Bill Text: IL SB3255 | 2017-2018 | 100th General Assembly | Enrolled

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Amends the Emergency Medical Services (EMS) Systems Act. Defines "Pre-Hospital Physician Assistant" or "PHPA". Includes Pre-Hospital Physician Assistants in the definition of "Emergency Medical Services Personnel". Adds PHPAs to provisions concerning licensing and educational requirements. Provides than an EMS Medical Director may immediately suspend a PHPA for specified reasons. Adds a PHPA to the State Emergency Medical Services Disciplinary Review Board. Adds PHPAs to provisions concerning misrepresentation. Makes other changes. Effective immediately.

Spectrum: Bipartisan Bill

Status: (Passed) 2018-08-24 - Public Act . . . . . . . . . 100-1082 [SB3255 Detail]

Download: Illinois-2017-SB3255-Enrolled.html

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AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Emergency Medical Services (EMS) Systems Act
is amended by changing Sections 3.5, 3.35, 3.40, 3.45, 3.50,
3.55, 3.65, 3.80, 3.87, and 3.165 as follows:
(210 ILCS 50/3.5)
Sec. 3.5. Definitions. As used in this Act:
"Clinical observation" means the on-going observation of a
patient's condition by a licensed health care professional
utilizing a medical skill set while continuing assessment and
care.
"Department" means the Illinois Department of Public
Health.
"Director" means the Director of the Illinois Department of
Public Health.
"Emergency" means a medical condition of recent onset and
severity that would lead a prudent layperson, possessing an
average knowledge of medicine and health, to believe that
urgent or unscheduled medical care is required.
"Emergency Medical Services personnel" or "EMS personnel"
means persons licensed as an Emergency Medical Responder (EMR)
(First Responder), Emergency Medical Dispatcher (EMD),

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Emergency Medical Technician (EMT), Emergency Medical
Technician-Intermediate (EMT-I), Advanced Emergency Medical
Technician (A-EMT), Paramedic (EMT-P), Emergency
Communications Registered Nurse (ECRN), or Pre-Hospital
Registered Nurse (PHRN), Pre-Hospital Advanced Practice
Registered Nurse (PHAPRN), or Pre-Hospital Physician Assistant
(PHPA).
"Health care facility" means a hospital, nursing home,
physician's office or other fixed location at which medical and
health care services are performed. It does not include
"pre-hospital emergency care settings" which utilize EMS
personnel to render pre-hospital emergency care prior to the
arrival of a transport vehicle, as defined in this Act.
"Hospital" has the meaning ascribed to that term in the
Hospital Licensing Act.
"Medical monitoring" means the performance of medical
tests and physical exams to evaluate an individual's on-going
exposure to a factor that could negatively impact that person's
health. "Medical monitoring" includes close surveillance or
supervision of patients liable to suffer deterioration in
physical or mental health and checks of various parameters such
as pulse rate, temperature, respiration rate, the condition of
the pupils, the level of consciousness and awareness, the
degree of appreciation of pain, and blood gas concentrations
such as oxygen and carbon dioxide.
"Trauma" means any significant injury which involves

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single or multiple organ systems.
(Source: P.A. 98-973, eff. 8-15-14; 99-661, eff. 1-1-17.)
(210 ILCS 50/3.35)
Sec. 3.35. Emergency Medical Services (EMS) Resource
Hospital; Functions. The Resource Hospital of an EMS System
shall:
(a) Prepare a Program Plan in accordance with the
provisions of this Act and minimum standards and criteria
established in rules adopted by the Department pursuant to
this Act, and submit such Program Plan to the Department
for approval.
(b) Appoint an EMS Medical Director, who will
continually monitor and supervise the System and who will
have the responsibility and authority for total management
of the System as delegated by the EMS Resource Hospital.
The Program Plan shall require the EMS Medical Director
to appoint an alternate EMS Medical Director and establish
a written protocol addressing the functions to be carried
out in his or her absence.
(c) Appoint an EMS System Coordinator and EMS
Administrative Director in consultation with the EMS
Medical Director and in accordance with rules adopted by
the Department pursuant to this Act.
(d) Identify potential EMS System participants and
obtain commitments from them for the provision of services.

