains the confidentiality of all | ||||||
5 | information shared by the woman and communicates | ||||||
6 | essential information among other health care | ||||||
7 | providers or family members only with explicit | ||||||
8 | permission from the woman and in situations of | ||||||
9 | compelling need; | ||||||
10 | (I) uses shared decision-making in partnership | ||||||
11 | with women and their families to enable and support | ||||||
12 | them in making informed choices about their health, | ||||||
13 | including the need or desire for referral or transfer | ||||||
14 | to other health care providers or facilities for | ||||||
15 | continued care when health care needs exceed the | ||||||
16 | abilities of the licensed certified professional | ||||||
17 | midwife, and their right to refuse testing or | ||||||
18 | intervention; | ||||||
19 | (J) works collaboratively with other health care | ||||||
20 | workers to improve the delivery of services to women | ||||||
21 | and families; | ||||||
22 | (K) follows appropriate protocol and etiquette for | ||||||
23 | transport or transfer of care of the mother or newborn | ||||||
24 | from home or birth center to the hospital during | ||||||
25 | pregnancy, in labor, or postpartum; and | ||||||
26 | (L) provides opportunity for client feedback; |
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1 | (23) classes ensuring that the midwife has the skill or | ||||||
2 | ability to: | ||||||
3 | (A) engage in health education discussions with | ||||||
4 | and for women and their families; | ||||||
5 | (B) use appropriate communication and listening | ||||||
6 | skills across all domains of competency; | ||||||
7 | (C) assemble, use, and maintain equipment and | ||||||
8 | supplies appropriate to setting of practice; | ||||||
9 | (D) document and interpret relevant findings for | ||||||
10 | services provided across all domains of competency, | ||||||
11 | including what was done and what needs follow-up | ||||||
12 | according to current best practices; | ||||||
13 | (E) comply with all local regulations for birth and | ||||||
14 | death registration, mandatory reporting for physical | ||||||
15 | abuse, and infectious disease reporting; | ||||||
16 | (F) take a leadership role in the practice arena | ||||||
17 | based on professional beliefs and values; and | ||||||
18 | (G) assume administration and management tasks and | ||||||
19 | activities, including, but not limited to, compliance | ||||||
20 | with privacy and protected health information | ||||||
21 | regulations, such as compliance with the requirements | ||||||
22 | of the Health Insurance Portability and Accountability | ||||||
23 | Act, and compliance with workplace safety regulations, | ||||||
24 | including compliance with regulations of the | ||||||
25 | Occupational Safety and Health Administration; | ||||||
26 | (24) anatomy and physiology of the human body; |
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1 | (25) the biology of human reproduction, the menstrual | ||||||
2 | cycle, and the process of conception; | ||||||
3 | (26) the growth and development of the unborn baby; | ||||||
4 | (27) signs and symptoms of pregnancy; | ||||||
5 | (28) examinations and tests for confirmation of | ||||||
6 | pregnancy; | ||||||
7 | (29) signs and symptoms and methods for diagnosis of an | ||||||
8 | ectopic pregnancy; | ||||||
9 | (30) principles of dating pregnancy by menstrual | ||||||
10 | history, size of uterus, fundal growth patterns, and use of | ||||||
11 | ultrasound; | ||||||
12 | (31) components of a health history and focused | ||||||
13 | physical examination for antenatal visits; | ||||||
14 | (32) manifestations of various degrees of female | ||||||
15 | genital mutilation or cutting and their potential; | ||||||
16 | (33) factors involved in decisions relating to | ||||||
17 | unintended or mistimed pregnancies; | ||||||
18 | (34) normal findings or results of basic screening | ||||||
19 | laboratory tests, including, but not limited to, (i) | ||||||
20 | routine pregnancy blood work, (ii) urine dipstick, (iii) | ||||||
21 | fetal screening, such as genetic testing, biophysical | ||||||
22 | profiles, first and second trimester screen, non-stress | ||||||
23 | test, and ultrasound, (iv) glucose tolerance screen, (v) | ||||||
24 | pre-eclampsia screening tests, and (vi) Group B | ||||||
25 | streptococcus vaginal or rectal culture; | ||||||
26 | (35) normal progression of pregnancy, such as body |
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1 | changes, common discomforts, expected fundal growth | ||||||
2 | patterns, and weight gain; | ||||||
3 | (36) implications of deviation from expected fundal | ||||||
4 | growth patterns, including intrauterine growth retardation | ||||||
5 | or restriction, oligohydramnios and polyhydramnios, and | ||||||
6 | multiple fetuses; | ||||||
7 | (37) fetal risk factors requiring transfer of women to | ||||||
8 | higher levels of care prior to labor and birth; | ||||||
9 | (38) normal psychological changes in pregnancy, | ||||||
10 | indicators of psychosocial stress, and impact of pregnancy | ||||||
11 | on the woman and the family; | ||||||
12 | (39) safe locally available non-pharmacological | ||||||
13 | methods for the relief of common discomforts of pregnancy; | ||||||
14 | (40) how to determine fetal well-being during | ||||||
15 | pregnancy, including fetal heart rate and activity | ||||||
16 | patterns, amniocentesis, and ultrasound technology; | ||||||
17 | (41) components of a healthy diet and the nutritional | ||||||
18 | requirements of the pregnant woman and fetus, including the | ||||||
19 | appropriate use of vitamin and mineral supplements; | ||||||
20 | (42) health education needs in pregnancy, such as | ||||||
21 | information about relief of common discomforts, hygiene, | ||||||
22 | sexuality, and work inside and outside the home; | ||||||
23 | (43) basic principles of pharmacokinetics of drugs | ||||||
24 | prescribed, dispensed, or furnished to women during | ||||||
25 | pregnancy; | ||||||
26 | (44) effects of prescribed medications, ultrasound, |
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1 | street drugs, traditional medicines, and over-the-counter | ||||||
2 | drugs on pregnancy and the fetus; | ||||||
3 | (45) effects of smoking, alcohol abuse, and illicit | ||||||
4 | drug use on the pregnant woman and fetus; | ||||||
5 | (46) effects of environmental exposures, food-borne | ||||||
6 | illnesses, or certain activities on the pregnant woman and | ||||||
7 | fetus, such as heavy metals, listeriosis, pesticides, food | ||||||
8 | additives, saunas, and toxoplasmosis; | ||||||
9 | (47) the essential elements of birth planning, | ||||||
10 | including, but not limited to, preparation for labor and | ||||||
11 | birth and emergency preparedness; | ||||||
12 | (48) the physical preparation for labor; | ||||||
13 | (49) the components of preparation of the home and | ||||||
14 | family for the newborn; | ||||||
15 | (50) techniques for increasing relaxation and pain | ||||||
16 | relief measures available for labor; | ||||||
17 | (51) signs, symptoms, and potential effects of | ||||||
18 | conditions that are life-threatening to the pregnant woman | ||||||
19 | or her fetus, including, but not limited to, (i) | ||||||
20 | pre-eclampsia or eclampsia, (ii) vaginal bleeding, (iii) | ||||||
21 | premature labor, (iv) Rh isoimmunization, and (v) | ||||||
22 | syphilis; | ||||||
23 | (52) means and methods of advising about care, | ||||||
24 | treatment, and support for the HIV-positive pregnant | ||||||
25 | woman, including measures to prevent maternal-to-child | ||||||
26 | transmission (PMTCT) and feeding options; |
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1 | (53) signs, symptoms, and indications for referral of | ||||||
2 | selected complications and conditions of pregnancy that | ||||||
3 | affect either the mother or the fetus, including, but not | ||||||
4 | limited to, (i) anemia, (ii) asthma, (iii) HIV infection, | ||||||
5 | (iv) thyroid disorders, (v) diabetes, (vi) cardiac | ||||||
6 | conditions, (vii) malpresentations and abnormal lie, | ||||||
7 | (viii) placental disorders, (ix) pre-term labor, (x) | ||||||
8 | post-dates pregnancy, and (xi) hydatidiform mole; | ||||||
9 | (54) the prenatal methods for encouraging optimal | ||||||
10 | positioning at term, including external manual version; | ||||||
11 | (55) the physiology of lactation and methods to prepare | ||||||
12 | women for breastfeeding; | ||||||
13 | (56) classes ensuring that the midwife has the skill or | ||||||
14 | ability to: | ||||||
15 | (A) take an initial history and perform an ongoing | ||||||
16 | history for each antenatal visit; | ||||||
17 | (B) perform a complete physical examination and | ||||||
18 | explain the findings to the woman; | ||||||
19 | (C) take and assess maternal vital signs, | ||||||
20 | including temperature, blood pressure, and pulse; | ||||||
21 | (D) draw blood and collect urine and vaginal | ||||||
22 | culture specimens for laboratory testing; | ||||||
23 | (E) assess maternal nutrition and its relationship | ||||||
24 | to fetal growth and give appropriate advice on the | ||||||
25 | nutritional requirements of pregnancy and how to | ||||||
26 | achieve them; |
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1 | (F) perform a complete abdominal assessment | ||||||
2 | including measuring fundal height, lie, position, and | ||||||
3 | presentation; | ||||||
4 | (G) assess fetal growth using manual measurements; | ||||||
5 | (H) evaluate fetal growth, placental location, and | ||||||
6 | amniotic fluid volume by using manual measurements or | ||||||
7 | techniques and by referring for ultrasound | ||||||
8 | visualization and measurement; | ||||||
9 | (I) listen to the fetal heart rate, palpate the | ||||||
10 | uterus for fetal activity, and interpret findings; | ||||||
11 | (J) monitor fetal heart rate with Doppler; | ||||||
12 | (K) perform a pelvic examination, including sizing | ||||||
13 | the uterus, if indicated and when appropriate during | ||||||
14 | the course of pregnancy; | ||||||
15 | (L) perform clinical pelvimetry (evaluation of | ||||||
16 | bony pelvis) to determine the adequacy of the bony | ||||||
17 | structures; | ||||||
18 | (M) calculate the estimated date of birth and | ||||||
19 | assess gestational period through query about the last | ||||||
20 | menstrual period, bimanual examination, urine | ||||||
21 | pregnancy testing, or any combination thereof; | ||||||
22 | (N) provide health education to adolescents, | ||||||
23 | women, and families about normal pregnancy | ||||||
24 | progression, danger signs and symptoms, and when and | ||||||
25 | how to contact the midwife; | ||||||
26 | (O) teach or demonstrate measures to decrease |
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1 | common discomforts of pregnancy; | ||||||
2 | (P) provide guidance and basic preparation for | ||||||
3 | labor, birth, and parenting; | ||||||
4 | (Q) provide education regarding avoidance of | ||||||
5 | potentially harmful environmental exposures, | ||||||
6 | food-borne illnesses, or activities; | ||||||
7 | (R) identify variations during the course of the | ||||||
8 | pregnancy and institute appropriate first-line | ||||||
9 | independent or collaborative management based upon | ||||||
10 | evidence-based guidelines, local standards, and | ||||||
11 | available resources for (i) low or inadequate maternal | ||||||
12 | nutrition, including eating disorders and pica; (ii) | ||||||
13 | anemia; (iii) ectopic pregnancy; (iv) hyperemesis | ||||||
14 | gravidarum; (v) genital herpes; (vi) inadequate or | ||||||
15 | excessive uterine growth, including suspected | ||||||
16 | oligohydramnios or polyhydramnios, and molar | ||||||
17 | pregnancy; (vii) gestational diabetes; (viii) | ||||||
18 | insufficient cervix; (ix) elevated blood pressure, | ||||||
19 | proteinuria, presence of significant edema, severe | ||||||
20 | frontal headaches, visual changes, and epigastric pain | ||||||
21 | associated with elevated blood pressure; (x) vaginal | ||||||
22 | bleeding with or without cramping; (xi) multiple | ||||||
23 | gestation and abnormal lie or malpresentation at term; | ||||||
24 | (xii) intrauterine fetal death; (xiii) rupture of | ||||||
25 | membranes prior to term; (xiv) post term pregnancy; | ||||||
26 | (xv) exposure to or contraction of infectious disease, |
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1 | such as HIV, Hepatitis B and Hepatitis C, Varicella, | ||||||
2 | Rubella, and cytomegalovirus; (xvi) Group B | ||||||
3 | streptococcus positive vaginal or rectal culture; | ||||||
4 | (xvii) Toxoplasmosis; and (xviii) depression; | ||||||
5 | (S) identify deviations from normal during the | ||||||
6 | course of pregnancy and initiate the referral process | ||||||
7 | for conditions that require higher levels of | ||||||
8 | intervention; | ||||||
9 | (T) dispense, furnish, or administer (however | ||||||
10 | authorized to do so in the jurisdiction of practice) | ||||||
11 | selected, life-saving drugs, such as antibiotics, | ||||||
12 | anticonvulsants, antimalarials, antihypertensives, and | ||||||
13 | antiretrovirals, to women in need because of a | ||||||
14 | presenting condition; and | ||||||
15 | (U) provide individualized care according to the | ||||||
16 | needs and desires of each woman; | ||||||
17 | (57) physiology of the first, second, and third stages | ||||||
18 | of labor; | ||||||
19 | (58) anatomy of the fetal skull, critical diameters, | ||||||
20 | and landmarks; | ||||||
21 | (59) psychological and cultural aspects of labor and | ||||||
22 | birth; | ||||||
23 | (60) indicators of the latent phase and the onset of | ||||||
24 | active labor; | ||||||
25 | (61) indications for stimulation of the onset of labor, | ||||||
26 | and augmentation of uterine contractility; |
| |||||||
| |||||||
1 | (62) normal progression of labor; | ||||||
2 | (63) how to use the partograph, including, but not | ||||||
3 | limited to, completing the record and interpreting | ||||||
4 | information to determine timely and appropriate labor | ||||||
5 | management; | ||||||
6 | (64) measures to assess fetal well-being in labor; | ||||||
7 | (65) measures to assess maternal well-being in labor; | ||||||
8 | (66) process of fetal passage or descent through the | ||||||
9 | pelvis during labor and birth, mechanisms of labor in | ||||||
10 | various fetal presentations, and positions; | ||||||
11 | (67) comfort measures in the first and second stages of | ||||||
12 | labor, such as family presence or assistance, positioning | ||||||
13 | for labor and birth, hydration, emotional support, and | ||||||
14 | non-pharmacological methods of pain relief; | ||||||
15 | (68) pharmacological measures for management and | ||||||
16 | control of labor pain, including the relative risks, | ||||||
17 | disadvantages, and safety of specific methods of pain | ||||||
18 | management and their effect on the normal physiology of | ||||||
19 | labor; | ||||||
20 | (69) signs and symptoms of complications in labor, | ||||||
21 | including, but not limited to, (i) bleeding, (ii) labor | ||||||
22 | arrest or dysfunction, (iii) malpresentation, (iv) | ||||||
23 | eclampsia, (v) maternal distress, (vi) fetal distress, | ||||||
24 | (vii) infection, and (viii) prolapsed cord; | ||||||
25 | (70) the benefits, risks, criteria for risk | ||||||
26 | assessment, and midwifery management of vaginal birth |
| |||||||
| |||||||
1 | after a cesarean; | ||||||
2 | (71) indicators, risk factors, special needs, and | ||||||
3 | prenatal management of a pregnant woman with a multiple | ||||||
4 | gestation; | ||||||
5 | (72) principles of prevention of pelvic floor damage | ||||||
6 | and perineal tears; | ||||||
7 | (73) indications for performing an episiotomy; | ||||||
8 | (74) principles of expectant (physiologic) management | ||||||
9 | of the third stage of labor; | ||||||
10 | (75) principles of active management of the third stage | ||||||
11 | of labor; | ||||||
12 | (76) principles underpinning the technique for repair | ||||||
13 | of perineal tears and episiotomy; | ||||||
14 | (77) indicators of need for emergency management, | ||||||
15 | referral, or transfer for obstetric emergencies, | ||||||
16 | including, but not limited to, cord prolapse, shoulder | ||||||
17 | dystocia, placental abruption, uterine rupture, uterine | ||||||
18 | bleeding, and retained placenta; | ||||||
19 | (78) indicators of need for operative deliveries, | ||||||
20 | vacuum extraction, and use of forceps, including, but not | ||||||
21 | limited to, fetal distress and cephalopelvic | ||||||
22 | disproportion; | ||||||
23 | (79) indicators of need for and appropriate | ||||||
24 | administration of the following pharmacologic agents: | ||||||
25 | lidocaine/xylocaine for suturing, oxygen, methergine, | ||||||
26 | oxytocin (Pitocin) for postpartum hemorrhage, rhogam, |
| |||||||
| |||||||
1 | vitamin K, antibiotics for group B strep prophylaxis, | ||||||
2 | intravenous fluids, and newborn eye prophylaxis; and | ||||||
3 | (80) classes to ensure that the midwife has the skill | ||||||
4 | or ability to: | ||||||
5 | (A) take a specific history and maternal vital | ||||||
6 | signs in labor; | ||||||
7 | (B) perform a focused physical examination in | ||||||
8 | labor; | ||||||
9 | (C) perform a complete abdominal assessment for | ||||||
10 | fetal position and descent; | ||||||
11 | (D) time and assess the effectiveness of uterine | ||||||
12 | contractions; | ||||||
13 | (E) perform a complete and accurate pelvic | ||||||
14 | examination for dilatation, effacement, descent, | ||||||
15 | presenting part, position, status of membranes, and | ||||||
16 | adequacy of pelvis for birth of baby vaginally; | ||||||
17 | (F) monitor and chart progress of labor; | ||||||
18 | (G) provide physical and psychological support for | ||||||
19 | woman and family and promote normal birth, including | ||||||
20 | encouragement of adequate rest and sleep; | ||||||
21 | (H) facilitate the presence of a support person | ||||||
22 | during labor and birth; | ||||||
23 | (I) provide adequate hydration, nutrition, and | ||||||
24 | non-pharmacological comfort measures during labor and | ||||||
25 | birth; | ||||||
26 | (J) provide for bladder care, including |
| |||||||
| |||||||
1 | performance of urinary catheterization when indicated; | ||||||
2 | (K) promptly identify abnormal labor patterns or | ||||||
3 | progress and initiate appropriate and timely | ||||||
4 | intervention or referral, including, but not limited | ||||||
5 | to, occiput posterior position, asynclitism, pendulous | ||||||
6 | abdomen, maternal exhaustion, and maternal | ||||||
7 | dehydration; | ||||||
8 | (L) stimulate or augment uterine contractility | ||||||
9 | using non-pharmacologic agents; | ||||||
10 | (M) administer local anaesthetic to the perineum | ||||||
11 | when episiotomy is anticipated or perineal repair is | ||||||
12 | required; | ||||||
13 | (N) perform an episiotomy if needed; | ||||||
14 | (O) perform appropriate hand maneuvers for a | ||||||
15 | vertex birth; | ||||||
16 | (P) perform appropriate hand maneuvers for face | ||||||
17 | and breech deliveries; | ||||||
18 | (Q) manage the birth of multiples; | ||||||
19 | (R) recognize the various severities of meconium | ||||||
20 | stained amniotic fluid and perform suctioning of the | ||||||
21 | airway, as appropriate; | ||||||
22 | (S) clamp and cut the cord; | ||||||
23 | (T) institute immediate life-saving interventions | ||||||
24 | in obstetrical emergencies to save the life of the | ||||||
25 | fetus while requesting medical attention, awaiting | ||||||
26 | transfer, or both, including, but not limited to, (i) |
| |||||||
| |||||||
1 | prolapsed cord, (ii) placental abruption, (iii) | ||||||
2 | uterine rupture, (iv) malpresentation, (v) shoulder | ||||||
3 | dystocia, and (vi) fetal distress; | ||||||
4 | (U) manage a nuchal cord or arm at birth; | ||||||
5 | (V) support expectant (physiologic) management of | ||||||
6 | the third stage of labor; | ||||||
7 | (W) assess the need for and conduct active | ||||||
8 | management of the third stage of labor, following the | ||||||
9 | most current evidence-based protocol; | ||||||
10 | (X) inspect the placenta and membranes for | ||||||
11 | completeness; | ||||||
12 | (Y) perform fundal massage to stimulate postpartum | ||||||
13 | uterine contraction and uterine tone; | ||||||
14 | (Z) provide a safe environment for mother and | ||||||
15 | infant to promote attachment or bonding; | ||||||
16 | (AA) estimate and record maternal blood loss; | ||||||
17 | (BB) inspect the vagina and cervix for | ||||||
18 | lacerations; | ||||||
19 | (CC) repair an episiotomy, if needed; | ||||||
20 | (DD) repair first and second degree perineal or | ||||||
