Human Services Committee
Filed: 4/9/2008
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1 | AMENDMENT TO HOUSE BILL 5960
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2 | AMENDMENT NO. ______. Amend House Bill 5960 by replacing | ||||||
3 | everything after the enacting clause with the following:
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4 | "Section 5. The Nurse Practice Act is amended by changing | ||||||
5 | Section 50-15 and by adding Sections 50-80 and 60-45 as | ||||||
6 | follows:
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7 | (225 ILCS 65/50-15)
(was 225 ILCS 65/5-15)
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8 | (Section scheduled to be repealed on January 1, 2018)
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9 | Sec. 50-15. Policy; application of Act. | ||||||
10 | (a) For the protection of life and the
promotion of health, | ||||||
11 | and the prevention of illness and communicable diseases,
any | ||||||
12 | person practicing or offering to practice advanced,
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13 | professional, or practical
nursing in Illinois shall submit | ||||||
14 | evidence that he or she is qualified to
practice, and shall be | ||||||
15 | licensed as provided under this Act. No person shall
practice | ||||||
16 | or offer to practice advanced, professional, or practical |
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1 | nursing in Illinois or
use any title, sign, card or device to | ||||||
2 | indicate that such a person is
practicing professional or | ||||||
3 | practical nursing unless such person has been
licensed under | ||||||
4 | the provisions of this Act.
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5 | (b) This Act does not prohibit the following:
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6 | (1) The practice of nursing in Federal employment in | ||||||
7 | the discharge of the
employee's duties by a person who is | ||||||
8 | employed by the United States
government or any bureau, | ||||||
9 | division or agency thereof and is a legally
qualified and | ||||||
10 | licensed nurse of another state or territory and not in
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11 | conflict with Sections 50-50, 55-10, 60-10, and 70-5 of | ||||||
12 | this
Act.
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13 | (2) Nursing that is included in the program of study by
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14 | students
enrolled in programs of nursing or in current | ||||||
15 | nurse practice update courses
approved by the Department.
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16 | (3) The furnishing of nursing assistance in an | ||||||
17 | emergency.
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18 | (4) The practice of nursing by a nurse who holds an | ||||||
19 | active license in
another state when providing services to | ||||||
20 | patients in Illinois during a bonafide
emergency or in | ||||||
21 | immediate preparation for or during interstate
transit.
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22 | (5) The incidental care of the sick by members of the | ||||||
23 | family, domestic
servants or housekeepers, or care of the | ||||||
24 | sick where treatment is by prayer
or spiritual means.
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25 | (6) Persons from being employed as unlicensed | ||||||
26 | assistive personnel in private homes, long term care |
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1 | facilities,
nurseries, schools, hospitals , or other | ||||||
2 | institutions.
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3 | (7) The practice of practical nursing by one who is a | ||||||
4 | licensed practical
nurse under the laws of another U.S. | ||||||
5 | jurisdiction and has applied in writing
to the Department, | ||||||
6 | in form and substance satisfactory to the Department,
for a | ||||||
7 | license as a licensed practical nurse and who is qualified | ||||||
8 | to receive
such license under this Act, until (i) the | ||||||
9 | expiration of 6 months after
the filing of such written | ||||||
10 | application, (ii) the withdrawal of such application,
or | ||||||
11 | (iii) the denial of such application by the Department.
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12 | (8) The practice of advanced practice nursing by one | ||||||
13 | who is an advanced practice nurse under the laws of another | ||||||
14 | state, territory of the United States, or country and has | ||||||
15 | applied in writing to the Department, in form and substance | ||||||
16 | satisfactory to the Department, for a license as an | ||||||
17 | advanced practice nurse and who is qualified to receive | ||||||
18 | such license under this Act, until (i) the expiration of 6 | ||||||
19 | months after the filing of such written application, (ii) | ||||||
20 | the withdrawal of such application, or (iii) the denial of | ||||||
21 | such application by the Department.
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22 | (9) The practice of professional nursing by one who is | ||||||
23 | a registered
professional nurse under the laws of another | ||||||
24 | state, territory of the United
States or country and has | ||||||
25 | applied in writing to the Department, in form and
substance | ||||||
26 | satisfactory to the Department, for a license as a |
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1 | registered
professional nurse and who is qualified to | ||||||
2 | receive such license under
Section 55-10, until (1) the | ||||||
3 | expiration of 6 months after the filing of
such written | ||||||
4 | application, (2) the withdrawal of such application, or (3)
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5 | the denial of such application by the Department.
