SB 3445

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Full Text of SB3445
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	SB3445 - 104th General Assembly
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			Senate Amendment 001
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		SB3445 Enrolled		LRB104 18158 BAB 31597 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 1. Short title. This Act may be cited as the Kidney
5Disease Treatment Delegation Act.
6    Section 2. Purpose. The purpose of this Act is to
7safeguard individuals seeking kidney disease treatments in the
8State of Illinois by ensuring that the professionals who
9provide these services are licensed and trained.
10    Section 5. Definitions. In this Act:
11    "Advanced practice registered nurse" or "APRN" means a
12person who has met the qualifications for a (i) certified
13nurse midwife (CNM); (ii) certified nurse practitioner (CNP);
14(iii) certified registered nurse anesthetist (CRNA); or (iv)
15clinical nurse specialist (CNS) and has been licensed by the
16Department under the Nurse Practice Act.
17    "Central venous catheter procedure" includes providing
18dialysis through venous catheters, initiating and terminating
19dialysis through those catheters, connecting and disconnecting
20central venous catheter lines, and maintaining central venous
21catheters through dressing changes and other care.
22    "Certified dialysis technician" means a person with an
		SB3445 Enrolled	- 2 -	LRB104 18158 BAB 31597 b
1accredited high school diploma or State of Illinois High
2School Diploma who has been certified by the Nephrology
3Nursing Certification Commission as a certified clinical
4hemodialysis technician or by the Board of Nephrology
5Examiners Nursing and Technology as a certified hemodialysis
6technologist/technician.
7    "Department" means the Department of Financial and
8Professional Regulation.
9    "Kidney disease treatment center" has the meaning given to
10that term in subsection (5) of Section 3 of the Illinois Health
11Facilities Planning Act. "Kidney disease treatment center"
12includes a treatment center that provides dialysis through
13venous catheters, initiates and terminates dialysis through
14those catheters, connects and disconnects central venous
15catheter lines, and maintains central venous catheters through
16dressing changes and other care.
17    "Physician" means a person licensed to practice medicine
18in all its branches under the Medical Practice Act of 1987.
19    "Physician assistant" means a physician assistant licensed
20under the Physician Assistant Practice Act of 1987.
21    "Practical nurse", "licensed practical nurse", or "LPN"
22means a person who is licensed as a practical nurse under the
23Nurse Practice Act and practices practical nursing as defined
24in that Act.
25    "Registered nurse", "Registered Professional Nurse", or
26"RN" means a person who is licensed as a professional nurse
		SB3445 Enrolled	- 3 -	LRB104 18158 BAB 31597 b
1under the Nurse Practice Act and practices nursing as defined
2in that Act.
3    Section 10. Regulation of delegation in kidney disease
4treatment centers.
5    (a) Notwithstanding any provision of the Nurse Practice
6Act or any rule of the Department to the contrary, an
7individual working in a kidney disease treatment center shall
8be considered a licensed individual for the purposes of
9delegation under Section 50-75 of the Nurse Practice Act.
10    (b) Notwithstanding any provision of the Nurse Practice
11Act or any rule of the Department to the contrary, delegation
12under this Section, including, but not limited to, delegation
13of the performance of central venous catheter procedures in a
14kidney disease treatment center, shall only be allowed if the
15individual receiving delegation is a licensed practical nurse
16who has obtained the proper training, education, and
17experience or a certified dialysis technician who currently
18holds, or is in the process of acquiring, the necessary
19experience to apply for and obtain one of the following
20certifications:
21        (1) certified clinical hemodialysis technician by the
22    Nephrology Nursing Certification Commission; or
23        (2) certified hemodialysis technologist/technician by
24    the Board of Nephrology Examiners Nursing and Technology.
25    (c) Notwithstanding any provision of the Nurse Practice
		SB3445 Enrolled	- 4 -	LRB104 18158 BAB 31597 b
1Act or any rule of the Department to the contrary, delegation
2under this Section shall not include medication
3administration, except for the administration of heparin and
4saline for the purposes of performing dialysis treatments and
5flushing lines and the application of topical anesthetics. All
6patient care provided by a licensed practical nurse or a
7certified dialysis technician practicing under this Section
8shall be under the direct and immediate on-site supervision of
9a licensed physician, advanced practice registered nurse,
10physician assistant, or registered nurse. A certified dialysis
11technician shall not be permitted to administer heparin and
12saline to a patient with a central venous catheter.
