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Illinois General Assembly· HB 4477Governor Approved

EMS SYSTEMS-VARIOUS, the official text

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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,

3 represented in the General Assembly:

4   Section 5. The Emergency Medical Services (EMS) Systems

5 Act is amended by changing Sections 3.5, 3.35, 3.40, 3.45, and

6 3.50 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

10 patient's medical or mental health condition by a licensed

11 health care professional utilizing a medical skill set while

12 continuing assessment and care.

13  "Department" means the Illinois Department of Public

14 Health.

15  "Digital license" means a secure electronic record of a

16 license issued by the Department to EMS personnel that is

17 accessible to EMS personnel through a Department-maintained or

18 Department-approved electronic platform, website, or

19 electronic application and is readily verifiable by Resource

20 Hospitals and vehicle service providers.

21  "Director" means the Director of the Illinois Department

22 of Public Health.

23  "Emergency" means a medical condition of recent onset and
    HB4477 Enrolled         -2-  LRB104 17768 BAB 31200 b

1 severity that would lead a prudent layperson, possessing an

2 average knowledge of medicine and health, to believe that

3 urgent or unscheduled medical care is required.

4   "Emergency Medical Services personnel" or "EMS personnel"

5 means persons licensed as an Emergency Medical Responder (EMR)

6 (First Responder), Emergency Medical Dispatcher (EMD),

7 Emergency Medical Technician (EMT), Emergency Medical

8 Technician-Intermediate (EMT-I), Advanced Emergency Medical

9 Technician (A-EMT), Paramedic (EMT-P), Emergency

10 Communications Registered Nurse (ECRN), Pre-Hospital

11 Registered Nurse (PHRN), Pre-Hospital Advanced Practice

12 Registered Nurse (PHAPRN), or Pre-Hospital Physician Assistant

13 (PHPA).

14  "Exclusive representative" has the same meaning as defined

15 in Section 3 of the Illinois Public Labor Relations Act.

16  "Health care facility" means a hospital, nursing home,

17 physician's office or other fixed location at which medical

18 and health care services are performed. It does not include

19 "pre-hospital emergency care settings" which utilize EMS

20 personnel to render pre-hospital emergency care prior to the

21 arrival of a transport vehicle, as defined in this Act.

22  "Hospital" has the meaning ascribed to that term in the

23 Hospital Licensing Act.

24  "Just Culture" means a system approach to safety that

25 promotes accountability through fair and consistent evaluation

26 of conduct, distinguishing human error from at-risk and
    HB4477 Enrolled  -3-  LRB104 17768 BAB 31200 b

1 reckless behavior, and emphasizes learning, quality

2 improvement, and system improvement over punitive action when

3 appropriate.

4   "Labor organization" has the same meaning as defined in

5 Section 3 of the Illinois Public Labor Relations Act.

6   "Medical monitoring" means the performance of medical

7 tests and physical exams to evaluate an individual's ongoing

8 exposure to a factor that could negatively impact that

9 person's health. "Medical monitoring" includes close

10 surveillance or supervision of patients liable to suffer

11 deterioration in physical or mental health and checks of

12 various parameters such as pulse rate, temperature,

13 respiration rate, the condition of the pupils, the level of

14 consciousness and awareness, the degree of appreciation of

15 pain, and blood gas concentrations such as oxygen and carbon

16 dioxide.

17  "NREMT" means the National Registry of Emergency Medical

18 Technicians.

19  "Physical license" means the paper copy of the license

20 issued by the Department to EMS personnel who have met the

21 Department's education, training, and examination

22 requirements.

23  "Silver spanner program" means a program in which a member

24 under a fire department's or fire protection district's

25 collective bargaining agreement works on or at the EMS System

26 under another fire department's or fire protection district's
    HB4477 Enrolled         -4-      LRB104 17768 BAB 31200 b

1 collective bargaining agreement and (i) the other fire

2 department or fire protection district is not the member's

3 full-time employer and (ii) any EMS services not included

4 under the original fire department's or fire protection

5 district's collective bargaining agreement are included in the

6 other fire department's or fire protection district's

7 collective bargaining agreement.

8   "Trauma" means any significant injury which involves

9 single or multiple organ systems.

10 (Source: P.A. 103-521, eff. 1-1-24; 103-689, eff. 1-1-25;

11 104-362, eff. 8-15-25.)

