SB0385eng 95TH GENERAL ASSEMBLY

SB0385 Engrossed LRB095 09142 RAS 29335 b

AN ACT concerning regulation.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 1. Short title. This Act may be cited as the Midwifery Licensure Act.

Section 5. Purpose. The practice of midwifery in out-of-hospital settings is hereby declared to affect the public health, safety, and welfare and to be subject to regulation in the public interest. The purpose of the Act is to protect and benefit the public by setting standards for the qualifications, education, training, and experience of those who seek to obtain licensure and hold the title of Licensed Midwife, to promote high standards of professional performance for those licensed to practice midwifery in out-of-hospital settings in this State, and to protect the public from unprofessional conduct by persons licensed to practice midwifery, as defined in this Act. This Act shall be liberally construed to best carry out these purposes.

Section 10. Exemptions.

(a) This Act does not prohibit a person licensed under any other Act in this State from engaging in the practice for which he or she is licensed or from delegating services as provided for under that other Act.

(b) Nothing in this Act shall be construed to prohibit or require licensing under this Act, with regard to any of the following:

(1) The gratuitous rendering of services.

(2) The rendering of services by a person if such attendance is in accordance with the person's religious faith and is rendered to persons with a similar religious faith as an exercise and enjoyment of their religious freedom.

(3) Midwifery that is included in the educational programs of student midwives working under the direct supervision of a preceptor approved by the North American Registry of Midwives.

Section 15. Definitions. In this Act:

"American Midwifery Certification Board" or "AMCB" means the national certifying body for certified nurse-midwives (CNM) and certified midwives (CM) or its successor.

"Board" means the Illinois Midwifery Board.

"Certified professional midwife" means a person who has met the standards for certification set by the North American Registry of Midwives and has been awarded the Certified Professional Midwife (CPM) credential.

"Department" means the Department of Financial and Professional Regulation.

"Licensed midwife" means a person who has been granted a license under this Act to engage in the practice of midwifery.

"National Association of Certified Professional Midwives" or "NACPM" means the professional organization, or its successor, that promotes the growth and development of the profession of certified professional midwives.

"North American Registry of Midwives" or "NARM" means the accredited international agency, or its successor, that has established and has continued to administer certification for the credentialing of certified professional midwives.

"Practice of midwifery" means providing the necessary supervision, care, education, and advice to women during the antepartum, intrapartum, and postpartum period, conducting deliveries independently, and caring for the newborn, with such care including without limitation preventative measures, the detection of abnormal conditions in the mother and the child, the procurement of medical assistance, and the execution of emergency measures in the absence of medical help. "Practice of midwifery" includes non-prescriptive family planning.

"Secretary" means the Secretary of Financial and Professional Regulation.

Section 17. Unlicensed practice. Beginning 2 years after the effective date of this Act, no person may practice, attempt to practice, or hold himself or herself out to practice as a licensed midwife unless he or she is licensed as a midwife under this Act.

Section 20. Title. A licensed midwife may identify himself or herself as a Licensed Midwife or a Licensed Homebirth Midwife and may use the abbreviation L.M. A licensed midwife who carries the CPM credential may alternately identify himself or herself as a Licensed Certified Professional Midwife or Licensed CPM and may use the abbreviation CPM, LM.

A licensed midwife who carries the CNM credential may alternately identify himself or herself as a Licensed Certified Nurse-Midwife or Licensed CNM and may use the abbreviation CNM, LM. A licensed midwife who carries the CM credential may alternately identify himself or herself as a Licensed Certified Midwife or Licensed CM and may use the abbreviation CM, LM.

Section 25. Informed consent.

(a) A licensed midwife shall, at an initial consultation with a client, provide a copy of the rules adopted by the Department under this Act and disclose to the client orally and in writing all of the following:

(1) The licensed midwife's experience and training.

(2) Whether the licensed midwife has malpractice liability insurance coverage and the policy limits of any such coverage.

(3) A written protocol for the handling of medical emergencies, including transportation to a hospital, particular to each client.

(4) A recommendation that the client obtain a physical examination from an appropriately licensed provider.

(5) Any other information required by the Department by rule.

(b) A copy of the informed consent document, signed and dated by the client, must be kept in each client's chart.

Section 30. Vicarious liability. No other licensed midwife, doctor of medicine, doctor of osteopathy, acupuncturist, chiropractor, midwife, nurse-midwife, emergency medical personnel, first responder, or hospital or agent thereof shall be liable for an injury resulting from an act or omission by a licensed midwife, even if he or she has consulted with or accepted a referral from the licensed midwife.

Except as otherwise provided by law, no licensed midwife, doctor of medicine, doctor of osteopathy, acupuncturist, chiropractor, midwife, nurse-midwife, emergency medical personnel, first responder, or hospital or agent thereof may be exempt from liability for his or her own subsequent and independent negligent, grossly negligent, or willful or wanton acts or omissions.

Section 35. Advertising.

(a) Any person licensed under this Act may advertise the availability of professional midwifery services in the public media or on premises where professional services are rendered, if the advertising is truthful and not misleading and is in conformity with any rules adopted by the Department.

