Illinois 2023-2024 Regular Session

Illinois House Bill HB3746 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB3746 Introduced , by Rep. Natalie A. Manley SYNOPSIS AS INTRODUCED: 20 ILCS 1705/15.4 Amends the Mental Health and Developmental Disabilities Administrative Act. In provisions requiring the Department of Human Services to develop a medication administration training program for authorized directed staff at certain facilities for persons with a developmental disability, provides that non-licensed authorized direct care staff must, in addition to other specified requirements, (i) score 100% on the competency-based assessment demonstrating proficiency in the skill of passing medication and (ii) have received additional competency-based assessment by the nurse-trainer as deemed necessary by the nurse-trainer whenever it is determined that additional skill development and training is needed to administer a medication. Provides that every facility health care program shall adopt written policies and procedures for assisting individuals who choose to obtain preventative health and self-medication skills in consultation with a professional nurse or other medical personnel as specified. Provides that if an individual desires to gain independence in self-medication administration the individual shall be evaluated to determine the individual's ability to self-medicate by the nurse-trainer through the use of the Department's required, standardized screening and assessment instruments. LRB103 29607 KTG 56002 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB3746 Introduced , by Rep. Natalie A. Manley SYNOPSIS AS INTRODUCED: 20 ILCS 1705/15.4 20 ILCS 1705/15.4 Amends the Mental Health and Developmental Disabilities Administrative Act. In provisions requiring the Department of Human Services to develop a medication administration training program for authorized directed staff at certain facilities for persons with a developmental disability, provides that non-licensed authorized direct care staff must, in addition to other specified requirements, (i) score 100% on the competency-based assessment demonstrating proficiency in the skill of passing medication and (ii) have received additional competency-based assessment by the nurse-trainer as deemed necessary by the nurse-trainer whenever it is determined that additional skill development and training is needed to administer a medication. Provides that every facility health care program shall adopt written policies and procedures for assisting individuals who choose to obtain preventative health and self-medication skills in consultation with a professional nurse or other medical personnel as specified. Provides that if an individual desires to gain independence in self-medication administration the individual shall be evaluated to determine the individual's ability to self-medicate by the nurse-trainer through the use of the Department's required, standardized screening and assessment instruments. LRB103 29607 KTG 56002 b LRB103 29607 KTG 56002 b A BILL FOR
2	2	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB3746 Introduced , by Rep. Natalie A. Manley SYNOPSIS AS INTRODUCED:
3	3	20 ILCS 1705/15.4 20 ILCS 1705/15.4
4	4	20 ILCS 1705/15.4
5	5	Amends the Mental Health and Developmental Disabilities Administrative Act. In provisions requiring the Department of Human Services to develop a medication administration training program for authorized directed staff at certain facilities for persons with a developmental disability, provides that non-licensed authorized direct care staff must, in addition to other specified requirements, (i) score 100% on the competency-based assessment demonstrating proficiency in the skill of passing medication and (ii) have received additional competency-based assessment by the nurse-trainer as deemed necessary by the nurse-trainer whenever it is determined that additional skill development and training is needed to administer a medication. Provides that every facility health care program shall adopt written policies and procedures for assisting individuals who choose to obtain preventative health and self-medication skills in consultation with a professional nurse or other medical personnel as specified. Provides that if an individual desires to gain independence in self-medication administration the individual shall be evaluated to determine the individual's ability to self-medicate by the nurse-trainer through the use of the Department's required, standardized screening and assessment instruments.
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11	11	1 AN ACT concerning State government.
12	12	2 Be it enacted by the People of the State of Illinois,
13	13	3 represented in the General Assembly:
14	14	4 Section 5. The Mental Health and Developmental
15	15	5 Disabilities Administrative Act is amended by changing Section
16	16	6 15.4 as follows:
17	17	7 (20 ILCS 1705/15.4)
18	18	8 Sec. 15.4. Authorization for nursing delegation to permit
19	19	9 direct care staff to administer medications.
