HB1665ham002 97TH GENERAL ASSEMBLY

Rep. Robyn Gabel

Filed: 4/7/2011

09700HB1665ham002 LRB097 08321 RPM 53962 a

AMENDMENT TO HOUSE BILL 1665

AMENDMENT NO. ______. Amend House Bill 1665 by replacing everything after the enacting clause with the following:

"Section 1. Short title. This Act may be cited as the Home Birth Safe Transport Act.

Section 5. Purpose. The General Assembly finds that due to an extreme shortage of licensed home birth providers, a significant percentage of Illinois home birth families engage the services of unregulated, underground, community midwives to attend their planned home births. It further finds that some families and community midwives may hesitate to transport to the hospital in an emergency for fear of being reported to Child Protective Services, the Department of Professional and Financial Regulation, or local law enforcement agents. It further finds that the recent Publication #476 of the American College of Obstetricians and Gynecologists emphasizes the importance of providing home birth families with "an integrated and regulated health system" which ensures "a plan for safe and quick transportation to a nearby hospital in the event of an emergency". It is hereby declared that fear of legal repercussions may negatively affect the health, safety, and welfare of hundreds of Illinois mothers annually who choose to give birth at home as well as the health, safety, and welfare of their infants. The purpose of this Act is to allow community midwives to transport mother, baby, or both to a hospital in an emergency situation and to professionally communicate medical information to the emergency transport team and receiving hospital personnel without fear of legal repercussions, thereby removing all hesitations to transport in a situation where the health and welfare of mother or baby requires it. This Act shall be liberally construed to best carry out these purposes

Section 10. Definitions. As used in this Act:

"Community midwife" means any midwife serving the home birth community in Illinois who is not licensed as an Advanced Practice Nurse under the Nurse Practice Act.

"Department" means the Department of Public Health.

"Emergency" means a medical condition of recent onset and severity that would lead a prudent layperson, possessing an average knowledge of medicine and health, to believe that urgent or unscheduled medical care is required.

"Emergency medical facility" means a freestanding emergency center or trauma center, as defined in the Emergency Medical Services (EMS) Systems Act.

"Emergency Medical Services (EMS) System" means an organization of hospitals, vehicle service providers, and personnel approved by the Department in a specific geographic area, which coordinates and provides pre-hospital and inter-hospital emergency care and non-emergency medical transports at a BLS, ILS, or ALS level or any combination of these pursuant to a System program plan submitted to and approved by the Department, and pursuant to the EMS Region Plan adopted for the EMS Region in which the System is located.

"Patient" means the mother or unborn or newborn infant receiving or planning to receive home birth services from a community midwife.

"Medical professional" includes licensed physicians, nurses, advance practice nurses, nursing and physician assistants, and any medical technician or medical specialist, EMS transport team member or any other individual who has medical or related training.

"Hospital" has the meaning ascribed to that term in the Hospital Licensing Act.

"Transport" means the act of bringing a patient to a hospital or emergency medical facility or calling for Emergency Medical Services to bring the patient to the facility. "Transport" includes the professional communication of pertinent medical information to the receiving facility personnel

Section 15. Immunity for parents.

(a) The act of carrying out or attempting to carry out a home birth with a community midwife does not, by itself, constitute a basis for a finding of abuse or neglect of a new born or unborn infant nor a violation of Section 12-21.6 of the Criminal Code of 1961.

(b) Neither a child protective investigation nor a criminal investigation may be initiated solely because of a planned home birth or because of the engagement of an unlicensed community midwife.

Section 20. Immunity for transporting community midwife. Provided that the community midwife provides medical information regarding the mother or infant or both to the recipient emergency medical personnel, the act of a community midwife transporting a mother or infant or both to a hospital, fire station, or emergency medical facility in accordance with this Act does not, by itself, constitute a basis for a finding of abuse or neglect of the patient, nor practicing medicine or nursing or advance practice nursing without a license, pursuant to the laws of this State, nor does it, by itself, constitute a violation of Section 12-21.6 of the Criminal Code of 1961.

