HB 4477

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Full Text of HB4477
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	HB4477 - 104th General Assembly
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			House Amendment 001
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		HB4477 Enrolled		LRB104 17768 BAB 31200 b
1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Emergency Medical Services (EMS) Systems
5Act is amended by changing Sections 3.5, 3.35, 3.40, 3.45, and
63.50 as follows:
7    (210 ILCS 50/3.5)
8    Sec. 3.5. Definitions. As used in this Act:
9    "Clinical observation" means the ongoing observation of a
10patient's medical or mental health condition by a licensed
11health care professional utilizing a medical skill set while
12continuing assessment and care.
13    "Department" means the Illinois Department of Public
14Health.
15    "Digital license" means a secure electronic record of a 
16license issued by the Department to EMS personnel that is 
17accessible to EMS personnel through a Department-maintained or 
18Department-approved electronic platform, website, or 
19electronic application and is readily verifiable by Resource 
20Hospitals and vehicle service providers.
21    "Director" means the Director of the Illinois Department
22of Public Health.
23    "Emergency" means a medical condition of recent onset and
		HB4477 Enrolled	- 2 -	LRB104 17768 BAB 31200 b
1severity that would lead a prudent layperson, possessing an
2average knowledge of medicine and health, to believe that
3urgent or unscheduled medical care is required.
4    "Emergency Medical Services personnel" or "EMS personnel"
5means persons licensed as an Emergency Medical Responder (EMR)
6(First Responder), Emergency Medical Dispatcher (EMD),
7Emergency Medical Technician (EMT), Emergency Medical
8Technician-Intermediate (EMT-I), Advanced Emergency Medical
9Technician (A-EMT), Paramedic (EMT-P), Emergency
10Communications Registered Nurse (ECRN), Pre-Hospital
11Registered Nurse (PHRN), Pre-Hospital Advanced Practice
12Registered Nurse (PHAPRN), or Pre-Hospital Physician Assistant
13(PHPA).
14    "Exclusive representative" has the same meaning as defined
15in Section 3 of the Illinois Public Labor Relations Act.
16    "Health care facility" means a hospital, nursing home,
17physician's office or other fixed location at which medical
18and health care services are performed. It does not include
19"pre-hospital emergency care settings" which utilize EMS
20personnel to render pre-hospital emergency care prior to the
21arrival of a transport vehicle, as defined in this Act.
22    "Hospital" has the meaning ascribed to that term in the
23Hospital Licensing Act.
24    "Just Culture" means a system approach to safety that 
25promotes accountability through fair and consistent evaluation 
26of conduct, distinguishing human error from at-risk and 
		HB4477 Enrolled	- 3 -	LRB104 17768 BAB 31200 b
1reckless behavior, and emphasizes learning, quality 
2improvement, and system improvement over punitive action when 
3appropriate.
4    "Labor organization" has the same meaning as defined in
5Section 3 of the Illinois Public Labor Relations Act.
6    "Medical monitoring" means the performance of medical
7tests and physical exams to evaluate an individual's ongoing
8exposure to a factor that could negatively impact that
9person's health. "Medical monitoring" includes close
10surveillance or supervision of patients liable to suffer
11deterioration in physical or mental health and checks of
12various parameters such as pulse rate, temperature,
13respiration rate, the condition of the pupils, the level of
14consciousness and awareness, the degree of appreciation of
15pain, and blood gas concentrations such as oxygen and carbon
16dioxide.
17    "NREMT" means the National Registry of Emergency Medical
18Technicians.
19    "Physical license" means the paper copy of the license 
20issued by the Department to EMS personnel who have met the 
21Department's education, training, and examination 
22requirements.
23    "Silver spanner program" means a program in which a member
24under a fire department's or fire protection district's
25collective bargaining agreement works on or at the EMS System
26under another fire department's or fire protection district's
		HB4477 Enrolled	- 4 -	LRB104 17768 BAB 31200 b
1collective bargaining agreement and (i) the other fire
2department or fire protection district is not the member's
3full-time employer and (ii) any EMS services not included
4under the original fire department's or fire protection
5district's collective bargaining agreement are included in the
6other fire department's or fire protection district's
7collective bargaining agreement.
8    "Trauma" means any significant injury which involves
9single or multiple organ systems.
10(Source: P.A. 103-521, eff. 1-1-24; 103-689, eff. 1-1-25;
11104-362, eff. 8-15-25.)