20	20	10 (a) This Section applies to (i) all residential programs
21	21	11 for persons with a developmental disability in settings of 16
22	22	12 persons or fewer that are funded or licensed by the Department
23	23	13 of Human Services and that distribute or administer
24	24	14 medications, (ii) all intermediate care facilities for persons
25	25	15 with developmental disabilities with 16 beds or fewer that are
26	26	16 licensed by the Department of Public Health, and (iii) all day
27	27	17 programs certified to serve persons with developmental
28	28	18 disabilities by the Department of Human Services. The
29	29	19 Department of Human Services shall develop a training program
30	30	20 for authorized direct care staff to administer medications
31	31	21 under the supervision and monitoring of a registered
32	32	22 professional nurse. The training program for authorized direct
33	33	23 care staff shall include educational and oversight components
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37	37	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB3746 Introduced , by Rep. Natalie A. Manley SYNOPSIS AS INTRODUCED:
38	38	20 ILCS 1705/15.4 20 ILCS 1705/15.4
39	39	20 ILCS 1705/15.4
40	40	Amends the Mental Health and Developmental Disabilities Administrative Act. In provisions requiring the Department of Human Services to develop a medication administration training program for authorized directed staff at certain facilities for persons with a developmental disability, provides that non-licensed authorized direct care staff must, in addition to other specified requirements, (i) score 100% on the competency-based assessment demonstrating proficiency in the skill of passing medication and (ii) have received additional competency-based assessment by the nurse-trainer as deemed necessary by the nurse-trainer whenever it is determined that additional skill development and training is needed to administer a medication. Provides that every facility health care program shall adopt written policies and procedures for assisting individuals who choose to obtain preventative health and self-medication skills in consultation with a professional nurse or other medical personnel as specified. Provides that if an individual desires to gain independence in self-medication administration the individual shall be evaluated to determine the individual's ability to self-medicate by the nurse-trainer through the use of the Department's required, standardized screening and assessment instruments.
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68	68	1 for staff who work in day programs that are similar to those
69	69	2 for staff who work in residential programs. This training
70	70	3 program shall be developed in consultation with professional
71	71	4 associations representing (i) physicians licensed to practice
72	72	5 medicine in all its branches, (ii) registered professional
73	73	6 nurses, and (iii) pharmacists.
74	74	7 (b) For the purposes of this Section:
75	75	8 "Authorized direct care staff" means non-licensed persons
76	76	9 who have successfully completed a medication administration
77	77	10 training program approved by the Department of Human Services
78	78	11 and conducted by a nurse-trainer. This authorization is
79	79	12 specific to an individual receiving service in a specific
80	80	13 agency and does not transfer to another agency.
81	81	14 "Medications" means oral and topical medications, insulin
82	82	15 in an injectable form, oxygen, epinephrine auto-injectors, and
83	83	16 vaginal and rectal creams and suppositories. "Oral" includes
84	84	17 inhalants and medications administered through enteral tubes,
85	85	18 utilizing aseptic technique. "Topical" includes eye, ear, and
86	86	19 nasal medications. Any controlled substances must be packaged
87	87	20 specifically for an identified individual.
88	88	21 "Insulin in an injectable form" means a subcutaneous
89	89	22 injection via an insulin pen pre-filled by the manufacturer.
90	90	23 Authorized direct care staff may administer insulin, as
91	91	24 ordered by a physician, advanced practice registered nurse, or
92	92	25 physician assistant, if: (i) the staff has successfully
93	93	26 completed a Department-approved advanced training program
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104	104	1 specific to insulin administration developed in consultation
105	105	2 with professional associations listed in subsection (a) of
106	106	3 this Section, and (ii) the staff consults with the registered
107	107	4 nurse, prior to administration, of any insulin dose that is
108	108	5 determined based on a blood glucose test result. The
109	109	6 authorized direct care staff shall not: (i) calculate the
110	110	7 insulin dosage needed when the dose is dependent upon a blood
111	111	8 glucose test result, or (ii) administer insulin to individuals
112	112	9 who require blood glucose monitoring greater than 3 times
113	113	10 daily, unless directed to do so by the registered nurse.
114	114	11 "Nurse-trainer training program" means a standardized,
115	115	12 competency-based medication administration train-the-trainer
116	116	13 program provided by the Department of Human Services and
117	117	14 conducted by a Department of Human Services master
118	118	15 nurse-trainer for the purpose of training nurse-trainers to
119	119	16 train persons employed or under contract to provide direct
120	120	17 care or treatment to individuals receiving services to
121	121	18 administer medications and provide self-administration of
122	122	19 medication training to individuals under the supervision and
123	123	20 monitoring of the nurse-trainer. The program incorporates
124	124	21 adult learning styles, teaching strategies, classroom
125	125	22 management, and a curriculum overview, including the ethical
126	126	23 and legal aspects of supervising those administering
127	127	24 medications.
128	128	25 "Self-administration of medications" means an individual
129	129	26 administers his or her own medications, or a portion of his or
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140	140	1 her own medications. To be considered capable to
141	141	2 self-administer their own medication, individuals must, at a
142	142	3 minimum, be able to identify their medication by size, shape,
143	143	4 or color, know when they should take the medication, and know
144	144	5 the amount of medication to be taken each time. The use of
145	145	6 assistive or enabling technologies can be used to demonstrate
146	146	7 a person's capability to administer his or her own
147	147	8 medications.