Section 25. Immunity of facility and personnel. An EMS transport team, a hospital, fire station, or emergency medical facility, and any personnel of a hospital, fire station, or emergency medical facility, are immune from criminal or civil liability for acting in good faith in accordance with this Act.

Section 30. Anonymity of transporting community midwife. The transporting community midwife has the right to remain anonymous and to leave the hospital, fire station, or emergency medical facility at any time and not be pursued or followed.

Section 35. Use of information.

(a) No medical professional or fire department personnel may communicate identifying information gathered during or after an emergency home birth transport about the transporting community midwife or parents of the infant to law enforcement agents or the Department of Financial and Professional Regulation, Department of Children and Family Services, or any other department or agency solely for the fact of the parents and community midwife attempting or carrying out a home birth.

(b) Under no circumstances may an agent or employee of the Department of Financial and Professional Regulation or the Department of Children and Family Services or any other department or agency accept or use any evidence submitted to them about home birth families or unlicensed home birth community midwives related to an emergency home birth transport for the purpose of investigation or prosecution of parents or community midwife if there is no other complaint than the fact of a home birth or attempted home birth with a community midwife.

Section 900. The Medical Practice Act of 1987 is amended by changing Section 4 as follows:

(225 ILCS 60/4) (from Ch. 111, par. 4400-4)

(Section scheduled to be repealed on November 30, 2011)

Sec. 4. Exemptions.

(a) This Act does not apply to the following:

(1) persons lawfully carrying on their particular profession or business under any valid existing regulatory Act of this State;

(2) persons rendering gratuitous services in cases of emergency;

(3) persons treating human ailments by prayer or spiritual means as an exercise or enjoyment of religious freedom; or

(4) persons practicing the specified occupations set forth in in subsection (a) of, and pursuant to a licensing exemption granted in subsection (b) or (d) of, Section 2105-350 of the Department of Professional Regulation Law of the Civil Administrative Code of Illinois, but only for so long as the 2016 Olympic and Paralympic Games Professional Licensure Exemption Law is operable; or .

(5) community midwives engaged in the transport and transfer of care of home birth mothers or infants in a case of emergency.

(b) (Blank).

(Source: P.A. 96-7, eff. 4-3-09.)

Section 910. The Nurse Practice Act is amended by changing Section 50-15 as follows:

(225 ILCS 65/50-15) (was 225 ILCS 65/5-15)

(Section scheduled to be repealed on January 1, 2018)

Sec. 50-15. Policy; application of Act.

(a) 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 advanced, professional, or 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 advanced, 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.

(b) This Act does not prohibit the following:

(1) 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 50-50, 55-10, 60-10, and 70-5 of this Act.

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

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

(4) 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.

(5) 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.

(6) Persons from being employed as unlicensed assistive personnel in private homes, long term care facilities, nurseries, hospitals or other institutions.

(7) 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 this Act, until (i) the expiration of 6 months after the filing of such written application, (ii) the withdrawal of such application, or (iii) the denial of such application by the Department.

(8) The practice of advanced practice nursing by one who is an advanced practice 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 an advanced practice nurse and who is qualified to receive such license under this Act, until (i) the expiration of 6 months after the filing of such written application, (ii) the withdrawal of such application, or (iii) the denial of such application by the Department.

(9) 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 55-10, 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.

(10) 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.

(10.5) Community midwives engaged in the transport and transfer of care of home birth mothers or infants in a case of emergency.

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

(12) Delegation to authorized direct care staff trained under Section 15.4 of the Mental Health and Developmental Disabilities Administrative Act consistent with the policies of the Department.

