Illinois 2023-2024 Regular Session

Illinois Senate Bill SB2795 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 SB2795 Introduced 1/17/2024, by Sen. Michael W. Halpin SYNOPSIS AS INTRODUCED: See Index Creates the Safe Patient Limits Act. Provides the maximum number of patients that may be assigned to a registered nurse in specified situations. Provides that nothing shall preclude a facility from assigning fewer patients to a registered nurse than the limits provided in the Act. Provides that the maximum patient assignments may not be exceeded, regardless of the use and application of any patient acuity system. Requires the Department of Public Health to adopt rules governing the implementation and administration of the Act. Provides that all facilities shall adopt written policies and procedures for the training and orientation of nursing staff and that no registered nurse shall be assigned to a nursing unit or clinical area unless that nurse has, among other things, demonstrated competence in providing care in that area. Provides requirements for the Act's implementation. Establishes recordkeeping requirements. Provides rights and protections for nurses. Contains a severability provision and other provisions. Amends the Hospital Licensing Act. Provides that a hospital shall not mandate that a registered professional nurse delegate nursing interventions. Makes changes concerning staffing plans. Amends the Nurse Practice Act. Requires the exercise of professional judgment by a direct care registered professional nurse in the performance of his or her scope of practice to be provided in the exclusive interests of the patient. Ratifies and approves the Nurse Licensure Compact, which allows for the issuance of multistate licenses that allow nurses to practice in their home state and other compact states. Provides that the Compact does not supersede existing State labor laws. Provides that the State may not share with or disclose to the Interstate Commission of Nurse Licensure Compact Administrators or any other state any of the contents of a nationwide criminal history records check conducted for the purpose of multistate licensure under the Nurse Licensure Compact. LRB103 34815 SPS 64670 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2795 Introduced 1/17/2024, by Sen. Michael W. Halpin SYNOPSIS AS INTRODUCED: See Index See Index Creates the Safe Patient Limits Act. Provides the maximum number of patients that may be assigned to a registered nurse in specified situations. Provides that nothing shall preclude a facility from assigning fewer patients to a registered nurse than the limits provided in the Act. Provides that the maximum patient assignments may not be exceeded, regardless of the use and application of any patient acuity system. Requires the Department of Public Health to adopt rules governing the implementation and administration of the Act. Provides that all facilities shall adopt written policies and procedures for the training and orientation of nursing staff and that no registered nurse shall be assigned to a nursing unit or clinical area unless that nurse has, among other things, demonstrated competence in providing care in that area. Provides requirements for the Act's implementation. Establishes recordkeeping requirements. Provides rights and protections for nurses. Contains a severability provision and other provisions. Amends the Hospital Licensing Act. Provides that a hospital shall not mandate that a registered professional nurse delegate nursing interventions. Makes changes concerning staffing plans. Amends the Nurse Practice Act. Requires the exercise of professional judgment by a direct care registered professional nurse in the performance of his or her scope of practice to be provided in the exclusive interests of the patient. Ratifies and approves the Nurse Licensure Compact, which allows for the issuance of multistate licenses that allow nurses to practice in their home state and other compact states. Provides that the Compact does not supersede existing State labor laws. Provides that the State may not share with or disclose to the Interstate Commission of Nurse Licensure Compact Administrators or any other state any of the contents of a nationwide criminal history records check conducted for the purpose of multistate licensure under the Nurse Licensure Compact. LRB103 34815 SPS 64670 b LRB103 34815 SPS 64670 b A BILL FOR
2	2	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2795 Introduced 1/17/2024, by Sen. Michael W. Halpin SYNOPSIS AS INTRODUCED:
3	3	See Index See Index
4	4	See Index
5	5	Creates the Safe Patient Limits Act. Provides the maximum number of patients that may be assigned to a registered nurse in specified situations. Provides that nothing shall preclude a facility from assigning fewer patients to a registered nurse than the limits provided in the Act. Provides that the maximum patient assignments may not be exceeded, regardless of the use and application of any patient acuity system. Requires the Department of Public Health to adopt rules governing the implementation and administration of the Act. Provides that all facilities shall adopt written policies and procedures for the training and orientation of nursing staff and that no registered nurse shall be assigned to a nursing unit or clinical area unless that nurse has, among other things, demonstrated competence in providing care in that area. Provides requirements for the Act's implementation. Establishes recordkeeping requirements. Provides rights and protections for nurses. Contains a severability provision and other provisions. Amends the Hospital Licensing Act. Provides that a hospital shall not mandate that a registered professional nurse delegate nursing interventions. Makes changes concerning staffing plans. Amends the Nurse Practice Act. Requires the exercise of professional judgment by a direct care registered professional nurse in the performance of his or her scope of practice to be provided in the exclusive interests of the patient. Ratifies and approves the Nurse Licensure Compact, which allows for the issuance of multistate licenses that allow nurses to practice in their home state and other compact states. Provides that the Compact does not supersede existing State labor laws. Provides that the State may not share with or disclose to the Interstate Commission of Nurse Licensure Compact Administrators or any other state any of the contents of a nationwide criminal history records check conducted for the purpose of multistate licensure under the Nurse Licensure Compact.
6	6	LRB103 34815 SPS 64670 b LRB103 34815 SPS 64670 b
7	7	LRB103 34815 SPS 64670 b
8	8	A BILL FOR
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10	10	SB2795 LRB103 34815 SPS 64670 b
11	11	1 AN ACT concerning health.
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 1. Short title. This Act may be cited as the Safe
15	15	5 Patient Limits Act.
16	16	6 Section 5. Definitions. In this Act:
17	17	7 "Couplet" means one postpartum patient and one baby.
18	18	8 "Critical trauma patient" means a patient who has an
19	19	9 injury to an anatomic area that (i) requires life-saving
20	20	10 interventions or (ii) in conjunction with unstable vital
21	21	11 signs, poses an immediate threat to life or limb.
22	22	12 "Department" means the Department of Public Health.
23	23	13 "Direct care registered professional nurse" means a
24	24	14 registered professional nurse who has accepted a hands-on,
25	25	15 in-person patient care assignment and whose primary role is to
26	26	16 provide hands-on, in-person patient care.
27	27	17 "Facility" means a hospital licensed under the Hospital
28	28	18 Licensing Act or organized under the University of Illinois
29	29	19 Hospital Act, a private or State-owned and State-operated
30	30	20 general acute care hospital, an LTAC hospital as defined in
31	31	21 Section 10 of the Long Term Acute Care Hospital Quality
32	32	22 Improvement Transfer Program Act, an ambulatory surgical
33	33	23 treatment center as defined in Section 3 of the Ambulatory
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37	37	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2795 Introduced 1/17/2024, by Sen. Michael W. Halpin SYNOPSIS AS INTRODUCED:
38	38	See Index See Index
39	39	See Index
40	40	Creates the Safe Patient Limits Act. Provides the maximum number of patients that may be assigned to a registered nurse in specified situations. Provides that nothing shall preclude a facility from assigning fewer patients to a registered nurse than the limits provided in the Act. Provides that the maximum patient assignments may not be exceeded, regardless of the use and application of any patient acuity system. Requires the Department of Public Health to adopt rules governing the implementation and administration of the Act. Provides that all facilities shall adopt written policies and procedures for the training and orientation of nursing staff and that no registered nurse shall be assigned to a nursing unit or clinical area unless that nurse has, among other things, demonstrated competence in providing care in that area. Provides requirements for the Act's implementation. Establishes recordkeeping requirements. Provides rights and protections for nurses. Contains a severability provision and other provisions. Amends the Hospital Licensing Act. Provides that a hospital shall not mandate that a registered professional nurse delegate nursing interventions. Makes changes concerning staffing plans. Amends the Nurse Practice Act. Requires the exercise of professional judgment by a direct care registered professional nurse in the performance of his or her scope of practice to be provided in the exclusive interests of the patient. Ratifies and approves the Nurse Licensure Compact, which allows for the issuance of multistate licenses that allow nurses to practice in their home state and other compact states. Provides that the Compact does not supersede existing State labor laws. Provides that the State may not share with or disclose to the Interstate Commission of Nurse Licensure Compact Administrators or any other state any of the contents of a nationwide criminal history records check conducted for the purpose of multistate licensure under the Nurse Licensure Compact.
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43	43	A BILL FOR
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49	49	See Index
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68	68	1 Surgical Treatment Center Act, a freestanding emergency center
69	69	2 licensed under the Emergency Medical Services (EMS) Systems
70	70	3 Act, a birth center licensed under the Birth Center Licensing
71	71	4 Act, an acute psychiatric hospital, an acute care specialty
72	72	5 hospital, or an acute care unit within a health care facility.
73	73	6 "Health care emergency" means an emergency that is
74	74	7 declared by an authorized person within federal, State, or
75	75	8 local government and is related to circumstances that are
76	76	9 unpredictable and unavoidable, affect the delivery of medical
77	77	10 care, and require an immediate or exceptional level of
78	78	11 emergency or other medical services at the specific facility.
79	79	12 "Health care emergency" does not include a state of emergency
80	80	13 that results from a labor dispute in the health care industry
81	81	14 or consistent understaffing.
82	82	15 "Health care workforce" means personnel employed by or
83	83	16 contracted to work at a facility that have an effect upon the
84	84	17 delivery of quality care to patients, including, but not
85	85	18 limited to, registered nurses, licensed practical nurses,
86	86	19 unlicensed assistive personnel, service, maintenance,
87	87	20 clerical, professional, and technical workers, and other
88	88	21 health care workers.
89	89	22 "Immediate postpartum patient" means a patient who has
90	90	23 given birth within the previous 2 hours.
91	91	24 "Nursing care" means care that falls within the scope of
92	92	25 practice described in Section 55-30 or 60-35 of the Nurse
93	93	26 Practice Act or is otherwise encompassed within recognized
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104	104	1 standards of nursing practice.
105	105	2 "Rapid response team" means a team of health care
106	106	3 providers that provide care to patients with early signs of
107	107	4 deterioration to prevent respiratory or cardiac arrest.
108	108	5 "Registered nurse" or "registered professional nurse"
109	109	6 means a person who is licensed as a registered professional
110	110	7 nurse under the Nurse Practice Act and practices nursing as
111	111	8 described in Section 60-35 of the Nurse Practice Act.
112	112	9 "Specialty care unit" means a unit that is organized,
113	113	10 operated, and maintained to provide care for a specific
114	114	11 medical condition or a specific patient population.
115	115	12 Section 10. Maximum patient assignments for registered
116	116	13 nurses.
117	117	14 (a) The maximum number of patients assigned to a
118	118	15 registered nurse in a facility shall not exceed the limits
119	119	16 provided in this Section. However, nothing shall preclude a
120	120	17 facility from assigning fewer patients to a registered nurse
121	121	18 than the limits provided in this Section. The requirements of
122	122	19 this Section apply at all times during each shift within each
123	123	20 clinical unit and each patient care area. For the purposes of
124	124	21 this Act, a patient is assigned to a registered nurse if the
125	125	22 registered nurse accepts responsibility for the patient's
126	126	23 nursing care.
127	127	24 (b) In all units with critical care or intensive care
128	128	25 patients, including, but not limited to, coronary care, acute
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139	139	1 respiratory care, medical, burn, pediatric, or neonatal
140	140	2 intensive care patients, the maximum patient assignment of
141	141	3 critical care patients to a registered nurse is one.
142	142	4 (c) In all units with step-down or intermediate intensive
143	143	5 care patients, the maximum patient assignment of step-down or
144	144	6 intermediate intensive care patients to a registered nurse is
145	145	7 3.
146	146	8 (d) In all units with postanesthesia care patients,
147	147	9 regardless of the type of anesthesia administered, the maximum
148	148	10 patient assignment of postanesthesia care patients or patients
149	149	11 being monitored for the effects of any anesthetizing agent to
150	150	12 a registered nurse is one.
151	151	13 (e) In all units with operating room patients, the maximum
152	152	14 patient assignment of operating room patients to a registered
153	153	15 nurse is one, provided that a minimum of one additional person
154	154	16 serves as a scrub assistant for each patient.
155	155	17 (f) In the emergency department:
156	156	18 (1) In a unit providing basic emergency services or
157	157	19 comprehensive emergency services, the maximum patient
158	158	20 assignment at any time to a registered nurse is 3.
159	159	21 (2) The maximum assignment of critical care emergency
160	160	22 patients to a registered nurse is one. A patient in the
161	161	23 emergency department shall be considered a critical care
162	162	24 patient when the patient meets the criteria for admission
163	163	25 to a critical care service area within the facility.
164	164	26 (3) The maximum assignment of critical trauma patients
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175	175	1 in an emergency unit to a registered nurse is one.
176	176	2 (4) At least one direct care registered professional
177	177	3 nurse shall be assigned to triage patients. The direct
178	178	4 care registered professional nurse assigned to triage
179	179	5 patients shall be immediately available at all times to
180	180	6 triage patients when they arrive in the emergency
181	181	7 department. The direct care registered professional nurse
182	182	8 assigned to triage patients shall perform triage functions
183	183	9 only and may not be assigned the responsibility of the
184	184	10 base radio. Triage, radio, or flight registered nurses
185	185	11 shall not be counted in the calculation of direct care
186	186	12 registered nurse staffing levels.
187	187	13 (g) In all units with maternal child care patients the
188	188	14 maximum patient assignment:
189	189	15 (1) to a registered nurse of antepartum patients
190	190	16 requiring continuous fetal monitoring is 2;
191	191	17 (2) of other antepartum patients who are not in active
192	192	18 labor to a registered nurse is 3;
193	193	19 (3) of active labor patients to a registered nurse is
194	194	20 one;
195	195	21 (4) of patients with medical or obstetrical
196	196	22 complications during the initiation of epidural anesthesia
197	197	23 or during circulation for a caesarean section delivery to
198	198	24 a registered nurse is one;
199	199	25 (5) during birth is one registered nurse responsible
200	200	26 for the patient in labor and, for each newborn, one
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211	211	1 registered nurse whose sole responsibility is that newborn
212	212	2 patient;
213	213	3 (6) of postpartum patients when the parent has given
214	214	4 birth within the previous 2 hours is one registered nurse
215	215	5 for each couplet, and in the case of multiple births, one
216	216	6 registered nurse for each additional newborn;
217	217	7 (7) of couplets to a registered nurse is 2;
218	218	8 (8) of patients receiving postpartum or postoperative
219	219	9 gynecological care to a registered nurse is 4 when the
220	220	10 registered nurse has been assigned only to patients
221	221	11 receiving postpartum or postoperative gynecological care;
222	222	12 (9) of newborn patients when the patient is unstable,
223	223	13 as assessed by a direct care registered professional
224	224	14 nurse, to a registered nurse is one; and
225	225	15 (10) of newborn patients to a registered nurse is 2
226	226	16 when the patients are receiving intermediate care or the
227	227	17 nurse has been assigned to a patient care unit that
228	228	18 receives newborn patients requiring intermediate care,
229	229	19 including, but not limited to, an intermediate care
230	230	20 nursery.
231	231	21 (h) In all units with pediatric patients, the maximum
232	232	22 patient assignment of pediatric patients to a registered nurse
233	233	23 is 3.
234	234	24 (i) In all units with psychiatric patients, the maximum
235	235	25 patient assignment of psychiatric patients to a registered
236	236	26 nurse is 4.
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247	247	1 (j) In all units with medical and surgical patients, the
248	248	2 maximum patient assignment of medical or surgical patients to
249	249	3 a registered nurse is 4.
250	250	4 (k) In all units with telemetry patients, the maximum
251	251	5 patient assignment of telemetry patients to a registered nurse
252	252	6 is 3.
253	253	7 (l) In all units with observational patients, the maximum
254	254	8 patient assignment of observational patients to a registered
255	255	9 nurse is 3.
256	256	10 (m) In all units with acute rehabilitation patients, the
257	257	11 maximum patient assignment of acute rehabilitation patients to
258	258	12 a registered nurse is 4.