21 | vaginal lacerations; | ||||||
22 | (EE) manage postpartum bleeding and hemorrhage | ||||||
23 | using appropriate techniques and uterotonic agents as | ||||||
24 | indicated; | ||||||
25 | (FF) dispense, furnish, or administer (however | ||||||
26 | authorized to do so in the jurisdiction of practice) |
| |||||||
| |||||||
1 | selected, life-saving drugs, including antibiotics and | ||||||
2 | antihemorrhagics, to women in need because of a | ||||||
3 | presenting condition; | ||||||
4 | (GG) perform manual removal of placenta; | ||||||
5 | (HH) perform internal and external bimanual | ||||||
6 | compression of the uterus to control hemorrhage; | ||||||
7 | (II) perform aortic compression; | ||||||
8 | (JJ) identify and manage shock; | ||||||
9 | (KK) insert an intravenous line, administer | ||||||
10 | fluids, and draw blood for laboratory testing; | ||||||
11 | (LL) arrange for and undertake timely referral and | ||||||
12 | transfer of women with serious complications to a | ||||||
13 | higher level health facility, taking appropriate drugs | ||||||
14 | and equipment and arranging for a companion caregiver | ||||||
15 | on the journey in order to continue giving emergency | ||||||
16 | care as required; and | ||||||
17 | (MM) perform adult cardiopulmonary resuscitation. | ||||||
18 | Section 30. Qualifications for licensed certified | ||||||
19 | professional midwives. | ||||||
20 | (a) Each applicant who successfully meets the requirements | ||||||
21 | of this Section shall be licensed as a licensed certified | ||||||
22 | professional midwife. | ||||||
23 | (b) An applicant for licensure as a licensed certified | ||||||
24 | professional midwife must do each of the following: | ||||||
25 | (1) Submit a completed written application, on forms |
| |||||||
| |||||||
1 | provided by the Department, and fees, as established by the | ||||||
2 | Department. | ||||||
3 | (2) Be at least 21 years old. | ||||||
4 | (3) Be a high school graduate or have completed | ||||||
5 | equivalent education. | ||||||
6 | (4) Successfully complete one of the following formal | ||||||
7 | midwifery education and training programs: | ||||||
8 | (A) Accredited Educational Pathway: | ||||||
9 | (i) Applicants who are Certified Professional | ||||||
10 | Midwives and who have successfully completed an | ||||||
11 | educational program or pathway accredited by the | ||||||
12 | MEAC are eligible for licensure as a licensed | ||||||
13 | certified professional midwife. | ||||||
14 | (ii) After January 1, 2022, all new applicants | ||||||
15 | for licensure as a licensed certified professional | ||||||
16 | midwife must have graduated from an educational | ||||||
17 | program or pathway accredited by MEAC. | ||||||
18 | (B) Non-accredited Educational Pathway: | ||||||
19 | (i) Applicants who are Certified Professional | ||||||
20 | Midwives before January 1, 2022, and who have | ||||||
21 | completed non-accredited education pathways will | ||||||
22 | be required to obtain the NARM Midwifery Bridge | ||||||
23 | Certificate in order to become licensed as a | ||||||
24 | licensed certified professional midwife. | ||||||
25 | (ii) Applicants who have maintained licensure | ||||||
26 | in a state that does not require accredited |
| |||||||
| |||||||
1 | education, regardless of the date of their | ||||||
2 | certification, shall obtain the NARM Midwifery | ||||||
3 | Bridge Certificate to be eligible for licensure as | ||||||
4 | a licensed certified professional midwife. | ||||||
5 | (5) Hold a current valid Certified Professional | ||||||
6 | Midwife Credential granted by NARM or its successor | ||||||
7 | organization. | ||||||
8 | (6) Hold current cardiopulmonary resuscitation (CPR) | ||||||
9 | certification for health care professionals or providers | ||||||
10 | issued by the American Red Cross or the American Heart | ||||||
11 | Association. | ||||||
12 | (7) Within the last 2 years have successfully completed | ||||||
13 | the American Academy of Pediatric/American Heart | ||||||
14 | Association neonatal resuscitation program (NRP). | ||||||
15 | (8) Have not violated the provisions of this Act | ||||||
16 | concerning the grounds for disciplinary action. The | ||||||
17 | Department may take into consideration any felony | ||||||
18 | conviction of the applicant, but such a conviction may not | ||||||
19 | operate as an absolute bar to licensure as a licensed | ||||||
20 | certified professional midwife. | ||||||
21 | (9) Submit to the criminal history records check | ||||||
22 | required under Section 35 of this Act. | ||||||
23 | (10) Meet all other requirements established by the | ||||||
24 | Department by rule. | ||||||
25 | Section 35. Criminal history records background check. |
| |||||||
| |||||||
1 | Each applicant for licensure by examination or restoration | ||||||
2 | shall submit his or her fingerprints to the Department of State | ||||||
3 | Police in an electronic format that complies with the form and | ||||||
4 | manner for requesting and furnishing criminal history record | ||||||
5 | information prescribed by the Department of State Police. These | ||||||
6 | fingerprints shall be checked against the Department of State | ||||||
7 | Police and Federal Bureau of Investigation criminal history | ||||||
8 | record databases now and hereafter filed. The Department of | ||||||
9 | State Police shall charge applicants a fee for conducting the | ||||||
10 | criminal history records check, which shall be deposited into | ||||||
11 | the State Police Services Fund and shall not exceed the actual | ||||||
12 | cost of the records check. The Department of State Police shall | ||||||
13 | furnish, pursuant to positive identification, records of | ||||||
14 | Illinois convictions to the Department and shall forward the | ||||||
15 | national crime history record information to the Department. | ||||||
16 | The Department may require applicants to pay a separate | ||||||
17 | fingerprinting fee, either to the Department or to a vendor. | ||||||
18 | The Department, in its discretion, may allow an applicant who | ||||||
19 | does not have reasonable access to a designated vendor to | ||||||
20 | provide his or her fingerprints in an alternative manner. The | ||||||
21 | Department may adopt any rules necessary to implement this | ||||||
22 | Section. | ||||||
23 | Section 40. Title. Only a licensed certified professional | ||||||
24 | midwife may identify himself or herself as a "licensed | ||||||
25 | certified professional midwife" or use the abbreviation |
| |||||||
| |||||||
1 | "LCPM". | ||||||
2 | Section 45. Scope of practice of licensed certified | ||||||
3 | professional midwives. | ||||||
4 | (a) "Practice of midwifery" means: | ||||||
5 | (1) providing maternity care that is consistent with a | ||||||
6 | midwife's training, education, and experience; and | ||||||
7 | (2) identifying and referring patients who require | ||||||
8 | medical care to an appropriate health care provider. | ||||||
9 | (b) The practice of midwifery includes: | ||||||
10 | (1) Providing the necessary supervision, care, and | ||||||
11 | advice to a patient during a low-risk pregnancy, labor, | ||||||
12 | delivery, and postpartum period. | ||||||
13 | (2) Newborn care that is provided in a manner that is: | ||||||
14 | (A) consistent with national certified | ||||||
15 | professional midwifery standards; and | ||||||
16 | (B) based on the acquisition of clinical skills | ||||||
17 | necessary for the care of pregnant women and newborns, | ||||||
18 | including antepartum, intra-partum, and postpartum | ||||||
19 | care. | ||||||
20 | (3) Obtaining informed consent to provide services to | ||||||
21 | the patient in accordance with Section 50 of this Act. | ||||||
22 | (4) Discussing: | ||||||
23 | (A) any general risk factors associated with the | ||||||
24 | services to be provided; | ||||||
25 | (B) any specific risk factors pertaining to the |
| |||||||
| |||||||
1 | health and circumstances of the individual patient; | ||||||
2 | (C) conditions that preclude care by a licensed | ||||||
3 | certified professional midwife; and | ||||||
4 | (D) the conditions under which consultation, | ||||||
5 | transfer of care, or transport of the patient must be | ||||||
6 | implemented. | ||||||
7 | (5) Obtaining a health history of the patient and | ||||||
8 | performing a physical examination. | ||||||
9 | (6) Developing a written plan of care specific to the | ||||||
10 | patient, to ensure continuity of care throughout the | ||||||
11 | antepartum, intra-partum, and postpartum periods, that | ||||||
12 | includes: | ||||||
13 | (A) a plan for the management of any specific risk | ||||||
14 | factors pertaining to the individual health and | ||||||
15 | circumstances of the individual patient; and | ||||||
16 | (B) a plan to be followed in the event of an | ||||||
17 | emergency; including a plan for transportation. | ||||||
18 | (7) Evaluating the results of patient care and | ||||||
19 | reporting patient outcomes to the Department on a uniform | ||||||
20 | State form in accordance with rules. | ||||||
21 | (8) Consulting and collaborating with a health care | ||||||
22 | practitioner regarding the care of a patient, and referring | ||||||
23 | and transferring care to a health care practitioner, as | ||||||
24 | required. | ||||||
25 | (9) Referral of all patients, within 72 hours after | ||||||
26 | delivery, to a pediatric health care practitioner for care |
| |||||||
| |||||||
1 | of the newborn. | ||||||
2 | (10) Obtaining and administering appropriate | ||||||
3 | medications and using equipment and devices. | ||||||
4 | (11) Obtaining appropriate screening and testing, | ||||||
5 | including laboratory tests, urinalysis, and ultrasound. | ||||||
6 | (12) Providing prenatal care during the antepartum | ||||||
7 | period, with consultation or referral as required. | ||||||
8 | (13) Providing care during the intra-partum period, | ||||||
9 | including: | ||||||
10 | (A) monitoring and evaluating the condition of the | ||||||
11 | patient and fetus; | ||||||
12 | (B) performing emergency procedures, including: | ||||||
13 | (i) administering approved medications; | ||||||
14 | (ii) administering intravenous fluids for | ||||||
15 | stabilization; | ||||||
16 | (iii) performing an emergency episiotomy; and | ||||||
17 | (iv) providing care while on the way to a | ||||||
18 | hospital under circumstances in which emergency | ||||||
19 | medical services have not been activated; | ||||||
20 | (C) activating emergency medical services for an | ||||||
21 | emergency; and | ||||||
22 | (D) delivering in an out-of-hospital setting. | ||||||
23 | (14) Participating in mandatory peer review in cases | ||||||
24 | involving transfers of patients in accordance with rules | ||||||
25 | adopted by the Department, and peer review of any patient's | ||||||
26 | care upon request. |
| |||||||
| |||||||
1 | (15) Providing care during the postpartum period, | ||||||
2 | including: | ||||||
3 | (A) suturing of first and second degree perineal or | ||||||
4 | labial lacerations, or suturing of an episiotomy with | ||||||
5 | the administration of a local anesthetic; and | ||||||
6 | (B) making further contact with the patient within | ||||||
7 | 48 hours, within 2 weeks, and at 6 weeks after the | ||||||
8 | delivery to assess for hemorrhage, preeclampsia, | ||||||
9 | thrombo-embolism, infection, and emotional well-being. | ||||||
10 | (16) Providing routine care for the newborn for up to | ||||||
11 | 72 hours after delivery, exclusive of administering | ||||||
12 | immunizations, including: | ||||||
13 | (A) immediate care at birth, including | ||||||
14 | resuscitating as needed, performing a newborn | ||||||
15 | examination, and administering intramuscular vitamin K | ||||||
16 | and eye ointment for prevention of ophthalmia | ||||||
17 | neonatorium; | ||||||
18 | (B) assessing newborn feeding and hydration; | ||||||
19 | (C) performing metabolic screening and reporting | ||||||
20 | on the screening in accordance with the regulations | ||||||
21 | related to newborn screenings that are adopted by the | ||||||
22 | Department; | ||||||
23 | (D) performing critical congenital heart disease | ||||||
24 | screening and reporting on the screening in accordance | ||||||
25 | with the regulations related to newborn screenings | ||||||
26 | that are adopted by the Department; and |
| |||||||
| |||||||
1 | (E) referring the infant to an audiologist for a | ||||||
2 | hearing screening in accordance with the regulations | ||||||
3 | related to newborn screenings that are adopted by the | ||||||
4 | Department. | ||||||
5 | (17) Within 24 hours after delivery notifying a | ||||||
6 | pediatric health care practitioner of the delivery. | ||||||
7 | (18) Within 72 hours after delivery: | ||||||
8 | (A) transferring health records to the pediatric | ||||||
9 | health care practitioner, including documentation of | ||||||
10 | the performance of the screenings required under | ||||||
11 | subparagraphs (C) and (D) of paragraph (16) of this | ||||||
12 | subsection (b); and | ||||||
13 | (B) referring the newborn to a pediatric health | ||||||
14 | care practitioner. | ||||||
15 | (19) Providing the following care of the newborn beyond | ||||||
16 | the first 72 hours after delivery: | ||||||
17 | (A) weight checks and general observation of the | ||||||
18 | newborn's activity, with abnormal findings | ||||||
19 | communicated to the newborn's pediatric health care | ||||||
20 | practitioner; | ||||||
21 | (B) assessment of newborn feeding and hydration; | ||||||
22 | and | ||||||
23 | (C) breastfeeding support and counseling. | ||||||
24 | (20) Providing limited services to the patient after | ||||||
25 | the postpartum period, including: | ||||||
26 | (A) breastfeeding support and counseling; and |
| |||||||
| |||||||
1 | (B) counseling and referral for all family | ||||||
2 | planning methods. | ||||||
3 | (21) Providing a copy of all newborn care records to | ||||||
4 | the designated health care provider after the birth of the | ||||||
5 | baby at time of transfer of care. The licensed certified | ||||||
6 | professional midwife shall obtain consent for the transfer | ||||||
7 | of records per the Health Insurance Portability and | ||||||
8 | Accountability Act of 1996. | ||||||
9 | (22) Distributing Illinois Department of Public Health | ||||||
10 | materials about metabolic and hearing screenings for | ||||||
11 | newborns if such materials are available. | ||||||
12 | (c) The practice of midwifery does not include: | ||||||
13 | (1) Out-of-hospital care to a woman who has had a | ||||||
14 | caesarean section. | ||||||
15 | (2) Out-of-hospital care in cases of multifetal | ||||||
16 | gestation. | ||||||
17 | (3) Out-of-hospital care in cases involving breech | ||||||
18 | delivery. | ||||||
19 | (4) Administering prescription pharmacological agents | ||||||
20 | intended to induce or augment labor or artificial rupture | ||||||
21 | of membranes prior to onset of labor. | ||||||
22 | (5) Administering prescription pharmacological agents | ||||||
23 | to provide pain management or anesthetic except for the | ||||||
24 | administration of a local anesthetic. | ||||||
25 | (6) Using vacuum extractors or forceps. | ||||||
26 | (7) Prescribing medications. |
| |||||||
| |||||||
1 | (8) Performing surgical procedures, including, but not | ||||||
2 | limited to, abortions, cesarean sections and | ||||||
3 | circumcisions, except for an emergency episiotomy. | ||||||
4 | (9) Knowingly accepting responsibility for prenatal or | ||||||
5 | intra-partum care of a patient with any of the following | ||||||
6 | risk factors: | ||||||
7 | (A) previous uterine surgery, including a cesarean | ||||||
8 | section or myomectomy; | ||||||
9 | (B) chronic significant maternal cardiac, | ||||||
10 | pulmonary, renal, or hepatic disease; | ||||||
11 | (C) malignant disease in an active phase; | ||||||
12 | (D) significant hematological disorders or | ||||||
13 | coagulopathies or pulmonary embolism; | ||||||
14 | (E) diabetes mellitus requiring insulin; | ||||||
15 | (F) known maternal congenital abnormalities | ||||||
16 | affecting childbirth; | ||||||
17 | (G) confirmed isoimmunization, Rh disease with | ||||||
18 | positive titer levels; | ||||||
19 | (H) active tuberculosis; | ||||||
20 | (I) active syphilis or gonorrhea; | ||||||
21 | (J) active genital herpes infection 2 weeks prior | ||||||
22 | to labor or during labor; | ||||||
23 | (K) pelvic or uterine abnormalities affecting | ||||||
24 | normal vaginal births, including tumors and | ||||||
25 | malformations; | ||||||
26 | (L) alcoholism or abuse; |
| |||||||
| |||||||
1 | (M) drug addiction or abuse; | ||||||
2 | (N) confirmed HIV or AIDS status; | ||||||
3 | (O) uncontrolled current serious psychiatric | ||||||
4 | illness; | ||||||
5 | (P) social or familial conditions unsatisfactory | ||||||
6 | for out-of-hospital maternity care services; | ||||||
7 | (Q) fetus with suspected or diagnosed congenital | ||||||
8 | abnormalities that may require immediate medical | ||||||
9 | intervention; | ||||||
10 | (R) indications that the fetus has died in utero; | ||||||
11 | or | ||||||
12 | (S) premature labor (gestation less than 37 | ||||||
13 | weeks). | ||||||
14 | (10) Continuing to provide care for conditions for | ||||||
15 | which a transfer is required under subsection (c) of | ||||||
16 | Section 60. | ||||||
17 | (11) Administering drugs other than those listed in | ||||||
18 | Section 60 of this Act. | ||||||
19 | Section 50. Informed consent. | ||||||
20 | (a) A licensed certified professional midwife shall, at an | ||||||
21 | initial consultation with a patient, disclose to the patient | ||||||
22 | orally and in writing on a Department-specified uniform | ||||||
23 | informed consent form all of the following: | ||||||
24 | (1) The licensed certified professional midwife's | ||||||
25 | experience and training. |
| |||||||
| |||||||
1 | (2) The general risk factors associated with the | ||||||
2 | services to be provided. | ||||||
3 | (3) The definition of the "practice of midwifery" in | ||||||
4 | this Act. | ||||||
5 | (4) That the client is retaining a licensed certified | ||||||
6 | professional midwife, not an advanced practice nurse who is | ||||||
7 | a certified nurse midwife, and that the licensed certified | ||||||
8 | professional midwife is not supervised by a physician or | ||||||
9 | nurse. | ||||||
10 | (5) The licensed certified professional midwife's | ||||||
11 | current licensure status and license number. | ||||||
12 | (6) The practice settings in which the licensed | ||||||
13 | certified professional midwife practices. | ||||||
14 | (7) A description of the procedures, benefits and risks | ||||||
15 | of home births, including those conditions that may arise | ||||||
16 | during delivery. | ||||||
17 | (8) That there are conditions that are outside of the | ||||||
18 | scope of practice of a licensed certified professional | ||||||
19 | midwife that will result in a referral for a consultation | ||||||
20 | from, or transfer of care to, a health care practitioner. | ||||||
21 | (9) That there may be benefits to pre-registration at | ||||||
22 | the nearest hospital. | ||||||
23 | (10) The specific arrangements for the referral of | ||||||
24 | complications to a health care practitioner for | ||||||
25 | consultation. The licensed certified professional midwife | ||||||
26 | shall not be required to identify a specific health care |
| |||||||
| |||||||
1 | practitioner. | ||||||
2 | (11) Instructions for filing a complaint with the | ||||||
3 | Department. | ||||||
4 | (12) That if, during the course of care, the client is | ||||||
5 | informed that she has or may have a condition indicating | ||||||
6 | the need for a mandatory transfer, the licensed certified | ||||||
7 | professional midwife shall initiate the transfer. | ||||||
8 | (13) A written protocol for the handling of both | ||||||
9 | patient's and newborn's medical emergencies, including | ||||||
10 | transportation to a hospital, particular to each client, | ||||||
11 | complete with identification of the appropriate hospital, | ||||||
12 | and the estimated travel time to the hospital. A verbal | ||||||
13 | report of the care provided must be provided to emergency | ||||||
14 | services providers and a copy of the client records shall | ||||||
15 | be sent with the client at the time of any transfer to a | ||||||
16 | hospital. | ||||||
17 | (b) A copy of the informed consent document, signed and | ||||||
18 | dated by the patient, must be kept in each patient's chart. All | ||||||
19 | patients' charts and records of services provided shall be | ||||||
20 | maintained for a minimum of 10 years after the last patient | ||||||
21 | visit. | ||||||
22 | Section 55. Midwife requirements. A licensed certified | ||||||
23 | professional midwife shall do all of the following: | ||||||