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6 | (10) The practice of professional nursing that is | ||||||
7 | included in a program of
study by one who is a registered | ||||||
8 | professional nurse under the laws of
another state or | ||||||
9 | territory of the United States or foreign country,
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10 | territory or province and who is enrolled in a graduate | ||||||
11 | nursing education
program or a program for the completion | ||||||
12 | of a baccalaureate nursing degree in
this State, which | ||||||
13 | includes clinical supervision by faculty as
determined by | ||||||
14 | the educational institution offering the program and the
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15 | health care organization where the practice of nursing | ||||||
16 | occurs.
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17 | (11) Any person licensed in this State under any other | ||||||
18 | Act from engaging
in the practice for which she or he is | ||||||
19 | licensed.
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20 | (12) Delegation to authorized direct care staff | ||||||
21 | trained under Section 15.4
of the Mental Health and
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22 | Developmental Disabilities Administrative Act consistent | ||||||
23 | with the policies of the Department.
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24 | (13) Nothing in this Act shall be construed to limit the | ||||||
25 | delegation of tasks or duties by a physician, dentist, or | ||||||
26 | podiatrist to a licensed practical nurse, a registered |
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1 | professional nurse, or other persons.
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2 | (Source: P.A. 95-639, eff. 10-5-07; revised 12-7-07.)
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3 | (225 ILCS 65/50-80 new)
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4 | Sec. 50-80. First aid, emergency care, and cardiopulmonary | ||||||
5 | resuscitation. Nothing in this Act prevents a licensed | ||||||
6 | practical nurse, a registered professional nurse, a school | ||||||
7 | nurse, or an advanced practice nurse from teaching or training | ||||||
8 | other persons in first aid, emergency care, or cardiopulmonary | ||||||
9 | resuscitation. | ||||||
10 | (225 ILCS 65/60-45 new) | ||||||
11 | Sec. 60-45. School nurses. | ||||||
12 | (a) "School nurse" means a licensed registered | ||||||
13 | professional nurse certified by the State Board of Education | ||||||
14 | pursuant to Section 21-25 of the School Code as a certified | ||||||
15 | school nurse or any noncertified registered professional | ||||||
16 | nurses employed by a school district to perform professional | ||||||
17 | nursing services. School nursing is a unique field of nursing | ||||||
18 | with unique challenges. School nurses have the ability to | ||||||
19 | practice within the scope of practice of a registered | ||||||
20 | professional nurse under this Act. | ||||||
21 | (b) School nurses may administer and supervise the | ||||||
22 | administration of medications or care that need to be | ||||||
23 | administered in school or during school activities as | ||||||
24 | authorized under Section 22-30 of the School Code. |
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1 | (c) Notwithstanding the provisions of subsection (c) of | ||||||
2 | Section 50-75 of this Act, school nurses may authorize persons | ||||||
3 | trained pursuant to Section 10-22.21b of the School Code to | ||||||
4 | carry out a health care management plan, including | ||||||
5 | administration of medications. | ||||||
6 | (d) Notwithstanding any other rulemaking authority that | ||||||
7 | may exist, neither the Governor nor any agency or agency head | ||||||
8 | under the jurisdiction of the Governor has any authority to | ||||||
9 | make or promulgate rules to implement or enforce the provisions | ||||||
10 | of this amendatory Act of the 95th General Assembly. If, | ||||||
11 | however, the Governor believes that rules are necessary to | ||||||
12 | implement or enforce the provisions of this amendatory Act of | ||||||
13 | the 95th General Assembly, the Governor may suggest rules to | ||||||
14 | the General Assembly by filing them with the Clerk of the House | ||||||
15 | and the Secretary of the Senate and by requesting that the | ||||||
16 | General Assembly authorize such rulemaking by law, enact those | ||||||
17 | suggested rules into law, or take any other appropriate action | ||||||
18 | in the General Assembly's discretion. Nothing contained in this | ||||||
19 | amendatory Act of the 95th General Assembly shall be | ||||||
20 | interpreted to grant rulemaking authority under any other | ||||||
21 | Illinois statute where such authority is not otherwise | ||||||
22 | explicitly given. For the purposes of this amendatory Act of | ||||||
23 | the 95th General Assembly, "rules" is given the meaning | ||||||
24 | contained in Section 1-70 of the Illinois Administrative | ||||||
25 | Procedure Act, and "agency" and "agency head" are given the | ||||||
26 | meanings contained in Sections 1-20 and 1-25 of the Illinois |
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1 | Administrative Procedure Act to the extent that such | ||||||
2 | definitions apply to agencies or agency heads under the | ||||||
3 | jurisdiction of the Governor. | ||||||
4 | Section 10. The School Code is amended by changing Sections | ||||||
5 | 10-20.14b and 10-22.21b as follows:
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6 | (105 ILCS 5/10-20.14b) (from Ch. 122, par. 10-20.14b)
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7 | Sec. 10-20.14b. Medications policy. To develop a policy for | ||||||
8 | administration
of medications in
schools, which includes | ||||||
9 | health care management plans under Section 10-22.21b of this | ||||||
10 | Code, to
furnish a copy of the policy to the parents or | ||||||
11 | guardians of each pupil
within 15 days after the beginning of | ||||||
12 | each
school year,
or within 15 days after starting classes for | ||||||
13 | a pupil who transfers into the
district,
and
to require that | ||||||
14 | each school informs its
pupils of the contents of its policy.
