Register Rules

RULES ILLINOISOF GOVERNMENTAL REGISTER AGENCIES

Index Department Administrative Code Division 111 E. Monroe St. Springfield, IL 62756 217-782-7017 www.cyberdriveillinois.com

Printed on recycled paper

PUBLISHED BY JESSE WHITE • SECRETARY OF STATE

TABLE OF CONTENTS

January 22, 2021 Volume 45, Issue 4

PROPOSED RULES FINANCIAL AND PROFESSIONAL REGULATION, DEPARTMENT OF Illinois Credit Union Act 38 Ill. Adm. Code 190...... 1093 HEALTHCARE AND FAMILY SERVICES, DEPARTMENT OF Specialized Healthcare Delivery Systems 89 Ill. Adm. Code 146...... 1096 Reimbursement for Nursing Costs for Geriatric Facilities 89 Ill. Adm. Code 147...... 1103 Long Term Care Reimbursement Changes 89 Ill. Adm. Code 153...... 1112 SECRETARY OF STATE, OFFICE OF THE Business Corporation Act 14 Ill. Adm. Code 150...... 1114 Issuance of Licenses 92 Ill. Adm. Code 1030...... 1117 School Bus Driver Permit 92 Ill. Adm. Code 1035...... 1132 ADOPTED RULES PUBLIC HEALTH, DEPARTMENT OF Skilled Nursing and Intermediate Care Facilities Code 77 Ill. Adm. Code 300...... 1134 EMERGENCY RULES FINANCIAL AND PROFESSIONAL REGULATION, DEPARTMENT OF Illinois Credit Union Act 38 Ill. Adm. Code 190...... 1186 HEALTHCARE AND FAMILY SERVICES, DEPARTMENT OF Long Term Care Reimbursement Changes 89 Ill. Adm. Code 153...... 1191 PUBLIC HEALTH, DEPARTMENT OF Hospital Licensing Requirements 77 Ill. Adm. Code 250...... 1202 SECRETARY OF STATE, OFFICE OF THE Business Corporation Act 14 Ill. Adm. Code 150...... 1215 School Bus Driver Permit 92 Ill. Adm. Code 1035...... 1222 SECOND NOTICES RECEIVED JOINT COMMITTEE ON ADMINISTRATIVE RULES Second Notices Received...... 1226

OTHER INFORMATION REQUIRED BY LAW TO BE PUBLISHED IN THE ILLINOIS REGISTER EDUCATIONAL LABOR RELATIONS BOARD, ILLINOIS General Procedures (Agency Response to JCAR Objection) 80 Ill. Adm. Code 1100...... 1228 EXECUTIVE ORDERS AND PROCLAMATIONS EXECUTIVE ORDERS Executive Order 2021-1 (COVID-19 Executive Order No. 71) 2021-1...... 1232 PROCLAMATIONS National Problem Gambling Awareness Month 2020-76...... 1241 Gerald M. Brookhart Arts in Education Spring Celebration Months 2020-77...... 1241 Prevent Child Abuse Illinois Day 2020-78...... 1242 AmeriCorps Week 2020-79...... 1243 Peripartum Cardiomyopathy Awareness Week 2020-80...... 1244 Vive tu Vida! Get Up! Get Moving! Wellness Day 2020-81...... 1245 Apraxia Awareness Day 2020-82...... 1246 Blount's Disease Day 2020-83...... 1247 Fabry Disease Awareness Month 2020-84...... 1248 National School Breakfast Week 2020-85...... 1248 Public Health Week 2020-86...... 1249 Women Veterans Recognition Month 2020-87...... 1250 Day of Prayer 2020-88...... 1251 Foster Parent Appreciation Month 2020-89...... 1251 National Nurses Week and National Nurses Day 2020-90...... 1252 Peace Officers Memorial Day 2020-91...... 1253 Congenital Diaphragmatic Hernia Awareness Month 2020-92...... 1254