(b) A licensee must include in every advertisement for midwifery services regulated under this Act his or her title as it appears on the license or the initials authorized under this Act.

Section 40. Powers and duties of the Department; rulemaking.

(a) The Department shall adopt all rules necessary for the implementation and administration of this Act, including rules establishing criteria for licensure, professional conduct, and discipline; however, the Department must consult with the Board regarding rulemaking and review any responses and recommendations made by the Board. Initial rules concerning the licensed practice of midwifery must be adopted on or before January 1, 2008.

(b) All rules adopted by the Department under this Act must be consistent with standards regarding the practice of midwifery established by the National Association of Certified Professional Midwives or a successor organization whose essential documents include without limitation subject matter concerning scope of practice, standards of practice, informed consent, appropriate consultation, collaboration or referral, and acknowledgement of a woman's right to self determination concerning her maternity care.

(c) Rules adopted by the Department must provide for the following:

(1) the scope of practice and services provided regarding the use of equipment, procedures, and medications;

(2) the administration by a licensed midwife of oxygen during the practice of midwifery;

(3) the issuance of temporary permits to practice midwifery pending qualification for licensure; and

(4) the administration during the practice of midwifery, of oxytocin (Pitocin) and Methergine solely as postpartum anti-hemorrhagic agents, RhoGAM for the prevention of Rh sensitization, intravenous fluids for stabilization, vitamin K, eye prophylactics, and other drugs or procedures in keeping with current midwifery standards, as determined by the Department, and the procurement of prescriptions for such medications by a licensed midwife.

(d) The rules adopted by the Department under this Section may not:

(1) require a licensed midwife to have a nursing or nurse-midwifery degree or diploma;

(2) require a licensed midwife to practice midwifery under the supervision of or in collaboration with another healthcare provider;

(3) require a licensed midwife to enter into an agreement, written or otherwise, with another health care provider; and

(4) permit a licensed midwife to use forceps, a vacuum extraction, or Cytotec or its generic equivalent.

(e) The Department shall, on a quarterly basis, issue a status report to the Board of all complaints submitted to the Department related to the midwifery profession.

(f) The Department must verify that the North American Registry of Midwives meets and maintains all accreditation standards set forth by the National Commission of Certifying Agencies or a successor organization.

Section 45. Illinois Midwifery Board.

(a) There is created under the authority of the Department the Illinois Midwifery Board, which shall consist of 7 members appointed by the Secretary, 4 of whom shall be licensed midwives who carry the CPM credential, except that initial appointees must have at least 3 years of experience in the practice of midwifery in an out-of-hospital setting, be certified by the North American Registry of Midwives, and meet the qualifications for licensure set forth in this Act; one of whom shall be an obstetrician licensed under the Medical Practice Act of 1987 who has a minimum of 2 years of experience working or consulting with homebirth providers or, alternately, a family practice physician licensed under the Medical Practice Act of 1987 who has a minimum of 2 years of experience providing homebirth services; one of whom shall be a certified nurse midwife who has at least 2 years of experience in providing home birth services; and one of whom shall be a knowledgeable public member who has given birth with the assistance of a certified professional midwife in an out-of-hospital birth setting. Board members shall serve 4-year terms, except that in the case of initial appointments, terms shall be staggered as follows: 3 members shall serve for 4 years, 2 members shall serve for 3 years, and 2 members shall serve for 2 years. The Board shall annually elect a chairperson and vice chairperson.

(b) Any appointment made to fill a vacancy shall be for the unexpired portion of the term. Appointments to fill vacancies shall be made in the same manner as original appointments. No Board member may be reappointed for a term that would cause his or her continuous service on the Board to exceed 9 years.

(c) Board membership must have reasonable representation from different geographic areas of this State.

(d) The members of the Board shall be reimbursed for all legitimate, necessary, and authorized expenses incurred in attending the meetings of the Board.

(e) The Secretary may remove any member for cause at any time prior to the expiration of his or her term.

(f) A majority of the Board members currently appointed shall constitute a quorum. A vacancy in the membership of the Board shall not impair the right of a quorum to perform all of the duties of the Board.

(g) The Board shall provide the Department with recommendations concerning the administration of this Act and perform each of the following duties:

(1) Recommend to the Department the adoption and, from time to time, the revision of any rules that may be necessary to carry out the provisions of this Act, including those that are designed to protect the health, safety, and welfare of the public.

(2) Conduct hearings and disciplinary conferences on disciplinary charges of licensees.

(3) Report to the Department, upon completion of a hearing, the disciplinary actions recommended to be taken against a person found in violation of this Act.

(4) Recommend the approval, denial of approval, and withdrawal of approval of required education and continuing educational programs.

(h) The Secretary shall give due consideration to all recommendations of the Board. If the Secretary takes action contrary to a recommendation of the Board, the Secretary must promptly provide a written explanation of that action.