259	259	13 (n) In all units with conscious sedation patients, the
260	260	14 maximum patient assignment of conscious sedation patients to a
261	261	15 registered nurse is one.
262	262	16 (o) In any unit not otherwise listed in this Section,
263	263	17 including all specialty care units not otherwise listed in
264	264	18 this Section, the maximum patient assignment to a registered
265	265	19 nurse is 4.
266	266	20 Section 15. Use of rapid response teams as first
267	267	21 responders prohibited. A rapid response team's registered
268	268	22 nurse shall not be given direct care patient assignments while
269	269	23 assigned as a registered nurse who is responsible for
270	270	24 responding to a rapid response team request.
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281	281	1 Section 20. Implementation by a facility.
282	282	2 (a) A facility shall implement the patient limits
283	283	3 established under Section 10 without diminishing the staffing
284	284	4 levels of the facility's health care workforce. A facility may
285	285	5 not lay off licensed practical nurses, licensed psychiatric
286	286	6 technicians, certified nursing assistants, or other ancillary
287	287	7 support staff to meet the patient limits under Section 10.
288	288	8 (b) Each patient shall be assigned to a direct care
289	289	9 registered professional nurse who shall directly provide the
290	290	10 comprehensive patient assessment, development of a plan of
291	291	11 care, and supervision, implementation, and evaluation of the
292	292	12 nursing care provided to the patient at least every shift and
293	293	13 who has the responsibility for the provision of care to a
294	294	14 particular patient within the registered nurse's scope of
295	295	15 practice.
296	296	16 (c) There shall be no averaging of the number of patients
297	297	17 and the total number of registered nurses in each clinical
298	298	18 unit or patient care area in order to meet the patient limits
299	299	19 under Section 10.
300	300	20 (d) Only registered nurses providing direct patient care
301	301	21 shall be considered when evaluating compliance with the
302	302	22 patient limits under Section 10. Ancillary staff and
303	303	23 unlicensed personnel shall not be considered when evaluating
304	304	24 compliance with the patient limits under Section 10.
305	305	25 (e) The hours in which a nurse administrator, nurse
306	306	26 supervisor, nurse manager, charge nurse, and other licensed
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317	317	1 nurse provides patient care shall not be considered when
318	318	2 evaluating compliance with the patient limits under Section 10
319	319	3 and with the patient assignment requirement under subsection
320	320	4 (b) unless the registered nurse:
321	321	5 (1) has a current and active direct patient care
322	322	6 assignment;
323	323	7 (2) provides direct patient care in compliance with
324	324	8 this Act;
325	325	9 (3) has demonstrated the registered nurse's competence
326	326	10 in providing care in the registered nurse's assigned unit
327	327	11 to the facility; and
328	328	12 (4) has the principal responsibility of providing
329	329	13 direct patient care and has no additional job duties
330	330	14 during the time period during which the nurse has a
331	331	15 patient assignment.
332	332	16 (f) The hours in which a nurse administrator, nurse
333	333	17 supervisor, nurse manager, charge nurse, or other licensed
334	334	18 nurse provides direct patient care may be considered when
335	335	19 evaluating compliance with the patient limits under Section 10
336	336	20 and with the patient assignment requirement under subsection
337	337	21 (b) only if he or she is providing relief for a direct care
338	338	22 registered professional nurse during breaks, meals, and other
339	339	23 routine and expected absences from that unit.
340	340	24 (g) At all times during each shift within a facility unit,
341	341	25 clinical unit, or patient care area of a facility, and with the
342	342	26 full complement of ancillary support staff, at least 2 direct
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353	353	1 care registered nurses shall be physically present in each
354	354	2 facility unit, clinical unit, or patient care area where a
355	355	3 patient is present.
356	356	4 (h) Identifying a clinical unit or patient care area by a
357	357	5 name or term other than those listed in this Act does not
358	358	6 affect a facility's requirement to staff the unit consistent
359	359	7 with the patient limits identified for the level of intensity
360	360	8 or type of care described in this Act.
361	361	9 (i) A registered nurse providing direct care to a patient
362	362	10 has the authority to determine if a change in the patient's
363	363	11 status places the patient in a different category requiring a
364	364	12 different patient limit under Section 10.
365	365	13 (j) A facility shall assign direct care professional
366	366	14 registered nurses in a patient care unit in accordance with
367	367	15 Section 10 in order to meet the highest level of intensity and
368	368	16 type of care provided in the patient care unit. If multiple
369	369	17 assignments described under Section 10 apply to a patient, the
370	370	18 facility shall assign a direct care professional registered
371	371	19 nurse in accordance with the lowest numerical patient
372	372	20 assignment under that Section.
373	373	21 (k) A facility shall provide staffing of direct care
374	374	22 registered professional nurses above the number of direct care
375	375	23 registered professional nurses required to comply with the
376	376	24 patient levels under Section 10, or additional staffing of
377	377	25 licensed practical nurses, certified nursing assistants, or
378	378	26 other licensed or unlicensed ancillary support staff, based on
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389	389	1 the direct care registered professional nurse's assessment of
390	390	2 each assigned individual patient, the individual patient's
391	391	3 nursing care requirements, and the individual patient's
392	392	4 nursing care plan.
393	393	5 (l) A facility shall not employ video monitors, remote
394	394	6 patient monitoring, or any form of electronic visualization of
395	395	7 a patient as a substitute for the direct in-person observation
396	396	8 required for patient assessment by a registered nurse or for
397	397	9 patient protection. Video monitors or any form of electronic
398	398	10 visualization of a patient shall not constitute compliance
399	399	11 with the patient limits under Section 10.
400	400	12 (m) A facility must provide relief by a direct care
401	401	13 registered professional nurse with unit-specific education,
402	402	14 training, and competence during another direct care registered
403	403	15 professional nurse's meal periods, breaks, and routine
404	404	16 absences as part of the facility's obligation to meet the
405	405	17 patient limits under Section 10 at all times.
406	406	18 Section 25. Changes in patient census.
407	407	19 (a) A facility shall plan for routine fluctuations in its
408	408	20 patient census, including, but not limited to, admissions,
409	409	21 discharges, and transfers.
410	410	22 (b) If a health care emergency causes a change in the
411	411	23 number of patients in a clinical care unit or patient care
412	412	24 area, the facility must be able to demonstrate that immediate
413	413	25 and diligent efforts were made to maintain required staffing
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424	424	1 levels under this Act.
425	425	2 (c) A facility shall immediately notify the Department if
426	426	3 a health care emergency described under subsection (b) causes
427	427	4 a change in the number of patients in a clinical care unit or
428	428	5 patient care area and shall report to the Department efforts
429	429	6 made to maintain staffing levels required under this Act.
430	430	7 Section 30. Record of staff assignments.
431	431	8 (a) A facility shall keep a record of the actual direct
432	432	9 care registered professional nurse, licensed practical nurse,
433	433	10 certified nursing assistant, and other ancillary staff
434	434	11 assignments to individual patients documented on a day-to-day,
435	435	12 shift-by-shift basis, shall submit copies of its records to
436	436	13 the Department quarterly, and shall keep copies of its staff
437	437	14 assignments on file for a period of 7 years.
438	438	15 (b) The documentation required under subsection (a) shall
439	439	16 be submitted to the Department as a mandatory condition of
440	440	17 licensure. The documentation shall be submitted with a
441	441	18 certification by the chief nursing officer of the facility
442	442	19 that the documentation completely and accurately reflects
443	443	20 registered nurse staffing levels by the facility for each
444	444	21 shift in each facility unit, clinical unit, and patient care
445	445	22 area in which patients receive care. The chief nursing officer
446	446	23 shall execute the certification under penalty of perjury and
447	447	24 the certification must contain an expressed acknowledgment
448	448	25 that any false statement constitutes fraud and is subject to
449	449
450	450
451	451
452	452
453	453
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455	455
456	456
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458	458	SB2795 - 13 - LRB103 34815 SPS 64670 b
459	459	1 criminal and civil prosecution and penalties.
460	460	2 Section 35. Implementation by the Department. The
461	461	3 Department shall adopt rules governing the implementation and
462	462	4 administration of this Act, including methods for facility
463	463	5 staff, facility staff's collective bargaining representatives,
464	464	6 and the public to file complaints regarding violations of this
465	465	7 Act with the Department. The Department shall conduct periodic
466	466	8 audits to ensure compliance with this Act.
467	467	9 Section 40. Nursing staff education, training, and
468	468	10 orientation.
469	469	11 (a) A facility shall adopt written policies that include,
470	470	12 but are not limited to:
471	471	13 (1) procedures for the education, training, and
472	472	14 orientation of nursing staff to each clinical area where
473	473	15 the nursing staff will work; and
474	474	16 (2) criteria for the facility to use in determining
475	475	17 whether a registered nurse has demonstrated current
476	476	18 competence in providing care in a clinical area.
477	477	19 (b) A registered nurse shall not be assigned to a facility
478	478	20 unit, clinical unit, or patient care area unless the
479	479	21 registered nurse has first received education, training, and
480	480	22 orientation in that clinical area that is sufficient to
481	481	23 provide safe, therapeutic, and competent care to patients in
482	482	24 that clinical area and has demonstrated competence in
483	483
484	484
485	485
486	486
487	487
488	488	SB2795 - 13 - LRB103 34815 SPS 64670 b
489	489
490	490
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492	492	SB2795 - 14 - LRB103 34815 SPS 64670 b
493	493	1 providing care in that clinical area.
494	494	2 (c) A registered nurse shall not be assigned to relieve a
495	495	3 direct care professional registered nurse during breaks,
496	496	4 meals, and routine absences from a facility unit, clinical
497	497	5 unit, or patient care area unless that registered nurse has
498	498	6 first received education, training, and orientation in that
499	499	7 clinical area that is sufficient to provide safe, therapeutic,
500	500	8 and competent care to patients in that clinical area and has
501	501	9 demonstrated competence in providing care in that clinical
502	502	10 area.
503	503	11 (d) A health care facility may not assign any nursing
504	504	12 personnel from a temporary nursing agency to the facility's
505	505	13 unit, clinical unit, or patient care area unless the nursing
506	506	14 personnel have first received education, training, and
507	507	15 orientation in that clinical area that is sufficient to
508	508	16 provide safe, therapeutic, and competent care to patients in
509	509	17 that clinical area and have demonstrated competence in
510	510	18 providing care in that clinical area.
511	511	19 Section 45. Enforcement.
512	512	20 (a) In addition to any other penalty prescribed by law,
513	513	21 the Department may impose a civil penalty against a facility
514	514	22 that violates this Act of up to $25,000 for each violation,
515	515	23 except that the Department shall impose a civil penalty of at
516	516	24 least $25,000 for each violation if the Department determines
517	517	25 that the health care facility has a pattern of violation. A
518	518
519	519
520	520
521	521
522	522
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524	524
525	525
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527	527	SB2795 - 15 - LRB103 34815 SPS 64670 b
528	528	1 separate and distinct violation shall be deemed to have been
529	529	2 committed on each day during which any violation continues
530	530	3 after receipt of written notice of the violation from the
531	531	4 Department by the facility.
532	532	5 (b) The Department shall post on its website the names of
533	533	6 facilities against which civil penalties have been imposed
534	534	7 under this Act, the violation for which the penalty was
535	535	8 imposed, and additional information as the Department deems
536	536	9 necessary.
537	537	10 (c) A facility's failure to adhere to the patient
538	538	11 assignment limits under Section 10, any other violation of
539	539	12 this Act, or any violation of Section 10.10 of the Hospital
540	540	13 Licensing Act shall be reported by the Department to the
541	541	14 Attorney General for enforcement, for which the Attorney
542	542	15 General may bring action in a court of competent jurisdiction
543	543	16 seeking injunctive relief and civil penalties.
544	544	17 (d) It is a defense to an enforcement action under this Act
545	545	18 if the facility demonstrates that a health care emergency was
546	546	19 in force at the time of the alleged violation and that the
547	547	20 facility made immediate and diligent efforts to maintain
548	548	21 staffing levels required under this Act.
549	549	22 Section 50. Nurse rights and protections.
550	550	23 (a) A registered professional nurse may object to or
551	551	24 refuse to participate in any activity, practice, assignment,
552	552	25 or task if:
553	553
554	554
555	555
556	556
557	557
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559	559
560	560
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562	562	SB2795 - 16 - LRB103 34815 SPS 64670 b
563	563	1 (1) in good faith, the registered nurse reasonably
564	564	2 believes it to be a violation of the direct care
565	565	3 registered professional nurse maximum patient assignments
566	566	4 or any other provision established under this Act or a
567	567	5 rule adopted by the Department under this Act;
568	568	6 (2) the registered nurse, based on the registered
569	569	7 nurse's nursing judgment, reasonably believes the
570	570	8 registered nurse is not prepared by education, training,
571	571	9 or experience to fulfill the assignment without
572	572	10 compromising the safety of any patient or jeopardizing the
573	573	11 license of the registered nurse; or
574	574	12 (3) in the registered nurse's nursing judgment, the
575	575	13 activity, policy, practice, assignment or task would be
576	576	14 outside the registered nurse's scope of practice or would
577	577	15 otherwise compromise the safety of any patient or the
578	578	16 registered nurse.
579	579	17 (b) A facility shall not retaliate, discriminate, or
580	580	18 otherwise take adverse action in any manner with respect to
581	581	19 any aspect of a nurse's employment, including discharge,
582	582	20 promotion, compensation, or terms, conditions, or privileges
583	583	21 of employment, based on the nurse's refusal to complete an
584	584	22 assignment under subsection (a).
585	585	23 (c) A facility shall not file a complaint against a
586	586	24 registered professional nurse with the Board of Nursing based
587	587	25 on the nurse's refusal to complete an assignment under
588	588	26 subsection (a).
589	589
590	590
591	591
592	592
593	593
594	594	SB2795 - 16 - LRB103 34815 SPS 64670 b
595	595
596	596
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598	598	SB2795 - 17 - LRB103 34815 SPS 64670 b
599	599	1 (d) A facility shall not retaliate, discriminate, or
600	600	2 otherwise take adverse action in any manner against any person
601	601	3 or with respect to any aspect of a nurse's employment,
602	602	4 including discharge, promotion, compensation, or terms,
603	603	5 conditions, or privileges of employment, based on that nurse's
604	604	6 or that person's opposition to any facility policy, practice,
605	605	7 or action that the nurse in good faith believes violates this
606	606	8 Act.
607	607	9 (e) A facility shall not retaliate, discriminate, or
608	608	10 otherwise take adverse action against any patient or employee
609	609	11 of the facility or any other individual on the basis that the
610	610	12 patient, employee, or individual, in good faith, individually
611	611	13 or in conjunction with another person or persons, has
612	612	14 presented a grievance or complaint, initiated or cooperated in
613	613	15 any investigation or proceeding of any governmental entity,
614	614	16 regulatory agency, or private accreditation body, made a civil
615	615	17 claim or demand, or filed an action relating to the care,
616	616	18 services, or conditions of the facility or of any affiliated
617	617	19 or related facility.
618	618	20 (f) A facility shall not:
619	619	21 (1) interfere with, restrain, or deny the exercise of,
620	620	22 or attempt to deny the exercise of, a right conferred
621	621	23 under this Act; or
622	622	24 (2) coerce or intimidate any individual regarding the
623	623	25 exercise of, or an attempt to exercise, a right conferred
624	624	26 under this Act.
625	625
626	626
627	627
628	628
629	629
630	630	SB2795 - 17 - LRB103 34815 SPS 64670 b
631	631
632	632
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634	634	SB2795 - 18 - LRB103 34815 SPS 64670 b
635	635	1 Section 97. Severability. The provisions of this Act are
636	636	2 severable under Section 1.31 of the Statute on Statutes.
