Illinois 2023-2024 Regular Session

Illinois Senate Bill SB3499 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 SB3499 Introduced 2/9/2024, by Sen. Linda Holmes SYNOPSIS AS INTRODUCED: New Act Creates the End-of-Life Options for Terminally Ill Patients Act. Authorizes a qualified patient with a terminal disease to request that a physician prescribe aid-in-dying medication that will allow the patient to end the patient's life in a peaceful manner. Contains provisions concerning: the procedures and forms to be used to request aid-in-dying medication; the responsibilities of attending and consulting physicians; the referral of patients for determinations of mental capacity; the residency of qualified patients; the safe disposal of unused medications; the obligations of health care entities; the immunities granted for actions taken in good faith reliance upon the Act; the reporting requirements of physicians; the effect of the Act on the construction of wills, contracts, and statutes; the effect of the Act on insurance policies and annuities; the procedures for the completion of death certificates; the liabilities and penalties provided by the Act; the construction of the Act; the definitions of terms used in the Act; and other matters. Effective 6 months after becoming law. LRB103 38464 RPS 68600 b A BILL FOR 103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB3499 Introduced 2/9/2024, by Sen. Linda Holmes SYNOPSIS AS INTRODUCED: New Act New Act Creates the End-of-Life Options for Terminally Ill Patients Act. Authorizes a qualified patient with a terminal disease to request that a physician prescribe aid-in-dying medication that will allow the patient to end the patient's life in a peaceful manner. Contains provisions concerning: the procedures and forms to be used to request aid-in-dying medication; the responsibilities of attending and consulting physicians; the referral of patients for determinations of mental capacity; the residency of qualified patients; the safe disposal of unused medications; the obligations of health care entities; the immunities granted for actions taken in good faith reliance upon the Act; the reporting requirements of physicians; the effect of the Act on the construction of wills, contracts, and statutes; the effect of the Act on insurance policies and annuities; the procedures for the completion of death certificates; the liabilities and penalties provided by the Act; the construction of the Act; the definitions of terms used in the Act; and other matters. Effective 6 months after becoming law. LRB103 38464 RPS 68600 b LRB103 38464 RPS 68600 b A BILL FOR
2	2	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB3499 Introduced 2/9/2024, by Sen. Linda Holmes SYNOPSIS AS INTRODUCED:
3	3	New Act New Act
4	4	New Act
5	5	Creates the End-of-Life Options for Terminally Ill Patients Act. Authorizes a qualified patient with a terminal disease to request that a physician prescribe aid-in-dying medication that will allow the patient to end the patient's life in a peaceful manner. Contains provisions concerning: the procedures and forms to be used to request aid-in-dying medication; the responsibilities of attending and consulting physicians; the referral of patients for determinations of mental capacity; the residency of qualified patients; the safe disposal of unused medications; the obligations of health care entities; the immunities granted for actions taken in good faith reliance upon the Act; the reporting requirements of physicians; the effect of the Act on the construction of wills, contracts, and statutes; the effect of the Act on insurance policies and annuities; the procedures for the completion of death certificates; the liabilities and penalties provided by the Act; the construction of the Act; the definitions of terms used in the Act; and other matters. Effective 6 months after becoming law.
6	6	LRB103 38464 RPS 68600 b LRB103 38464 RPS 68600 b
7	7	LRB103 38464 RPS 68600 b
8	8	A BILL FOR
9	9	SB3499LRB103 38464 RPS 68600 b SB3499 LRB103 38464 RPS 68600 b
10	10	SB3499 LRB103 38464 RPS 68600 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
15	15	5 End-of-Life Options for Terminally Ill Patients Act.
16	16	6 Section 5. Definitions. As used in this Act:
17	17	7 "Adult" means an individual 18 years of age or older.
18	18	8 "Advanced practice registered nurse" means an advanced
19	19	9 practice registered nurse licensed under the Nurse Practice
20	20	10 Act who is certified as a psychiatric mental health
21	21	11 practitioner.
22	22	12 "Aid in dying" means an end-of-life care option that
23	23	13 allows a qualified patient to obtain a prescription for
24	24	14 medication pursuant to this Act.
25	25	15 "Attending physician" means the physician who has primary
26	26	16 responsibility for the care of the patient and treatment of
27	27	17 the patient's terminal disease.
28	28	18 "Clinical psychologist" means a psychologist licensed
29	29	19 under the Clinical Psychologist Licensing Act.
30	30	20 "Clinical social worker" means a person licensed under the
31	31	21 Clinical Social Work and Social Work Practice Act.
32	32	22 "Coercion or undue influence" means the willful attempt,
33	33	23 whether by deception, intimidation, or any other means to:
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37	37	103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB3499 Introduced 2/9/2024, by Sen. Linda Holmes SYNOPSIS AS INTRODUCED:
38	38	New Act New Act
39	39	New Act
40	40	Creates the End-of-Life Options for Terminally Ill Patients Act. Authorizes a qualified patient with a terminal disease to request that a physician prescribe aid-in-dying medication that will allow the patient to end the patient's life in a peaceful manner. Contains provisions concerning: the procedures and forms to be used to request aid-in-dying medication; the responsibilities of attending and consulting physicians; the referral of patients for determinations of mental capacity; the residency of qualified patients; the safe disposal of unused medications; the obligations of health care entities; the immunities granted for actions taken in good faith reliance upon the Act; the reporting requirements of physicians; the effect of the Act on the construction of wills, contracts, and statutes; the effect of the Act on insurance policies and annuities; the procedures for the completion of death certificates; the liabilities and penalties provided by the Act; the construction of the Act; the definitions of terms used in the Act; and other matters. Effective 6 months after becoming law.
41	41	LRB103 38464 RPS 68600 b LRB103 38464 RPS 68600 b
42	42	LRB103 38464 RPS 68600 b
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68	68	1 (1) cause a patient to request, obtain, or
69	69	2 self-administer medication pursuant to this Act with
70	70	3 intent to cause the death of the patient; or
71	71	4 (2) prevent a qualified patient, in a manner that
72	72	5 conflicts with the Health Care Right of Conscience Act,
73	73	6 from obtaining or self-administering medication pursuant
74	74	7 to this Act.