12  (210 ILCS 50/3.35)

13  Sec. 3.35. Emergency Medical Services (EMS) Resource

14 Hospital; Functions. The Resource Hospital of an EMS System

15 shall:

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

22 Process.

23  (a) An EMS Medical Director may suspend from participation

24 within the System any EMS personnel, EMS Lead Instructor (LI),

25 individual, individual provider, or other participant
    HB4477 Enrolled  -9-  LRB104 17768 BAB 31200 b

1 considered not to be meeting the requirements of the Program

2 Plan of that approved EMS System. An EMS Medical Director must

3 submit a suspension order to the Department describing which

4 requirements of the Program Plan were not met and the

5 suspension's duration. The Department shall review and confirm

6 receipt of the suspension order, request additional

7 information, or initiate an investigation. The Department

8 shall incorporate the duration of that suspension into any

9 further action taken by the Department to suspend, revoke, or

10 refuse to issue or renew the license of the individual or

11 entity for any violation of this Act or the Program Plan

12 arising from the same conduct for which the suspension order

13 was issued if the suspended party has neither requested a

14 Department hearing on the suspension nor worked as a provider

15 in any other System during the term of the suspension.

16  (b) Prior to suspending any individual or entity, an EMS

17 Medical Director shall provide an opportunity for a hearing

18 before the local System review board in accordance with

19 subsection (f) and the rules promulgated by the Department.

20 The local System review board shall have the authority to

21 affirm, reduce, reverse, or modify, but not increase, the EMS

22 Medical Director's suspension order. The local System review

23 board shall consist of 3 members. One member shall be an

24 emergency department physician with knowledge of EMS, and 2

25 members shall be of the same professional category as the

26 individual, individual provider, or other participant
    HB4477 Enrolled  - 10 - LRB104 17768 BAB 31200 b

1 requesting the hearing. The EMS Medical Director shall

2 establish, maintain, and post in a 24-hour accessible location

3 a roster of pre-identified System review board members. The

4 roster shall include multiple individuals representing each

5 professional category operating within the EMS System, no less

6 than 5 members. The roster shall be structured to ensure

7 representation across the range of license types within the

8 EMS System and support the selection of impartial and

9 appropriately matched peers for each proceeding.

10  The selection of the System review board members for a

11 hearing shall be conducted by the EMS Medical Director or the

12 EMS Medical Director's designee from the roster. Prior to

13 finalizing the selection, the individual provider or

14 participant requesting the hearing shall be provided the

15 opportunity to review and approve the proposed review board

16 members and provide any objections based on conflicts of

17 interest or demonstrated bias. If the EMS Medical Director or

18 the EMS Medical Director's designee and the EMS System

19 participant or participating entity are unable to come to an

20 agreement, 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

21 system review board or the Department shall have the right to a

22 union representative and legal counsel of the individual's

23 choosing present at any interview. The union representative

24 must comply with any confidentiality requirements and

25 requirements for the protection of any patient information

26 presented during the proceeding.
    HB4477 Enrolled  - 12 - LRB104 17768 BAB 31200 b

1   (d) An EMS Medical Director may immediately suspend an

2 EMR, EMD, EMT, EMT-I, A-EMT, Paramedic, ECRN, PHRN, LI, PHPA,

3 PHAPRN, or other individual or entity if he or she finds that

4 the continuation in practice by the individual or entity would

5 constitute an imminent danger to the public. The suspended

6 individual or entity shall be issued an immediate verbal

7 notification followed by a written suspension order by the EMS

8 Medical Director which states the length, terms, and basis for

9 the 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

6 directly related to medical care, the EMS Medical Director

7 shall also provide the individual or entity with the

8 opportunity for a hearing before the local System review

9 board, in accordance with subsection (f) and the rules

10 promulgated by the Department. The local System review board

11 shall have the authority to affirm, reduce, reverse, or

12 modify, but not increase, the EMS Medical Director's

13 suspension 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

5 review board in accordance with the rules of the Department,

6 for the purpose of providing a hearing to any individual or

7 entity participating within the System who is suspended from

8 participation by the EMS Medical Director. The EMS Medical

9 Director shall arrange for a certified shorthand reporter to

10 make a stenographic record of that hearing and thereafter

11 prepare a transcript of the proceedings. The EMS Medical

12 Director shall inform the individual of the individual's right

13 to have a union representative and legal counsel of the

14 individual's choosing present at any interview. The union

15 representative must comply with any confidentiality

16 requirements and requirements for the protection of any

17 patient information presented during the proceeding. The

18 transcript, all documents or materials received as evidence

19 during the hearing and the local System review board's written

20 decision shall be retained in the custody of the EMS system.