637	637	3 Section 110. The Hospital Licensing Act is amended by
638	638	4 changing Section 10.10 as follows:
639	639	5 (210 ILCS 85/10.10)
640	640	6 (Text of Section before amendment by P.A. 103-211)
641	641	7 Sec. 10.10. Nurse staffing by patient acuity.
642	642	8 (a) Findings. The Legislature finds and declares all of
643	643	9 the following:
644	644	10 (1) The State of Illinois has a substantial interest
645	645	11 in promoting quality care and improving the delivery of
646	646	12 health care services.
647	647	13 (2) Evidence-based studies have shown that the basic
648	648	14 principles of staffing in the acute care setting should be
649	649	15 based on the complexity of patients' care needs aligned
650	650	16 with available nursing skills to promote quality patient
651	651	17 care consistent with professional nursing standards.
652	652	18 (3) Compliance with this Section promotes an
653	653	19 organizational climate that values registered nurses'
654	654	20 input in meeting the health care needs of hospital
655	655	21 patients.
656	656	22 (b) Definitions. As used in this Section:
657	657	23 "Acuity model" means an assessment tool selected and
658	658
659	659
660	660
661	661
662	662
663	663	SB2795 - 18 - LRB103 34815 SPS 64670 b
664	664
665	665
666	666	SB2795- 19 -LRB103 34815 SPS 64670 b SB2795 - 19 - LRB103 34815 SPS 64670 b
667	667	SB2795 - 19 - LRB103 34815 SPS 64670 b
668	668	1 implemented by a hospital, as recommended by a nursing care
669	669	2 committee, that assesses the complexity of patient care needs
670	670	3 requiring professional nursing care and skills and aligns
671	671	4 patient care needs and nursing skills consistent with
672	672	5 professional nursing standards.
673	673	6 "Department" means the Department of Public Health.
674	674	7 "Direct patient care" means care provided by a registered
675	675	8 professional nurse with direct responsibility to oversee or
676	676	9 carry out medical regimens or nursing care for one or more
677	677	10 patients.
678	678	11 "Nursing care committee" means a hospital-wide committee
679	679	12 or committees of nurses whose functions, in part or in whole,
680	680	13 contribute to the development, recommendation, and review of
681	681	14 the hospital's nurse staffing plan established pursuant to
682	682	15 subsection (d).
683	683	16 "Registered professional nurse" means a person licensed as
684	684	17 a Registered Nurse under the Nurse Practice Act.
685	685	18 "Written staffing plan for nursing care services" means a
686	686	19 written plan for the assignment of patient care nursing staff
687	687	20 based on multiple nurse and patient considerations that yield
688	688	21 minimum staffing levels for inpatient care units and the
689	689	22 adopted acuity model aligning patient care needs with nursing
690	690	23 skills required for quality patient care consistent with
691	691	24 professional nursing standards.
692	692	25 (c) Written staffing plan.
693	693	26 (1) Every hospital shall implement a written
694	694
695	695
696	696
697	697
698	698
699	699	SB2795 - 19 - LRB103 34815 SPS 64670 b
700	700
701	701
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703	703	SB2795 - 20 - LRB103 34815 SPS 64670 b
704	704	1 hospital-wide staffing plan, prepared by a nursing care
705	705	2 committee or committees, that provides for minimum direct
706	706	3 care professional registered nurse-to-patient staffing
707	707	4 needs for each inpatient care unit, including inpatient
708	708	5 emergency departments. If the staffing plan prepared by
709	709	6 the nursing care committee is not adopted by the hospital,
710	710	7 or if substantial changes are proposed to it, the chief
711	711	8 nursing officer shall either: (i) provide a written
712	712	9 explanation to the committee of the reasons the plan was
713	713	10 not adopted; or (ii) provide a written explanation of any
714	714	11 substantial changes made to the proposed plan prior to it
715	715	12 being adopted by the hospital. The written hospital-wide
716	716	13 staffing plan shall include, but need not be limited to,
717	717	14 the following considerations:
718	718	15 (A) The complexity of complete care, assessment on
719	719	16 patient admission, volume of patient admissions,
720	720	17 discharges and transfers, evaluation of the progress
721	721	18 of a patient's problems, ongoing physical assessments,
722	722	19 planning for a patient's discharge, assessment after a
723	723	20 change in patient condition, and assessment of the
724	724	21 need for patient referrals.
725	725	22 (B) The complexity of clinical professional
726	726	23 nursing judgment needed to design and implement a
727	727	24 patient's nursing care plan, the need for specialized
728	728	25 equipment and technology, the skill mix of other
729	729	26 personnel providing or supporting direct patient care,
730	730
731	731
732	732
733	733
734	734
735	735	SB2795 - 20 - LRB103 34815 SPS 64670 b
736	736
737	737
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739	739	SB2795 - 21 - LRB103 34815 SPS 64670 b
740	740	1 and involvement in quality improvement activities,
741	741	2 professional preparation, and experience.
742	742	3 (C) Patient acuity and the number of patients for
743	743	4 whom care is being provided.
744	744	5 (D) The ongoing assessments of a unit's patient
745	745	6 acuity levels and nursing staff needed shall be
746	746	7 routinely made by the unit nurse manager or his or her
747	747	8 designee.
748	748	9 (E) The identification of additional registered
749	749	10 nurses available for direct patient care when
750	750	11 patients' unexpected needs exceed the planned workload
751	751	12 for direct care staff.
752	752	13 (2) In order to provide staffing flexibility to meet
753	753	14 patient needs, every hospital shall identify an acuity
754	754	15 model for adjusting the staffing plan for each inpatient
755	755	16 care unit.
756	756	17 (2.5) Each hospital shall implement the staffing plan
757	757	18 and assign nursing personnel to each inpatient care unit,
758	758	19 including inpatient emergency departments, in accordance
759	759	20 with the staffing plan.
760	760	21 (A) A registered nurse may report to the nursing
761	761	22 care committee any variations where the nurse
762	762	23 personnel assignment in an inpatient care unit is not
763	763	24 in accordance with the adopted staffing plan and may
764	764	25 make a written report to the nursing care committee
765	765	26 based on the variations.
766	766
767	767
768	768
769	769
770	770
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772	772
773	773
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775	775	SB2795 - 22 - LRB103 34815 SPS 64670 b
776	776	1 (B) Shift-to-shift adjustments in staffing levels
777	777	2 required by the staffing plan may be made by the
778	778	3 appropriate hospital personnel overseeing inpatient
779	779	4 care operations. If a registered nurse in an inpatient
780	780	5 care unit objects to a shift-to-shift adjustment, the
781	781	6 registered nurse may submit a written report to the
782	782	7 nursing care committee.
783	783	8 (C) The nursing care committee shall develop a
784	784	9 process to examine and respond to written reports
785	785	10 submitted under subparagraphs (A) and (B) of this
786	786	11 paragraph (2.5), including the ability to determine if
787	787	12 a specific written report is resolved or should be
788	788	13 dismissed.
789	789	14 (3) The written staffing plan shall be posted, either
790	790	15 by physical or electronic means, in a conspicuous and
791	791	16 accessible location for both patients and direct care
792	792	17 staff, as required under the Hospital Report Card Act. A
793	793	18 copy of the written staffing plan shall be provided to any
794	794	19 member of the general public upon request.
795	795	20 (d) Nursing care committee.
796	796	21 (1) Every hospital shall have a nursing care committee
797	797	22 that meets at least 6 times per year. A hospital shall
798	798	23 appoint members of a committee whereby at least 55% of the
799	799	24 members are registered professional nurses providing
800	800	25 direct inpatient care, one of whom shall be selected
801	801	26 annually by the direct inpatient care nurses to serve as
802	802
803	803
804	804
805	805
806	806
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808	808
809	809
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811	811	SB2795 - 23 - LRB103 34815 SPS 64670 b
812	812	1 co-chair of the committee.
813	813	2 (2) (Blank).
814	814	3 (2.5) A nursing care committee shall prepare and
815	815	4 recommend to hospital administration the hospital's
816	816	5 written hospital-wide staffing plan. If the staffing plan
817	817	6 is not adopted by the hospital, the chief nursing officer
818	818	7 shall provide a written statement to the committee prior
819	819	8 to a staffing plan being adopted by the hospital that: (A)
820	820	9 explains the reasons the committee's proposed staffing
821	821	10 plan was not adopted; and (B) describes the changes to the
822	822	11 committee's proposed staffing or any alternative to the
823	823	12 committee's proposed staffing plan.
824	824	13 (3) A nursing care committee's or committees' written
825	825	14 staffing plan for the hospital shall be based on the
826	826	15 principles from the staffing components set forth in
827	827	16 subsection (c). In particular, a committee or committees
828	828	17 shall provide input and feedback on the following:
829	829	18 (A) Selection, implementation, and evaluation of
830	830	19 minimum staffing levels for inpatient care units.
831	831	20 (B) Selection, implementation, and evaluation of
832	832	21 an acuity model to provide staffing flexibility that
833	833	22 aligns changing patient acuity with nursing skills
834	834	23 required.
835	835	24 (C) Selection, implementation, and evaluation of a
836	836	25 written staffing plan incorporating the items
837	837	26 described in subdivisions (c)(1) and (c)(2) of this
838	838
839	839
840	840
841	841
842	842
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844	844
845	845
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847	847	SB2795 - 24 - LRB103 34815 SPS 64670 b
848	848	1 Section.
849	849	2 (D) Review the nurse staffing plans for all
850	850	3 inpatient areas and current acuity tools and measures
851	851	4 in use. The nursing care committee's review shall
852	852	5 consider:
853	853	6 (i) patient outcomes;
854	854	7 (ii) complaints regarding staffing, including
855	855	8 complaints about a delay in direct care nursing or
856	856	9 an absence of direct care nursing;
857	857	10 (iii) the number of hours of nursing care
858	858	11 provided through an inpatient hospital unit
859	859	12 compared with the number of inpatients served by
860	860	13 the hospital unit during a 24-hour period;
861	861	14 (iv) the aggregate hours of overtime worked by
862	862	15 the nursing staff;
863	863	16 (v) the extent to which actual nurse staffing
864	864	17 for each hospital inpatient unit differs from the
865	865	18 staffing specified by the staffing plan; and
866	866	19 (vi) any other matter or change to the
867	867	20 staffing plan determined by the committee to
868	868	21 ensure that the hospital is staffed to meet the
869	869	22 health care needs of patients.
870	870	23 (4) A nursing care committee must issue a written
871	871	24 report addressing the items described in subparagraphs (A)
872	872	25 through (D) of paragraph (3) semi-annually. A written copy
873	873	26 of this report shall be made available to direct inpatient
874	874
875	875
876	876
877	877
878	878
879	879	SB2795 - 24 - LRB103 34815 SPS 64670 b
880	880
881	881
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883	883	SB2795 - 25 - LRB103 34815 SPS 64670 b
884	884	1 care nurses by making available a paper copy of the
885	885	2 report, distributing it electronically, or posting it on
886	886	3 the hospital's website.
887	887	4 (5) A nursing care committee must issue a written
888	888	5 report at least annually to the hospital governing board
889	889	6 that addresses items including, but not limited to: the
890	890	7 items described in paragraph (3); changes made based on
891	891	8 committee recommendations and the impact of such changes;
892	892	9 and recommendations for future changes related to nurse
893	893	10 staffing.
894	894	11 (e) Nothing in this Section 10.10 shall be construed to
895	895	12 limit, alter, or modify any of the terms, conditions, or
896	896	13 provisions of a collective bargaining agreement entered into
897	897	14 by the hospital.
898	898	15 (f) No hospital may discipline, discharge, or take any
899	899	16 other adverse employment action against an employee solely
900	900	17 because the employee expresses a concern or complaint
901	901	18 regarding an alleged violation of this Section or concerns
902	902	19 related to nurse staffing.
903	903	20 (g) Any employee of a hospital may file a complaint with
904	904	21 the Department regarding an alleged violation of this Section.
905	905	22 The Department must forward notification of the alleged
906	906	23 violation to the hospital in question within 10 business days
907	907	24 after the complaint is filed. Upon receiving a complaint of a
908	908	25 violation of this Section, the Department may take any action
909	909	26 authorized under Section Sections 7 or 9 of this Act.
910	910
911	911
912	912
913	913
914	914
915	915	SB2795 - 25 - LRB103 34815 SPS 64670 b
916	916
917	917
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919	919	SB2795 - 26 - LRB103 34815 SPS 64670 b
920	920	1 (Source: P.A. 102-4, eff. 4-27-21; 102-641, eff. 8-27-21;
921	921	2 102-813, eff. 5-13-22; revised 9-26-23.)
922	922	3 (Text of Section after amendment by P.A. 103-211)
923	923	4 Sec. 10.10. Nurse staffing by patient acuity.
924	924	5 (a) Findings. The Legislature finds and declares all of
925	925	6 the following:
926	926	7 (1) The State of Illinois has a substantial interest
927	927	8 in promoting quality care and improving the delivery of
928	928	9 health care services.
929	929	10 (2) Evidence-based studies have shown that the basic
930	930	11 principles of staffing in the acute care setting should be
931	931	12 based on the complexity of patients' care needs aligned
932	932	13 with available nursing skills to promote quality patient
933	933	14 care consistent with professional nursing standards.
934	934	15 (3) Compliance with this Section promotes an
935	935	16 organizational climate that values registered nurses'
936	936	17 input in meeting the health care needs of hospital
937	937	18 patients.
938	938	19 (b) Definitions. As used in this Section:
939	939	20 "Acuity model" means an assessment tool selected and
940	940	21 implemented by a hospital, as recommended by a nursing care
941	941	22 committee, that assesses the complexity of patient care needs
942	942	23 requiring professional nursing care and skills and aligns
943	943	24 patient care needs and nursing skills consistent with
944	944	25 professional nursing standards.
945	945
946	946
947	947
948	948
949	949
950	950	SB2795 - 26 - LRB103 34815 SPS 64670 b
951	951
952	952
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954	954	SB2795 - 27 - LRB103 34815 SPS 64670 b
955	955	1 "Department" means the Department of Public Health.
956	956	2 "Direct patient care" means care provided in person by a
957	957	3 registered professional nurse with direct responsibility to
958	958	4 oversee or carry out medical regimens or nursing care for one
959	959	5 or more patients.
960	960	6 "Nursing care committee" means a hospital-wide committee
961	961	7 or committees of nurses whose functions, in part or in whole,
962	962	8 contribute to the development, recommendation, and review of
963	963	9 the hospital's nurse staffing plan established pursuant to
964	964	10 subsection (d).
965	965	11 "Registered professional nurse" means a person licensed as
966	966	12 a Registered Nurse under the Nurse Practice Act.
967	967	13 "Written staffing plan for nursing care services" means a
968	968	14 written plan for the assignment of patient care nursing staff
969	969	15 based on multiple nurse and patient considerations that
970	970	16 ensures the facility meets the maximum patient assignment
971	971	17 limits under Section 10 of the Safe Patient Limits Act and the
972	972	18 adopted method to adjust the staffing plan for each inpatient
973	973	19 care unit when additional staff are needed to fulfill the care
974	974	20 needs of each individual patient as determined by the
975	975	21 patient's assigned direct care registered professional nurse
976	976	22 yield minimum staffing levels for inpatient care units and the
977	977	23 adopted acuity model aligning patient care needs with nursing
978	978	24 skills required for quality patient care consistent with
979	979	25 professional nursing standards.
980	980	26 (c) Written staffing plan.
981	981
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991	991	1 (1) Every hospital shall implement a written
992	992	2 hospital-wide staffing plan, prepared by a nursing care
993	993	3 committee or committees, that provides for minimum direct
994	994	4 care professional registered nurse-to-patient staffing
995	995	5 needs for each inpatient care unit and , including
996	996	6 inpatient emergency department departments. If the
997	997	7 staffing plan prepared by the nursing care committee is
998	998	8 not adopted by the hospital, or if substantial changes are
999	999	9 proposed to it, the chief nursing officer shall either:
1000	1000	10 (i) provide a written explanation to the committee of the
1001	1001	11 reasons the plan was not adopted; or (ii) provide a
1002	1002	12 written explanation of any substantial changes made to the
1003	1003	13 proposed plan prior to it being adopted by the hospital.
