Bill Amendment: IL HB2431 | 2021-2022 | 102nd General Assembly

NOTE: For additional amemendments please see the Bill Drafting List

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Bill Title: MASSAGE THERAPY-SUNSET

Status: 2021-11-29 - Rule 19(b) / Re-referred to Rules Committee [HB2431 Detail]

Download: Illinois-2021-HB2431-Senate_Amendment_002.html

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Sen. David Koehler

Filed: 10/25/2021

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

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

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(b-5) "Advanced Emergency Medical Technician" or "A-EMT"
means a person who has successfully completed a course in
basic and limited advanced emergency medical care as approved
by the Department, is currently licensed by the Department in
accordance with standards prescribed by this Act and rules
adopted by the Department pursuant to this Act, and practices
within an Intermediate or Advanced Life Support EMS System.
(c) "Paramedic (EMT-P)" means a person who has
successfully completed a course in advanced life support care
as approved by the Department, is licensed by the Department
in accordance with standards prescribed by this Act and rules
adopted by the Department pursuant to this Act, and practices
within an Advanced Life Support EMS System. A valid Emergency
Medical Technician-Paramedic (EMT-P) license issued under this
Act shall continue to be valid and shall be recognized as a
Paramedic license until the Emergency Medical
Technician-Paramedic (EMT-P) license expires.
(c-5) "Emergency Medical Responder" or "EMR (First
Responder)" means a person who has successfully completed a
course in emergency medical response as approved by the
Department and provides emergency medical response services in
accordance with the level of care established by the National
EMS Educational Standards Emergency Medical Responder course
as modified by the Department, or who provides services as
part of an EMS System response plan, as approved by the
Department, of that EMS System. The Department shall have the

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authority to adopt rules governing the curriculum, practice,
and necessary equipment applicable to Emergency Medical
Responders.
On August 15, 2014 (the effective date of Public Act
98-973), a person who is licensed by the Department as a First
Responder and has completed a Department-approved course in
first responder defibrillator training based on, or equivalent
to, the National EMS Educational Standards or other standards
previously recognized by the Department shall be eligible for
licensure as an Emergency Medical Responder upon meeting the
licensure requirements and submitting an application to the
Department. A valid First Responder license issued under this
Act shall continue to be valid and shall be recognized as an
Emergency Medical Responder license until the First Responder
license expires.
(c-10) All EMS Systems and licensees shall be fully
compliant with the National EMS Education Standards, as
modified by the Department in administrative rules, within 24
months after the adoption of the administrative rules.
(d) The Department shall have the authority and
responsibility to:
(1) Prescribe education and training requirements,
which includes training in the use of epinephrine, for all
levels of EMS personnel except for EMRs, based on the
National EMS Educational Standards and any modifications
to those curricula specified by the Department through

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

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

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

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

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

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

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

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

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

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

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

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

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

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