HB0822ham001 94TH GENERAL ASSEMBLY

Rep. Eddie Washington

Filed: 4/11/2005

09400HB0822ham001 LRB094 07335 DRJ 44826 a

AMENDMENT TO HOUSE BILL 822

AMENDMENT NO. ______. Amend House Bill 822 by replacing everything after the enacting clause with the following:

"Section 5. The Assisted Living and Shared Housing Act is amended by changing Section 70 as follows:

(210 ILCS 9/70)

Sec. 70. Service requirements. An establishment must provide all mandatory services and may provide optional services, including medication reminders, supervision of self-administered medication and medication administration as defined by this Section and nonmedical services defined by rule, whether provided directly by the establishment or by another entity arranged for by the establishment with the consent of the resident or the resident's representative.

For the purposes of this Section, "medication reminders" means reminding residents to take pre-dispensed, self-administered medication, observing the resident, and documenting whether or not the resident took the medication.

For the purposes of this Section, "supervision of self-administered medication" means assisting the resident with self-administered medication using any combination of the following: reminding residents to take medication, reading the medication label to residents, checking the self-administered medication dosage against the label of the medication, confirming that residents have obtained and are taking the dosage as prescribed, and documenting in writing that the resident has taken (or refused to take) the medication. If residents are physically unable to open the container, the container may be opened for them. Supervision of self-administered medication shall be under the direction of a licensed health care professional.

For the purposes of this Section, "medication administration" refers to a licensed health care professional employed by an establishment engaging in administering routine insulin and vitamin B-12 injections, oral medications, topical treatments, eye and ear drops, or nitroglycerin patches. Non-licensed staff may not administer any medication, except that a certified medication aide may administer all medications allowed under Department of Public Health rules adopted to implement Section 3-206.05 of the Nursing Home Care Act. A certified medication aide is prohibited from administering medication to a resident until the required comprehensive assessment by a physician is completed. A certified medication aide is prohibited from administering medication to a resident whose medical condition is determined to be unstable.

The Department shall specify by rule procedures for medication reminders, supervision of self-administered medication, and medication administration.

Nothing in this Act shall preclude a physician licensed to practice medicine in all its branches from providing services to any resident.

(Source: P.A. 91-656, eff. 1-1-01.)

Section 10. The Nursing Home Care Act is amended by adding Section 3-206.05 as follows:

(210 ILCS 45/3-206.05 new)

Sec. 3-206.05. Certified medication aide.

(a) The General Assembly finds that 30 other states have had successful medication aide programs for many years. Further, the addition of certified medication aides would increase the amount of skilled nursing care available by enabling licensed nurses to devote even more time to the assessment and monitoring of patient conditions. The certified medication aide will assist a licensed nurse in the administration of routine medications.

(b) The Director shall appoint a Planning and Certification Committee to develop the training curriculum, certification test, certification requirements, continuing education standards, regulations, and ongoing evaluation process for medication aides. The committee shall review any reports of gross negligence on the part of any medication aide and shall monitor the overall effectiveness of the medication aide program. The committee shall be composed of one representative from a nursing association, one representative from a nursing school, one representative from the community colleges, one representative from an organization advocating for seniors, and 3 representatives from associations representing long-term care providers. The committee shall submit an annual progress report to the General Assembly beginning July 1, 2006. The report shall include a progress report on medication aide program implementation and recommendations for legislative changes necessary for program improvement.

(c) Based on the recommendations of the Planning and Certification Committee, the Department shall adopt and implement rules for the training, certification, and employment of certified medication aides in facilities licensed under this Act. Certified medication aides shall be allowed to administer medications to facility residents under the supervision of a duly licensed health care professional in accordance with rules adopted by the Department under this Section.

(d) Unless an individual is certified under this Section:

(1) The individual may not practice as a certified medication aide.

(2) A facility may not employ the individual as a certified medication aide.

(e) A certified medication aide must comply with all of the following:

(1) He or she must be a duly certified nursing assistant under this Act for at least one year.

(2) He or she must satisfactorily complete the medication aide training program involving at least 60 hours of classroom training and 40 hours of clinical training prescribed by the Department.

(3) He or she must satisfactorily meet all continuing education and recertification requirements prescribed by the Department.

(4) He or she may not administer any schedule II controlled substances, any medication by sub-cutaneous, intramuscular, intradermal, or intravenous route, or any medications injected into a tube.

(5) He or she may not pass medications in a sub-acute section of a nursing home.

(6) He or she is prohibited from administering medication to a resident of a long-term care facility until the initial comprehensive assessment is completed and reviewed by a licensed health care professional.

(7) He or she is prohibited from administering medication to a resident whose comprehensive assessment indicated an unstable medical condition.

(f) A facility must comply with the following staffing requirements:

(1) Only a certified medication aide may be employed in the capacity of a medication aide.

(2) A certified medication aide may not be assigned other duties when employed in the capacity of a medication aide.

(3) A certified medication aide may not be used to achieve minimum staffing requirements under this Act.

(g) The Department shall do all of the following:

(1) Prescribe education and training programs for certified medication aides.

(2) Prescribe requirements for re-certification, including continuing education and in-service requirements.

(3) Develop standards concerning the functions that may be performed by certified medication aides, including standards for oversight by a licensed healthcare professional.