1004	1004	14 The written hospital-wide staffing plan shall include, but
1005	1005	15 need not be limited to, the following considerations:
1006	1006	16 (A) The complexity of complete care, assessment on
1007	1007	17 patient admission, volume of patient admissions,
1008	1008	18 discharges and transfers, evaluation of the progress
1009	1009	19 of a patient's problems, ongoing physical assessments,
1010	1010	20 planning for a patient's discharge, assessment after a
1011	1011	21 change in patient condition, and assessment of the
1012	1012	22 need for patient referrals.
1013	1013	23 (B) The complexity of clinical professional
1014	1014	24 nursing judgment needed to design and implement a
1015	1015	25 patient's nursing care plan, the need for specialized
1016	1016	26 equipment and technology, the skill mix of other
1017	1017
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1027	1027	1 personnel providing or supporting direct patient care,
1028	1028	2 and involvement in quality improvement activities,
1029	1029	3 professional preparation, and experience.
1030	1030	4 (C) Patient acuity and the number of patients for
1031	1031	5 whom care is being provided.
1032	1032	6 (D) The ongoing assessments of a unit's patient
1033	1033	7 acuity levels, as determined by the direct care
1034	1034	8 registered professional nurse responsible for each
1035	1035	9 patient's care, and nursing staff needed shall be
1036	1036	10 routinely made by the unit nurse manager or the unit
1037	1037	11 nurse manager's his or her designee.
1038	1038	12 (E) The identification of additional registered
1039	1039	13 nurses available for direct patient care when
1040	1040	14 patients' unexpected needs exceed the planned workload
1041	1041	15 for direct care staff.
1042	1042	16 (F) Ensuring that patient limits under Section 10
1043	1043	17 of the Safe Patient Limits Act to a registered nurse
1044	1044	18 are not exceeded.
1045	1045	19 (2) In order to provide staffing flexibility to meet
1046	1046	20 patient needs, every hospital shall include in its
1047	1047	21 staffing plan a method to adjust the staffing plan for
1048	1048	22 each inpatient care unit when the maximum patient
1049	1049	23 assignment under Section 10 of the Safe Patient Limits Act
1050	1050	24 should be reduced or additional staff are needed to
1051	1051	25 fulfill the care needs of each individual patient as
1052	1052	26 determined by the patient's assigned direct care
1053	1053
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1063	1063	1 registered professional nurse identify an acuity model for
1064	1064	2 adjusting the staffing plan for each inpatient care unit.
1065	1065	3 (2.5) Each hospital shall implement the staffing plan
1066	1066	4 and assign nursing personnel to each inpatient care unit
1067	1067	5 and emergency department , including inpatient emergency
1068	1068	6 departments, in accordance with the staffing plan.
1069	1069	7 (A) A registered nurse may report to the nursing
1070	1070	8 care committee any variations where the nurse
1071	1071	9 personnel assignment in an inpatient care unit is not
1072	1072	10 in accordance with the adopted staffing plan and may
1073	1073	11 make a written report to the nursing care committee
1074	1074	12 based on the variations.
1075	1075	13 (B) Shift-to-shift adjustments in staffing levels
1076	1076	14 required by the staffing plan may be made by the
1077	1077	15 appropriate hospital personnel overseeing inpatient
1078	1078	16 care operations. If a registered nurse in an inpatient
1079	1079	17 care unit objects to a shift-to-shift adjustment, the
1080	1080	18 registered nurse may submit a written report to the
1081	1081	19 nursing care committee.
1082	1082	20 (C) The nursing care committee shall develop a
1083	1083	21 process to examine and respond to written reports
1084	1084	22 submitted under subparagraphs (A) and (B) of this
1085	1085	23 paragraph (2.5), including the ability to determine if
1086	1086	24 a specific written report is resolved or should be
1087	1087	25 dismissed.
1088	1088	26 (3) The written staffing plan shall be posted, either
1089	1089
1090	1090
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1099	1099	1 by physical or electronic means, in a conspicuous and
1100	1100	2 accessible location for both patients and direct care
1101	1101	3 staff, as required under the Hospital Report Card Act. A
1102	1102	4 copy of the written staffing plan shall be provided to any
1103	1103	5 member of the general public upon request.
1104	1104	6 (4) The written staffing plan shall be updated on an
1105	1105	7 annual basis and submitted to the Department.
1106	1106	8 (5) Any acuity model, or other method, software, or
1107	1107	9 tool used to create or evaluate a staffing plan adopted by
1108	1108	10 a facility, shall be transparent in all respects,
1109	1109	11 including disclosure of detailed documentation of the
1110	1110	12 methodology used to determine nurse staffing and
1111	1111	13 identifying each factor, assumption, and value used in
1112	1112	14 applying the methodology. This documentation shall be
1113	1113	15 submitted to the Department and made available to facility
1114	1114	16 staff, facility staff's collective bargaining
1115	1115	17 representatives, and the public upon request. The patient
1116	1116	18 limits under Section 10 of the Safe Patient Limits Act
1117	1117	19 shall not be exceeded regardless of the use and
1118	1118	20 application of any acuity model.
1119	1119	21 (d) Nursing care committee.
1120	1120	22 (1) Every hospital shall have a nursing care committee
1121	1121	23 that meets at least 6 times per year. A hospital shall
1122	1122	24 appoint members of a committee whereby at least 55% of the
1123	1123	25 members are registered professional nurses providing
1124	1124	26 direct inpatient care, one of whom shall be selected
1125	1125
1126	1126
1127	1127
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1135	1135	1 annually by the direct inpatient care nurses to serve as
1136	1136	2 co-chair of the committee.
1137	1137	3 (2) (Blank).
1138	1138	4 (2.5) A nursing care committee shall prepare and
1139	1139	5 recommend to hospital administration the hospital's
1140	1140	6 written hospital-wide staffing plan. If the staffing plan
1141	1141	7 is not adopted by the hospital, the chief nursing officer
1142	1142	8 shall provide a written statement to the committee prior
1143	1143	9 to a staffing plan being adopted by the hospital that: (A)
1144	1144	10 explains the reasons the committee's proposed staffing
1145	1145	11 plan was not adopted; and (B) describes the changes to the
1146	1146	12 committee's proposed staffing or any alternative to the
1147	1147	13 committee's proposed staffing plan.
1148	1148	14 (3) A nursing care committee's or committees' written
1149	1149	15 staffing plan for the hospital shall be based on the
1150	1150	16 principles from the staffing components set forth in
1151	1151	17 subsection (c). In particular, a committee or committees
1152	1152	18 shall provide input and feedback on the following:
1153	1153	19 (A) Selection, implementation, and evaluation of
1154	1154	20 minimum staffing levels consistent with the maximum
1155	1155	21 patient limits under the Safe Patient Limits Act for
1156	1156	22 inpatient care units.
1157	1157	23 (B) Selection, implementation, and evaluation of a
1158	1158	24 method to increase staffing as needed to meet patient
1159	1159	25 care needs an acuity model to provide staffing
1160	1160	26 flexibility that aligns changing patient acuity with
1161	1161
1162	1162
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1171	1171	1 nursing skills required.
1172	1172	2 (C) Selection, implementation, and evaluation of a
1173	1173	3 written staffing plan incorporating the items
1174	1174	4 described in subdivisions (c)(1) and (c)(2) of this
1175	1175	5 Section.
1176	1176	6 (D) Review the nurse staffing plans for all
1177	1177	7 inpatient areas and current acuity tools and measures
1178	1178	8 in use. The nursing care committee's review shall
1179	1179	9 consider:
1180	1180	10 (i) patient outcomes;
1181	1181	11 (ii) complaints regarding staffing, including
1182	1182	12 complaints about a delay in direct care nursing or
1183	1183	13 an absence of direct care nursing;
1184	1184	14 (iii) the number of hours of nursing care
1185	1185	15 provided through an inpatient hospital unit
1186	1186	16 compared with the number of inpatients served by
1187	1187	17 the hospital unit during a 24-hour period;
1188	1188	18 (iv) the aggregate hours of overtime worked by
1189	1189	19 the nursing staff;
1190	1190	20 (v) the extent to which actual nurse staffing
1191	1191	21 for each hospital inpatient unit differs from the
1192	1192	22 staffing specified by the staffing plan; and
1193	1193	23 (vi) any other matter or change to the
1194	1194	24 staffing plan determined by the committee to
1195	1195	25 ensure that the hospital is staffed to meet the
1196	1196	26 health care needs of patients.
1197	1197
1198	1198
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1207	1207	1 (4) A nursing care committee must issue a written
1208	1208	2 report addressing the items described in subparagraphs (A)
1209	1209	3 through (D) of paragraph (3) semi-annually. A written copy
1210	1210	4 of this report shall be made available to direct inpatient
1211	1211	5 care nurses by making available a paper copy of the
1212	1212	6 report, distributing it electronically, or posting it on
1213	1213	7 the hospital's website.
1214	1214	8 (5) A nursing care committee must issue a written
1215	1215	9 report at least annually to the hospital governing board
1216	1216	10 that addresses items including, but not limited to: the
1217	1217	11 items described in paragraph (3); changes made based on
1218	1218	12 committee recommendations and the impact of such changes;
1219	1219	13 and recommendations for future changes related to nurse
1220	1220	14 staffing.
1221	1221	15 (6) A nursing care committee must annually notify the
1222	1222	16 hospital nursing staff of the staff's rights under this
1223	1223	17 Section. The annual notice must provide a phone number and
1224	1224	18 an email address for staff to report noncompliance with
1225	1225	19 the nursing staff's rights as described in this Section.
1226	1226	20 The notice must be provided by email or by regular mail in
1227	1227	21 a manner that effectively facilitates receipt of the
1228	1228	22 notice. The Department shall monitor and enforce the
1229	1229	23 requirements of this paragraph (6).
1230	1230	24 (e) Nothing in this Section 10.10 shall be construed to
1231	1231	25 limit, alter, or modify any of the terms, conditions, or
1232	1232	26 provisions of a collective bargaining agreement entered into
1233	1233
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1243	1243	1 by the hospital.
1244	1244	2 (f) No hospital may discipline, discharge, or take any
1245	1245	3 other adverse employment action against an employee solely
1246	1246	4 because the employee expresses a concern or complaint
1247	1247	5 regarding an alleged violation of this Section or concerns
1248	1248	6 related to nurse staffing.
1249	1249	7 (g) Any employee of a hospital may file a complaint with
1250	1250	8 the Department regarding an alleged violation of this Section.
1251	1251	9 The Department must forward notification of the alleged
1252	1252	10 violation to the hospital in question within 10 business days
1253	1253	11 after the complaint is filed. Upon receiving a complaint of a
1254	1254	12 violation of this Section, the Department may take any action
1255	1255	13 authorized under Section Sections 7 or 9 of this Act.
1256	1256	14 (h) Delegation of nursing interventions by a registered
1257	1257	15 professional nurse must be in accordance with the Nurse
1258	1258	16 Practice Act.
1259	1259	17 (i) A hospital shall not mandate that a registered
1260	1260	18 professional nurse delegate any element of the nursing
1261	1261	19 process, including, but not limited to, nursing interventions,
1262	1262	20 medication administration, nursing judgment, comprehensive
1263	1263	21 patient assessment, development of the plan of care, or
1264	1264	22 evaluation of care. A delegation of a nursing intervention by
1265	1265	23 a registered professional nurse shall not be delegated again
1266	1266	24 to another person.
1267	1267	25 (j) The Department shall establish procedures to ensure
1268	1268	26 that the documentation submitted under this Section is
1269	1269
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1279	1279	1 available for public inspection in its entirety.
1280	1280	2 (k) Nothing in this Section shall be construed to limit,
1281	1281	3 alter, or modify the requirements of the Safe Patient Limits
1282	1282	4 Act.
1283	1283	5 (Source: P.A. 102-4, eff. 4-27-21; 102-641, eff. 8-27-21;
1284	1284	6 102-813, eff. 5-13-22; 103-211, eff. 1-1-24; revised 9-26-23.)
1285	1285	7 Section 115. The Nurse Practice Act is amended by adding
1286	1286	8 Section 50-15.15 and Article 85 as follows:
1287	1287	9 (225 ILCS 65/50-15.15 new)
1288	1288	10 Sec. 50-15.15. Nursing judgment.
1289	1289	11 (a) The General Assembly finds that:
1290	1290	12 (1) Performance of the scope of practice of a direct
1291	1291	13 care registered professional nurse requires the exercise
1292	1292	14 of nursing judgment in the exclusive interests of the
1293	1293	15 patient.
1294	1294	16 (2) The exercise of nursing judgment, unencumbered by
1295	1295	17 the commercial or revenue-generation priorities of a
1296	1296	18 hospital, long-term acute care hospital, ambulatory
1297	1297	19 surgical treatment center, or other employing entity of a
1298	1298	20 direct care registered professional nurse is necessary to
1299	1299	21 ensure safe, therapeutic, effective, and competent
1300	1300	22 treatment of patients and is essential to protect the
1301	1301	23 health and safety of the people of Illinois.
1302	1302	24 (b) The exercise of nursing judgment by a direct care
1303	1303
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1313	1313	1 registered professional nurse in the performance of the scope
1314	1314	2 of practice of the registered professional nurse under Section
1315	1315	3 60-35 or the scope of practice of the advanced practice
1316	1316	4 registered nurse under Section 65-30 shall be provided in the
1317	1317	5 exclusive interests of the patient and shall not, for any
1318	1318	6 purpose, be considered, relied upon, or represented as a job
1319	1319	7 function, authority, responsibility, or activity undertaken in
1320	1320	8 any respect for the purpose of serving the business,
1321	1321	9 commercial, operational, or other institutional interests of
1322	1322	10 the employer.
1323	1323	11 (c) A hospital, long-term acute care hospital, ambulatory
1324	1324	12 surgical treatment center, or other health care facility shall
1325	1325	13 not adopt a policy that:
1326	1326	14 (1) limits a direct care registered professional nurse
1327	1327	15 in performing duties that are part of the nursing process,
1328	1328	16 including, but not limited to, full exercise of nursing
1329	1329	17 judgment in assessing, planning, implementing, and
1330	1330	18 evaluating care;
1331	1331	19 (2) substitutes recommendations, decisions, or outputs
1332	1332	20 of health information technology, algorithms used to
1333	1333	21 achieve a medical or nursing care objective at a facility,
1334	1334	22 systems based on artificial intelligence or machine
1335	1335	23 learning, or clinical practice guidelines for the
1336	1336	24 independent nursing judgment of a direct care registered
1337	1337	25 professional nurse or penalize a direct care registered
1338	1338	26 professional nurse for overriding the technology or
1339	1339
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1349	1349	1 guidelines if, in that registered nurse's judgment, and in
1350	1350	2 accordance with that registered nurse's scope of practice,
1351	1351	3 it is in the best interest of the patient to do so; or
1352	1352	4 (3) limits a direct care registered professional nurse
1353	1353	5 in acting as a patient advocate in the exclusive interests
1354	1354	6 of the patient.
