Bill Text: IL HB5085 | 2023-2024 | 103rd General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Reinserts the provisions of the introduced bill with the following changes. Removes changes to provisions concerning the EMT Training, Recruitment, and Retention Task Force; Emergency Medical Services personnel licensure levels; and vehicle service providers. Removes language providing that an education plan within a resource hospital may include classes performed outside of the region in which the resource hospital is located. Provides that an EMS System may coordinate education outside of the region of which it is located with valid justification and Department of Public Health approval. Provides that the didactic portion of education may be conducted through an online platform with EMS System and Department approval. Sets forth provisions concerning Department approval. Provides that an EMS Lead Instructor may oversee a paramedic with at least 3 years of experience to teach EMT classes, with a licensed teacher, in high schools. Provides that high school students electing to not take the National Registry of Emergency Medical Technicians (NREMT) Certification exam shall not be accounted for in calculating the course pass rate by the EMS System or Department.

Spectrum: Slight Partisan Bill (Democrat 15-7)

Status: (Passed) 2024-07-19 - Public Act . . . . . . . . . 103-0689 [HB5085 Detail]

Download: Illinois-2023-HB5085-Introduced.html

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
HB5085

Introduced , by Rep. William "Will" Davis

SYNOPSIS AS INTRODUCED:
210 ILCS 50/3.5
210 ILCS 50/3.22
210 ILCS 50/3.35
210 ILCS 50/3.50
210 ILCS 50/3.65
210 ILCS 50/3.85

Amends the Emergency Medical Services (EMS) Systems Act. Provides that "clinical observation" means the ongoing observation of a patient's medical or mental health condition by a licensed health care professional utilizing a medical skill set while continuing assessment and care. Provides that the EMS Medical Directors on the EMT Training, Recruitment, and Retention Task Force may be active or retired. Provides that an education plan within a resource hospital may include classes performed outside of the region in which the resource hospital is located. Provides that "paramedic" means a person who has successfully completed a course in advanced life support care as approved by the Department of Public Health or accredited by the Committee on Accreditation for the EMS Professions (CoAEMSP), is licensed by the Department, and practices with an Advanced Life Support EMS System. Provides that the Department shall have the authority to adopt rules governing the curriculum, practice, and necessary equipment applicable to emergency medical responders and shall allow curriculum in addition to the National Registry curriculum. Provides that a fee for EMS personnel examination, licensure, and license renewal shall be reasonable. Provides that a lead instructor is permitted to oversee a paramedic with at least 3 years of experience to teach EMT classes in high schools with a licensed teacher. Provides that pass rates for classes taught in high schools shall not adversely impact the lead instructor or affiliated EMS system, resource hospital, or provider. Provides that the Department may not include any additional criteria for approval of a staffing waiver utilizing an EMR other than the criteria outlined. Provides that the EMR pilot program shall not be implemented before Department approval which must be granted upon EMS System Medical Director approval.
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A BILL FOR

HB5085LRB103 38312 CES 68447 b
1 AN ACT concerning regulation.
2 Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4 Section 5. The Emergency Medical Services (EMS) Systems
5Act is amended by changing Sections 3.5, 3.22, 3.35, 3.50,
63.65, and 3.85 as follows:
7 (210 ILCS 50/3.5)
8 Sec. 3.5. Definitions. As used in this Act:
9 "Clinical observation" means the ongoing observation of a
10patient's medical or mental health condition by a licensed
11health care professional utilizing a medical skill set while
12continuing assessment and care.
13 "Department" means the Illinois Department of Public
14Health.
15 "Director" means the Director of the Illinois Department
16of Public Health.
17 "Emergency" means a medical condition of recent onset and
18severity that would lead a prudent layperson, possessing an
19average knowledge of medicine and health, to believe that
20urgent or unscheduled medical care is required.
21 "Emergency Medical Services personnel" or "EMS personnel"
22means persons licensed as an Emergency Medical Responder (EMR)
23(First Responder), Emergency Medical Dispatcher (EMD),

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1Emergency Medical Technician (EMT), Emergency Medical
2Technician-Intermediate (EMT-I), Advanced Emergency Medical
3Technician (A-EMT), Paramedic (EMT-P), Emergency
4Communications Registered Nurse (ECRN), Pre-Hospital
5Registered Nurse (PHRN), Pre-Hospital Advanced Practice
6Registered Nurse (PHAPRN), or Pre-Hospital Physician Assistant
7(PHPA).
8 "Exclusive representative" has the same meaning as defined
9in Section 3 of the Illinois Public Labor Relations Act.
10 "Health care facility" means a hospital, nursing home,
11physician's office or other fixed location at which medical
12and health care services are performed. It does not include
13"pre-hospital emergency care settings" which utilize EMS
14personnel to render pre-hospital emergency care prior to the
15arrival of a transport vehicle, as defined in this Act.
16 "Hospital" has the meaning ascribed to that term in the
17Hospital Licensing Act.
18 "Labor organization" has the same meaning as defined in
19Section 3 of the Illinois Public Labor Relations Act.
20 "Medical monitoring" means the performance of medical
21tests and physical exams to evaluate an individual's ongoing
22exposure to a factor that could negatively impact that
23person's health. "Medical monitoring" includes close
24surveillance or supervision of patients liable to suffer
25deterioration in physical or mental health and checks of
26various parameters such as pulse rate, temperature,