12    (210 ILCS 50/3.35)
13    Sec. 3.35. Emergency Medical Services (EMS) Resource
14Hospital; Functions. The Resource Hospital of an EMS System
15shall:
16        (a) Prepare a Program Plan in accordance with the
17    provisions of this Act and minimum standards and criteria
18    established in rules adopted by the Department pursuant to
19    this Act, and submit such Program Plan to the Department
20    for approval. The Department shall require each EMS System 
21    to have a Department-approved policy regarding Just 
22    Culture for evaluating and responding to human error, 
23    at-risk, reckless behavior, or failures to perform 
24    emergency and nonemergency medical services in accordance 
25    with the defined scope of practice of the EMS personnel, 
		HB4477 Enrolled	- 5 -	LRB104 17768 BAB 31200 b
1    EMS System Program Plan, and rules established by the 
2    Department. The Just Culture policy shall be used by the 
3    EMS Medical Director when issuing EMS System discipline or 
4    EMS System participation suspension.
5        (b) Appoint an EMS Medical Director, who will
6    continually monitor and supervise the System and who will
7    have the responsibility and authority for total management
8    of the System as delegated by the EMS Resource Hospital.
9        The Program Plan shall require the EMS Medical
10    Director to appoint an alternate EMS Medical Director and
11    establish a written protocol addressing the functions to
12    be carried out in his or her absence.
13        (c) Appoint an EMS System Coordinator and EMS
14    Administrative Director in consultation with the EMS
15    Medical Director and in accordance with rules adopted by
16    the Department pursuant to this Act.
17        (d) Identify potential EMS System participants and
18    obtain commitments from them for the provision of
19    services.
20        (e) Educate or coordinate the education of EMS
21    personnel and all other license holders in accordance with
22    the requirements of this Act, rules adopted by the
23    Department pursuant to this Act, and the EMS System
24    Program Plan. An EMS System may coordinate education
25    outside of the region of which it is located with valid
26    justification and Department approval. The didactic
		HB4477 Enrolled	- 6 -	LRB104 17768 BAB 31200 b
1    portion of education may be conducted through an online
2    platform with EMS System and Department approval. An
3    education plan within a Resource Hospital may include
4    classes performed outside of the region in which the
5    Resource Hospital is located. When considering whether to
6    approve or deny an education plan for classes performed
7    outside of the region in which a Resource Hospital is
8    located, the Department shall give deference to the EMS
9    Medical Director's education plan request and shall not
10    unreasonably withhold approval.
11        (f) Notify the Department of EMS personnel who have
12    successfully completed the requirements as provided by law
13    for initial licensure, license renewal, and license
14    reinstatement by the Department.
15        (g) Educate or coordinate the education of Emergency
16    Medical Dispatcher candidates, in accordance with the
17    requirements of this Act, rules adopted by the Department
18    pursuant to this Act, and the EMS System Program Plan.
19        (h) Establish or approve protocols for prearrival
20    medical instructions to callers by System Emergency
21    Medical Dispatchers who provide such instructions.
22        (i) Educate or coordinate the education of
23    Pre-Hospital Registered Nurse, Pre-Hospital Advanced
24    Practice Registered Nurse, Pre-Hospital Physician
25    Assistant, and ECRN candidates, in accordance with the
26    requirements of this Act, rules adopted by the Department
		HB4477 Enrolled	- 7 -	LRB104 17768 BAB 31200 b
1    pursuant to this Act, and the EMS System Program Plan.
2        (j) Approve Pre-Hospital Registered Nurse,
3    Pre-Hospital Advanced Practice Registered Nurse,
4    Pre-Hospital Physician Assistant, and ECRN candidates to
5    practice within the System, and reapprove Pre-Hospital
6    Registered Nurses, Pre-Hospital Advanced Practice
7    Registered Nurses, Pre-Hospital Physician Assistants, and
8    ECRNs every 4 years in accordance with the requirements of
9    the Department and the System Program Plan.
10        (k) Establish protocols for the use of Pre-Hospital
11    Registered Nurses, Pre-Hospital Advanced Practice
12    Registered Nurses, and Pre-Hospital Physician Assistants
13    within the System.
14        (l) Establish protocols for utilizing ECRNs and
15    physicians licensed to practice medicine in all of its
16    branches to monitor telecommunications from, and give
17    voice orders to, EMS personnel, under the authority of the
18    EMS Medical Director.
19        (m) Monitor emergency and non-emergency medical
20    transports within the System, in accordance with rules
21    adopted by the Department pursuant to this Act.
22        (n) Utilize levels of personnel required by the
23    Department to provide emergency care to the sick and
24    injured at the scene of an emergency, during transport to
25    a hospital or during inter-hospital transport and within
26    the hospital emergency department until the responsibility
		HB4477 Enrolled	- 8 -	LRB104 17768 BAB 31200 b
1    for the care of the patient is assumed by the medical
2    personnel of a hospital emergency department or other
3    facility within the hospital to which the patient is first
4    delivered by System personnel.