1355	1355	7 (225 ILCS 65/Art. 85 heading new)
1356	1356	8 ARTICLE 85. NURSE LICENSURE COMPACT
1357	1357	9 (225 ILCS 65/85-5 new)
1358	1358	10 Sec. 85-5. Nurse Licensure Compact. The State of Illinois
1359	1359	11 ratifies and approves the following Compact:
1360	1360	12 ARTICLE I
1361	1361	13 Findings and Declaration of Purpose
1362	1362	14 a. The party states find that:
1363	1363	15 1. The health and safety of the public are affected by
1364	1364	16 the degree of compliance with and the effectiveness of
1365	1365	17 enforcement activities related to state nurse licensure
1366	1366	18 laws;
1367	1367	19 2. Violations of nurse licensure and other laws
1368	1368	20 regulating the practice of nursing may result in injury or
1369	1369	21 harm to the public;
1370	1370	22 3. The expanded mobility of nurses and the use of
1371	1371
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1381	1381	1 advanced communication technologies as part of our
1382	1382	2 nation's health care delivery system require greater
1383	1383	3 coordination and cooperation among states in the areas of
1384	1384	4 nurse licensure and regulation;
1385	1385	5 4. New practice modalities and technology make
1386	1386	6 compliance with individual state nurse licensure laws
1387	1387	7 difficult and complex;
1388	1388	8 5. The current system of duplicative licensure for
1389	1389	9 nurses practicing in multiple states is cumbersome and
1390	1390	10 redundant for both nurses and states; and
1391	1391	11 6. Uniformity of nurse licensure requirements
1392	1392	12 throughout the states promotes public safety and public
1393	1393	13 health benefits.
1394	1394	14 b. The general purposes of this Compact are to:
1395	1395	15 1. Facilitate the states' responsibility to protect
1396	1396	16 the public's health and safety;
1397	1397	17 2. Ensure and encourage the cooperation of party
1398	1398	18 states in the areas of nurse licensure and regulation;
1399	1399	19 3. Facilitate the exchange of information between
1400	1400	20 party states in the areas of nurse regulation,
1401	1401	21 investigation and adverse actions;
1402	1402	22 4. Promote compliance with the laws governing the
1403	1403	23 practice of nursing in each jurisdiction;
1404	1404	24 5. Invest all party states with the authority to hold
1405	1405	25 a nurse accountable for meeting all state practice laws in
1406	1406	26 the state in which the patient is located at the time care
1407	1407
1408	1408
1409	1409
1410	1410
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1413	1413
1414	1414
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1417	1417	1 is rendered through the mutual recognition of party state
1418	1418	2 licenses;
1419	1419	3 6. Decrease redundancies in the consideration and
1420	1420	4 issuance of nurse licenses; and
1421	1421	5 7. Provide opportunities for interstate practice by
1422	1422	6 nurses who meet uniform licensure requirements.
1423	1423	7 ARTICLE II
1424	1424	8 Definitions
1425	1425	9 As used in this Compact:
1426	1426	10 a. "Adverse action" means any administrative, civil,
1427	1427	11 equitable or criminal action permitted by a state's laws
1428	1428	12 which is imposed by a licensing board or other authority
1429	1429	13 against a nurse, including actions against an individual's
1430	1430	14 license or multistate licensure privilege such as
1431	1431	15 revocation, suspension, probation, monitoring of the
1432	1432	16 licensee, limitation on the licensee's practice, or any
1433	1433	17 other encumbrance on licensure affecting a nurse's
1434	1434	18 authorization to practice, including issuance of a cease
1435	1435	19 and desist action.
1436	1436	20 b. "Alternative program" means a non-disciplinary
1437	1437	21 monitoring program approved by a licensing board.
1438	1438	22 c. "Coordinated licensure information system" means an
1439	1439	23 integrated process for collecting, storing and sharing
1440	1440	24 information on nurse licensure and enforcement activities
1441	1441
1442	1442
1443	1443
1444	1444
1445	1445
1446	1446	SB2795 - 40 - LRB103 34815 SPS 64670 b
1447	1447
1448	1448
1449	1449	SB2795- 41 -LRB103 34815 SPS 64670 b SB2795 - 41 - LRB103 34815 SPS 64670 b
1450	1450	SB2795 - 41 - LRB103 34815 SPS 64670 b
1451	1451	1 related to nurse licensure laws that is administered by a
1452	1452	2 nonprofit organization composed of and controlled by
1453	1453	3 licensing boards.
1454	1454	4 d. "Current significant investigative information"
1455	1455	5 means:
1456	1456	6 1. Investigative information that a licensing
1457	1457	7 board, after a preliminary inquiry that includes
1458	1458	8 notification and an opportunity for the nurse to
1459	1459	9 respond, if required by state law, has reason to
1460	1460	10 believe is not groundless and, if proved true, would
1461	1461	11 indicate more than a minor infraction; or
1462	1462	12 2. Investigative information that indicates that
1463	1463	13 the nurse represents an immediate threat to public
1464	1464	14 health and safety regardless of whether the nurse has
1465	1465	15 been notified and had an opportunity to respond.
1466	1466	16 e. "Encumbrance" means a revocation or suspension of,
1467	1467	17 or any limitation on, the full and unrestricted practice
1468	1468	18 of nursing imposed by a licensing board.
1469	1469	19 f. "Home state" means the party state which is the
1470	1470	20 nurse's primary state of residence.
1471	1471	21 g. "Licensing board" means a party state's regulatory
1472	1472	22 body responsible for issuing nurse licenses.
1473	1473	23 h. "Multistate license" means a license to practice as
1474	1474	24 a registered or a licensed practical/vocational nurse
1475	1475	25 (LPN/VN) issued by a home state licensing board that
1476	1476	26 authorizes the licensed nurse to practice in all party
1477	1477
1478	1478
1479	1479
1480	1480
1481	1481
1482	1482	SB2795 - 41 - LRB103 34815 SPS 64670 b
1483	1483
1484	1484
1485	1485	SB2795- 42 -LRB103 34815 SPS 64670 b SB2795 - 42 - LRB103 34815 SPS 64670 b
1486	1486	SB2795 - 42 - LRB103 34815 SPS 64670 b
1487	1487	1 states under a multistate licensure privilege.
1488	1488	2 i. "Multistate licensure privilege" means a legal
1489	1489	3 authorization associated with a multistate license
1490	1490	4 permitting the practice of nursing as either a registered
1491	1491	5 nurse (RN) or LPN/VN in a remote state.
1492	1492	6 j. "Nurse" means RN or LPN/VN, as those terms are
1493	1493	7 defined by each party state's practice laws.
1494	1494	8 k. "Party state" means any state that has adopted this
1495	1495	9 Compact.
1496	1496	10 l. "Remote state" means a party state, other than the
1497	1497	11 home state.
1498	1498	12 m. "Single-state license" means a nurse license issued
1499	1499	13 by a party state that authorizes practice only within the
1500	1500	14 issuing state and does not include a multistate licensure
1501	1501	15 privilege to practice in any other party state.
1502	1502	16 n. "State" means a state, territory or possession of
1503	1503	17 the United States and the District of Columbia.
1504	1504	18 o. "State practice laws" means a party state's laws,
1505	1505	19 rules and regulations that govern the practice of nursing,
1506	1506	20 define the scope of nursing practice, and create the
1507	1507	21 methods and grounds for imposing discipline. "State
1508	1508	22 practice laws" do not include requirements necessary to
1509	1509	23 obtain and retain a license, except for qualifications or
1510	1510	24 requirements of the home state.
1511	1511	25 ARTICLE III
1512	1512
1513	1513
1514	1514
1515	1515
1516	1516
1517	1517	SB2795 - 42 - LRB103 34815 SPS 64670 b
1518	1518
1519	1519
1520	1520	SB2795- 43 -LRB103 34815 SPS 64670 b SB2795 - 43 - LRB103 34815 SPS 64670 b
1521	1521	SB2795 - 43 - LRB103 34815 SPS 64670 b
1522	1522	1 General Provisions and Jurisdiction
1523	1523	2 a. A multistate license to practice registered or licensed
1524	1524	3 practical/vocational nursing issued by a home state to a
1525	1525	4 resident in that state will be recognized by each party state
1526	1526	5 as authorizing a nurse to practice as a registered nurse (RN)
1527	1527	6 or as a licensed practical/vocational nurse (LPN/VN), under a
1528	1528	7 multistate licensure privilege, in each party state.
1529	1529	8 b. A state must implement procedures for considering the
1530	1530	9 criminal history records of applicants for initial multistate
1531	1531	10 license or licensure by endorsement. Such procedures shall
1532	1532	11 include the submission of fingerprints or other
1533	1533	12 biometric-based information by applicants for the purpose of
1534	1534	13 obtaining an applicant's criminal history record information
1535	1535	14 from the Federal Bureau of Investigation and the agency
1536	1536	15 responsible for retaining that state's criminal records.
1537	1537	16 c. Each party state shall require the following for an
1538	1538	17 applicant to obtain or retain a multistate license in the home
1539	1539	18 state:
1540	1540	19 1. Meets the home state's qualifications for licensure
1541	1541	20 or renewal of licensure, as well as, all other applicable
1542	1542	21 state laws;
1543	1543	22 2. i. Has graduated or is eligible to graduate from a
1544	1544	23 licensing board-approved RN or LPN/VN prelicensure
1545	1545	24 education program; or
1546	1546	25 ii. Has graduated from a foreign RN or LPN/VN
1547	1547
1548	1548
1549	1549
1550	1550
1551	1551
1552	1552	SB2795 - 43 - LRB103 34815 SPS 64670 b
1553	1553
1554	1554
1555	1555	SB2795- 44 -LRB103 34815 SPS 64670 b SB2795 - 44 - LRB103 34815 SPS 64670 b
1556	1556	SB2795 - 44 - LRB103 34815 SPS 64670 b
1557	1557	1 prelicensure education program that (a) has been approved
1558	1558	2 by the authorized accrediting body in the applicable
1559	1559	3 country and (b) has been verified by an independent
1560	1560	4 credentials review agency to be comparable to a licensing
1561	1561	5 board-approved prelicensure education program;
1562	1562	6 3. Has, if a graduate of a foreign prelicensure
1563	1563	7 education program not taught in English or if English is
1564	1564	8 not the individual's native language, successfully passed
1565	1565	9 an English proficiency examination that includes the
1566	1566	10 components of reading, speaking, writing and listening;
1567	1567	11 4. Has successfully passed an NCLEX-RN or NCLEX-PN
1568	1568	12 Examination or recognized predecessor, as applicable;
1569	1569	13 5. Is eligible for or holds an active, unencumbered
1570	1570	14 license;
1571	1571	15 6. Has submitted, in connection with an application
1572	1572	16 for initial licensure or licensure by endorsement,
1573	1573	17 fingerprints or other biometric data for the purpose of
1574	1574	18 obtaining criminal history record information from the
1575	1575	19 Federal Bureau of Investigation and the agency responsible
1576	1576	20 for retaining that state's criminal records;
1577	1577	21 7. Has not been convicted or found guilty, or has
1578	1578	22 entered into an agreed disposition, of a felony offense
1579	1579	23 under applicable state or federal criminal law;
1580	1580	24 8. Has not been convicted or found guilty, or has
1581	1581	25 entered into an agreed disposition, of a misdemeanor
1582	1582	26 offense related to the practice of nursing as determined
1583	1583
1584	1584
1585	1585
1586	1586
1587	1587
1588	1588	SB2795 - 44 - LRB103 34815 SPS 64670 b
1589	1589
1590	1590
1591	1591	SB2795- 45 -LRB103 34815 SPS 64670 b SB2795 - 45 - LRB103 34815 SPS 64670 b
1592	1592	SB2795 - 45 - LRB103 34815 SPS 64670 b
1593	1593	1 on a case-by-case basis;
1594	1594	2 9. Is not currently enrolled in an alternative
1595	1595	3 program;
1596	1596	4 10. Is subject to self-disclosure requirements
1597	1597	5 regarding current participation in an alternative program;
1598	1598	6 and
1599	1599	7 11. Has a valid United States Social Security number.
1600	1600	8 d. All party states shall be authorized, in accordance
1601	1601	9 with existing state due process law, to take adverse action
1602	1602	10 against a nurse's multistate licensure privilege such as
1603	1603	11 revocation, suspension, probation or any other action that
1604	1604	12 affects a nurse's authorization to practice under a multistate
1605	1605	13 licensure privilege, including cease and desist actions. If a
1606	1606	14 party state takes such action, it shall promptly notify the
1607	1607	15 administrator of the coordinated licensure information system.
1608	1608	16 The administrator of the coordinated licensure information
1609	1609	17 system shall promptly notify the home state of any such
1610	1610	18 actions by remote states.
1611	1611	19 e. A nurse practicing in a party state must comply with the
1612	1612	20 state practice laws of the state in which the client is located
1613	1613	21 at the time service is provided. The practice of nursing is not
1614	1614	22 limited to patient care, but shall include all nursing
1615	1615	23 practice as defined by the state practice laws of the party
1616	1616	24 state in which the client is located. The practice of nursing
1617	1617	25 in a party state under a multistate licensure privilege will
1618	1618	26 subject a nurse to the jurisdiction of the licensing board,
1619	1619
1620	1620
1621	1621
1622	1622
1623	1623
1624	1624	SB2795 - 45 - LRB103 34815 SPS 64670 b
1625	1625
1626	1626
1627	1627	SB2795- 46 -LRB103 34815 SPS 64670 b SB2795 - 46 - LRB103 34815 SPS 64670 b
1628	1628	SB2795 - 46 - LRB103 34815 SPS 64670 b
1629	1629	1 the courts and the laws of the party state in which the client
1630	1630	2 is located at the time service is provided.
1631	1631	3 f. Individuals not residing in a party state shall
1632	1632	4 continue to be able to apply for a party state's single-state
1633	1633	5 license as provided under the laws of each party state.
1634	1634	6 However, the single-state license granted to these individuals
1635	1635	7 will not be recognized as granting the privilege to practice
1636	1636	8 nursing in any other party state. Nothing in this Compact
1637	1637	9 shall affect the requirements established by a party state for
1638	1638	10 the issuance of a single-state license.
1639	1639	11 g. Any nurse holding a home state multistate license, on
1640	1640	12 the effective date of this Compact, may retain and renew the
1641	1641	13 multistate license issued by the nurse's then-current home
1642	1642	14 state, provided that:
1643	1643	15 1. A nurse, who changes primary state of residence
1644	1644	16 after this Compact's effective date, must meet all
1645	1645	17 applicable Article III.c. requirements to obtain a
1646	1646	18 multistate license from a new home state.
1647	1647	19 2. A nurse who fails to satisfy the multistate
1648	1648	20 licensure requirements in Article III.c. due to a
1649	1649	21 disqualifying event occurring after this Compact's
1650	1650	22 effective date shall be ineligible to retain or renew a
1651	1651	23 multistate license, and the nurse's multistate license
1652	1652	24 shall be revoked or deactivated in accordance with
1653	1653	25 applicable rules adopted by the Interstate Commission of
1654	1654	26 Nurse Licensure Compact Administrators ("Commission").
1655	1655
1656	1656
1657	1657
1658	1658
1659	1659
1660	1660	SB2795 - 46 - LRB103 34815 SPS 64670 b
1661	1661
1662	1662
1663	1663	SB2795- 47 -LRB103 34815 SPS 64670 b SB2795 - 47 - LRB103 34815 SPS 64670 b
1664	1664	SB2795 - 47 - LRB103 34815 SPS 64670 b
1665	1665	1 ARTICLE IV
1666	1666	2 Applications for Licensure in a Party State
1667	1667	3 a. Upon application for a multistate license, the
1668	1668	4 licensing board in the issuing party state shall ascertain,
1669	1669	5 through the coordinated licensure information system, whether
1670	1670	6 the applicant has ever held, or is the holder of, a license
1671	1671	7 issued by any other state, whether there are any encumbrances
1672	1672	8 on any license or multistate licensure privilege held by the
1673	1673	9 applicant, whether any adverse action has been taken against
1674	1674	10 any license or multistate licensure privilege held by the
1675	1675	11 applicant and whether the applicant is currently participating
1676	1676	12 in an alternative program.
1677	1677	13 b. A nurse may hold a multistate license, issued by the
1678	1678	14 home state, in only one party state at a time.