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15 | (Source: P.A. 90-789, eff. 8-14-98.)
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16 | (105 ILCS 5/10-22.21b) (from Ch. 122, par. 10-22.21b)
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17 | Sec. 10-22.21b. Administering medication and health care | ||||||
18 | management plans . | ||||||
19 | (a) To provide for the
administration of medication to | ||||||
20 | students. It shall be the policy of the
State of Illinois that | ||||||
21 | the administration of medication to students during
regular | ||||||
22 | school hours and during school-related activities should be
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23 | discouraged unless absolutely necessary for the critical |
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1 | health and
well-being of the student. | ||||||
2 | (b) Under no circumstances shall
teachers or other | ||||||
3 | non-administrative school employees, except certified
school | ||||||
4 | nurses , and non-certificated registered professional nurses, | ||||||
5 | and designated health care aides as defined in subsection (c) | ||||||
6 | of this Section, be
required
to administer medication to | ||||||
7 | students. | ||||||
8 | (c) When a pupil needs to receive medications or care in | ||||||
9 | school or during school activities, a health care management | ||||||
10 | plan must be established. A parent or guardian for any student | ||||||
11 | who seeks assistance with care in the school setting must | ||||||
12 | submit a signed request for a health care management plan. | ||||||
13 | A health care management plan must be submitted to the | ||||||
14 | school at one of the following times: before or at the | ||||||
15 | beginning of the school year; upon enrollment of a student in | ||||||
16 | need of a plan, if the student enrolls in the school after the | ||||||
17 | beginning of the school year; as soon as practicable following | ||||||
18 | a student's diagnosis; or when a student's care needs change | ||||||
19 | during the school year. The request for a health care | ||||||
20 | management plan must be accompanied by proof of diagnosis of a | ||||||
21 | condition or illness necessitating assistance and any | ||||||
22 | prescription or prescriptions, including the name of the | ||||||
23 | medication and the method of administration. Proof shall | ||||||
24 | consist of a statement from a physician licensed to practice | ||||||
25 | medicine in all its branches on the physician's letterhead, an | ||||||
26 | advanced practice registered nurse with a collaborative |
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1 | agreement authorizing these services on practice letterhead, | ||||||
2 | or a physician assistant with authority to provide these | ||||||
3 | services authorized by a supervising physician on practice | ||||||
4 | letterhead. The principal and parent or guardian must develop | ||||||
5 | any health care management plan. The statement must provide the | ||||||
6 | diagnosis, list of any medications, dosage, frequency and time | ||||||
7 | of administration, and administration route or other | ||||||
8 | directions. The principal and parent or guardian and any | ||||||
9 | designated health care aide to provide services shall sign the | ||||||
10 | health care management plan. A copy of the health care | ||||||
11 | management plan must be provided to the parent or guardian, the | ||||||
12 | appropriate designated health care aide, and the school nurse, | ||||||
13 | if available. | ||||||
14 | The services and accommodations specified in a health care | ||||||
15 | management plan must be reasonable, reflect the current | ||||||
16 | standards of care, and include appropriate safeguards to ensure | ||||||
17 | that any health care supplies, including, but not limited to, | ||||||
18 | syringes and lancets, are disposed of properly. | ||||||
19 | A school nurse or a designated health care aide shall | ||||||
20 | provide health care for a student under this subsection (c) | ||||||
21 | only after a student's parent or guardian submits a written | ||||||
22 | request for assistance and signs a health care management plan | ||||||
23 | with the school. | ||||||
24 | Designated health care aides are individuals who assist in | ||||||
25 | carrying out health care management plans in accordance with | ||||||
26 | the following: |
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1 | (1) In the absence of a full-time school nurse, a | ||||||
2 | school principal shall appoint a designated health care | ||||||
3 | aide to perform the tasks necessary to assist a student in | ||||||
4 | accordance with his or her health care management plan. A | ||||||
5 | school nurse assigned to the school and the principal must | ||||||
6 | be notified, in writing, of each and every time any | ||||||
7 | intervention under the plan is made. Parents must also be | ||||||
8 | notified, unless notification is waived in writing. | ||||||
9 | Interventions must be in accordance with standardized | ||||||
10 | protocols, adopted by the Department of Human Services' | ||||||
11 | school health program and approved by the Board of Nursing | ||||||
12 | based on nationally accepted standards for the treatment of | ||||||