21 The System shall implement a decision of the local System

22 review board unless that decision has been appealed to the

23 State Emergency Medical Services Disciplinary Review Board in

24 accordance with this Act and the rules of the Department.

25  (g) The Resource Hospital shall implement a decision of

26 the State Emergency Medical Services Disciplinary Review Board
    HB4477 Enrolled     - 16 - LRB104 17768 BAB 31200 b

1 which has been rendered in accordance with this Act and the
2 rules of the Department.
3 (Source: P.A. 103-521, eff. 1-1-24; 103-779, eff. 8-2-24;
4 104-417, eff. 8-15-25.)

5   (210 ILCS 50/3.45)

6   Sec. 3.45. State Emergency Medical Services Disciplinary

7 Review Board.

8   (a) The Governor shall appoint a State Emergency Medical

9 Services Disciplinary Review Board, composed of an EMS Medical

10 Director, an EMS System Coordinator, a Paramedic, an Emergency

11 Medical Technician (EMT), and the following members, who shall

12 only review cases in which a party is from the same

13 professional category: a Pre-Hospital Registered Nurse, a

14 Pre-Hospital Advanced Practice Registered Nurse, a

15 Pre-Hospital Physician Assistant, an ECRN, a Trauma Nurse

16 Specialist, an Emergency Medical Technician-Intermediate

17 (EMT-I), an Advanced Emergency Medical Technician (A-EMT), a

18 representative from a private vehicle service provider, a

19 representative from a public vehicle service provider, and an

20 emergency physician who monitors telecommunications from and

21 gives voice orders to EMS personnel. The Governor shall also

22 appoint one alternate for each member of the Board, from the

23 same professional category as the member of the Board.

24  (b) The members shall be appointed for a term of 3 years.

25 All appointees shall serve until their successors are
    HB4477 Enrolled   - 17 - LRB104 17768 BAB 31200 b

1 appointed. The alternate members shall be appointed and serve

2 in the same fashion as the members of the Board. If a member

3 resigns his or her appointment, the corresponding alternate

4 shall serve the remainder of that member's term until a

5 subsequent member is appointed by the Governor.

6   (c) The function of the Board is to review and affirm,

7 reduce, reverse, or modify, but not increase, disciplinary

8 orders.

9   (d) Any individual or entity, who received an immediate

10 suspension from an EMS Medical Director may request the Board

11 to reduce, reverse, or modify the suspension order. If the

12 suspension had been affirmed, or reduced, or modified by a

13 local System review board, the suspended individual or entity

14 may request the Board to reduce, reverse, or modify the local

15 board's decision.

16  (e) Any individual or entity who received a non-immediate

17 suspension order from an EMS Medical Director which was

18 affirmed or modified by a local System review board may

19 request the Board to reduce, reverse, or modify the local

20 board's decision. The individual shall be informed of the

21 individual's right to have one representative from the labor

22 organization recognized as the exclusive representative of

23 that individual's bargaining unit present and a legal

24 representative present during the State Emergency Medical

25 Services Disciplinary Review Board proceedings during open

26 session. The labor organization's representative must also
    HB4477 Enrolled    - 18 - LRB104 17768 BAB 31200 b

1 comply with all confidentiality requirements and requirements

2 for the protection of any patient information presented during

3 the proceeding.

4   (f) An EMS Medical Director whose suspension order was

5 reduced, reversed, or modified by a local System review board

6 may request the Board to reverse or modify the local board's

7 decision.

8   (g) The Board shall meet on the first Tuesday of every

9 month, unless no requests for review have been submitted.

10 Additional meetings of the Board shall be scheduled to ensure

11 that a request for direct review of an immediate suspension

12 order is scheduled within 14 days after the Department

13 receives the request for review or as soon thereafter as a

14 quorum is available. The Board shall meet in Springfield or

15 Chicago, whichever location is closer to the majority of the

16 members or alternates attending the meeting. The Department

17 shall reimburse the members and alternates of the Board for

18 reasonable travel expenses incurred in attending meetings of

19 the Board.

