Illinois General Assembly - Full Text of HB2431
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Full Text of HB2431  102nd General Assembly


Sen. David Koehler

Filed: 10/25/2021





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2    AMENDMENT NO. ______. Amend House Bill 2431, AS AMENDED,
3by replacing everything after the enacting clause with the
5    "Section 5. The Illinois Administrative Procedure Act is
6amended by adding Section 5-45.20 as follows:
7    (5 ILCS 100/5-45.20 new)
8    Sec. 5-45.20. Emergency rulemaking; Department of Public
9Health. To provide for the expeditious and timely
10implementation of the provisions of Sections 3.50 of the
11Emergency Medical Services (EMS) Systems Act, emergency rules
12implementing the changes made to Sections 3.50 of the
13Emergency Medical Services (EMS) Systems Act by this
14amendatory Act of the 102nd General Assembly may be adopted by
15the Department of Public Health in accordance with Section
165-45. The adoption of emergency rules authorized by Section



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15-45 and this Section is deemed to be necessary for the public
2interest, safety, and welfare.
3    Section 10. The Emergency Medical Services (EMS) Systems
4Act is amended by changing Sections 3.50 and 3.85 as follows:
5    (210 ILCS 50/3.50)
6    Sec. 3.50. Emergency Medical Services personnel licensure
8    (a) "Emergency Medical Technician" or "EMT" means a person
9who has successfully completed a course in basic life support
10as approved by the Department, is currently licensed by the
11Department in accordance with standards prescribed by this Act
12and rules adopted by the Department pursuant to this Act, and
13practices within an EMS System. A valid Emergency Medical
14Technician-Basic (EMT-B) license issued under this Act shall
15continue to be valid and shall be recognized as an Emergency
16Medical Technician (EMT) license until the Emergency Medical
17Technician-Basic (EMT-B) license expires.
18    (b) "Emergency Medical Technician-Intermediate" or "EMT-I"
19means a person who has successfully completed a course in
20intermediate life support as approved by the Department, is
21currently licensed by the Department in accordance with
22standards prescribed by this Act and rules adopted by the
23Department pursuant to this Act, and practices within an
24Intermediate or Advanced Life Support EMS System.



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1    (b-5) "Advanced Emergency Medical Technician" or "A-EMT"
2means a person who has successfully completed a course in
3basic and limited advanced emergency medical care as approved
4by the Department, is currently licensed by the Department in
5accordance with standards prescribed by this Act and rules
6adopted by the Department pursuant to this Act, and practices
7within an Intermediate or Advanced Life Support EMS System.
8    (c) "Paramedic (EMT-P)" means a person who has
9successfully completed a course in advanced life support care
10as approved by the Department, is licensed by the Department
11in accordance with standards prescribed by this Act and rules
12adopted by the Department pursuant to this Act, and practices
13within an Advanced Life Support EMS System. A valid Emergency
14Medical Technician-Paramedic (EMT-P) license issued under this
15Act shall continue to be valid and shall be recognized as a
16Paramedic license until the Emergency Medical
17Technician-Paramedic (EMT-P) license expires.
18    (c-5) "Emergency Medical Responder" or "EMR (First
19Responder)" means a person who has successfully completed a
20course in emergency medical response as approved by the
21Department and provides emergency medical response services in
22accordance with the level of care established by the National
23EMS Educational Standards Emergency Medical Responder course
24as modified by the Department, or who provides services as
25part of an EMS System response plan, as approved by the
26Department, of that EMS System. The Department shall have the



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1authority to adopt rules governing the curriculum, practice,
2and necessary equipment applicable to Emergency Medical
4    On August 15, 2014 (the effective date of Public Act
598-973), a person who is licensed by the Department as a First
6Responder and has completed a Department-approved course in
7first responder defibrillator training based on, or equivalent
8to, the National EMS Educational Standards or other standards
9previously recognized by the Department shall be eligible for
10licensure as an Emergency Medical Responder upon meeting the
11licensure requirements and submitting an application to the
12Department. A valid First Responder license issued under this
13Act shall continue to be valid and shall be recognized as an
14Emergency Medical Responder license until the First Responder
15license expires.
16    (c-10) All EMS Systems and licensees shall be fully
17compliant with the National EMS Education Standards, as
18modified by the Department in administrative rules, within 24
19months after the adoption of the administrative rules.
20    (d) The Department shall have the authority and
21responsibility to:
22        (1) Prescribe education and training requirements,
23    which includes training in the use of epinephrine, for all
24    levels of EMS personnel except for EMRs, based on the
25    National EMS Educational Standards and any modifications
26    to those curricula specified by the Department through



