Public Act 103-0521
HB1595 EnrolledLRB103 06018 CPF 51045 b HB1595 Enrolled LRB103 06018 CPF 51045 b
HB1595 Enrolled LRB103 06018 CPF 51045 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Emergency Medical Services (EMS) Systems
Act is amended by changing Sections 3.5, 3.25, 3.40, 3.45, and
3.55 as follows:
(210 ILCS 50/3.5)
Sec. 3.5. Definitions. As used in this Act:
"Clinical observation" means the ongoing observation of a
patient's condition by a licensed health care professional
utilizing a medical skill set while continuing assessment and
care.
"Department" means the Illinois Department of Public
Health.
"Director" means the Director of the Illinois Department
of Public Health.
"Emergency" means a medical condition of recent onset and
severity that would lead a prudent layperson, possessing an
average knowledge of medicine and health, to believe that
urgent or unscheduled medical care is required.
"Emergency Medical Services personnel" or "EMS personnel"
means persons licensed as an Emergency Medical Responder (EMR)
(First Responder), Emergency Medical Dispatcher (EMD),
HB1595 Enrolled LRB103 06018 CPF 51045 b
Emergency Medical Technician (EMT), Emergency Medical
Technician-Intermediate (EMT-I), Advanced Emergency Medical
Technician (A-EMT), Paramedic (EMT-P), Emergency
Communications Registered Nurse (ECRN), Pre-Hospital
Registered Nurse (PHRN), Pre-Hospital Advanced Practice
Registered Nurse (PHAPRN), or Pre-Hospital Physician Assistant
(PHPA).
"Exclusive representative" has the same meaning as defined
in Section 3 of the Illinois Public Labor Relations Act.
"Health care facility" means a hospital, nursing home,
physician's office or other fixed location at which medical
and health care services are performed. It does not include
"pre-hospital emergency care settings" which utilize EMS
personnel to render pre-hospital emergency care prior to the
arrival of a transport vehicle, as defined in this Act.
"Hospital" has the meaning ascribed to that term in the
Hospital Licensing Act.
"Labor organization" has the same meaning as defined in
Section 3 of the Illinois Public Labor Relations Act.
"Medical monitoring" means the performance of medical
tests and physical exams to evaluate an individual's ongoing
exposure to a factor that could negatively impact that
person's health. "Medical monitoring" includes close
surveillance or supervision of patients liable to suffer
deterioration in physical or mental health and checks of
various parameters such as pulse rate, temperature,
respiration rate, the condition of the pupils, the level of
consciousness and awareness, the degree of appreciation of
pain, and blood gas concentrations such as oxygen and carbon
dioxide.
"Silver spanner program" means a program in which a member
under a fire department's or fire protection district's
collective bargaining agreement works on or at the EMS System
under another fire department's or fire protection district's
collective bargaining agreement and (i) the other fire
department or fire protection district is not the member's
full-time employer and (ii) any EMS services not included
under the original fire department's or fire protection
district's collective bargaining agreement are included in the
other fire department's or fire protection district's
collective bargaining agreement.
"Trauma" means any significant injury which involves
single or multiple organ systems.
(Source: P.A. 100-1082, eff. 8-24-19; 101-81, eff. 7-12-19.)
(210 ILCS 50/3.25)
Sec. 3.25. EMS Region Plan; Development.
(a) Within 6 months after designation of an EMS Region, an
EMS Region Plan addressing at least the information prescribed
in Section 3.30 shall be submitted to the Department for
approval. The Plan shall be developed by the Region's EMS
Medical Directors Committee with advice from the Regional EMS
Advisory Committee; portions of the plan concerning trauma
shall be developed jointly with the Region's Trauma Center
Medical Directors or Trauma Center Medical Directors
Committee, whichever is applicable, with advice from the
Regional Trauma Advisory Committee, if such Advisory Committee
has been established in the Region. Portions of the Plan
concerning stroke shall be developed jointly with the Regional
Stroke Advisory Subcommittee.