75	75	8 "Consulting physician" means a physician who is qualified
76	76	9 by specialty or experience to make a professional diagnosis
77	77	10 and prognosis regarding the patient's disease.
78	78	11 "Department" means the Department of Public Health.
79	79	12 "Health care entity" means a hospital or hospital
80	80	13 affiliate, nursing home, hospice or any other facility
81	81	14 licensed under any of the following Acts: the Ambulatory
82	82	15 Surgical Treatment Center Act; the Home Health, Home Services,
83	83	16 and Home Nursing Agency Licensing Act; the Hospice Program
84	84	17 Licensing Act; the Hospital Licensing Act; the Nursing Home
85	85	18 Care Act; or the University of Illinois Hospital Act. "Health
86	86	19 care entity" does not include a physician.
87	87	20 "Health care professional" means a physician, pharmacist,
88	88	21 or licensed mental health professional.
89	89	22 "Informed decision" means a decision by a patient with
90	90	23 mental capacity and a terminal disease to request and obtain a
91	91	24 prescription for medication pursuant to this Act, that the
92	92	25 qualified patient may self-administer to bring about a
93	93	26 peaceful death, after being fully informed by the attending
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104	104	1 physician and consulting physician of:
105	105	2 (1) the patient's diagnosis and prognosis;
106	106	3 (2) the potential risks and benefits associated with
107	107	4 taking the medication to be prescribed;
108	108	5 (3) the probable result of taking the medication to be
109	109	6 prescribed;
110	110	7 (4) the feasible end-of-life care and treatment
111	111	8 options for the patient's terminal disease, including, but
112	112	9 not limited to, comfort care, palliative care, hospice
113	113	10 care, and pain control, and the risks and benefits of
114	114	11 each;
115	115	12 (5) the patient's right to withdraw a request pursuant
116	116	13 this Act, or consent for any other treatment, at any time;
117	117	14 and
118	118	15 (6) the patient's right to choose not to obtain the
119	119	16 drug or to choose to obtain the drug but not to ingest it.
120	120	17 "Licensed mental health care professional" means a
121	121	18 psychiatrist, clinical psychologist, clinical social worker,
122	122	19 or advanced practice registered nurse.
123	123	20 "Mental capacity" means that, in the opinion of the
124	124	21 attending physician or the consulting physician or, if the
125	125	22 opinion of a licensed mental health care professional is
126	126	23 required under Section 40, the licensed mental health care
127	127	24 professional, the patient requesting medication pursuant to
128	128	25 this Act has the ability to make and communicate an informed
129	129	26 decision.
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140	140	1 "Oral request" means an affirmative statement that
141	141	2 demonstrates a contemporaneous affirmatively stated desire by
142	142	3 the patient seeking aid in dying.
143	143	4 "Pharmacist" means an individual licensed to engage in the
144	144	5 practice of pharmacy under the Pharmacy Practice Act.
145	145	6 "Physician" means a person licensed to practice medicine
146	146	7 in all of its branches under the Medical Practice Act of 1987.
147	147	8 "Psychiatrist" means a physician who has successfully
148	148	9 completed a residency program in psychiatry accredited by
149	149	10 either the Accreditation Council for Graduate Medical
150	150	11 Education or the American Osteopathic Association.
151	151	12 "Qualified patient" means an adult Illinois resident with
152	152	13 the mental capacity to make medical decisions who has
153	153	14 satisfied the requirements of this Act in order to obtain a
154	154	15 prescription for medication to bring about a peaceful death.
155	155	16 No person will be considered a "qualified patient" under this
156	156	17 Act solely because of advanced age, disability, or a mental
157	157	18 health condition, including depression.
158	158	19 "Self-administer" means an affirmative, conscious,
159	159	20 voluntary action, performed by a qualified patient, to ingest
160	160	21 medication prescribed pursuant to this Act to bring about the
161	161	22 patient's peaceful death. Self-administration does not include
162	162	23 administration by parenteral injection or infusion.
163	163	24 "Terminal disease" means an incurable and irreversible
164	164	25 disease that will, within reasonable medical judgment, result
165	165	26 in death within 6 months. The existence of a terminal disease,
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176	176	1 as determined after in-person examination by the patient's
177	177	2 physician and concurrence by another physician, shall be
178	178	3 documented in writing in the patient's medical record. A
179	179	4 diagnosis of a major depressive disorder, as defined in the
180	180	5 current edition of the Diagnostic and Statistical Manual of
181	181	6 Mental Disorders, alone does not qualify as a terminal
182	182	7 disease.
183	183	8 Section 10. Informed consent.
184	184	9 (a) Nothing in this Act may be construed to limit the
185	185	10 amount of information provided to a patient to ensure the
186	186	11 patient can make a fully informed health care decision.
187	187	12 (b) An attending physician must provide sufficient
188	188	13 information to a patient regarding all appropriate end-of-life
189	189	14 care options, including comfort care, hospice care, palliative
190	190	15 care, and pain control, as well as the foreseeable risks and
191	191	16 benefits of each, so that the patient can make a voluntary and
192	192	17 affirmative decision regarding the patient's end-of-life care.
193	193	18 (c) If a patient requests for the patient's medical
194	194	19 records to be transmitted to an alternative physician, the
195	195	20 patient's medical records shall be transmitted without undue
196	196	21 delay.
197	197	22 Section 15. Standard of care. Nothing contained in this
198	198	23 Act shall be interpreted to lower the applicable standard of
199	199	24 care for the health care professionals participating under
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210	210	1 this Act.
211	211	2 Section 20. Qualification.
212	212	3 (a) A qualified patient with a terminal disease may
213	213	4 request a prescription for medication under this Act in the
214	214	5 following manner:
215	215	6 (1) The qualified patient may orally request a
216	216	7 prescription for medication under this Act from the
217	217	8 patient's attending physician.