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1    rules adopted pursuant to this Act.
2        (1.5) Adopt rules permitting immediate reciprocity to
3    all EMS personnel who have received a certification issued
4    by the National Registry of Emergency Medical Technicians,
5    allowing such individuals to operate in a provisional
6    status until the Illinois license is issued. To operate as
7    EMS personnel on provisional status, an individual must
8    have applied for licensure with the Department and meet
9    all requirements for licensure under this Act.
10        (2) Prescribe licensure testing requirements for all
11    levels of EMS personnel, which shall include a requirement
12    that all phases of instruction, training, and field
13    experience be completed before taking the appropriate
14    licensure examination. Candidates may elect to take the
15    appropriate National Registry examination in lieu of the
16    Department's examination, but are responsible for making
17    their own arrangements for taking the National Registry
18    examination. In prescribing licensure testing requirements
19    for honorably discharged members of the armed forces of
20    the United States under this paragraph (2), the Department
21    shall ensure that a candidate's military emergency medical
22    training, emergency medical curriculum completed, and
23    clinical experience, as described in paragraph (2.5), are
24    recognized.
25        (2.5) Review applications for EMS personnel licensure
26    from honorably discharged members of the armed forces of



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1    the United States with military emergency medical
2    training. Applications shall be filed with the Department
3    within one year after military discharge and shall
4    contain: (i) proof of successful completion of military
5    emergency medical training; (ii) a detailed description of
6    the emergency medical curriculum completed; and (iii) a
7    detailed description of the applicant's clinical
8    experience. The Department may request additional and
9    clarifying information. The Department shall evaluate the
10    application, including the applicant's training and
11    experience, consistent with the standards set forth under
12    subsections (a), (b), (c), and (d) of Section 3.10. If the
13    application clearly demonstrates that the training and
14    experience meet such standards, the Department shall offer
15    the applicant the opportunity to successfully complete a
16    Department-approved EMS personnel examination for the
17    level of license for which the applicant is qualified.
18    Upon passage of an examination, the Department shall issue
19    a license, which shall be subject to all provisions of
20    this Act that are otherwise applicable to the level of EMS
21    personnel license issued.
22        (3) License individuals as an EMR, EMT, EMT-I, A-EMT,
23    or Paramedic who have met the Department's education,
24    training and examination requirements.
25        (4) Prescribe annual continuing education and
26    relicensure requirements for all EMS personnel licensure



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1    levels.
2        (5) Relicense individuals as an EMD, EMR, EMT, EMT-I,
3    A-EMT, PHRN, PHAPRN, PHPA, or Paramedic every 4 years,
4    based on their compliance with continuing education and
5    relicensure requirements as required by the Department
6    pursuant to this Act. Every 4 years, a Paramedic shall
7    have 100 hours of approved continuing education, an EMT-I
8    and an advanced EMT shall have 80 hours of approved
9    continuing education, and an EMT shall have 60 hours of
10    approved continuing education. An Illinois licensed EMR,
11    EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN, PHPA, PHAPRN, or
12    PHRN whose license has been expired for less than 36
13    months may apply for reinstatement by the Department.
14    Reinstatement shall require that the applicant (i) submit
15    satisfactory proof of completion of continuing medical
16    education and clinical requirements to be prescribed by
17    the Department in an administrative rule; (ii) submit a
18    positive recommendation from an Illinois EMS Medical
19    Director attesting to the applicant's qualifications for
20    retesting; and (iii) pass a Department approved test for
21    the level of EMS personnel license sought to be
22    reinstated.
23        (6) Grant inactive status to any EMR, EMD, EMT, EMT-I,
24    A-EMT, Paramedic, ECRN, PHAPRN, PHPA, or PHRN who
25    qualifies, based on standards and procedures established
26    by the Department in rules adopted pursuant to this Act.