20  (h) A request for review shall be submitted in writing to

21 the Chief of the Department's Division of Emergency Medical

22 Services and Highway Safety, within 10 days after receiving

23 the local board's decision or the EMS Medical Director's

24 suspension order, whichever is applicable, a copy of which

25 shall be enclosed.

26  (i) At its regularly scheduled meetings, the Board shall
    HB4477 Enrolled  - 19 - LRB104 17768 BAB 31200 b

1 review requests which have been received by the Department at

2 least 10 working days prior to the Board's meeting date.

3 Requests for review which are received less than 10 working

4 days prior to a scheduled meeting shall be considered at the

5 Board's next scheduled meeting, except that requests for

6 direct review of an immediate suspension order may be

7 scheduled up to 3 working days prior to the Board's meeting

8 date.

9   (j) A quorum shall be required for the Board to meet, which

10 shall consist of 3 members or alternates, including the EMS

11 Medical Director or alternate and the member or alternate from

12 the same professional category as the subject of the

13 suspension order. At each meeting of the Board, the members or

14 alternates present shall select a Chairperson to conduct the

15 meeting.

16  (k) Deliberations for decisions of the State EMS

17 Disciplinary Review Board shall be conducted in closed

18 session. Department staff may attend for the purpose of

19 providing clerical assistance, but no other persons may be in

20 attendance except for the parties to the dispute being

21 reviewed by the Board and their attorneys, unless by request

22 of the Board.

23  (l) The Board shall review the transcript, evidence, and

24 written decision of the local review board, or the written

25 decision and supporting documentation of the EMS Medical

26 Director, whichever is applicable, along with any additional
    HB4477 Enrolled     - 20 - LRB104 17768 BAB 31200 b

1 written or verbal testimony or argument offered by the parties

2 to the dispute.

3   (m) At the conclusion of its review, the Board shall issue

4 its decision and the basis for its decision on a form provided

5 by the Department, and shall submit to the Department its

6 written decision together with the record of the local System

7 review board. The Department shall promptly issue a copy of

8 the Board's decision to all affected parties. The Board's

9 decision 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

13 levels.

14  (a) "Emergency Medical Technician" or "EMT" means a person

15 who has successfully completed a course in basic life support

16 as approved by the Department, is currently licensed by the

17 Department in accordance with standards prescribed by this Act

18 and rules adopted by the Department pursuant to this Act, and

19 practices within an EMS System. A valid Emergency Medical

20 Technician-Basic (EMT-B) license issued under this Act shall

21 continue to be valid and shall be recognized as an Emergency

22 Medical Technician (EMT) license until the Emergency Medical

23 Technician-Basic (EMT-B) license expires.

24  (b) "Emergency Medical Technician-Intermediate" or "EMT-I"

25 means a person who has successfully completed a course in
    HB4477 Enrolled  - 21 - LRB104 17768 BAB 31200 b

1 intermediate life support as approved by the Department, is

2 currently licensed by the Department in accordance with

3 standards prescribed by this Act and rules adopted by the

4 Department pursuant to this Act, and practices within an

5 Intermediate or Advanced Life Support EMS System.

6   (b-5) "Advanced Emergency Medical Technician" or "A-EMT"

7 means a person who has successfully completed a course in

8 basic and limited advanced emergency medical care as approved

9 by the Department, is currently licensed by the Department in

10 accordance with standards prescribed by this Act and rules

11 adopted by the Department pursuant to this Act, and practices

12 within an Intermediate or Advanced Life Support EMS System.