218	218	9 (2) The oral request from the qualified patient shall
219	219	10 be documented by the attending physician.
220	220	11 (3) The qualified patient shall provide a written
221	221	12 request in accordance with this Act to the patient's
222	222	13 attending physician after making the initial oral request.
223	223	14 (4) The qualified patient shall repeat the oral
224	224	15 request to the patient's attending physician no less than
225	225	16 5 days after making the initial oral request.
226	226	17 (b) The attending and consulting physicians of a qualified
227	227	18 patient shall have met all the requirements of Sections 30 and
228	228	19 35.
229	229	20 (c) Notwithstanding subsection (a), if the individual's
230	230	21 attending physician has medically determined that the
231	231	22 individual will, within reasonable medical judgment, die
232	232	23 within 5 days after making the initial oral request under this
233	233	24 Section, the individual may satisfy the requirements of this
234	234	25 Section by providing a written request and reiterating the
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245	245	1 oral request to the attending physician at any time after
246	246	2 making the initial oral request.
247	247	3 (d) At the time the patient makes the second oral request,
248	248	4 the attending physician shall offer the patient an opportunity
249	249	5 to rescind the request.
250	250	6 (e) Oral and written requests for aid in dying may be made
251	251	7 only by the patient and shall not be made by the patient's
252	252	8 surrogate decision-maker, health care proxy, health care
253	253	9 agent, attorney-in-fact for health care, nor via advance
254	254	10 health care directive.
255	255	11 (f) If a requesting patient decides to transfer care to an
256	256	12 alternative physician, the records custodian shall, upon
257	257	13 written request, transmit, without undue delay, the patient's
258	258	14 medical records, including written documentation of the dates
259	259	15 of the patient's requests concerning aid in dying.
260	260	16 (g) A transfer of care or medical records does not toll or
261	261	17 restart any waiting period.
262	262	18 Section 25. Form of written request.
263	263	19 (a) A written request for medication under this Act shall
264	264	20 be in substantially the form below, signed and dated by the
265	265	21 requesting patient, and witnessed in the presence of the
266	266	22 patient by at least 2 witnesses who attest that to the best of
267	267	23 their knowledge and belief the patient has mental capacity, is
268	268	24 acting voluntarily, and is not being coerced or unduly
269	269	25 influenced to sign the request.
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280	280	1 (b) One of the witnesses required under this Section must
281	281	2 be a person who is not:
282	282	3 (1) a relative of the patient by blood, marriage,
283	283	4 civil union, registered domestic partnership, or adoption;
284	284	5 (2) a person who, at the time the request is signed,
285	285	6 would be entitled to any portion of the estate of the
286	286	7 qualified patient upon death, under any will or by
287	287	8 operation of law; or
288	288	9 (3) an owner, operator, or employee of a health care
289	289	10 entity where the qualified patient is receiving medical
290	290	11 treatment or is a resident.
291	291	12 (c) The patient's attending physician at the time the
292	292	13 request is signed shall not be a witness.
293	293	14 (d) If a person uses an interpreter, the interpreter shall
294	294	15 not be a witness.
295	295	16 (e) The written request for medication under this Act
296	296	17 shall be substantially as follows:
297	297	18 "Request for Medication to End My Life in a Peaceful Manner
298	298	19 I, ............... (insert name of patient), am an adult
299	299	20 of sound mind, and a resident of Illinois. I have been
300	300	21 diagnosed with ..............., (insert name of condition) and
301	301	22 given a terminal disease prognosis of 6 months or less to live
302	302	23 by my attending physician.
303	303	24 I affirm that my terminal disease diagnosis was given or
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314	314	1 confirmed during at least one in-person visit to a health care
315	315	2 professional.
316	316	3 I have been fully informed of the feasible alternatives
317	317	4 and concurrent or additional treatment opportunities for my
318	318	5 terminal disease, including, but not limited to, comfort care,
319	319	6 palliative care, hospice care, or pain control, as well as the
320	320	7 potential risks and benefits of each. I have been offered,
321	321	8 have received, or have been offered and received resources or
322	322	9 referrals to pursue these alternatives and concurrent or
323	323	10 additional treatment opportunities for my terminal disease.
324	324	11 I have been fully informed of the nature of the medication
325	325	12 to be prescribed, including the risks and benefits, and I
326	326	13 understand that the likely outcome of self-administering the
327	327	14 medication is death.
328	328	15 I understand that I can rescind this request at any time,
329	329	16 that I am under no obligation to fill the prescription once
330	330	17 written, and that I have no duty to self-administer the
331	331	18 medication if I obtain it.
332	332	19 I request that my attending physician furnish a
333	333	20 prescription for medication that will end my life if I choose
334	334	21 to self-administer it, and I authorize my attending physician
335	335	22 to transmit the prescription to a pharmacist to dispense the
336	336	23 medication at a time of my choosing.
337	337	24 I make this request voluntarily, free from coercion or
338	338	25 undue influence.
339	339	26 Dated: ................
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350	350	1 Signed..................................
351	351	2 (patient)
352	352	3 Dated: ................
353	353	4 Signed...............................
354	354	5 (witness #1)
355	355	6 Dated: ................
356	356	7 Signed..............................
357	357	8 (witness #2)"
358	358	9 (f) The interpreter attachment for a written request for
359	359	10 medication under this Act shall be substantially as follows:
360	360	11 "Request for Medication to End My Life in a Peaceful Manner
361	361	12 Interpreter Attachment
362	362	13 I, ...............(insert name of interpreter), am fluent
363	363	14 in English and ...............(insert language of patient,
364	364	15 including sign language).
365	365	16 On .......(insert date) at approximately .......(insert
366	366	17 time), I read the "Request for Medication to End My Life in a
367	367	18 Peaceful Manner" form to ...............(insert name of
368	368	19 patient) in ...............(insert language of patient).
369	369	20 ...............(insert name of patient) affirmed to me
370	370	21 that they understand the content of this form, that they
371	371	22 desire to sign this form under their own power and volition,
372	372	23 and that they requested to sign the form after consultations
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380	380	(patient)
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382	382	(witness #1)
383	383
384	384	(witness #2)"
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389	389	1 with an attending physician and a consulting physician.