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1respiration rate, the condition of the pupils, the level of
2consciousness and awareness, the degree of appreciation of
3pain, and blood gas concentrations such as oxygen and carbon
4dioxide.
5 "Silver spanner program" means a program in which a member
6under a fire department's or fire protection district's
7collective bargaining agreement works on or at the EMS System
8under another fire department's or fire protection district's
9collective bargaining agreement and (i) the other fire
10department or fire protection district is not the member's
11full-time employer and (ii) any EMS services not included
12under the original fire department's or fire protection
13district's collective bargaining agreement are included in the
14other fire department's or fire protection district's
15collective bargaining agreement.
16 "Trauma" means any significant injury which involves
17single or multiple organ systems.
18(Source: P.A. 103-521, eff. 1-1-24.)
19 (210 ILCS 50/3.22)
20 Sec. 3.22. EMT Training, Recruitment, and Retention Task
21Force.
22 (a) The EMT Training, Recruitment, and Retention Task
23Force is created to address the following:
24 (1) the impact that the EMT and Paramedic shortage is
25 having on this State's EMS System and health care system;

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1 (2) barriers to the training, recruitment, and
2 retention of Emergency Medical Technicians throughout this
3 State;
4 (3) steps that the State of Illinois can take,
5 including coordination and identification of State and
6 federal funding sources, to assist Illinois high schools,
7 community colleges, and ground ambulance providers to
8 train, recruit, and retain emergency medical technicians;
9 (4) the examination of current testing mechanisms for
10 EMRs, EMTs, and Paramedics and the utilization of the
11 National Registry of Emergency Medical Technicians,
12 including current pass rates by licensure level, national
13 utilization, and test preparation strategies;
14 (5) how apprenticeship programs, local, regional, and
15 statewide, can be utilized to recruit and retain EMRs,
16 EMTs, and Paramedics;
17 (6) how ground ambulance reimbursement affects the
18 recruitment and retention of EMTs and Paramedics; and
19 (7) all other areas that the Task Force deems
20 necessary to examine and assist in the recruitment and
21 retention of EMTs and Paramedics.
22 (b) The Task Force shall be comprised of the following
23members:
24 (1) one member of the Illinois General Assembly,
25 appointed by the President of the Senate, who shall serve
26 as co-chair;

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1 (2) one member of the Illinois General Assembly,
2 appointed by the Speaker of the House of Representatives;
3 (3) one member of the Illinois General Assembly,
4 appointed by the Senate Minority Leader;
5 (4) one member of the Illinois General Assembly,
6 appointed by the House Minority Leader, who shall serve as
7 co-chair;
8 (5) 9 members representing private ground ambulance
9 providers throughout this State representing for-profit
10 and non-profit rural and urban ground ambulance providers,
11 appointed by the President of the Senate;
12 (6) 3 members representing hospitals, appointed by the
13 Speaker of the House of Representatives, with one member
14 representing safety-net hospitals and one member
15 representing rural hospitals;
16 (7) 3 members representing a statewide association of
17 nursing homes, appointed by the President of the Senate;
18 (8) one member representing the State Board of
19 Education, appointed by the House Minority Leader;
20 (9) 2 active or retired EMS Medical Directors from a
21 Regional EMS Medical Directors Committee, appointed by the
22 Governor; and
23 (10) one member representing the Illinois Community
24 College Systems, appointed by the Minority Leader of the
25 Senate.
26 (c) Members of the Task Force shall serve without

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1compensation.
2 (d) The Task Force shall convene at the call of the
3co-chairs and shall hold at least 6 meetings.
4 (e) The Task Force shall submit its final report to the
5General Assembly and the Governor no later than September 1,
62024, and upon the submission of its final report, the Task
7Force shall be dissolved.
8(Source: P.A. 103-547, eff. 8-11-23; 103-563, eff. 11-17-23.)
9 (210 ILCS 50/3.35)
10 Sec. 3.35. Emergency Medical Services (EMS) Resource
11Hospital; Functions. The Resource Hospital of an EMS System
12shall:
13 (a) Prepare a Program Plan in accordance with the
14 provisions of this Act and minimum standards and criteria
15 established in rules adopted by the Department pursuant to
16 this Act, and submit such Program Plan to the Department
17 for approval.
18 (b) Appoint an EMS Medical Director, who will
19 continually monitor and supervise the System and who will
20 have the responsibility and authority for total management
21 of the System as delegated by the EMS Resource Hospital.
22 The Program Plan shall require the EMS Medical
23 Director to appoint an alternate EMS Medical Director and
24 establish a written protocol addressing the functions to
25 be carried out in his or her absence.