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(e) Educate or coordinate the education of EMS
personnel and all other license holders in accordance with
the requirements of this Act, rules adopted by the
Department pursuant to this Act, and the EMS System Program
Plan.
(f) Notify the Department of EMS personnel who have
successfully completed the requirements as provided by law
for initial licensure, license renewal, and license
reinstatement by the Department.
(g) Educate or coordinate the education of Emergency
Medical Dispatcher candidates, in accordance with the
requirements of this Act, rules adopted by the Department
pursuant to this Act, and the EMS System Program Plan.
(h) Establish or approve protocols for prearrival
medical instructions to callers by System Emergency
Medical Dispatchers who provide such instructions.
(i) Educate or coordinate the education of
Pre-Hospital Registered Nurse, Pre-Hospital Advanced
Practice Registered Nurse, Pre-Hospital Physician
Assistant, and ECRN candidates, in accordance with the
requirements of this Act, rules adopted by the Department
pursuant to this Act, and the EMS System Program Plan.
(j) Approve Pre-Hospital Registered Nurse,
Pre-Hospital Advanced Practice Registered Nurse,
Pre-Hospital Physician Assistant, and ECRN candidates to
practice within the System, and reapprove Pre-Hospital

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Registered Nurses, Pre-Hospital Advanced Practice
Registered Nurses, Pre-Hospital Physician Assistants, and
ECRNs every 4 years in accordance with the requirements of
the Department and the System Program Plan.
(k) Establish protocols for the use of Pre-Hospital
Registered Nurses, Pre-Hospital Advanced Practice
Registered Nurses, and Pre-Hospital Physician Assistants
within the System.
(l) Establish protocols for utilizing ECRNs and
physicians licensed to practice medicine in all of its
branches to monitor telecommunications from, and give
voice orders to, EMS personnel, under the authority of the
EMS Medical Director.
(m) Monitor emergency and non-emergency medical
transports within the System, in accordance with rules
adopted by the Department pursuant to this Act.
(n) Utilize levels of personnel required by the
Department to provide emergency care to the sick and
injured at the scene of an emergency, during transport to a
hospital or during inter-hospital transport and within the
hospital emergency department until the responsibility for
the care of the patient is assumed by the medical personnel
of a hospital emergency department or other facility within
the hospital to which the patient is first delivered by
System personnel.
(o) Utilize levels of personnel required by the

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Department to provide non-emergency medical services
during transport to a health care facility and within the
health care facility until the responsibility for the care
of the patient is assumed by the medical personnel of the
health care facility to which the patient is delivered by
System personnel.
(p) Establish and implement a program for System
participant information and education, in accordance with
rules adopted by the Department pursuant to this Act.
(q) Establish and implement a program for public
information and education, in accordance with rules
adopted by the Department pursuant to this Act.
(r) Operate in compliance with the EMS Region Plan.
(Source: P.A. 98-973, eff. 8-15-14.)
(210 ILCS 50/3.40)
Sec. 3.40. EMS System Participation Suspensions and Due
Process.
(a) An EMS Medical Director may suspend from participation
within the System any EMS personnel, EMS Lead Instructor (LI),
individual, individual provider or other participant
considered not to be meeting the requirements of the Program
Plan of that approved EMS System.
(b) Prior to suspending any individual or entity, an EMS
Medical Director shall provide an opportunity for a hearing
before the local System review board in accordance with

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subsection (f) and the rules promulgated by the Department.
(1) If the local System review board affirms or
modifies the EMS Medical Director's suspension order, the
individual or entity shall have the opportunity for a
review of the local board's decision by the State EMS
Disciplinary Review Board, pursuant to Section 3.45 of this
Act.
(2) If the local System review board reverses or
modifies the EMS Medical Director's order, the EMS Medical
Director shall have the opportunity for a review of the
local board's decision by the State EMS Disciplinary Review
Board, pursuant to Section 3.45 of this Act.
(3) The suspension shall commence only upon the
occurrence of one of the following:
(A) the individual or entity has waived the
opportunity for a hearing before the local System
review board; or
(B) the order has been affirmed or modified by the
local system review board and the individual or entity
has waived the opportunity for review by the State
Board; or
(C) the order has been affirmed or modified by the
local system review board, and the local board's
decision has been affirmed or modified by the State
Board.
(c) An EMS Medical Director may immediately suspend an EMR,