390	390	2 Under penalty of perjury, I declare that I am fluent in
391	391	3 English and ...............(language of patient, including
392	392	4 sign language) and that the contents of this form, to the best
393	393	5 of my knowledge, are true and correct. Executed at
394	394	6 ..................................(insert name of city,
395	395	7 county, and state) on .......(date).
396	396	8 Interpreter's signature: ....................................
397	397	9 Interpreter's printed name: .................................
398	398	10 Interpreter's address: ......................................".
399	399	11 Section 30. Attending physician responsibilities.
400	400	12 (a) Following the request of a patient for aid in dying,
401	401	13 the attending physician shall conduct an evaluation of the
402	402	14 patient and:
403	403	15 (1) determine whether the patient has a terminal
404	404	16 disease or has been diagnosed as having a terminal
405	405	17 disease;
406	406	18 (2) determine whether a patient has mental capacity;
407	407	19 (3) confirm that the patient's request does not arise
408	408	20 from coercion or undue influence;
409	409	21 (4) inform the patient of:
410	410	22 (A) the diagnosis;
411	411	23 (B) the prognosis;
412	412	24 (C) the potential risks, benefits, and probable
413	413	25 result of self-administering the prescribed medication
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424	424	1 to bring about a peaceful death;
425	425	2 (D) the potential benefits and risks of feasible
426	426	3 alternatives, including, but not limited to,
427	427	4 concurrent or additional treatment options for the
428	428	5 patient's terminal disease, comfort care, palliative
429	429	6 care, hospice care, and pain control; and
430	430	7 (E) the patient's right to rescind the request for
431	431	8 medication pursuant to this Act at any time;
432	432	9 (5) inform the patient that there is no obligation to
433	433	10 fill the prescription nor an obligation to self-administer
434	434	11 the medication, if it is obtained;
435	435	12 (6) provide the patient with a referral for comfort
436	436	13 care, palliative care, hospice care, pain control, or
437	437	14 other end-of-life treatment options as requested by the
438	438	15 patient and as clinically indicated;
439	439	16 (7) refer the patient to a consulting physician for
440	440	17 medical confirmation that the patient requesting
441	441	18 medication pursuant to this Act:
442	442	19 (A) has a terminal disease with a prognosis of 6
443	443	20 months or less to live; and
444	444	21 (B) has mental capacity.
445	445	22 (8) include the consulting physician's written
446	446	23 determination in the patient's medical record;
447	447	24 (9) refer the patient to a licensed mental health
448	448	25 professional in accordance with Section 40 if the
449	449	26 attending physician observes signs that the individual may
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460	460	1 not be capable of making an informed decision;
461	461	2 (10) include the licensed mental health professional's
462	462	3 written determination in the patient's medical record, if
463	463	4 such determination was requested;
464	464	5 (11) inform the patient of the benefits of notifying
465	465	6 the next of kin of the patient's decision to request
466	466	7 medication pursuant to this Act;
467	467	8 (12) fulfill the medical record documentation
468	468	9 requirements;
469	469	10 (13) ensure that all steps are carried out in
470	470	11 accordance with this Act before providing a prescription
471	471	12 to a qualified patient for medication pursuant to this Act
472	472	13 including:
473	473	14 (A) confirming that the patient has made an
474	474	15 informed decision to obtain a prescription for
475	475	16 medication;
476	476	17 (B) offering the patient an opportunity to rescind
477	477	18 the request for medication; and
478	478	19 (C) providing information to the patient on:
479	479	20 (I) the recommended procedure for
480	480	21 self-administering the medication to be
481	481	22 prescribed;
482	482	23 (II) the safekeeping and proper disposal of
483	483	24 unused medication in accordance with State and
484	484	25 federal law; and
485	485	26 (III) the importance of having another person
486	486
487	487
488	488
489	489
490	490
491	491	SB3499 - 13 - LRB103 38464 RPS 68600 b
492	492
493	493
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495	495	SB3499 - 14 - LRB103 38464 RPS 68600 b
496	496	1 present when the patient self-administers the
497	497	2 medication to be prescribed;
498	498	3 (D) not taking the aid-in-dying medication in a
499	499	4 public place;
500	500	5 (14) deliver, in accordance with State and federal
501	501	6 law, the prescription personally, by mail, or through an
502	502	7 authorized electronic transmission to a licensed
503	503	8 pharmacist who will dispense the medication, including any
504	504	9 ancillary medications, to the qualified patient, or to a
505	505	10 person expressly designated by the qualified patient in
506	506	11 person or with a signature required on delivery, by mail
507	507	12 service, or by messenger service;
508	508	13 (15) if authorized by the Drug Enforcement
509	509	14 Administration, dispense the prescribed medication,
510	510	15 including any ancillary medications, to the qualified
511	511	16 patient or a person designated by the qualified patient;
512	512	17 and
513	513	18 (16) include, in the qualified patient's medical
514	514	19 record, the patient's diagnosis and prognosis,
515	515	20 determination of mental capacity, the date of each oral
516	516	21 request, a copy of the written request, a notation that
517	517	22 the requirements under this Section have been completed,
518	518	23 and an identification of the medication and ancillary
519	519	24 medications prescribed to the qualified patient pursuant
520	520	25 to this Act.
521	521	26 (b) Notwithstanding any other provision of law, the
522	522
523	523
524	524
525	525
526	526
527	527	SB3499 - 14 - LRB103 38464 RPS 68600 b
528	528
529	529
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531	531	SB3499 - 15 - LRB103 38464 RPS 68600 b
532	532	1 attending physician may sign the patient's death certificate.