24 | (a) Prior to labor, develop a written plan of care specific | ||||||
25 | to the patient, including specific risk factors pertaining to |
| |||||||
| |||||||
1 | the individual health and circumstances of the patient, to | ||||||
2 | ensure continuity of antepartum, intra-partum, and postpartum | ||||||
3 | care. The plan shall include: | ||||||
4 | (1) twenty-four hour, on-call availability by a | ||||||
5 | licensed certified professional midwife, advanced practice | ||||||
6 | nurse who is a certified nurse midwife, or licensed | ||||||
7 | physician throughout pregnancy, intra-partum, and 6 weeks | ||||||
8 | postpartum; | ||||||
9 | (2) appropriate screening and testing, including | ||||||
10 | laboratory tests, urinalysis, and ultrasound; and | ||||||
11 | (3) labor support, fetal monitoring, and routine | ||||||
12 | assessment of vital signs once active labor is established. | ||||||
13 | (b) Perform emergency procedures including: administering | ||||||
14 | approved medications; administering intravenous fluids for | ||||||
15 | stabilization; performing an emergency episiotomy; providing | ||||||
16 | care while on the way to a hospital under circumstances in | ||||||
17 | which emergency medical services have not been activated; and | ||||||
18 | activating emergency medical services for an emergency. | ||||||
19 | (c) Supervise delivery of infant and placenta, assess | ||||||
20 | newborn and maternal well-being in immediate postpartum, and | ||||||
21 | perform Apgar tests. | ||||||
22 | (d) Provide immediate care at birth, including | ||||||
23 | resuscitating as needed, performing a newborn examination, and | ||||||
24 | administering intramuscular vitamin K and eye ointment for the | ||||||
25 | prevention of blindness. | ||||||
26 | (e) Perform routine cord management and inspect for the |
| |||||||
| |||||||
1 | appropriate number of vessels. | ||||||
2 | (f) Inspect the placenta and membranes for completeness. | ||||||
3 | (g) Inspect the perineum and vagina postpartum for | ||||||
4 | lacerations and stabilize suturing of first and second degree | ||||||
5 | perineal or labial lacerations or suturing of an episiotomy | ||||||
6 | with administration of a local anesthetic. | ||||||
7 | (h) Observe mother and newborn postpartum until stable | ||||||
8 | condition is achieved, but in no event for less than 2 hours to | ||||||
9 | assess for hemorrhage, preeclampsia, thromboembolism, | ||||||
10 | infection, and emotional well-being. | ||||||
11 | (i) Instruct the mother, father, and other support persons, | ||||||
12 | both verbally and in writing, of the special care and | ||||||
13 | precautions for both mother and newborn in the immediate | ||||||
14 | postpartum period. | ||||||
15 | (j) Reevaluate maternal and newborn well-being within 36 | ||||||
16 | hours of delivery. | ||||||
17 | (k) Use universal precautions with all biohazard | ||||||
18 | materials. | ||||||
19 | (l) Ensure that a birth certificate is accurately completed | ||||||
20 | and filed in accordance with State law. | ||||||
21 | (m) Within 24 hours after delivery, notify a pediatric | ||||||
22 | health care professional of the delivery including | ||||||
23 | transferring health records to the pediatric health | ||||||
24 | practitioner documenting performance of the required newborn | ||||||
25 | screenings. | ||||||
26 | (n) Within 24 to 36 hours after delivery, submit a blood |
| |||||||
| |||||||
1 | sample in accordance with metabolic screening requirements for | ||||||
2 | newborns. | ||||||
3 | (o) Within one week after delivery, perform newborn weight | ||||||
4 | checks and general observation of the newborn's activities with | ||||||
5 | abnormal findings communicated to the newborn's pediatric | ||||||
6 | health care practitioner, assessment of newborn feeding and | ||||||
7 | hydration, offer a newborn hearing screening to every newborn | ||||||
8 | or refer the parents to a facility with a newborn hearing | ||||||
9 | screening program. | ||||||
10 | (p) Provide services to the patient after the post-partum | ||||||
11 | period limited to breastfeeding support and counseling and | ||||||
12 | counseling and referral for family planning. | ||||||
13 | (q) Maintain adequate antenatal and perinatal records of | ||||||
14 | each client and provide records to consulting licensed | ||||||
15 | physicians and advanced practice nurses who are certified nurse | ||||||
16 | midwives in accordance with federal Health Insurance | ||||||
17 | Portability and Accountability Act regulations and State law. | ||||||
18 | Section 60. Administration of drugs. | ||||||
19 | (a) A licensed certified professional midwife may | ||||||
20 | administer the following agents during the practice of | ||||||
21 | midwifery: | ||||||
22 | (1) oxygen for the treatment of fetal distress; | ||||||
23 | (2) eye prophylactics - 0.5% erythromycin ophthalmic | ||||||
24 | ointment for the prevention of neonatal ophthalmia; | ||||||
25 | (3) oxytocin (Pitocin) as a postpartum antihemorrhagic |
| |||||||
| |||||||
1 | agent or as prophylaxis for hemorrhage; | ||||||
2 | (4) Methyl-ergonovine or Methergine for the treatment | ||||||
3 | of postpartum hemorrhage; | ||||||
4 | (5) Misoprostol (Cytotec) for the treatment of | ||||||
5 | postpartum hemorrhage; | ||||||
6 | (6) Vitamin K for the prophylaxis for hemorrhagic | ||||||
7 | disease of the newborn; | ||||||
8 | (7) RHo(D) immune globulin for the prevention for | ||||||
9 | RHo(D) sensitization in RHo(D) negative women; | ||||||
10 | (8) intravenous fluids for maternal stabilization, | ||||||
11 | including lactated Ringer's solution, or with 5% dextrose | ||||||
12 | (D5LR), unless unavailable or impractical, in which case | ||||||
13 | 0.9% sodium chloride may be administered; | ||||||
14 | (9) Lidocaine injection as a local anesthetic for | ||||||
15 | perineal repair; | ||||||
16 | (10) sterile water subcutaneous injections as a | ||||||
17 | non-pharmacological form of pain relief during the first | ||||||
18 | and second stages of labor; and | ||||||
19 | (11) ibuprofen for postpartum pain relief. | ||||||
20 | (b) The medication indications, dose, route of | ||||||
21 | administration, and duration of treatment relating to the | ||||||
22 | administration of drugs and procedures identified under this | ||||||
23 | Section shall be determined by rule as the Department deems | ||||||
24 | necessary to be in keeping with current evidence-based practice | ||||||
25 | standards. The Department may approve additional medications, | ||||||
26 | agents, or procedures based upon updated evidence-based |
| |||||||
| |||||||
1 | obstetrical guidelines or based upon limited availability of | ||||||
2 | standard medications or agents. | ||||||
3 | (c) A licensed certified professional midwife shall not | ||||||
4 | administer Schedule II-V drugs. | ||||||
5 | Section 65. Consultation, referral, and transfer. | ||||||
6 | (a) A licensed certified professional midwife shall | ||||||
7 | consult with a licensed physician concentrating in obstetrics, | ||||||
8 | a licensed physician concentrating in a family practice who | ||||||
9 | performs deliveries, or an advanced practice nurse who is a | ||||||
10 | certified nurse midwife providing obstetrical care whenever | ||||||
11 | there are significant deviations, including abnormal | ||||||
12 | laboratory results, relative to a patient's pregnancy or to a | ||||||
13 | neonate. If a referral to a physician or advanced practice | ||||||
14 | nurse who is a certified midwife is needed, the licensed | ||||||
15 | certified professional midwife shall refer the patient to a | ||||||
16 | physician concentrating in obstetrics or to a physician | ||||||
17 | concentrating in family practice who performs deliveries, and, | ||||||
18 | if possible, remain in consultation with the physician or nurse | ||||||
19 | until resolution of the concern. Consultation does not preclude | ||||||
20 | the possibility of an out-of-hospital birth. It is appropriate | ||||||
21 | for the licensed certified professional midwife to maintain | ||||||
22 | care of the patient to the greatest degree possible, in | ||||||
23 | accordance with the patient's wishes, during the pregnancy and, | ||||||
24 | if possible, during labor, birth, and the postpartum period. | ||||||
25 | (b) The midwife shall document during prenatal care the |
| |||||||
| |||||||
1 | health care practitioner the parents have chosen to provide | ||||||
2 | pediatric care for the newborn in the weeks immediately | ||||||
3 | following the birth. If no pediatric health care practitioner | ||||||
4 | has been chosen by 36 weeks of pregnancy, the licensed | ||||||
5 | certified professional midwife shall provide a referral. | ||||||
6 | (c) A licensed certified professional midwife shall | ||||||
7 | consult with a licensed physician concentrating in obstetrics, | ||||||
8 | a licensed physician concentrating in family practice who | ||||||
9 | performs deliveries, or an advanced practice nurse who is a | ||||||
10 | certified nurse midwife with regard to any patient who presents | ||||||
11 | with or develops the following risk factors, or presents with | ||||||
12 | or develops other risk factors that, in the judgment of the | ||||||
13 | licensed certified professional midwife, warrant consultation: | ||||||
14 | (1) Antepartum. | ||||||
15 | (A) Pregnancy-induced hypertension, as evidenced | ||||||
16 | by a blood pressure of 140/90 on 2 occasions greater | ||||||
17 | than 6 hours apart. | ||||||
18 | (B) Persistent, severe headaches, epigastric pain, | ||||||
19 | or visual disturbances. | ||||||
20 | (C) Persistent symptoms of urinary tract | ||||||
21 | infection. | ||||||
22 | (D) Significant vaginal bleeding before the onset | ||||||
23 | of labor not associated with uncomplicated spontaneous | ||||||
24 | abortion. | ||||||
25 | (E) Rupture of membranes prior to the 37th week of | ||||||
26 | gestation. |
| |||||||
| |||||||
1 | (F) Noted abnormal decrease in or cessation of | ||||||
2 | fetal movement. | ||||||
3 | (G) Anemia resistant to supplemental therapy. | ||||||
4 | (H) Fever of 102 degrees Fahrenheit or 39 degrees | ||||||
5 | Celsius or greater for more than 24 hours. | ||||||
6 | (I) Non-vertex presentation after 36 weeks | ||||||
7 | gestation. | ||||||
8 | (J) Hyperemesis or significant dehydration. | ||||||
9 | (K) Isoimmunization, Rh-negative sensitized, | ||||||
10 | positive titers, or any other positive antibody titer, | ||||||
11 | which may have a detrimental effect on mother or fetus. | ||||||
12 | (L) Elevated blood glucose levels unresponsive to | ||||||
13 | dietary management. | ||||||
14 | (M) Positive HIV antibody test. | ||||||
15 | (N) Primary genital herpes infection in pregnancy | ||||||
16 | or active recurrent herpes infection within 2 weeks of | ||||||
17 | labor. | ||||||
18 | (O) Symptoms of malnutrition or anorexia or | ||||||
19 | protracted weight loss or failure to gain weight. | ||||||
20 | (P) Suspected deep vein thrombosis. | ||||||
21 | (Q) Documented placental anomaly or previa. | ||||||
22 | (R) Labor prior to the 37th week of gestation. | ||||||
23 | (S) Lie other than vertex at term. | ||||||
24 | (T) Known fetal anomalies that may be affected by | ||||||
25 | the site of birth. | ||||||
26 | (U) Marked abnormal fetal heart tones. |
| |||||||
| |||||||
1 | (V) Abnormal non-stress test or abnormal | ||||||
2 | biophysical profile. | ||||||
3 | (W) Marked or severe polyhydramnios or | ||||||
4 | oligohydramnios. | ||||||
5 | (X) Evidence of intrauterine growth restriction. | ||||||
6 | (Y) Significant abnormal ultrasound findings. | ||||||
7 | (Z) Gestation beyond 42 weeks by reliable | ||||||
8 | confirmed dates. | ||||||
9 | (AA) Controlled hypothyroidism, being treated with | ||||||
10 | thyroid replacement and euthyroid, and with thyroid | ||||||
11 | test numbers in the normal range. | ||||||
12 | (BB) Previous obstetrical problems, including | ||||||
13 | uterine abnormalities, placental abruption, placenta | ||||||
14 | accreta, obstetric hemorrhage, incompetent cervix, or | ||||||
15 | preterm delivery for any reason. | ||||||
16 | (CC) Unforeseen multifetal gestation. | ||||||
17 | (2) Intra-partum. | ||||||
18 | (A) Rise in blood pressure above baseline, more | ||||||
19 | than 30/15 points or greater than 140/90. | ||||||
20 | (B) Persistent, severe headaches, epigastric pain, | ||||||
21 | or visual disturbances. | ||||||
22 | (C) Significant proteinuria or ketonuria. | ||||||
23 | (D) Fever over 100.6 degrees Fahrenheit or 38 | ||||||
24 | degrees Celsius in absence of environmental factors. | ||||||
25 | (E) Ruptured membranes without onset of | ||||||
26 | established labor after 18 hours. |
| |||||||
| |||||||
1 | (F) Significant bleeding prior to delivery or any | ||||||
2 | abnormal bleeding, with or without abdominal pain, or | ||||||
3 | evidence of placental abruption. | ||||||
4 | (G) Fetal lie not compatible with spontaneous | ||||||
5 | vaginal delivery or unstable fetal lie. | ||||||
6 | (H) Failure to progress after 5 hours of active | ||||||
7 | labor or following 2 hours of active second stage | ||||||
8 | labor. | ||||||
9 | (I) Signs or symptoms of maternal infection. | ||||||
10 | (J) Active genital herpes at onset of labor or | ||||||
11 | within 2 weeks of the onset of labor. | ||||||
12 | (K) Fetal heart tones with non-reassuring | ||||||
13 | patterns. | ||||||
14 | (L) Signs or symptoms of fetal distress. | ||||||
15 | (M) Thick meconium or frank bleeding with birth not | ||||||
16 | imminent. | ||||||
17 | (N) Patient or licensed certified professional | ||||||
18 | midwife desires physician or advanced practice nurse | ||||||
19 | consultation or transfer. | ||||||
20 | (3) Postpartum. | ||||||
21 | (A) Failure to void within 6 hours of birth. | ||||||
22 | (B) Signs or symptoms of maternal shock. | ||||||
23 | (C) Fever of 102 degrees Fahrenheit or 39 degrees | ||||||
24 | Celsius and unresponsive to therapy for 12 hours. | ||||||
25 | (D) Abnormal lochia or signs or symptoms of uterine | ||||||
26 | sepsis. |
| |||||||
| |||||||
1 | (E) Suspected deep vein thrombosis. | ||||||
2 | (F) Signs of clinically significant depression. | ||||||
3 | (G) Retained placenta. | ||||||
4 | (H) Patient with a third or fourth degree | ||||||
5 | laceration or a laceration beyond the licensed | ||||||
6 | certified professional midwife's ability to repair. | ||||||
7 | (d) A licensed certified professional midwife shall | ||||||
8 | consult with a licensed physician with a concentration in | ||||||
9 | obstetrics, a licensed physician with a concentration in | ||||||
10 | pediatrics, a licensed physician with a concentration in family | ||||||
11 | practice who performs deliveries, or an advanced practice nurse | ||||||
12 | who is a certified nurse midwife with regard to any neonate who | ||||||
13 | is born with or develops the following risk factors: | ||||||
14 | (1) Apgar score of 6 or less at 5 minutes without | ||||||
15 | significant improvement by 10 minutes. | ||||||
16 | (2) Persistent grunting respirations or retractions. | ||||||
17 | (3) Persistent cardiac irregularities. | ||||||
18 | (4) Persistent central cyanosis or pallor. | ||||||
19 | (5) Persistent lethargy or poor muscle tone. | ||||||
20 | (6) Abnormal cry. | ||||||
21 | (7) Birth weight less than 2,300 grams. | ||||||
22 | (8) Jitteriness or seizures. | ||||||
23 | (9) Jaundice occurring before 24 hours or outside of | ||||||
24 | normal range. | ||||||
25 | (10) Failure to urinate within 24 hours of birth. | ||||||
26 | (11) Failure to pass meconium within 48 hours of birth. |
| |||||||
| |||||||
1 | (12) Edema. | ||||||
2 | (13) Prolonged temperature instability. | ||||||
3 | (14) Significant signs or symptoms of infection. | ||||||
4 | (15) Significant clinical evidence of glycemic | ||||||
5 | instability. | ||||||
6 | (16) Abnormal, bulging, or depressed fontanel. | ||||||
7 | (17) Significant clinical evidence of prematurity. | ||||||
8 | (18) Medically significant congenital anomalies. | ||||||
9 | (19) Significant or suspected birth injury. | ||||||
10 | (20) Persistent inability to suck. | ||||||
11 | (21) Diminished consciousness. | ||||||
12 | (22) Clinically significant abnormalities in vital | ||||||
13 | signs, muscle tone, or behavior. | ||||||
14 | (23) Clinically significant color abnormality, | ||||||
15 | cyanotic, or pale or abnormal perfusion. | ||||||
16 | (24) Abdominal distension or projectile vomiting. | ||||||
17 | (25) Signs of clinically significant dehydration or | ||||||
18 | failure to thrive. | ||||||
19 | Section 70. Transfer. | ||||||
20 | (a) Transport via private vehicle is an acceptable method | ||||||
21 | of transport if it is the most expedient and safest method for | ||||||
22 | accessing medical services. The licensed certified | ||||||
23 | professional midwife shall initiate immediate transport | ||||||
24 | according to the licensed certified professional midwife's | ||||||
25 | emergency plan, provide emergency stabilization until |
| |||||||
| |||||||
1 | emergency medical services arrive or transfer is completed, | ||||||
2 | accompany the patient or follow the patient to a hospital in a | ||||||
3 | timely fashion, provide pertinent information to the receiving | ||||||
4 | facility, and complete an emergency transport record. The | ||||||
5 | following conditions shall require immediate physician or | ||||||
6 | advanced practice nurse notification and emergency transfer to | ||||||
7 | a hospital: | ||||||
8 | (1) Seizures or unconsciousness. | ||||||
9 | (2) Respiratory distress or arrest. | ||||||
10 | (3) Evidence of shock. | ||||||
11 | (4) Psychosis. | ||||||
12 | (5) Symptomatic chest pain or cardiac arrhythmias. | ||||||
13 | (6) Prolapsed umbilical cord. | ||||||
14 | (7) Shoulder dystocia not resolved by Advanced Life | ||||||
15 | Support in Obstetrics (ALSO) protocol. | ||||||
16 | (8) Symptoms of uterine rupture. | ||||||
17 | (9) Preeclampsia or eclampsia. | ||||||
18 | (10) Severe abdominal pain inconsistent with normal | ||||||
19 | labor. | ||||||
20 | (11) Chorioamnionitis. | ||||||
21 | (12) Clinically significant fetal heart rate patterns | ||||||
22 | or other manifestation of fetal distress. | ||||||
23 | (13) Presentation not compatible with spontaneous | ||||||
24 | vaginal delivery. | ||||||
25 | (14) Laceration greater than second degree perineal or | ||||||
26 | any cervical. |
| |||||||
| |||||||
1 | (15) Hemorrhage non-responsive to therapy. | ||||||
2 | (16) Uterine prolapse or inversion. | ||||||
3 | (17) Persistent uterine atony. | ||||||
4 | (18) Anaphylaxis. | ||||||
5 | (19) Failure to deliver placenta after one hour if | ||||||
6 | there is no bleeding or fundus is firm. | ||||||
7 | (20) Sustained instability or persistent abnormal | ||||||
8 | vital signs. | ||||||
9 | (21) Other conditions or symptoms that could threaten | ||||||
10 | the life of the mother, fetus, or neonate. | ||||||
11 | (b) If birth is imminent and the patient refuses to be | ||||||
12 | transferred after the licensed certified professional midwife | ||||||
13 | determines that a transfer is necessary, the licensed certified | ||||||
14 | professional midwife shall: | ||||||
15 | (1) call 9-1-1 and remain with the patient until | ||||||
16 | emergency services personnel arrive; and | ||||||
17 | (2) transfer care and give a verbal report of the care | ||||||
18 | provided to the emergency medical services providers. | ||||||
19 | (c) For each patient who is transported under this section, | ||||||
20 | the licensed certified professional midwife shall complete a | ||||||
21 | standard transport reporting form and submit the completed form | ||||||
22 | to the Department. | ||||||
23 | (d) The Board shall develop and recommend to the Department | ||||||
24 | for adoption in the rules implementing this Act a planned | ||||||
25 | out-of-hospital birth transport protocol. |
| |||||||
| |||||||
1 | Section 75. Annual reports. | ||||||
2 | (a) A licensed certified professional midwife shall | ||||||
3 | annually report to the Department by no later than March 31st | ||||||
4 | of each year beginning in 2020, in a form specified by the | ||||||
5 | Department, the following information regarding cases in which | ||||||
6 | the licensed certified professional midwife assisted during | ||||||
7 | the previous calendar year when the intended place of birth at | ||||||
8 | the onset of care was an out-of-hospital setting: | ||||||
9 | (1) the total number of patients served at the onset of | ||||||
10 | care; | ||||||
11 | (2) the number, by county, of live births attended; | ||||||
12 | (3) the number, by county, of cases of fetal demise, | ||||||
13 | infant deaths, and maternal deaths attended at the | ||||||
14 | discovery of the demise or death; | ||||||
15 | (4) the number of women whose care was transferred to | ||||||