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EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN, PHRN, LI, PHPA,
PHAPRN, or other individual or entity if he or she finds that
the continuation in practice by the individual or entity would
constitute an imminent danger to the public. The suspended
individual or entity shall be issued an immediate verbal
notification followed by a written suspension order by the EMS
Medical Director which states the length, terms and basis for
the suspension.
(1) Within 24 hours following the commencement of the
suspension, the EMS Medical Director shall deliver to the
Department, by messenger, telefax, or other
Department-approved electronic communication, a copy of
the suspension order and copies of any written materials
which relate to the EMS Medical Director's decision to
suspend the individual or entity. All medical and
patient-specific information, including Department
findings with respect to the quality of care rendered,
shall be strictly confidential pursuant to the Medical
Studies Act (Part 21 of Article VIII of the Code of Civil
Procedure).
(2) Within 24 hours following the commencement of the
suspension, the suspended individual or entity may deliver
to the Department, by messenger, telefax, or other
Department-approved electronic communication, a written
response to the suspension order and copies of any written
materials which the individual or entity feels are

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appropriate. All medical and patient-specific information,
including Department findings with respect to the quality
of care rendered, shall be strictly confidential pursuant
to the Medical Studies Act.
(3) Within 24 hours following receipt of the EMS
Medical Director's suspension order or the individual or
entity's written response, whichever is later, the
Director or the Director's designee shall determine
whether the suspension should be stayed pending an
opportunity for a hearing or review in accordance with this
Act, or whether the suspension should continue during the
course of that hearing or review. The Director or the
Director's designee shall issue this determination to the
EMS Medical Director, who shall immediately notify the
suspended individual or entity. The suspension shall
remain in effect during this period of review by the
Director or the Director's designee.
(d) Upon issuance of a suspension order for reasons
directly related to medical care, the EMS Medical Director
shall also provide the individual or entity with the
opportunity for a hearing before the local System review board,
in accordance with subsection (f) and the rules promulgated by
the Department.
(1) If the local System review board affirms or
modifies the EMS Medical Director's suspension order, the
individual or entity shall have the opportunity for a

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review of the local board's decision by the State EMS
Disciplinary Review Board, pursuant to Section 3.45 of this
Act.
(2) If the local System review board reverses or
modifies the EMS Medical Director's suspension order, the
EMS Medical Director shall have the opportunity for a
review of the local board's decision by the State EMS
Disciplinary Review Board, pursuant to Section 3.45 of this
Act.
(3) The suspended individual or entity may elect to
bypass the local System review board and seek direct review
of the EMS Medical Director's suspension order by the State
EMS Disciplinary Review Board.
(e) The Resource Hospital shall designate a local System
review board in accordance with the rules of the Department,
for the purpose of providing a hearing to any individual or
entity participating within the System who is suspended from
participation by the EMS Medical Director. The EMS Medical
Director shall arrange for a certified shorthand reporter to
make a stenographic record of that hearing and thereafter
prepare a transcript of the proceedings. The transcript, all
documents or materials received as evidence during the hearing
and the local System review board's written decision shall be
retained in the custody of the EMS system. The System shall
implement a decision of the local System review board unless
that decision has been appealed to the State Emergency Medical

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Services Disciplinary Review Board in accordance with this Act
and the rules of the Department.
(f) The Resource Hospital shall implement a decision of the
State Emergency Medical Services Disciplinary Review Board
which has been rendered in accordance with this Act and the
rules of the Department.
(Source: P.A. 100-201, eff. 8-18-17.)
(210 ILCS 50/3.45)
Sec. 3.45. State Emergency Medical Services Disciplinary
Review Board.
(a) The Governor shall appoint a State Emergency Medical
Services Disciplinary Review Board, composed of an EMS Medical
Director, an EMS System Coordinator, a Paramedic, an Emergency
Medical Technician (EMT), and the following members, who shall
only review cases in which a party is from the same
professional category: a Pre-Hospital Registered Nurse, a
Pre-Hospital Advanced Practice Registered Nurse, a
Pre-Hospital Physician Assistant, an ECRN, a Trauma Nurse
Specialist, an Emergency Medical Technician-Intermediate
(EMT-I), an Advanced Emergency Medical Technician (A-EMT), a
representative from a private vehicle service provider, a
representative from a public vehicle service provider, and an
emergency physician who monitors telecommunications from and
gives voice orders to EMS personnel. The Governor shall also
appoint one alternate for each member of the Board, from the