1679	1679	15 c. If a nurse changes primary state of residence by moving
1680	1680	16 between two party states, the nurse must apply for licensure
1681	1681	17 in the new home state, and the multistate license issued by the
1682	1682	18 prior home state will be deactivated in accordance with
1683	1683	19 applicable rules adopted by the Commission.
1684	1684	20 1. The nurse may apply for licensure in advance of a
1685	1685	21 change in primary state of residence.
1686	1686	22 2. A multistate license shall not be issued by the new
1687	1687	23 home state until the nurse provides satisfactory evidence
1688	1688	24 of a change in primary state of residence to the new home
1689	1689
1690	1690
1691	1691
1692	1692
1693	1693
1694	1694	SB2795 - 47 - LRB103 34815 SPS 64670 b
1695	1695
1696	1696
1697	1697	SB2795- 48 -LRB103 34815 SPS 64670 b SB2795 - 48 - LRB103 34815 SPS 64670 b
1698	1698	SB2795 - 48 - LRB103 34815 SPS 64670 b
1699	1699	1 state and satisfies all applicable requirements to obtain
1700	1700	2 a multistate license from the new home state.
1701	1701	3 d. If a nurse changes primary state of residence by moving
1702	1702	4 from a party state to a non-party state, the multistate
1703	1703	5 license issued by the prior home state will convert to a
1704	1704	6 single-state license, valid only in the former home state.
1705	1705	7 ARTICLE V
1706	1706	8 Additional Authorities Invested in Party State Licensing
1707	1707	9 Boards
1708	1708	10 a. In addition to the other powers conferred by state law,
1709	1709	11 a licensing board shall have the authority to:
1710	1710	12 1. Take adverse action against a nurse's multistate
1711	1711	13 licensure privilege to practice within that party state.
1712	1712	14 i. Only the home state shall have the power to take
1713	1713	15 adverse action against a nurse's license issued by the
1714	1714	16 home state.
1715	1715	17 ii. For purposes of taking adverse action, the
1716	1716	18 home state licensing board shall give the same
1717	1717	19 priority and effect to reported conduct received from
1718	1718	20 a remote state as it would if such conduct had occurred
1719	1719	21 within the home state. In so doing, the home state
1720	1720	22 shall apply its own state laws to determine
1721	1721	23 appropriate action.
1722	1722	24 2. Issue cease and desist orders or impose an
1723	1723
1724	1724
1725	1725
1726	1726
1727	1727
1728	1728	SB2795 - 48 - LRB103 34815 SPS 64670 b
1729	1729
1730	1730
1731	1731	SB2795- 49 -LRB103 34815 SPS 64670 b SB2795 - 49 - LRB103 34815 SPS 64670 b
1732	1732	SB2795 - 49 - LRB103 34815 SPS 64670 b
1733	1733	1 encumbrance on a nurse's authority to practice within that
1734	1734	2 party state.
1735	1735	3 3. Complete any pending investigations of a nurse who
1736	1736	4 changes primary state of residence during the course of
1737	1737	5 such investigations. The licensing board shall also have
1738	1738	6 the authority to take appropriate action(s) and shall
1739	1739	7 promptly report the conclusions of such investigations to
1740	1740	8 the administrator of the coordinated licensure information
1741	1741	9 system. The administrator of the coordinated licensure
1742	1742	10 information system shall promptly notify the new home
1743	1743	11 state of any such actions.
1744	1744	12 4. Issue subpoenas for both hearings and
1745	1745	13 investigations that require the attendance and testimony
1746	1746	14 of witnesses, as well as, the production of evidence.
1747	1747	15 Subpoenas issued by a licensing board in a party state for
1748	1748	16 the attendance and testimony of witnesses or the
1749	1749	17 production of evidence from another party state shall be
1750	1750	18 enforced in the latter state by any court of competent
1751	1751	19 jurisdiction, according to the practice and procedure of
1752	1752	20 that court applicable to subpoenas issued in proceedings
1753	1753	21 pending before it. The issuing authority shall pay any
1754	1754	22 witness fees, travel expenses, mileage and other fees
1755	1755	23 required by the service statutes of the state in which the
1756	1756	24 witnesses or evidence are located.
1757	1757	25 5. Obtain and submit, for each nurse licensure
1758	1758	26 applicant, fingerprint or other biometric-based
1759	1759
1760	1760
1761	1761
1762	1762
1763	1763
1764	1764	SB2795 - 49 - LRB103 34815 SPS 64670 b
1765	1765
1766	1766
1767	1767	SB2795- 50 -LRB103 34815 SPS 64670 b SB2795 - 50 - LRB103 34815 SPS 64670 b
1768	1768	SB2795 - 50 - LRB103 34815 SPS 64670 b
1769	1769	1 information to the Federal Bureau of Investigation for
1770	1770	2 criminal background checks, receive the results of the
1771	1771	3 Federal Bureau of Investigation record search on criminal
1772	1772	4 background checks and use the results in making licensure
1773	1773	5 decisions.
1774	1774	6 6. If otherwise permitted by state law, recover from
1775	1775	7 the affected nurse the costs of investigations and
1776	1776	8 disposition of cases resulting from any adverse action
1777	1777	9 taken against that nurse.
1778	1778	10 7. Take adverse action based on the factual findings
1779	1779	11 of the remote state, provided that the licensing board
1780	1780	12 follows its own procedures for taking such adverse action.
1781	1781	13 b. If adverse action is taken by the home state against a
1782	1782	14 nurse's multistate license, the nurse's multistate licensure
1783	1783	15 privilege to practice in all other party states shall be
1784	1784	16 deactivated until all encumbrances have been removed from the
1785	1785	17 multistate license. All home state disciplinary orders that
1786	1786	18 impose adverse action against a nurse's multistate license
1787	1787	19 shall include a statement that the nurse's multistate
1788	1788	20 licensure privilege is deactivated in all party states during
1789	1789	21 the pendency of the order.
1790	1790	22 c. Nothing in this Compact shall override a party state's
1791	1791	23 decision that participation in an alternative program may be
1792	1792	24 used in lieu of adverse action. The home state licensing board
1793	1793	25 shall deactivate the multistate licensure privilege under the
1794	1794	26 multistate license of any nurse for the duration of the
1795	1795
1796	1796
1797	1797
1798	1798
1799	1799
1800	1800	SB2795 - 50 - LRB103 34815 SPS 64670 b
1801	1801
1802	1802
1803	1803	SB2795- 51 -LRB103 34815 SPS 64670 b SB2795 - 51 - LRB103 34815 SPS 64670 b
1804	1804	SB2795 - 51 - LRB103 34815 SPS 64670 b
1805	1805	1 nurse's participation in an alternative program.
1806	1806	2 ARTICLE VI
1807	1807	3 Coordinated Licensure Information System and Exchange of
1808	1808	4 Information
1809	1809	5 a. All party states shall participate in a coordinated
1810	1810	6 licensure information system of all licensed registered nurses
1811	1811	7 (RNs) and licensed practical/vocational nurses (LPNs/VNs).
1812	1812	8 This system will include information on the licensure and
1813	1813	9 disciplinary history of each nurse, as submitted by party
1814	1814	10 states, to assist in the coordination of nurse licensure and
1815	1815	11 enforcement efforts.
1816	1816	12 b. The Commission, in consultation with the administrator
1817	1817	13 of the coordinated licensure information system, shall
1818	1818	14 formulate necessary and proper procedures for the
1819	1819	15 identification, collection and exchange of information under
1820	1820	16 this Compact.
1821	1821	17 c. All licensing boards shall promptly report to the
1822	1822	18 coordinated licensure information system any adverse action,
1823	1823	19 any current significant investigative information, denials of
1824	1824	20 applications (with the reasons for such denials) and nurse
1825	1825	21 participation in alternative programs known to the licensing
1826	1826	22 board regardless of whether such participation is deemed
1827	1827	23 nonpublic or confidential under state law.
1828	1828	24 d. Current significant investigative information and
1829	1829
1830	1830
1831	1831
1832	1832
1833	1833
1834	1834	SB2795 - 51 - LRB103 34815 SPS 64670 b
1835	1835
1836	1836
1837	1837	SB2795- 52 -LRB103 34815 SPS 64670 b SB2795 - 52 - LRB103 34815 SPS 64670 b
1838	1838	SB2795 - 52 - LRB103 34815 SPS 64670 b
1839	1839	1 participation in nonpublic or confidential alternative
1840	1840	2 programs shall be transmitted through the coordinated
1841	1841	3 licensure information system only to party state licensing
1842	1842	4 boards.
1843	1843	5 e. Notwithstanding any other provision of law, all party
1844	1844	6 state licensing boards contributing information to the
1845	1845	7 coordinated licensure information system may designate
1846	1846	8 information that may not be shared with non-party states or
1847	1847	9 disclosed to other entities or individuals without the express
1848	1848	10 permission of the contributing state.
1849	1849	11 f. Any personally identifiable information obtained from
1850	1850	12 the coordinated licensure information system by a party state
1851	1851	13 licensing board shall not be shared with non-party states or
1852	1852	14 disclosed to other entities or individuals except to the
1853	1853	15 extent permitted by the laws of the party state contributing
1854	1854	16 the information.
1855	1855	17 g. Any information contributed to the coordinated
1856	1856	18 licensure information system that is subsequently required to
1857	1857	19 be expunged by the laws of the party state contributing that
1858	1858	20 information shall also be expunged from the coordinated
1859	1859	21 licensure information system.
1860	1860	22 h. The Compact administrator of each party state shall
1861	1861	23 furnish a uniform data set to the Compact administrator of
1862	1862	24 each other party state, which shall include, at a minimum:
1863	1863	25 1. Identifying information;
1864	1864	26 2. Licensure data;
1865	1865
1866	1866
1867	1867
1868	1868
1869	1869
1870	1870	SB2795 - 52 - LRB103 34815 SPS 64670 b
1871	1871
1872	1872
1873	1873	SB2795- 53 -LRB103 34815 SPS 64670 b SB2795 - 53 - LRB103 34815 SPS 64670 b
1874	1874	SB2795 - 53 - LRB103 34815 SPS 64670 b
1875	1875	1 3. Information related to alternative program
1876	1876	2 participation; and
1877	1877	3 4. Other information that may facilitate the
1878	1878	4 administration of this Compact, as determined by
1879	1879	5 Commission rules.
1880	1880	6 i. The Compact administrator of a party state shall
1881	1881	7 provide all investigative documents and information requested
1882	1882	8 by another party state.
1883	1883	9 ARTICLE VII
1884	1884	10 Establishment of the Interstate Commission of Nurse Licensure
1885	1885	11 Compact Administrators
1886	1886	12 a. The party states hereby create and establish a joint
1887	1887	13 public entity known as the Interstate Commission of Nurse
1888	1888	14 Licensure Compact Administrators.
1889	1889	15 1. The Commission is an instrumentality of the party
1890	1890	16 states.
1891	1891	17 2. Venue is proper, and judicial proceedings by or
1892	1892	18 against the Commission shall be brought solely and
1893	1893	19 exclusively, in a court of competent jurisdiction where
1894	1894	20 the principal office of the Commission is located. The
1895	1895	21 Commission may waive venue and jurisdictional defenses to
1896	1896	22 the extent it adopts or consents to participate in
1897	1897	23 alternative dispute resolution proceedings.
1898	1898	24 3. Nothing in this Compact shall be construed to be a
1899	1899
1900	1900
1901	1901
1902	1902
1903	1903
1904	1904	SB2795 - 53 - LRB103 34815 SPS 64670 b
1905	1905
1906	1906
1907	1907	SB2795- 54 -LRB103 34815 SPS 64670 b SB2795 - 54 - LRB103 34815 SPS 64670 b
1908	1908	SB2795 - 54 - LRB103 34815 SPS 64670 b
1909	1909	1 waiver of sovereign immunity.
1910	1910	2 b. Membership, Voting and Meetings
1911	1911	3 1. Each party state shall have and be limited to one
1912	1912	4 administrator. The head of the state licensing board or
1913	1913	5 designee shall be the administrator of this Compact for
1914	1914	6 each party state. Any administrator may be removed or
1915	1915	7 suspended from office as provided by the law of the state
1916	1916	8 from which the Administrator is appointed. Any vacancy
1917	1917	9 occurring in the Commission shall be filled in accordance
1918	1918	10 with the laws of the party state in which the vacancy
1919	1919	11 exists.
1920	1920	12 2. Each administrator shall be entitled to one (1)
1921	1921	13 vote with regard to the promulgation of rules and creation
1922	1922	14 of bylaws and shall otherwise have an opportunity to
1923	1923	15 participate in the business and affairs of the Commission.
1924	1924	16 An administrator shall vote in person or by such other
1925	1925	17 means as provided in the bylaws. The bylaws may provide
1926	1926	18 for an administrator's participation in meetings by
1927	1927	19 telephone or other means of communication.
1928	1928	20 3. The Commission shall meet at least once during each
1929	1929	21 calendar year. Additional meetings shall be held as set
1930	1930	22 forth in the bylaws or rules of the commission.
1931	1931	23 4. All meetings shall be open to the public, and
1932	1932	24 public notice of meetings shall be given in the same
1933	1933	25 manner as required under the rulemaking provisions in
1934	1934	26 Article VIII.
1935	1935
1936	1936
1937	1937
1938	1938
1939	1939
1940	1940	SB2795 - 54 - LRB103 34815 SPS 64670 b
1941	1941
1942	1942
1943	1943	SB2795- 55 -LRB103 34815 SPS 64670 b SB2795 - 55 - LRB103 34815 SPS 64670 b
1944	1944	SB2795 - 55 - LRB103 34815 SPS 64670 b
1945	1945	1 5. The Commission may convene in a closed, nonpublic
1946	1946	2 meeting if the Commission must discuss:
1947	1947	3 i. Noncompliance of a party state with its
1948	1948	4 obligations under this Compact;
1949	1949	5 ii. The employment, compensation, discipline or
1950	1950	6 other personnel matters, practices or procedures
1951	1951	7 related to specific employees or other matters related
1952	1952	8 to the Commission's internal personnel practices and
1953	1953	9 procedures;
1954	1954	10 iii. Current, threatened or reasonably anticipated
1955	1955	11 litigation;
1956	1956	12 iv. Negotiation of contracts for the purchase or
1957	1957	13 sale of goods, services or real estate;
1958	1958	14 v. Accusing any person of a crime or formally
1959	1959	15 censuring any person;
1960	1960	16 vi. Disclosure of trade secrets or commercial or
1961	1961	17 financial information that is privileged or
1962	1962	18 confidential;
1963	1963	19 vii. Disclosure of information of a personal
1964	1964	20 nature where disclosure would constitute a clearly
1965	1965	21 unwarranted invasion of personal privacy;
1966	1966	22 viii. Disclosure of investigatory records compiled
1967	1967	23 for law enforcement purposes;
1968	1968	24 ix. Disclosure of information related to any
1969	1969	25 reports prepared by or on behalf of the Commission for
1970	1970	26 the purpose of investigation of compliance with this
1971	1971
1972	1972
1973	1973
1974	1974
1975	1975
1976	1976	SB2795 - 55 - LRB103 34815 SPS 64670 b
1977	1977
1978	1978
1979	1979	SB2795- 56 -LRB103 34815 SPS 64670 b SB2795 - 56 - LRB103 34815 SPS 64670 b
1980	1980	SB2795 - 56 - LRB103 34815 SPS 64670 b
1981	1981	1 Compact; or
1982	1982	2 x. Matters specifically exempted from disclosure
1983	1983	3 by federal or state statute.
1984	1984	4 6. If a meeting, or portion of a meeting, is closed
1985	1985	5 pursuant to this provision, the Commission's legal counsel
1986	1986	6 or designee shall certify that the meeting may be closed
1987	1987	7 and shall reference each relevant exempting provision. The
1988	1988	8 Commission shall keep minutes that fully and clearly
1989	1989	9 describe all matters discussed in a meeting and shall
1990	1990	10 provide a full and accurate summary of actions taken, and
1991	1991	11 the reasons therefor, including a description of the views
1992	1992	12 expressed. All documents considered in connection with an
1993	1993	13 action shall be identified in such minutes. All minutes
1994	1994	14 and documents of a closed meeting shall remain under seal,
1995	1995	15 subject to release by a majority vote of the Commission or
1996	1996	16 order of a court of competent jurisdiction.