5        (o) Utilize levels of personnel required by the
6    Department to provide non-emergency medical services
7    during transport to a health care facility and within the
8    health care facility until the responsibility for the care
9    of the patient is assumed by the medical personnel of the
10    health care facility to which the patient is delivered by
11    System personnel.
12        (p) Establish and implement a program for System
13    participant information and education, in accordance with
14    rules adopted by the Department pursuant to this Act.
15        (q) Establish and implement a program for public
16    information and education, in accordance with rules
17    adopted by the Department pursuant to this Act.
18        (r) Operate in compliance with the EMS Region Plan.
19(Source: P.A. 103-689, eff. 1-1-25.)
20    (210 ILCS 50/3.40)
21    Sec. 3.40. EMS System Participation Suspensions and Due
22Process.
23    (a) An EMS Medical Director may suspend from participation
24within the System any EMS personnel, EMS Lead Instructor (LI),
25individual, individual provider, or other participant
		HB4477 Enrolled	- 9 -	LRB104 17768 BAB 31200 b
1considered not to be meeting the requirements of the Program
2Plan of that approved EMS System. An EMS Medical Director must
3submit a suspension order to the Department describing which
4requirements of the Program Plan were not met and the
5suspension's duration. The Department shall review and confirm
6receipt of the suspension order, request additional
7information, or initiate an investigation. The Department
8shall incorporate the duration of that suspension into any
9further action taken by the Department to suspend, revoke, or
10refuse to issue or renew the license of the individual or
11entity for any violation of this Act or the Program Plan
12arising from the same conduct for which the suspension order
13was issued if the suspended party has neither requested a
14Department hearing on the suspension nor worked as a provider
15in any other System during the term of the suspension.
16    (b) Prior to suspending any individual or entity, an EMS
17Medical Director shall provide an opportunity for a hearing
18before the local System review board in accordance with
19subsection (f) and the rules promulgated by the Department.
20The local System review board shall have the authority to 
21affirm, reduce, reverse, or modify, but not increase, the EMS 
22Medical Director's suspension order. The local System review 
23board shall consist of 3 members. One member shall be an 
24emergency department physician with knowledge of EMS, and 2 
25members shall be of the same professional category as the 
26individual, individual provider, or other participant 
		HB4477 Enrolled	- 10 -	LRB104 17768 BAB 31200 b
1requesting the hearing. The EMS Medical Director shall 
2establish, maintain, and post in a 24-hour accessible location 
3a roster of pre-identified System review board members. The 
4roster shall include multiple individuals representing each 
5professional category operating within the EMS System, no less 
6than 5 members. The roster shall be structured to ensure 
7representation across the range of license types within the 
8EMS System and support the selection of impartial and 
9appropriately matched peers for each proceeding.
10    The selection of the System review board members for a 
11hearing shall be conducted by the EMS Medical Director or the 
12EMS Medical Director's designee from the roster. Prior to 
13finalizing the selection, the individual provider or 
14participant requesting the hearing shall be provided the 
15opportunity to review and approve the proposed review board 
16members and provide any objections based on conflicts of 
17interest or demonstrated bias. If the EMS Medical Director or 
18the EMS Medical Director's designee and the EMS System 
19participant or participating entity are unable to come to an 
20agreement, the final decision shall be made by the Department.
21        (1) If the local System review board affirms, [or]
22    reduces, or modifies the EMS Medical Director's suspension
23    order, the individual or entity shall have the opportunity
24    for a review of the local board's decision by the State EMS
25    Disciplinary Review Board, pursuant to Section 3.45 of
26    this Act.
		HB4477 Enrolled	- 11 -	LRB104 17768 BAB 31200 b
1        (2) If the local System review board reverses, [or]
2    reduces, or modifies the EMS Medical Director's suspension
3    order, the EMS Medical Director shall have the opportunity
4    for a review of the local board's decision by the State EMS
5    Disciplinary Review Board, pursuant to Section 3.45 of
6    this Act.
7        (3) The suspension shall commence only upon the
8    occurrence of one of the following:
9            (A) the individual or entity has waived the
10        opportunity for a hearing before the local System
11        review board;
12            (B) the order has been affirmed, [or] reduced, or
13        modified by the local system review board and the
14        individual or entity has waived the opportunity for
15        review by the State Board; or
16            (C) the order has been affirmed, [or] reduced, or
17        modified by the local system review board, and the
18        local board's decision has been affirmed, [or] reduced, 
19        or modified by the State Board.
