Illinois 2023 2023-2024 Regular Session

Illinois Senate Bill SB0761 Engrossed / Bill

Filed 03/30/2023

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1  AN ACT concerning regulation.
2  Be it enacted by the People of the State of Illinois,
3  represented in the General Assembly:
4  Section 5. The Emergency Medical Services (EMS) Systems
5  Act is amended by changing Sections 3.20, 3.65, and 3.85 and by
6  adding Section 3.22 as follows:
7  (210 ILCS 50/3.20)
8  Sec. 3.20. Emergency Medical Services (EMS) Systems.
9  (a) "Emergency Medical Services (EMS) System" means an
10  organization of hospitals, vehicle service providers and
11  personnel approved by the Department in a specific geographic
12  area, which coordinates and provides pre-hospital and
13  inter-hospital emergency care and non-emergency medical
14  transports at a BLS, ILS and/or ALS level pursuant to a System
15  program plan submitted to and approved by the Department, and
16  pursuant to the EMS Region Plan adopted for the EMS Region in
17  which the System is located.
18  (b) One hospital in each System program plan must be
19  designated as the Resource Hospital. All other hospitals which
20  are located within the geographic boundaries of a System and
21  which have standby, basic or comprehensive level emergency
22  departments must function in that EMS System as either an
23  Associate Hospital or Participating Hospital and follow all

 

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1  System policies specified in the System Program Plan,
2  including but not limited to the replacement of drugs and
3  equipment used by providers who have delivered patients to
4  their emergency departments. All hospitals and vehicle service
5  providers participating in an EMS System must specify their
6  level of participation in the System Program Plan.
7  (c) The Department shall have the authority and
8  responsibility to:
9  (1) Approve BLS, ILS and ALS level EMS Systems which
10  meet minimum standards and criteria established in rules
11  adopted by the Department pursuant to this Act, including
12  the submission of a Program Plan for Department approval.
13  Beginning September 1, 1997, the Department shall approve
14  the development of a new EMS System only when a local or
15  regional need for establishing such System has been
16  verified by the Department. This shall not be construed as
17  a needs assessment for health planning or other purposes
18  outside of this Act. Following Department approval, EMS
19  Systems must be fully operational within one year from the
20  date of approval.
21  (2) Monitor EMS Systems, based on minimum standards
22  for continuing operation as prescribed in rules adopted by
23  the Department pursuant to this Act, which shall include
24  requirements for submitting Program Plan amendments to the
25  Department for approval.
26  (3) Renew EMS System approvals every 4 years, after an

 

 

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1  inspection, based on compliance with the standards for
2  continuing operation prescribed in rules adopted by the
3  Department pursuant to this Act.
4  (4) Suspend, revoke, or refuse to renew approval of
5  any EMS System, after providing an opportunity for a
6  hearing, when findings show that it does not meet the
7  minimum standards for continuing operation as prescribed
8  by the Department, or is found to be in violation of its
9  previously approved Program Plan.
10  (5) Require each EMS System to adopt written protocols
11  for the bypassing of or diversion to any hospital, trauma
12  center or regional trauma center, which provide that a
13  person shall not be transported to a facility other than
14  the nearest hospital, regional trauma center or trauma
15  center unless the medical benefits to the patient
16  reasonably expected from the provision of appropriate
17  medical treatment at a more distant facility outweigh the
18  increased risks to the patient from transport to the more
19  distant facility, or the transport is in accordance with
20  the System's protocols for patient choice or refusal.
21  (6) Require that the EMS Medical Director of an ILS or
22  ALS level EMS System be a physician licensed to practice
23  medicine in all of its branches in Illinois, and certified
24  by the American Board of Emergency Medicine or the
25  American Osteopathic Board of Emergency Medicine, and that
26  the EMS Medical Director of a BLS level EMS System be a

 

 