1997	1997	17 c. The Commission shall, by a majority vote of the
1998	1998	18 administrators, prescribe bylaws or rules to govern its
1999	1999	19 conduct as may be necessary or appropriate to carry out the
2000	2000	20 purposes and exercise the powers of this Compact, including
2001	2001	21 but not limited to:
2002	2002	22 1. Establishing the fiscal year of the Commission;
2003	2003	23 2. Providing reasonable standards and procedures:
2004	2004	24 i. For the establishment and meetings of other
2005	2005	25 committees; and
2006	2006	26 ii. Governing any general or specific delegation
2007	2007
2008	2008
2009	2009
2010	2010
2011	2011
2012	2012	SB2795 - 56 - LRB103 34815 SPS 64670 b
2013	2013
2014	2014
2015	2015	SB2795- 57 -LRB103 34815 SPS 64670 b SB2795 - 57 - LRB103 34815 SPS 64670 b
2016	2016	SB2795 - 57 - LRB103 34815 SPS 64670 b
2017	2017	1 of any authority or function of the Commission;
2018	2018	2 3. Providing reasonable procedures for calling and
2019	2019	3 conducting meetings of the Commission, ensuring reasonable
2020	2020	4 advance notice of all meetings and providing an
2021	2021	5 opportunity for attendance of such meetings by interested
2022	2022	6 parties, with enumerated exceptions designed to protect
2023	2023	7 the public's interest, the privacy of individuals, and
2024	2024	8 proprietary information, including trade secrets. The
2025	2025	9 Commission may meet in closed session only after a
2026	2026	10 majority of the administrators vote to close a meeting in
2027	2027	11 whole or in part. As soon as practicable, the Commission
2028	2028	12 must make public a copy of the vote to close the meeting
2029	2029	13 revealing the vote of each administrator, with no proxy
2030	2030	14 votes allowed;
2031	2031	15 4. Establishing the titles, duties and authority and
2032	2032	16 reasonable procedures for the election of the officers of
2033	2033	17 the Commission;
2034	2034	18 5. Providing reasonable standards and procedures for
2035	2035	19 the establishment of the personnel policies and programs
2036	2036	20 of the Commission. Notwithstanding any civil service or
2037	2037	21 other similar laws of any party state, the bylaws shall
2038	2038	22 exclusively govern the personnel policies and programs of
2039	2039	23 the Commission; and
2040	2040	24 6. Providing a mechanism for winding up the operations
2041	2041	25 of the Commission and the equitable disposition of any
2042	2042	26 surplus funds that may exist after the termination of this
2043	2043
2044	2044
2045	2045
2046	2046
2047	2047
2048	2048	SB2795 - 57 - LRB103 34815 SPS 64670 b
2049	2049
2050	2050
2051	2051	SB2795- 58 -LRB103 34815 SPS 64670 b SB2795 - 58 - LRB103 34815 SPS 64670 b
2052	2052	SB2795 - 58 - LRB103 34815 SPS 64670 b
2053	2053	1 Compact after the payment or reserving of all of its debts
2054	2054	2 and obligations;
2055	2055	3 d. The Commission shall publish its bylaws and rules, and
2056	2056	4 any amendments thereto, in a convenient form on the website of
2057	2057	5 the Commission.
2058	2058	6 e. The Commission shall maintain its financial records in
2059	2059	7 accordance with the bylaws.
2060	2060	8 f. The Commission shall meet and take such actions as are
2061	2061	9 consistent with the provisions of this Compact and the bylaws.
2062	2062	10 g. The Commission shall have the following powers:
2063	2063	11 1. To promulgate uniform rules to facilitate and
2064	2064	12 coordinate implementation and administration of this
2065	2065	13 Compact. The rules shall have the force and effect of law
2066	2066	14 and shall be binding in all party states;
2067	2067	15 2. To bring and prosecute legal proceedings or actions
2068	2068	16 in the name of the Commission, provided that the standing
2069	2069	17 of any licensing board to sue or be sued under applicable
2070	2070	18 law shall not be affected;
2071	2071	19 3. To purchase and maintain insurance and bonds;
2072	2072	20 4. To borrow, accept or contract for services of
2073	2073	21 personnel, including, but not limited to, employees of a
2074	2074	22 party state or nonprofit organizations;
2075	2075	23 5. To cooperate with other organizations that
2076	2076	24 administer state compacts related to the regulation of
2077	2077	25 nursing, including but not limited to sharing
2078	2078	26 administrative or staff expenses, office space or other
2079	2079
2080	2080
2081	2081
2082	2082
2083	2083
2084	2084	SB2795 - 58 - LRB103 34815 SPS 64670 b
2085	2085
2086	2086
2087	2087	SB2795- 59 -LRB103 34815 SPS 64670 b SB2795 - 59 - LRB103 34815 SPS 64670 b
2088	2088	SB2795 - 59 - LRB103 34815 SPS 64670 b
2089	2089	1 resources;
2090	2090	2 6. To hire employees, elect or appoint officers, fix
2091	2091	3 compensation, define duties, grant such individuals
2092	2092	4 appropriate authority to carry out the purposes of this
2093	2093	5 Compact, and to establish the Commission's personnel
2094	2094	6 policies and programs relating to conflicts of interest,
2095	2095	7 qualifications of personnel and other related personnel
2096	2096	8 matters;
2097	2097	9 7. To accept any and all appropriate donations, grants
2098	2098	10 and gifts of money, equipment, supplies, materials and
2099	2099	11 services, and to receive, utilize and dispose of the same;
2100	2100	12 provided that at all times the Commission shall avoid any
2101	2101	13 appearance of impropriety or conflict of interest;
2102	2102	14 8. To lease, purchase, accept appropriate gifts or
2103	2103	15 donations of, or otherwise to own, hold, improve or use,
2104	2104	16 any property, whether real, personal or mixed; provided
2105	2105	17 that at all times the Commission shall avoid any
2106	2106	18 appearance of impropriety;
2107	2107	19 9. To sell, convey, mortgage, pledge, lease, exchange,
2108	2108	20 abandon or otherwise dispose of any property, whether
2109	2109	21 real, personal or mixed;
2110	2110	22 10. To establish a budget and make expenditures;
2111	2111	23 11. To borrow money;
2112	2112	24 12. To appoint committees, including advisory
2113	2113	25 committees comprised of administrators, state nursing
2114	2114	26 regulators, state legislators or their representatives,
2115	2115
2116	2116
2117	2117
2118	2118
2119	2119
2120	2120	SB2795 - 59 - LRB103 34815 SPS 64670 b
2121	2121
2122	2122
2123	2123	SB2795- 60 -LRB103 34815 SPS 64670 b SB2795 - 60 - LRB103 34815 SPS 64670 b
2124	2124	SB2795 - 60 - LRB103 34815 SPS 64670 b
2125	2125	1 and consumer representatives, and other such interested
2126	2126	2 persons;
2127	2127	3 13. To provide and receive information from, and to
2128	2128	4 cooperate with, law enforcement agencies;
2129	2129	5 14. To adopt and use an official seal; and
2130	2130	6 15. To perform such other functions as may be
2131	2131	7 necessary or appropriate to achieve the purposes of this
2132	2132	8 Compact consistent with the state regulation of nurse
2133	2133	9 licensure and practice.
2134	2134	10 h. Financing of the Commission
2135	2135	11 1. The Commission shall pay, or provide for the
2136	2136	12 payment of, the reasonable expenses of its establishment,
2137	2137	13 organization and ongoing activities.
2138	2138	14 2. The Commission may also levy on and collect an
2139	2139	15 annual assessment from each party state to cover the cost
2140	2140	16 of its operations, activities and staff in its annual
2141	2141	17 budget as approved each year. The aggregate annual
2142	2142	18 assessment amount, if any, shall be allocated based upon a
2143	2143	19 formula to be determined by the Commission, which shall
2144	2144	20 promulgate a rule that is binding upon all party states.
2145	2145	21 3. The Commission shall not incur obligations of any
2146	2146	22 kind prior to securing the funds adequate to meet the
2147	2147	23 same; nor shall the Commission pledge the credit of any of
2148	2148	24 the party states, except by, and with the authority of,
2149	2149	25 such party state.
2150	2150	26 4. The Commission shall keep accurate accounts of all
2151	2151
2152	2152
2153	2153
2154	2154
2155	2155
2156	2156	SB2795 - 60 - LRB103 34815 SPS 64670 b
2157	2157
2158	2158
2159	2159	SB2795- 61 -LRB103 34815 SPS 64670 b SB2795 - 61 - LRB103 34815 SPS 64670 b
2160	2160	SB2795 - 61 - LRB103 34815 SPS 64670 b
2161	2161	1 receipts and disbursements. The receipts and disbursements
2162	2162	2 of the Commission shall be subject to the audit and
2163	2163	3 accounting procedures established under its bylaws.
2164	2164	4 However, all receipts and disbursements of funds handled
2165	2165	5 by the Commission shall be audited yearly by a certified
2166	2166	6 or licensed public accountant, and the report of the audit
2167	2167	7 shall be included in and become part of the annual report
2168	2168	8 of the Commission.
2169	2169	9 i. Qualified Immunity, Defense and Indemnification
2170	2170	10 1. The administrators, officers, executive director,
2171	2171	11 employees and representatives of the Commission shall be
2172	2172	12 immune from suit and liability, either personally or in
2173	2173	13 their official capacity, for any claim for damage to or
2174	2174	14 loss of property or personal injury or other civil
2175	2175	15 liability caused by or arising out of any actual or
2176	2176	16 alleged act, error or omission that occurred, or that the
2177	2177	17 person against whom the claim is made had a reasonable
2178	2178	18 basis for believing occurred, within the scope of
2179	2179	19 Commission employment, duties or responsibilities;
2180	2180	20 provided that nothing in this paragraph shall be construed
2181	2181	21 to protect any such person from suit or liability for any
2182	2182	22 damage, loss, injury or liability caused by the
2183	2183	23 intentional, willful or wanton misconduct of that person.
2184	2184	24 2. The Commission shall defend any administrator,
2185	2185	25 officer, executive director, employee or representative of
2186	2186	26 the Commission in any civil action seeking to impose
2187	2187
2188	2188
2189	2189
2190	2190
2191	2191
2192	2192	SB2795 - 61 - LRB103 34815 SPS 64670 b
2193	2193
2194	2194
2195	2195	SB2795- 62 -LRB103 34815 SPS 64670 b SB2795 - 62 - LRB103 34815 SPS 64670 b
2196	2196	SB2795 - 62 - LRB103 34815 SPS 64670 b
2197	2197	1 liability arising out of any actual or alleged act, error
2198	2198	2 or omission that occurred within the scope of Commission
2199	2199	3 employment, duties or responsibilities, or that the person
2200	2200	4 against whom the claim is made had a reasonable basis for
2201	2201	5 believing occurred within the scope of Commission
2202	2202	6 employment, duties or responsibilities; provided that
2203	2203	7 nothing herein shall be construed to prohibit that person
2204	2204	8 from retaining his or her own counsel; and provided
2205	2205	9 further that the actual or alleged act, error or omission
2206	2206	10 did not result from that person's intentional, willful or
2207	2207	11 wanton misconduct.
2208	2208	12 3. The Commission shall indemnify and hold harmless
2209	2209	13 any administrator, officer, executive director, employee
2210	2210	14 or representative of the Commission for the amount of any
2211	2211	15 settlement or judgment obtained against that person
2212	2212	16 arising out of any actual or alleged act, error or
2213	2213	17 omission that occurred within the scope of Commission
2214	2214	18 employment, duties or responsibilities, or that such
2215	2215	19 person had a reasonable basis for believing occurred
2216	2216	20 within the scope of Commission employment, duties or
2217	2217	21 responsibilities, provided that the actual or alleged act,
2218	2218	22 error or omission did not result from the intentional,
2219	2219	23 willful or wanton misconduct of that person.
2220	2220	24 ARTICLE VIII
2221	2221	25 Rulemaking
2222	2222
2223	2223
2224	2224
2225	2225
2226	2226
2227	2227	SB2795 - 62 - LRB103 34815 SPS 64670 b
2228	2228
2229	2229
2230	2230	SB2795- 63 -LRB103 34815 SPS 64670 b SB2795 - 63 - LRB103 34815 SPS 64670 b
2231	2231	SB2795 - 63 - LRB103 34815 SPS 64670 b
2232	2232	1 a. The Commission shall exercise its rulemaking powers
2233	2233	2 pursuant to the criteria set forth in this Article and the
2234	2234	3 rules adopted thereunder. Rules and amendments shall become
2235	2235	4 binding as of the date specified in each rule or amendment and
2236	2236	5 shall have the same force and effect as provisions of this
2237	2237	6 Compact.
2238	2238	7 b. Rules or amendments to the rules shall be adopted at a
2239	2239	8 regular or special meeting of the Commission.
2240	2240	9 c. Prior to promulgation and adoption of a final rule or
2241	2241	10 rules by the Commission, and at least sixty (60) days in
2242	2242	11 advance of the meeting at which the rule will be considered and
2243	2243	12 voted upon, the Commission shall file a notice of proposed
2244	2244	13 rulemaking:
2245	2245	14 1. On the website of the Commission; and
2246	2246	15 2. On the website of each licensing board or the
2247	2247	16 publication in which each state would otherwise publish
2248	2248	17 proposed rules.
2249	2249	18 d. The notice of proposed rulemaking shall include:
2250	2250	19 1. The proposed time, date and location of the meeting
2251	2251	20 in which the rule will be considered and voted upon;
2252	2252	21 2. The text of the proposed rule or amendment, and the
2253	2253	22 reason for the proposed rule;
2254	2254	23 3. A request for comments on the proposed rule from
2255	2255	24 any interested person; and
2256	2256	25 4. The manner in which interested persons may submit
2257	2257
2258	2258
2259	2259
2260	2260
2261	2261
2262	2262	SB2795 - 63 - LRB103 34815 SPS 64670 b
2263	2263
2264	2264
2265	2265	SB2795- 64 -LRB103 34815 SPS 64670 b SB2795 - 64 - LRB103 34815 SPS 64670 b
2266	2266	SB2795 - 64 - LRB103 34815 SPS 64670 b
2267	2267	1 notice to the Commission of their intention to attend the
2268	2268	2 public hearing and any written comments.
2269	2269	3 e. Prior to adoption of a proposed rule, the Commission
2270	2270	4 shall allow persons to submit written data, facts, opinions
2271	2271	5 and arguments, which shall be made available to the public.
2272	2272	6 f. The Commission shall grant an opportunity for a public
2273	2273	7 hearing before it adopts a rule or amendment.
2274	2274	8 g. The Commission shall publish the place, time and date
2275	2275	9 of the scheduled public hearing.
2276	2276	10 1. Hearings shall be conducted in a manner providing
2277	2277	11 each person who wishes to comment a fair and reasonable
2278	2278	12 opportunity to comment orally or in writing. All hearings
2279	2279	13 will be recorded, and a copy will be made available upon
2280	2280	14 request.
2281	2281	15 2. Nothing in this section shall be construed as
2282	2282	16 requiring a separate hearing on each rule. Rules may be
2283	2283	17 grouped for the convenience of the Commission at hearings
2284	2284	18 required by this section.
2285	2285	19 h. If no one appears at the public hearing, the Commission
2286	2286	20 may proceed with promulgation of the proposed rule.
2287	2287	21 i. Following the scheduled hearing date, or by the close
2288	2288	22 of business on the scheduled hearing date if the hearing was
2289	2289	23 not held, the Commission shall consider all written and oral
2290	2290	24 comments received.