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1 (c) Appoint an EMS System Coordinator and EMS
2 Administrative Director in consultation with the EMS
3 Medical Director and in accordance with rules adopted by
4 the Department pursuant to this Act.
5 (d) Identify potential EMS System participants and
6 obtain commitments from them for the provision of
7 services.
8 (e) Educate or coordinate the education of EMS
9 personnel and all other license holders in accordance with
10 the requirements of this Act, rules adopted by the
11 Department pursuant to this Act, and the EMS System
12 Program Plan. An education plan within a resource hospital
13 may include classes performed outside of the region in
14 which the resource hospital is located.
15 (f) Notify the Department of EMS personnel who have
16 successfully completed the requirements as provided by law
17 for initial licensure, license renewal, and license
18 reinstatement by the Department.
19 (g) Educate or coordinate the education of Emergency
20 Medical Dispatcher candidates, in accordance with the
21 requirements of this Act, rules adopted by the Department
22 pursuant to this Act, and the EMS System Program Plan.
23 (h) Establish or approve protocols for prearrival
24 medical instructions to callers by System Emergency
25 Medical Dispatchers who provide such instructions.
26 (i) Educate or coordinate the education of

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1 Pre-Hospital Registered Nurse, Pre-Hospital Advanced
2 Practice Registered Nurse, Pre-Hospital Physician
3 Assistant, and ECRN candidates, in accordance with the
4 requirements of this Act, rules adopted by the Department
5 pursuant to this Act, and the EMS System Program Plan.
6 (j) Approve Pre-Hospital Registered Nurse,
7 Pre-Hospital Advanced Practice Registered Nurse,
8 Pre-Hospital Physician Assistant, and ECRN candidates to
9 practice within the System, and reapprove Pre-Hospital
10 Registered Nurses, Pre-Hospital Advanced Practice
11 Registered Nurses, Pre-Hospital Physician Assistants, and
12 ECRNs every 4 years in accordance with the requirements of
13 the Department and the System Program Plan.
14 (k) Establish protocols for the use of Pre-Hospital
15 Registered Nurses, Pre-Hospital Advanced Practice
16 Registered Nurses, and Pre-Hospital Physician Assistants
17 within the System.
18 (l) Establish protocols for utilizing ECRNs and
19 physicians licensed to practice medicine in all of its
20 branches to monitor telecommunications from, and give
21 voice orders to, EMS personnel, under the authority of the
22 EMS Medical Director.
23 (m) Monitor emergency and non-emergency medical
24 transports within the System, in accordance with rules
25 adopted by the Department pursuant to this Act.
26 (n) Utilize levels of personnel required by the

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1 Department to provide emergency care to the sick and
2 injured at the scene of an emergency, during transport to
3 a hospital or during inter-hospital transport and within
4 the hospital emergency department until the responsibility
5 for the care of the patient is assumed by the medical
6 personnel of a hospital emergency department or other
7 facility within the hospital to which the patient is first
8 delivered by System personnel.
9 (o) Utilize levels of personnel required by the
10 Department to provide non-emergency medical services
11 during transport to a health care facility and within the
12 health care facility until the responsibility for the care
13 of the patient is assumed by the medical personnel of the
14 health care facility to which the patient is delivered by
15 System personnel.
16 (p) Establish and implement a program for System
17 participant information and education, in accordance with
18 rules adopted by the Department pursuant to this Act.
19 (q) Establish and implement a program for public
20 information and education, in accordance with rules
21 adopted by the Department pursuant to this Act.
22 (r) Operate in compliance with the EMS Region Plan.
23(Source: P.A. 100-1082, eff. 8-24-19.)
24 (210 ILCS 50/3.50)
25 Sec. 3.50. Emergency Medical Services personnel licensure

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

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1successfully completed a course in advanced life support care
2as approved by the Department or accredited by the Committee
3on Accreditation for the EMS Professions (CoAEMSP), is
4licensed by the Department in accordance with standards
5prescribed by this Act and rules adopted by the Department
6pursuant to this Act, and practices within an Advanced Life
7Support EMS System. A valid Emergency Medical
8Technician-Paramedic (EMT-P) license issued under this Act
9shall continue to be valid and shall be recognized as a
10Paramedic license until the Emergency Medical
11Technician-Paramedic (EMT-P) license expires.
12 (c-5) "Emergency Medical Responder" or "EMR (First
13Responder)" means a person who has successfully completed a
14course in emergency medical response as approved by the
15Department and provides emergency medical response services in
16accordance with the level of care established by the National
17EMS Educational Standards Emergency Medical Responder course
18as modified by the Department, or who provides services as
19part of an EMS System response plan, as approved by the
20Department, of that EMS System. The Department shall have the
21authority to adopt rules governing the curriculum, practice,
22and necessary equipment applicable to Emergency Medical
23Responders and shall allow curriculum in addition to the
24National Registry curriculum.
25 On August 15, 2014 (the effective date of Public Act
2698-973), a person who is licensed by the Department as a First

