Bill Amendment: IL SB0761 | 2023-2024 | 103rd General Assembly

NOTE: For additional amemendments please see the Bill Drafting List

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Bill Title: REGULATION-TECH

Status: 2023-08-11 - Public Act . . . . . . . . . 103-0547 [SB0761 Detail]

Download: Illinois-2023-SB0761-Senate_Amendment_001.html

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Sen. Kimberly A. Lightford

Filed: 3/24/2023

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AMENDMENT TO SENATE BILL 761
AMENDMENT NO. ______. Amend Senate Bill 761 by replacing
everything after the enacting clause with the following:
"Section 5. The Emergency Medical Services (EMS) Systems
Act is amended by changing Sections 3.20, 3.65, and 3.85 and by
adding Section 3.22 as follows:
(210 ILCS 50/3.20)
Sec. 3.20. Emergency Medical Services (EMS) Systems.
(a) "Emergency Medical Services (EMS) System" means an
organization of hospitals, vehicle service providers and
personnel approved by the Department in a specific geographic
area, which coordinates and provides pre-hospital and
inter-hospital emergency care and non-emergency medical
transports at a BLS, ILS and/or ALS level pursuant to a System
program plan submitted to and approved by the Department, and
pursuant to the EMS Region Plan adopted for the EMS Region in

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which the System is located.
(b) One hospital in each System program plan must be
designated as the Resource Hospital. All other hospitals which
are located within the geographic boundaries of a System and
which have standby, basic or comprehensive level emergency
departments must function in that EMS System as either an
Associate Hospital or Participating Hospital and follow all
System policies specified in the System Program Plan,
including but not limited to the replacement of drugs and
equipment used by providers who have delivered patients to
their emergency departments. All hospitals and vehicle service
providers participating in an EMS System must specify their
level of participation in the System Program Plan.
(c) The Department shall have the authority and
responsibility to:
(1) Approve BLS, ILS and ALS level EMS Systems which
meet minimum standards and criteria established in rules
adopted by the Department pursuant to this Act, including
the submission of a Program Plan for Department approval.
Beginning September 1, 1997, the Department shall approve
the development of a new EMS System only when a local or
regional need for establishing such System has been
verified by the Department. This shall not be construed as
a needs assessment for health planning or other purposes
outside of this Act. Following Department approval, EMS
Systems must be fully operational within one year from the

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date of approval.
(2) Monitor EMS Systems, based on minimum standards
for continuing operation as prescribed in rules adopted by
the Department pursuant to this Act, which shall include
requirements for submitting Program Plan amendments to the
Department for approval.
(3) Renew EMS System approvals every 4 years, after an
inspection, based on compliance with the standards for
continuing operation prescribed in rules adopted by the
Department pursuant to this Act.
(4) Suspend, revoke, or refuse to renew approval of
any EMS System, after providing an opportunity for a
hearing, when findings show that it does not meet the
minimum standards for continuing operation as prescribed
by the Department, or is found to be in violation of its
previously approved Program Plan.
(5) Require each EMS System to adopt written protocols
for the bypassing of or diversion to any hospital, trauma
center or regional trauma center, which provide that a
person shall not be transported to a facility other than
the nearest hospital, regional trauma center or trauma
center unless the medical benefits to the patient
reasonably expected from the provision of appropriate
medical treatment at a more distant facility outweigh the
increased risks to the patient from transport to the more
distant facility, or the transport is in accordance with