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same professional category as the member of the Board.
(b) The members shall be appointed for a term of 3 years.
All appointees shall serve until their successors are
appointed. The alternate members shall be appointed and serve
in the same fashion as the members of the Board. If a member
resigns his or her appointment, the corresponding alternate
shall serve the remainder of that member's term until a
subsequent member is appointed by the Governor.
(c) The function of the Board is to review and affirm,
reverse or modify disciplinary orders.
(d) Any individual or entity, who received an immediate
suspension from an EMS Medical Director may request the Board
to reverse or modify the suspension order. If the suspension
had been affirmed or modified by a local System review board,
the suspended individual or entity may request the Board to
reverse or modify the local board's decision.
(e) Any individual or entity who received a non-immediate
suspension order from an EMS Medical Director which was
affirmed or modified by a local System review board may request
the Board to reverse or modify the local board's decision.
(f) An EMS Medical Director whose suspension order was
reversed or modified by a local System review board may request
the Board to reverse or modify the local board's decision.
(g) The Board shall meet on the first Tuesday of every
month, unless no requests for review have been submitted.
Additional meetings of the Board shall be scheduled to ensure

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that a request for direct review of an immediate suspension
order is scheduled within 14 days after the Department receives
the request for review or as soon thereafter as a quorum is
available. The Board shall meet in Springfield or Chicago,
whichever location is closer to the majority of the members or
alternates attending the meeting. The Department shall
reimburse the members and alternates of the Board for
reasonable travel expenses incurred in attending meetings of
the Board.
(h) A request for review shall be submitted in writing to
the Chief of the Department's Division of Emergency Medical
Services and Highway Safety, within 10 days after receiving the
local board's decision or the EMS Medical Director's suspension
order, whichever is applicable, a copy of which shall be
enclosed.
(i) At its regularly scheduled meetings, the Board shall
review requests which have been received by the Department at
least 10 working days prior to the Board's meeting date.
Requests for review which are received less than 10 working
days prior to a scheduled meeting shall be considered at the
Board's next scheduled meeting, except that requests for direct
review of an immediate suspension order may be scheduled up to
3 working days prior to the Board's meeting date.
(j) A quorum shall be required for the Board to meet, which
shall consist of 3 members or alternates, including the EMS
Medical Director or alternate and the member or alternate from

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the same professional category as the subject of the suspension
order. At each meeting of the Board, the members or alternates
present shall select a Chairperson to conduct the meeting.
(k) Deliberations for decisions of the State EMS
Disciplinary Review Board shall be conducted in closed session.
Department staff may attend for the purpose of providing
clerical assistance, but no other persons may be in attendance
except for the parties to the dispute being reviewed by the
Board and their attorneys, unless by request of the Board.
(l) The Board shall review the transcript, evidence and
written decision of the local review board or the written
decision and supporting documentation of the EMS Medical
Director, whichever is applicable, along with any additional
written or verbal testimony or argument offered by the parties
to the dispute.
(m) At the conclusion of its review, the Board shall issue
its decision and the basis for its decision on a form provided
by the Department, and shall submit to the Department its
written decision together with the record of the local System
review board. The Department shall promptly issue a copy of the
Board's decision to all affected parties. The Board's decision
shall be binding on all parties.
(Source: P.A. 98-973, eff. 8-15-14.)
(210 ILCS 50/3.50)
Sec. 3.50. Emergency Medical Services personnel licensure

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levels.
(a) "Emergency Medical Technician" or "EMT" means a person
who has successfully completed a course in basic life support
as approved by the Department, is currently licensed by the
Department in accordance with standards prescribed by this Act
and rules adopted by the Department pursuant to this Act, and
practices within an EMS System. A valid Emergency Medical
Technician-Basic (EMT-B) license issued under this Act shall
continue to be valid and shall be recognized as an Emergency
Medical Technician (EMT) license until the Emergency Medical
Technician-Basic (EMT-B) license expires.
(b) "Emergency Medical Technician-Intermediate" or "EMT-I"
means a person who has successfully completed a course in
intermediate life support as approved by the Department, is
currently licensed by the Department in accordance with
standards prescribed by this Act and rules adopted by the
Department pursuant to this Act, and practices within an
Intermediate or Advanced Life Support EMS System.
(b-5) "Advanced Emergency Medical Technician" or "A-EMT"
means a person who has successfully completed a course in basic
and limited advanced emergency medical care as approved by the
Department, is currently licensed by the Department in
accordance with standards prescribed by this Act and rules
adopted by the Department pursuant to this Act, and practices
within an Intermediate or Advanced Life Support EMS System.
(c) "Paramedic (EMT-P)" means a person who has successfully