20    (c) An individual interviewed or investigated by the local
21system review board or the Department shall have the right to a
22union representative and legal counsel of the individual's
23choosing present at any interview. The union representative
24must comply with any confidentiality requirements and
25requirements for the protection of any patient information
26presented during the proceeding.
		HB4477 Enrolled	- 12 -	LRB104 17768 BAB 31200 b
1    (d) An EMS Medical Director may immediately suspend an
2EMR, EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN, PHRN, LI, PHPA,
3PHAPRN, or other individual or entity if he or she finds that
4the continuation in practice by the individual or entity would
5constitute an imminent danger to the public. The suspended
6individual or entity shall be issued an immediate verbal
7notification followed by a written suspension order by the EMS
8Medical Director which states the length, terms, and basis for
9the suspension.
10        (1) Within 24 hours following the commencement of the
11    suspension, the EMS Medical Director shall deliver to the
12    Department, by messenger, telefax, or other
13    Department-approved electronic communication, a copy of
14    the suspension order and copies of any written materials
15    which relate to the EMS Medical Director's decision to
16    suspend the individual or entity. All medical and
17    patient-specific information, including Department
18    findings with respect to the quality of care rendered,
19    shall be strictly confidential pursuant to the Medical
20    Studies Act (Part 21 of Article VIII of the Code of Civil
21    Procedure).
22        (2) Within 24 hours following the commencement of the
23    suspension, the suspended individual or entity may deliver
24    to the Department, by messenger, telefax, or other
25    Department-approved electronic communication, a written
26    response to the suspension order and copies of any written
		HB4477 Enrolled	- 13 -	LRB104 17768 BAB 31200 b
1    materials which the individual or entity feels are
2    appropriate. All medical and patient-specific information,
3    including Department findings with respect to the quality
4    of care rendered, shall be strictly confidential pursuant
5    to the Medical Studies Act.
6        (3) Within 24 hours following receipt of the EMS
7    Medical Director's suspension order or the individual or
8    entity's written response, whichever is later, the
9    Director or the Director's designee shall determine
10    whether the suspension should be stayed pending an
11    opportunity for a hearing or review in accordance with
12    this Act, or whether the suspension should continue during
13    the course of that hearing or review. When an immediate
14    suspension order is not stayed, the Director or the
15    Director's designee within the Department shall identify
16    if that suspension shall immediately apply to statewide
17    participation only in situations when a licensee has been
18    charged with a crime while performing the licensee's
19    official duties as an EMR, EMD, EMT, EMT-I, A-EMT,
20    Paramedic, ECRN, TNS, PHRN, LI, PHPA, or PHAPRN and the
21    licensee's continuation to practice poses the possibility
22    of imminent harm to the public based upon factual evidence
23    provided to the Department. The determination to issue an
24    immediate statewide suspension shall not deny the right to
25    due process to a licensee. The Director or the Director's
26    designee shall issue this determination to the EMS Medical
		HB4477 Enrolled	- 14 -	LRB104 17768 BAB 31200 b
1    Director, who shall immediately notify the suspended
2    individual or entity. The suspension shall remain in
3    effect during this period of review by the Director or the
4    Director's designee.
5    (e) Upon issuance of a suspension order for reasons
6directly related to medical care, the EMS Medical Director
7shall also provide the individual or entity with the
8opportunity for a hearing before the local System review
9board, in accordance with subsection (f) and the rules
10promulgated by the Department. The local System review board 
11shall have the authority to affirm, reduce, reverse, or 
12modify, but not increase, the EMS Medical Director's 
13suspension order.
14        (1) If the local System review board affirms, [or]
15    reduces, or modifies the EMS Medical Director's suspension
16    order, the individual or entity shall have the opportunity
17    for a review of the local board's decision by the State EMS
18    Disciplinary Review Board, pursuant to Section 3.45 of
19    this Act.
20        (2) If the local System review board reverses, [or]
21    reduces, or modifies the EMS Medical Director's suspension
22    order, the EMS Medical Director shall have the opportunity
23    for a review of the local board's decision by the State EMS
24    Disciplinary Review Board, pursuant to Section 3.45 of
25    this Act.
26        (3) The suspended individual or entity may elect to
		HB4477 Enrolled	- 15 -	LRB104 17768 BAB 31200 b
1    bypass the local System review board and seek direct
2    review of the EMS Medical Director's suspension order by
3    the State EMS Disciplinary Review Board.