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1  physician licensed to practice medicine in all of its
2  branches in Illinois, with regular and frequent
3  involvement in pre-hospital emergency medical services. In
4  addition, all EMS Medical Directors shall:
5  (A) Have experience on an EMS vehicle at the
6  highest level available within the System, or make
7  provision to gain such experience within 12 months
8  prior to the date responsibility for the System is
9  assumed or within 90 days after assuming the position;
10  (B) Be thoroughly knowledgeable of all skills
11  included in the scope of practices of all levels of EMS
12  personnel within the System;
13  (C) Have or make provision to gain experience
14  instructing students at a level similar to that of the
15  levels of EMS personnel within the System; and
16  (D) For ILS and ALS EMS Medical Directors,
17  successfully complete a Department-approved EMS
18  Medical Director's Course.
19  (7) Prescribe statewide EMS data elements to be
20  collected and documented by providers in all EMS Systems
21  for all emergency and non-emergency medical services, with
22  a one-year phase-in for commencing collection of such data
23  elements.
24  (8) Define, through rules adopted pursuant to this
25  Act, the terms "Resource Hospital", "Associate Hospital",
26  "Participating Hospital", "Basic Emergency Department",

 

 

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1  "Standby Emergency Department", "Comprehensive Emergency
2  Department", "EMS Medical Director", "EMS Administrative
3  Director", and "EMS System Coordinator".
4  (A) (Blank).
5  (B) (Blank).
6  (9) Investigate the circumstances that caused a
7  hospital in an EMS system to go on bypass status to
8  determine whether that hospital's decision to go on bypass
9  status was reasonable. The Department may impose
10  sanctions, as set forth in Section 3.140 of the Act, upon a
11  Department determination that the hospital unreasonably
12  went on bypass status in violation of the Act.
13  (10) Evaluate the capacity and performance of any
14  freestanding emergency center established under Section
15  32.5 of this Act in meeting emergency medical service
16  needs of the public, including compliance with applicable
17  emergency medical standards and assurance of the
18  availability of and immediate access to the highest
19  quality of medical care possible.
20  (11) Permit limited EMS System participation by
21  facilities operated by the United States Department of
22  Veterans Affairs, Veterans Health Administration. Subject
23  to patient preference, Illinois EMS providers may
24  transport patients to Veterans Health Administration
25  facilities that voluntarily participate in an EMS System.
26  Any Veterans Health Administration facility seeking

 

 

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1  limited participation in an EMS System shall agree to
2  comply with all Department administrative rules
3  implementing this Section. The Department may promulgate
4  rules, including, but not limited to, the types of
5  Veterans Health Administration facilities that may
6  participate in an EMS System and the limitations of
7  participation.
8  (12) Ensure that EMS systems are transporting pregnant
9  women to the appropriate facilities based on the
10  classification of the levels of maternal care described
11  under subsection (a) of Section 2310-223 of the Department
12  of Public Health Powers and Duties Law of the Civil
13  Administrative Code of Illinois.
14  (13) Provide administrative support to the EMT
15  Training, Recruitment, and Retention Task Force.
16  (Source: P.A. 101-447, eff. 8-23-19.)
17  (210 ILCS 50/3.22 new)
18  Sec. 3.22. EMT Training, Recruitment, and Retention Task
19  Force.
20  (a) The EMT Training, Recruitment, and Retention Task
21  Force is created to address the following:
22  (1) the impact that the EMT and Paramedic shortage is
23  having on this State's EMS System and health care system;
24  (2) barriers to the training, recruitment, and
25  retention of Emergency Medical Technicians throughout this

 

 

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1  State;
2  (3) steps that the State of Illinois can take,
3  including coordination and identification of State and
4  federal funding sources, to assist Illinois high schools,
5  community colleges, and ground ambulance providers to
6  train, recruit, and retain emergency medical technicians;
7  (4) how emergency medical responder and emergency
8  medical technician licensure and testing and certification
9  requirements affect the recruitment and retention of
10  emergency medical technicians, including, without
11  limitation, how the implementation of the National
12  Registry of Emergency Medical Technician training criteria
13  have impacted the certification and licensure of new EMRs,
14  EMTs, and Paramedics;
15  (5) how apprenticeship programs, local, regional, and
16  statewide, can be utilized to recruit and retain EMRs,
17  EMTs, and Paramedics;
18  (6) how ground ambulance reimbursement affects the
19  recruitment and retention of EMTs and Paramedics; and
20  (7) all other areas that the Task Force deems
21  necessary to examine to assist in the recruitment and
22  retention of EMTs and Paramedics.
23  (b) The Task Force shall be comprised of the following
24  members:
25  (1) one member of the Illinois General Assembly,
26  appointed by the Senate President, who shall serve as

 

 