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1Responder and has completed a Department-approved course in
2first responder defibrillator training based on, or equivalent
3to, the National EMS Educational Standards or other standards
4previously recognized by the Department shall be eligible for
5licensure as an Emergency Medical Responder upon meeting the
6licensure requirements and submitting an application to the
7Department. A valid First Responder license issued under this
8Act shall continue to be valid and shall be recognized as an
9Emergency Medical Responder license until the First Responder
10license expires.
11 (c-10) All EMS Systems and licensees shall be fully
12compliant with the National EMS Education Standards, as
13modified by the Department in administrative rules, within 24
14months after the adoption of the administrative rules.
15 (d) The Department shall have the authority and
16responsibility to:
17 (1) Prescribe education and training requirements,
18 which includes training in the use of epinephrine, for all
19 levels of EMS personnel except for EMRs, based on the
20 National EMS Educational Standards and any modifications
21 to those curricula specified by the Department through
22 rules adopted pursuant to this Act.
23 (2) Prescribe licensure testing requirements for all
24 levels of EMS personnel, which shall include a requirement
25 that all phases of instruction, training, and field
26 experience be completed before taking the appropriate

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1 licensure examination. Candidates may elect to take the
2 appropriate National Registry examination in lieu of the
3 Department's examination, but are responsible for making
4 their own arrangements for taking the National Registry
5 examination. In prescribing licensure testing requirements
6 for honorably discharged members of the armed forces of
7 the United States under this paragraph (2), the Department
8 shall ensure that a candidate's military emergency medical
9 training, emergency medical curriculum completed, and
10 clinical experience, as described in paragraph (2.5), are
11 recognized.
12 (2.5) Review applications for EMS personnel licensure
13 from honorably discharged members of the armed forces of
14 the United States with military emergency medical
15 training. Applications shall be filed with the Department
16 within one year after military discharge and shall
17 contain: (i) proof of successful completion of military
18 emergency medical training; (ii) a detailed description of
19 the emergency medical curriculum completed; and (iii) a
20 detailed description of the applicant's clinical
21 experience. The Department may request additional and
22 clarifying information. The Department shall evaluate the
23 application, including the applicant's training and
24 experience, consistent with the standards set forth under
25 subsections (a), (b), (c), and (d) of Section 3.10. If the
26 application clearly demonstrates that the training and

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1 experience meet such standards, the Department shall offer
2 the applicant the opportunity to successfully complete a
3 Department-approved EMS personnel examination for the
4 level of license for which the applicant is qualified.
5 Upon passage of an examination, the Department shall issue
6 a license, which shall be subject to all provisions of
7 this Act that are otherwise applicable to the level of EMS
8 personnel license issued.
9 (3) License individuals as an EMR, EMT, EMT-I, A-EMT,
10 or Paramedic who have met the Department's education,
11 training and examination requirements.
12 (4) Prescribe annual continuing education and
13 relicensure requirements for all EMS personnel licensure
14 levels.
15 (5) Relicense individuals as an EMD, EMR, EMT, EMT-I,
16 A-EMT, PHRN, PHAPRN, PHPA, or Paramedic every 4 years,
17 based on their compliance with continuing education and
18 relicensure requirements as required by the Department
19 pursuant to this Act. Every 4 years, a Paramedic shall
20 have 100 hours of approved continuing education, an EMT-I
21 and an advanced EMT shall have 80 hours of approved
22 continuing education, and an EMT shall have 60 hours of
23 approved continuing education. An Illinois licensed EMR,
24 EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN, PHPA, PHAPRN, or
25 PHRN whose license has been expired for less than 36
26 months may apply for reinstatement by the Department.