4    (f) The Resource Hospital shall designate a local System
5review board in accordance with the rules of the Department,
6for the purpose of providing a hearing to any individual or
7entity participating within the System who is suspended from
8participation by the EMS Medical Director. The EMS Medical
9Director shall arrange for a certified shorthand reporter to
10make a stenographic record of that hearing and thereafter
11prepare a transcript of the proceedings. The EMS Medical
12Director shall inform the individual of the individual's right
13to have a union representative and legal counsel of the
14individual's choosing present at any interview. The union
15representative must comply with any confidentiality
16requirements and requirements for the protection of any
17patient information presented during the proceeding. The
18transcript, all documents or materials received as evidence
19during the hearing and the local System review board's written
20decision shall be retained in the custody of the EMS system.
21The System shall implement a decision of the local System
22review board unless that decision has been appealed to the
23State Emergency Medical Services Disciplinary Review Board in
24accordance with this Act and the rules of the Department.
25    (g) The Resource Hospital shall implement a decision of
26the State Emergency Medical Services Disciplinary Review Board
		HB4477 Enrolled	- 16 -	LRB104 17768 BAB 31200 b
1which has been rendered in accordance with this Act and the
2rules of the Department.
3(Source: P.A. 103-521, eff. 1-1-24; 103-779, eff. 8-2-24;
4104-417, eff. 8-15-25.)
5    (210 ILCS 50/3.45)
6    Sec. 3.45. State Emergency Medical Services Disciplinary
7Review Board.
8    (a) The Governor shall appoint a State Emergency Medical
9Services Disciplinary Review Board, composed of an EMS Medical
10Director, an EMS System Coordinator, a Paramedic, an Emergency
11Medical Technician (EMT), and the following members, who shall
12only review cases in which a party is from the same
13professional category: a Pre-Hospital Registered Nurse, a
14Pre-Hospital Advanced Practice Registered Nurse, a
15Pre-Hospital Physician Assistant, an ECRN, a Trauma Nurse
16Specialist, an Emergency Medical Technician-Intermediate
17(EMT-I), an Advanced Emergency Medical Technician (A-EMT), a
18representative from a private vehicle service provider, a
19representative from a public vehicle service provider, and an
20emergency physician who monitors telecommunications from and
21gives voice orders to EMS personnel. The Governor shall also
22appoint one alternate for each member of the Board, from the
23same professional category as the member of the Board.
24    (b) The members shall be appointed for a term of 3 years.
25All appointees shall serve until their successors are
		HB4477 Enrolled	- 17 -	LRB104 17768 BAB 31200 b
1appointed. The alternate members shall be appointed and serve
2in the same fashion as the members of the Board. If a member
3resigns his or her appointment, the corresponding alternate
4shall serve the remainder of that member's term until a
5subsequent member is appointed by the Governor.
6    (c) The function of the Board is to review and affirm,
7reduce, reverse, or modify, but not increase, disciplinary
8orders.
9    (d) Any individual or entity, who received an immediate
10suspension from an EMS Medical Director may request the Board
11to reduce, reverse, or modify the suspension order. If the
12suspension had been affirmed, [or] reduced, or modified by a
13local System review board, the suspended individual or entity
14may request the Board to reduce, reverse, or modify the local
15board's decision.
16    (e) Any individual or entity who received a non-immediate
17suspension order from an EMS Medical Director which was
18affirmed or modified by a local System review board may
19request the Board to reduce, reverse, or modify the local
20board's decision. The individual shall be informed of the
21individual's right to have one representative from the labor
22organization recognized as the exclusive representative of
23that individual's bargaining unit present and a legal
24representative present during the State Emergency Medical
25Services Disciplinary Review Board proceedings during open
26session. The labor organization's representative must also
		HB4477 Enrolled	- 18 -	LRB104 17768 BAB 31200 b
1comply with all confidentiality requirements and requirements
2for the protection of any patient information presented during
3the proceeding.
4    (f) An EMS Medical Director whose suspension order was
5reduced, reversed, or modified by a local System review board
6may request the Board to reverse or modify the local board's
7decision.
8    (g) The Board shall meet on the first Tuesday of every
9month, unless no requests for review have been submitted.
10Additional meetings of the Board shall be scheduled to ensure
11that a request for direct review of an immediate suspension
12order is scheduled within 14 days after the Department
13receives the request for review or as soon thereafter as a
14quorum is available. The Board shall meet in Springfield or
15Chicago, whichever location is closer to the majority of the
16members or alternates attending the meeting. The Department
17shall reimburse the members and alternates of the Board for
18reasonable travel expenses incurred in attending meetings of
19the Board.
20    (h) A request for review shall be submitted in writing to
21the Chief of the Department's Division of Emergency Medical
22Services and Highway Safety, within 10 days after receiving
23the local board's decision or the EMS Medical Director's
24suspension order, whichever is applicable, a copy of which
25shall be enclosed.