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1  co-chair;
2  (2) one member of the Illinois General Assembly,
3  appointed by the Speaker of the House;
4  (3) one member of the Illinois General Assembly,
5  appointed by the Senate Minority Leader;
6  (4) one member of the Illinois General Assembly,
7  appointed by the House Minority Leader, who shall serve as
8  co-chair;
9  (5) 9 members representing private ground ambulance
10  providers throughout this State representing for-profit
11  and non-profit rural and ground ambulance providers,
12  appointed by the Governor;
13  (6) 3 members representing hospitals, appointed by the
14  Speaker of the House, with one member representing safety
15  net hospitals and one member representing rural hospitals;
16  (7) 3 members representing a statewide association of
17  nursing homes, appointed by the President of the Senate;
18  (8) one member representing the State Board of
19  Education, appointed by the Minority Leader of the House;
20  and
21  (9) one member representing the Illinois Community
22  College Systems, appointed by the Minority Leader of the
23  Senate.
24  (c) Members of the Task Force shall serve without
25  compensation.
26  (d) The Task Force shall convene at the call of the

 

 

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1  co-chairs and shall hold at least 6 meetings.
2  (e) The Task Force shall submit its final report to the
3  General Assembly and the Governor no later than January 1,
4  2024, and upon the submission of its final report, the Task
5  Force shall be dissolved.
6  (210 ILCS 50/3.65)
7  Sec. 3.65. EMS Lead Instructor.
8  (a) "EMS Lead Instructor" means a person who has
9  successfully completed a course of education as approved by
10  the Department or has obtained sufficient experience as
11  determined by the EMS Medical Director, and who is currently
12  approved by the Department to coordinate or teach education,
13  training and continuing education courses, in accordance with
14  standards prescribed by this Act and rules adopted by the
15  Department pursuant to this Act.
16  (b) The Department shall have the authority and
17  responsibility to:
18  (1) Prescribe education requirements for EMS Lead
19  Instructor candidates through rules adopted pursuant to
20  this Act.
21  (2) Prescribe testing requirements for EMS Lead
22  Instructor candidates through rules adopted pursuant to
23  this Act.
24  (3) Charge each candidate for EMS Lead Instructor a
25  fee to be submitted with an application for an

 

 

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1  examination, an application for licensure, and an
2  application for relicensure.
3  (4) Approve individuals as EMS Lead Instructors who
4  have met the Department's education and testing
5  requirements.
6  (5) Require that all education, training and
7  continuing education courses for EMT, EMT-I, A-EMT,
8  Paramedic, PHRN, PHPA, PHAPRN, ECRN, EMR, and Emergency
9  Medical Dispatcher be coordinated by at least one approved
10  EMS Lead Instructor. A program which includes education,
11  training or continuing education for more than one type of
12  personnel may use one EMS Lead Instructor to coordinate
13  the program, and a single EMS Lead Instructor may
14  simultaneously coordinate more than one program or course.
15  (6) Provide standards and procedures for awarding EMS
16  Lead Instructor approval to persons previously approved by
17  the Department to coordinate such courses, based on
18  qualifications prescribed by the Department through rules
19  adopted pursuant to this Act.
20  (7) Suspend, revoke, or refuse to issue or renew the
21  approval of an EMS Lead Instructor, after an opportunity
22  for a hearing, when findings show one or more of the
23  following:
24  (A) The EMS Lead Instructor has failed to conduct
25  a course in accordance with the curriculum prescribed
26  by this Act and rules adopted by the Department

 

 

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1  pursuant to this Act; or
2  (B) The EMS Lead Instructor has failed to comply
3  with protocols prescribed by the Department through
4  rules adopted pursuant to this Act.
5  (Source: P.A. 100-1082, eff. 8-24-19.)
6  (210 ILCS 50/3.85)
7  Sec. 3.85. Vehicle Service Providers.
8  (a) "Vehicle Service Provider" means an entity licensed by
9  the Department to provide emergency or non-emergency medical
10  services in compliance with this Act, the rules promulgated by
11  the Department pursuant to this Act, and an operational plan
12  approved by its EMS System(s), utilizing at least ambulances
13  or specialized emergency medical service vehicles (SEMSV).
14  (1) "Ambulance" means any publicly or privately owned
15  on-road vehicle that is specifically designed, constructed
16  or modified and equipped, and is intended to be used for,
17  and is maintained or operated for the emergency
18  transportation of persons who are sick, injured, wounded
19  or otherwise incapacitated or helpless, or the
20  non-emergency medical transportation of persons who
21  require the presence of medical personnel to monitor the
22  individual's condition or medical apparatus being used on
23  such individuals.
24  (2) "Specialized Emergency Medical Services Vehicle"
25  or "SEMSV" means a vehicle or conveyance, other than those