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the System's protocols for patient choice or refusal.
(6) Require that the EMS Medical Director of an ILS or
ALS level EMS System be a physician licensed to practice
medicine in all of its branches in Illinois, and certified
by the American Board of Emergency Medicine or the
American Osteopathic Board of Emergency Medicine, and that
the EMS Medical Director of a BLS level EMS System be a
physician licensed to practice medicine in all of its
branches in Illinois, with regular and frequent
involvement in pre-hospital emergency medical services. In
addition, all EMS Medical Directors shall:
(A) Have experience on an EMS vehicle at the
highest level available within the System, or make
provision to gain such experience within 12 months
prior to the date responsibility for the System is
assumed or within 90 days after assuming the position;
(B) Be thoroughly knowledgeable of all skills
included in the scope of practices of all levels of EMS
personnel within the System;
(C) Have or make provision to gain experience
instructing students at a level similar to that of the
levels of EMS personnel within the System; and
(D) For ILS and ALS EMS Medical Directors,
successfully complete a Department-approved EMS
Medical Director's Course.
(7) Prescribe statewide EMS data elements to be

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collected and documented by providers in all EMS Systems
for all emergency and non-emergency medical services, with
a one-year phase-in for commencing collection of such data
elements.
(8) Define, through rules adopted pursuant to this
Act, the terms "Resource Hospital", "Associate Hospital",
"Participating Hospital", "Basic Emergency Department",
"Standby Emergency Department", "Comprehensive Emergency
Department", "EMS Medical Director", "EMS Administrative
Director", and "EMS System Coordinator".
(A) (Blank).
(B) (Blank).
(9) Investigate the circumstances that caused a
hospital in an EMS system to go on bypass status to
determine whether that hospital's decision to go on bypass
status was reasonable. The Department may impose
sanctions, as set forth in Section 3.140 of the Act, upon a
Department determination that the hospital unreasonably
went on bypass status in violation of the Act.
(10) Evaluate the capacity and performance of any
freestanding emergency center established under Section
32.5 of this Act in meeting emergency medical service
needs of the public, including compliance with applicable
emergency medical standards and assurance of the
availability of and immediate access to the highest
quality of medical care possible.

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(11) Permit limited EMS System participation by
facilities operated by the United States Department of
Veterans Affairs, Veterans Health Administration. Subject
to patient preference, Illinois EMS providers may
transport patients to Veterans Health Administration
facilities that voluntarily participate in an EMS System.
Any Veterans Health Administration facility seeking
limited participation in an EMS System shall agree to
comply with all Department administrative rules
implementing this Section. The Department may promulgate
rules, including, but not limited to, the types of
Veterans Health Administration facilities that may
participate in an EMS System and the limitations of
participation.
(12) Ensure that EMS systems are transporting pregnant
women to the appropriate facilities based on the
classification of the levels of maternal care described
under subsection (a) of Section 2310-223 of the Department
of Public Health Powers and Duties Law of the Civil
Administrative Code of Illinois.
(13) Provide administrative support to the EMT
Training, Recruitment, and Retention Task Force.
(Source: P.A. 101-447, eff. 8-23-19.)
(210 ILCS 50/3.22 new)
Sec. 3.22. EMT Training, Recruitment, and Retention Task

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Force.
(a) The EMT Training, Recruitment, and Retention Task
Force is created to address the following:
(1) the impact that the EMT and Paramedic shortage is
having on this State's EMS System and health care system;
(2) barriers to the training, recruitment, and
retention of Emergency Medical Technicians throughout this
State;
(3) steps that the State of Illinois can take,
including coordination and identification of State and
federal funding sources, to assist Illinois high schools,
community colleges, and ground ambulance providers to
train, recruit, and retain emergency medical technicians;
(4) how emergency medical responder and emergency
medical technician licensure and testing and certification
requirements affect the recruitment and retention of
emergency medical technicians, including, without
limitation, how the implementation of the National
Registry of Emergency Medical Technician training criteria
have impacted the certification and licensure of new EMRs,
EMTs, and Paramedics;
(5) how apprenticeship programs, local, regional, and
statewide, can be utilized to recruit and retain EMRs,
EMTs, and Paramedics;
(6) how ground ambulance reimbursement affects the
recruitment and retention of EMTs and Paramedics; and