(i) The Board may recommend to the Secretary that one or more licensed midwives be selected by the Secretary to assist in any investigation under this Act. Compensation shall be provided to any licensee who provides assistance under this subsection (i), in an amount determined by the Secretary.

(j) Members of the Board shall be immune from suit in an action based upon a disciplinary proceeding or other activity performed in good faith as a member of the Board, except for willful or wanton misconduct.

Section 50. Qualifications.

(a) A person is qualified for licensure as a midwife if that person meets each of the following qualifications:

(1) He or she has successfully completed a program of midwifery education approved by the North American Registry of Midwives which includes both didactic and clinical experience, the sum of which, on average, takes 3 to 5 years to complete.

(A) The didactic component of the educational program required under item (1) of this Section must include the procurement of knowledge, which may be demonstrated in either a classroom or clinical setting, of at least all of the following subject matters:

(i) Midwifery counseling, education, and communication, including childbirth education; the physical and emotional process of pregnancy and birth; informed consent; confidentiality; diet, nutrition, and vitamins; prenatal testing and lab work; female reproductive anatomy and physiology; prenatal exercise; breast self-exams; environmental and teratogenic hazards to pregnancy; the benefits and risks of birth site options; preparing for birth at home or at a birth center; and an emergency care plan.

(ii) General healthcare skills, including universal precautions and aseptic techniques; recognizing and managing symptoms of shock; adult and infant cardio-pulmonary resuscitation (CPR); the benefits and risks of ultrasound; and the appropriate use of medications in childbirth, such as lidocaine or other numbing agents for repair of lacerations, medical oxygen, methergine and pitocin to prevent postpartum hemorrhage, eye prophylaxis, RhoGAM, and vitamin K.

(iii) The appropriate use and care of equipment, including bags and masks; bulb syringes; delee suction; hemostats; lancets; suturing equipment; urinary catheters; and vacutainer collection tubes.

(iv) The appropriate evaluation of laboratory records, including records related to hematocrit; blood sugar; HIV; Hepatitis B and C; Rubella; Syphilis; Group B Strep; Gonorrhea cultures; blood type and Rh factors; Rh antibodies; Chlamydia, and PAP smears.

(v) Maternal health assessment, including health, reproductive, and family health history and complete initial physical examinations to identify normalcy, including examinations related to the head, eyes, ears, nose, and throat; weight and height; vital signs; thyroid; lymph glands; breasts; reflexes; heart and lungs; abdominal palpatations; kidney pain; pelvic landmarks, uterus, cervix, and vagina; musculo-skeletal system; and vascular system.

(vi) Prenatal care, including routine prenatal examinations for health and well-being; signs and symptoms of infection; vital signs; nutritional status; blood work or lab results; urine for glucose, protein, and ketones; fetal heart rate; assessment of fetal growth and well-being; and fetal position by palpation.

(vii) The recognition of and response to or referral for potential complications, including bleeding; hypertension; any abnormal signs in the prenatal exam, including without limitation blood work and growth; malpresentation; multiple gestation; vaginal birth after cesarean; pre-term labor; post-date pregnancy; and premature rupture of membranes.

(viii) Labor, birth, and immediate postpartum, including signs of prodromal or active labor; maternal comfort measures for labor; maternal vital signs; normal and abnormal labor patterns; fetal lie, presentation, position, and descent; effacement and dilation of the cervix; and normal, spontaneous, and vaginal birth.

(ix) The appropriate response to abnormal conditions in labor, including signs of fetal distress; variations in presentation; maternal exhaustion; and excessive bleeding.

(x) The immediate care and assessment of the newborn.

(xi) The immediate care and assessment of the mother.

(xii) The delivery of the placenta.

(xiii) The assessment and repair of the perineum.

(xiv) Postpartum, including the daily and weekly assessment of the mother and newborn; breastfeeding support; the filing of birth certificates; and assessing for postpartum depression, uterine or breast infections, and abnormal newborn jaundice and referring as necessary.

(xv) Well baby care, including the assessment of normal or abnormal newborn conditions and referral, as necessary, in first six weeks, such as respirations; temperature; heart rate and rhythm; appropriate weight gain; appropriate size and growth; reflexes; elimination patterns; feeding patterns; thrush; jaundice; diaper rash; cradle cap; colic; and any significant deviation from normalcy.

(xvi) Metabolic screening for the newborn.

(B) The clinical component of the educational process must do each of the following:

(i) Include prenatal, intrapartal, and postpartal care as well as newborn care.

(ii) Be at least one year in duration.

(iii) Be equivalent to 1,350 clinical contact hours under the direct supervision of one or more preceptors approved by the North American Registry of Midwives.

(iv) Be based upon a job analyses designed and implemented in accordance with the standards set by the National Commission on Certifying Agencies or its successor, which identifies core topics that must be mastered for the performance of midwifery skills in an out-of-hospital setting.

(v) Require the student to receive an assessment of competency as an assistant at a minimum of 20 births and as the primary midwife at a minimum of 75 prenatal exams, 20 initial exams, 20 births, 20 newborn exams, and 40 postpartum exams.