 

 

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1  owned or operated by the federal government, that is
2  primarily intended for use in transporting the sick or
3  injured by means of air, water, or ground transportation,
4  that is not an ambulance as defined in this Act. The term
5  includes watercraft, aircraft and special purpose ground
6  transport vehicles or conveyances not intended for use on
7  public roads.
8  (3) An ambulance or SEMSV may also be designated as a
9  Limited Operation Vehicle or Special-Use Vehicle:
10  (A) "Limited Operation Vehicle" means a vehicle
11  which is licensed by the Department to provide basic,
12  intermediate or advanced life support emergency or
13  non-emergency medical services that are exclusively
14  limited to specific events or locales.
15  (B) "Special-Use Vehicle" means any publicly or
16  privately owned vehicle that is specifically designed,
17  constructed or modified and equipped, and is intended
18  to be used for, and is maintained or operated solely
19  for the emergency or non-emergency transportation of a
20  specific medical class or category of persons who are
21  sick, injured, wounded or otherwise incapacitated or
22  helpless (e.g. high-risk obstetrical patients,
23  neonatal patients).
24  (C) "Reserve Ambulance" means a vehicle that meets
25  all criteria set forth in this Section and all
26  Department rules, except for the required inventory of

 

 

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1  medical supplies and durable medical equipment, which
2  may be rapidly transferred from a fully functional
3  ambulance to a reserve ambulance without the use of
4  tools or special mechanical expertise.
5  (b) The Department shall have the authority and
6  responsibility to:
7  (1) Require all Vehicle Service Providers, both
8  publicly and privately owned, to function within an EMS
9  System.
10  (2) Require a Vehicle Service Provider utilizing
11  ambulances to have a primary affiliation with an EMS
12  System within the EMS Region in which its Primary Service
13  Area is located, which is the geographic areas in which
14  the provider renders the majority of its emergency
15  responses. This requirement shall not apply to Vehicle
16  Service Providers which exclusively utilize Limited
17  Operation Vehicles.
18  (3) Establish licensing standards and requirements for
19  Vehicle Service Providers, through rules adopted pursuant
20  to this Act, including but not limited to:
21  (A) Vehicle design, specification, operation and
22  maintenance standards, including standards for the use
23  of reserve ambulances;
24  (B) Equipment requirements;
25  (C) Staffing requirements; and
26  (D) License renewal at intervals determined by the

 

 

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1  Department, which shall be not less than every 4
2  years.
3  The Department's standards and requirements with
4  respect to vehicle staffing for private, nonpublic local
5  government employers must allow for alternative staffing
6  models that include an EMR who drives an ambulance with a
7  licensed EMT, EMT-I, A-EMT, Paramedic, or PHRN, as
8  appropriate, in the patient compartment providing care to
9  the patient pursuant to the approval of the EMS System
10  Program Plan developed and approved by the EMS Medical
11  Director for an EMS System. The Department shall monitor
12  the implementation and performance of alternative staffing
13  models and may issue a notice of termination of an
14  alternative staffing model only upon evidence that an EMS
15  System Program Plan is not being adhered to. Adoption of
16  an alternative staffing model shall not result in a
17  Vehicle Service Provider being prohibited or limited in
18  the utilization of its staff or equipment from providing
19  any of the services authorized by this Act or as otherwise
20  outlined in the approved EMS System Program Plan,
21  including, without limitation, the deployment of resources
22  to provide out-of-state disaster response.
23  An EMS System Program Plan for a Basic Life Support,
24  advanced life support, and critical care transport
25  services transport utilizing an EMR and an EMT, Paramedic,
26  or appropriate critical care transport staff shall include

 

 