13    Additionally, the following conditions must be present:
14        (1) the RN or APRN must complete an assessment of the
15    patient's nursing care needs prior to the delegation and
16    make modifications to the patient's nursing care needs
17    during the course of dialysis treatment to address any
18    patient problems and complications;
19        (2) the RN or APRN must have either instructed the
20    certified dialysis technician or LPN in the delegated
21    activity or verified the individual's competency to
22    perform the activity; and
23        (3) clinical competency of an individual delegated to
24    under this Section shall be documented and available and
25    verified at least annually by the individual's employer.
26    If the delegating party is a physician or physician
		SB3445 Enrolled	- 5 -	LRB104 18158 BAB 31597 b
1    assistant, the physician or physician assistant shall act
2    in a similar manner as required by the Medical Practice
3    Act of 1987 and the Physician Assistant Practice Act of
4    1987.
5    (d) Delegation under this Section shall comply with
6Section 50-75 of the Nurse Practice Act and any rules adopted
7under the Illinois Health Facilities Planning Act, the Nurse
8Practice Act, and any other Illinois statute or rule regarding
9the operation of a kidney disease treatment center as
10described by this Section.
11    (e) Nothing in this Section shall be construed to apply to
12any other facility or practice setting. This Section shall not
13be construed as granting a license under the Nurse Practice
14Act and shall not allow individuals receiving delegation under
15this Section to use any title regulated by the Nurse Practice
16Act. Nothing in this Act shall be construed to limit the
17ability of a licensed physician to practice medicine in all
18its branches.
19    Section 15. Rulemaking. The Department is authorized to
20adopt rules for the administration and enforcement of this
21Act. The rules may define standards and criteria for the
22necessary training, education, and experience for licensed
23practical nurses to obtain before receiving delegation under
24this Act.
		SB3445 Enrolled	- 6 -	LRB104 18158 BAB 31597 b
1    Section 20. The Nurse Practice Act is amended by changing
2Section 70-5 as follows:
3    (225 ILCS 65/70-5)  (was 225 ILCS 65/10-45)
4    (Section scheduled to be repealed on January 1, 2028)
5    Sec. 70-5. Grounds for disciplinary action.
6    (a) The Department may refuse to issue or to renew, or may
7revoke, suspend, place on probation, reprimand, or take other
8disciplinary or non-disciplinary action as the Department may
9deem appropriate, including fines not to exceed $10,000 per
10violation, with regard to a license for any one or combination
11of the causes set forth in subsection (b) below. All fines
12collected under this Section shall be deposited in the Nursing
13Dedicated and Professional Fund.
14    (b) Grounds for disciplinary action include the following:
15        (1) Material deception in furnishing information to
16    the Department.
17        (2) Material violations of any provision of this Act
18    or violation of the rules of or final administrative
19    action of the Secretary, after consideration of the
20    recommendation of the Board.
21        (3) Conviction by plea of guilty or nolo contendere,
22    finding of guilt, jury verdict, or entry of judgment or by
23    sentencing of any crime, including, but not limited to,
24    convictions, preceding sentences of supervision,
25    conditional discharge, or first offender probation, under
		SB3445 Enrolled	- 7 -	LRB104 18158 BAB 31597 b
1    the laws of any jurisdiction of the United States: (i)
2    that is a felony; or (ii) that is a misdemeanor, an
3    essential element of which is dishonesty, or that is
4    directly related to the practice of the profession.
5        (4) A pattern of practice or other behavior which
6    demonstrates incapacity or incompetency to practice under
7    this Act.
8        (5) Knowingly aiding or assisting another person in
9    violating any provision of this Act or rules.
10        (6) Failing, within 90 days, to provide a response to
11    a request for information in response to a written request
12    made by the Department by certified or registered mail or
13    by email to the email address of record.
14        (7) Engaging in dishonorable, unethical, or
15    unprofessional conduct of a character likely to deceive,
16    defraud, or harm the public, as defined by rule.