(vi) Include certification in adult CPR and infant CPR or neonatal resuscitation.

(vii) Document clinical experience in an out-of-hospital setting.

(2) He or she has earned an associate's degree or 60 hours of college credit at an accredited institution of postsecondary education.

(3) He or she has completed a pharmacology class specific to home birth that is recommended by the Board, approved and administered by the Department, and taught by a licensed physician or certified nurse-midwife with at least 3 years of home birth experience.

(4) He or she has passed an 8-hour written and practical skills examination for the practice of midwifery that has been developed following the standards set by the National Commission for Certifying Agencies or a successor organization and is administered by the North American Registry of Midwives.

(5) He or she holds a valid CPM credential granted by the North American Registry of Midwives.

(b) An individual who has not completed the requirements of subsection (a) of this Section shall be deemed qualified for licensure as a midwife if that person holds a valid CNM or CM credential granted by the American Midwifery Certification Board and practices midwifery in an out-of-hospital setting.

Section 55. Conditional licensure. For a period of one year after the effective date of this Act, the Department may issue a conditional license to an applicant who submits acceptable proof to the Department that he or she has practiced midwifery prior to the effective date of this Act and has applied to the North American Registry of Midwives for certification as a certified professional midwife. A conditional license issued under this Section shall automatically terminate one year after the date of issue unless the applicant has, by such time, successfully completed the certification examination provided by the North American Registry of Midwives.

Section 60. Application; temporary licensure.

(a) Application for an original license must be made to the Department in writing on forms prescribed by the Department and must be accompanied by the required fee, which shall be nonrefundable. The application shall require all information that, in the judgment of the Department, shall enable the Department to pass on the qualifications of an applicant for licensure.

(b) Applicants for licensure under this Act have 2 years after the date of application to complete the application process. If the process has not been completed in 2 years, the application shall be denied and the fee forfeited, and the applicant must reapply and meet all requirements in effect at the time of reapplication.

(c) Pending the issuance of a license, the Department may grant an applicant a temporary license to practice midwifery as a licensed midwife if the Department is satisfied that the applicant holds an active, unencumbered license in good standing in another jurisdiction.

Section 65. Social Security Number on application. In addition to any other information required to be contained in the application, every application for an original, renewal, reinstated, or restored license under this Act shall include the applicant's Social Security Number.

Section 70. Licensure by endorsement. Upon the payment of any applicable licensure fees, the Department may issue a license under this Act to an applicant licensed, registered, or certified under the laws of another jurisdiction if the requirements for licensure, registration, or certification in that jurisdiction are, on the date of licensure, registration, or certification, substantially equivalent to the requirements of this Act.

Section 75. Continuing education.

(a) The Department shall adopt rules of continuing education for persons licensed under this Act that require at least 25 hours of continuing education and 5 hours of peer review, per 3-year license renewal cycle.

(b) The rules shall require the licensed midwife to maintain CPM certification by meeting all the requirements set forth by the North American Registry of Midwives or to maintain CNM or CM certification by meeting all the requirements set forth by the American Midwifery Certification Board.

(c) Each licensee is responsible for maintaining records of completion of continuing education and shall be prepared to produce the records when requested by the Department.

(d) Continuing education requirements may be waived in cases of extreme hardship, as defined by rules of the Department.

Section 80. Inactive status.

(a) A licensed midwife who notifies the Department in writing on forms prescribed by the Department may elect to place his or her license on an inactive status and shall be excused from payment of renewal fees until he or she notifies the Department in writing of his or her intent to restore the license.

(b) A licensed midwife whose license is on inactive status may not practice licensed midwifery in the State of Illinois.

(c) A licensed midwife requesting restoration from inactive status shall be required to pay the current renewal fee and to restore his or her license, as provided by the Department by rule.

(d) Any licensee who engages in the practice of midwifery while his or her license is lapsed or on inactive status shall be considered to be practicing without a license, which shall be grounds for discipline.

Section 85. Renewal, reinstatement, or restoration of licensure; military service.

(a) The expiration date and renewal period for each license issued under this Act shall be set by the Department by rule.

(b) All renewal applicants shall provide proof of having met the requirements of continuing education set forth by the North American Registry of Midwives or the American Midwifery Certification Board. The Department shall, by rule, provide for an orderly process for the reinstatement of licenses that have not been renewed due to failure to meet continuing education requirements.

(c) Any licensed midwife who has permitted his or her license to expire or who has had his or her license on inactive status may have his or her license restored by making application to the Department and filing proof acceptable to the Department of fitness to have the license restored and by paying the required fees. Proof of fitness may include evidence attesting to active lawful practice in another jurisdiction.

(d) The Department shall determine, by an evaluation program established by rule, fitness for restoration of a license under this Section and shall establish procedures and requirements for restoration.

(e) Any licensed midwife whose license expired while he or she was (i) in federal service on active duty with the Armed Forces of the United States or the State Militia and called into service or training or (ii) in training or education under the supervision of the United States preliminary to induction into the military service may have his or her license restored without paying any lapsed renewal fees, if, within 2 years after honorable termination of service, training, or education, he or she furnishes the Department with satisfactory evidence to the effect that he or she has been so engaged.