26    (i) At its regularly scheduled meetings, the Board shall
		HB4477 Enrolled	- 19 -	LRB104 17768 BAB 31200 b
1review requests which have been received by the Department at
2least 10 working days prior to the Board's meeting date.
3Requests for review which are received less than 10 working
4days prior to a scheduled meeting shall be considered at the
5Board's next scheduled meeting, except that requests for
6direct review of an immediate suspension order may be
7scheduled up to 3 working days prior to the Board's meeting
8date.
9    (j) A quorum shall be required for the Board to meet, which
10shall consist of 3 members or alternates, including the EMS
11Medical Director or alternate and the member or alternate from
12the same professional category as the subject of the
13suspension order. At each meeting of the Board, the members or
14alternates present shall select a Chairperson to conduct the
15meeting.
16    (k) Deliberations for decisions of the State EMS
17Disciplinary Review Board shall be conducted in closed
18session. Department staff may attend for the purpose of
19providing clerical assistance, but no other persons may be in
20attendance except for the parties to the dispute being
21reviewed by the Board and their attorneys, unless by request
22of the Board.
23    (l) The Board shall review the transcript, evidence, and
24written decision of the local review board, or the written
25decision and supporting documentation of the EMS Medical
26Director, whichever is applicable, along with any additional
		HB4477 Enrolled	- 20 -	LRB104 17768 BAB 31200 b
1written or verbal testimony or argument offered by the parties
2to the dispute.
3    (m) At the conclusion of its review, the Board shall issue
4its decision and the basis for its decision on a form provided
5by the Department, and shall submit to the Department its
6written decision together with the record of the local System
7review board. The Department shall promptly issue a copy of
8the Board's decision to all affected parties. The Board's
9decision shall be binding on all parties.
10(Source: P.A. 103-521, eff. 1-1-24.)
11    (210 ILCS 50/3.50)
12    Sec. 3.50. Emergency Medical Services personnel licensure
13levels.
14    (a) "Emergency Medical Technician" or "EMT" means a person
15who has successfully completed a course in basic life support
16as approved by the Department, is currently licensed by the
17Department in accordance with standards prescribed by this Act
18and rules adopted by the Department pursuant to this Act, and
19practices within an EMS System. A valid Emergency Medical
20Technician-Basic (EMT-B) license issued under this Act shall
21continue to be valid and shall be recognized as an Emergency
22Medical Technician (EMT) license until the Emergency Medical
23Technician-Basic (EMT-B) license expires.
24    (b) "Emergency Medical Technician-Intermediate" or "EMT-I"
25means a person who has successfully completed a course in
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1intermediate life support as approved by the Department, is
2currently licensed by the Department in accordance with
3standards prescribed by this Act and rules adopted by the
4Department pursuant to this Act, and practices within an
5Intermediate or Advanced Life Support EMS System.
6    (b-5) "Advanced Emergency Medical Technician" or "A-EMT"
7means a person who has successfully completed a course in
8basic and limited advanced emergency medical care as approved
9by the Department, is currently licensed by the Department in
10accordance with standards prescribed by this Act and rules
11adopted by the Department pursuant to this Act, and practices
12within an Intermediate or Advanced Life Support EMS System.
13    (c) "Paramedic (EMT-P)" means a person who has
14successfully completed a course in advanced life support care
15as approved by the Department, is licensed by the Department
16in accordance with standards prescribed by this Act and rules
17adopted by the Department pursuant to this Act, and practices
18within an Advanced Life Support EMS System. A valid Emergency
19Medical Technician-Paramedic (EMT-P) license issued under this
20Act shall continue to be valid and shall be recognized as a
21Paramedic license until the Emergency Medical
22Technician-Paramedic (EMT-P) license expires.
23    (c-5) "Emergency Medical Responder" or "EMR (First
24Responder)" means a person who has successfully completed a
25course in emergency medical response as approved by the
26Department and provides emergency medical response services in
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1accordance with the level of care established by the National
2EMS Educational Standards Emergency Medical Responder course
3as modified by the Department, or who provides services as
4part of an EMS System response plan, as approved by the
5Department, of that EMS System. The Department shall have the
6authority to adopt rules governing the curriculum, practice,
7and necessary equipment applicable to Emergency Medical
8Responders.
9    On August 15, 2014 (the effective date of Public Act
1098-973), a person who is licensed by the Department as a First
11Responder and has completed a Department-approved course in
12first responder defibrillator training based on, or equivalent
13to, the National EMS Educational Standards or other standards
14previously recognized by the Department shall be eligible for
15licensure as an Emergency Medical Responder upon meeting the
16licensure requirements and submitting an application to the
17Department. A valid First Responder license issued under this
18Act shall continue to be valid and shall be recognized as an
19Emergency Medical Responder license until the First Responder
20license expires.