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1  the following:
2  (A) Alternative staffing models for a Basic Life
3  Support transport utilizing an EMR and an EMT shall
4  only be utilized for interfacility Basic Life Support
5  transports specified by the EMS System Program Plan as
6  determined by the EMS System Medical Director and
7  medical appointments, excluding any transport to or
8  from a dialysis center.
9  (B) Protocols that shall include dispatch
10  procedures to properly screen and assess patients for
11  EMR-staffed transports and EMT-staffed Basic Life
12  Support transport.
13  (C) A requirement that a provider shall implement
14  a quality assurance plan with mechanisms outlined to
15  audit dispatch screening and the outcome of transports
16  performed.
17  (D) The EMT, Paramedic, and critical care
18  transport staff shall have the minimum at least one
19  year of experience in performance of pre-hospital,
20  inter-hospital emergency care and other health care
21  experience as a clinician, as determined by the EMS
22  Medical Director in accordance with the EMS System
23  Program Plan.
24  (E) The licensed EMR must complete a defensive
25  driving course prior to participation in the
26  Department's alternative staffing model.

 

 

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1  (F) The length of the EMS System Program Plan for a
2  Basic Life Support transport utilizing an EMR and an
3  EMT shall be for one year, and must be renewed annually
4  if proof of the criteria being met is submitted,
5  validated, and approved by the EMS Medical Director
6  for the EMS System and the Department.
7  The Department must allow for an alternative rural
8  staffing model for those vehicle service providers that
9  serve a rural or semi-rural population of 10,000 or fewer
10  inhabitants and exclusively uses volunteers, paid-on-call,
11  or a combination thereof.
12  (4) License all Vehicle Service Providers that have
13  met the Department's requirements for licensure, unless
14  such Provider is owned or licensed by the federal
15  government. All Provider licenses issued by the Department
16  shall specify the level and type of each vehicle covered
17  by the license (BLS, ILS, ALS, ambulance, SEMSV, limited
18  operation vehicle, special use vehicle, ambulance assist
19  vehicle, reserve ambulance) and shall allow for ambulances
20  to be immediately upgraded to a higher level of service
21  when the Vehicle Service Provider sends an ambulance
22  assist vehicle with appropriate equipment and licensed
23  staff to intercept with the licensed ambulance in the
24  field.
25  (5) Annually inspect all licensed vehicles operated by
26  Vehicle Service Providers.

 

 

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1  (6) Suspend, revoke, refuse to issue or refuse to
2  renew the license of any Vehicle Service Provider, or that
3  portion of a license pertaining to a specific vehicle
4  operated by the Provider, after an opportunity for a
5  hearing, when findings show that the Provider or one or
6  more of its vehicles has failed to comply with the
7  standards and requirements of this Act or rules adopted by
8  the Department pursuant to this Act.
9  (7) Issue an Emergency Suspension Order for any
10  Provider or vehicle licensed under this Act, when the
11  Director or his designee has determined that an immediate
12  and serious danger to the public health, safety and
13  welfare exists. Suspension or revocation proceedings which
14  offer an opportunity for hearing shall be promptly
15  initiated after the Emergency Suspension Order has been
16  issued.
17  (8) Exempt any licensed vehicle from subsequent
18  vehicle design standards or specifications required by the
19  Department, as long as said vehicle is continuously in
20  compliance with the vehicle design standards and
21  specifications originally applicable to that vehicle, or
22  until said vehicle's title of ownership is transferred.
23  (9) Exempt any vehicle (except an SEMSV) which was
24  being used as an ambulance on or before December 15, 1980,
25  from vehicle design standards and specifications required
26  by the Department, until said vehicle's title of ownership

 

 

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1  is transferred. Such vehicles shall not be exempt from all
2  other licensing standards and requirements prescribed by
3  the Department.
4  (10) Prohibit any Vehicle Service Provider from
5  advertising, identifying its vehicles, or disseminating
6  information in a false or misleading manner concerning the
7  Provider's type and level of vehicles, location, primary
8  service area, response times, level of personnel,
9  licensure status or System participation.
10  (10.5) Prohibit any Vehicle Service Provider, whether
11  municipal, private, or hospital-owned, from advertising
12  itself as a critical care transport provider unless it
13  participates in a Department-approved EMS System critical
14  care transport plan.
15  (11) Charge each Vehicle Service Provider a fee per
16  transport vehicle, due annually at time of inspection. The
17  fee per transport vehicle shall be set by administrative
18  rule by the Department and shall not exceed 100 vehicles
19  per provider.
20  (Source: P.A. 102-623, eff. 8-27-21.)

 

 

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