(1) A Region's EMS Medical Directors Committee shall
be comprised of the Region's EMS Medical Directors, along
with the medical advisor to a fire department vehicle
service provider. For regions which include a municipal
fire department serving a population of over 2,000,000
people, that fire department's medical advisor shall serve
on the Committee. For other regions, the fire department
vehicle service providers shall select which medical
advisor to serve on the Committee on an annual basis.
(2) A Region's Trauma Center Medical Directors
Committee shall be comprised of the Region's Trauma Center
Medical Directors.
(b) A Region's Trauma Center Medical Directors may choose
to participate in the development of the EMS Region Plan
through membership on the Regional EMS Advisory Committee,
rather than through a separate Trauma Center Medical Directors
Committee. If that option is selected, the Region's Trauma
Center Medical Director shall also determine whether a
separate Regional Trauma Advisory Committee is necessary for
the Region.
(c) In the event of disputes over content of the Plan
between the Region's EMS Medical Directors Committee and the
Region's Trauma Center Medical Directors or Trauma Center
Medical Directors Committee, whichever is applicable, the
Director of the Illinois Department of Public Health shall
intervene through a mechanism established by the Department
through rules adopted pursuant to this Act. An individual
interviewed or investigated by an EMS Medical Director or the
Department shall have the right to a union representative and
legal counsel of the individual's choosing present at any
interview. The union representative must comply with any
confidentiality requirements and requirements for the
protection of any patient information presented during the
proceeding.
(d) "Regional EMS Advisory Committee" means a committee
formed within an Emergency Medical Services (EMS) Region to
advise the Region's EMS Medical Directors Committee and to
select the Region's representative to the State Emergency
Medical Services Advisory Council, consisting of at least the
members of the Region's EMS Medical Directors Committee, the
Chair of the Regional Trauma Committee, the EMS System
Coordinators from each Resource Hospital within the Region,
one administrative representative from an Associate Hospital
within the Region, one administrative representative from a
Participating Hospital within the Region, one administrative
representative from the vehicle service provider which
responds to the highest number of calls for emergency service
within the Region, one representative from the vehicle service
provider that responds to the highest number of calls for
non-emergency services within the Region, one representative
from the labor organization recognized as the exclusive
representative of employees of the vehicle service provider
that responds to the highest number of calls for non-emergency
services within the Region, if applicable, one administrative
representative of a vehicle service provider from each System
within the Region, one representative from a labor
organization recognized as the exclusive representative of a
vehicle service provider's employees in each System and
selected by a statewide organization of such labor
organizations, one individual from each level of license
provided in Section 3.50 of this Act, one Pre-Hospital
Registered Nurse practicing within the Region, and one
registered professional nurse currently practicing in an
emergency department within the Region. Of the 2
administrative representatives of vehicle service providers,
at least one shall be an administrative representative of a
private vehicle service provider. The Department's Regional
EMS Coordinator for each Region shall serve as a non-voting
member of that Region's EMS Advisory Committee.
Every 2 years, the members of the Region's EMS Medical
Directors Committee shall rotate serving as Committee Chair,
and select the Associate Hospital, Participating Hospital and
vehicle service providers which shall send representatives to
the Advisory Committee, and the EMS personnel and nurse who
shall serve on the Advisory Committee.
(e) "Regional Trauma Advisory Committee" means a committee
formed within an Emergency Medical Services (EMS) Region, to
advise the Region's Trauma Center Medical Directors Committee,
consisting of at least the Trauma Center Medical Directors and
Trauma Coordinators from each Trauma Center within the Region,
one EMS Medical Director from a resource hospital within the
Region, one EMS System Coordinator from another resource
hospital within the Region, one representative each from a
public and private vehicle service provider which transports
trauma patients within the Region, an administrative
representative from each trauma center within the Region, one
EMR, EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN, or PHRN
representing the highest level of EMS personnel practicing
within the Region, one emergency physician, and one Trauma
Nurse Specialist (TNS) currently practicing in a trauma
center. The Department's Regional EMS Coordinator for each
Region shall serve as a non-voting member of that Region's
Trauma Advisory Committee.