2291	2291	25 j. The Commission shall, by majority vote of all
2292	2292	26 administrators, take final action on the proposed rule and
2293	2293
2294	2294
2295	2295
2296	2296
2297	2297
2298	2298	SB2795 - 64 - LRB103 34815 SPS 64670 b
2299	2299
2300	2300
2301	2301	SB2795- 65 -LRB103 34815 SPS 64670 b SB2795 - 65 - LRB103 34815 SPS 64670 b
2302	2302	SB2795 - 65 - LRB103 34815 SPS 64670 b
2303	2303	1 shall determine the effective date of the rule, if any, based
2304	2304	2 on the rulemaking record and the full text of the rule.
2305	2305	3 k. Upon determination that an emergency exists, the
2306	2306	4 Commission may consider and adopt an emergency rule without
2307	2307	5 prior notice, opportunity for comment or hearing, provided
2308	2308	6 that the usual rulemaking procedures provided in this Compact
2309	2309	7 and in this section shall be retroactively applied to the rule
2310	2310	8 as soon as reasonably possible, in no event later than ninety
2311	2311	9 (90) days after the effective date of the rule. For the
2312	2312	10 purposes of this provision, an emergency rule is one that must
2313	2313	11 be adopted immediately in order to:
2314	2314	12 1. Meet an imminent threat to public health, safety or
2315	2315	13 welfare;
2316	2316	14 2. Prevent a loss of Commission or party state funds;
2317	2317	15 or
2318	2318	16 3. Meet a deadline for the promulgation of an
2319	2319	17 administrative rule that is required by federal law or
2320	2320	18 rule.
2321	2321	19 l. The Commission may direct revisions to a previously
2322	2322	20 adopted rule or amendment for purposes of correcting
2323	2323	21 typographical errors, errors in format, errors in consistency
2324	2324	22 or grammatical errors. Public notice of any revisions shall be
2325	2325	23 posted on the website of the Commission. The revision shall be
2326	2326	24 subject to challenge by any person for a period of thirty (30)
2327	2327	25 days after posting. The revision may be challenged only on
2328	2328	26 grounds that the revision results in a material change to a
2329	2329
2330	2330
2331	2331
2332	2332
2333	2333
2334	2334	SB2795 - 65 - LRB103 34815 SPS 64670 b
2335	2335
2336	2336
2337	2337	SB2795- 66 -LRB103 34815 SPS 64670 b SB2795 - 66 - LRB103 34815 SPS 64670 b
2338	2338	SB2795 - 66 - LRB103 34815 SPS 64670 b
2339	2339	1 rule. A challenge shall be made in writing, and delivered to
2340	2340	2 the Commission, prior to the end of the notice period. If no
2341	2341	3 challenge is made, the revision will take effect without
2342	2342	4 further action. If the revision is challenged, the revision
2343	2343	5 may not take effect without the approval of the Commission.
2344	2344	6 ARTICLE IX
2345	2345	7 Oversight, Dispute Resolution and Enforcement
2346	2346	8 a. Oversight
2347	2347	9 1. Each party state shall enforce this Compact and
2348	2348	10 take all actions necessary and appropriate to effectuate
2349	2349	11 this Compact's purposes and intent.
2350	2350	12 2. The Commission shall be entitled to receive service
2351	2351	13 of process in any proceeding that may affect the powers,
2352	2352	14 responsibilities or actions of the Commission, and shall
2353	2353	15 have standing to intervene in such a proceeding for all
2354	2354	16 purposes. Failure to provide service of process in such
2355	2355	17 proceeding to the Commission shall render a judgment or
2356	2356	18 order void as to the Commission, this Compact or
2357	2357	19 promulgated rules.
2358	2358	20 b. Default, Technical Assistance and Termination
2359	2359	21 1. If the Commission determines that a party state has
2360	2360	22 defaulted in the performance of its obligations or
2361	2361	23 responsibilities under this Compact or the promulgated
2362	2362	24 rules, the Commission shall:
2363	2363
2364	2364
2365	2365
2366	2366
2367	2367
2368	2368	SB2795 - 66 - LRB103 34815 SPS 64670 b
2369	2369
2370	2370
2371	2371	SB2795- 67 -LRB103 34815 SPS 64670 b SB2795 - 67 - LRB103 34815 SPS 64670 b
2372	2372	SB2795 - 67 - LRB103 34815 SPS 64670 b
2373	2373	1 i. Provide written notice to the defaulting state
2374	2374	2 and other party states of the nature of the default,
2375	2375	3 the proposed means of curing the default or any other
2376	2376	4 action to be taken by the Commission; and
2377	2377	5 ii. Provide remedial training and specific
2378	2378	6 technical assistance regarding the default.
2379	2379	7 2. If a state in default fails to cure the default, the
2380	2380	8 defaulting state's membership in this Compact may be
2381	2381	9 terminated upon an affirmative vote of a majority of the
2382	2382	10 administrators, and all rights, privileges and benefits
2383	2383	11 conferred by this Compact may be terminated on the
2384	2384	12 effective date of termination. A cure of the default does
2385	2385	13 not relieve the offending state of obligations or
2386	2386	14 liabilities incurred during the period of default.
2387	2387	15 3. Termination of membership in this Compact shall be
2388	2388	16 imposed only after all other means of securing compliance
2389	2389	17 have been exhausted. Notice of intent to suspend or
2390	2390	18 terminate shall be given by the Commission to the governor
2391	2391	19 of the defaulting state and to the executive officer of
2392	2392	20 the defaulting state's licensing board and each of the
2393	2393	21 party states.
2394	2394	22 4. A state whose membership in this Compact has been
2395	2395	23 terminated is responsible for all assessments, obligations
2396	2396	24 and liabilities incurred through the effective date of
2397	2397	25 termination, including obligations that extend beyond the
2398	2398	26 effective date of termination.
2399	2399
2400	2400
2401	2401
2402	2402
2403	2403
2404	2404	SB2795 - 67 - LRB103 34815 SPS 64670 b
2405	2405
2406	2406
2407	2407	SB2795- 68 -LRB103 34815 SPS 64670 b SB2795 - 68 - LRB103 34815 SPS 64670 b
2408	2408	SB2795 - 68 - LRB103 34815 SPS 64670 b
2409	2409	1 5. The Commission shall not bear any costs related to
2410	2410	2 a state that is found to be in default or whose membership
2411	2411	3 in this Compact has been terminated unless agreed upon in
2412	2412	4 writing between the Commission and the defaulting state.
2413	2413	5 6. The defaulting state may appeal the action of the
2414	2414	6 Commission by petitioning the U.S. District Court for the
2415	2415	7 District of Columbia or the federal district in which the
2416	2416	8 Commission has its principal offices. The prevailing party
2417	2417	9 shall be awarded all costs of such litigation, including
2418	2418	10 reasonable attorneys' fees.
2419	2419	11 c. Dispute Resolution
2420	2420	12 1. Upon request by a party state, the Commission shall
2421	2421	13 attempt to resolve disputes related to the Compact that
2422	2422	14 arise among party states and between party and non-party
2423	2423	15 states.
2424	2424	16 2. The Commission shall promulgate a rule providing
2425	2425	17 for both mediation and binding dispute resolution for
2426	2426	18 disputes, as appropriate.
2427	2427	19 3. In the event the Commission cannot resolve disputes
2428	2428	20 among party states arising under this Compact:
2429	2429	21 i. The party states may submit the issues in
2430	2430	22 dispute to an arbitration panel, which will be
2431	2431	23 comprised of individuals appointed by the Compact
2432	2432	24 administrator in each of the affected party states and
2433	2433	25 an individual mutually agreed upon by the Compact
2434	2434	26 administrators of all the party states involved in the
2435	2435
2436	2436
2437	2437
2438	2438
2439	2439
2440	2440	SB2795 - 68 - LRB103 34815 SPS 64670 b
2441	2441
2442	2442
2443	2443	SB2795- 69 -LRB103 34815 SPS 64670 b SB2795 - 69 - LRB103 34815 SPS 64670 b
2444	2444	SB2795 - 69 - LRB103 34815 SPS 64670 b
2445	2445	1 dispute.
2446	2446	2 ii. The decision of a majority of the arbitrators
2447	2447	3 shall be final and binding.
2448	2448	4 d. Enforcement
2449	2449	5 1. The Commission, in the reasonable exercise of its
2450	2450	6 discretion, shall enforce the provisions and rules of this
2451	2451	7 Compact.
2452	2452	8 2. By majority vote, the Commission may initiate legal
2453	2453	9 action in the U.S. District Court for the District of
2454	2454	10 Columbia or the federal district in which the Commission
2455	2455	11 has its principal offices against a party state that is in
2456	2456	12 default to enforce compliance with the provisions of this
2457	2457	13 Compact and its promulgated rules and bylaws. The relief
2458	2458	14 sought may include both injunctive relief and damages. In
2459	2459	15 the event judicial enforcement is necessary, the
2460	2460	16 prevailing party shall be awarded all costs of such
2461	2461	17 litigation, including reasonable attorneys' fees.
2462	2462	18 3. The remedies herein shall not be the exclusive
2463	2463	19 remedies of the Commission. The Commission may pursue any
2464	2464	20 other remedies available under federal or state law.
2465	2465	21 ARTICLE X
2466	2466	22 Effective Date, Withdrawal and Amendment
2467	2467	23 a. This Compact shall become effective and binding on the
2468	2468	24 earlier of the date of legislative enactment of this Compact
2469	2469
2470	2470
2471	2471
2472	2472
2473	2473
2474	2474	SB2795 - 69 - LRB103 34815 SPS 64670 b
2475	2475
2476	2476
2477	2477	SB2795- 70 -LRB103 34815 SPS 64670 b SB2795 - 70 - LRB103 34815 SPS 64670 b
2478	2478	SB2795 - 70 - LRB103 34815 SPS 64670 b
2479	2479	1 into law by no less than twenty-six (26) states or December 31,
2480	2480	2 2018. All party states to this Compact, that also were parties
2481	2481	3 to the prior Nurse Licensure Compact, superseded by this
2482	2482	4 Compact, ("Prior Compact"), shall be deemed to have withdrawn
2483	2483	5 from said Prior Compact within six (6) months after the
2484	2484	6 effective date of this Compact.
2485	2485	7 b. Each party state to this Compact shall continue to
2486	2486	8 recognize a nurse's multistate licensure privilege to practice
2487	2487	9 in that party state issued under the Prior Compact until such
2488	2488	10 party state has withdrawn from the Prior Compact.
2489	2489	11 c. Any party state may withdraw from this Compact by
2490	2490	12 enacting a statute repealing the same. A party state's
2491	2491	13 withdrawal shall not take effect until six (6) months after
2492	2492	14 enactment of the repealing statute.
2493	2493	15 d. A party state's withdrawal or termination shall not
2494	2494	16 affect the continuing requirement of the withdrawing or
2495	2495	17 terminated state's licensing board to report adverse actions
2496	2496	18 and significant investigations occurring prior to the
2497	2497	19 effective date of such withdrawal or termination.
2498	2498	20 e. Nothing contained in this Compact shall be construed to
2499	2499	21 invalidate or prevent any nurse licensure agreement or other
2500	2500	22 cooperative arrangement between a party state and a non-party
2501	2501	23 state that is made in accordance with the other provisions of
2502	2502	24 this Compact.
2503	2503	25 f. This Compact may be amended by the party states. No
2504	2504	26 amendment to this Compact shall become effective and binding
2505	2505
2506	2506
2507	2507
2508	2508
2509	2509
2510	2510	SB2795 - 70 - LRB103 34815 SPS 64670 b
2511	2511
2512	2512
2513	2513	SB2795- 71 -LRB103 34815 SPS 64670 b SB2795 - 71 - LRB103 34815 SPS 64670 b
2514	2514	SB2795 - 71 - LRB103 34815 SPS 64670 b
2515	2515	1 upon the party states unless and until it is enacted into the
2516	2516	2 laws of all party states.
2517	2517	3 g. Representatives of non-party states to this Compact
2518	2518	4 shall be invited to participate in the activities of the
2519	2519	5 Commission, on a nonvoting basis, prior to the adoption of
2520	2520	6 this Compact by all states.
2521	2521	7 ARTICLE XI
2522	2522	8 Construction and Severability
2523	2523	9 This Compact shall be liberally construed so as to effectuate
2524	2524	10 the purposes thereof. The provisions of this Compact shall be
2525	2525	11 severable, and if any phrase, clause, sentence or provision of
2526	2526	12 this Compact is declared to be contrary to the constitution of
2527	2527	13 any party state or of the United States, or if the
2528	2528	14 applicability thereof to any government, agency, person or
2529	2529	15 circumstance is held invalid, the validity of the remainder of
2530	2530	16 this Compact and the applicability thereof to any government,
2531	2531	17 agency, person or circumstance shall not be affected thereby.
2532	2532	18 If this Compact shall be held to be contrary to the
2533	2533	19 constitution of any party state, this Compact shall remain in
2534	2534	20 full force and effect as to the remaining party states and in
2535	2535	21 full force and effect as to the party state affected as to all
2536	2536	22 severable matters.
2537	2537	23 (225 ILCS 65/85-10 new)
2538	2538
2539	2539
2540	2540
2541	2541
2542	2542
2543	2543	SB2795 - 71 - LRB103 34815 SPS 64670 b
2544	2544
2545	2545
2546	2546	SB2795- 72 -LRB103 34815 SPS 64670 b SB2795 - 72 - LRB103 34815 SPS 64670 b
2547	2547	SB2795 - 72 - LRB103 34815 SPS 64670 b
2548	2548	1 Sec. 85-10. State labor laws. The Nurse Licensure Compact
2549	2549	2 does not supersede existing State labor laws.
2550	2550	3 (225 ILCS 65/85-15 new)
2551	2551	4 Sec. 85-15. Criminal history record checks. The State may
2552	2552	5 not share with or disclose to the Interstate Commission of
2553	2553	6 Nurse Licensure Compact Administrators or any other state any
2554	2554	7 of the contents of a nationwide criminal history records check
2555	2555	8 conducted for the purpose of multistate licensure under the
2556	2556	9 Nurse Licensure Compact.
2557	2557	10 Section 995. No acceleration or delay. Where this Act
2558	2558	11 makes changes in a statute that is represented in this Act by
2559	2559	12 text that is not yet or no longer in effect (for example, a
2560	2560	13 Section represented by multiple versions), the use of that
2561	2561	14 text does not accelerate or delay the taking effect of (i) the
2562	2562	15 changes made by this Act or (ii) provisions derived from any
2563	2563	16 other Public Act.
2564	2564	SB2795- 73 -LRB103 34815 SPS 64670 b 1 INDEX 2 Statutes amended in order of appearance SB2795- 73 -LRB103 34815 SPS 64670 b SB2795 - 73 - LRB103 34815 SPS 64670 b 1 INDEX 2 Statutes amended in order of appearance
2565	2565	SB2795- 73 -LRB103 34815 SPS 64670 b SB2795 - 73 - LRB103 34815 SPS 64670 b
2566	2566	SB2795 - 73 - LRB103 34815 SPS 64670 b
2567	2567	1 INDEX
2568	2568	2 Statutes amended in order of appearance
2569	2569
2570	2570
2571	2571
2572	2572
2573	2573
2574	2574	SB2795 - 72 - LRB103 34815 SPS 64670 b
2575	2575
2576	2576
2577	2577
2578	2578	SB2795- 73 -LRB103 34815 SPS 64670 b SB2795 - 73 - LRB103 34815 SPS 64670 b
2579	2579	SB2795 - 73 - LRB103 34815 SPS 64670 b
2580	2580	1 INDEX
2581	2581	2 Statutes amended in order of appearance
2582	2582
2583	2583
2584	2584
2585	2585
2586	2586
2587	2587	SB2795 - 73 - LRB103 34815 SPS 64670 b