21    (c-10) All EMS Systems and licensees shall be fully
22compliant with the National EMS Education Standards, as
23modified by the Department in administrative rules, within 24
24months after the adoption of the administrative rules.
25    (d) The Department shall have the authority and
26responsibility to:
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1        (1) Prescribe education and training requirements,
2    which includes training in the use of epinephrine, for all
3    levels of EMS personnel except for EMRs, based on the
4    National EMS Educational Standards and any modifications
5    to those curricula specified by the Department through
6    rules adopted pursuant to this Act.
7            (A) A failure rate per course of 30% or greater at
8        the first attempt on the licensure examination shall
9        require the EMS System to submit a quality improvement
10        plan to the Department. The EMS System shall share
11        failure rates with the EMS Lead Instructor quarterly.
12        Neither the EMS System nor the Department may take
13        licensure action against an EMS Lead Instructor based
14        solely on first-attempt pass rates.
15            (B) Candidates shall complete the licensure
16        examination within the timeline required by the NREMT.
17            (C) An accredited Paramedic program shall be
18        conducted only by an EMS System or an academic
19        institution whose curriculum has been approved by the
20        EMS System. An EMS System associate hospital may allow
21        students from an EMS System-approved and
22        Department-approved Paramedic course to complete
23        clinical rotations as approved by the EMS System
24        Medical Director. The approval by the EMS System
25        Medical Director may not be unreasonably denied.
26        (2) Prescribe licensure testing requirements for all
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1    levels of EMS personnel, which shall include a requirement
2    that all phases of instruction, training, and field
3    experience be completed before taking the appropriate
4    licensure examination. Candidates shall take the
5    appropriate National Registry examination. In prescribing
6    licensure testing requirements for honorably discharged
7    members of the armed forces of the United States under
8    this paragraph (2), the Department shall ensure that a
9    candidate's military emergency medical training, emergency
10    medical curriculum completed, and clinical experience, as
11    described in paragraph (2.5), are recognized.
12        (2.5) Review applications for EMS personnel licensure
13    from honorably discharged members of the armed forces of
14    the United States with military emergency medical
15    training. Applications shall be filed with the Department
16    within one year after military discharge and shall
17    contain: (i) proof of successful completion of military
18    emergency medical training; (ii) a detailed description of
19    the emergency medical curriculum completed; and (iii) a
20    detailed description of the applicant's clinical
21    experience. The Department may request additional and
22    clarifying information. The Department shall evaluate the
23    application, including the applicant's training and
24    experience, consistent with the standards set forth under
25    subsections (a), (b), (c), and (d) of Section 3.10. If the
26    application clearly demonstrates that the training and
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1    experience meet such standards, the Department shall offer
2    the applicant the opportunity to successfully complete a
3    Department-approved EMS personnel examination for the
4    level of license for which the applicant is qualified.
5    Upon passage of an examination, the Department shall issue
6    a license, which shall be subject to all provisions of
7    this Act that are otherwise applicable to the level of EMS
8    personnel license issued.
9        (3) License individuals as an EMR, EMT, EMT-I, A-EMT,
10    or Paramedic who have met the Department's education,
11    training and examination requirements.
12            (A) The Department shall issue to EMS personnel a 
13        physical license or digital license.
14            (B) A licensee shall not be required to possess a 
15        copy of a physical license or a digital license on the 
16        licensee's person while on duty.
17        (4) Prescribe annual continuing education and
18    relicensure requirements for all EMS personnel licensure
19    levels.
20        (5) Relicense individuals as an EMD, EMR, EMT, EMT-I,
21    A-EMT, PHRN, PHAPRN, PHPA, or Paramedic every 4 years,
22    based on their compliance with continuing education and
23    relicensure requirements as required by the Department
24    pursuant to this Act. Every 4 years, a Paramedic shall
25    have 100 hours of approved continuing education, an EMT-I
26    and an advanced EMT shall have 80 hours of approved
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1    continuing education, and an EMT shall have 60 hours of
2    approved continuing education. An Illinois licensed EMR,
3    EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN, PHPA, PHAPRN, or
4    PHRN whose license has been expired for less than 36
5    months may apply for reinstatement by the Department.
6    Reinstatement shall require that the applicant (i) submit
7    satisfactory proof of completion of continuing medical
8    education and clinical requirements to be prescribed by
9    the Department in an administrative rule; (ii) submit a
10    positive recommendation from an Illinois EMS Medical
11    Director attesting to the applicant's qualifications for
12    retesting; and (iii) pass a Department approved test for
13    the level of EMS personnel license sought to be
14    reinstated.