16 | another health care practitioner during the antepartum | ||||||
17 | period and the reason for transfer; | ||||||
18 | (5) the number, reason for, and outcome of each | ||||||
19 | nonemergency hospital transfer during the intra-partum or | ||||||
20 | postpartum period; | ||||||
21 | (6) the number, reason for, and outcome of each urgent | ||||||
22 | or emergency transport of an expectant mother in the | ||||||
23 | antepartum period; | ||||||
24 | (7) the number, reason for, and outcome of each urgent | ||||||
25 | or emergency transport of an infant or mother during the | ||||||
26 | intra-partum or immediate postpartum period; |
| |||||||
| |||||||
1 | (8) the number of planned out-of-hospital births at the | ||||||
2 | onset of labor and the number of births completed in an | ||||||
3 | out-of-hospital setting; | ||||||
4 | (9) a brief description of any complications resulting | ||||||
5 | in the morbidity or mortality of a mother or a neonate; and | ||||||
6 | (10) any other information required by rule by the | ||||||
7 | Department. | ||||||
8 | (b) The Department shall send a written notice of | ||||||
9 | noncompliance to each licensee who fails to meet the reporting | ||||||
10 | requirements under subsection (a) of this Section. | ||||||
11 | (c) A licensed certified professional midwife who fails to | ||||||
12 | comply with the reporting requirements under this Section shall | ||||||
13 | be prohibited from license renewal until the information | ||||||
14 | required under subsection (a) of this Section is reported. | ||||||
15 | (d) The Committee shall maintain the confidentiality of any | ||||||
16 | report under subsection (f) of this Section. | ||||||
17 | (e) Notwithstanding any other provision of law, a licensed | ||||||
18 | certified professional midwife shall be subject to the same | ||||||
19 | reporting requirements as other health care practitioners who | ||||||
20 | provide care to individuals. | ||||||
21 | (f) All reports required shall be submitted to the | ||||||
22 | Department in a timely fashion. Unless otherwise provided in | ||||||
23 | this Section, the reports shall be filed in writing within 60 | ||||||
24 | days after a determination that a report is required under this | ||||||
25 | Act. | ||||||
26 | The Department may also exercise the power under Section |
| |||||||
| |||||||
1 | 165 of this Act to subpoena copies of hospital or medical | ||||||
2 | records in cases concerning death or permanent bodily injury. | ||||||
3 | Rules shall be adopted by the Department to implement this | ||||||
4 | Section. | ||||||
5 | Nothing contained in this Section shall act to in any way | ||||||
6 | waive or modify the confidentiality of reports and committee | ||||||
7 | reports to the extent provided by law. Any information reported | ||||||
8 | or disclosed shall be kept for the confidential use of the | ||||||
9 | Department, its attorneys, the investigative staff, and | ||||||
10 | authorized clerical staff, as provided in this Act, and shall | ||||||
11 | be afforded the same status as is provided information | ||||||
12 | concerning medical studies in Part 21 of Article VIII of the | ||||||
13 | Code of Civil Procedure, except that the Department may | ||||||
14 | disclose information and documents to a federal, state, or | ||||||
15 | local law enforcement agency pursuant to a subpoena in an | ||||||
16 | ongoing criminal investigation or to a health care licensing | ||||||
17 | body or midwifery licensing authority of another state or | ||||||
18 | jurisdiction pursuant to an official request made by that | ||||||
19 | licensing body or authority. Furthermore, information and | ||||||
20 | documents disclosed to a federal, state, or local law | ||||||
21 | enforcement agency may be used by that agency only for the | ||||||
22 | investigation and prosecution of a criminal offense, or, in the | ||||||
23 | case of disclosure to a health care licensing body or medical | ||||||
24 | licensing authority, only for investigations and disciplinary | ||||||
25 | action proceedings with regard to a license. Information and | ||||||
26 | documents disclosed to the Department of Public Health may be |
| |||||||
| |||||||
1 | used by that Department only for investigation and disciplinary | ||||||
2 | action regarding the license of a health care institution | ||||||
3 | licensed by the Department of Public Health. | ||||||
4 | Section 80. Illinois Certified Professional Midwifery | ||||||
5 | Board. | ||||||
6 | (a) There is created under the authority of the Department | ||||||
7 | the Illinois Certified Professional Midwifery Board, which | ||||||
8 | shall consist of the following 9 members appointed by the | ||||||
9 | Secretary: | ||||||
10 | Three of whom shall be licensed certified professional | ||||||
11 | midwives who currently practice midwifery; except that the | ||||||
12 | initial appointees shall be Certified Professional | ||||||
13 | Midwives who have at least 3 years of experience in the | ||||||
14 | practice of midwifery in an out-of-hospital setting, and | ||||||
15 | otherwise meet the qualifications for licensure set forth | ||||||
16 | in this Act. | ||||||
17 | One of whom shall be a licensed physician concentrating | ||||||
18 | in obstetrics. | ||||||
19 | One of whom shall be a licensed physician concentrating | ||||||
20 | in a family practice who performs deliveries. | ||||||
21 | One of whom shall be a licensed physician who | ||||||
22 | concentrates in pediatrics. | ||||||
23 | Two of whom shall be advanced practice nurses who are | ||||||
24 | certified nurse midwives. | ||||||
25 | One of whom shall be a knowledgeable public member who |
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1 | has given birth with the assistance of a licensed certified | ||||||
2 | professional midwife or a Certified Professional Midwife | ||||||
3 | in an out-of-hospital birth setting. | ||||||
4 | Board members shall serve 4-year terms, except that in the | ||||||
5 | case of initial appointments, terms shall be staggered as | ||||||
6 | follows: 4 members shall serve for 4 years, and 5 members shall | ||||||
7 | serve for 2 years. The Board shall annually elect a chairperson | ||||||
8 | and vice chairperson. | ||||||
9 | (b) Any appointment made to fill a vacancy shall be for the | ||||||
10 | unexpired portion of the term. Appointments to fill vacancies | ||||||
11 | shall be made in the same manner as original appointments. No | ||||||
12 | Board member may be reappointed for a term that would cause his | ||||||
13 | or her continuous service on the Board to exceed 9 years. | ||||||
14 | (c) Board membership must have reasonable representation | ||||||
15 | from different geographic areas of this State. | ||||||
16 | (d) The members of the Board shall serve without | ||||||
17 | compensation but may be reimbursed for all legitimate, | ||||||
18 | necessary, and authorized expenses incurred in attending the | ||||||
19 | meetings of the Board if funds are available for such purposes. | ||||||
20 | (e) The Secretary may remove any member of the Board for | ||||||
21 | misconduct, incapacity, or neglect of duty at any time prior to | ||||||
22 | the expiration of his or her term. | ||||||
23 | (f) Five Board members shall constitute a quorum. A vacancy | ||||||
24 | in the membership of the Board shall not impair the right of a | ||||||
25 | quorum to perform all of the duties of the Board. | ||||||
26 | (g) The Board shall provide the Department with |
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| |||||||
1 | recommendations concerning the administration of this Act and | ||||||
2 | may perform each of the following duties: | ||||||
3 | (1) Recommend to the Department from time to time | ||||||
4 | revisions to any rules that may be necessary to carry out | ||||||
5 | the provisions of this Act, including those that are | ||||||
6 | designed to protect the health, safety, and welfare of the | ||||||
7 | public. | ||||||
8 | (2) Conduct hearings and disciplinary conferences on | ||||||
9 | disciplinary charges of licensees. | ||||||
10 | (3) Report to the Department, upon completion of a | ||||||
11 | hearing, the disciplinary actions recommended to be taken | ||||||
12 | against a person found in violation of this Act. | ||||||
13 | (4) Recommend the approval, denial of approval, or | ||||||
14 | withdrawal of approval of required education and | ||||||
15 | continuing educational programs. | ||||||
16 | (h) The Secretary shall give due consideration to all | ||||||
17 | recommendations of the Board. If the Secretary takes action | ||||||
18 | contrary to a recommendation of the Board, the Secretary must | ||||||
19 | promptly provide a written explanation of that action. | ||||||
20 | (i) The Board may recommend to the Secretary that one or | ||||||
21 | more licensed certified professional midwives be selected by | ||||||
22 | the Secretary to assist in any investigation under this Act. | ||||||
23 | Travel expenses shall be provided to any licensee who provides | ||||||
24 | assistance under this subsection (i), in an amount determined | ||||||
25 | by the Secretary, if funds are available for such purposes. | ||||||
26 | (j) Members of the Board shall be immune from suit in an |
| |||||||
| |||||||
1 | action based upon a disciplinary proceeding or other activity | ||||||
2 | performed in good faith as a member of the Board, except for | ||||||
3 | willful or wanton misconduct. | ||||||
4 | (k) Members of the Board may participate in and act at any | ||||||
5 | meeting of the Illinois Midwifery Board through the use of any | ||||||
6 | real-time Internet or telephone communication media, by means | ||||||
7 | of which all persons participating in the meeting can | ||||||
8 | communicate with each other. Participation in such meeting | ||||||
9 | shall constitute attendance and presence in person at the | ||||||
10 | meeting of the person or persons so participating. | ||||||
11 | Section 85. Continuing education for certified | ||||||
12 | professional midwife licensees. | ||||||
13 | The Department shall adopt rules of continuing education | ||||||
14 | for licensed certified professional midwives that require a | ||||||
15 | total of 24 hours of continuing education per 2-year license | ||||||
16 | renewal cycle. Four hours of continuing education shall consist | ||||||
17 | of successful completion of peer review in accordance with NARM | ||||||
18 | standards for official peer review. The rules shall address | ||||||
19 | variances in part or in whole for good cause, including without | ||||||
20 | limitation illness or hardship. The continuing education rules | ||||||
21 | must ensure that licensees are given the opportunity to | ||||||
22 | participate in programs sponsored by or through their State or | ||||||
23 | national professional associations, hospitals, or other | ||||||
24 | providers of continuing education. Each licensee is | ||||||
25 | responsible for maintaining records of completion of |
| |||||||
| |||||||
1 | continuing education and shall produce the records when | ||||||
2 | requested by the Department. | ||||||
3 | Section 90. Vicarious liability. | ||||||
4 | (a) No physician, advanced practice nurse, nurse, | ||||||
5 | hospital, emergency room personnel, emergency medical | ||||||
6 | technician, or ambulance personnel shall be liable in any civil | ||||||
7 | action arising out of any injury resulting from an act or | ||||||
8 | omission of a licensed certified professional midwife, even if | ||||||
9 | the health care practitioner has consulted with or accepted a | ||||||
10 | referral from the licensed certified professional midwife. A | ||||||
11 | physician or advanced practice nurse who consults with a | ||||||
12 | licensed certified professional midwife but who does not | ||||||
13 | examine or treat a client of the licensed certified | ||||||
14 | professional midwife shall not be deemed to have created a | ||||||
15 | physician-patient or advanced practice nurse-patient | ||||||
16 | relationship with such client. | ||||||
17 | (b) Consultation with a physician or advanced practice | ||||||
18 | nurse does not alone create a physician-patient or advanced | ||||||
19 | practice nurse-patient relationship or any other relationship | ||||||
20 | with the physician or advanced practice nurse. The informed | ||||||
21 | consent shall specifically state that the licensed certified | ||||||
22 | professional midwife and any consulting physician or advanced | ||||||
23 | practice nurse are not employees, partners, associates, | ||||||
24 | agents, or principals of one another. The licensed certified | ||||||
25 | professional midwife shall inform the patient that he or she is |
| |||||||
| |||||||
1 | independently licensed and practicing midwifery and in that | ||||||
2 | regard is solely responsible for the services he or she | ||||||
3 | provides. | ||||||
4 | Section 95. Advertising. | ||||||
5 | (a) Any person licensed under this Act may advertise the | ||||||
6 | availability of midwifery services in the public media or on | ||||||
7 | premises where services are rendered, if the advertising is | ||||||
8 | truthful and not misleading and is in conformity with any rules | ||||||
9 | regarding the practice of a licensed certified professional | ||||||
10 | midwife. | ||||||
11 | (b) A licensee must include in every advertisement for | ||||||
12 | midwifery services regulated under this Act his or her title as | ||||||
13 | it appears on the license or the initials authorized under this | ||||||
14 | Act. | ||||||
15 | Section 100. Social Security Number on application. In | ||||||
16 | addition to any other information required to be contained in | ||||||
17 | the application, every application for an original, renewal, | ||||||
18 | reinstated, or restored license under this Act shall include | ||||||
19 | the applicant's Social Security Number. | ||||||
20 | Section 105. Renewal of licensure. | ||||||
21 | (a) Licensed certified professional midwives shall renew | ||||||
22 | their license biannually at the discretion of the Department. | ||||||
23 | (b) Rules adopted under this Act shall require the licensed |
| |||||||
| |||||||
1 | certified professional midwife to maintain CPM certification | ||||||
2 | by meeting all the continuing education requirements and other | ||||||
3 | requirements set forth by the North American Registry of | ||||||
4 | Midwives. | ||||||
5 | Section 110. Inactive status. | ||||||
6 | (a) A licensed certified professional midwife who notifies | ||||||
7 | the Department in writing on forms prescribed by the Department | ||||||
8 | may elect to place his or her license on an inactive status and | ||||||
9 | shall be excused from payment of renewal fees until he or she | ||||||
10 | notifies the Department in writing of his or her intent to | ||||||
11 | restore the license. | ||||||
12 | (b) A licensed certified professional midwife whose | ||||||
13 | license is on inactive status may not practice licensed | ||||||
14 | certified professional midwifery in the State of Illinois. | ||||||
15 | (c) A licensed certified professional midwife requesting | ||||||
16 | restoration from inactive status shall be required to pay the | ||||||
17 | current renewal fee and to restore his or her license, as | ||||||
18 | provided by the Department. | ||||||
19 | (d) Any licensee who engages in the practice of midwifery | ||||||
20 | while his or her license is lapsed or on inactive status shall | ||||||
21 | be considered to be practicing without a license, which shall | ||||||
22 | be grounds for discipline. | ||||||
23 | Section 115. Renewal, reinstatement, or restoration of | ||||||
24 | licensure; military service. |
| |||||||
| |||||||
1 | (a) The expiration date and renewal period for each license | ||||||
2 | issued under this Act shall be set by the Department. | ||||||
3 | (b) All renewal applicants shall provide proof of having | ||||||
4 | maintained CPM certification by meeting continuing education | ||||||
5 | requirements and other requirements set forth by the North | ||||||
6 | American Registry of Midwives and current CPR certification | ||||||
7 | required under Section 30. | ||||||
8 | (c) Any licensed certified professional midwife who has | ||||||
9 | permitted his or her license to expire or who has had his or | ||||||
10 | her license on inactive status may have his or her license | ||||||
11 | restored by making application to the Department and filing | ||||||
12 | proof acceptable to the Department of fitness to have the | ||||||
13 | license restored and by paying the required fees. Proof of | ||||||
14 | fitness may include evidence attesting to active lawful | ||||||
15 | practice in another jurisdiction. | ||||||
16 | (d) The Department shall determine, by an evaluation | ||||||
17 | program, fitness for restoration of a license under this | ||||||
18 | Section and shall establish procedures and requirements for | ||||||
19 | restoration. | ||||||
20 | (e) Any licensed certified professional midwife whose | ||||||
21 | license expired while he or she was (i) in federal service on | ||||||
22 | active duty with the Armed Forces of the United States or the | ||||||
23 | State Militia and called into service or training or (ii) | ||||||
24 | received education under the supervision of the United States | ||||||
25 | preliminary to induction into the military service may have his | ||||||
26 | or her license restored without paying any lapsed renewal fees, |
| |||||||
| |||||||
1 | if, within 2 years after honorable termination of service, | ||||||
2 | training, or education, he or she furnishes the Department with | ||||||
3 | satisfactory evidence to the effect that he or she has been so | ||||||
4 | engaged. | ||||||
5 | Section 120. Roster. The Department shall maintain a roster | ||||||
6 | of the names and addresses of all licensees and of all persons | ||||||
7 | whose licenses have been suspended or revoked. This roster | ||||||
8 | shall be available upon written request and payment of the | ||||||
9 | required fee. | ||||||
10 | Section 125. Fees. | ||||||
11 | (a) The Department shall provide for a schedule of fees for | ||||||
12 | the administration and enforcement of this Act, including | ||||||
13 | without limitation original licensure, renewal, and | ||||||
14 | restoration, which fees shall be nonrefundable. | ||||||
15 | (b) All fees collected under this Act shall be deposited | ||||||
16 | into the General Professions Dedicated Fund and appropriated to | ||||||
17 | the Department for the ordinary and contingent expenses of the | ||||||
18 | Department in the administration of this Act. | ||||||
19 | Section 130. Returned checks; fines. Any person who | ||||||
20 | delivers a check or other payment to the Department that is | ||||||
21 | returned to the Department unpaid by the financial institution | ||||||
22 | upon which it is drawn shall pay to the Department, in addition | ||||||
23 | to the amount already owed to the Department, a fine of $50. |
| |||||||
| |||||||
1 | The fines imposed by this Section are in addition to any other | ||||||
2 | discipline provided under this Act for unlicensed practice or | ||||||
3 | practice on a non-renewed license. The Department shall notify | ||||||
4 | the person that fees and fines shall be paid to the Department | ||||||
5 | by certified check or money order within 30 calendar days after | ||||||
6 | the notification. If, after the expiration of 30 days from the | ||||||
7 | date of the notification, the person has failed to submit the | ||||||
8 | necessary remittance, the Department shall automatically | ||||||
9 | terminate the license or deny the application, without hearing. | ||||||
10 | If, after termination or denial, the person seeks a license, he | ||||||
11 | or she shall apply to the Department for restoration or | ||||||
12 | issuance of the license and pay all fees and fines due to the | ||||||
13 | Department. The Department may establish a fee for the | ||||||
14 | processing of an application for restoration of a license to | ||||||
15 | defray all expenses of processing the application. The | ||||||
16 | Secretary may waive the fines due under this Section in | ||||||
17 | individual cases where the Secretary finds that the fines would | ||||||
18 | be unreasonable or unnecessarily burdensome. | ||||||
19 | Section 135. Unlicensed practice; civil penalty. Any | ||||||
20 | person who practices, offers to practice, attempts to practice, | ||||||
21 | or holds himself or herself out to practice certified | ||||||
22 | professional midwifery or as a midwife without being licensed | ||||||
23 | under this Act shall, in addition to any other penalty provided | ||||||
24 | by law, pay a civil penalty to the Department in an amount not | ||||||
25 | to exceed $5,000 for each offense, as determined by the |