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(7) all other areas that the Task Force deems
necessary to examine to assist in the recruitment and
retention of EMTs and Paramedics.
(b) The Task Force shall be comprised of the following
members:
(1) one member of the Illinois General Assembly,
appointed by the Senate President, who shall serve as
co-chair;
(2) one member of the Illinois General Assembly,
appointed by the Speaker of the House;
(3) one member of the Illinois General Assembly,
appointed by the Senate Minority Leader;
(4) one member of the Illinois General Assembly,
appointed by the House Minority Leader, who shall serve as
co-chair;
(5) 9 members representing private ground ambulance
providers throughout this State representing for-profit
and non-profit rural and ground ambulance providers,
appointed by the Governor;
(6) 3 members representing hospitals, appointed by the
Speaker of the House, with one member representing safety
net hospitals and one member representing rural hospitals;
(7) 2 members representing a statewide association of
nursing homes, appointed by the Minority Leader of the
Senate;
(8) one member representing the State Board of

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Education, appointed by the Minority Leader of the House;
and
(9) one member representing the Illinois Community
College Systems, appointed by the Minority Leader of the
House.
(c) Members of the Task Force shall serve without
compensation.
(d) The Task Force shall convene at the call of the
co-chairs and shall hold at least 6 meetings.
(e) The Task Force shall submit its final report to the
General Assembly and the Governor no later than January 1,
2024, and upon the submission of its final report, the Task
Force shall be dissolved.
(210 ILCS 50/3.65)
Sec. 3.65. EMS Lead Instructor.
(a) "EMS Lead Instructor" means a person who has
successfully completed a course of education as approved by
the Department or has obtained sufficient experience as
determined by the EMS Medical Director, and who is currently
approved by the Department to coordinate or teach education,
training and continuing education courses, in accordance with
standards prescribed by this Act and rules adopted by the
Department pursuant to this Act.
(b) The Department shall have the authority and
responsibility to:

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(1) Prescribe education requirements for EMS Lead
Instructor candidates through rules adopted pursuant to
this Act.
(2) Prescribe testing requirements for EMS Lead
Instructor candidates through rules adopted pursuant to
this Act.
(3) Charge each candidate for EMS Lead Instructor a
fee to be submitted with an application for an
examination, an application for licensure, and an
application for relicensure.
(4) Approve individuals as EMS Lead Instructors who
have met the Department's education and testing
requirements.
(5) Require that all education, training and
continuing education courses for EMT, EMT-I, A-EMT,
Paramedic, PHRN, PHPA, PHAPRN, ECRN, EMR, and Emergency
Medical Dispatcher be coordinated by at least one approved
EMS Lead Instructor. A program which includes education,
training or continuing education for more than one type of
personnel may use one EMS Lead Instructor to coordinate
the program, and a single EMS Lead Instructor may
simultaneously coordinate more than one program or course.
(6) Provide standards and procedures for awarding EMS
Lead Instructor approval to persons previously approved by
the Department to coordinate such courses, based on
qualifications prescribed by the Department through rules

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adopted pursuant to this Act.
(7) Suspend, revoke, or refuse to issue or renew the
approval of an EMS Lead Instructor, after an opportunity
for a hearing, when findings show one or more of the
following:
(A) The EMS Lead Instructor has failed to conduct
a course in accordance with the curriculum prescribed
by this Act and rules adopted by the Department
pursuant to this Act; or
(B) The EMS Lead Instructor has failed to comply
with protocols prescribed by the Department through
rules adopted pursuant to this Act.
(Source: P.A. 100-1082, eff. 8-24-19.)
(210 ILCS 50/3.85)
Sec. 3.85. Vehicle Service Providers.
(a) "Vehicle Service Provider" means an entity licensed by
the Department to provide emergency or non-emergency medical
services in compliance with this Act, the rules promulgated by
the Department pursuant to this Act, and an operational plan
approved by its EMS System(s), utilizing at least ambulances
or specialized emergency medical service vehicles (SEMSV).
(1) "Ambulance" means any publicly or privately owned
on-road vehicle that is specifically designed, constructed
or modified and equipped, and is intended to be used for,
and is maintained or operated for the emergency