17        (8) Unlawful taking, theft, selling, distributing, or
18    manufacturing of any drug, narcotic, or prescription
19    device.
20        (9) Habitual or excessive use or addiction to alcohol,
21    narcotics, stimulants, or any other chemical agent or drug
22    that could result in a licensee's inability to practice
23    with reasonable judgment, skill, or safety.
24        (10) Discipline by another U.S. jurisdiction or
25    foreign nation, if at least one of the grounds for the
26    discipline is the same or substantially equivalent to
		SB3445 Enrolled	- 8 -	LRB104 18158 BAB 31597 b
1    those set forth in this Section.
2        (11) A finding that the licensee, after having her or
3    his license placed on probationary status or subject to
4    conditions or restrictions, has violated the terms of
5    probation or failed to comply with such terms or
6    conditions.
7        (12) Being named as a perpetrator in an indicated
8    report by the Department of Children and Family Services
9    and under the Abused and Neglected Child Reporting Act,
10    and upon proof by clear and convincing evidence that the
11    licensee has caused a child to be an abused child or
12    neglected child as defined in the Abused and Neglected
13    Child Reporting Act.
14        (13) Willful omission to file or record, or willfully
15    impeding the filing or recording or inducing another
16    person to omit to file or record medical reports as
17    required by law.
18        (13.5) Willfully failing to report an instance of
19    suspected child abuse or neglect as required by the Abused
20    and Neglected Child Reporting Act.
21        (14) Gross negligence in the practice of practical,
22    professional, or advanced practice registered nursing.
23        (15) Holding oneself out to be practicing nursing
24    under any name other than one's own.
25        (16) Failure of a licensee to report to the Department
26    any adverse final action taken against him or her by
		SB3445 Enrolled	- 9 -	LRB104 18158 BAB 31597 b
1    another licensing jurisdiction of the United States or any
2    foreign state or country, any peer review body, any health
3    care institution, any professional or nursing society or
4    association, any governmental agency, any law enforcement
5    agency, or any court or a nursing liability claim related
6    to acts or conduct similar to acts or conduct that would
7    constitute grounds for action as defined in this Section.
8        (17) Failure of a licensee to report to the Department
9    surrender by the licensee of a license or authorization to
10    practice nursing or advanced practice registered nursing
11    in another state or jurisdiction or current surrender by
12    the licensee of membership on any nursing staff or in any
13    nursing or advanced practice registered nursing or
14    professional association or society while under
15    disciplinary investigation by any of those authorities or
16    bodies for acts or conduct similar to acts or conduct that
17    would constitute grounds for action as defined by this
18    Section.
19        (18) Failing, within 60 days, to provide information
20    in response to a written request made by the Department.
21        (19) Failure to establish and maintain records of
22    patient care and treatment as required by law.
23        (20) Fraud, deceit, or misrepresentation in applying
24    for or procuring a license under this Act or in connection
25    with applying for renewal of a license under this Act.
26        (21) Allowing another person or organization to use
		SB3445 Enrolled	- 10 -	LRB104 18158 BAB 31597 b
1    the licensee's license to deceive the public.
2        (22) Willfully making or filing false records or
3    reports in the licensee's practice, including, but not
4    limited to, false records to support claims against the
5    medical assistance program of the Department of Healthcare
6    and Family Services (formerly Department of Public Aid)
7    under the Illinois Public Aid Code.
8        (23) Attempting to subvert or cheat on a licensing
9    examination administered under this Act.
10        (24) Immoral conduct in the commission of an act,
11    including, but not limited to, sexual abuse, sexual
12    misconduct, or sexual exploitation, related to the
13    licensee's practice.
14        (25) Willfully or negligently violating the
15    confidentiality between nurse and patient except as
16    required by law.
17        (26) Practicing under a false or assumed name, except
18    as provided by law.
19        (27) The use of any false, fraudulent, or deceptive
20    statement in any document connected with the licensee's
21    practice.
