SB3445: KIDNEY TREATMENT DELEGATE ACT

SB3445 Enrolled LRB104 18158 BAB 31597 b 1 AN ACT concerning regulation. 2 Be it enacted by the People of the State of Illinois, 3 represented in the General Assembly: 4 Section 1. Short title. This Act may be cited as the Kidney 5 Disease Treatment Delegation Act. 6 Section 2. Purpose. The purpose of this Act is to 7 safeguard individuals seeking kidney disease treatments in the 8 State of Illinois by ensuring that the professionals who 9 provide these services are licensed and trained. 10 Section 5. Definitions. In this Act: 11 "Advanced practice registered nurse" or "APRN" means a 12 person who has met the qualifications for a (i) certified 13 nurse midwife (CNM); (ii) certified nurse practitioner (CNP); 14 (iii) certified registered nurse anesthetist (CRNA); or (iv) 15 clinical nurse specialist (CNS) and has been licensed by the 16 Department under the Nurse Practice Act. 17 "Central venous catheter procedure" includes providing 18 dialysis through venous catheters, initiating and terminating 19 dialysis through those catheters, connecting and disconnecting 20 central venous catheter lines, and maintaining central venous 21 catheters through dressing changes and other care. 22 "Certified dialysis technician" means a person with an SB3445 Enrolled - 2 - LRB104 18158 BAB 31597 b 1 accredited high school diploma or State of Illinois High 2 School Diploma who has been certified by the Nephrology 3 Nursing Certification Commission as a certified clinical 4 hemodialysis technician or by the Board of Nephrology 5 Examiners Nursing and Technology as a certified hemodialysis 6 technologist/technician. 7 "Department" means the Department of Financial and 8 Professional Regulation. 9 "Kidney disease treatment center" has the meaning given to 10 that term in subsection (5) of Section 3 of the Illinois Health 11 Facilities Planning Act. "Kidney disease treatment center" 12 includes a treatment center that provides dialysis through 13 venous catheters, initiates and terminates dialysis through 14 those catheters, connects and disconnects central venous 15 catheter lines, and maintains central venous catheters through 16 dressing changes and other care. 17 "Physician" means a person licensed to practice medicine 18 in all its branches under the Medical Practice Act of 1987. 19 "Physician assistant" means a physician assistant licensed 20 under the Physician Assistant Practice Act of 1987. 21 "Practical nurse", "licensed practical nurse", or "LPN" 22 means a person who is licensed as a practical nurse under the 23 Nurse Practice Act and practices practical nursing as defined 24 in 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 1 under the Nurse Practice Act and practices nursing as defined 2 in that Act. 3 Section 10. Regulation of delegation in kidney disease 4 treatment centers. 5 (a) Notwithstanding any provision of the Nurse Practice 6 Act or any rule of the Department to the contrary, an 7 individual working in a kidney disease treatment center shall 8 be considered a licensed individual for the purposes of 9 delegation under Section 50-75 of the Nurse Practice Act. 10 (b) Notwithstanding any provision of the Nurse Practice 11 Act or any rule of the Department to the contrary, delegation 12 under this Section, including, but not limited to, delegation 13 of the performance of central venous catheter procedures in a 14 kidney disease treatment center, shall only be allowed if the 15 individual receiving delegation is a licensed practical nurse 16 who has obtained the proper training, education, and 17 experience or a certified dialysis technician who currently 18 holds, or is in the process of acquiring, the necessary 19 experience to apply for and obtain one of the following 20 certifications: 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 1 Act or any rule of the Department to the contrary, delegation 2 under this Section shall not include medication 3 administration, except for the administration of heparin and 4 saline for the purposes of performing dialysis treatments and 5 flushing lines and the application of topical anesthetics. All 6 patient care provided by a licensed practical nurse or a 7 certified dialysis technician practicing under this Section 8 shall be under the direct and immediate on-site supervision of 9 a licensed physician, advanced practice registered nurse, 10 physician assistant, or registered nurse. A certified dialysis 11 technician shall not be permitted to administer heparin and 12 saline 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 6 Section 50-75 of the Nurse Practice Act and any rules adopted 7 under the Illinois Health Facilities Planning Act, the Nurse 8 Practice Act, and any other Illinois statute or rule regarding 9 the operation of a kidney disease treatment center as 10 described by this Section. 11 (e) Nothing in this Section shall be construed to apply to 12 any other facility or practice setting. This Section shall not 13 be construed as granting a license under the Nurse Practice 14 Act and shall not allow individuals receiving delegation under 15 this Section to use any title regulated by the Nurse Practice 16 Act. Nothing in this Act shall be construed to limit the 17 ability of a licensed physician to practice medicine in all 18 its branches. 19 Section 15. Rulemaking. The Department is authorized to 20 adopt rules for the administration and enforcement of this 21 Act. The rules may define standards and criteria for the 22 necessary training, education, and experience for licensed 23 practical nurses to obtain before receiving delegation under 24 this Act. SB3445 Enrolled - 6 - LRB104 18158 BAB 31597 b 1 Section 20. The Nurse Practice Act is amended by changing 2 Section 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 7 revoke, suspend, place on probation, reprimand, or take other 8 disciplinary or non-disciplinary action as the Department may 9 deem appropriate, including fines not to exceed $10,000 per 10 violation, with regard to a license for any one or combination 11 of the causes set forth in subsection (b) below. All fines 12 collected under this Section shall be deposited in the Nursing 13 Dedicated 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 5 suspend, place on probation, reprimand, refuse to issue or 6 renew, or take any other disciplinary or non-disciplinary 7 action against a person's authorization to practice under this 8 Act based solely upon the person providing, authorizing, 9 recommending, aiding, assisting, referring for, or otherwise 10 participating in any health care service, so long as the care 11 was not unlawful under the laws of this State, regardless of 12 whether the patient was a resident of this State or another 13 state. 