533	533	2 Section 35. Consulting physician responsibilities. A
534	534	3 consulting physician shall:
535	535	4 (1) conduct an evaluation of the patient and review
536	536	5 the patient's relevant medical records, including the
537	537	6 evaluation pursuant to Section 40, if such evaluation was
538	538	7 necessary;
539	539	8 (2) confirm in writing to the attending physician that
540	540	9 the patient:
541	541	10 (A) has requested a prescription for aid-in-dying
542	542	11 medication;
543	543	12 (B) has a documented terminal disease;
544	544	13 (C) has mental capacity or has provided
545	545	14 documentation that the consulting health care
546	546	15 professional has referred the individual for further
547	547	16 evaluation in accordance with Section 40; and
548	548	17 (D) is acting voluntarily, free from coercion or
549	549	18 undue influence.
550	550	19 Section 40. Referral for determination that the requesting
551	551	20 patient has mental capacity.
552	552	21 (a) If either the attending physician or the consulting
553	553	22 physician has doubts whether the individual has mental
554	554	23 capacity and if either one is unable to confirm that the
555	555	24 individual is capable of making an informed decision, the
556	556
557	557
558	558
559	559
560	560
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562	562
563	563
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565	565	SB3499 - 16 - LRB103 38464 RPS 68600 b
566	566	1 attending physician or consulting physician shall refer the
567	567	2 patient to a licensed mental health professional for
568	568	3 determination regarding mental capability.
569	569	4 (b) The licensed mental health professional shall
570	570	5 additionally determine whether the patient is suffering from a
571	571	6 psychiatric or psychological disorder causing impaired
572	572	7 judgment.
573	573	8 (c) The licensed mental health professional who evaluates
574	574	9 the patient under this Section shall submit to the requesting
575	575	10 attending or consulting physician a written determination of
576	576	11 whether the patient has mental capacity.
577	577	12 (d) If the licensed mental health professional determines
578	578	13 that the patient does not have mental capacity, or is
579	579	14 suffering from a psychiatric or psychological disorder causing
580	580	15 impaired judgment, the patient shall not be deemed a qualified
581	581	16 patient and the attending physician shall not prescribe
582	582	17 medication to the patient under this Act.
583	583	18 Section 45. Residency requirement.
584	584	19 (a) Only requests made by Illinois residents may be
585	585	20 granted under this Act.
586	586	21 (b) A patient is able to establish residency through any
587	587	22 one or more of the following means:
588	588	23 (1) possession of a driver's license or other
589	589	24 identification issued by the Secretary of State or State
590	590	25 of Illinois;
591	591
592	592
593	593
594	594
595	595
596	596	SB3499 - 16 - LRB103 38464 RPS 68600 b
597	597
598	598
599	599	SB3499- 17 -LRB103 38464 RPS 68600 b SB3499 - 17 - LRB103 38464 RPS 68600 b
600	600	SB3499 - 17 - LRB103 38464 RPS 68600 b
601	601	1 (2) registration to vote in Illinois;
602	602	2 (3) evidence that the person owns, rents, or leases
603	603	3 property in Illinois;
604	604	4 (4) the location of any dwelling occupied by the
605	605	5 person;
606	606	6 (5) the place where any motor vehicle owned by the
607	607	7 person is registered;
608	608	8 (6) the residence address, not a post office box,
609	609	9 shown on an income tax return filed for the year preceding
610	610	10 the year in which the person initially makes an oral
611	611	11 request under this Act;
612	612	12 (7) the residence address, not a post office box, at
613	613	13 which the person's mail is received;
614	614	14 (8) the residence address, not a post office box,
615	615	15 shown on any unexpired resident hunting or fishing or
616	616	16 other licenses held by the person;
617	617	17 (9) the residence address, not a post office box,
618	618	18 shown on any driver's license held by the person;
619	619	19 (10) the receipt of any public benefit conditioned
620	620	20 upon residency; or
621	621	21 (11) any other objective facts tending to indicate a
622	622	22 person's place of residence is in Illinois.
623	623	23 Section 50. Safe disposal of unused medications. A person
624	624	24 who has custody or control of medication prescribed pursuant
625	625	25 to this Act after the qualified patient's death shall dispose
626	626
627	627
628	628
629	629
630	630
631	631	SB3499 - 17 - LRB103 38464 RPS 68600 b
632	632
633	633
634	634	SB3499- 18 -LRB103 38464 RPS 68600 b SB3499 - 18 - LRB103 38464 RPS 68600 b
635	635	SB3499 - 18 - LRB103 38464 RPS 68600 b
636	636	1 of the medication by delivering it to the nearest qualified
637	637	2 facility that properly disposes of controlled substances or,
638	638	3 if none is available, by lawful means in accordance with
639	639	4 applicable State and federal guidelines.
640	640	5 Section 55. No duty to provide aid in dying.
641	641	6 (a) A health care professional shall not be under any
642	642	7 duty, by law or contract, to participate in the provision of
643	643	8 aid-in-dying care to a patient as set forth in this Act.
644	644	9 (b) A health care professional shall not be subject to
645	645	10 civil or criminal liability for participating or refusing to
646	646	11 participate in the provision of aid-in-dying care to a patient
647	647	12 in good faith compliance with this Act.
648	648	13 (c) A health care entity or licensing board shall not
649	649	14 subject a health care professional to censure, discipline,
650	650	15 suspension, loss of license, loss of privileges, loss of
651	651	16 membership, or other penalty for participating or refusing to
652	652	17 participate in accordance with this Act.
653	653	18 (d) A health care professional may choose not to engage in
654	654	19 aid-in-dying care.
655	655	20 (e) Only willing health care professionals shall provide
656	656	21 aid-in-dying care in accordance with this Act. If a health
657	657	22 care professional is unable or unwilling to carry out a
658	658	23 patient's request under this Act, and the patient transfers
659	659	24 the patient's care to a new health care professional, the
660	660	25 prior health care professional shall transmit, upon request, a
661	661
662	662
663	663
664	664
665	665
666	666	SB3499 - 18 - LRB103 38464 RPS 68600 b
667	667
668	668
669	669	SB3499- 19 -LRB103 38464 RPS 68600 b SB3499 - 19 - LRB103 38464 RPS 68600 b
670	670	SB3499 - 19 - LRB103 38464 RPS 68600 b
671	671	1 copy of the patient's relevant medical records to the new
672	672	2 health care professional without undue delay.