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1        (7) Charge a fee for EMS personnel examination,
2    licensure, and license renewal.
3        (8) Suspend, revoke, or refuse to issue or renew the
4    license of any licensee, after an opportunity for an
5    impartial hearing before a neutral administrative law
6    judge appointed by the Director, where the preponderance
7    of the evidence shows one or more of the following:
8            (A) The licensee has not met continuing education
9        or relicensure requirements as prescribed by the
10        Department;
11            (B) The licensee has failed to maintain
12        proficiency in the level of skills for which he or she
13        is licensed;
14            (C) The licensee, during the provision of medical
15        services, engaged in dishonorable, unethical, or
16        unprofessional conduct of a character likely to
17        deceive, defraud, or harm the public;
18            (D) The licensee has failed to maintain or has
19        violated standards of performance and conduct as
20        prescribed by the Department in rules adopted pursuant
21        to this Act or his or her EMS System's Program Plan;
22            (E) The licensee is physically impaired to the
23        extent that he or she cannot physically perform the
24        skills and functions for which he or she is licensed,
25        as verified by a physician, unless the person is on
26        inactive status pursuant to Department regulations;



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1            (F) The licensee is mentally impaired to the
2        extent that he or she cannot exercise the appropriate
3        judgment, skill and safety for performing the
4        functions for which he or she is licensed, as verified
5        by a physician, unless the person is on inactive
6        status pursuant to Department regulations;
7            (G) The licensee has violated this Act or any rule
8        adopted by the Department pursuant to this Act; or
9            (H) The licensee has been convicted (or entered a
10        plea of guilty or nolo contendere) by a court of
11        competent jurisdiction of a Class X, Class 1, or Class
12        2 felony in this State or an out-of-state equivalent
13        offense.
14        (9) Prescribe education and training requirements in
15    the administration and use of opioid antagonists for all
16    levels of EMS personnel based on the National EMS
17    Educational Standards and any modifications to those
18    curricula specified by the Department through rules
19    adopted pursuant to this Act.
20    (d-5) An EMR, EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN,
21PHAPRN, PHPA, or PHRN who is a member of the Illinois National
22Guard or an Illinois State Trooper or who exclusively serves
23as a volunteer for units of local government with a population
24base of less than 5,000 or as a volunteer for a not-for-profit
25organization that serves a service area with a population base
26of less than 5,000 may submit an application to the Department



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1for a waiver of the fees described under paragraph (7) of
2subsection (d) of this Section on a form prescribed by the
4    The education requirements prescribed by the Department
5under this Section must allow for the suspension of those
6requirements in the case of a member of the armed services or
7reserve forces of the United States or a member of the Illinois
8National Guard who is on active duty pursuant to an executive
9order of the President of the United States, an act of the
10Congress of the United States, or an order of the Governor at
11the time that the member would otherwise be required to
12fulfill a particular education requirement. Such a person must
13fulfill the education requirement within 6 months after his or
14her release from active duty.
15    (e) In the event that any rule of the Department or an EMS
16Medical Director that requires testing for drug use as a
17condition of the applicable EMS personnel license conflicts
18with or duplicates a provision of a collective bargaining
19agreement that requires testing for drug use, that rule shall
20not apply to any person covered by the collective bargaining
22    (f) At the time of applying for or renewing his or her
23license, an applicant for a license or license renewal may
24submit an email address to the Department. The Department
25shall keep the email address on file as a form of contact for
26the individual. The Department shall send license renewal



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1notices electronically and by mail to a licensee who provides
2the Department with his or her email address. The notices
3shall be sent at least 60 days prior to the expiration date of
4the license.
5(Source: P.A. 101-81, eff. 7-12-19; 101-153, eff. 1-1-20;
6102-558, eff. 8-20-21; 102-623, eff. 8-27-21.)
7    (210 ILCS 50/3.85)
8    Sec. 3.85. Vehicle Service Providers.
9    (a) "Vehicle Service Provider" means an entity licensed by
10the Department to provide emergency or non-emergency medical
11services in compliance with this Act, the rules promulgated by
12the Department pursuant to this Act, and an operational plan
13approved by its EMS System(s), utilizing at least ambulances
14or specialized emergency medical service vehicles (SEMSV).
15        (1) "Ambulance" means any publicly or privately owned
16    on-road vehicle that is specifically designed, constructed
17    or modified and equipped, and is intended to be used for,
18    and is maintained or operated for the emergency
19    transportation of persons who are sick, injured, wounded
20    or otherwise incapacitated or helpless, or the
21    non-emergency medical transportation of persons who
22    require the presence of medical personnel to monitor the
23    individual's condition or medical apparatus being used on
24    such individuals.
25        (2) "Specialized Emergency Medical Services Vehicle"