Every 2 years, the members of the Trauma Center Medical
Directors Committee shall rotate serving as Committee Chair,
and select the vehicle service providers, EMS personnel,
emergency physician, EMS System Coordinator and TNS who shall
serve on the Advisory Committee.
(Source: P.A. 98-973, eff. 8-15-14.)
(210 ILCS 50/3.40)
Sec. 3.40. EMS System Participation Suspensions and Due
Process.
(a) An EMS Medical Director may suspend from participation
within the System any EMS personnel, EMS Lead Instructor (LI),
individual, individual provider or other participant
considered not to be meeting the requirements of the Program
Plan of that approved EMS System. An EMS Medical Director must
submit a suspension order to the Department describing which
requirements of the Program Plan were not met and the
suspension's duration. The Department shall review and confirm
receipt of the suspension order, request additional
information, or initiate an investigation. The Department
shall incorporate the duration of that suspension into any
further action taken by the Department to suspend, revoke, or
refuse to issue or renew the license of the individual or
entity for any violation of this Act or the Program Plan
arising from the same conduct for which the suspension order
was issued if the suspended party has neither requested a
Department hearing on the suspension nor worked as a provider
in any other System during the term of the suspension.
(b) Prior to suspending any individual or entity, an EMS
Medical Director shall provide an opportunity for a hearing
before the local System review board in accordance with
subsection (f) and the rules promulgated by the Department.
(1) If the local System review board affirms or
modifies the EMS Medical Director's suspension order, the
individual or entity shall have the opportunity for a
review of the local board's decision by the State EMS
Disciplinary Review Board, pursuant to Section 3.45 of
this Act.
(2) If the local System review board reverses or
modifies the EMS Medical Director's order, the EMS Medical
Director shall have the opportunity for a review of the
local board's decision by the State EMS Disciplinary
Review Board, pursuant to Section 3.45 of this Act.
(3) The suspension shall commence only upon the
occurrence of one of the following:
(A) the individual or entity has waived the
opportunity for a hearing before the local System
review board; or
(B) the order has been affirmed or modified by the
local system review board and the individual or entity
has waived the opportunity for review by the State
Board; or
(C) the order has been affirmed or modified by the
local system review board, and the local board's
decision has been affirmed or modified by the State
Board.
(c) An individual interviewed or investigated by the local
system review board or the Department shall have the right to a
union representative and legal counsel of the individual's
choosing present at any interview. The union representative
must comply with any confidentiality requirements and
requirements for the protection of any patient information
presented during the proceeding.
(d) (c) An EMS Medical Director may immediately suspend an
EMR, EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN, PHRN, LI, PHPA,
PHAPRN, or other individual or entity if he or she finds that
the continuation in practice by the individual or entity would
constitute an imminent danger to the public. The suspended
individual or entity shall be issued an immediate verbal
notification followed by a written suspension order by the EMS
Medical Director which states the length, terms and basis for
the suspension.
(1) Within 24 hours following the commencement of the
suspension, the EMS Medical Director shall deliver to the
Department, by messenger, telefax, or other
Department-approved electronic communication, a copy of
the suspension order and copies of any written materials
which relate to the EMS Medical Director's decision to
suspend the individual or entity. All medical and
patient-specific information, including Department
findings with respect to the quality of care rendered,
shall be strictly confidential pursuant to the Medical
Studies Act (Part 21 of Article VIII of the Code of Civil
Procedure).
(2) Within 24 hours following the commencement of the
suspension, the suspended individual or entity may deliver
to the Department, by messenger, telefax, or other
Department-approved electronic communication, a written
response to the suspension order and copies of any written
materials which the individual or entity feels are
appropriate. All medical and patient-specific information,
including Department findings with respect to the quality
of care rendered, shall be strictly confidential pursuant
to the Medical Studies Act.