13  (c) "Paramedic (EMT-P)" means a person who has

14 successfully completed a course in advanced life support care

15 as approved by the Department, is licensed by the Department

16 in accordance with standards prescribed by this Act and rules

17 adopted by the Department pursuant to this Act, and practices

18 within an Advanced Life Support EMS System. A valid Emergency

19 Medical Technician-Paramedic (EMT-P) license issued under this

20 Act shall continue to be valid and shall be recognized as a

21 Paramedic license until the Emergency Medical

22 Technician-Paramedic (EMT-P) license expires.

23  (c-5) "Emergency Medical Responder" or "EMR (First

24 Responder)" means a person who has successfully completed a

25 course in emergency medical response as approved by the

26 Department and provides emergency medical response services in
    HB4477 Enrolled    - 22 - LRB104 17768 BAB 31200 b

1 accordance with the level of care established by the National

2 EMS Educational Standards Emergency Medical Responder course

3 as modified by the Department, or who provides services as

4 part of an EMS System response plan, as approved by the

5 Department, of that EMS System. The Department shall have the

6 authority to adopt rules governing the curriculum, practice,

7 and necessary equipment applicable to Emergency Medical

8 Responders.

9   On August 15, 2014 (the effective date of Public Act

10 98-973), a person who is licensed by the Department as a First

11 Responder and has completed a Department-approved course in

12 first responder defibrillator training based on, or equivalent

13 to, the National EMS Educational Standards or other standards

14 previously recognized by the Department shall be eligible for

15 licensure as an Emergency Medical Responder upon meeting the

16 licensure requirements and submitting an application to the

17 Department. A valid First Responder license issued under this

18 Act shall continue to be valid and shall be recognized as an

19 Emergency Medical Responder license until the First Responder

20 license expires.

21  (c-10) All EMS Systems and licensees shall be fully

22 compliant with the National EMS Education Standards, as

23 modified by the Department in administrative rules, within 24

24 months after the adoption of the administrative rules.

25  (d) The Department shall have the authority and

26 responsibility 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
    HB4477 Enrolled  - 24 - LRB104 17768 BAB 31200 b

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
    HB4477 Enrolled  - 25 - LRB104 17768 BAB 31200 b

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
    HB4477 Enrolled  - 26 - LRB104 17768 BAB 31200 b

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
    HB4477 Enrolled  - 27 - LRB104 17768 BAB 31200 b

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
    HB4477 Enrolled  - 28 - LRB104 17768 BAB 31200 b

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,

13 PHAPRN, PHPA, or PHRN who is a member of the Illinois National

14 Guard or an Illinois State Trooper or who exclusively serves

15 as a volunteer for units of local government with a population

16 base of less than 5,000 or as a volunteer for a not-for-profit

17 organization that serves a service area with a population base

18 of less than 5,000 may submit an application to the Department

19 for a waiver of the fees described under paragraph (7) of

20 subsection (d) of this Section on a form prescribed by the

21 Department.

22  (d-10) A person who is not an EMS personnel may operate an

23 EMS vehicle pursuant to this Act if the following requirements

24 are met: (i) the person meets the requirements of Section

25 11-1421 of the Illinois Vehicle Code; (ii) 2

26 Department-licensed EMS personnel are present and have met
    HB4477 Enrolled  - 29 - LRB104 17768 BAB 31200 b

1 educational requirements prescribed by the Department; and

2 (iii) the clinical condition of the patient necessitates the

3 involvement of additional licensed personnel to ensure

4 appropriate assessment, treatment, and patient safety. If a

5 waiver is issued by the Department, the person who is not an

6 EMS personnel may operate the EMS vehicle if only one EMS

7 personnel is present. Upon request, the Department may issue a

8 retroactive waiver when appropriate.

9   The education requirements prescribed by the Department

10 under this Section must allow for the suspension of those

11 requirements in the case of a member of the armed services or

12 reserve forces of the United States or a member of the Illinois

13 National Guard who is on active duty pursuant to an executive

14 order of the President of the United States, an act of the

15 Congress of the United States, or an order of the Governor at

16 the time that the member would otherwise be required to

17 fulfill a particular education requirement. Such a person must

18 fulfill the education requirement within 6 months after his or

19 her release from active duty.

20  (e) In the event that any rule of the Department or an EMS

21 Medical Director that requires testing for drug use as a

22 condition of the applicable EMS personnel license conflicts

23 with or duplicates a provision of a collective bargaining

24 agreement that requires testing for drug use, that rule shall

25 not apply to any person covered by the collective bargaining

26 agreement.
   HB4477 Enrolled  - 30 - LRB104 17768 BAB 31200 b

1  (f) At the time of applying for or renewing his or her

2 license, an applicant for a license or license renewal may

3 submit an email address to the Department. The Department

4 shall keep the email address on file as a form of contact for

5 the individual. The Department shall send license renewal

6 notices electronically and by mail to a licensee who provides

7 the Department with his or her email address. The notices

8 shall be sent at least 60 days prior to the expiration date of

9 the license.

10 (Source: P.A. 104-362, eff. 8-15-25.)
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