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completed a course in advanced life support care as approved by
the Department, is licensed by the Department in accordance
with standards prescribed by this Act and rules adopted by the
Department pursuant to this Act, and practices within an
Advanced Life Support EMS System. A valid Emergency Medical
Technician-Paramedic (EMT-P) license issued under this Act
shall continue to be valid and shall be recognized as a
Paramedic license until the Emergency Medical
Technician-Paramedic (EMT-P) license expires.
(c-5) "Emergency Medical Responder" or "EMR (First
Responder)" means a person who has successfully completed a
course in emergency medical response as approved by the
Department and provides emergency medical response services
prior to the arrival of an ambulance or specialized emergency
medical services vehicle, in accordance with the level of care
established by the National EMS Educational Standards
Emergency Medical Responder course as modified by the
Department. An Emergency Medical Responder who provides
services as part of an EMS System response plan shall comply
with the applicable sections of the Program Plan, as approved
by the Department, of that EMS System. The Department shall
have the authority to adopt rules governing the curriculum,
practice, and necessary equipment applicable to Emergency
Medical Responders.
On the effective date of this amendatory Act of the 98th
General Assembly, a person who is licensed by the Department as

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

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

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

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

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services, engaged in dishonorable, unethical, or
unprofessional conduct of a character likely to
deceive, defraud, or harm the public;
(D) The licensee has failed to maintain or has
violated standards of performance and conduct as
prescribed by the Department in rules adopted pursuant
to this Act or his or her EMS System's Program Plan;
(E) The licensee is physically impaired to the
extent that he or she cannot physically perform the
skills and functions for which he or she is licensed,
as verified by a physician, unless the person is on
inactive status pursuant to Department regulations;
(F) The licensee is mentally impaired to the extent
that he or she cannot exercise the appropriate
judgment, skill and safety for performing the
functions for which he or she is licensed, as verified
by a physician, unless the person is on inactive status
pursuant to Department regulations;
(G) The licensee has violated this Act or any rule
adopted by the Department pursuant to this Act; or
(H) The licensee has been convicted (or entered a
plea of guilty or nolo-contendere) by a court of
competent jurisdiction of a Class X, Class 1, or Class
2 felony in this State or an out-of-state equivalent
offense.
(9) Prescribe education and training requirements in

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

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(e) In the event that any rule of the Department or an EMS
Medical Director that requires testing for drug use as a
condition of the applicable EMS personnel license conflicts
with or duplicates a provision of a collective bargaining
agreement that requires testing for drug use, that rule shall
not apply to any person covered by the collective bargaining
agreement.
(Source: P.A. 98-53, eff. 1-1-14; 98-463, eff. 8-16-13; 98-973,
eff. 8-15-14; 99-480, eff. 9-9-15.)
(210 ILCS 50/3.55)
Sec. 3.55. Scope of practice.
(a) Any person currently licensed as an EMR, EMT, EMT-I,
A-EMT, PHRN, PHAPRN, PHPA, or Paramedic may perform emergency
and non-emergency medical services as defined in this Act, in
accordance with his or her level of education, training and
licensure, the standards of performance and conduct prescribed
by the Department in rules adopted pursuant to this Act, and
the requirements of the EMS System in which he or she
practices, as contained in the approved Program Plan for that
System. The Director may, by written order, temporarily modify
individual scopes of practice in response to public health
emergencies for periods not exceeding 180 days.
(a-5) EMS personnel who have successfully completed a
Department approved course in automated defibrillator
operation and who are functioning within a Department approved

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EMS System may utilize such automated defibrillator according
to the standards of performance and conduct prescribed by the
Department in rules adopted pursuant to this Act and the
requirements of the EMS System in which they practice, as
contained in the approved Program Plan for that System.
(a-7) An EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or
Paramedic who has successfully completed a Department approved
course in the administration of epinephrine shall be required
to carry epinephrine with him or her as part of the EMS
personnel medical supplies whenever he or she is performing
official duties as determined by the EMS System. The
epinephrine may be administered from a glass vial,
auto-injector, ampule, or pre-filled syringe.
(b) An EMR, EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or
Paramedic may practice as an EMR, EMT, EMT-I, A-EMT, or
Paramedic or utilize his or her EMR, EMT, EMT-I, A-EMT, PHRN,
PHAPRN, PHPA, or Paramedic license in pre-hospital or
inter-hospital emergency care settings or non-emergency
medical transport situations, under the written or verbal
direction of the EMS Medical Director. For purposes of this
Section, a "pre-hospital emergency care setting" may include a
location, that is not a health care facility, which utilizes
EMS personnel to render pre-hospital emergency care prior to
the arrival of a transport vehicle. The location shall include
communication equipment and all of the portable equipment and
drugs appropriate for the EMR, EMT, EMT-I, A-EMT, or