Parkinson's Disease Awareness Month in Illinois 2020-93...... 1255 Illinois Community College Month 2020-94...... 1256 Illinois Pollinator Week 2020-95...... 1257 American Eagle Day 2020-96...... 1257 Pollution Control Board Day 2020-97...... 1258 Bob Molaro Day 2020-98...... 1259 Honorary Poet Laureate 2020-99...... 1261 Chronic Disease Awareness Day 2020-100...... 1262 ISEPS 50 Years of Service Day 2020-101...... 1263 Wind Week in Illinois 2020-102...... 1263 Gastroparesis Awareness Month 2020-103...... 1264 Immunization Awareness Week in Illinois 2020-104...... 1265 IARF Membership Appreciation Week 2020-105...... 1266 Illinois Rail Safety Week 2020-106...... 1266 Chiropractic Health Care Month 2020-107...... 1267 Direct Support Professionals Week 2020-108...... 1268 Gold Star Mother's Day 2020-109...... 1269 Principals Week and Principals Day 2020-110...... 1270 Family Meals Month 2020-111...... 1271 Manufacturing Month in Illinois 2020-112...... 1271 Suicide Prevention Month 2020-113...... 1272 Cybersecurity Awareness Month 2020-114...... 1274

iii

Domestic Violence Awareness Month 2020-115...... 1275 Fire Prevention Week 2020-116...... 1275 Malnutrition Awareness Week 2020-117...... 1277 Filipino American History Awareness Month 2020-118...... 1278 St. Augustine College 40th Anniversary 2020-119...... 1279 Infant Safe Sleep Awareness Month 2020-120...... 1280 Adoption Awareness Month 2020-121...... 1281 Breast Cancer Awareness Month and Mammography Day 2020-122...... 1281 Women's Small Business Month in Illinois 2020-123...... 1282 National Samosa Day 2020-124...... 1283 TAR Syndrome Awareness Month 2020-125...... 1284 Election Hero Day 2020-126...... 1285 Disability Employment Awareness Month 2020-127...... 1285 American Pharmacists Month 2020-128...... 1286 Illinois Rural Health Day 2020-129...... 1288 Congenital Heart Defect Awareness Week 2020-130...... 1288 NET Cancer Awareness Day 2020-131...... 1289 Volunteers of America Day 2020-132...... 1290 Antibiotics Awareness Week 2020-133...... 1291 Manuel Barbosa Conference Room 2020-134...... 1291 National Apprenticeship Week 2020-135...... 1292 First Generation Students' Day 2020-136...... 1293

National Adoption Day 2020-137...... 1294 Wilton D. Gregory Day 2020-138...... 1295 Pearl Harbor Remembrance Day 2020-139...... 1296 National Native American Heritage Month 2020-140...... 1297 Lois M. Moorman Day 2020-141...... 1298 Move Over Day 2020-142...... 1300 Flag Lowering - CPD Titus Theopsy Moore 2020-143...... 1300 Gubernatorial Disaster Proclamation 2021-1...... 1301

INTRODUCTION

The Illinois Register is the official state document for publishing public notice of rulemaking activity initiated by State governmental agencies. The table of contents is arranged categorically by rulemaking activity and alphabetically by agency within each category.

Rulemaking activity consists of proposed or adopted new rules; amendments to or repealers of existing rules; and rules promulgated by emergency or peremptory action. Executive Orders and Proclamations issued by the Governor; notices of public information required by State Statute; and activities (meeting agendas; Statements of Objection or Recommendation, etc.) of the Joint Committee on Administrative Rules (JCAR), a legislative oversight committee which monitors the rulemaking activities of State Agencies; is also published in the Register.

The Register is a weekly update of the Illinois Administrative Code (a compilation of the rules adopted by State agencies). The most recent edition of the Code, along with the Register, comprise the most current accounting of State agencies’ rulemakings.

The Illinois Register is the property of the State of Illinois, granted by the authority of the Illinois Administrative Procedure Act [5 ILCS 100/1-1, et seq.].