14 (b-10) The Department shall not revoke, suspend, summarily 15 suspend, place on prohibition, reprimand, refuse to issue or 16 renew, or take any other disciplinary or non-disciplinary 17 action against a person's authorization to practice under this 18 Act based upon the person's license, registration, or permit 19 being revoked or suspended, or the person being otherwise 20 disciplined, by any other state if that revocation, 21 suspension, or other form of discipline was based solely on 22 the person violating another state's laws prohibiting the 23 provision of, authorization of, recommendation of, aiding or 24 assisting in, referring for, or participation in any health 25 care service if that health care service as provided would not 26 have been unlawful under the laws of this State and is SB3445 Enrolled - 14 - LRB104 18158 BAB 31597 b 1 consistent with the applicable standard of conduct for the 2 person 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 5 65-65 or constitute grounds for suspension under Section 6 70-60. 7 (b-20) An applicant seeking licensure, certification, or 8 authorization under this Act who has been subject to 9 disciplinary action by a duly authorized professional 10 disciplinary agency of another jurisdiction solely on the 11 basis of having provided, authorized, recommended, aided, 12 assisted, referred for, or otherwise participated in health 13 care shall not be denied such licensure, certification, or 14 authorization, unless the Department determines that such 15 action would have constituted professional misconduct in this 16 State; however, nothing in this Section shall be construed as 17 prohibiting the Department from evaluating the conduct of such 18 applicant and making a determination regarding the licensure, 19 certification, or authorization to practice a profession under 20 this Act. 21 (c) The determination by a circuit court that a licensee 22 is subject to involuntary admission or judicial admission as 23 provided in the Mental Health and Developmental Disabilities 24 Code, as amended, operates as an automatic suspension. The 25 suspension will end only upon a finding by a court that the 26 patient is no longer subject to involuntary admission or SB3445 Enrolled - 15 - LRB104 18158 BAB 31597 b 1 judicial admission and issues an order so finding and 2 discharging the patient; and upon the recommendation of the 3 Board to the Secretary that the licensee be allowed to resume 4 his or her practice. 5 (d) The Department may refuse to issue or may suspend or 6 otherwise discipline the license of any person who fails to 7 file a return, or to pay the tax, penalty, or interest shown in 8 a filed return, or to pay any final assessment of the tax, 9 penalty, or interest as required by any tax Act administered 10 by the Department of Revenue, until such time as the 11 requirements of any such tax Act are satisfied. 12 (e) In enforcing this Act, the Department, upon a showing 13 of a possible violation, may compel an individual licensed to 14 practice under this Act or who has applied for licensure under 15 this Act, to submit to a mental or physical examination, or 16 both, as required by and at the expense of the Department. The 17 Department may order the examining physician to present 18 testimony concerning the mental or physical examination of the 19 licensee or applicant. No information shall be excluded by 20 reason of any common law or statutory privilege relating to 21 communications between the licensee or applicant and the 22 examining physician. The examining physicians shall be 23 specifically designated by the Department. The individual to 24 be examined may have, at his or her own expense, another 25 physician of his or her choice present during all aspects of 26 this examination. Failure of an individual to submit to a SB3445 Enrolled - 16 - LRB104 18158 BAB 31597 b 1 mental or physical examination, when directed, shall result in 2 an automatic suspension without hearing. 3 All substance-related violations shall mandate an 4 automatic substance abuse assessment. Failure to submit to an 5 assessment by a licensed physician who is certified as an 6 addictionist or an advanced practice registered nurse with 7 specialty certification in addictions may be grounds for an 8 automatic suspension, as defined by rule. 9 If the Department finds an individual unable to practice 10 or unfit for duty because of the reasons set forth in this 11 subsection (e), the Department may require that individual to 12 submit to a substance abuse evaluation or treatment by 13 individuals or programs approved or designated by the 14 Department, as a condition, term, or restriction for 15 continued, restored, or renewed licensure to practice; or, in 16 lieu of evaluation or treatment, the Department may file, or 17 the Board may recommend to the Department to file, a complaint 18 to immediately suspend, revoke, or otherwise discipline the 19 license of the individual. An individual whose license was 20 granted, continued, restored, renewed, disciplined, or 21 supervised subject to such terms, conditions, or restrictions, 22 and who fails to comply with such terms, conditions, or 23 restrictions, shall be referred to the Secretary for a 24 determination as to whether the individual shall have his or 25 her license suspended immediately, pending a hearing by the 26 Department. SB3445 Enrolled - 17 - LRB104 18158 BAB 31597 b 1 In instances in which the Secretary immediately suspends a 2 person's license under this subsection (e), a hearing on that 3 person's license must be convened by the Department within 15 4 days after the suspension and completed without appreciable 5 delay. The Department and Board shall have the authority to 6 review the subject individual's record of treatment and 7 counseling regarding the impairment to the extent permitted by 8 applicable federal statutes and regulations safeguarding the 9 confidentiality of medical records. 10 An individual licensed under this Act and affected under 11 this subsection (e) shall be afforded an opportunity to 12 demonstrate to the Department that he or she can resume 13 practice in compliance with nursing standards under the 14 provisions of his or her license. 15 (f) The Department may adopt rules to implement, 16 administer, and enforce this Section. 17 (Source: P.A. 104-432, eff. 1-1-26 .) 18 Section 99. Effective date. This Act takes effect upon 19 becoming law.