Section 15. The Nursing and Advanced Practice Nursing Act is amended by changing Section 5-15 as follows:

(225 ILCS 65/5-15)

(Section scheduled to be repealed on January 1, 2008)

Sec. 5-15. Policy; application of Act. For the protection of life and the promotion of health, and the prevention of illness and communicable diseases, any person practicing or offering to practice professional and practical nursing in Illinois shall submit evidence that he or she is qualified to practice, and shall be licensed as provided under this Act. No person shall practice or offer to practice professional or practical nursing in Illinois or use any title, sign, card or device to indicate that such a person is practicing professional or practical nursing unless such person has been licensed under the provisions of this Act.

This Act does not prohibit the following:

(a) The practice of nursing in Federal employment in the discharge of the employee's duties by a person who is employed by the United States government or any bureau, division or agency thereof and is a legally qualified and licensed nurse of another state or territory and not in conflict with Sections 10-5, 10-30, and 10-45 of this Act.

(b) Nursing that is included in their program of study by students enrolled in programs of nursing or in current nurse practice update courses approved by the Department.

(c) The furnishing of nursing assistance in an emergency.

(d) The practice of nursing by a nurse who holds an active license in another state when providing services to patients in Illinois during a bonafide emergency or in immediate preparation for or during interstate transit.

(e) The incidental care of the sick by members of the family, domestic servants or housekeepers, or care of the sick where treatment is by prayer or spiritual means.

(f) Persons from being employed as nursing aides, attendants, orderlies, and other auxiliary workers in private homes, long term care facilities, nurseries, hospitals or other institutions.

(g) The practice of practical nursing by one who has applied in writing to the Department in form and substance satisfactory to the Department, for a license as a licensed practical nurse and who has complied with all the provisions under Section 10-30, except the passing of an examination to be eligible to receive such license, until: the decision of the Department that the applicant has failed to pass the next available examination authorized by the Department or has failed, without an approved excuse, to take the next available examination authorized by the Department or until the withdrawal of the application, but not to exceed 3 months. An applicant practicing practical nursing under this Section who passes the examination, however, may continue to practice under this Section until such time as he or she receives his or her license to practice or until the Department notifies him or her that the license has been denied. No applicant for licensure practicing under the provisions of this paragraph shall practice practical nursing except under the direct supervision of a registered professional nurse licensed under this Act or a licensed physician, dentist or podiatrist. In no instance shall any such applicant practice or be employed in any supervisory capacity.

(h) The practice of practical nursing by one who is a licensed practical nurse under the laws of another U.S. jurisdiction and has applied in writing to the Department, in form and substance satisfactory to the Department, for a license as a licensed practical nurse and who is qualified to receive such license under Section 10-30, until (1) the expiration of 6 months after the filing of such written application, (2) the withdrawal of such application, or (3) the denial of such application by the Department.

(i) The practice of professional nursing by one who has applied in writing to the Department in form and substance satisfactory to the Department for a license as a registered professional nurse and has complied with all the provisions under Section 10-30 except the passing of an examination to be eligible to receive such license, until the decision of the Department that the applicant has failed to pass the next available examination authorized by the Department or has failed, without an approved excuse, to take the next available examination authorized by the Department or until the withdrawal of the application, but not to exceed 3 months. An applicant practicing professional nursing under this Section who passes the examination, however, may continue to practice under this Section until such time as he or she receives his or her license to practice or until the Department notifies him or her that the license has been denied. No applicant for licensure practicing under the provisions of this paragraph shall practice professional nursing except under the direct supervision of a registered professional nurse licensed under this Act. In no instance shall any such applicant practice or be employed in any supervisory capacity.

(j) The practice of professional nursing by one who is a registered professional nurse under the laws of another state, territory of the United States or country and has applied in writing to the Department, in form and substance satisfactory to the Department, for a license as a registered professional nurse and who is qualified to receive such license under Section 10-30, until (1) the expiration of 6 months after the filing of such written application, (2) the withdrawal of such application, or (3) the denial of such application by the Department.

(k) The practice of professional nursing that is included in a program of study by one who is a registered professional nurse under the laws of another state or territory of the United States or foreign country, territory or province and who is enrolled in a graduate nursing education program or a program for the completion of a baccalaureate nursing degree in this State, which includes clinical supervision by faculty as determined by the educational institution offering the program and the health care organization where the practice of nursing occurs. The educational institution will file with the Department each academic term a list of the names and origin of license of all professional nurses practicing nursing as part of their programs under this provision.

(l) Any person licensed in this State under any other Act from engaging in the practice for which she or he is licensed.

(m) Delegation to authorized direct care staff trained under Section 15.4 of the Mental Health and Developmental Disabilities Administrative Act.

(n) Administration of medications by a certified medication aide certified under Section 3-206.05 of the Nursing Home Care Act. Any nurse providing supervision to a certified medication aide is not liable under this Act for the actions of the medication aide.

An applicant for license practicing under the exceptions set forth in subparagraphs (g), (h), (i), and (j) of this Section shall use the title R.N. Lic. Pend. or L.P.N. Lic. Pend. respectively and no other.

(Source: P.A. 93-265, eff. 7-22-03.)".