ILLINOIS REGISTER PUBLICATION SCHEDULE FOR 2021

Issue# Rules Due Date Date of Issue 1 December 21, 2020 January 4, 2021 2 December 28, 2020 January 8, 2021 3 January 4, 2021 January 15, 2021 4 January 11, 2021 January 22, 2021 5 January 19, 2021 January 29, 2021 6 January 25, 2021 February 5, 2021 7 February 1, 2021 February 16, 2021 8 February 8, 2021 February 19, 2021 9 February 16, 2021 February 26, 2021 10 February 22, 2021 March 5, 2021 11 March 1, 2021 March 12, 2021 12 March 8, 2021 March 19, 2021 13 March 15, 2021 March 26, 2021 14 March 22, 2021 April 2, 2021 15 March 29, 2021 April 9, 2021 16 April 5, 2021 April 16, 2021 17 April 12, 2021 April 23, 2021 18 April 19, 2021 April 30, 2021 19 April 26, 2021 May 7, 2021 20 May 3, 2021 May 14, 2021 21 May 10, 2021 May 21, 2021

22 May 17, 2021 May 28, 2021 23 May 24, 2021 June 4, 2021 24 June 1, 2021 June 11, 2021 25 June 7, 2021 June 18, 2021 26 June 14, 2021 June 25, 2021 27 June 21, 2021 July 2, 2021 28 June 28, 2021 July 9, 2021 29 July 6, 2021 July 16, 2021 30 July 12, 2021 July 23, 2021 31 July 19, 2021 July 30, 2021 32 July 26, 2021 August 6, 2021 33 August 2, 2021 August 13, 2021 34 August 9, 2021 August 20, 2021 35 August 16, 2021 August 27, 2021 36 August 23, 2021 September 3, 2021 37 August 30, 2021 September 10, 2021 38 September 7, 2021 September 17, 2021 39 September 13, 2021 September 24, 2021 40 September 20, 2021 October 1, 2021 41 September 27, 2021 October 8, 2021 42 October 4, 2021 October 15, 2021 43 October 12, 2021 October 22, 2021 44 October 18, 2021 October 29, 2021 45 October 25, 2021 November 5, 2021 46 November 1, 2021 November 12, 2021 47 November 8, 2021 November 19, 2021 48 November 15, 2021 November 29, 2021 49 November 22, 2021 December 3, 2021 50 November 29, 2021 December 10, 2021 51 December 6, 2021 December 17, 2021 52 December 13, 2021 December 27, 2021 53 December 20, 2021 December 31, 2021

vii ILLINOIS REGISTER 1093 21 DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

NOTICE OF PROPOSED AMENDMENT

1) Heading of the Part: Illinois Credit Union Act

2) Code Citation: 38 Ill. Adm. Code 190

3) Section Number: Proposed Action: 190.230 New Section

4) Statutory Authority: Implementing and authorized by the Illinois Credit Union Act [205 ILCS 305].

5) A Complete Description of the Subjects and Issues Involved: The proposed amendment permits the Board of Directors of Credit Unions to provide by resolution that all members may attend, participate in, act, and vote at the annual meeting or special meeting of the members through audio or video conference or other communication technology that enables meeting participants to communicate with each other. The rule provides that attendance through such means shall constitute in person attendance. Permitting remote meeting eliminates unnecessary travel and will likely lead to greater member participation. The Board of Directors is in the best position to determine whether remote meetings are appropriate for a specific credit union. Remote meetings are commonly permitted in other contexts (e.g. shareholder meetings) under Illinois law. This amendment also modernizes the Act by removing ambiguity regarding the permissibility of remote meetings.

The proposed language is materially consistent with language in many other Illinois laws including the General Not For Profit Corporation Act of 1986 and the Business Incorporation Act of 1983.

6) Any published studies or reports, along with the sources of underlying data, that were used when comprising this rulemaking, in accordance with 1 Ill. Adm. Code 100.355: None

7) Will this rulemaking replace any emergency rule currently in effect? Yes

8) Does this rulemaking contain an automatic repeal date? No

9) Does this rulemaking contain incorporations by reference? No

10) Are there any other rulemakings pending on this Part? No

ILLINOIS REGISTER 1094 21 DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

NOTICE OF PROPOSED AMENDMENT

11) Statement of Statewide Policy Objective: This rulemaking will not require a local government to establish, expand or modify its activities in such a way as to necessitate additional expenditures from local revenues.

12) Time, Place, and Manner in which interested persons may comment on this proposed rulemaking: Persons who wish to comment on this proposed rulemaking may submit written comments no later than 45 days after the publication of this Notice to:

Department of Financial and Professional Regulation Attention: Craig Cellini 320 West Washington, 2nd Floor Springfield IL 62786

217/785-0813 fax: 217/557-4451

All written comments received within 45 days after this issue of the Illinois Register will be considered.