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transportation of persons who are sick, injured, wounded
or otherwise incapacitated or helpless, or the
non-emergency medical transportation of persons who
require the presence of medical personnel to monitor the
individual's condition or medical apparatus being used on
such individuals.
(2) "Specialized Emergency Medical Services Vehicle"
or "SEMSV" means a vehicle or conveyance, other than those
owned or operated by the federal government, that is
primarily intended for use in transporting the sick or
injured by means of air, water, or ground transportation,
that is not an ambulance as defined in this Act. The term
includes watercraft, aircraft and special purpose ground
transport vehicles or conveyances not intended for use on
public roads.
(3) An ambulance or SEMSV may also be designated as a
Limited Operation Vehicle or Special-Use Vehicle:
(A) "Limited Operation Vehicle" means a vehicle
which is licensed by the Department to provide basic,
intermediate or advanced life support emergency or
non-emergency medical services that are exclusively
limited to specific events or locales.
(B) "Special-Use Vehicle" means any publicly or
privately owned vehicle that is specifically designed,
constructed or modified and equipped, and is intended
to be used for, and is maintained or operated solely

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for the emergency or non-emergency transportation of a
specific medical class or category of persons who are
sick, injured, wounded or otherwise incapacitated or
helpless (e.g. high-risk obstetrical patients,
neonatal patients).
(C) "Reserve Ambulance" means a vehicle that meets
all criteria set forth in this Section and all
Department rules, except for the required inventory of
medical supplies and durable medical equipment, which
may be rapidly transferred from a fully functional
ambulance to a reserve ambulance without the use of
tools or special mechanical expertise.
(b) The Department shall have the authority and
responsibility to:
(1) Require all Vehicle Service Providers, both
publicly and privately owned, to function within an EMS
System.
(2) Require a Vehicle Service Provider utilizing
ambulances to have a primary affiliation with an EMS
System within the EMS Region in which its Primary Service
Area is located, which is the geographic areas in which
the provider renders the majority of its emergency
responses. This requirement shall not apply to Vehicle
Service Providers which exclusively utilize Limited
Operation Vehicles.
(3) Establish licensing standards and requirements for

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Vehicle Service Providers, through rules adopted pursuant
to this Act, including but not limited to:
(A) Vehicle design, specification, operation and
maintenance standards, including standards for the use
of reserve ambulances;
(B) Equipment requirements;
(C) Staffing requirements; and
(D) License renewal at intervals determined by the
Department, which shall be not less than every 4
years.
The Department's standards and requirements with
respect to vehicle staffing for private, nonpublic local
government employers must allow for alternative staffing
models that include an EMR who drives an ambulance with a
licensed EMT, EMT-I, A-EMT, Paramedic, or PHRN, as
appropriate, in the patient compartment providing care to
the patient pursuant to the approval of the EMS System
Program Plan developed and approved by the EMS Medical
Director for an EMS System. The Department shall monitor
the implementation and performance of alternative staffing
models and may issue a notice of termination of an
alternative staffing model only upon evidence that an EMS
System Program Plan is not being adhered to. Adoption of
an alternative staffing model shall not result in a
Vehicle Service Provider being prohibited or limited in
the utilization of its staff or equipment from providing

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any of the services authorized by this Act or as otherwise
outlined in the approved EMS System Program Plan,
including, without limitation, the deployment of resources
to provide out-of-state disaster response.
An EMS System Program Plan for a Basic Life Support,
advanced life support, and critical care transport
services transport utilizing an EMR and an EMT, Paramedic,
or appropriate critical care transport staff shall include
the following:
(A) Alternative staffing models for a Basic Life
Support transport utilizing an EMR and an EMT shall
only be utilized for interfacility Basic Life Support
transports specified by the EMS System Program Plan as
determined by the EMS System Medical Director and
medical appointments, excluding any transport to or
from a dialysis center.
(B) Protocols that shall include dispatch
procedures to properly screen and assess patients for
EMR-staffed transports and EMT-staffed Basic Life
Support transport.
(C) A requirement that a provider shall implement
a quality assurance plan with mechanisms outlined to
audit dispatch screening and the outcome of transports
performed.
(D) The EMT, Paramedic, and critical care
transport staff shall have the minimum at least one