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1    or "SEMSV" means a vehicle or conveyance, other than those
2    owned or operated by the federal government, that is
3    primarily intended for use in transporting the sick or
4    injured by means of air, water, or ground transportation,
5    that is not an ambulance as defined in this Act. The term
6    includes watercraft, aircraft and special purpose ground
7    transport vehicles or conveyances not intended for use on
8    public roads.
9        (3) An ambulance or SEMSV may also be designated as a
10    Limited Operation Vehicle or Special-Use Vehicle:
11            (A) "Limited Operation Vehicle" means a vehicle
12        which is licensed by the Department to provide basic,
13        intermediate or advanced life support emergency or
14        non-emergency medical services that are exclusively
15        limited to specific events or locales.
16            (B) "Special-Use Vehicle" means any publicly or
17        privately owned vehicle that is specifically designed,
18        constructed or modified and equipped, and is intended
19        to be used for, and is maintained or operated solely
20        for the emergency or non-emergency transportation of a
21        specific medical class or category of persons who are
22        sick, injured, wounded or otherwise incapacitated or
23        helpless (e.g. high-risk obstetrical patients,
24        neonatal patients).
25            (C) "Reserve Ambulance" means a vehicle that meets
26        all criteria set forth in this Section and all



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1        Department rules, except for the required inventory of
2        medical supplies and durable medical equipment, which
3        may be rapidly transferred from a fully functional
4        ambulance to a reserve ambulance without the use of
5        tools or special mechanical expertise.
6    (b) The Department shall have the authority and
7responsibility to:
8        (1) Require all Vehicle Service Providers, both
9    publicly and privately owned, to function within an EMS
10    System.
11        (2) Require a Vehicle Service Provider utilizing
12    ambulances to have a primary affiliation with an EMS
13    System within the EMS Region in which its Primary Service
14    Area is located, which is the geographic areas in which
15    the provider renders the majority of its emergency
16    responses. This requirement shall not apply to Vehicle
17    Service Providers which exclusively utilize Limited
18    Operation Vehicles.
19        (3) Establish licensing standards and requirements for
20    Vehicle Service Providers, through rules adopted pursuant
21    to this Act, including but not limited to:
22            (A) Vehicle design, specification, operation and
23        maintenance standards, including standards for the use
24        of reserve ambulances;
25            (B) Equipment requirements;
26            (C) Staffing requirements; and



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1            (D) License renewal at intervals determined by the
2        Department, which shall be not less than every 4
3        years.
4        The Department's standards and requirements with
5    respect to vehicle staffing for private, nonpublic local
6    government employers must allow for alternative staffing
7    models that include an EMR who drives an ambulance with a
8    licensed EMT, EMT-I, A-EMT, Paramedic, or PHRN, as
9    appropriate, in the patient compartment providing care to
10    the patient pursuant to the approval of the EMS System
11    Program Plan developed and approved by the EMS Medical
12    Director for an EMS System. The Department shall monitor
13    the implementation and performance of alternative staffing
14    models and may issue a notice of termination of an
15    alternative staffing model only upon evidence that an EMS
16    System Program Plan is not being adhered to.
17        An EMS System Program Plan for a Basic Life Support
18    transport utilizing an EMR and an EMT shall include the
19    following:
20            (A) Alternative staffing models for a Basic Life
21        Support transport utilizing an EMR and an EMT shall
22        only be utilized for interfacility Basic Life Support
23        transports and medical appointments, excluding any
24        transport to or from a dialysis center.
25            (B) Protocols that shall include dispatch
26        procedures to properly screen and assess patients for