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1 Reinstatement shall require that the applicant (i) submit
2 satisfactory proof of completion of continuing medical
3 education and clinical requirements to be prescribed by
4 the Department in an administrative rule; (ii) submit a
5 positive recommendation from an Illinois EMS Medical
6 Director attesting to the applicant's qualifications for
7 retesting; and (iii) pass a Department approved test for
8 the level of EMS personnel license sought to be
9 reinstated.
10 (6) Grant inactive status to any EMR, EMD, EMT, EMT-I,
11 A-EMT, Paramedic, ECRN, PHAPRN, PHPA, or PHRN who
12 qualifies, based on standards and procedures established
13 by the Department in rules adopted pursuant to this Act.
14 (7) Charge a reasonable fee for EMS personnel
15 examination, licensure, and license renewal.
16 (8) Suspend, revoke, or refuse to issue or renew the
17 license of any licensee, after an opportunity for an
18 impartial hearing before a neutral administrative law
19 judge appointed by the Director, where the preponderance
20 of the evidence shows one or more of the following:
21 (A) The licensee has not met continuing education
22 or relicensure requirements as prescribed by the
23 Department;
24 (B) The licensee has failed to maintain
25 proficiency in the level of skills for which he or she
26 is licensed;

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1 (C) The licensee, during the provision of medical
2 services, engaged in dishonorable, unethical, or
3 unprofessional conduct of a character likely to
4 deceive, defraud, or harm the public;
5 (D) The licensee has failed to maintain or has
6 violated standards of performance and conduct as
7 prescribed by the Department in rules adopted pursuant
8 to this Act or his or her EMS System's Program Plan;
9 (E) The licensee is physically impaired to the
10 extent that he or she cannot physically perform the
11 skills and functions for which he or she is licensed,
12 as verified by a physician, unless the person is on
13 inactive status pursuant to Department regulations;
14 (F) The licensee is mentally impaired to the
15 extent that he or she cannot exercise the appropriate
16 judgment, skill and safety for performing the
17 functions for which he or she is licensed, as verified
18 by a physician, unless the person is on inactive
19 status pursuant to Department regulations;
20 (G) The licensee has violated this Act or any rule
21 adopted by the Department pursuant to this Act; or
22 (H) The licensee has been convicted (or entered a
23 plea of guilty or nolo contendere) by a court of
24 competent jurisdiction of a Class X, Class 1, or Class
25 2 felony in this State or an out-of-state equivalent
26 offense.

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1 (9) Prescribe education and training requirements in
2 the administration and use of opioid antagonists for all
3 levels of EMS personnel based on the National EMS
4 Educational Standards and any modifications to those
5 curricula specified by the Department through rules
6 adopted pursuant to this Act.
7 (d-5) An EMR, EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN,
8PHAPRN, PHPA, or PHRN who is a member of the Illinois National
9Guard or an Illinois State Trooper or who exclusively serves
10as a volunteer for units of local government with a population
11base of less than 5,000 or as a volunteer for a not-for-profit
12organization that serves a service area with a population base
13of less than 5,000 may submit an application to the Department
14for a waiver of the fees described under paragraph (7) of
15subsection (d) of this Section on a form prescribed by the
16Department.
17 The education requirements prescribed by the Department
18under this Section must allow for the suspension of those
19requirements in the case of a member of the armed services or
20reserve forces of the United States or a member of the Illinois
21National Guard who is on active duty pursuant to an executive
22order of the President of the United States, an act of the
23Congress of the United States, or an order of the Governor at
24the time that the member would otherwise be required to
25fulfill a particular education requirement. Such a person must
26fulfill the education requirement within 6 months after his or

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1her release from active duty.
2 (e) In the event that any rule of the Department or an EMS
3Medical Director that requires testing for drug use as a
4condition of the applicable EMS personnel license conflicts
5with or duplicates a provision of a collective bargaining
6agreement that requires testing for drug use, that rule shall
7not apply to any person covered by the collective bargaining
8agreement.
9 (f) At the time of applying for or renewing his or her
10license, an applicant for a license or license renewal may
11submit an email address to the Department. The Department
12shall keep the email address on file as a form of contact for
13the individual. The Department shall send license renewal
14notices electronically and by mail to a licensee who provides
15the Department with his or her email address. The notices
16shall be sent at least 60 days prior to the expiration date of
17the license.
18(Source: P.A. 101-81, eff. 7-12-19; 101-153, eff. 1-1-20;
19102-558, eff. 8-20-21; 102-623, eff. 8-27-21.)
20 (210 ILCS 50/3.65)
21 Sec. 3.65. EMS Lead Instructor.
22 (a) "EMS Lead Instructor" means a person who has
23successfully completed a course of education as approved by
24the Department, and who is currently approved by the
25Department to coordinate or teach education, training and

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1continuing education courses, in accordance with standards
2prescribed by this Act and rules adopted by the Department
3pursuant to this Act.
4 (b) The Department shall have the authority and
5responsibility to:
6 (1) Prescribe education requirements for EMS Lead
7 Instructor candidates through rules adopted pursuant to
8 this Act.
9 (2) Prescribe testing requirements for EMS Lead
10 Instructor candidates through rules adopted pursuant to
11 this Act.
12 (3) Charge each candidate for EMS Lead Instructor a
13 fee to be submitted with an application for an
14 examination, an application for licensure, and an
15 application for relicensure.
16 (4) Approve individuals as EMS Lead Instructors who
17 have met the Department's education and testing
18 requirements.
19 (5) Require that all education, training and
20 continuing education courses for EMT, EMT-I, A-EMT,
21 Paramedic, PHRN, PHPA, PHAPRN, ECRN, EMR, and Emergency
22 Medical Dispatcher be coordinated by at least one approved
23 EMS Lead Instructor. A program which includes education,
24 training or continuing education for more than one type of
25 personnel may use one EMS Lead Instructor to coordinate
26 the program, and a single EMS Lead Instructor may