673	673	3 (f) A health care professional shall not engage in false,
674	674	4 misleading, or deceptive practices relating to a willingness
675	675	5 to qualify a patient or provide aid-in-dying care.
676	676	6 Intentionally misleading a patient constitutes coercion.
677	677	7 (g) The provisions of the Health Care Right of Conscience
678	678	8 Act apply to this Act and are incorporated by reference.
679	679	9 Section 60. Health care entity permissible prohibitions
680	680	10 and duties.
681	681	11 (a) A health care entity may prohibit health care
682	682	12 professionals from practicing aid-in-dying care while
683	683	13 performing duties for the entity. A prohibiting entity must
684	684	14 provide advance notice in writing to health care professionals
685	685	15 and staff at the time of hiring, contracting with, or
686	686	16 privileging and on a yearly basis thereafter.
687	687	17 (b) If a patient wishes to transfer care to another health
688	688	18 care entity, the prohibiting entity shall coordinate a timely
689	689	19 transfer of care, including transmitting, without undue delay,
690	690	20 the patient's medical records that include notation of the
691	691	21 date the patient first made a request concerning aid-in-dying
692	692	22 care.
693	693	23 (c) No health care entity shall prohibit a health care
694	694	24 professional from:
695	695	25 (1) providing information to a patient regarding the
696	696
697	697
698	698
699	699
700	700
701	701	SB3499 - 19 - LRB103 38464 RPS 68600 b
702	702
703	703
704	704	SB3499- 20 -LRB103 38464 RPS 68600 b SB3499 - 20 - LRB103 38464 RPS 68600 b
705	705	SB3499 - 20 - LRB103 38464 RPS 68600 b
706	706	1 patient's health status, including, but not limited to,
707	707	2 diagnosis, prognosis, recommended treatment and treatment
708	708	3 alternatives, and the risks and benefits of each;
709	709	4 (2) providing information regarding health care
710	710	5 services available pursuant to this Act, information about
711	711	6 relevant community resources, and how to access those
712	712	7 resources for obtaining care of the patient's choice;
713	713	8 (3) practicing aid-in-dying care outside the scope of
714	714	9 the health care professional's employment or contract with
715	715	10 the prohibiting entity and off the premises of the
716	716	11 prohibiting entity; or
717	717	12 (4) being present, if outside the scope of the health
718	718	13 care professional's employment or contractual duties, when
719	719	14 a qualified patient self-administers medication prescribed
720	720	15 pursuant to this Act or at the time of death, if requested
721	721	16 by the qualified patient or their representative.
722	722	17 (d) A health care entity shall not engage in false,
723	723	18 misleading, or deceptive practices relating to its policy
724	724	19 around end-of-life care services, including whether it has a
725	725	20 policy that prohibits affiliated health care professionals
726	726	21 from practicing aid-in-dying care; or intentionally denying a
727	727	22 patient access to medication pursuant to this Act by
728	728	23 intentionally failing to transfer a patient and the patient's
729	729	24 medical records to another health care professional in a
730	730	25 timely manner. Intentionally misleading a patient or deploying
731	731	26 misinformation to obstruct access to services pursuant to this
732	732
733	733
734	734
735	735
736	736
737	737	SB3499 - 20 - LRB103 38464 RPS 68600 b
738	738
739	739
740	740	SB3499- 21 -LRB103 38464 RPS 68600 b SB3499 - 21 - LRB103 38464 RPS 68600 b
741	741	SB3499 - 21 - LRB103 38464 RPS 68600 b
742	742	1 Act constitutes coercion or undue influence.
743	743	2 (e) The provisions of the Health Care Right of Conscience
744	744	3 Act apply to this Act and are incorporated by reference.
745	745	4 (f) If any part of this Section is found to be in conflict
746	746	5 with federal requirements which are a prescribed condition to
747	747	6 receipt of federal funds, the conflicting part of this Section
748	748	7 is inoperative solely to the extent of the conflict with
749	749	8 respect to the entity directly affected, and such finding or
750	750	9 determination shall not affect the operation of the remainder
751	751	10 of the Section or this Act.
752	752	11 Section 65. Immunities for actions in good faith;
753	753	12 prohibition against reprisals.
754	754	13 (a) A health care professional or health care entity shall
755	755	14 not be subject to civil or criminal liability, licensing
756	756	15 sanctions, or other professional disciplinary action for
757	757	16 actions taken in good faith compliance with this Act.
758	758	17 (b) If a health care professional or health care entity is
759	759	18 unable or unwilling to carry out an individual's request for
760	760	19 aid in dying, the professional or entity shall, at a minimum:
761	761	20 (1) inform the individual of the professional's or
762	762	21 entity's inability or unwillingness;
763	763	22 (2) refer the individual either to a health care
764	764	23 professional who is able and willing to evaluate and
765	765	24 qualify the individual or to another individual or entity
766	766	25 to assist the requesting individual in seeking aid in
767	767
768	768
769	769
770	770
771	771
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773	773
774	774
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776	776	SB3499 - 22 - LRB103 38464 RPS 68600 b
777	777	1 dying, in accordance with the Health Care Right of
778	778	2 Conscience Act; and
779	779	3 (3) note, in the medical record, the individual's date
780	780	4 of request and health care professional's notice to the
781	781	5 individual of the health care professional's unwillingness
782	782	6 or inability to carry out the individual's request.
783	783	7 (c) A health care entity or licensing board shall not
784	784	8 subject a health care professional to censure, discipline,
785	785	9 suspension, loss of license, loss of privileges, loss of
786	786	10 membership, or other penalty for engaging in good faith
787	787	11 compliance with this Act.
788	788	12 (d) A health care professional, health care entity, or
789	789	13 licensing board shall not subject a health care professional
790	790	14 to discharge, demotion, censure, discipline, suspension, loss
791	791	15 of license, loss of privileges, loss of membership,
792	792	16 discrimination, or any other penalty for providing
793	793	17 aid-in-dying care in accordance with the standard of care and
794	794	18 in good faith under this Act when:
795	795	19 (1) engaged in the outside practice of medicine and
796	796	20 off of the objecting health care entity's premises; or
797	797	21 (2) providing scientific and accurate information
798	798	22 about aid-in-dying care to a patient when discussing
799	799	23 end-of-life care options.