22        (28) Directly or indirectly giving to or receiving
23    from a person, firm, corporation, partnership, or
24    association a fee, commission, rebate, or other form of
25    compensation for professional services not actually or
26    personally rendered. Nothing in this paragraph (28)
		SB3445 Enrolled	- 11 -	LRB104 18158 BAB 31597 b
1    affects any bona fide independent contractor or employment
2    arrangements among health care professionals, health
3    facilities, health care providers, or other entities,
4    except as otherwise prohibited by law. Any employment
5    arrangements may include provisions for compensation,
6    health insurance, pension, or other employment benefits
7    for the provision of services within the scope of the
8    licensee's practice under this Act. Nothing in this
9    paragraph (28) shall be construed to require an employment
10    arrangement to receive professional fees for services
11    rendered.
12        (29) A violation of the Health Care Worker
13    Self-Referral Act.
14        (30) Physical illness, mental illness, or disability
15    that results in the inability to practice the profession
16    with reasonable judgment, skill, or safety.
17        (31) Exceeding the terms of a collaborative agreement
18    or the prescriptive authority delegated to a licensee by
19    his or her collaborating physician or podiatric physician
20    in guidelines established under a written collaborative
21    agreement.
22        (32) Making a false or misleading statement regarding
23    a licensee's skill or the efficacy or value of the
24    medicine, treatment, or remedy prescribed by him or her in
25    the course of treatment.
26        (33) Prescribing, selling, administering,
		SB3445 Enrolled	- 12 -	LRB104 18158 BAB 31597 b
1    distributing, giving, or self-administering a drug
2    classified as a controlled substance (designated product)
3    or narcotic for other than medically accepted therapeutic
4    purposes.
5        (34) Promotion of the sale of drugs, devices,
6    appliances, or goods provided for a patient in a manner to
7    exploit the patient for financial gain.
8        (35) Violating State or federal laws, rules, or
9    regulations relating to controlled substances.
10        (36) Willfully or negligently violating the
11    confidentiality between an advanced practice registered
12    nurse, collaborating physician, dentist, or podiatric
13    physician and a patient, except as required by law.
14        (37) Willfully failing to report an instance of
15    suspected abuse, neglect, financial exploitation, or
16    self-neglect of an eligible adult as defined in and
17    required by the Adult Protective Services Act.
18        (38) Being named as an abuser in a verified report by
19    the Department on Aging and under the Adult Protective
20    Services Act, and upon proof by clear and convincing
21    evidence that the licensee abused, neglected, or
22    financially exploited an eligible adult as defined in the
23    Adult Protective Services Act.
24        (39) A violation of any provision of this Act or any
25    rules adopted under this Act.
26        (40) Violating the Compassionate Use of Medical
		SB3445 Enrolled	- 13 -	LRB104 18158 BAB 31597 b
1    Cannabis Program Act.
2        (41) Violating the Kidney Disease Treatment Delegation 
3    Act.
4    (b-5) The Department shall not revoke, suspend, summarily
5suspend, place on probation, reprimand, refuse to issue or
6renew, or take any other disciplinary or non-disciplinary
7action against a person's authorization to practice under this
8Act based solely upon the person providing, authorizing,
9recommending, aiding, assisting, referring for, or otherwise
10participating in any health care service, so long as the care
11was not unlawful under the laws of this State, regardless of
12whether the patient was a resident of this State or another
13state.
14    (b-10) The Department shall not revoke, suspend, summarily
15suspend, place on prohibition, reprimand, refuse to issue or
16renew, or take any other disciplinary or non-disciplinary
17action against a person's authorization to practice under this
18Act based upon the person's license, registration, or permit
19being revoked or suspended, or the person being otherwise
20disciplined, by any other state if that revocation,
21suspension, or other form of discipline was based solely on
22the person violating another state's laws prohibiting the
23provision of, authorization of, recommendation of, aiding or
24assisting in, referring for, or participation in any health
25care service if that health care service as provided would not
26have been unlawful under the laws of this State and is
		SB3445 Enrolled	- 14 -	LRB104 18158 BAB 31597 b
1consistent with the applicable standard of conduct for the
2person practicing in Illinois under this Act.
3    (b-15) The conduct specified in subsections (b-5) and
4(b-10) shall not trigger reporting requirements under Section
565-65 or constitute grounds for suspension under Section
670-60.