| |||||||
| |||||||
1 | Department. The civil penalty shall be assessed by the | ||||||
2 | Department after a hearing is held in accordance with the | ||||||
3 | provisions set forth in this Act regarding the provision of a | ||||||
4 | hearing for the discipline of a licensee. The civil penalty | ||||||
5 | shall be paid within 60 days after the effective date of the | ||||||
6 | order imposing the civil penalty. The order shall constitute a | ||||||
7 | judgment and may be filed and execution had thereon in the same | ||||||
8 | manner as any judgment from any court of record. The Department | ||||||
9 | may investigate any unlicensed activity. | ||||||
10 | Section 140. Grounds for disciplinary action. | ||||||
11 | (a) The Department may refuse to issue or to renew or may | ||||||
12 | revoke, suspend, place on probation, reprimand, or take other | ||||||
13 | disciplinary action as the Department may deem proper, | ||||||
14 | including fines not to exceed $5,000 for each violation, with | ||||||
15 | regard to any licensee or license for any one or combination of | ||||||
16 | the following causes: | ||||||
17 | (1) Violations of this Act or its rules. | ||||||
18 | (2) Material misstatement in furnishing information to | ||||||
19 | the Department. | ||||||
20 | (3) Conviction of any crime under the laws of any U.S. | ||||||
21 | jurisdiction that is (i) a felony, (ii) a misdemeanor, an | ||||||
22 | essential element of which is dishonesty, or (iii) directly | ||||||
23 | related to the practice of the profession. | ||||||
24 | (4) Making any misrepresentation for the purpose of | ||||||
25 | obtaining a license. |
| |||||||
| |||||||
1 | (5) Professional incompetence or gross negligence. | ||||||
2 | (6) Gross malpractice. | ||||||
3 | (7) Aiding or assisting another person in violating any | ||||||
4 | provision of this Act or its rules. | ||||||
5 | (8) Failing to provide information within 60 days in | ||||||
6 | response to a written request made by the Department. | ||||||
7 | (9) Engaging in dishonorable, unethical, or | ||||||
8 | unprofessional conduct of a character likely to deceive, | ||||||
9 | defraud, or harm the public. | ||||||
10 | (10) Habitual or excessive use or addiction to alcohol, | ||||||
11 | narcotics, stimulants, or any other chemical agent or drug | ||||||
12 | that results in the inability to practice with reasonable | ||||||
13 | judgment, skill, or safety. | ||||||
14 | (11) Discipline by another U.S. jurisdiction or | ||||||
15 | foreign nation if at least one of the grounds for the | ||||||
16 | discipline is the same or substantially equivalent to those | ||||||
17 | set forth in this Act. | ||||||
18 | (12) Directly or indirectly giving to or receiving from | ||||||
19 | any person, firm, corporation, partnership, or association | ||||||
20 | any fee, commission, rebate, or other form of compensation | ||||||
21 | for any professional services not actually or personally | ||||||
22 | rendered. This shall not be deemed to include rent or other | ||||||
23 | remunerations paid to an individual, partnership, or | ||||||
24 | corporation by a licensed certified professional midwife | ||||||
25 | for the lease, rental, or use of space, owned or controlled | ||||||
26 | by the individual, partnership, corporation, or |
| |||||||
| |||||||
1 | association. | ||||||
2 | (13) A finding by the Department that the licensee, | ||||||
3 | after having his or her license placed on probationary | ||||||
4 | status, has violated the terms of probation. | ||||||
5 | (14) Abandonment of a patient. | ||||||
6 | (15) Willfully making or filing false records or | ||||||
7 | reports relating to a licensee's practice, including, but | ||||||
8 | not limited to, false records filed with State agencies or | ||||||
9 | departments. | ||||||
10 | (16) Physical illness or mental illness, including, | ||||||
11 | but not limited to, deterioration through the aging process | ||||||
12 | or loss of motor skill that results in the inability to | ||||||
13 | practice the profession with reasonable judgment, skill, | ||||||
14 | or safety. | ||||||
15 | (17) Failure to provide a patient with a copy of his or | ||||||
16 | her record upon the written request of the patient. | ||||||
17 | (18) Conviction by any court of competent | ||||||
18 | jurisdiction, either within or without this State, of any | ||||||
19 | violation of any law governing the practice of licensed | ||||||
20 | certified professional midwifery or conviction in this or | ||||||
21 | another state of any crime that is a felony under the laws | ||||||
22 | of this State or conviction of a felony in a federal court, | ||||||
23 | if the Department determines, after investigation, that | ||||||
24 | the person has not been sufficiently rehabilitated to | ||||||
25 | warrant the public trust. | ||||||
26 | (19) A finding that licensure has been applied for or |
| |||||||
| |||||||
1 | obtained by fraudulent means. | ||||||
2 | (20) Being named as a perpetrator in an indicated | ||||||
3 | report by the Department of Children and Family Services | ||||||
4 | under the Abused and Neglected Child Reporting Act and upon | ||||||
5 | proof by clear and convincing evidence that the licensee | ||||||
6 | has caused a child to be an abused child or a neglected | ||||||
7 | child, as defined in Section 3 of the Abused and Neglected | ||||||
8 | Child Reporting Act. | ||||||
9 | (21) Practicing or attempting to practice under a name | ||||||
10 | other than the full name shown on a license issued under | ||||||
11 | this Act. | ||||||
12 | (22) Immoral conduct in the commission of any act, such | ||||||
13 | as sexual abuse, sexual misconduct, or sexual | ||||||
14 | exploitation, related to the licensee's practice. | ||||||
15 | (23) Maintaining a professional relationship with any | ||||||
16 | person, firm, or corporation when the licensed certified | ||||||
17 | professional midwife knows or should know that a person, | ||||||
18 | firm, or corporation is violating this Act. | ||||||
19 | (24) Failure to provide satisfactory proof of having | ||||||
20 | participated in approved continuing education programs as | ||||||
21 | determined by the Board and approved by the Secretary. | ||||||
22 | Exceptions for extreme hardships are to be defined by the | ||||||
23 | Department. | ||||||
24 | (b) The Department may refuse to issue or may suspend the | ||||||
25 | license of any person who fails to (i) file a tax return or to | ||||||
26 | pay the tax, penalty, or interest shown in a filed return or |
| |||||||
| |||||||
1 | (ii) pay any final assessment of the tax, penalty, or interest, | ||||||
2 | as required by any tax Act administered by the Illinois | ||||||
3 | Department of Revenue, until the time that the requirements of | ||||||
4 | that tax Act are satisfied. | ||||||
5 | (c) The determination by a circuit court that a licensee is | ||||||
6 | subject to involuntary admission or judicial admission as | ||||||
7 | provided in the Mental Health and Developmental Disabilities | ||||||
8 | Code operates as an automatic suspension. The suspension shall | ||||||
9 | end only upon a finding by a court that the patient is no | ||||||
10 | longer subject to involuntary admission or judicial admission, | ||||||
11 | the issuance of an order so finding and discharging the | ||||||
12 | patient, and the recommendation of the Board to the Secretary | ||||||
13 | that the licensee be allowed to resume his or her practice. | ||||||
14 | (d) In enforcing this Section, the Department, upon a | ||||||
15 | showing of a possible violation, may compel any person licensed | ||||||
16 | to practice under this Act or who has applied for licensure or | ||||||
17 | certification pursuant to this Act to submit to a mental or | ||||||
18 | physical examination, or both, as required by and at the | ||||||
19 | expense of the Department. The examining physicians shall be | ||||||
20 | those specifically designated by the Department. The | ||||||
21 | Department may order an examining physician to present | ||||||
22 | testimony concerning the mental or physical examination of the | ||||||
23 | licensee or applicant. No information shall be excluded by | ||||||
24 | reason of any common law or statutory privilege relating to | ||||||
25 | communications between the licensee or applicant and the | ||||||
26 | examining physician. The person to be examined may have, at his |
| |||||||
| |||||||
1 | or her own expense, another physician of his or her choice | ||||||
2 | present during all aspects of the examination. Failure of any | ||||||
3 | person to submit to a mental or physical examination when | ||||||
4 | directed shall be grounds for suspension of a license until the | ||||||
5 | person submits to the examination if the Department finds, | ||||||
6 | after notice and hearing, that the refusal to submit to the | ||||||
7 | examination was without reasonable cause. | ||||||
8 | If the Department finds an individual unable to practice | ||||||
9 | because of the reasons set forth in this subsection (d), the | ||||||
10 | Department may require that individual to submit to care, | ||||||
11 | counseling, or treatment by physicians approved or designated | ||||||
12 | by the Department, as a condition, term, or restriction for | ||||||
13 | continued, reinstated, or renewed licensure to practice or, in | ||||||
14 | lieu of care, counseling, or treatment, the Department may file | ||||||
15 | a complaint to immediately suspend, revoke, or otherwise | ||||||
16 | discipline the license of the individual. Any person whose | ||||||
17 | license was granted, reinstated, renewed, disciplined, or | ||||||
18 | supervised subject to such terms, conditions, or restrictions | ||||||
19 | and who fails to comply with such terms, conditions, or | ||||||
20 | restrictions shall be referred to the Secretary for a | ||||||
21 | determination as to whether or not the person shall have his or | ||||||
22 | her license suspended immediately, pending a hearing by the | ||||||
23 | Department. | ||||||
24 | In instances in which the Secretary immediately suspends a | ||||||
25 | person's license under this Section, a hearing on that person's | ||||||
26 | license must be convened by the Department within 15 days after |
| |||||||
| |||||||
1 | the suspension and completed without appreciable delay. The | ||||||
2 | Department may review the person's record of treatment and | ||||||
3 | counseling regarding the impairment, to the extent permitted by | ||||||
4 | applicable federal statutes and regulations safeguarding the | ||||||
5 | confidentiality of medical records. | ||||||
6 | A person licensed under this Act and affected under this | ||||||
7 | subsection (d) shall be afforded an opportunity to demonstrate | ||||||
8 | to the Department that he or she can resume practice in | ||||||
9 | compliance with acceptable and prevailing standards under the | ||||||
10 | provisions of his or her license. | ||||||
11 | Section 145. Failure to pay restitution. The Department, | ||||||
12 | without further process or hearing, shall suspend the license | ||||||
13 | or other authorization to practice of any person issued under | ||||||
14 | this Act who has been certified by court order as not having | ||||||
15 | paid restitution to a person under Section 8A-3.5 of the | ||||||
16 | Illinois Public Aid Code, under Section 46-1 of the Criminal | ||||||
17 | Code of 1961, or under Sections 17-8.5 or 17-10.5 of the | ||||||
18 | Criminal Code of 2012. A person whose license or other | ||||||
19 | authorization to practice is suspended under this Section is | ||||||
20 | prohibited from practicing until restitution is paid in full. | ||||||
21 | Section 150. Injunction; cease and desist order. | ||||||
22 | (a) If a person violates any provision of this Act, the | ||||||
23 | Secretary may, in the name of the People of the State of | ||||||
24 | Illinois, through the Attorney General or the State's Attorney |
| |||||||
| |||||||
1 | of any county in which the action is brought, petition for an | ||||||
2 | order enjoining the violation or enforcing compliance with this | ||||||
3 | Act. Upon the filing of a verified petition in court, the court | ||||||
4 | may issue a temporary restraining order, without notice or | ||||||
5 | bond, and may preliminarily and permanently enjoin the | ||||||
6 | violation. If it is established that the person has violated or | ||||||
7 | is violating the injunction, the court may punish the offender | ||||||
8 | for contempt of court. Proceedings under this Section shall be | ||||||
9 | in addition to, and not in lieu of, all other remedies and | ||||||
10 | penalties provided by this Act. | ||||||
11 | (b) If any person practices as a licensed certified | ||||||
12 | professional midwife or holds himself or herself out as a | ||||||
13 | licensed certified professional midwife without being licensed | ||||||
14 | under the provisions of this Act, then any licensed certified | ||||||
15 | professional midwife, any interested party, or any person | ||||||
16 | injured thereby may, in addition to the Secretary, petition for | ||||||
17 | relief as provided in subsection (a) of this Section. | ||||||
18 | (c) Whenever, in the opinion of the Department, any person | ||||||
19 | violates any provision of this Act, the Department may issue a | ||||||
20 | rule to show cause why an order to cease and desist should not | ||||||
21 | be entered against that person. The rule shall clearly set | ||||||
22 | forth the grounds relied upon by the Department and shall | ||||||
23 | provide a period of 7 days after the date of the rule to file an | ||||||
24 | answer to the satisfaction of the Department. Failure to answer | ||||||
25 | to the satisfaction of the Department shall cause an order to | ||||||
26 | cease and desist to be issued immediately. |
| |||||||
| |||||||
1 | Section 155. Violation; criminal penalty. | ||||||
2 | (a) Whoever knowingly practices or offers to practice | ||||||
3 | midwifery in this State without being licensed for that purpose | ||||||
4 | or exempt under this Act shall be guilty of a Class A | ||||||
5 | misdemeanor; and shall be guilty of a Class 4 felony for a | ||||||
6 | second or subsequent violation. | ||||||
7 | (b) Notwithstanding any other provision of this Act, all | ||||||
8 | criminal fines, moneys, or other property collected or received | ||||||
9 | by the Department under this Section or any other State or | ||||||
10 | federal statute, including, but not limited to, property | ||||||
11 | forfeited to the Department under Section 505 of the Illinois | ||||||
12 | Controlled Substances Act or Section 85 of the Methamphetamine | ||||||
13 | Control and Community Protection Act, shall be deposited into | ||||||
14 | the Professional Regulation Evidence Fund. | ||||||
15 | Section 160. Investigation; notice; hearing. The | ||||||
16 | Department may investigate the actions of any applicant or of | ||||||
17 | any person or persons holding or claiming to hold a license | ||||||
18 | under this Act. Before refusing to issue or to renew or taking | ||||||
19 | any disciplinary action regarding a license, the Department | ||||||
20 | shall, at least 30 days prior to the date set for the hearing, | ||||||
21 | notify in writing the applicant or licensee of the nature of | ||||||
22 | any charges and that a hearing shall be held on a date | ||||||
23 | designated. The Department shall direct the applicant or | ||||||
24 | licensee to file a written answer with the Board under oath |
| |||||||
| |||||||
1 | within 20 days after the service of the notice and inform the | ||||||
2 | applicant or licensee that failure to file an answer shall | ||||||
3 | result in default being taken against the applicant or licensee | ||||||
4 | and that the license may be suspended, revoked, or placed on | ||||||
5 | probationary status or that other disciplinary action may be | ||||||
6 | taken, including limiting the scope, nature, or extent of | ||||||
7 | practice, as the Secretary may deem proper. Written notice may | ||||||
8 | be served by personal delivery or certified or registered mail | ||||||
9 | to the respondent at the address of his or her last | ||||||
10 | notification to the Department. If the person fails to file an | ||||||
11 | answer after receiving notice, his or her license may, in the | ||||||
12 | discretion of the Department, be suspended, revoked, or placed | ||||||
13 | on probationary status, or the Department may take any | ||||||
14 | disciplinary action deemed proper, including limiting the | ||||||
15 | scope, nature, or extent of the person's practice or the | ||||||
16 | imposition of a fine, without a hearing, if the act or acts | ||||||
17 | charged constitute sufficient grounds for such action under | ||||||
18 | this Act. At the time and place fixed in the notice, the Board | ||||||
19 | shall proceed to hear the charges and the parties or their | ||||||
20 | counsel shall be accorded ample opportunity to present such | ||||||
21 | statements, testimony, evidence, and argument as may be | ||||||
22 | pertinent to the charges or to their defense. The Board may | ||||||
23 | continue a hearing from time to time. | ||||||
24 | Section 165. Formal hearing; preservation of record. The | ||||||
25 | Department, at its expense, shall preserve a record of all |
| |||||||
| |||||||
1 | proceedings at the formal hearing of any case. The notice of | ||||||
2 | hearing, complaint, and all other documents in the nature of | ||||||
3 | pleadings and written motions filed in the proceedings, the | ||||||
4 | transcript of testimony, the report of the Board or hearing | ||||||
5 | officer, and order of the Department shall be the record of the | ||||||
6 | proceeding. The Department shall furnish a transcript of the | ||||||
7 | record to any person interested in the hearing upon payment of | ||||||
8 | the fee required under Section 2105-115 of the Department of | ||||||
9 | Professional Regulation Law. | ||||||
10 | Section 170. Witnesses; production of documents; contempt. | ||||||
11 | Any circuit court may upon application of the Department or its | ||||||
12 | designee or of the applicant or licensee against whom | ||||||
13 | proceedings under Section 95 of this Act are pending, enter an | ||||||
14 | order requiring the attendance of witnesses and their testimony | ||||||
15 | and the production of documents, papers, files, books, and | ||||||
16 | records in connection with any hearing or investigation. The | ||||||
17 | court may compel obedience to its order by proceedings for | ||||||
18 | contempt. | ||||||
19 | Section 175. Subpoena; oaths. The Department shall have the | ||||||
20 | power to subpoena and bring before it any person in this State | ||||||
21 | and to take testimony either orally or by deposition or both | ||||||
22 | with the same fees and mileage and in the same manner as | ||||||
23 | prescribed in civil cases in circuit courts of this State. The | ||||||
24 | Secretary, the designated hearing officer, and every member of |
| |||||||
| |||||||
1 | the Board has the power to administer oaths to witnesses at any | ||||||
2 | hearing that the Department is authorized to conduct and any | ||||||
3 | other oaths authorized in any Act administered by the | ||||||
4 | Department. Any circuit court may, upon application of the | ||||||
5 | Department or its designee or upon application of the person | ||||||
6 | against whom proceedings under this Act are pending, enter an | ||||||
7 | order requiring the attendance of witnesses and their | ||||||
8 | testimony, and the production of documents, papers, files, | ||||||
9 | books, and records in connection with any hearing or | ||||||
10 | investigation. The court may compel obedience to its order by | ||||||
11 | proceedings for contempt. | ||||||
12 | Section 180. Findings of fact, conclusions of law, and | ||||||
13 | recommendations. At the conclusion of the hearing the Board | ||||||
14 | shall present to the Secretary a written report of its findings | ||||||
15 | of fact, conclusions of law, and recommendations. The report | ||||||
16 | shall contain a finding as to whether or not the accused person | ||||||
17 | violated this Act or failed to comply with the conditions | ||||||
18 | required under this Act. The Board shall specify the nature of | ||||||
19 | the violation or failure to comply and shall make its | ||||||
20 | recommendations to the Secretary. | ||||||
21 | The report of findings of fact, conclusions of law, and | ||||||
22 | recommendations of the Board shall be the basis for the | ||||||
23 | Department's order. If the Secretary disagrees in any regard | ||||||
24 | with the report of the Board, the Secretary may issue an order | ||||||
25 | in contravention of the report. The finding is not admissible |
| |||||||
| |||||||