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1 simultaneously coordinate more than one program or course.
2 An EMS Lead Instructor may oversee a paramedic with at
3 least 3 years of experience to teach EMT classes in high
4 schools with a licensed teacher. Pass rates for classes
5 taught in high schools shall not adversely impact the EMS
6 Lead Instructor or affiliated EMS system/resource
7 hospital/provider.
8 (6) Provide standards and procedures for awarding EMS
9 Lead Instructor approval to persons previously approved by
10 the Department to coordinate such courses, based on
11 qualifications prescribed by the Department through rules
12 adopted pursuant to this Act.
13 (7) Suspend, revoke, or refuse to issue or renew the
14 approval of an EMS Lead Instructor, after an opportunity
15 for a hearing, when findings show one or more of the
16 following:
17 (A) The EMS Lead Instructor has failed to conduct
18 a course in accordance with the curriculum prescribed
19 by this Act and rules adopted by the Department
20 pursuant to this Act; or
21 (B) The EMS Lead Instructor has failed to comply
22 with protocols prescribed by the Department through
23 rules adopted pursuant to this Act.
24(Source: P.A. 100-1082, eff. 8-24-19.)
25 (210 ILCS 50/3.85)

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1 Sec. 3.85. Vehicle Service Providers.
2 (a) "Vehicle Service Provider" means an entity licensed by
3the Department to provide emergency or non-emergency medical
4services in compliance with this Act, the rules promulgated by
5the Department pursuant to this Act, and an operational plan
6approved by its EMS System(s), utilizing at least ambulances
7or specialized emergency medical service vehicles (SEMSV).
8 (1) "Ambulance" means any publicly or privately owned
9 on-road vehicle that is specifically designed, constructed
10 or modified and equipped, and is intended to be used for,
11 and is maintained or operated for the emergency
12 transportation of persons who are sick, injured, wounded
13 or otherwise incapacitated or helpless, or the
14 non-emergency medical transportation of persons who
15 require the presence of medical personnel to monitor the
16 individual's condition or medical apparatus being used on
17 such individuals.
18 (2) "Specialized Emergency Medical Services Vehicle"
19 or "SEMSV" means a vehicle or conveyance, other than those
20 owned or operated by the federal government, that is
21 primarily intended for use in transporting the sick or
22 injured by means of air, water, or ground transportation,
23 that is not an ambulance as defined in this Act. The term
24 includes watercraft, aircraft and special purpose ground
25 transport vehicles or conveyances not intended for use on
26 public roads.

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1 (3) An ambulance or SEMSV may also be designated as a
2 Limited Operation Vehicle or Special-Use Vehicle:
3 (A) "Limited Operation Vehicle" means a vehicle
4 which is licensed by the Department to provide basic,
5 intermediate or advanced life support emergency or
6 non-emergency medical services that are exclusively
7 limited to specific events or locales.
8 (B) "Special-Use Vehicle" means any publicly or
9 privately owned vehicle that is specifically designed,
10 constructed or modified and equipped, and is intended
11 to be used for, and is maintained or operated solely
12 for the emergency or non-emergency transportation of a
13 specific medical class or category of persons who are
14 sick, injured, wounded or otherwise incapacitated or
15 helpless (e.g. high-risk obstetrical patients,
16 neonatal patients).
17 (C) "Reserve Ambulance" means a vehicle that meets
18 all criteria set forth in this Section and all
19 Department rules, except for the required inventory of
20 medical supplies and durable medical equipment, which
21 may be rapidly transferred from a fully functional
22 ambulance to a reserve ambulance without the use of
23 tools or special mechanical expertise.
24 (b) The Department shall have the authority and
25responsibility to:
26 (1) Require all Vehicle Service Providers, both

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1 publicly and privately owned, to function within an EMS
2 System.
3 (2) Require a Vehicle Service Provider utilizing
4 ambulances to have a primary affiliation with an EMS
5 System within the EMS Region in which its Primary Service
6 Area is located, which is the geographic areas in which
7 the provider renders the majority of its emergency
8 responses. This requirement shall not apply to Vehicle
9 Service Providers which exclusively utilize Limited
10 Operation Vehicles.
11 (3) Establish licensing standards and requirements for
12 Vehicle Service Providers, through rules adopted pursuant
13 to this Act, including but not limited to:
14 (A) Vehicle design, specification, operation and
15 maintenance standards, including standards for the use
16 of reserve ambulances;
17 (B) Equipment requirements;
18 (C) Staffing requirements; and
19 (D) License renewal at intervals determined by the
20 Department, which shall be not less than every 4
21 years.
22 The Department's standards and requirements with
23 respect to vehicle staffing for private, nonpublic local
24 government employers must allow for alternative staffing
25 models that include an EMR with a licensed EMT, EMT-I,
26 A-EMT, Paramedic, or PHRN, as appropriate, pursuant to the