(13) The practice, services, or activities of persons practicing the specified occupations set forth in subsection (a) of, and pursuant to a licensing exemption granted in subsection (b) or (d) of, Section 2105-350 of the Department of Professional Regulation Law of the Civil Administrative Code of Illinois, but only for so long as the 2016 Olympic and Paralympic Games Professional Licensure Exemption Law is operable.

(14) County correctional personnel from delivering prepackaged medication for self-administration to an individual detainee in a correctional facility.

Nothing in this Act shall be construed to limit the delegation of tasks or duties by a physician, dentist, or podiatrist to a licensed practical nurse, a registered professional nurse, or other persons.

(Source: P.A. 95-639, eff. 10-5-07; 95-876, eff. 8-21-08; 96-7, eff. 4-3-09; 96-516, eff. 8-14-09; 96-1000, eff. 7-2-10.)

Section 915. The Juvenile Court Act of 1987 is amended by changing Section 2-3 as follows:

(705 ILCS 405/2-3) (from Ch. 37, par. 802-3)

Sec. 2-3. Neglected or abused minor.

(1) Those who are neglected include:

(a) any minor under 18 years of age who is not receiving the proper or necessary support, education as required by law, or medical or other remedial care recognized under State law as necessary for a minor's well-being, or other care necessary for his or her well-being, including adequate food, clothing and shelter, or who is abandoned by his or her parent or parents or other person or persons responsible for the minor's welfare, except that a minor shall not be considered neglected for the sole reason that the minor's parent or parents or other person or persons responsible for the minor's welfare have left the minor in the care of an adult relative for any period of time, who the parent or parents or other person responsible for the minor's welfare know is both a mentally capable adult relative and physically capable adult relative, as defined by this Act; or

(b) any minor under 18 years of age whose environment is injurious to his or her welfare; or

(c) any newborn infant whose blood, urine, or meconium contains any amount of a controlled substance as defined in subsection (f) of Section 102 of the Illinois Controlled Substances Act, as now or hereafter amended, or a metabolite of a controlled substance, with the exception of controlled substances or metabolites of such substances, the presence of which in the newborn infant is the result of medical treatment administered to the mother or the newborn infant; or

(d) any minor under the age of 14 years whose parent or other person responsible for the minor's welfare leaves the minor without supervision for an unreasonable period of time without regard for the mental or physical health, safety, or welfare of that minor; or

(e) any minor who has been provided with interim crisis intervention services under Section 3-5 of this Act and whose parent, guardian, or custodian refuses to permit the minor to return home unless the minor is an immediate physical danger to himself, herself, or others living in the home.

Whether the minor was left without regard for the mental or physical health, safety, or welfare of that minor or the period of time was unreasonable shall be determined by considering the following factors, including but not limited to:

(1) the age of the minor;

(2) the number of minors left at the location;

(3) special needs of the minor, including whether the minor is physically or mentally handicapped, or otherwise in need of ongoing prescribed medical treatment such as periodic doses of insulin or other medications;

(4) the duration of time in which the minor was left without supervision;

(5) the condition and location of the place where the minor was left without supervision;

(6) the time of day or night when the minor was left without supervision;

(7) the weather conditions, including whether the minor was left in a location with adequate protection from the natural elements such as adequate heat or light;

(8) the location of the parent or guardian at the time the minor was left without supervision, the physical distance the minor was from the parent or guardian at the time the minor was without supervision;

(9) whether the minor's movement was restricted, or the minor was otherwise locked within a room or other structure;

(10) whether the minor was given a phone number of a person or location to call in the event of an emergency and whether the minor was capable of making an emergency call;

(11) whether there was food and other provision left for the minor;

(12) whether any of the conduct is attributable to economic hardship or illness and the parent, guardian or other person having physical custody or control of the child made a good faith effort to provide for the health and safety of the minor;

(13) the age and physical and mental capabilities of the person or persons who provided supervision for the minor;

(14) whether the minor was left under the supervision of another person;

(15) any other factor that would endanger the health and safety of that particular minor.