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Paramedic's level of care, as required by this Act, rules
adopted by the Department pursuant to this Act, and the
protocols of the EMS Systems, and shall operate only with the
approval and under the direction of the EMS Medical Director.
This Section shall not prohibit an EMR, EMT, EMT-I, A-EMT,
PHRN, PHAPRN, PHPA, or Paramedic from practicing within an
emergency department or other health care setting for the
purpose of receiving continuing education or training approved
by the EMS Medical Director. This Section shall also not
prohibit an EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or Paramedic
from seeking credentials other than his or her EMT, EMT-I,
A-EMT, PHRN, PHAPRN, PHPA, or Paramedic license and utilizing
such credentials to work in emergency departments or other
health care settings under the jurisdiction of that employer.
(c) An EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or Paramedic
may honor Do Not Resuscitate (DNR) orders and powers of
attorney for health care only in accordance with rules adopted
by the Department pursuant to this Act and protocols of the EMS
System in which he or she practices.
(d) A student enrolled in a Department approved EMS
personnel program, while fulfilling the clinical training and
in-field supervised experience requirements mandated for
licensure or approval by the System and the Department, may
perform prescribed procedures under the direct supervision of a
physician licensed to practice medicine in all of its branches,
a qualified registered professional nurse, or qualified EMS

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personnel, only when authorized by the EMS Medical Director.
(e) An EMR, EMT, EMT-I, A-EMT, PHRN, PHAPRN, PHPA, or
Paramedic may transport a police dog injured in the line of
duty to a veterinary clinic or similar facility if there are no
persons requiring medical attention or transport at that time.
For the purposes of this subsection, "police dog" means a dog
owned or used by a law enforcement department or agency in the
course of the department or agency's work, including a search
and rescue dog, service dog, accelerant detection canine, or
other dog that is in use by a county, municipal, or State law
enforcement agency.
(Source: P.A. 99-862, eff. 1-1-17; 100-108, eff. 1-1-18.)
(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, 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:
(1) Prescribe education requirements for EMS Lead
Instructor candidates through rules adopted pursuant to

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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
adopted pursuant to this Act.
(7) Suspend, revoke, or refuse to issue or renew the

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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. 98-973, eff. 8-15-14.)
(210 ILCS 50/3.80)
Sec. 3.80. Pre-Hospital Registered Nurse, Pre-Hospital
Advanced Practice Registered Nurse, Pre-Hospital Physician
Assistant, and Emergency Communications Registered Nurse.
(a) "Emergency Communications Registered Nurse" or "ECRN"
means a registered professional nurse licensed under the Nurse
Practice Act who has successfully completed supplemental
education in accordance with rules adopted by the Department,
and who is approved by an EMS Medical Director to monitor
telecommunications from and give voice orders to EMS System
personnel, under the authority of the EMS Medical Director and
in accordance with System protocols. For out-of-state
facilities that have Illinois recognition under the EMS, trauma
or pediatric programs, the professional shall have an

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unencumbered registered nurse license in the state in which he
or she practices. In this Section, the term "license" is used
to reflect a change in terminology from "certification" to
"license" only.
(b) "Pre-Hospital Registered Nurse", "PHRN", or
"Pre-Hospital RN" means a registered professional nurse
licensed under the Nurse Practice Act who has successfully
completed supplemental education in accordance with rules
adopted by the Department pursuant to this Act, and who is
approved by an EMS Medical Director to practice within an
Illinois EMS System as emergency medical services personnel for
pre-hospital and inter-hospital emergency care and
non-emergency medical transports. For out-of-state facilities
that have Illinois recognition under the EMS, trauma or
pediatric programs, the professional shall have an
unencumbered registered nurse license in the state in which he
or she practices. In this Section, the term "license" is used
to reflect a change in terminology from "certification" to
"license" only.
(b-5) "Pre-Hospital Advanced Practice Registered Nurse",
"PHAPRN", or "Pre-Hospital APRN" means an advanced practice
registered nurse licensed under the Nurse Practice Act who has
successfully completed supplemental education in accordance
with rules adopted by the Department pursuant to this Act, and
who has the approval of an EMS Medical Director to practice
within an Illinois EMS System as emergency medical services