13) Initial Regulatory Flexibility Analysis:

A) Types of small businesses, small municipalities and not-for-profit corporations affected: None

B) Reporting, bookkeeping or other procedures required for compliance: None

C) Types of professional skills necessary for compliance: None

14) Small Business Impact Analysis:

A) Types of businesses subject to the proposed rule:

54 professional, scientific and technical services

B) Categories that the Agency reasonably believes the rulemaking will impact, including:

ii regulatory requirements

ILLINOIS REGISTER 1095 21 DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

NOTICE OF PROPOSED AMENDMENT

15) Regulatory Agenda on which this rulemaking was summarized: This rule was not included on either of the 2 most recent agendas because the need for it was unanticipated.

The full text of the Proposed Amendment is identical to that of the Emergency Amendment for this Part, and begins in this issue of the Illinois Register on page 1186.

ILLINOIS REGISTER 1096 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

1) Heading of the Part: Specialized Health Care Delivery Systems

2) Code Citation: 89 Ill. Adm. Code 146

3) Section Number: Proposed Action: 146.910 Amendment

4) Statutory Authority: Section 12-13 of the Illinois Public Aid Code [305 ILCS 5/12-13]

5) Complete Description of the Subjects and Issues Involved: This proposed amendment implements a change made to 210 ILCS 49/5-106 by PA 101-636 (the FY2021 Budget Implementation Act), by clarifying the therapeutic visit reimbursement rate for facilities licensed or provisionally licensed by June 1, 2018 under the Specialized Mental Health Rehabilitation Act of 2013 is 75% of the facility's current paid rate instead of 75% of the rate in effect on July 27, 2018.

6) Published studies or reports, and sources of underlying data, used to compose this rulemaking: None

7) Will this rulemaking replace any emergency rule currently in effect? Yes

8) Does this rulemaking contain an automatic repeal date? No

9) Does this rulemaking contain incorporations by reference? No

10) Are there any other rulemakings pending on this Part? Yes

Section Number: Proposed Action: Illinois Register Citation: 146.550 Amendment 44 Ill. Reg. 13629; August 21, 2020

11) Statement of Statewide Policy Objective: This rulemaking does not affect units of local government.

12) Time, Place, and Manner in which interested persons may comment on this rulemaking: Any interested parties may submit comments, data, views, or arguments concerning this proposed rulemaking. All comments must be in writing and should be addressed to:

Steffanie Garrett General Counsel

ILLINOIS REGISTER 1097 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

Illinois Department of Healthcare and Family Services 201 South Grand Avenue East, 3rd Floor Springfield IL 62763-0002

[email protected]

The Department requests the submission of written comments within 45 days after the publication of this Notice. The Department will consider all written comments it receives during the first notice period as required by Section 5-40 of the Illinois Administrative Procedure Act [5 ILCS 100/5-40].

13) Initial Regulatory Flexibility Analysis:

A) Types of small businesses, small municipalities and not-for-profit corporations affected: None

B) Reporting, bookkeeping or other procedures required for compliance: None

C) Types of professional skills necessary for compliance: None

14) Small Business Impact Analysis: None

15) Regulatory Agenda on which this rulemaking was summarized: July 2020

The full text of the Proposed Amendment begins on the next page:

ILLINOIS REGISTER 1098 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

TITLE 89: SOCIAL SERVICES CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES SUBCHAPTER d: MEDICAL PROGRAMS

PART 146 SPECIALIZED HEALTH CARE DELIVERY SYSTEMS

SUBPART A: AMBULATORY SURGICAL TREATMENT CENTERS

Section 146.100 General Description 146.105 Definitions 146.110 Participation Requirements 146.115 Records and Data Reporting Requirements 146.125 Covered Ambulatory Surgical Treatment Center Services 146.130 Reimbursement for Services

SUBPART B: SUPPORTIVE LIVING PROGRAM (SLP) SETTINGS

Section 146.200 General Description 146.205 Definitions 146.210 Structural Requirements 146.215 SLP Participation Requirements 146.220 Resident Participation Requirements 146.225 Reimbursement for Medicaid Residents 146.230 Services 146.235 Staffing 146.240 Resident Contract 146.245 Assessment and Service Plan and Quarterly Evaluation 146.250 Resident Rights 146.255 Discharge 146.260 Grievance Procedure 146.265 Records and Reporting Requirements 146.270 Quality Assurance Plan 146.275 Monitoring 146.280 Non-Compliance Action 146.285 Voluntary Surrender of Certification 146.290 Geographic Groups