Section 90. Roster. The Department shall maintain a roster of the names and addresses of all licensees and of all persons whose licenses have been suspended or revoked. This roster shall be available upon written request and payment of the required fee.

Section 95. Fees.

(a) The Department shall, by rule, provide for a schedule of fees for the administration and enforcement of this Act, including without limitation original licensure, renewal, and restoration, which fees shall be nonrefundable.

(b) All fees collected under this Act shall be deposited into the General Professions Dedicated Fund and appropriated to the Department for the ordinary and contingent expenses of the Department in the administration of this Act.

Section 100. Returned checks; fines. Any person who delivers a check or other payment to the Department that is returned to the Department unpaid by the financial institution upon which it is drawn shall pay to the Department, in addition to the amount already owed to the Department, a fine of $50. The fines imposed by this Section are in addition to any other discipline provided under this Act for unlicensed practice or practice on a non-renewed license. The Department shall notify the person that fees and fines shall be paid to the Department by certified check or money order within 30 calendar days after the notification. If, after the expiration of 30 days from the date of the notification, the person has failed to submit the necessary remittance, the Department shall automatically terminate the license or deny the application, without hearing. If, after termination or denial, the person seeks a license, he or she shall apply to the Department for restoration or issuance of the license and pay all fees and fines due to the Department. The Department may establish a fee for the processing of an application for restoration of a license to defray all expenses of processing the application. The Secretary may waive the fines due under this Section in individual cases where the Secretary finds that the fines would be unreasonable or unnecessarily burdensome.

Section 105. Unlicensed practice; civil penalty. Any person who practices, offers to practice, attempts to practice, or holds himself or herself out to practice midwifery or as a midwife without being licensed under this Act shall, in addition to any other penalty provided by law, pay a civil penalty to the Department in an amount not to exceed $5,000 for each offense, as determined by the Department. The civil penalty shall be assessed by the Department after a hearing is held in accordance with the provisions set forth in this Act regarding the provision of a hearing for the discipline of a licensee. The civil penalty shall be paid within 60 days after the effective date of the order imposing the civil penalty. The order shall constitute a judgment and may be filed and execution had thereon in the same manner as any judgment from any court of record. The Department may investigate any unlicensed activity.

Section 110. Exemption from civil liability. Exemption from civil liability for emergency care and for services rendered without compensation is as provided in the Good Samaritan Act.

Section 115. Grounds for disciplinary action. The Department may refuse to issue or to renew or may revoke, suspend, place on probation, reprimand or take other disciplinary action as the Department may deem proper, including fines not to exceed $5,000 for each violation, with regard to any licensee or license for any one or combination of the following causes:

(1) Violations of this Act or its rules.

(2) Material misstatement in furnishing information to the Department.

(3) Conviction of any crime under the laws of any U.S. jurisdiction that is (i) a felony, (ii) a misdemeanor, an essential element of which is dishonesty, or (iii) directly related to the practice of the profession.

(4) Making any misrepresentation for the purpose of obtaining a license.

(5) Professional incompetence or gross negligence.

(6) Gross malpractice.

(7) Aiding or assisting another person in violating any provision of this Act or its rules.

(8) Failing to provide information within 60 days in response to a written request made by the Department.

(9) Engaging in dishonorable, unethical, or unprofessional conduct of a character likely to deceive, defraud, or harm the public.

(10) Habitual or excessive use or addiction to alcohol, narcotics, stimulants, or any other chemical agent or drug that results in the inability to practice with reasonable judgment, skill, or safety.

(11) Discipline by another U.S. jurisdiction or foreign nation if at least one of the grounds for the discipline is the same or substantially equivalent to those set forth in this Act.

(12) Directly or indirectly giving to or receiving from any person, firm, corporation, partnership, or association any fee, commission, rebate, or other form of compensation for any professional services not actually or personally rendered. This shall not be deemed to include rent or other remunerations paid to an individual, partnership, or corporation by a licensed midwife for the lease, rental, or use of space, owned or controlled by the individual, partnership, corporation, or association.

(13) A finding by the Department that the licensee, after having his or her license placed on probationary status, has violated the terms of probation.

(14) Abandonment of a patient without cause.

(15) Willfully making or filing false records or reports relating to a licensee's practice, including, but not limited to, false records filed with State agencies or departments.

(16) Physical illness or mental illness, including, but not limited to, deterioration through the aging process or loss of motor skill that results in the inability to practice the profession with reasonable judgment, skill, or safety.

(17) Failure to provide a patient with a copy of his or her record upon the written request of the patient.

(18) Conviction by any court of competent jurisdiction, either within or without this State, of any violation of any law governing the practice of licensed midwifery or conviction in this or another state of any crime that is a felony under the laws of this State or conviction of a felony in a federal court, if the Department determines, after investigation, that the person has not been sufficiently rehabilitated to warrant the public trust.

