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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,
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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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

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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

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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

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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

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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

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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

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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

HB4477 Enrolled
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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

HB4477 Enrolled
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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
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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
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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.

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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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