800	800	24 (e) A physician is not subject to civil or criminal
801	801	25 liability or professional discipline if, at the request of the
802	802	26 qualified patient, the physician is present outside the scope
803	803
804	804
805	805
806	806
807	807
808	808	SB3499 - 22 - LRB103 38464 RPS 68600 b
809	809
810	810
811	811	SB3499- 23 -LRB103 38464 RPS 68600 b SB3499 - 23 - LRB103 38464 RPS 68600 b
812	812	SB3499 - 23 - LRB103 38464 RPS 68600 b
813	813	1 of the physician's employment contract and off the entity's
814	814	2 premises, when the qualified patient self-administers
815	815	3 medication pursuant to this Act, or at the time of death.
816	816	4 (f) A physician who is present at self-administration may,
817	817	5 without civil or criminal liability, assist the qualified
818	818	6 patient by preparing the medication prescribed pursuant to
819	819	7 this Act.
820	820	8 (g) A request by a patient for aid in dying does not alone
821	821	9 constitute grounds for neglect or elder abuse for any purpose
822	822	10 of law, nor shall it be the sole basis for appointment of a
823	823	11 guardian.
824	824	12 (h) This Section does not limit civil liability for
825	825	13 intentional misconduct.
826	826	14 Section 70. Reporting requirements.
827	827	15 (a) Within 45 days after the effective date of this Act,
828	828	16 the Department shall create and post to its website an
829	829	17 Attending Physician Checklist Form and Attending Physician
830	830	18 Follow-Up Form to facilitate collection of the information
831	831	19 described in this Section. Failure to create or post the
832	832	20 Attending Physician Checklist Form, the Attending Physician
833	833	21 Follow-Up Form, or both shall not suspend the effective date
834	834	22 of this Act.
835	835	23 (b) Within 30 calendar days of providing a prescription
836	836	24 for medication pursuant to this Act, the attending physician
837	837	25 shall submit to the Department an Attending Physician
838	838
839	839
840	840
841	841
842	842
843	843	SB3499 - 23 - LRB103 38464 RPS 68600 b
844	844
845	845
846	846	SB3499- 24 -LRB103 38464 RPS 68600 b SB3499 - 24 - LRB103 38464 RPS 68600 b
847	847	SB3499 - 24 - LRB103 38464 RPS 68600 b
848	848	1 Checklist Form with the following information:
849	849	2 (1) the qualifying patient's name and date of birth;
850	850	3 (2) the qualifying patient's terminal diagnosis and
851	851	4 prognosis;
852	852	5 (3) notice that the requirements under this Act were
853	853	6 completed; and
854	854	7 (4) notice that medication has been prescribed
855	855	8 pursuant to this Act.
856	856	9 (c) Within 60 calendar days of notification of a qualified
857	857	10 patient's death from self-administration of medication
858	858	11 prescribed pursuant to this Act, the attending physician shall
859	859	12 submit to the Department, an Attending Physician Follow-Up
860	860	13 Form with the following information:
861	861	14 (1) the qualified patient's name and date of birth;
862	862	15 (2) the date of the qualified patient's death; and
863	863	16 (3) a notation of whether the qualified patient was
864	864	17 enrolled in hospice services at the time of the qualified
865	865	18 patient's death.
866	866	19 (d) The Department shall collect and annually review the
867	867	20 forms filed pursuant to Section to ensure compliance. If a
868	868	21 physician required to report information to the Department
869	869	22 under this Act provides an inadequate or incomplete report,
870	870	23 the Department shall contact the physician to request an
871	871	24 adequate or complete report. The information collected shall
872	872	25 be confidential and shall be collected in a manner that
873	873	26 protects the privacy of the patient, the patient's family, and
874	874
875	875
876	876
877	877
878	878
879	879	SB3499 - 24 - LRB103 38464 RPS 68600 b
880	880
881	881
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883	883	SB3499 - 25 - LRB103 38464 RPS 68600 b
884	884	1 any health care professional involved with the patient under
885	885	2 the provisions of this Act. The information shall be
886	886	3 privileged and strictly confidential, and shall not be
887	887	4 disclosed, discoverable, or compelled to be produced in any
888	888	5 civil, criminal, administrative, or other proceeding.
889	889	6 (e) One year after the effective date of this Act, and each
890	890	7 year thereafter, the Department shall create and post on its
891	891	8 website a public statistical report of nonidentifying
892	892	9 information. The report shall be limited to:
893	893	10 (1) the number of prescriptions for medication written
894	894	11 pursuant to this Act;
895	895	12 (2) the number of physicians who wrote prescriptions
896	896	13 for medication pursuant to this Act;
897	897	14 (3) the number of qualified patients who died
898	898	15 following self-administration of medication prescribed and
899	899	16 dispensed pursuant to this Act; and
900	900	17 (4) the number of people who died due to using an
901	901	18 aid-in-dying drug, with demographic percentages organized
902	902	19 by the following characteristics:
903	903	20 (A) age at death;
904	904	21 (B) education level;
905	905	22 (C) race;
906	906	23 (D) gender;
907	907	24 (E) type of insurance, including whether the
908	908	25 patient had insurance;
909	909	26 (F) underlying illness; and
910	910
911	911
912	912
913	913
914	914
915	915	SB3499 - 25 - LRB103 38464 RPS 68600 b
916	916
917	917
918	918	SB3499- 26 -LRB103 38464 RPS 68600 b SB3499 - 26 - LRB103 38464 RPS 68600 b
919	919	SB3499 - 26 - LRB103 38464 RPS 68600 b
920	920	1 (G) enrollment in hospice.
921	921	2 (f) Except as otherwise required by law, the information
922	922	3 collected by the Department is not a public record and is not
923	923	4 available for public inspection.