15        (6) Grant inactive status to any EMR, EMD, EMT, EMT-I,
16    A-EMT, Paramedic, ECRN, PHAPRN, PHPA, or PHRN who
17    qualifies, based on standards and procedures established
18    by the Department in rules adopted pursuant to this Act.
19        (7) Charge a fee for EMS personnel examination,
20    licensure, and license renewal.
21        (8) Suspend, revoke, or refuse to issue or renew the
22    license of any licensee, after an opportunity for an
23    impartial hearing before a neutral administrative law
24    judge appointed by the Director, where the preponderance
25    of the evidence shows one or more of the following:
26            (A) The licensee has not met continuing education
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1        or relicensure requirements as prescribed by the
2        Department;
3            (B) The licensee has failed to maintain
4        proficiency in the level of skills for which he or she
5        is licensed;
6            (C) The licensee, during the provision of medical
7        services, engaged in dishonorable, unethical, or
8        unprofessional conduct of a character likely to
9        deceive, defraud, or harm the public;
10            (D) The licensee has failed to maintain or has
11        violated standards of performance and conduct as
12        prescribed by the Department in rules adopted pursuant
13        to this Act or his or her EMS System's Program Plan;
14            (E) The licensee is physically impaired to the
15        extent that he or she cannot physically perform the
16        skills and functions for which he or she is licensed,
17        as verified by a physician, unless the person is on
18        inactive status pursuant to Department regulations;
19            (F) The licensee is mentally impaired to the
20        extent that he or she cannot exercise the appropriate
21        judgment, skill and safety for performing the
22        functions for which he or she is licensed, as verified
23        by a physician, unless the person is on inactive
24        status pursuant to Department regulations;
25            (G) The licensee has violated this Act or any rule
26        adopted by the Department pursuant to this Act; or
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1            (H) The licensee has been convicted (or entered a
2        plea of guilty or nolo contendere) by a court of
3        competent jurisdiction of a Class X, Class 1, or Class
4        2 felony in this State or an out-of-state equivalent
5        offense.
6        (9) Prescribe education and training requirements in
7    the administration and use of opioid antagonists for all
8    levels of EMS personnel based on the National EMS
9    Educational Standards and any modifications to those
10    curricula specified by the Department through rules
11    adopted pursuant to this Act.
12    (d-5) An EMR, EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN,
13PHAPRN, PHPA, or PHRN who is a member of the Illinois National
14Guard or an Illinois State Trooper or who exclusively serves
15as a volunteer for units of local government with a population
16base of less than 5,000 or as a volunteer for a not-for-profit
17organization that serves a service area with a population base
18of less than 5,000 may submit an application to the Department
19for a waiver of the fees described under paragraph (7) of
20subsection (d) of this Section on a form prescribed by the
21Department.
22    (d-10) A person who is not an EMS personnel may operate an
23EMS vehicle pursuant to this Act if the following requirements
24are met: (i) the person meets the requirements of Section
2511-1421 of the Illinois Vehicle Code; (ii) 2
26Department-licensed EMS personnel are present and have met
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1educational requirements prescribed by the Department; and
2(iii) the clinical condition of the patient necessitates the
3involvement of additional licensed personnel to ensure
4appropriate assessment, treatment, and patient safety. If a
5waiver is issued by the Department, the person who is not an
6EMS personnel may operate the EMS vehicle if only one EMS
7personnel is present. Upon request, the Department may issue a
8retroactive waiver when appropriate.
9    The education requirements prescribed by the Department
10under this Section must allow for the suspension of those
11requirements in the case of a member of the armed services or
12reserve forces of the United States or a member of the Illinois
13National Guard who is on active duty pursuant to an executive
14order of the President of the United States, an act of the
15Congress of the United States, or an order of the Governor at
16the time that the member would otherwise be required to
17fulfill a particular education requirement. Such a person must
18fulfill the education requirement within 6 months after his or
19her release from active duty.
20    (e) In the event that any rule of the Department or an EMS
21Medical Director that requires testing for drug use as a
22condition of the applicable EMS personnel license conflicts
23with or duplicates a provision of a collective bargaining
24agreement that requires testing for drug use, that rule shall
25not apply to any person covered by the collective bargaining
26agreement.
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1    (f) At the time of applying for or renewing his or her
2license, an applicant for a license or license renewal may
3submit an email address to the Department. The Department
4shall keep the email address on file as a form of contact for
5the individual. The Department shall send license renewal
6notices electronically and by mail to a licensee who provides
7the Department with his or her email address. The notices
8shall be sent at least 60 days prior to the expiration date of
9the license.
10(Source: P.A. 104-362, eff. 8-15-25.)