1 | in evidence against the person in a criminal prosecution | ||||||
2 | brought for the violation of this Act, but the hearing and | ||||||
3 | findings are not a bar to a criminal prosecution brought for | ||||||
4 | the violation of this Act. | ||||||
5 | Section 185. Hearing officer. The Secretary may appoint any | ||||||
6 | attorney duly licensed to practice law in the State of Illinois | ||||||
7 | to serve as the hearing officer in any action for departmental | ||||||
8 | refusal to issue, renew, or license an applicant or for | ||||||
9 | disciplinary action against a licensee. The hearing officer | ||||||
10 | shall have full authority to conduct the hearing. The hearing | ||||||
11 | officer shall report his or her findings of fact, conclusions | ||||||
12 | of law, and recommendations to the Board and the Secretary. The | ||||||
13 | Board shall have 60 calendar days after receipt of the report | ||||||
14 | to review the report of the hearing officer and present its | ||||||
15 | findings of fact, conclusions of law, and recommendations to | ||||||
16 | the Secretary. If the Board fails to present its report within | ||||||
17 | the 60-day period, the Secretary may issue an order based on | ||||||
18 | the report of the hearing officer. If the Secretary disagrees | ||||||
19 | with the recommendation of the Board or the hearing officer, he | ||||||
20 | or she may issue an order in contravention of that | ||||||
21 | recommendation. | ||||||
22 | Section 190. Service of report; motion for rehearing. In | ||||||
23 | any case involving the discipline of a license, a copy of the | ||||||
24 | Board's report shall be served upon the respondent by the |
| |||||||
| |||||||
1 | Department, either personally or as provided in this Act for | ||||||
2 | the service of the notice of hearing. Within 20 days after the | ||||||
3 | service, the respondent may present to the Department a motion | ||||||
4 | in writing for a rehearing that shall specify the particular | ||||||
5 | grounds for rehearing. If no motion for rehearing is filed, | ||||||
6 | then upon the expiration of the time specified for filing a | ||||||
7 | motion, or if a motion for rehearing is denied, then upon the | ||||||
8 | denial, the Secretary may enter an order in accordance with | ||||||
9 | this Act. If the respondent orders from the reporting service | ||||||
10 | and pays for a transcript of the record within the time for | ||||||
11 | filing a motion for rehearing, the 20-day period within which | ||||||
12 | the motion may be filed shall commence upon the delivery of the | ||||||
13 | transcript to the respondent. | ||||||
14 | Section 195. Rehearing. Whenever the Secretary is | ||||||
15 | satisfied that substantial justice has not been done in the | ||||||
16 | revocation, suspension, or refusal to issue or renew a license, | ||||||
17 | the Secretary may order a rehearing by the same or another | ||||||
18 | hearing officer or by the Board. | ||||||
19 | Section 200. Prima facie proof. An order or a certified | ||||||
20 | copy thereof, over the seal of the Department and purporting to | ||||||
21 | be signed by the Secretary, shall be prima facie proof of the | ||||||
22 | following: | ||||||
23 | (1) that the signature is the genuine signature of the | ||||||
24 | Secretary; |
| |||||||
| |||||||
1 | (2) that such Secretary is duly appointed and qualified; | ||||||
2 | (3) that the Board and its members are qualified to act; | ||||||
3 | and | ||||||
4 | (4) that the findings and conclusions set forth therein are | ||||||
5 | prima facie true and correct. | ||||||
6 | Section 205. Restoration of license. At any time after the | ||||||
7 | suspension or revocation of any license, the Department may | ||||||
8 | restore the license to the accused person, unless after an | ||||||
9 | investigation and a hearing the Department determines that | ||||||
10 | restoration is not in the public interest. | ||||||
11 | Section 210. Surrender of license. Upon the revocation or | ||||||
12 | suspension of any license, the licensee shall immediately | ||||||
13 | surrender the license to the Department. If the licensee fails | ||||||
14 | to do so, the Department shall have the right to seize the | ||||||
15 | license. | ||||||
16 | Section 215. Summary suspension. The Secretary may | ||||||
17 | summarily suspend the license of a licensee under this Act | ||||||
18 | without a hearing, simultaneously with the institution of | ||||||
19 | proceedings for a hearing provided for in this Act, if the | ||||||
20 | Secretary finds that evidence in his or her possession | ||||||
21 | indicates that continuation in practice would constitute an | ||||||
22 | imminent danger to the public. In the event that the Secretary | ||||||
23 | summarily suspends a license without a hearing, a hearing by |
| |||||||
| |||||||
1 | the Department must be held within 30 days after the suspension | ||||||
2 | has occurred. | ||||||
3 | Section 220. Certificate of record. The Department shall | ||||||
4 | not be required to certify any record to the court or file any | ||||||
5 | answer in court or otherwise appear in any court in a judicial | ||||||
6 | review proceeding, unless there is filed in the court, with the | ||||||
7 | complaint, a receipt from the Department acknowledging payment | ||||||
8 | of the costs of furnishing and certifying the record. Failure | ||||||
9 | on the part of the plaintiff to file a receipt in court shall | ||||||
10 | be grounds for dismissal of the action. | ||||||
11 | Section 225. Administrative Review Law. All final | ||||||
12 | administrative decisions of the Department are subject to | ||||||
13 | judicial review under the Administrative Review Law and its | ||||||
14 | rules. The term "administrative decision" is defined as in | ||||||
15 | Section 3-101 of the Code of Civil Procedure. | ||||||
16 | Section 230. Illinois Administrative Procedure Act. The | ||||||
17 | Illinois Administrative Procedure Act is hereby expressly | ||||||
18 | adopted and incorporated in this Act as if all of the | ||||||
19 | provisions of such Act were included in this Act, except that | ||||||
20 | the provision of subsection (d) of Section 10-65 of the | ||||||
21 | Illinois Administrative Procedure Act that provides that at | ||||||
22 | hearings the licensee has the right to show compliance with all | ||||||
23 | lawful requirements for retention, continuation, or renewal of |
| |||||||
| |||||||
1 | the license is specifically excluded. For purposes of this Act, | ||||||
2 | the notice required under Section 10-25 of the Illinois | ||||||
3 | Administrative Procedure Act is deemed sufficient when mailed | ||||||
4 | to the last known address of a party. | ||||||
5 | Section 235. Home rule. The regulation and licensing of | ||||||
6 | midwives are exclusive powers and functions of the State. A | ||||||
7 | home rule unit may not regulate or license midwives. This | ||||||
8 | Section is a denial and limitation of home rule powers and | ||||||
9 | functions under subsection (h) of Section 6 of Article VII of | ||||||
10 | the Illinois Constitution. | ||||||
11 | Section 240. Severability. The provisions of this Act are | ||||||
12 | severable under Section 1.31 of the Statute on Statutes. | ||||||
13 | Section 900. The Regulatory Sunset Act is amended by adding | ||||||
14 | Section 4.38 as follows: | ||||||
15 | (5 ILCS 80/4.38 new) | ||||||
16 | Sec. 4.38. Act repealed on January 1, 2028. The following | ||||||
17 | Act is repealed on January 1, 2028: | ||||||
18 | The Home Birth Safety Act. | ||||||
19 | Section 905. The Medical Practice Act of 1987 is amended by | ||||||
20 | changing Section 4 as follows:
|
| |||||||
| |||||||
1 | (225 ILCS 60/4) (from Ch. 111, par. 4400-4)
| ||||||
2 | (Section scheduled to be repealed on December 31, 2017)
| ||||||
3 | Sec. 4. Exemptions. This Act does not apply to the | ||||||
4 | following:
| ||||||
5 | (1) persons lawfully carrying on their particular | ||||||
6 | profession or business
under any valid existing regulatory | ||||||
7 | Act of this State , including without limitation persons | ||||||
8 | engaged in the practice of midwifery who are licensed under | ||||||
9 | the Home Birth Safety Act ;
| ||||||
10 | (2) persons rendering gratuitous services in cases of | ||||||
11 | emergency; or
| ||||||
12 | (3) persons treating human ailments by prayer or | ||||||
13 | spiritual means as an
exercise or enjoyment of religious | ||||||
14 | freedom.
| ||||||
15 | (Source: P.A. 96-7, eff. 4-3-09; 97-622, eff. 11-23-11 .)
| ||||||
16 | Section 910. The Nurse Practice Act is amended by changing | ||||||
17 | Section 50-15 as follows:
| ||||||
18 | (225 ILCS 65/50-15)
(was 225 ILCS 65/5-15)
| ||||||
19 | (Section scheduled to be repealed on January 1, 2018)
| ||||||
20 | Sec. 50-15. Policy; application of Act. | ||||||
21 | (a) For the protection of life and the
promotion of health, | ||||||
22 | and the prevention of illness and communicable diseases,
any | ||||||
23 | person practicing or offering to practice advanced,
| ||||||
24 | professional, or practical
nursing in Illinois shall submit |
| |||||||
| |||||||
1 | evidence that he or she is qualified to
practice, and shall be | ||||||
2 | licensed as provided under this Act. No person shall
practice | ||||||
3 | or offer to practice advanced, professional, or practical | ||||||
4 | nursing in Illinois or
use any title, sign, card or device to | ||||||
5 | indicate that such a person is
practicing professional or | ||||||
6 | practical nursing unless such person has been
licensed under | ||||||
7 | the provisions of this Act.
| ||||||
8 | (b) This Act does not prohibit the following:
| ||||||
9 | (1) The practice of nursing in Federal employment in | ||||||
10 | the discharge of the
employee's duties by a person who is | ||||||
11 | employed by the United States
government or any bureau, | ||||||
12 | division or agency thereof and is a legally
qualified and | ||||||
13 | licensed nurse of another state or territory and not in
| ||||||
14 | conflict with Sections 50-50, 55-10, 60-10, and 70-5 of | ||||||
15 | this
Act.
| ||||||
16 | (2) Nursing that is included in the program of study by
| ||||||
17 | students
enrolled in programs of nursing or in current | ||||||
18 | nurse practice update courses
approved by the Department.
| ||||||
19 | (3) The furnishing of nursing assistance in an | ||||||
20 | emergency.
| ||||||
21 | (4) The practice of nursing by a nurse who holds an | ||||||
22 | active license in
another state when providing services to | ||||||
23 | patients in Illinois during a bonafide
emergency or in | ||||||
24 | immediate preparation for or during interstate
transit.
| ||||||
25 | (5) The incidental care of the sick by members of the | ||||||
26 | family, domestic
servants or housekeepers, or care of the |
| |||||||
| |||||||
1 | sick where treatment is by prayer
or spiritual means.
| ||||||
2 | (6) Persons from being employed as unlicensed | ||||||
3 | assistive personnel in private homes, long term care | ||||||
4 | facilities,
nurseries, hospitals or other institutions.
| ||||||
5 | (7) The practice of practical nursing by one who is a | ||||||
6 | licensed practical
nurse under the laws of another U.S. | ||||||
7 | jurisdiction and has applied in writing
to the Department, | ||||||
8 | in form and substance satisfactory to the Department,
for a | ||||||
9 | license as a licensed practical nurse and who is qualified | ||||||
10 | to receive
such license under this Act, until (i) the | ||||||
11 | expiration of 6 months after
the filing of such written | ||||||
12 | application, (ii) the withdrawal of such application,
or | ||||||
13 | (iii) the denial of such application by the Department.
| ||||||
14 | (8) The practice of advanced practice nursing by one | ||||||
15 | who is an advanced practice nurse under the laws of another | ||||||
16 | state, territory of the United States, or country and has | ||||||
17 | applied in writing to the Department, in form and substance | ||||||
18 | satisfactory to the Department, for a license as an | ||||||
19 | advanced practice nurse and who is qualified to receive | ||||||
20 | such license under this Act, until (i) the expiration of 6 | ||||||
21 | months after the filing of such written application, (ii) | ||||||
22 | the withdrawal of such application, or (iii) the denial of | ||||||
23 | such application by the Department.
| ||||||
24 | (9) The practice of professional nursing by one who is | ||||||
25 | a registered
professional nurse under the laws of another | ||||||
26 | state, territory of the United
States or country and has |
| |||||||
| |||||||
1 | applied in writing to the Department, in form and
substance | ||||||
2 | satisfactory to the Department, for a license as a | ||||||
3 | registered
professional nurse and who is qualified to | ||||||
4 | receive such license under
Section 55-10, until (1) the | ||||||
5 | expiration of 6 months after the filing of
such written | ||||||
6 | application, (2) the withdrawal of such application, or (3)
| ||||||
7 | the denial of such application by the Department.
| ||||||
8 | (10) The practice of professional nursing that is | ||||||
9 | included in a program of
study by one who is a registered | ||||||
10 | professional nurse under the laws of
another state or | ||||||
11 | territory of the United States or foreign country,
| ||||||
12 | territory or province and who is enrolled in a graduate | ||||||
13 | nursing education
program or a program for the completion | ||||||
14 | of a baccalaureate nursing degree in
this State, which | ||||||
15 | includes clinical supervision by faculty as
determined by | ||||||
16 | the educational institution offering the program and the
| ||||||
17 | health care organization where the practice of nursing | ||||||
18 | occurs.
| ||||||
19 | (11) Any person licensed in this State under any other | ||||||
20 | Act from engaging
in the practice for which she or he is | ||||||
21 | licensed , including without limitation any person engaged | ||||||
22 | in the practice of midwifery who is licensed under the Home | ||||||
23 | Birth Safety Act .
| ||||||
24 | (12) Delegation to authorized direct care staff | ||||||
25 | trained under Section 15.4
of the Mental Health and
| ||||||
26 | Developmental Disabilities Administrative Act consistent |
| |||||||
| |||||||
1 | with the policies of the Department.
| ||||||
2 | (13) The practice, services, or activities of persons | ||||||
3 | practicing the specified occupations set forth in | ||||||
4 | subsection (a) of, and pursuant to a licensing exemption | ||||||
5 | granted in subsection (b) or (d) of, Section 2105-350 of | ||||||
6 | the Department of Professional Regulation Law of the Civil | ||||||
7 | Administrative Code of Illinois, but only for so long as | ||||||
8 | the 2016 Olympic and Paralympic Games Professional | ||||||
9 | Licensure Exemption Law is operable. | ||||||
10 | (14) County correctional personnel from delivering | ||||||
11 | prepackaged medication for self-administration to an | ||||||
12 | individual detainee in a correctional facility. | ||||||
13 | Nothing in this Act shall be construed to limit the | ||||||
14 | delegation of tasks or duties by a physician, dentist, or | ||||||
15 | podiatric physician to a licensed practical nurse, a registered | ||||||
16 | professional nurse, or other persons.
| ||||||
17 | (Source: P.A. 98-214, eff. 8-9-13.)
| ||||||
18 | Section 915. The Illinois Public Aid Code is amended by | ||||||
19 | changing Section 5-5 as follows:
| ||||||
20 | (305 ILCS 5/5-5) (from Ch. 23, par. 5-5)
| ||||||
21 | Sec. 5-5. Medical services. The Illinois Department, by | ||||||
22 | rule, shall
determine the quantity and quality of and the rate | ||||||
23 | of reimbursement for the
medical assistance for which
payment | ||||||
24 | will be authorized, and the medical services to be provided,
|
| |||||||
| |||||||
1 | which may include all or part of the following: (1) inpatient | ||||||
2 | hospital
services; (2) outpatient hospital services; (3) other | ||||||
3 | laboratory and
X-ray services; (4) skilled nursing home | ||||||
4 | services; (5) physicians'
services whether furnished in the | ||||||
5 | office, the patient's home, a
hospital, a skilled nursing home, | ||||||
6 | or elsewhere; (6) medical care, or any
other type of remedial | ||||||
7 | care furnished by licensed practitioners , including the | ||||||
8 | services of licensed certified professional midwives pursuant | ||||||
9 | to the Home Birth Safety Act ; (7)
home health care services; | ||||||
10 | (8) private duty nursing service; (9) clinic
services; (10) | ||||||
11 | dental services, including prevention and treatment of | ||||||
12 | periodontal disease and dental caries disease for pregnant | ||||||
13 | women, provided by an individual licensed to practice dentistry | ||||||
14 | or dental surgery; for purposes of this item (10), "dental | ||||||
15 | services" means diagnostic, preventive, or corrective | ||||||
16 | procedures provided by or under the supervision of a dentist in | ||||||
17 | the practice of his or her profession; (11) physical therapy | ||||||
18 | and related
services; (12) prescribed drugs, dentures, and | ||||||
19 | prosthetic devices; and
eyeglasses prescribed by a physician | ||||||
20 | skilled in the diseases of the eye,
or by an optometrist, | ||||||
21 | whichever the person may select; (13) other
diagnostic, | ||||||
22 | screening, preventive, and rehabilitative services, including | ||||||
23 | to ensure that the individual's need for intervention or | ||||||
24 | treatment of mental disorders or substance use disorders or | ||||||
25 | co-occurring mental health and substance use disorders is | ||||||
26 | determined using a uniform screening, assessment, and |
| |||||||
| |||||||
1 | evaluation process inclusive of criteria, for children and | ||||||
2 | adults; for purposes of this item (13), a uniform screening, | ||||||
3 | assessment, and evaluation process refers to a process that | ||||||
4 | includes an appropriate evaluation and, as warranted, a | ||||||
5 | referral; "uniform" does not mean the use of a singular | ||||||
6 | instrument, tool, or process that all must utilize; (14)
| ||||||
7 | transportation and such other expenses as may be necessary; | ||||||
8 | (15) medical
treatment of sexual assault survivors, as defined | ||||||
9 | in
Section 1a of the Sexual Assault Survivors Emergency | ||||||
10 | Treatment Act, for
injuries sustained as a result of the sexual | ||||||
11 | assault, including
examinations and laboratory tests to | ||||||
12 | discover evidence which may be used in
criminal proceedings | ||||||
13 | arising from the sexual assault; (16) the
diagnosis and | ||||||
14 | treatment of sickle cell anemia; and (17)
any other medical | ||||||
15 | care, and any other type of remedial care recognized
under the | ||||||
16 | laws of this State, but not including abortions, or induced
| ||||||
17 | miscarriages or premature births, unless, in the opinion of a | ||||||
18 | physician,
such procedures are necessary for the preservation | ||||||
19 | of the life of the
woman seeking such treatment, or except an | ||||||
20 | induced premature birth
intended to produce a live viable child | ||||||
21 | and such procedure is necessary
for the health of the mother or | ||||||
22 | her unborn child. The Illinois Department,
by rule, shall | ||||||
23 | prohibit any physician from providing medical assistance
to | ||||||
24 | anyone eligible therefor under this Code where such physician | ||||||
25 | has been
found guilty of performing an abortion procedure in a | ||||||
26 | wilful and wanton
manner upon a woman who was not pregnant at |
| |||||||
| |||||||
1 | the time such abortion
procedure was performed. The term "any | ||||||
2 | other type of remedial care" shall
include nursing care and | ||||||
3 | nursing home service for persons who rely on
treatment by | ||||||
4 | spiritual means alone through prayer for healing.
| ||||||
5 | Notwithstanding any other provision of this Section, a | ||||||
6 | comprehensive
tobacco use cessation program that includes | ||||||
7 | purchasing prescription drugs or
prescription medical devices | ||||||
8 | approved by the Food and Drug Administration shall
be covered | ||||||
9 | under the medical assistance
program under this Article for | ||||||
10 | persons who are otherwise eligible for
assistance under this | ||||||
11 | Article.
| ||||||
12 | Notwithstanding any other provision of this Code, the | ||||||
13 | Illinois
Department may not require, as a condition of payment | ||||||
14 | for any laboratory
test authorized under this Article, that a | ||||||
15 | physician's handwritten signature
appear on the laboratory | ||||||
16 | test order form. The Illinois Department may,
however, impose | ||||||
17 | other appropriate requirements regarding laboratory test
order | ||||||
18 | documentation.