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1 approval of the EMS System Program Plan developed and
2 approved by the EMS Medical Director for an EMS System.
3 The EMS personnel licensed at the highest level shall
4 provide the initial assessment of the patient to determine
5 the level of care required for transport to the receiving
6 health care facility, and this assessment shall be
7 documented in the patient care report and documented with
8 online medical control. The EMS personnel licensed at or
9 above the level of care required by the specific patient
10 as directed by the EMS Medical Director shall be the
11 primary care provider en route to the destination facility
12 or patient's residence. The Department shall monitor the
13 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. Adoption of
17 an alternative staffing model shall not result in a
18 Vehicle Service Provider being prohibited or limited in
19 the utilization of its staff or equipment from providing
20 any of the services authorized by this Act or as otherwise
21 outlined in the approved EMS System Program Plan,
22 including, without limitation, the deployment of resources
23 to provide out-of-state disaster response. EMS System
24 Program Plans must address a process for out-of-state
25 disaster response deployments that must meet the
26 following:

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1 (A) All deployments to provide out-of-state
2 disaster response must first be approved by the EMS
3 Medical Director and submitted to the Department.
4 (B) The submission must include the number of
5 units being deployed, vehicle identification numbers,
6 length of deployment, and names of personnel and their
7 licensure level.
8 (C) Ensure that all necessary in-state requests
9 for services will be covered during the duration of
10 the deployment.
11 An EMS System Program Plan for a Basic Life Support,
12 advanced life support, and critical care transport
13 utilizing an EMR and an EMT shall include the following:
14 (A) Alternative staffing models for a Basic Life
15 Support transport utilizing an EMR shall only be
16 utilized for interfacility Basic Life Support
17 transports as specified by the EMS System Program Plan
18 as determined by the EMS System Medical Director.
19 (B) Protocols that shall include dispatch
20 procedures to properly screen and assess patients for
21 EMR-staffed transports.
22 (C) A requirement that a provider and EMS System
23 shall implement a quality assurance plan that shall
24 include for the initial waiver period the review of at
25 least 5% of total interfacility transports utilizing
26 an EMR with mechanisms outlined to audit dispatch

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1 screening, reason for transport, patient diagnosis,
2 level of care, and the outcome of transports
3 performed. Quality assurance reports must be submitted
4 and reviewed by the provider and EMS System monthly
5 and made available to the Department upon request. The
6 percentage of transports reviewed under quality
7 assurance plans for renewal periods shall be
8 determined by the EMS Medical Director, however, it
9 shall not be less than 3%.
10 (D) The EMS System Medical Director shall develop
11 a minimum set of requirements for individuals based on
12 level of licensure that includes education, training,
13 and credentialing for all team members identified to
14 participate in an alternative staffing plan. The EMT,
15 Paramedic, PHRN, PHPA, PHAPRN, and critical care
16 transport staff shall have the minimum experience in
17 performance of pre-hospital and inter-hospital care,
18 as determined by the EMS Medical Director in
19 accordance with the EMS System Program Plan, but at a
20 minimum of 6 months of prehospital experience or at
21 least 50 documented patient care interventions during
22 transport as the primary care provider and approved by
23 the Department.
24 (E) The licensed EMR must complete a defensive
25 driving course prior to participation in the
26 Department's alternative staffing model.

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1 (F) The length of the EMS System Program Plan for a
2 Basic Life Support transport utilizing an EMR shall be
3 for one year, and must be renewed annually if proof of
4 the criteria outlined in statute being met is
5 submitted, validated, and approved by the EMS Medical
6 Director for the EMS System and the Department. The
7 Department may not include any additional criteria for
8 approval of a staffing waiver utilizing an EMR other
9 than the criteria outlined in this Act.
10 (G) Beginning July 1, 2023, the utilization of
11 EMRs for advanced life support transports and Tier III
12 Critical Care Transports shall be allowed for periods
13 not to exceed 3 years under a pilot program. The pilot
14 program shall not be implemented before Department
15 approval which must be granted upon EMS System Medical
16 Director approval. Agencies requesting to utilize this
17 staffing model for the time period of the pilot
18 program must complete the following:
19 (i) Submit a waiver request to the Department
20 requesting to participate in the pilot program
21 with specific details of how quality assurance and
22 improvement will be gathered, measured, reported
23 to the Department, and reviewed and utilized
24 internally by the participating agency.
25 (ii) Submit a signed approval letter from the
26 EMS System Medical Director approving