13 | each specific diagnosis. The minimum standardized protocol | ||||||
14 | for diabetes management is set forth in subdivision (2) of | ||||||
15 | this subsection (c). | ||||||
16 | (2) With respect to the diabetes management protocol, | ||||||
17 | training of a designated health care aide must include all | ||||||
18 | of the following: | ||||||
19 | (A) The details of a student's diabetes management | ||||||
20 | plan. | ||||||
21 | (B) How to test blood glucose and record results. | ||||||
22 | (C) How to recognize and respond to the symptoms of | ||||||
23 | hypoglycemia. | ||||||
24 | (D) How to recognize and respond to the symptoms of | ||||||
25 | hyperglycemia. | ||||||
26 | (E) What to do in an emergency, including how to |
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1 | administer glucagon. | ||||||
2 | (F) How to prepare and administer insulin | ||||||
3 | according to the device identified in the student's | ||||||
4 | diabetes management plan and keep a record of the | ||||||
5 | amount administered. | ||||||
6 | (G) How carbohydrates, physical activity, and | ||||||
7 | other factors affect blood glucose levels and how to | ||||||
8 | respond when blood glucose levels are outside the | ||||||
9 | target ranges specified in the student's diabetes | ||||||
10 | management plan. | ||||||
11 | A student with diabetes must be permitted to do the | ||||||
12 | following: | ||||||
13 | (i) perform blood glucose tests as needed; | ||||||
14 | (ii) administer insulin with the insulin delivery | ||||||
15 | system used by the student; | ||||||
16 | (iii) treat hypoglycemia and hyperglycemia and | ||||||
17 | otherwise attend to the care and management of his or | ||||||
18 | her diabetes in the classroom, in any area of the | ||||||
19 | school or school grounds, and at any school-related | ||||||
20 | activity or event; and | ||||||
21 | (iv) possess on his or her person, at all times, | ||||||
22 | the supplies and equipment necessary to monitor and | ||||||
23 | treat diabetes, including, but not limited to, | ||||||
24 | glucometers, lancets, test strips, insulin, syringes, | ||||||
25 | insulin pens and needle tips, insulin pumps, infusion | ||||||
26 | sets, alcohol swabs, a glucagon injection kit, glucose |
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1 | tablets, and food. | ||||||
2 | (3) If a school nurse is assigned to a school, the | ||||||
3 | school nurse shall coordinate the training of designated | ||||||
4 | health care aides. If a school nurse is not assigned to a | ||||||
5 | school, the principal shall coordinate the training of | ||||||
6 | designated health care aides in accordance with | ||||||
7 | standardized protocols. Training may be provided by a | ||||||
8 | physician licensed to practice medicine in all its | ||||||
9 | branches, a licensed advanced practice nurse, a licensed | ||||||
10 | physician assistant, or a licensed registered nurse with | ||||||
11 | expertise in the conditions or illness generally occurring | ||||||
12 | in the school-age population. In addition, training may be | ||||||
13 | provided by the parent or guardian of the student. | ||||||
14 | (4) Designated health care aides shall serve under the | ||||||
15 | supervision of the principal. | ||||||
16 | (5) A school employee must not be subject to any | ||||||
17 | penalty, sanction, or other disciplinary action for | ||||||
18 | refusing to serve as a designated health care aide. | ||||||
19 | (6) Training must be provided annually and may be | ||||||
20 | provided as part of in-service training. | ||||||
21 | (7) Training may be provided for other school employees | ||||||
22 | who are not currently serving as designated health care | ||||||
23 | aides, at the discretion of the principal. | ||||||
24 | (8) The principal shall ensure the school has at least | ||||||
25 | one designated health care aide or one full-time nurse | ||||||
26 | assigned to the school and available during school hours. |
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1 | The principal or school nurse, should one be assigned | ||||||
2 | full-time to a school, shall maintain a copy of the | ||||||
3 | training records. | ||||||
4 | A school shall provide a one-page information sheet to each | ||||||
5 | employee providing transportation for a student with a health | ||||||
6 | care management plan or supervising a student with a plan | ||||||
7 | during a school-sponsored activity. The information sheet | ||||||
8 | shall do the following: | ||||||
9 | (I) identify the student's condition; | ||||||
10 | (II) identify potential emergencies that may occur as a | ||||||
11 | result of the student's condition and the appropriate | ||||||
12 | responses to such emergencies; and | ||||||
13 | (III) provide emergency contact information for the | ||||||
14 | student's parent or guardian. | ||||||
15 | A school district may not restrict the assignment of a | ||||||
16 | student with a health care management plan to a particular | ||||||
17 | school on the basis that the school does not have a full-time | ||||||
18 | nurse or the required designated health care aides, nor may a | ||||||
19 | school deny access to a student on the basis that a student has | ||||||
20 | been diagnosed with a condition or illness requiring a health | ||||||
21 | care management plan.