7    (b-20) An applicant seeking licensure, certification, or
8authorization under this Act who has been subject to
9disciplinary action by a duly authorized professional
10disciplinary agency of another jurisdiction solely on the
11basis of having provided, authorized, recommended, aided,
12assisted, referred for, or otherwise participated in health
13care shall not be denied such licensure, certification, or
14authorization, unless the Department determines that such
15action would have constituted professional misconduct in this
16State; however, nothing in this Section shall be construed as
17prohibiting the Department from evaluating the conduct of such
18applicant and making a determination regarding the licensure,
19certification, or authorization to practice a profession under
20this Act.
21    (c) The determination by a circuit court that a licensee
22is subject to involuntary admission or judicial admission as
23provided in the Mental Health and Developmental Disabilities
24Code, as amended, operates as an automatic suspension. The
25suspension will end only upon a finding by a court that the
26patient is no longer subject to involuntary admission or
		SB3445 Enrolled	- 15 -	LRB104 18158 BAB 31597 b
1judicial admission and issues an order so finding and
2discharging the patient; and upon the recommendation of the
3Board to the Secretary that the licensee be allowed to resume
4his or her practice.
5    (d) The Department may refuse to issue or may suspend or
6otherwise discipline the license of any person who fails to
7file a return, or to pay the tax, penalty, or interest shown in
8a filed return, or to pay any final assessment of the tax,
9penalty, or interest as required by any tax Act administered
10by the Department of Revenue, until such time as the
11requirements of any such tax Act are satisfied.
12    (e) In enforcing this Act, the Department, upon a showing
13of a possible violation, may compel an individual licensed to
14practice under this Act or who has applied for licensure under
15this Act, to submit to a mental or physical examination, or
16both, as required by and at the expense of the Department. The
17Department may order the examining physician to present
18testimony concerning the mental or physical examination of the
19licensee or applicant. No information shall be excluded by
20reason of any common law or statutory privilege relating to
21communications between the licensee or applicant and the
22examining physician. The examining physicians shall be
23specifically designated by the Department. The individual to
24be examined may have, at his or her own expense, another
25physician of his or her choice present during all aspects of
26this examination. Failure of an individual to submit to a
		SB3445 Enrolled	- 16 -	LRB104 18158 BAB 31597 b
1mental or physical examination, when directed, shall result in
2an automatic suspension without hearing.
3    All substance-related violations shall mandate an
4automatic substance abuse assessment. Failure to submit to an
5assessment by a licensed physician who is certified as an
6addictionist or an advanced practice registered nurse with
7specialty certification in addictions may be grounds for an
8automatic suspension, as defined by rule.
9    If the Department finds an individual unable to practice
10or unfit for duty because of the reasons set forth in this
11subsection (e), the Department may require that individual to
12submit to a substance abuse evaluation or treatment by
13individuals or programs approved or designated by the
14Department, as a condition, term, or restriction for
15continued, restored, or renewed licensure to practice; or, in
16lieu of evaluation or treatment, the Department may file, or
17the Board may recommend to the Department to file, a complaint
18to immediately suspend, revoke, or otherwise discipline the
19license of the individual. An individual whose license was
20granted, continued, restored, renewed, disciplined, or
21supervised subject to such terms, conditions, or restrictions,
22and who fails to comply with such terms, conditions, or
23restrictions, shall be referred to the Secretary for a
24determination as to whether the individual shall have his or
25her license suspended immediately, pending a hearing by the
26Department.
		SB3445 Enrolled	- 17 -	LRB104 18158 BAB 31597 b
1    In instances in which the Secretary immediately suspends a
2person's license under this subsection (e), a hearing on that
3person's license must be convened by the Department within 15
4days after the suspension and completed without appreciable
5delay. The Department and Board shall have the authority to
6review the subject individual's record of treatment and
7counseling regarding the impairment to the extent permitted by
8applicable federal statutes and regulations safeguarding the
9confidentiality of medical records.
10    An individual licensed under this Act and affected under
11this subsection (e) shall be afforded an opportunity to
12demonstrate to the Department that he or she can resume
13practice in compliance with nursing standards under the
14provisions of his or her license.
15    (f) The Department may adopt rules to implement,
16administer, and enforce this Section.
17(Source: P.A. 104-432, eff. 1-1-26.)
18    Section 99. Effective date. This Act takes effect upon
19becoming law.