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year of experience in performance of pre-hospital,
inter-hospital emergency care and other health care
experience as a clinician, as determined by the EMS
Medical Director in accordance with the EMS System
Program Plan.
(E) The licensed EMR must complete a defensive
driving course prior to participation in the
Department's alternative staffing model.
(F) The length of the EMS System Program Plan for a
Basic Life Support transport utilizing an EMR and an
EMT shall be for one year, and must be renewed annually
if proof of the criteria being met is submitted,
validated, and approved by the EMS Medical Director
for the EMS System and the Department.
The Department must allow for an alternative rural
staffing model for those vehicle service providers that
serve a rural or semi-rural population of 10,000 or fewer
inhabitants and exclusively uses volunteers, paid-on-call,
or a combination thereof.
(4) License all Vehicle Service Providers that have
met the Department's requirements for licensure, unless
such Provider is owned or licensed by the federal
government. All Provider licenses issued by the Department
shall specify the level and type of each vehicle covered
by the license (BLS, ILS, ALS, ambulance, SEMSV, limited
operation vehicle, special use vehicle, ambulance assist

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vehicle, reserve ambulance) and shall allow for ambulances
to be immediately upgraded to a higher level of service
when the Vehicle Service Provider sends an ambulance
assist vehicle with appropriate equipment and licensed
staff to intercept with the licensed ambulance in the
field.
(5) Annually inspect all licensed vehicles operated by
Vehicle Service Providers.
(6) Suspend, revoke, refuse to issue or refuse to
renew the license of any Vehicle Service Provider, or that
portion of a license pertaining to a specific vehicle
operated by the Provider, after an opportunity for a
hearing, when findings show that the Provider or one or
more of its vehicles has failed to comply with the
standards and requirements of this Act or rules adopted by
the Department pursuant to this Act.
(7) Issue an Emergency Suspension Order for any
Provider or vehicle licensed under this Act, when the
Director or his designee has determined that an immediate
and serious danger to the public health, safety and
welfare exists. Suspension or revocation proceedings which
offer an opportunity for hearing shall be promptly
initiated after the Emergency Suspension Order has been
issued.
(8) Exempt any licensed vehicle from subsequent
vehicle design standards or specifications required by the

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Department, as long as said vehicle is continuously in
compliance with the vehicle design standards and
specifications originally applicable to that vehicle, or
until said vehicle's title of ownership is transferred.
(9) Exempt any vehicle (except an SEMSV) which was
being used as an ambulance on or before December 15, 1980,
from vehicle design standards and specifications required
by the Department, until said vehicle's title of ownership
is transferred. Such vehicles shall not be exempt from all
other licensing standards and requirements prescribed by
the Department.
(10) Prohibit any Vehicle Service Provider from
advertising, identifying its vehicles, or disseminating
information in a false or misleading manner concerning the
Provider's type and level of vehicles, location, primary
service area, response times, level of personnel,
licensure status or System participation.
(10.5) Prohibit any Vehicle Service Provider, whether
municipal, private, or hospital-owned, from advertising
itself as a critical care transport provider unless it
participates in a Department-approved EMS System critical
care transport plan.
(11) Charge each Vehicle Service Provider a fee per
transport vehicle, due annually at time of inspection. The
fee per transport vehicle shall be set by administrative
rule by the Department and shall not exceed 100 vehicles

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per provider.
(Source: P.A. 102-623, eff. 8-27-21.)".