A school or a school employee is not | ||||||
22 | liable for civil or other damages as a result of conduct, other | ||||||
23 | than willful or wanton misconduct, related to the care of a | ||||||
24 | student in accordance with a heath care management plan under | ||||||
25 | this subsection (c). | ||||||
26 | A school employee must not be subject to any disciplinary |
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1 | proceeding resulting from an action taken in compliance with | ||||||
2 | this subsection (c), unless the action constitutes willful or | ||||||
3 | wanton misconduct, as long as the provisions of this subsection | ||||||
4 | (c) are met. | ||||||
5 | The State Board of Education may adopt standardized forms | ||||||
6 | for the convenience of parents and schools, but no rules are | ||||||
7 | necessary to implement this subsection (c). | ||||||
8 | (d) This
Section shall not prohibit a school district from | ||||||
9 | adopting guidelines for
self-administration of medication by | ||||||
10 | students. | ||||||
11 | (e) This Section shall not
prohibit any school employee or | ||||||
12 | volunteer from providing emergency assistance to students.
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13 | (f) Notwithstanding any other rulemaking authority that | ||||||
14 | may exist, neither the Governor nor any agency or agency head | ||||||
15 | under the jurisdiction of the Governor has any authority to | ||||||
16 | make or promulgate rules to implement or enforce the provisions | ||||||
17 | of this amendatory Act of the 95th General Assembly. If, | ||||||
18 | however, the Governor believes that rules are necessary to | ||||||
19 | implement or enforce the provisions of this amendatory Act of | ||||||
20 | the 95th General Assembly, the Governor may suggest rules to | ||||||
21 | the General Assembly by filing them with the Clerk of the House | ||||||
22 | and the Secretary of the Senate and by requesting that the | ||||||
23 | General Assembly authorize such rulemaking by law, enact those | ||||||
24 | suggested rules into law, or take any other appropriate action | ||||||
25 | in the General Assembly's discretion. Nothing contained in this | ||||||
26 | amendatory Act of the 95th General Assembly shall be |
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| |||||||
1 | interpreted to grant rulemaking authority under any other | ||||||
2 | Illinois statute where such authority is not otherwise | ||||||
3 | explicitly given. For the purposes of this amendatory Act of | ||||||
4 | the 95th General Assembly, "rules" is given the meaning | ||||||
5 | contained in Section 1-70 of the Illinois Administrative | ||||||
6 | Procedure Act, and "agency" and "agency head" are given the | ||||||
7 | meanings contained in Sections 1-20 and 1-25 of the Illinois | ||||||
8 | Administrative Procedure Act to the extent that such | ||||||
9 | definitions apply to agencies or agency heads under the | ||||||
10 | jurisdiction of the Governor. | ||||||
11 | (Source: P.A. 91-719, eff. 6-2-00.)
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12 | Section 85. Federal law. Nothing in this Act shall limit | ||||||
13 | any rights available under federal law. Notwithstanding any | ||||||
14 | other provision in this Act, accommodations established in | ||||||
15 | either an Individualized Education Program pursuant to 20 | ||||||
16 | U.S.C. 1400 et seq. or a Section 504 plan pursuant to 29 U.S.C. | ||||||
17 | 794 et seq. shall control over the provisions of a health care | ||||||
18 | medical management plan. | ||||||
19 | Section 90. The State Mandates Act is amended by adding | ||||||
20 | Section 8.32 as follows: | ||||||
21 | (30 ILCS 805/8.32 new) | ||||||
22 | Sec. 8.32. Exempt mandate. Notwithstanding Sections 6 and 8 | ||||||
23 | of this Act, no reimbursement by the State is required for the |
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1 | implementation of any mandate created by this amendatory Act of | ||||||
2 | the 95th General Assembly.
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3 | Section 99. Effective date. This Act takes effect June 30, | ||||||
4 | 2008.".
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