(3) Within 24 hours following receipt of the EMS
Medical Director's suspension order or the individual or
entity's written response, whichever is later, the
Director or the Director's designee shall determine
whether the suspension should be stayed pending an
opportunity for a hearing or review in accordance with
this Act, or whether the suspension should continue during
the course of that hearing or review. The Director or the
Director's designee shall issue this determination to the
EMS Medical Director, who shall immediately notify the
suspended individual or entity. The suspension shall
remain in effect during this period of review by the
Director or the Director's designee.
(e) (d) Upon issuance of a suspension order for reasons
directly related to medical care, the EMS Medical Director
shall also provide the individual or entity with the
opportunity for a hearing before the local System review
board, in accordance with subsection (f) and the rules
promulgated by the Department.
(1) If the local System review board affirms or
modifies the EMS Medical Director's suspension order, the
individual or entity shall have the opportunity for a
review of the local board's decision by the State EMS
Disciplinary Review Board, pursuant to Section 3.45 of
this Act.
(2) If the local System review board reverses or
modifies the EMS Medical Director's suspension order, the
EMS Medical Director shall have the opportunity for a
review of the local board's decision by the State EMS
Disciplinary Review Board, pursuant to Section 3.45 of
this Act.
(3) The suspended individual or entity may elect to
bypass the local System review board and seek direct
review of the EMS Medical Director's suspension order by
the State EMS Disciplinary Review Board.
(f) (e) The Resource Hospital shall designate a local
System review board in accordance with the rules of the
Department, for the purpose of providing a hearing to any
individual or entity participating within the System who is
suspended from participation by the EMS Medical Director. The
EMS Medical Director shall arrange for a certified shorthand
reporter to make a stenographic record of that hearing and
thereafter prepare a transcript of the proceedings. The EMS
Medical Director shall inform the individual of the
individual's right to have a union representative and legal
counsel of the individual's choosing present at any interview.
The union representative must comply with any confidentiality
requirements and requirements for the protection of any
patient information presented during the proceeding. The
transcript, all documents or materials received as evidence
during the hearing and the local System review board's written
decision shall be retained in the custody of the EMS system.
The System shall implement a decision of the local System
review board unless that decision has been appealed to the
State Emergency Medical Services Disciplinary Review Board in
accordance with this Act and the rules of the Department.
(g) (f) The Resource Hospital shall implement a decision
of the State Emergency Medical Services Disciplinary Review
Board which has been rendered in accordance with this Act and
the rules of the Department.
(Source: P.A. 100-201, eff. 8-18-17; 100-1082, eff. 8-24-19.)
(210 ILCS 50/3.45)
Sec. 3.45. State Emergency Medical Services Disciplinary
Review Board.
(a) The Governor shall appoint a State Emergency Medical
Services Disciplinary Review Board, composed of an EMS Medical
Director, an EMS System Coordinator, a Paramedic, an Emergency
Medical Technician (EMT), and the following members, who shall
only review cases in which a party is from the same
professional category: a Pre-Hospital Registered Nurse, a
Pre-Hospital Advanced Practice Registered Nurse, a
Pre-Hospital Physician Assistant, an ECRN, a Trauma Nurse
Specialist, an Emergency Medical Technician-Intermediate
(EMT-I), an Advanced Emergency Medical Technician (A-EMT), a
representative from a private vehicle service provider, a
representative from a public vehicle service provider, and an
emergency physician who monitors telecommunications from and
gives voice orders to EMS personnel. The Governor shall also
appoint one alternate for each member of the Board, from the
same professional category as the member of the Board.
(b) The members shall be appointed for a term of 3 years.
All appointees shall serve until their successors are
appointed. The alternate members shall be appointed and serve
in the same fashion as the members of the Board. If a member
resigns his or her appointment, the corresponding alternate
shall serve the remainder of that member's term until a
subsequent member is appointed by the Governor.
(c) The function of the Board is to review and affirm,
reverse or modify disciplinary orders.
(d) Any individual or entity, who received an immediate
suspension from an EMS Medical Director may request the Board
to reverse or modify the suspension order. If the suspension
had been affirmed or modified by a local System review board,
the suspended individual or entity may request the Board to
reverse or modify the local board's decision.