(19) A finding that licensure has been applied for or obtained by fraudulent means.

(20) Being named as a perpetrator in an indicated report by the Department of Healthcare and Family Services under the Abused and Neglected Child Reporting Act and upon proof by clear and convincing evidence that the licensee has caused a child to be an abused child or a neglected child, as defined in the Abused and Neglected Child Reporting Act.

(21) Practicing or attempting to practice under a name other than the full name shown on a license issued under this Act.

(22) Immoral conduct in the commission of any act, such as sexual abuse, sexual misconduct, or sexual exploitation, related to the licensee's practice.

(23) Maintaining a professional relationship with any person, firm, or corporation when the licensed midwife knows or should know that a person, firm, or corporation is violating this Act.

(24) Failure to provide satisfactory proof of having participated in approved continuing education programs as determined by the Board and approved by the Secretary. Exceptions for extreme hardships are to be defined by the Department by rule.

(b) The Department may refuse to issue or may suspend the license of any person who fails to (i) file a tax return or to pay the tax, penalty, or interest shown in a filed return or (ii) pay any final assessment of the tax, penalty, or interest, as required by any tax Act administered by the Illinois Department of Revenue, until the time that the requirements of that tax Act are satisfied.

(c) The determination by a circuit court that a licensee is subject to involuntary admission or judicial admission as provided in the Mental Health and Developmental Disabilities Code operates as an automatic suspension. The suspension shall end only upon a finding by a court that the patient is no longer subject to involuntary admission or judicial admission, the issuance of an order so finding and discharging the patient, and the recommendation of the Board to the Secretary that the licensee be allowed to resume his or her practice.

(d) In enforcing this Section, the Department, upon a showing of a possible violation, may compel any person licensed to practice under this Act or who has applied for licensure or certification pursuant to this Act to submit to a mental or physical examination, or both, as required by and at the expense of the Department. The examining physicians shall be those specifically designated by the Department. The Department may order an examining physician to present testimony concerning the mental or physical examination of the licensee or applicant. No information shall be excluded by reason of any common law or statutory privilege relating to communications between the licensee or applicant and the examining physician. The person to be examined may have, at his or her own expense, another physician of his or her choice present during all aspects of the examination. Failure of any person to submit to a mental or physical examination when directed shall be grounds for suspension of a license until the person submits to the examination if the Department finds, after notice and hearing, that the refusal to submit to the examination was without reasonable cause.

If the Department finds an individual unable to practice because of the reasons set forth in this subsection (d), the Department may require that individual to submit to care, counseling, or treatment by physicians approved or designated by the Department, as a condition, term, or restriction for continued, reinstated, or renewed licensure to practice or, in lieu of care, counseling, or treatment, the Department may file a complaint to immediately suspend, revoke, or otherwise discipline the license of the individual. Any person whose license was granted, reinstated, renewed, disciplined, or supervised subject to such terms, conditions, or restrictions and who fails to comply with such terms, conditions, or restrictions shall be referred to the Secretary for a determination as to whether or not the person shall have his or her license suspended immediately, pending a hearing by the Department.

In instances in which the Secretary immediately suspends a person's license under this Section, a hearing on that person's license must be convened by the Department within 15 days after the suspension and completed without appreciable delay. The Department may review the person's record of treatment and counseling regarding the impairment, to the extent permitted by applicable federal statutes and regulations safeguarding the confidentiality of medical records.

A person licensed under this Act and affected under this subsection (d) shall be afforded an opportunity to demonstrate to the Department that he or she can resume practice in compliance with acceptable and prevailing standards under the provisions of his or her license.

Section 120. Failure to pay restitution. The Department, without further process or hearing, shall suspend the license or other authorization to practice of any person issued under this Act who has been certified by court order as not having paid restitution to a person under Section 8A-3.5 of the Illinois Public Aid Code or under Section 46-1 of the Criminal Code of 1961. A person whose license or other authorization to practice is suspended under this Section is prohibited from practicing until restitution is made in full.

Section 125. Injunction; cease and desist order.

(a) If a person violates any provision of this Act, the Secretary may, in the name of the People of the State of Illinois, through the Attorney General or the State's Attorney of any county in which the action is brought, petition for an order enjoining the violation or enforcing compliance with this Act. Upon the filing of a verified petition in court, the court may issue a temporary restraining order, without notice or bond, and may preliminarily and permanently enjoin the violation. If it is established that the person has violated or is violating the injunction, the court may punish the offender for contempt of court. Proceedings under this Section shall be in addition to, and not in lieu of, all other remedies and penalties provided by this Act.

(b) If any person practices as a licensed midwife or holds himself or herself out as a licensed midwife without being licensed under the provisions of this Act, then any licensed midwife, any interested party, or any person injured thereby may, in addition to the Secretary, petition for relief as provided in subsection (a) of this Section.