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personnel for pre-hospital and inter-hospital emergency care
and non-emergency medical transports. For out-of-state
facilities that have Illinois recognition under the EMS, trauma
or pediatric programs, the professional shall have an
unencumbered advanced practice registered nurse license in the
state in which he or she practices.
(b-10) "Pre-Hospital Physician Assistant", "PHPA", or
"Pre-Hospital PA" means a physician assistant licensed under
the Physician Assistant Practice Act of 1987 who has
successfully completed supplemental education in accordance
with rules adopted by the Department pursuant to this Act, and
who has the approval of an EMS Medical Director to practice
within an Illinois EMS System as emergency medical services
personnel for pre-hospital and inter-hospital emergency care
and non-emergency medical transports. For out-of-state
facilities that have Illinois recognition under the EMS, trauma
or pediatric programs, the professional shall have an
unencumbered physician assistant license in the state in which
he or she practices.
(c) The Department shall have the authority and
responsibility to:
(1) Prescribe or pre-approve education and continuing
education requirements for Pre-Hospital Registered Nurse,
Pre-Hospital Advanced Practice Registered Nurse,
Pre-Hospital Physician Assistant, and ECRN candidates
through rules adopted pursuant to this Act:

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(A) Education for a Pre-Hospital Registered Nurse,
a Pre-Hospital Advanced Practice Registered Nurse, or
a Pre-Hospital Physician Assistant shall include
extrication, telecommunications, EMS System standing
medical orders, the procedures and protocols
established by the EMS Medical Director, and
pre-hospital cardiac, medical, and trauma care;
(B) Education for ECRN shall include
telecommunications, System standing medical orders and
the procedures and protocols established by the EMS
Medical Director;
(C) A Pre-Hospital Registered Nurse, Pre-Hospital
Advanced Practice Registered Nurse, or Pre-Hospital
Physician Assistant candidate who is fulfilling
clinical training and in-field supervised experience
requirements may perform prescribed procedures under
the direct supervision of a physician licensed to
practice medicine in all of its branches, a qualified
registered professional nurse or a qualified EMT, only
when authorized by the EMS Medical Director;
(D) An EMS Medical Director may impose in-field
supervised field experience requirements on System
ECRNs as part of their training or continuing
education, in which they perform prescribed procedures
under the direct supervision of a physician licensed to
practice medicine in all of its branches, a qualified

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registered professional nurse, or qualified EMS
personnel, only when authorized by the EMS Medical
Director;
(2) Require EMS Medical Directors to reapprove
Pre-Hospital Registered Nurses, Pre-Hospital Advanced
Practice Registered Nurses, Pre-Hospital Physician
Assistants, and ECRNs every 4 years, based on compliance
with continuing education requirements prescribed by the
Department through rules adopted pursuant to this Act;
(3) Allow EMS Medical Directors to grant inactive EMS
System status to any Pre-Hospital Registered Nurse,
Pre-Hospital Advanced Practice Registered Nurse,
Pre-Hospital Physician Assistant, or ECRN who qualifies,
based on standards and procedures established by the
Department in rules adopted pursuant to this Act;
(4) Require a Pre-Hospital Registered Nurse, a
Pre-Hospital Advanced Practice Registered Nurse, or a
Pre-Hospital Physician Assistant to honor Do Not
Resuscitate (DNR) orders and powers of attorney for health
care only in accordance with rules adopted by the
Department pursuant to this Act and protocols of the EMS
System in which he or she practices;
(5) Charge each Pre-Hospital Registered Nurse,
Pre-Hospital Advanced Practice Registered Nurse,
Pre-Hospital Physician Assistant, applicant and ECRN
applicant a fee for licensure and relicensure.

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(d) The Department shall have the authority to suspend,
revoke, or refuse to issue or renew a Department-issued PHRN,
PHAPRN, PHPA, or ECRN license when, after notice and the
opportunity for a hearing, the Department demonstrates that the
licensee has violated this Act, violated the rules adopted by
the Department, or failed to comply with the applicable
standards of care.
(Source: P.A. 98-973, eff. 8-15-14.)
(210 ILCS 50/3.87)
Sec. 3.87. Ambulance service provider and vehicle service
provider upgrades; rural population.
(a) In this Section, "rural ambulance service provider"
means an ambulance service provider licensed under this Act
that serves a rural population of 7,500 or fewer inhabitants.
In this Section, "rural vehicle service provider" means an
entity that serves a rural population of 7,500 or fewer
inhabitants and is licensed by the Department to provide
emergency or non-emergency medical services in compliance with
this Act, the rules adopted by the Department pursuant to this
Act, and an operational plan approved by the entity's EMS
System, utilizing at least an ambulance, alternate response
vehicle as defined by the Department in rules, or specialized
emergency medical services vehicle.
(b) A rural ambulance service provider or rural vehicle
service provider may submit a proposal to the EMS System