924	924	5 (g) Willful failure or refusal to timely submit records
925	925	6 required under this Act may result in disciplinary action.
926	926	7 Section 75. Effect on construction of wills, contracts,
927	927	8 and statutes.
928	928	9 (a) No provision in a contract, will, or other agreement,
929	929	10 whether written or oral, that would determine whether a
930	930	11 patient may make or rescind a request pursuant to this Act is
931	931	12 valid.
932	932	13 (b) No obligation owing under any contract that is in
933	933	14 effect on the effective date of this Act shall be conditioned
934	934	15 or affected by a patient's act of making or rescinding a
935	935	16 request pursuant to this Act.
936	936	17 (c) It is unlawful for an insurer to deny or alter health
937	937	18 care benefits otherwise available to a patient with a terminal
938	938	19 disease based on the availability of aid-in-dying care or
939	939	20 otherwise attempt to coerce a patient with a terminal disease
940	940	21 to make a request for aid-in-dying medication.
941	941	22 Section 80. Insurance or annuity policies.
942	942	23 (a) The sale, procurement, or issuance of a life, health,
943	943	24 or accident insurance policy, annuity policy, or the rate
944	944
945	945
946	946
947	947
948	948
949	949	SB3499 - 26 - LRB103 38464 RPS 68600 b
950	950
951	951
952	952	SB3499- 27 -LRB103 38464 RPS 68600 b SB3499 - 27 - LRB103 38464 RPS 68600 b
953	953	SB3499 - 27 - LRB103 38464 RPS 68600 b
954	954	1 charged for a policy shall not be conditioned upon or affected
955	955	2 by a patient's act of making or rescinding a request for
956	956	3 medication pursuant to this Act.
957	957	4 (b) A qualified patient's act of self-administering
958	958	5 medication pursuant to this Act does not invalidate any part
959	959	6 of a life, health, or accident insurance, or annuity policy.
960	960	7 (c) An insurance plan, including medical assistance under
961	961	8 Article V of the Illinois Public Aid Code, shall not deny or
962	962	9 alter benefits to a patient with a terminal disease who is a
963	963	10 covered beneficiary of a health insurance plan, based on the
964	964	11 availability of aid-in-dying care, their request for
965	965	12 medication pursuant to this Act, or the absence of a request
966	966	13 for medication pursuant to this Act. Failure to meet this
967	967	14 requirement shall constitute a violation of the Illinois
968	968	15 Insurance Code.
969	969	16 Section 85. Death certificate.
970	970	17 (a) Unless otherwise prohibited by law, the attending
971	971	18 physician may sign the death certificate of a qualified
972	972	19 patient who obtained and self-administered a prescription for
973	973	20 medication pursuant to this Act.
974	974	21 (b) When a death has occurred in accordance with this Act,
975	975	22 the death shall be attributed to the underlying terminal
976	976	23 disease.
977	977	24 (1) Death following self-administering medication
978	978	25 under this Act does not alone constitute grounds for
979	979
980	980
981	981
982	982
983	983
984	984	SB3499 - 27 - LRB103 38464 RPS 68600 b
985	985
986	986
987	987	SB3499- 28 -LRB103 38464 RPS 68600 b SB3499 - 28 - LRB103 38464 RPS 68600 b
988	988	SB3499 - 28 - LRB103 38464 RPS 68600 b
989	989	1 postmortem inquiry.
990	990	2 (2) Death in accordance with this Act shall not be
991	991	3 designated a suicide or homicide.
992	992	4 (c) A qualified patient's act of self-administering
993	993	5 medication prescribed pursuant to this Act shall not be
994	994	6 indicated on the death certificate.
995	995	7 Section 90. Liabilities and penalties.
996	996	8 (a) Nothing in this Act limits civil or criminal liability
997	997	9 arising from:
998	998	10 (1) Intentionally or knowingly altering or forging a
999	999	11 patient's request for medication pursuant to this Act or
1000	1000	12 concealing or destroying a rescission of a request for
1001	1001	13 medication pursuant to this Act.
1002	1002	14 (2) Intentionally or knowingly coercing or exerting
1003	1003	15 undue influence on a patient with a terminal disease to
1004	1004	16 request medication pursuant to this Act or to request or
1005	1005	17 use or not use medication pursuant to this Act.
1006	1006	18 (3) Intentional misconduct by a health care
1007	1007	19 professional or health care entity.
1008	1008	20 (b) The penalties specified in this Act do not preclude
1009	1009	21 criminal penalties applicable under other laws for conduct
1010	1010	22 inconsistent with this Act.
1011	1011	23 (c) As used in this Section, "intentionally" and
1012	1012	24 "knowingly" have the meanings provided in Sections 4-4 and 4-5
1013	1013	25 of the Criminal Code of 2012.
1014	1014
1015	1015
1016	1016
1017	1017
1018	1018
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1020	1020
1021	1021
1022	1022	SB3499- 29 -LRB103 38464 RPS 68600 b SB3499 - 29 - LRB103 38464 RPS 68600 b
1023	1023	SB3499 - 29 - LRB103 38464 RPS 68600 b
1024	1024	1 Section 95. Construction.
1025	1025	2 (a) Nothing in this Act authorizes a physician or any
1026	1026	3 other person, including the qualified patient, to end the
1027	1027	4 qualified patient's life by lethal injection, lethal infusion,
1028	1028	5 mercy killing, homicide, murder, manslaughter, euthanasia, or
1029	1029	6 any other criminal act.
1030	1030	7 (b) Actions taken in accordance with this Act do not, for
1031	1031	8 any purposes, constitute suicide, assisted suicide,
1032	1032	9 euthanasia, mercy killing, homicide, murder, manslaughter,
1033	1033	10 elder abuse or neglect, or any other civil or criminal
1034	1034	11 violation under the law.
1035	1035	12 Section 100. Severability. The provisions of this Act are
1036	1036	13 severable under Section 1.31 of the Statute on Statutes.
1037	1037
1038	1038
1039	1039
1040	1040
1041	1041
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