(e) Any individual or entity who received a non-immediate
suspension order from an EMS Medical Director which was
affirmed or modified by a local System review board may
request the Board to reverse or modify the local board's
decision. The individual shall be informed of the individual's
right to have one representative from the labor organization
recognized as the exclusive representative of that
individual's bargaining unit present and a legal
representative present during the State Emergency Medical
Services Disciplinary Review Board proceedings during open
session. The labor organization's representative must also
comply with all confidentiality requirements and requirements
for the protection of any patient information presented during
the proceeding.
(f) An EMS Medical Director whose suspension order was
reversed or modified by a local System review board may
request the Board to reverse or modify the local board's
decision.
(g) The Board shall meet on the first Tuesday of every
month, unless no requests for review have been submitted.
Additional meetings of the Board shall be scheduled to ensure
that a request for direct review of an immediate suspension
order is scheduled within 14 days after the Department
receives the request for review or as soon thereafter as a
quorum is available. The Board shall meet in Springfield or
Chicago, whichever location is closer to the majority of the
members or alternates attending the meeting. The Department
shall reimburse the members and alternates of the Board for
reasonable travel expenses incurred in attending meetings of
the Board.
(h) A request for review shall be submitted in writing to
the Chief of the Department's Division of Emergency Medical
Services and Highway Safety, within 10 days after receiving
the local board's decision or the EMS Medical Director's
suspension order, whichever is applicable, a copy of which
shall be enclosed.
(i) At its regularly scheduled meetings, the Board shall
review requests which have been received by the Department at
least 10 working days prior to the Board's meeting date.
Requests for review which are received less than 10 working
days prior to a scheduled meeting shall be considered at the
Board's next scheduled meeting, except that requests for
direct review of an immediate suspension order may be
scheduled up to 3 working days prior to the Board's meeting
date.
(j) A quorum shall be required for the Board to meet, which
shall consist of 3 members or alternates, including the EMS
Medical Director or alternate and the member or alternate from
the same professional category as the subject of the
suspension order. At each meeting of the Board, the members or
alternates present shall select a Chairperson to conduct the
meeting.
(k) Deliberations for decisions of the State EMS
Disciplinary Review Board shall be conducted in closed
session. Department staff may attend for the purpose of
providing clerical assistance, but no other persons may be in
attendance except for the parties to the dispute being
reviewed by the Board and their attorneys, unless by request
of the Board.
(l) The Board shall review the transcript, evidence, and
written decision of the local review board, or the written
decision and supporting documentation of the EMS Medical
Director, whichever is applicable, along with any additional
written or verbal testimony or argument offered by the parties
to the dispute.
(m) At the conclusion of its review, the Board shall issue
its decision and the basis for its decision on a form provided
by the Department, and shall submit to the Department its
written decision together with the record of the local System
review board. The Department shall promptly issue a copy of
the Board's decision to all affected parties. The Board's
decision shall be binding on all parties.
(Source: P.A. 100-1082, eff. 8-24-19.)
(210 ILCS 50/3.55)
Sec. 3.55. Scope of practice.
(a) Any person currently licensed as an EMR, EMT, EMT-I,
A-EMT, PHRN, PHAPRN, PHPA, or Paramedic may perform emergency
and non-emergency medical services as defined in this Act, in
accordance with his or her level of education, training and
licensure, the standards of performance and conduct prescribed
by the Department in rules adopted pursuant to this Act, and
the requirements of the EMS System in which he or she
practices, as contained in the approved Program Plan for that
System. The Director may, by written order, temporarily modify
individual scopes of practice in response to public health
emergencies for periods not exceeding 180 days.
(a-5) EMS personnel who have successfully completed a
Department approved course in automated defibrillator
operation and who are functioning within a Department approved
EMS System may utilize such automated defibrillator according
to the standards of performance and conduct prescribed by the
Department in rules adopted pursuant to this Act and the
requirements of the EMS System in which they practice, as
contained in the approved Program Plan for that System.