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Medical Director requesting approval of either or both of the
following:
(1) Rural ambulance service provider or rural vehicle
service provider in-field service level upgrade.
(A) An ambulance operated by a rural ambulance
service provider or a specialized emergency medical
services vehicle or alternate response vehicle
operated by a rural vehicle service provider may be
upgraded, as defined by the EMS System Medical Director
in a policy or procedure, as long as the EMS System
Medical Director and the Department have approved the
proposal, to the highest level of EMT license (advanced
life support/paramedic, intermediate life support, or
basic life support) or Pre-Hospital APRN, Pre-Hospital
PA, or Pre-Hospital RN license certification held by
any person staffing that ambulance, specialized
emergency medical services vehicle, or alternate
response vehicle. The ambulance service provider's or
rural vehicle service provider's proposal for an
upgrade must include all of the following:
(i) The manner in which the provider will
secure and store advanced life support equipment,
supplies, and medications.
(ii) The type of quality assurance the
provider will perform.
(iii) An assurance that the provider will

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advertise only the level of care that can be
provided 24 hours a day.
(iv) A statement that the provider will have
that vehicle inspected by the Department annually.
(B) If a rural ambulance service provider or rural
vehicle service provider is approved to provide an
in-field service level upgrade based on the licensed
personnel on the vehicle, all the advanced life support
medical supplies, durable medical equipment, and
medications must be environmentally controlled,
secured, and locked with access by only the personnel
who have been authorized by the EMS System Medical
Director to utilize those supplies.
(C) The EMS System shall routinely perform quality
assurance, in compliance with the EMS System's quality
assurance plan approved by the Department, on in-field
service level upgrades authorized under this Section
to ensure compliance with the EMS System plan.
(2) Rural ambulance service provider or rural vehicle
service provider in-field service level upgrade. The EMS
System Medical Director may define what constitutes an
in-field service level upgrade through an EMS System policy
or procedure. An in-field service level upgrade may
include, but need not be limited to, an upgrade to a
licensed ambulance, alternate response vehicle, or
specialized emergency medical services vehicle.

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(c) If the EMS System Medical Director approves a proposal
for a rural in-field service level upgrade under this Section,
he or she shall submit the proposal to the Department along
with a statement of approval signed by him or her. Once the
Department has approved the proposal, the rural ambulance
service provider or rural vehicle service provider will be
authorized to function at the highest level of EMT license
(advanced life support/paramedic, intermediate life support,
or basic life support) or Pre-Hospital RN, Pre-Hospital APRN,
or Pre-Hospital PA license certification held by any person
staffing the vehicle.
(Source: P.A. 98-608, eff. 12-27-13; 98-880, eff. 1-1-15;
98-881, eff. 8-13-14; 99-78, eff. 7-20-15.)
(210 ILCS 50/3.165)
Sec. 3.165. Misrepresentation.
(a) No person shall hold himself or herself out to be or
engage in the practice of an EMS Medical Director, EMS
Administrative Director, EMS System Coordinator, EMR, EMD,
EMT, EMT-I, A-EMT, Paramedic, ECRN, PHRN, PHAPRN, PHPA, TNS, or
LI without being licensed, certified, approved or otherwise
authorized pursuant to this Act.
(b) A hospital or other entity which employs or utilizes an
EMR, EMD, EMT, EMT-I, A-EMT, or Paramedic in a manner which is
outside the scope of his or her license shall not use the words
"emergency medical responder", "EMR", "emergency medical

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technician", "EMT", "emergency medical
technician-intermediate", "EMT-I", "advanced emergency medical
technician", "A-EMT", or "Paramedic" in that person's job
description or title, or in any other manner hold that person
out to be so licensed.
(c) No provider or participant within an EMS System shall
hold itself out as providing a type or level of service that
has not been approved by that System's EMS Medical Director.
(Source: P.A. 98-973, eff. 8-15-14.)
Section 99. Effective date. This Act takes effect one year
after becoming law.