(c) Whenever, in the opinion of the Department, any person violates any provision of this Act, the Department may issue a rule to show cause why an order to cease and desist should not be entered against that person. The rule shall clearly set forth the grounds relied upon by the Department and shall provide a period of 7 days after the date of the rule to file an answer to the satisfaction of the Department. Failure to answer to the satisfaction of the Department shall cause an order to cease and desist to be issued immediately.

Section 130. Violation; criminal penalty.

(a) Whoever knowingly practices or offers to practice midwifery in this State without being licensed for that purpose or exempt under this Act shall be guilty of a Class A misdemeanor and, for each subsequent conviction, shall be guilty of a Class 4 felony.

(b) Any person who is found to have violated any other provision of this Act is guilty of a Class A misdemeanor.

(c) Notwithstanding any other provision of this Act, all criminal fines, moneys, or other property collected or received by the Department under this Section or any other State or federal statute, including, but not limited to, property forfeited to the Department under Section 505 of the Illinois Controlled Substances Act or Section 85 of the Methamphetamine Control and Community Protection Act, shall be deposited into the Professional Regulation Evidence Fund.

Section 135. Investigation; notice; hearing. The Department may investigate the actions of any applicant or of any person or persons holding or claiming to hold a license under this Act. Before refusing to issue or to renew or taking any disciplinary action regarding a license, the Department shall, at least 30 days prior to the date set for the hearing, notify in writing the applicant or licensee of the nature of any charges and that a hearing shall be held on a date designated. The Department shall direct the applicant or licensee to file a written answer with the Board under oath within 20 days after the service of the notice and inform the applicant or licensee that failure to file an answer shall result in default being taken against the applicant or licensee and that the license may be suspended, revoked, or placed on probationary status or that other disciplinary action may be taken, including limiting the scope, nature, or extent of practice, as the Secretary may deem proper. Written notice may be served by personal delivery or certified or registered mail to the respondent at the address of his or her last notification to the Department. If the person fails to file an answer after receiving notice, his or her license may, in the discretion of the Department, be suspended, revoked, or placed on probationary status, or the Department may take any disciplinary action deemed proper, including limiting the scope, nature, or extent of the person's practice or the imposition of a fine, without a hearing, if the act or acts charged constitute sufficient grounds for such action under this Act. At the time and place fixed in the notice, the Board shall proceed to hear the charges and the parties or their counsel shall be accorded ample opportunity to present such statements, testimony, evidence, and argument as may be pertinent to the charges or to their defense. The Board may continue a hearing from time to time.

Section 140. Formal hearing; preservation of record. The Department, at its expense, shall preserve a record of all proceedings at the formal hearing of any case. The notice of hearing, complaint, and all other documents in the nature of pleadings and written motions filed in the proceedings, the transcript of testimony, the report of the Board or hearing officer, and order of the Department shall be the record of the proceeding. The Department shall furnish a transcript of the record to any person interested in the hearing upon payment of the fee required under Section 2105-115 of the Department of Professional Regulation Law.

Section 145. Witnesses; production of documents; contempt. Any circuit court may upon application of the Department or its designee or of the applicant or licensee against whom proceedings under Section 115 of this Act are pending, enter an order requiring the attendance of witnesses and their testimony and the production of documents, papers, files, books, and records in connection with any hearing or investigation. The court may compel obedience to its order by proceedings for contempt.

Section 150. Subpoena; oaths. The Department shall have the power to subpoena and bring before it any person in this State and to take testimony either orally or by deposition or both with the same fees and mileage and in the same manner as prescribed in civil cases in circuit courts of this State. The Secretary, the designated hearing officer, and every member of the Board has the power to administer oaths to witnesses at any hearing that the Department is authorized to conduct and any other oaths authorized in any Act administered by the Department. Any circuit court may, upon application of the Department or its designee or upon application of the person against whom proceedings under this Act are pending, enter an order requiring the attendance of witnesses and their testimony, and the production of documents, papers, files, books, and records in connection with any hearing or investigation. The court may compel obedience to its order by proceedings for contempt.

Section 155. Findings of fact, conclusions of law, and recommendations. At the conclusion of the hearing the Board shall present to the Secretary a written report of its findings of fact, conclusions of law, and recommendations. The report shall contain a finding as to whether or not the accused person violated this Act or failed to comply with the conditions required under this Act. The Board shall specify the nature of the violation or failure to comply and shall make its recommendations to the Secretary.

The report of findings of fact, conclusions of law, and recommendations of the Board shall be the basis for the Department's order. If the Secretary disagrees in any regard with the report of the Board, the Secretary may issue an order in contravention of the report. The finding is not admissible in evidence against the person in a criminal prosecution brought for the violation of this Act, but the hearing and findings are not a bar to a criminal prosecution brought for the violation of this Act.

Section 160. Hearing officer. The Secretary may appoint any attorney duly licensed to practice law in the State of Illinois to serve as the hearing officer in any action for departmental refusal to issue, renew, or license an applicant or for disciplinary action against a licensee. The hearing officer shall have full authority to conduct the hearing. The hearing officer shall report his or her findings of fact, conclusions of law, and recommendations to the Board and the Secretary. The Board shall have 60 calendar days after receipt of the report to review the report of the hearing officer and present its findings of fact, conclusions of law, and recommendations to the Secretary. If the Board fails to present its report within the 60-day period, the Secretary may issue an order based on the report of the hearing officer. If the Secretary disagrees with the recommendation of the Board or the hearing officer, he or she may issue an order in contravention of that recommendation.