(a-7) An EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or
Paramedic who has successfully completed a Department approved
course in the administration of epinephrine shall be required
to carry epinephrine with him or her as part of the EMS
personnel medical supplies whenever he or she is performing
official duties as determined by the EMS System. The
epinephrine may be administered from a glass vial,
auto-injector, ampule, or pre-filled syringe.
(b) An EMR, EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or
Paramedic may practice as an EMR, EMT, EMT-I, A-EMT, or
Paramedic or utilize his or her EMR, EMT, EMT-I, A-EMT, PHRN,
PHAPRN, PHPA, or Paramedic license in pre-hospital or
inter-hospital emergency care settings or non-emergency
medical transport situations, under the written or verbal
direction of the EMS Medical Director. For purposes of this
Section, a "pre-hospital emergency care setting" may include a
location, that is not a health care facility, which utilizes
EMS personnel to render pre-hospital emergency care prior to
the arrival of a transport vehicle. The location shall include
communication equipment and all of the portable equipment and
drugs appropriate for the EMR, EMT, EMT-I, A-EMT, or
Paramedic's level of care, as required by this Act, rules
adopted by the Department pursuant to this Act, and the
protocols of the EMS Systems, and shall operate only with the
approval and under the direction of the EMS Medical Director.
This Section shall not prohibit an EMR, EMT, EMT-I, A-EMT,
PHRN, PHAPRN, PHPA, or Paramedic from practicing within an
emergency department or other health care setting for the
purpose of receiving continuing education or training approved
by the EMS Medical Director. This Section shall also not
prohibit an EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or
Paramedic from seeking credentials other than his or her EMT,
EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or Paramedic license and
utilizing such credentials to work in emergency departments or
other health care settings under the jurisdiction of that
employer.
(c) An EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or Paramedic
may honor Do Not Resuscitate (DNR) orders and powers of
attorney for health care only in accordance with rules adopted
by the Department pursuant to this Act and protocols of the EMS
System in which he or she practices.
(d) A student enrolled in a Department approved EMS
personnel program, while fulfilling the clinical training and
in-field supervised experience requirements mandated for
licensure or approval by the System and the Department, may
perform prescribed procedures under the direct supervision of
a physician licensed to practice medicine in all of its
branches, a qualified registered professional nurse, or
qualified EMS personnel, only when authorized by the EMS
Medical Director.
(e) An EMR, EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or
Paramedic may transport a police dog injured in the line of
duty to a veterinary clinic or similar facility if there are no
persons requiring medical attention or transport at that time.
For the purposes of this subsection, "police dog" means a dog
owned or used by a law enforcement department or agency in the
course of the department or agency's work, including a search
and rescue dog, service dog, accelerant detection canine, or
other dog that is in use by a county, municipal, or State law
enforcement agency.
(f) Nothing in this Act shall be construed to prohibit an
EMT, EMT-I, A-EMT, Paramedic, or PHRN from completing an
initial Occupational Safety and Health Administration
Respirator Medical Evaluation Questionnaire on behalf of fire
service personnel, as permitted by his or her EMS System
Medical Director.
(g) A member of a fire department's or fire protection
district's collective bargaining unit shall be eligible to
work under a silver spanner program for another EMS System's
fire department or fire protection district that is not the
full-time employer of that member, for a period not to exceed 2
weeks, if the member: (1) is under the direct supervision of
another licensed individual operating at the same or higher
licensure level as the member; (2) made a written request to
the EMS System's Medical Director for approval to work under
the silver spanner program, which shall be approved or denied
within 24 hours after the EMS System's Medical Director
received the request; and (3) tests into the EMS System based
upon appropriate standards as outlined in the EMS System
Program Plan. The EMS System within which the member is
seeking to join must make all required testing available to
the member within 2 weeks of the written request. Failure to do
so by the EMS System shall allow the member to continue working
under a silver spanner program until all required testing
becomes available.
(Source: P.A. 102-79, eff. 1-1-22.)