| ||||||
19 | Upon receipt of federal approval of an amendment to the | ||||||
20 | Illinois Title XIX State Plan for this purpose, the Department | ||||||
21 | shall authorize the Chicago Public Schools (CPS) to procure a | ||||||
22 | vendor or vendors to manufacture eyeglasses for individuals | ||||||
23 | enrolled in a school within the CPS system. CPS shall ensure | ||||||
24 | that its vendor or vendors are enrolled as providers in the | ||||||
25 | medical assistance program and in any capitated Medicaid | ||||||
26 | managed care entity (MCE) serving individuals enrolled in a |
| |||||||
| |||||||
1 | school within the CPS system. Under any contract procured under | ||||||
2 | this provision, the vendor or vendors must serve only | ||||||
3 | individuals enrolled in a school within the CPS system. Claims | ||||||
4 | for services provided by CPS's vendor or vendors to recipients | ||||||
5 | of benefits in the medical assistance program under this Code, | ||||||
6 | the Children's Health Insurance Program, or the Covering ALL | ||||||
7 | KIDS Health Insurance Program shall be submitted to the | ||||||
8 | Department or the MCE in which the individual is enrolled for | ||||||
9 | payment and shall be reimbursed at the Department's or the | ||||||
10 | MCE's established rates or rate methodologies for eyeglasses. | ||||||
11 | On and after July 1, 2012, the Department of Healthcare and | ||||||
12 | Family Services may provide the following services to
persons
| ||||||
13 | eligible for assistance under this Article who are | ||||||
14 | participating in
education, training or employment programs | ||||||
15 | operated by the Department of Human
Services as successor to | ||||||
16 | the Department of Public Aid:
| ||||||
17 | (1) dental services provided by or under the | ||||||
18 | supervision of a dentist; and
| ||||||
19 | (2) eyeglasses prescribed by a physician skilled in the | ||||||
20 | diseases of the
eye, or by an optometrist, whichever the | ||||||
21 | person may select.
| ||||||
22 | Notwithstanding any other provision of this Code and | ||||||
23 | subject to federal approval, the Department may adopt rules to | ||||||
24 | allow a dentist who is volunteering his or her service at no | ||||||
25 | cost to render dental services through an enrolled | ||||||
26 | not-for-profit health clinic without the dentist personally |
| |||||||
| |||||||
1 | enrolling as a participating provider in the medical assistance | ||||||
2 | program. A not-for-profit health clinic shall include a public | ||||||
3 | health clinic or Federally Qualified Health Center or other | ||||||
4 | enrolled provider, as determined by the Department, through | ||||||
5 | which dental services covered under this Section are performed. | ||||||
6 | The Department shall establish a process for payment of claims | ||||||
7 | for reimbursement for covered dental services rendered under | ||||||
8 | this provision. | ||||||
9 | The Illinois Department, by rule, may distinguish and | ||||||
10 | classify the
medical services to be provided only in accordance | ||||||
11 | with the classes of
persons designated in Section 5-2.
| ||||||
12 | The Department of Healthcare and Family Services must | ||||||
13 | provide coverage and reimbursement for amino acid-based | ||||||
14 | elemental formulas, regardless of delivery method, for the | ||||||
15 | diagnosis and treatment of (i) eosinophilic disorders and (ii) | ||||||
16 | short bowel syndrome when the prescribing physician has issued | ||||||
17 | a written order stating that the amino acid-based elemental | ||||||
18 | formula is medically necessary.
| ||||||
19 | The Illinois Department shall authorize the provision of, | ||||||
20 | and shall
authorize payment for, screening by low-dose | ||||||
21 | mammography for the presence of
occult breast cancer for women | ||||||
22 | 35 years of age or older who are eligible
for medical | ||||||
23 | assistance under this Article, as follows: | ||||||
24 | (A) A baseline
mammogram for women 35 to 39 years of | ||||||
25 | age.
| ||||||
26 | (B) An annual mammogram for women 40 years of age or |
| |||||||
| |||||||
1 | older. | ||||||
2 | (C) A mammogram at the age and intervals considered | ||||||
3 | medically necessary by the woman's health care provider for | ||||||
4 | women under 40 years of age and having a family history of | ||||||
5 | breast cancer, prior personal history of breast cancer, | ||||||
6 | positive genetic testing, or other risk factors. | ||||||
7 | (D) A comprehensive ultrasound screening of an entire | ||||||
8 | breast or breasts if a mammogram demonstrates | ||||||
9 | heterogeneous or dense breast tissue, when medically | ||||||
10 | necessary as determined by a physician licensed to practice | ||||||
11 | medicine in all of its branches. | ||||||
12 | (E) A screening MRI when medically necessary, as | ||||||
13 | determined by a physician licensed to practice medicine in | ||||||
14 | all of its branches. | ||||||
15 | All screenings
shall
include a physical breast exam, | ||||||
16 | instruction on self-examination and
information regarding the | ||||||
17 | frequency of self-examination and its value as a
preventative | ||||||
18 | tool. For purposes of this Section, "low-dose mammography" | ||||||
19 | means
the x-ray examination of the breast using equipment | ||||||
20 | dedicated specifically
for mammography, including the x-ray | ||||||
21 | tube, filter, compression device,
and image receptor, with an | ||||||
22 | average radiation exposure delivery
of less than one rad per | ||||||
23 | breast for 2 views of an average size breast.
The term also | ||||||
24 | includes digital mammography and includes breast | ||||||
25 | tomosynthesis. As used in this Section, the term "breast | ||||||
26 | tomosynthesis" means a radiologic procedure that involves the |
| |||||||
| |||||||
1 | acquisition of projection images over the stationary breast to | ||||||
2 | produce cross-sectional digital three-dimensional images of | ||||||
3 | the breast. If, at any time, the Secretary of the United States | ||||||
4 | Department of Health and Human Services, or its successor | ||||||
5 | agency, promulgates rules or regulations to be published in the | ||||||
6 | Federal Register or publishes a comment in the Federal Register | ||||||
7 | or issues an opinion, guidance, or other action that would | ||||||
8 | require the State, pursuant to any provision of the Patient | ||||||
9 | Protection and Affordable Care Act (Public Law 111-148), | ||||||
10 | including, but not limited to, 42 U.S.C. 18031(d)(3)(B) or any | ||||||
11 | successor provision, to defray the cost of any coverage for | ||||||
12 | breast tomosynthesis outlined in this paragraph, then the | ||||||
13 | requirement that an insurer cover breast tomosynthesis is | ||||||
14 | inoperative other than any such coverage authorized under | ||||||
15 | Section 1902 of the Social Security Act, 42 U.S.C. 1396a, and | ||||||
16 | the State shall not assume any obligation for the cost of | ||||||
17 | coverage for breast tomosynthesis set forth in this paragraph.
| ||||||
18 | On and after January 1, 2016, the Department shall ensure | ||||||
19 | that all networks of care for adult clients of the Department | ||||||
20 | include access to at least one breast imaging Center of Imaging | ||||||
21 | Excellence as certified by the American College of Radiology. | ||||||
22 | On and after January 1, 2012, providers participating in a | ||||||
23 | quality improvement program approved by the Department shall be | ||||||
24 | reimbursed for screening and diagnostic mammography at the same | ||||||
25 | rate as the Medicare program's rates, including the increased | ||||||
26 | reimbursement for digital mammography. |
| |||||||
| |||||||
1 | The Department shall convene an expert panel including | ||||||
2 | representatives of hospitals, free-standing mammography | ||||||
3 | facilities, and doctors, including radiologists, to establish | ||||||
4 | quality standards for mammography. | ||||||
5 | On and after January 1, 2017, providers participating in a | ||||||
6 | breast cancer treatment quality improvement program approved | ||||||
7 | by the Department shall be reimbursed for breast cancer | ||||||
8 | treatment at a rate that is no lower than 95% of the Medicare | ||||||
9 | program's rates for the data elements included in the breast | ||||||
10 | cancer treatment quality program. | ||||||
11 | The Department shall convene an expert panel, including | ||||||
12 | representatives of hospitals, free standing breast cancer | ||||||
13 | treatment centers, breast cancer quality organizations, and | ||||||
14 | doctors, including breast surgeons, reconstructive breast | ||||||
15 | surgeons, oncologists, and primary care providers to establish | ||||||
16 | quality standards for breast cancer treatment. | ||||||
17 | Subject to federal approval, the Department shall | ||||||
18 | establish a rate methodology for mammography at federally | ||||||
19 | qualified health centers and other encounter-rate clinics. | ||||||
20 | These clinics or centers may also collaborate with other | ||||||
21 | hospital-based mammography facilities. By January 1, 2016, the | ||||||
22 | Department shall report to the General Assembly on the status | ||||||
23 | of the provision set forth in this paragraph. | ||||||
24 | The Department shall establish a methodology to remind | ||||||
25 | women who are age-appropriate for screening mammography, but | ||||||
26 | who have not received a mammogram within the previous 18 |
| |||||||
| |||||||
1 | months, of the importance and benefit of screening mammography. | ||||||
2 | The Department shall work with experts in breast cancer | ||||||
3 | outreach and patient navigation to optimize these reminders and | ||||||
4 | shall establish a methodology for evaluating their | ||||||
5 | effectiveness and modifying the methodology based on the | ||||||
6 | evaluation. | ||||||
7 | The Department shall establish a performance goal for | ||||||
8 | primary care providers with respect to their female patients | ||||||
9 | over age 40 receiving an annual mammogram. This performance | ||||||
10 | goal shall be used to provide additional reimbursement in the | ||||||
11 | form of a quality performance bonus to primary care providers | ||||||
12 | who meet that goal. | ||||||
13 | The Department shall devise a means of case-managing or | ||||||
14 | patient navigation for beneficiaries diagnosed with breast | ||||||
15 | cancer. This program shall initially operate as a pilot program | ||||||
16 | in areas of the State with the highest incidence of mortality | ||||||
17 | related to breast cancer. At least one pilot program site shall | ||||||
18 | be in the metropolitan Chicago area and at least one site shall | ||||||
19 | be outside the metropolitan Chicago area. On or after July 1, | ||||||
20 | 2016, the pilot program shall be expanded to include one site | ||||||
21 | in western Illinois, one site in southern Illinois, one site in | ||||||
22 | central Illinois, and 4 sites within metropolitan Chicago. An | ||||||
23 | evaluation of the pilot program shall be carried out measuring | ||||||
24 | health outcomes and cost of care for those served by the pilot | ||||||
25 | program compared to similarly situated patients who are not | ||||||
26 | served by the pilot program. |
| |||||||
| |||||||
1 | The Department shall require all networks of care to | ||||||
2 | develop a means either internally or by contract with experts | ||||||
3 | in navigation and community outreach to navigate cancer | ||||||
4 | patients to comprehensive care in a timely fashion. The | ||||||
5 | Department shall require all networks of care to include access | ||||||
6 | for patients diagnosed with cancer to at least one academic | ||||||
7 | commission on cancer-accredited cancer program as an | ||||||
8 | in-network covered benefit. | ||||||
9 | Any medical or health care provider shall immediately | ||||||
10 | recommend, to
any pregnant woman who is being provided prenatal | ||||||
11 | services and is suspected
of drug abuse or is addicted as | ||||||
12 | defined in the Alcoholism and Other Drug Abuse
and Dependency | ||||||
13 | Act, referral to a local substance abuse treatment provider
| ||||||
14 | licensed by the Department of Human Services or to a licensed
| ||||||
15 | hospital which provides substance abuse treatment services. | ||||||
16 | The Department of Healthcare and Family Services
shall assure | ||||||
17 | coverage for the cost of treatment of the drug abuse or
| ||||||
18 | addiction for pregnant recipients in accordance with the | ||||||
19 | Illinois Medicaid
Program in conjunction with the Department of | ||||||
20 | Human Services.
| ||||||
21 | All medical providers providing medical assistance to | ||||||
22 | pregnant women
under this Code shall receive information from | ||||||
23 | the Department on the
availability of services under the Drug | ||||||
24 | Free Families with a Future or any
comparable program providing | ||||||
25 | case management services for addicted women,
including | ||||||
26 | information on appropriate referrals for other social services
|
| |||||||
| |||||||
1 | that may be needed by addicted women in addition to treatment | ||||||
2 | for addiction.
| ||||||
3 | The Illinois Department, in cooperation with the | ||||||
4 | Departments of Human
Services (as successor to the Department | ||||||
5 | of Alcoholism and Substance
Abuse) and Public Health, through a | ||||||
6 | public awareness campaign, may
provide information concerning | ||||||
7 | treatment for alcoholism and drug abuse and
addiction, prenatal | ||||||
8 | health care, and other pertinent programs directed at
reducing | ||||||
9 | the number of drug-affected infants born to recipients of | ||||||
10 | medical
assistance.
| ||||||
11 | Neither the Department of Healthcare and Family Services | ||||||
12 | nor the Department of Human
Services shall sanction the | ||||||
13 | recipient solely on the basis of
her substance abuse.
| ||||||
14 | The Illinois Department shall establish such regulations | ||||||
15 | governing
the dispensing of health services under this Article | ||||||
16 | as it shall deem
appropriate. The Department
should
seek the | ||||||
17 | advice of formal professional advisory committees appointed by
| ||||||
18 | the Director of the Illinois Department for the purpose of | ||||||
19 | providing regular
advice on policy and administrative matters, | ||||||
20 | information dissemination and
educational activities for | ||||||
21 | medical and health care providers, and
consistency in | ||||||
22 | procedures to the Illinois Department.
| ||||||
23 | The Illinois Department may develop and contract with | ||||||
24 | Partnerships of
medical providers to arrange medical services | ||||||
25 | for persons eligible under
Section 5-2 of this Code. | ||||||
26 | Implementation of this Section may be by
demonstration projects |
| |||||||
| |||||||
1 | in certain geographic areas. The Partnership shall
be | ||||||
2 | represented by a sponsor organization. The Department, by rule, | ||||||
3 | shall
develop qualifications for sponsors of Partnerships. | ||||||
4 | Nothing in this
Section shall be construed to require that the | ||||||
5 | sponsor organization be a
medical organization.
| ||||||
6 | The sponsor must negotiate formal written contracts with | ||||||
7 | medical
providers for physician services, inpatient and | ||||||
8 | outpatient hospital care,
home health services, treatment for | ||||||
9 | alcoholism and substance abuse, and
other services determined | ||||||
10 | necessary by the Illinois Department by rule for
delivery by | ||||||
11 | Partnerships. Physician services must include prenatal and
| ||||||
12 | obstetrical care. The Illinois Department shall reimburse | ||||||
13 | medical services
delivered by Partnership providers to clients | ||||||
14 | in target areas according to
provisions of this Article and the | ||||||
15 | Illinois Health Finance Reform Act,
except that:
| ||||||
16 | (1) Physicians participating in a Partnership and | ||||||
17 | providing certain
services, which shall be determined by | ||||||
18 | the Illinois Department, to persons
in areas covered by the | ||||||
19 | Partnership may receive an additional surcharge
for such | ||||||
20 | services.
| ||||||
21 | (2) The Department may elect to consider and negotiate | ||||||
22 | financial
incentives to encourage the development of | ||||||
23 | Partnerships and the efficient
delivery of medical care.
| ||||||
24 | (3) Persons receiving medical services through | ||||||
25 | Partnerships may receive
medical and case management | ||||||
26 | services above the level usually offered
through the |
| |||||||
| |||||||
1 | medical assistance program.
| ||||||
2 | Medical providers shall be required to meet certain | ||||||
3 | qualifications to
participate in Partnerships to ensure the | ||||||
4 | delivery of high quality medical
services. These | ||||||
5 | qualifications shall be determined by rule of the Illinois
| ||||||
6 | Department and may be higher than qualifications for | ||||||
7 | participation in the
medical assistance program. Partnership | ||||||
8 | sponsors may prescribe reasonable
additional qualifications | ||||||
9 | for participation by medical providers, only with
the prior | ||||||
10 | written approval of the Illinois Department.
| ||||||
11 | Nothing in this Section shall limit the free choice of | ||||||
12 | practitioners,
hospitals, and other providers of medical | ||||||
13 | services by clients.
In order to ensure patient freedom of | ||||||
14 | choice, the Illinois Department shall
immediately promulgate | ||||||
15 | all rules and take all other necessary actions so that
provided | ||||||
16 | services may be accessed from therapeutically certified | ||||||
17 | optometrists
to the full extent of the Illinois Optometric | ||||||
18 | Practice Act of 1987 without
discriminating between service | ||||||
19 | providers.
| ||||||
20 | The Department shall apply for a waiver from the United | ||||||
21 | States Health
Care Financing Administration to allow for the | ||||||
22 | implementation of
Partnerships under this Section.
| ||||||
23 | The Illinois Department shall require health care | ||||||
24 | providers to maintain
records that document the medical care | ||||||
25 | and services provided to recipients
of Medical Assistance under | ||||||
26 | this Article. Such records must be retained for a period of not |
| |||||||
| |||||||
1 | less than 6 years from the date of service or as provided by | ||||||
2 | applicable State law, whichever period is longer, except that | ||||||
3 | if an audit is initiated within the required retention period | ||||||
4 | then the records must be retained until the audit is completed | ||||||
5 | and every exception is resolved. The Illinois Department shall
| ||||||
6 | require health care providers to make available, when | ||||||
7 | authorized by the
patient, in writing, the medical records in a | ||||||
8 | timely fashion to other
health care providers who are treating | ||||||
9 | or serving persons eligible for
Medical Assistance under this | ||||||
10 | Article. All dispensers of medical services
shall be required | ||||||
11 | to maintain and retain business and professional records
| ||||||
12 | sufficient to fully and accurately document the nature, scope, | ||||||
13 | details and
receipt of the health care provided to persons | ||||||
14 | eligible for medical
assistance under this Code, in accordance | ||||||
15 | with regulations promulgated by
the Illinois Department. The | ||||||
16 | rules and regulations shall require that proof
of the receipt | ||||||
17 | of prescription drugs, dentures, prosthetic devices and
| ||||||
18 | eyeglasses by eligible persons under this Section accompany | ||||||
19 | each claim
for reimbursement submitted by the dispenser of such | ||||||
20 | medical services.
No such claims for reimbursement shall be | ||||||
21 | approved for payment by the Illinois
Department without such | ||||||
22 | proof of receipt, unless the Illinois Department
shall have put | ||||||
23 | into effect and shall be operating a system of post-payment
| ||||||
24 | audit and review which shall, on a sampling basis, be deemed | ||||||
25 | adequate by
the Illinois Department to assure that such drugs, | ||||||
26 | dentures, prosthetic
devices and eyeglasses for which payment |
| |||||||
| |||||||
1 | is being made are actually being
received by eligible | ||||||
2 | recipients. Within 90 days after September 16, 1984 (the | ||||||
3 | effective date of Public Act 83-1439), the Illinois Department | ||||||
4 | shall establish a
current list of acquisition costs for all | ||||||
5 | prosthetic devices and any
other items recognized as medical | ||||||
6 | equipment and supplies reimbursable under
this Article and | ||||||
7 | shall update such list on a quarterly basis, except that
the | ||||||
8 | acquisition costs of all prescription drugs shall be updated no
| ||||||
9 | less frequently than every 30 days as required by Section | ||||||
10 | 5-5.12.
| ||||||
11 | The rules and regulations of the Illinois Department shall | ||||||
12 | require
that a written statement including the required opinion | ||||||
13 | of a physician
shall accompany any claim for reimbursement for | ||||||
14 | abortions, or induced
miscarriages or premature births. This | ||||||
15 | statement shall indicate what
procedures were used in providing | ||||||
16 | such medical services.
| ||||||
17 | Notwithstanding any other law to the contrary, the Illinois | ||||||
18 | Department shall, within 365 days after July 22, 2013 (the | ||||||
19 | effective date of Public Act 98-104), establish procedures to | ||||||
20 | permit skilled care facilities licensed under the Nursing Home | ||||||
21 | Care Act to submit monthly billing claims for reimbursement | ||||||
22 | purposes. Following development of these procedures, the | ||||||
23 | Department shall, by July 1, 2016, test the viability of the | ||||||
24 | new system and implement any necessary operational or | ||||||
25 | structural changes to its information technology platforms in | ||||||
26 | order to allow for the direct acceptance and payment of nursing |
| |||||||
| |||||||
1 | home claims. | ||||||
2 | Notwithstanding any other law to the contrary, the Illinois | ||||||
3 | Department shall, within 365 days after August 15, 2014 (the | ||||||
4 | effective date of Public Act 98-963), establish procedures to | ||||||
5 | permit ID/DD facilities licensed under the ID/DD Community Care | ||||||
6 | Act and MC/DD facilities licensed under the MC/DD Act to submit | ||||||
7 | monthly billing claims for reimbursement purposes. Following | ||||||
8 | development of these procedures, the Department shall have an | ||||||
9 | additional 365 days to test the viability of the new system and | ||||||
10 | to ensure that any necessary operational or structural changes | ||||||
11 | to its information technology platforms are implemented. | ||||||
12 | The Illinois Department shall require all dispensers of | ||||||
13 | medical
services, other than an individual practitioner or | ||||||
14 | group of practitioners,
desiring to participate in the Medical | ||||||
15 | Assistance program
established under this Article to disclose | ||||||
16 | all financial, beneficial,
ownership, equity, surety or other | ||||||
17 | interests in any and all firms,
corporations, partnerships, | ||||||
18 | associations, business enterprises, joint
ventures, agencies, | ||||||
19 | institutions or other legal entities providing any
form of | ||||||
20 | health care services in this State under this Article.
| ||||||
21 | The Illinois Department may require that all dispensers of | ||||||
22 | medical
services desiring to participate in the medical | ||||||
23 | assistance program
established under this Article disclose, | ||||||
24 | under such terms and conditions as
the Illinois Department may | ||||||
25 | by rule establish, all inquiries from clients
and attorneys | ||||||
26 | regarding medical bills paid by the Illinois Department, which
|
| |||||||
| |||||||
1 | inquiries could indicate potential existence of claims or liens | ||||||
2 | for the
Illinois Department.
| ||||||
3 | Enrollment of a vendor
shall be
subject to a provisional | ||||||
4 | period and shall be conditional for one year. During the period | ||||||
5 | of conditional enrollment, the Department may
terminate the | ||||||
6 | vendor's eligibility to participate in, or may disenroll the | ||||||
7 | vendor from, the medical assistance
program without cause. | ||||||
8 | Unless otherwise specified, such termination of eligibility or | ||||||
9 | disenrollment is not subject to the
Department's hearing | ||||||
10 | process.