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1 participation in the pilot program.
2 (iii) Submit updated EMS System plans,
3 additional education, and training of the EMR and
4 protocols related to the pilot program.
5 (iv) Submit agency policies and procedures
6 related to the pilot program.
7 (v) Submit the number of individuals currently
8 participating and committed to participating in
9 education programs to achieve a higher level of
10 licensure at the time of submission.
11 (vi) Submit an explanation of how the provider
12 will support individuals obtaining a higher level
13 of licensure and encourage a higher level of
14 licensure during the year of the alternative
15 staffing plan and specific examples of recruitment
16 and retention activities or initiatives.
17 Upon submission of a renewal application and
18 recruitment and retention plan, the provider shall
19 include additional data regarding current employment
20 numbers, attrition rates over the year, and activities
21 and initiatives over the previous year to address
22 recruitment and retention.
23 The information required under this subparagraph
24 (G) shall be provided to and retained by the EMS System
25 upon initial application and renewal and shall be
26 provided to the Department upon request.

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1 The Department must allow for an alternative rural
2 staffing model for those vehicle service providers that
3 serve a rural or semi-rural population of 10,000 or fewer
4 inhabitants and exclusively uses volunteers, paid-on-call,
5 or a combination thereof.
6 (4) License all Vehicle Service Providers that have
7 met the Department's requirements for licensure, unless
8 such Provider is owned or licensed by the federal
9 government. All Provider licenses issued by the Department
10 shall specify the level and type of each vehicle covered
11 by the license (BLS, ILS, ALS, ambulance, critical care
12 transport, SEMSV, limited operation vehicle, special use
13 vehicle, reserve ambulance).
14 (5) Annually inspect all licensed vehicles operated by
15 Vehicle Service Providers.
16 (6) Suspend, revoke, refuse to issue or refuse to
17 renew the license of any Vehicle Service Provider, or that
18 portion of a license pertaining to a specific vehicle
19 operated by the Provider, after an opportunity for a
20 hearing, when findings show that the Provider or one or
21 more of its vehicles has failed to comply with the
22 standards and requirements of this Act or rules adopted by
23 the Department pursuant to this Act.
24 (7) Issue an Emergency Suspension Order for any
25 Provider or vehicle licensed under this Act, when the
26 Director or his designee has determined that an immediate

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1 and serious danger to the public health, safety and
2 welfare exists. Suspension or revocation proceedings which
3 offer an opportunity for hearing shall be promptly
4 initiated after the Emergency Suspension Order has been
5 issued.
6 (8) Exempt any licensed vehicle from subsequent
7 vehicle design standards or specifications required by the
8 Department, as long as said vehicle is continuously in
9 compliance with the vehicle design standards and
10 specifications originally applicable to that vehicle, or
11 until said vehicle's title of ownership is transferred.
12 (9) Exempt any vehicle (except an SEMSV) which was
13 being used as an ambulance on or before December 15, 1980,
14 from vehicle design standards and specifications required
15 by the Department, until said vehicle's title of ownership
16 is transferred. Such vehicles shall not be exempt from all
17 other licensing standards and requirements prescribed by
18 the Department.
19 (10) Prohibit any Vehicle Service Provider from
20 advertising, identifying its vehicles, or disseminating
21 information in a false or misleading manner concerning the
22 Provider's type and level of vehicles, location, primary
23 service area, response times, level of personnel,
24 licensure status or System participation.
25 (10.5) Prohibit any Vehicle Service Provider, whether
26 municipal, private, or hospital-owned, from advertising

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1 itself as a critical care transport provider unless it
2 participates in a Department-approved EMS System critical
3 care transport plan.
4 (11) Charge each Vehicle Service Provider a fee per
5 transport vehicle, due annually at time of inspection. The
6 fee per transport vehicle shall be set by administrative
7 rule by the Department and shall not exceed 100 vehicles
8 per provider.
9 (12) Beginning July 1, 2023, as part of a pilot
10 program that shall not exceed a term of 3 years, an
11 ambulance may be upgraded to a higher level of care for
12 interfacility transports by an ambulance assistance
13 vehicle with appropriate equipment and licensed personnel
14 to intercept with the licensed ambulance at the sending
15 facility before departure. The pilot program shall not be
16 implemented before Department approval. To participate in
17 the pilot program, an agency must:
18 (A) Submit a waiver request to the Department with
19 intercept vehicle vehicle identification numbers,
20 calls signs, equipment detail, and a robust quality
21 assurance plan that shall list, at minimum, detailed
22 reasons each intercept had to be completed, barriers
23 to initial dispatch of advanced life support services,
24 and how this benefited the patient.
25 (B) Report to the Department quarterly additional
26 data deemed meaningful by the providing agency along

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