A minor shall not be considered neglected for the sole reason that the minor has been relinquished in accordance with the Abandoned Newborn Infant Protection Act.

A minor shall not be considered neglected for the sole reason that the minor is a patient in the care of a community midwife who is engaged in the transport and transfer of care of the minor to a hospital, fire station, or emergency medical facility in an emergency situation occurring during the course of a home birth, in accordance with the Home Birth Safe Transport Act.

(2) Those who are abused include any minor under 18 years of age whose parent or immediate family member, or any person responsible for the minor's welfare, or any person who is in the same family or household as the minor, or any individual residing in the same home as the minor, or a paramour of the minor's parent:

(i) inflicts, causes to be inflicted, or allows to be inflicted upon such minor physical injury, by other than accidental means, which causes death, disfigurement, impairment of physical or emotional health, or loss or impairment of any bodily function;

(ii) creates a substantial risk of physical injury to such minor by other than accidental means which would be likely to cause death, disfigurement, impairment of emotional health, or loss or impairment of any bodily function;

(iii) commits or allows to be committed any sex offense against such minor, as such sex offenses are defined in the Criminal Code of 1961, as amended, or in the Wrongs to Children Act, and extending those definitions of sex offenses to include minors under 18 years of age;

(iv) commits or allows to be committed an act or acts of torture upon such minor;

(v) inflicts excessive corporal punishment;

(vi) commits or allows to be committed the offense of involuntary servitude, involuntary sexual servitude of a minor, or trafficking in persons for forced labor or services defined in Section 10-9 of the Criminal Code of 1961, upon such minor; or

(vii) allows, encourages or requires a minor to commit any act of prostitution, as defined in the Criminal Code of 1961, and extending those definitions to include minors under 18 years of age.

A minor shall not be considered abused for the sole reason that the minor has been relinquished in accordance with the Abandoned Newborn Infant Protection Act.

A minor shall not be considered abused for the sole reason that the minor is a patient in the care of a community midwife who is engaged in the transport and transfer of care of the minor to a hospital, fire station, or emergency medical facility in an emergency situation occurring during the course of a home birth, in accordance with the Home Birth Safe Transport Act.

(3) This Section does not apply to a minor who would be included herein solely for the purpose of qualifying for financial assistance for himself, his parents, guardian or custodian.

(Source: P.A. 95-443, eff. 1-1-08; 96-168, eff. 8-10-09; 96-1464, eff. 8-20-10.)

Section 920. The Criminal Code of 1961 is amended by changing Section 12-21.6 as follows:

(720 ILCS 5/12-21.6)

Sec. 12-21.6. Endangering the life or health of a child.

(a) It is unlawful for any person to willfully cause or permit the life or health of a child under the age of 18 to be endangered or to willfully cause or permit a child to be placed in circumstances that endanger the child's life or health, except that it is not unlawful for a person to relinquish a child in accordance with the Abandoned Newborn Infant Protection Act or for a community midwife to transport or transfer the care of the newborn infant of a home birth mother to an emergency medical center, fire station, or hospital during a medical emergency in accordance with the Home Birth Safe Transport Act.

(b) There is a rebuttable presumption that a person committed the offense if he or she left a child 6 years of age or younger unattended in a motor vehicle for more than 10 minutes.

(c) "Unattended" means either: (i) not accompanied by a person 14 years of age or older; or (ii) if accompanied by a person 14 years of age or older, out of sight of that person.

(d) A violation of this Section is a Class A misdemeanor. A second or subsequent violation of this Section is a Class 3 felony. A violation of this Section that is a proximate cause of the death of the child is a Class 3 felony for which a person, if sentenced to a term of imprisonment, shall be sentenced to a term of not less than 2 years and not more than 10 years.

(Source: P.A. 92-408, eff. 8-17-01; 92-432, eff. 8-17-01; 92-515, eff. 6-1-02; 92-651, eff. 7-11-02.)".