However, a disenrolled vendor may reapply without | ||||||
11 | penalty.
| ||||||
12 | The Department has the discretion to limit the conditional | ||||||
13 | enrollment period for vendors based upon category of risk of | ||||||
14 | the vendor. | ||||||
15 | Prior to enrollment and during the conditional enrollment | ||||||
16 | period in the medical assistance program, all vendors shall be | ||||||
17 | subject to enhanced oversight, screening, and review based on | ||||||
18 | the risk of fraud, waste, and abuse that is posed by the | ||||||
19 | category of risk of the vendor. The Illinois Department shall | ||||||
20 | establish the procedures for oversight, screening, and review, | ||||||
21 | which may include, but need not be limited to: criminal and | ||||||
22 | financial background checks; fingerprinting; license, | ||||||
23 | certification, and authorization verifications; unscheduled or | ||||||
24 | unannounced site visits; database checks; prepayment audit | ||||||
25 | reviews; audits; payment caps; payment suspensions; and other | ||||||
26 | screening as required by federal or State law. |
| |||||||
| |||||||
1 | The Department shall define or specify the following: (i) | ||||||
2 | by provider notice, the "category of risk of the vendor" for | ||||||
3 | each type of vendor, which shall take into account the level of | ||||||
4 | screening applicable to a particular category of vendor under | ||||||
5 | federal law and regulations; (ii) by rule or provider notice, | ||||||
6 | the maximum length of the conditional enrollment period for | ||||||
7 | each category of risk of the vendor; and (iii) by rule, the | ||||||
8 | hearing rights, if any, afforded to a vendor in each category | ||||||
9 | of risk of the vendor that is terminated or disenrolled during | ||||||
10 | the conditional enrollment period. | ||||||
11 | To be eligible for payment consideration, a vendor's | ||||||
12 | payment claim or bill, either as an initial claim or as a | ||||||
13 | resubmitted claim following prior rejection, must be received | ||||||
14 | by the Illinois Department, or its fiscal intermediary, no | ||||||
15 | later than 180 days after the latest date on the claim on which | ||||||
16 | medical goods or services were provided, with the following | ||||||
17 | exceptions: | ||||||
18 | (1) In the case of a provider whose enrollment is in | ||||||
19 | process by the Illinois Department, the 180-day period | ||||||
20 | shall not begin until the date on the written notice from | ||||||
21 | the Illinois Department that the provider enrollment is | ||||||
22 | complete. | ||||||
23 | (2) In the case of errors attributable to the Illinois | ||||||
24 | Department or any of its claims processing intermediaries | ||||||
25 | which result in an inability to receive, process, or | ||||||
26 | adjudicate a claim, the 180-day period shall not begin |
| |||||||
| |||||||
1 | until the provider has been notified of the error. | ||||||
2 | (3) In the case of a provider for whom the Illinois | ||||||
3 | Department initiates the monthly billing process. | ||||||
4 | (4) In the case of a provider operated by a unit of | ||||||
5 | local government with a population exceeding 3,000,000 | ||||||
6 | when local government funds finance federal participation | ||||||
7 | for claims payments. | ||||||
8 | For claims for services rendered during a period for which | ||||||
9 | a recipient received retroactive eligibility, claims must be | ||||||
10 | filed within 180 days after the Department determines the | ||||||
11 | applicant is eligible. For claims for which the Illinois | ||||||
12 | Department is not the primary payer, claims must be submitted | ||||||
13 | to the Illinois Department within 180 days after the final | ||||||
14 | adjudication by the primary payer. | ||||||
15 | In the case of long term care facilities, within 5 days of | ||||||
16 | receipt by the facility of required prescreening information, | ||||||
17 | data for new admissions shall be entered into the Medical | ||||||
18 | Electronic Data Interchange (MEDI) or the Recipient | ||||||
19 | Eligibility Verification (REV) System or successor system, and | ||||||
20 | within 15 days of receipt by the facility of required | ||||||
21 | prescreening information, admission documents shall be | ||||||
22 | submitted through MEDI or REV or shall be submitted directly to | ||||||
23 | the Department of Human Services using required admission | ||||||
24 | forms. Effective September
1, 2014, admission documents, | ||||||
25 | including all prescreening
information, must be submitted | ||||||
26 | through MEDI or REV. Confirmation numbers assigned to an |
| |||||||
| |||||||
1 | accepted transaction shall be retained by a facility to verify | ||||||
2 | timely submittal. Once an admission transaction has been | ||||||
3 | completed, all resubmitted claims following prior rejection | ||||||
4 | are subject to receipt no later than 180 days after the | ||||||
5 | admission transaction has been completed. | ||||||
6 | Claims that are not submitted and received in compliance | ||||||
7 | with the foregoing requirements shall not be eligible for | ||||||
8 | payment under the medical assistance program, and the State | ||||||
9 | shall have no liability for payment of those claims. | ||||||
10 | To the extent consistent with applicable information and | ||||||
11 | privacy, security, and disclosure laws, State and federal | ||||||
12 | agencies and departments shall provide the Illinois Department | ||||||
13 | access to confidential and other information and data necessary | ||||||
14 | to perform eligibility and payment verifications and other | ||||||
15 | Illinois Department functions. This includes, but is not | ||||||
16 | limited to: information pertaining to licensure; | ||||||
17 | certification; earnings; immigration status; citizenship; wage | ||||||
18 | reporting; unearned and earned income; pension income; | ||||||
19 | employment; supplemental security income; social security | ||||||
20 | numbers; National Provider Identifier (NPI) numbers; the | ||||||
21 | National Practitioner Data Bank (NPDB); program and agency | ||||||
22 | exclusions; taxpayer identification numbers; tax delinquency; | ||||||
23 | corporate information; and death records. | ||||||
24 | The Illinois Department shall enter into agreements with | ||||||
25 | State agencies and departments, and is authorized to enter into | ||||||
26 | agreements with federal agencies and departments, under which |
| |||||||
| |||||||
1 | such agencies and departments shall share data necessary for | ||||||
2 | medical assistance program integrity functions and oversight. | ||||||
3 | The Illinois Department shall develop, in cooperation with | ||||||
4 | other State departments and agencies, and in compliance with | ||||||
5 | applicable federal laws and regulations, appropriate and | ||||||
6 | effective methods to share such data. At a minimum, and to the | ||||||
7 | extent necessary to provide data sharing, the Illinois | ||||||
8 | Department shall enter into agreements with State agencies and | ||||||
9 | departments, and is authorized to enter into agreements with | ||||||
10 | federal agencies and departments, including but not limited to: | ||||||
11 | the Secretary of State; the Department of Revenue; the | ||||||
12 | Department of Public Health; the Department of Human Services; | ||||||
13 | and the Department of Financial and Professional Regulation. | ||||||
14 | Beginning in fiscal year 2013, the Illinois Department | ||||||
15 | shall set forth a request for information to identify the | ||||||
16 | benefits of a pre-payment, post-adjudication, and post-edit | ||||||
17 | claims system with the goals of streamlining claims processing | ||||||
18 | and provider reimbursement, reducing the number of pending or | ||||||
19 | rejected claims, and helping to ensure a more transparent | ||||||
20 | adjudication process through the utilization of: (i) provider | ||||||
21 | data verification and provider screening technology; and (ii) | ||||||
22 | clinical code editing; and (iii) pre-pay, pre- or | ||||||
23 | post-adjudicated predictive modeling with an integrated case | ||||||
24 | management system with link analysis. Such a request for | ||||||
25 | information shall not be considered as a request for proposal | ||||||
26 | or as an obligation on the part of the Illinois Department to |
| |||||||
| |||||||
1 | take any action or acquire any products or services. | ||||||
2 | The Illinois Department shall establish policies, | ||||||
3 | procedures,
standards and criteria by rule for the acquisition, | ||||||
4 | repair and replacement
of orthotic and prosthetic devices and | ||||||
5 | durable medical equipment. Such
rules shall provide, but not be | ||||||
6 | limited to, the following services: (1)
immediate repair or | ||||||
7 | replacement of such devices by recipients; and (2) rental, | ||||||
8 | lease, purchase or lease-purchase of
durable medical equipment | ||||||
9 | in a cost-effective manner, taking into
consideration the | ||||||
10 | recipient's medical prognosis, the extent of the
recipient's | ||||||
11 | needs, and the requirements and costs for maintaining such
| ||||||
12 | equipment. Subject to prior approval, such rules shall enable a | ||||||
13 | recipient to temporarily acquire and
use alternative or | ||||||
14 | substitute devices or equipment pending repairs or
| ||||||
15 | replacements of any device or equipment previously authorized | ||||||
16 | for such
recipient by the Department. Notwithstanding any | ||||||
17 | provision of Section 5-5f to the contrary, the Department may, | ||||||
18 | by rule, exempt certain replacement wheelchair parts from prior | ||||||
19 | approval and, for wheelchairs, wheelchair parts, wheelchair | ||||||
20 | accessories, and related seating and positioning items, | ||||||
21 | determine the wholesale price by methods other than actual | ||||||
22 | acquisition costs. | ||||||
23 | The Department shall require, by rule, all providers of | ||||||
24 | durable medical equipment to be accredited by an accreditation | ||||||
25 | organization approved by the federal Centers for Medicare and | ||||||
26 | Medicaid Services and recognized by the Department in order to |
| |||||||
| |||||||
1 | bill the Department for providing durable medical equipment to | ||||||
2 | recipients. No later than 15 months after the effective date of | ||||||
3 | the rule adopted pursuant to this paragraph, all providers must | ||||||
4 | meet the accreditation requirement.
| ||||||
5 | The Department shall execute, relative to the nursing home | ||||||
6 | prescreening
project, written inter-agency agreements with the | ||||||
7 | Department of Human
Services and the Department on Aging, to | ||||||
8 | effect the following: (i) intake
procedures and common | ||||||
9 | eligibility criteria for those persons who are receiving
| ||||||
10 | non-institutional services; and (ii) the establishment and | ||||||
11 | development of
non-institutional services in areas of the State | ||||||
12 | where they are not currently
available or are undeveloped; and | ||||||
13 | (iii) notwithstanding any other provision of law, subject to | ||||||
14 | federal approval, on and after July 1, 2012, an increase in the | ||||||
15 | determination of need (DON) scores from 29 to 37 for applicants | ||||||
16 | for institutional and home and community-based long term care; | ||||||
17 | if and only if federal approval is not granted, the Department | ||||||
18 | may, in conjunction with other affected agencies, implement | ||||||
19 | utilization controls or changes in benefit packages to | ||||||
20 | effectuate a similar savings amount for this population; and | ||||||
21 | (iv) no later than July 1, 2013, minimum level of care | ||||||
22 | eligibility criteria for institutional and home and | ||||||
23 | community-based long term care; and (v) no later than October | ||||||
24 | 1, 2013, establish procedures to permit long term care | ||||||
25 | providers access to eligibility scores for individuals with an | ||||||
26 | admission date who are seeking or receiving services from the |
| |||||||
| |||||||
1 | long term care provider. In order to select the minimum level | ||||||
2 | of care eligibility criteria, the Governor shall establish a | ||||||
3 | workgroup that includes affected agency representatives and | ||||||
4 | stakeholders representing the institutional and home and | ||||||
5 | community-based long term care interests. This Section shall | ||||||
6 | not restrict the Department from implementing lower level of | ||||||
7 | care eligibility criteria for community-based services in | ||||||
8 | circumstances where federal approval has been granted.
| ||||||
9 | The Illinois Department shall develop and operate, in | ||||||
10 | cooperation
with other State Departments and agencies and in | ||||||
11 | compliance with
applicable federal laws and regulations, | ||||||
12 | appropriate and effective
systems of health care evaluation and | ||||||
13 | programs for monitoring of
utilization of health care services | ||||||
14 | and facilities, as it affects
persons eligible for medical | ||||||
15 | assistance under this Code.
| ||||||
16 | The Illinois Department shall report annually to the | ||||||
17 | General Assembly,
no later than the second Friday in April of | ||||||
18 | 1979 and each year
thereafter, in regard to:
| ||||||
19 | (a) actual statistics and trends in utilization of | ||||||
20 | medical services by
public aid recipients;
| ||||||
21 | (b) actual statistics and trends in the provision of | ||||||
22 | the various medical
services by medical vendors;
| ||||||
23 | (c) current rate structures and proposed changes in | ||||||
24 | those rate structures
for the various medical vendors; and
| ||||||
25 | (d) efforts at utilization review and control by the | ||||||
26 | Illinois Department.
|
| |||||||
| |||||||
1 | The period covered by each report shall be the 3 years | ||||||
2 | ending on the June
30 prior to the report. The report shall | ||||||
3 | include suggested legislation
for consideration by the General | ||||||
4 | Assembly. The filing of one copy of the
report with the | ||||||
5 | Speaker, one copy with the Minority Leader and one copy
with | ||||||
6 | the Clerk of the House of Representatives, one copy with the | ||||||
7 | President,
one copy with the Minority Leader and one copy with | ||||||
8 | the Secretary of the
Senate, one copy with the Legislative | ||||||
9 | Research Unit, and such additional
copies
with the State | ||||||
10 | Government Report Distribution Center for the General
Assembly | ||||||
11 | as is required under paragraph (t) of Section 7 of the State
| ||||||
12 | Library Act shall be deemed sufficient to comply with this | ||||||
13 | Section.
| ||||||
14 | Rulemaking authority to implement Public Act 95-1045, if | ||||||
15 | any, is conditioned on the rules being adopted in accordance | ||||||
16 | with all provisions of the Illinois Administrative Procedure | ||||||
17 | Act and all rules and procedures of the Joint Committee on | ||||||
18 | Administrative Rules; any purported rule not so adopted, for | ||||||
19 | whatever reason, is unauthorized. | ||||||
20 | On and after July 1, 2012, the Department shall reduce any | ||||||
21 | rate of reimbursement for services or other payments or alter | ||||||
22 | any methodologies authorized by this Code to reduce any rate of | ||||||
23 | reimbursement for services or other payments in accordance with | ||||||
24 | Section 5-5e. | ||||||
25 | Because kidney transplantation can be an appropriate, cost | ||||||
26 | effective
alternative to renal dialysis when medically |
| |||||||
| |||||||
1 | necessary and notwithstanding the provisions of Section 1-11 of | ||||||
2 | this Code, beginning October 1, 2014, the Department shall | ||||||
3 | cover kidney transplantation for noncitizens with end-stage | ||||||
4 | renal disease who are not eligible for comprehensive medical | ||||||
5 | benefits, who meet the residency requirements of Section 5-3 of | ||||||
6 | this Code, and who would otherwise meet the financial | ||||||
7 | requirements of the appropriate class of eligible persons under | ||||||
8 | Section 5-2 of this Code. To qualify for coverage of kidney | ||||||
9 | transplantation, such person must be receiving emergency renal | ||||||
10 | dialysis services covered by the Department. Providers under | ||||||
11 | this Section shall be prior approved and certified by the | ||||||
12 | Department to perform kidney transplantation and the services | ||||||
13 | under this Section shall be limited to services associated with | ||||||
14 | kidney transplantation. | ||||||
15 | Notwithstanding any other provision of this Code to the | ||||||
16 | contrary, on or after July 1, 2015, all FDA approved forms of | ||||||
17 | medication assisted treatment prescribed for the treatment of | ||||||
18 | alcohol dependence or treatment of opioid dependence shall be | ||||||
19 | covered under both fee for service and managed care medical | ||||||
20 | assistance programs for persons who are otherwise eligible for | ||||||
21 | medical assistance under this Article and shall not be subject | ||||||
22 | to any (1) utilization control, other than those established | ||||||
23 | under the American Society of Addiction Medicine patient | ||||||
24 | placement criteria,
(2) prior authorization mandate, or (3) | ||||||
25 | lifetime restriction limit
mandate. | ||||||
26 | On or after July 1, 2015, opioid antagonists prescribed for |
| |||||||
| |||||||
1 | the treatment of an opioid overdose, including the medication | ||||||
2 | product, administration devices, and any pharmacy fees related | ||||||
3 | to the dispensing and administration of the opioid antagonist, | ||||||
4 | shall be covered under the medical assistance program for | ||||||
5 | persons who are otherwise eligible for medical assistance under | ||||||
6 | this Article. As used in this Section, "opioid antagonist" | ||||||
7 | means a drug that binds to opioid receptors and blocks or | ||||||
8 | inhibits the effect of opioids acting on those receptors, | ||||||
9 | including, but not limited to, naloxone hydrochloride or any | ||||||
10 | other similarly acting drug approved by the U.S. Food and Drug | ||||||
11 | Administration. | ||||||
12 | Upon federal approval, the Department shall provide | ||||||
13 | coverage and reimbursement for all drugs that are approved for | ||||||
14 | marketing by the federal Food and Drug Administration and that | ||||||
15 | are recommended by the federal Public Health Service or the | ||||||
16 | United States Centers for Disease Control and Prevention for | ||||||
17 | pre-exposure prophylaxis and related pre-exposure prophylaxis | ||||||
18 | services, including, but not limited to, HIV and sexually | ||||||
19 | transmitted infection screening, treatment for sexually | ||||||
20 | transmitted infections, medical monitoring, assorted labs, and | ||||||
21 | counseling to reduce the likelihood of HIV infection among | ||||||
22 | individuals who are not infected with HIV but who are at high | ||||||
23 | risk of HIV infection. | ||||||
24 | (Source: P.A. 98-104, Article 9, Section 9-5, eff. 7-22-13; | ||||||
25 | 98-104, Article 12, Section 12-20, eff. 7-22-13; 98-303, eff. | ||||||
26 | 8-9-13; 98-463, eff. 8-16-13; 98-651, eff. 6-16-14; 98-756, |
| |||||||
| |||||||
1 | eff. 7-16-14; 98-963, eff. 8-15-14; 99-78, eff. 7-20-15; | ||||||
2 | 99-180, eff. 7-29-15; 99-236, eff. 8-3-15; 99-407 (see Section | ||||||
3 | 20 of P.A. 99-588 for the effective date of P.A. 99-407); | ||||||
4 | 99-433, eff. 8-21-15; 99-480, eff. 9-9-15; 99-588, eff. | ||||||
5 | 7-20-16; 99-642, eff. 7-28-16; 99-772, eff. 1-1-17; 99-895, | ||||||
6 | eff. 1-1-17; revised 9-20-16.)
|