Section 165. Service of report; motion for rehearing. In any case involving the discipline of a license, a copy of the Board's report shall be served upon the respondent by the Department, either personally or as provided in this Act for the service of the notice of hearing. Within 20 days after the service, the respondent may present to the Department a motion in writing for a rehearing that shall specify the particular grounds for rehearing. If no motion for rehearing is filed, then upon the expiration of the time specified for filing a motion, or if a motion for rehearing is denied, then upon the denial, the Secretary may enter an order in accordance with this Act. If the respondent orders from the reporting service and pays for a transcript of the record within the time for filing a motion for rehearing, the 20-day period within which the motion may be filed shall commence upon the delivery of the transcript to the respondent.

Section 170. Rehearing. Whenever the Secretary is satisfied that substantial justice has not been done in the revocation, suspension, or refusal to issue or renew a license, the Secretary may order a rehearing by the same or another hearing officer or by the Board.

Section 175. Prima facie proof. An order or a certified copy thereof, over the seal of the Department and purporting to be signed by the Secretary, shall be prima facie proof of the following:

(1) that the signature is the genuine signature of the Secretary;

(2) that such Secretary is duly appointed and qualified; and

(3) that the Board and its members are qualified to act.

Section 180. Restoration of license. At any time after the suspension or revocation of any license, the Department may restore the license to the accused person, unless after an investigation and a hearing the Department determines that restoration is not in the public interest.

Section 185. Surrender of license. Upon the revocation or suspension of any license, the licensee shall immediately surrender the license to the Department. If the licensee fails to do so, the Department shall have the right to seize the license.

Section 190. Summary suspension. The Secretary may summarily suspend the license of a licensee under this Act without a hearing, simultaneously with the institution of proceedings for a hearing provided for in this Act, if the Secretary finds that evidence in his or her possession indicates that continuation in practice would constitute an imminent danger to the public. In the event that the Secretary summarily suspends a license without a hearing, a hearing by the Department must be held within 30 days after the suspension has occurred.

Section 195. Certificate of record. The Department shall not be required to certify any record to the court or file any answer in court or otherwise appear in any court in a judicial review proceeding, unless there is filed in the court, with the complaint, a receipt from the Department acknowledging payment of the costs of furnishing and certifying the record. Failure on the part of the plaintiff to file a receipt in court shall be grounds for dismissal of the action.

Section 200. Administrative Review Law. All final administrative decisions of the Department are subject to judicial review under the Administrative Review Law and its rules. The term "administrative decision" is defined as in Section 3-101 of the Code of Civil Procedure.

Section 205. Illinois Administrative Procedure Act. The Illinois Administrative Procedure Act is hereby expressly adopted and incorporated in this Act as if all of the provisions of such Act were included in this Act, except that the provision of subsection (d) of Section 10-65 of the Illinois Administrative Procedure Act that provides that at hearings the licensee has the right to show compliance with all lawful requirements for retention, continuation, or renewal of the license is specifically excluded. For purposes of this Act, the notice required under Section 10-25 of the Illinois Administrative Procedure Act is deemed sufficient when mailed to the last known address of a party.

Section 210. Home rule. Pursuant to paragraph (h) of Section 6 of Article VII of the Illinois Constitution of 1970, the power to regulate and issue licenses for the practice of midwifery shall, except as may otherwise be provided within and pursuant to the provisions of this Act, be exercised by the State and may not be exercised by any unit of local government, including home rule units.

Section 215. Severability. The provisions of this Act are severable under Section 1.31 of the Statute on Statutes.

Section 900. The Regulatory Sunset Act is amended by adding Section 4.28 as follows:

(5 ILCS 80/4.28 new)

Sec. 4.28. Act repealed on January 1, 2018. The following Act is repealed on January 1, 2018:

The Midwifery Licensure Act.

Section 905. 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 December 31, 2008)

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, including without limitation persons engaged in the practice of midwifery who are licensed under the Midwifery Licensure Act;

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

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

(b) (Blank).

(Source: P.A. 93-379, eff. 7-24-03.)

Section 910. 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, including without limitation any person engaged in the practice of midwifery who is licensed under the Midwifery Licensure Act.

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

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.)

Section 915. The Good Samaritan Act is amended by adding Section 41 as follows:

(745 ILCS 49/41 new)

Sec. 41. Midwives; exemption from civil liability for emergency care or services rendered without compensation. Any person licensed as a midwife under the Midwifery Licensure Act who in good faith provides emergency care without fee or renders midwifery services without fee to a person shall not, as a result of her or his acts or omissions, except for willful or wanton misconduct on the part of the person, in providing the care, be liable for civil damages.

Section 999. Effective date. This Act takes effect upon becoming law.