148	148	9 "Training program" means a standardized medication
149	149	10 administration training program approved by the Department of
150	150	11 Human Services and conducted by a registered professional
151	151	12 nurse for the purpose of training persons employed or under
152	152	13 contract to provide direct care or treatment to individuals
153	153	14 receiving services to administer medications and provide
154	154	15 self-administration of medication training to individuals
155	155	16 under the delegation and supervision of a nurse-trainer. The
156	156	17 program incorporates adult learning styles, teaching
157	157	18 strategies, classroom management, curriculum overview,
158	158	19 including ethical-legal aspects, and standardized
159	159	20 competency-based evaluations on administration of medications
160	160	21 and self-administration of medication training programs.
161	161	22 (c) Training and authorization of non-licensed direct care
162	162	23 staff by nurse-trainers must meet the requirements of this
163	163	24 subsection.
164	164	25 (1) Prior to training non-licensed direct care staff
165	165	26 to administer medication, the nurse-trainer shall perform
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176	176	1 the following for each individual to whom medication will
177	177	2 be administered by non-licensed direct care staff:
178	178	3 (A) An assessment of the individual's health
179	179	4 history and physical and mental status.
180	180	5 (B) An evaluation of the medications prescribed.
181	181	6 (2) Non-licensed authorized direct care staff shall
182	182	7 meet the following criteria:
183	183	8 (A) Be 18 years of age or older.
184	184	9 (B) Have completed high school or have a State of
185	185	10 Illinois High School Diploma.
186	186	11 (C) Have demonstrated functional literacy.
187	187	12 (D) Have satisfactorily completed the Health and
188	188	13 Safety component of a Department of Human Services
189	189	14 authorized direct care staff training program.
190	190	15 (E) Have successfully completed the training
191	191	16 program, pass the written portion of the comprehensive
192	192	17 exam, and score 100% on the competency-based
193	193	18 assessment demonstrating proficiency in the skill of
194	194	19 passing medication specific to the individual and his
195	195	20 or her medications.
196	196	21 (F) Have received additional competency-based
197	197	22 assessment by the nurse-trainer as deemed necessary by
198	198	23 the nurse-trainer whenever it is determined that
199	199	24 additional skill development and training is needed to
200	200	25 administer a medication a change of medication occurs
201	201	26 or a new individual that requires medication
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212	212	1 administration enters the program.
213	213	2 (3) Authorized direct care staff shall be re-evaluated
214	214	3 by a nurse-trainer at least annually or more frequently at
215	215	4 the discretion of the registered professional nurse. Any
216	216	5 necessary retraining shall be to the extent that is
217	217	6 necessary to ensure competency of the authorized direct
218	218	7 care staff to administer medication.
219	219	8 (4) Authorization of direct care staff to administer
220	220	9 medication shall be revoked if, in the opinion of the
221	221	10 registered professional nurse, the authorized direct care
222	222	11 staff is no longer competent to administer medication.
223	223	12 (5) The registered professional nurse shall assess an
224	224	13 individual's health status at least annually or more
225	225	14 frequently at the discretion of the registered
226	226	15 professional nurse.
227	227	16 (d) Medication self-administration shall meet the
228	228	17 following requirements:
229	229	18 (1) As part of the normalization process, in order for
230	230	19 each individual to attain the highest possible level of
231	231	20 independent functioning, all individuals shall be
232	232	21 permitted to participate in their total health care
233	233	22 program. This program shall include, but not be limited
234	234	23 to, individual training in preventive health and
235	235	24 self-medication procedures.
236	236	25 (A) Every program shall adopt written policies and
237	237	26 procedures for assisting individuals who choose to
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248	248	1 obtain in obtaining preventative health and
249	249	2 self-medication skills in consultation with a
250	250	3 registered professional nurse, advanced practice
251	251	4 registered nurse, physician assistant, or physician
252	252	5 licensed to practice medicine in all its branches.
253	253	6 (B) If an individual desires to gain independence
254	254	7 in self-medication administration the individual
255	255	8 Individuals shall be evaluated to determine the
256	256	9 individual's their ability to self-medicate by the
257	257	10 nurse-trainer through the use of the Department's
258	258	11 required, standardized screening and assessment
259	259	12 instruments.
260	260	13 (C) (Blank). When the results of the screening and
261	261	14 assessment indicate an individual not to be capable to
262	262	15 self-administer his or her own medications, programs
263	263	16 shall be developed in consultation with the Community
264	264	17 Support Team or Interdisciplinary Team to provide
265	265	18 individuals with self-medication administration.