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1        EMR-staffed and EMT-staffed Basic Life Support
2        transport.
3            (C) A requirement that a provider shall implement
4        a quality assurance plan with mechanisms outlined to
5        audit dispatch screening and the outcome of transports
6        performed.
7            (D) The EMT shall have at least one year of
8        experience in performance of pre-hospital emergency
9        care.
10            (E) The licensed EMR must complete a defensive
11        driving course prior to participation in the
12        Department's alternative staffing model.
13            (F) The length of the EMS System Program Plan for a
14        Basic Life Support transport utilizing an EMR and an
15        EMT shall be for one year, and must be renewed annually
16        if proof of the criteria being met is submitted,
17        validated, and approved by the EMS Medical Director
18        for the EMS System and the Department.
19        Until October 1, 2022, the Department must require
20    each EMS System Program Plan to permit the utilization of
21    alternative staffing models for use of an EMR as the
22    driver and an EMT in the patient compartment for basic
23    life support services, an EMR as the driver and a
24    paramedic in the patient compartment for advanced life
25    support services, and an EMR as the driver and appropriate
26    critical care transport staffing in the patient



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1    compartment for critical care transport services. Each EMS
2    System Program Plan shall be required to implement
3    alternative staffing models no later than January 1, 2022.
4    Local governments and local government employees who
5    provide EMS services are not required to implement
6    alternative staffing models.
7        The Department must allow for an alternative rural
8    staffing model for those vehicle service providers that
9    serve a rural or semi-rural population of 10,000 or fewer
10    inhabitants and exclusively uses volunteers, paid-on-call,
11    or a combination thereof.
12        (4) License all Vehicle Service Providers that have
13    met the Department's requirements for licensure, unless
14    such Provider is owned or licensed by the federal
15    government. All Provider licenses issued by the Department
16    shall specify the level and type of each vehicle covered
17    by the license (BLS, ILS, ALS, ambulance, SEMSV, limited
18    operation vehicle, special use vehicle, reserve
19    ambulance).
20        (5) Annually inspect all licensed vehicles operated by
21    Vehicle Service Providers.
22        (6) Suspend, revoke, refuse to issue or refuse to
23    renew the license of any Vehicle Service Provider, or that
24    portion of a license pertaining to a specific vehicle
25    operated by the Provider, after an opportunity for a
26    hearing, when findings show that the Provider or one or



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1    more of its vehicles has failed to comply with the
2    standards and requirements of this Act or rules adopted by
3    the Department pursuant to this Act.
4        (7) Issue an Emergency Suspension Order for any
5    Provider or vehicle licensed under this Act, when the
6    Director or his designee has determined that an immediate
7    and serious danger to the public health, safety and
8    welfare exists. Suspension or revocation proceedings which
9    offer an opportunity for hearing shall be promptly
10    initiated after the Emergency Suspension Order has been
11    issued.
12        (8) Exempt any licensed vehicle from subsequent
13    vehicle design standards or specifications required by the
14    Department, as long as said vehicle is continuously in
15    compliance with the vehicle design standards and
16    specifications originally applicable to that vehicle, or
17    until said vehicle's title of ownership is transferred.
18        (9) Exempt any vehicle (except an SEMSV) which was
19    being used as an ambulance on or before December 15, 1980,
20    from vehicle design standards and specifications required
21    by the Department, until said vehicle's title of ownership
22    is transferred. Such vehicles shall not be exempt from all
23    other licensing standards and requirements prescribed by
24    the Department.
25        (10) Prohibit any Vehicle Service Provider from
26    advertising, identifying its vehicles, or disseminating



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1    information in a false or misleading manner concerning the
2    Provider's type and level of vehicles, location, primary
3    service area, response times, level of personnel,
4    licensure status or System participation.
5        (10.5) Prohibit any Vehicle Service Provider, whether
6    municipal, private, or hospital-owned, from advertising
7    itself as a critical care transport provider unless it
8    participates in a Department-approved EMS System critical
9    care transport plan.
10        (11) Charge each Vehicle Service Provider a fee per
11    transport vehicle, due annually at time of inspection. The
12    fee per transport vehicle shall be set by administrative
13    rule by the Department and shall not exceed 100 vehicles
14    per provider.
15(Source: P.A. 102-623, eff. 8-27-21.)
16    Section 99. Effective date. This Act takes effect upon
17becoming law.".