266	266	19 (2) Each individual shall be presumed to be competent
267	267	20 to self-administer medications if:
268	268	21 (A) authorized by an order of a physician licensed
269	269	22 to practice medicine in all its branches, an advanced
270	270	23 practice registered nurse, or a physician assistant;
271	271	24 and
272	272	25 (B) approved to self-administer medication by the
273	273	26 individual's Community Support Team or
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284	284	1 Interdisciplinary Team, which includes a registered
285	285	2 professional nurse or an advanced practice registered
286	286	3 nurse.
287	287	4 (e) Quality Assurance.
288	288	5 (1) A registered professional nurse, advanced practice
289	289	6 registered nurse, licensed practical nurse, physician
290	290	7 licensed to practice medicine in all its branches,
291	291	8 physician assistant, or pharmacist shall review the
292	292	9 following for all individuals:
293	293	10 (A) Medication orders.
294	294	11 (B) Medication labels, including medications
295	295	12 listed on the medication administration record for
296	296	13 persons who are not self-medicating to ensure the
297	297	14 labels match the orders issued by the physician
298	298	15 licensed to practice medicine in all its branches,
299	299	16 advanced practice registered nurse, or physician
300	300	17 assistant.
301	301	18 (C) Medication administration records for persons
302	302	19 who are not self-medicating to ensure that the records
303	303	20 are completed appropriately for:
304	304	21 (i) medication administered as prescribed;
305	305	22 (ii) refusal by the individual; and
306	306	23 (iii) full signatures provided for all
307	307	24 initials used.
308	308	25 (2) Reviews shall occur at least quarterly, but may be
309	309	26 done more frequently at the discretion of the registered
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320	320	1 professional nurse or advanced practice registered nurse.
321	321	2 (3) A quality assurance review of medication errors
322	322	3 and data collection for the purpose of monitoring and
323	323	4 recommending corrective action shall be conducted within 7
324	324	5 days and included in the required annual review.
325	325	6 (f) Programs using authorized direct care staff to
326	326	7 administer medications are responsible for documenting and
327	327	8 maintaining records on the training that is completed.
328	328	9 (g) The absence of this training program constitutes a
329	329	10 threat to the public interest, safety, and welfare and
330	330	11 necessitates emergency rulemaking by the Departments of Human
331	331	12 Services and Public Health under Section 5-45 of the Illinois
332	332	13 Administrative Procedure Act.
333	333	14 (h) Direct care staff who fail to qualify for delegated
334	334	15 authority to administer medications pursuant to the provisions
335	335	16 of this Section shall be given additional education and
336	336	17 testing to meet criteria for delegation authority to
337	337	18 administer medications. Any direct care staff person who fails
338	338	19 to qualify as an authorized direct care staff after initial
339	339	20 training and testing must within 3 months be given another
340	340	21 opportunity for retraining and retesting. A direct care staff
341	341	22 person who fails to meet criteria for delegated authority to
342	342	23 administer medication, including, but not limited to, failure
343	343	24 of the written test on 2 occasions shall be given
344	344	25 consideration for shift transfer or reassignment, if possible.
345	345	26 No employee shall be terminated for failure to qualify during
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356	356	1 the 3-month time period following initial testing. Refusal to
357	357	2 complete training and testing required by this Section may be
358	358	3 grounds for immediate dismissal.
359	359	4 (i) No authorized direct care staff person delegated to
360	360	5 administer medication shall be subject to suspension or
361	361	6 discharge for errors resulting from the staff person's acts or
362	362	7 omissions when performing the functions unless the staff
363	363	8 person's actions or omissions constitute willful and wanton
364	364	9 conduct. Nothing in this subsection is intended to supersede
365	365	10 paragraph (4) of subsection (c).
366	366	11 (j) A registered professional nurse, advanced practice
367	367	12 registered nurse, physician licensed to practice medicine in
368	368	13 all its branches, or physician assistant shall be on duty or on
369	369	14 call at all times in any program covered by this Section.
370	370	15 (k) The employer shall be responsible for maintaining
371	371	16 liability insurance for any program covered by this Section.
372	372	17 (l) Any direct care staff person who qualifies as
373	373	18 authorized direct care staff pursuant to this Section shall be
374	374	19 granted consideration for a one-time additional salary
375	375	20 differential. The Department shall determine and provide the
376	376	21 necessary funding for the differential in the base. This
377	377	22 subsection (l) is inoperative on and after June 30, 2000.
378	378	23 (Source: P.A. 102-1100, eff. 1-1-23.)
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