ILLINOIS REGISTER 1099 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

146.295 Emergency Contingency Plan 146.300 Waivers 146.305 Reporting of Suspected Abuse, Neglect and Financial Exploitation 146.310 Facility Management of Resident Funds

SUBPART C: STATE HEMOPHILIA PROGRAM

Section 146.400 Definitions 146.410 Patient Eligibility 146.420 Hemophilia Treatment Centers 146.430 Comprehensive Care Evaluation 146.440 Home Transfusion Arrangements 146.450 Obligations of the Department

SUBPART D: CHILDREN'S COMMUNITY-BASED HEALTH CARE CENTERS

Section 146.500 General Description 146.510 Definitions 146.520 Participation Requirements 146.530 Records and Data Reporting Requirements 146.540 Covered Children's Community-Based Health Care Center Services 146.550 Reimbursement for Services 146.560 Individuals Eligible for Services Provided in a Children's Community-Based Health Care Center 146.570 Prior and Post Approval of Services

SUBPART E: SUPPORTIVE LIVING PROGRAM (SLP) SETTINGS WITH DEMENTIA CARE UNITS

Section 146.600 General Description 146.610 Structural Requirements 146.620 Participation Requirements 146.630 Resident Participation Requirements 146.640 Services 146.650 Reimbursement for Medicaid Residents 146.660 Staffing

ILLINOIS REGISTER 1100 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

146.670 Assessment and Service Plan and Quarterly Evaluation 146.680 Monitoring 146.690 Reporting Requirements 146.700 Resident Rights 146.710 Discharge

SUBPART F: BIRTH CENTERS

Section 146.800 General Description 146.810 Participation Requirements 146.820 Record Requirements 146.830 Covered Birth Center Services 146.840 Reimbursement of Birth Center Services

SUBPART G: SPECIALIZED MENTAL HEALTH REHABILITATION FACILITIES

Section 146.900 General Provisions 146.910 Reimbursement

AUTHORITY: Implementing and authorized by Articles III, IV, V, VI and Section 12-13 of the Illinois Public Aid Code [305 ILCS 5].

SOURCE: Old Part repealed at 14 Ill. Reg. 13800, effective August 15, 1990; new Part adopted at 20 Ill. Reg. 4419, effective February 29, 1996; emergency amendment at 21 Ill. Reg. 13875, effective October 1, 1997, for a maximum of 150 days; amended at 22 Ill. Reg. 4430, effective February 27, 1998; emergency amendment at 22 Ill. Reg. 13146, effective July 1, 1998, for a maximum of 150 days; amended at 22 Ill. Reg. 19914, effective October 30, 1998; amended at 23 Ill. Reg. 5819, effective April 30, 1999; emergency amendment at 23 Ill. Reg. 8256, effective July 1, 1999, for a maximum of 150 days; amended at 23 Ill. Reg. 13663, effective November 1, 1999; amended at 24 Ill. Reg. 8353, effective June 1, 2000; emergency amendment at 26 Ill. Reg. 14882, effective October 1, 2002, for a maximum of 150 days; amended at 27 Ill. Reg. 2176, effective February 1, 2003; emergency amendment at 27 Ill. Reg. 10854, effective July 1, 2003, for a maximum of 150 days; amended at 27 Ill. Reg. 18671, effective November 26, 2003; emergency amendment at 28 Ill. Reg. 12218, effective August 11, 2004, for a maximum of 150 days; emergency amendment at 28 Ill. Reg. 14214, effective October 18, 2004, for a maximum of 150 days; amended at 29 Ill. Reg. 852, effective January 1, 2005; emergency amendment at 29 Ill. Reg. 2014, effective January 21, 2005, for a maximum of 150 days; amended at 29 Ill. Reg.

ILLINOIS REGISTER 1101 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

4360, effective March 7, 2005; expedited correction at 29 Ill. Reg. 14127, effective March 7, 2005; amended at 29 Ill. Reg. 6967, effective May 1, 2005; amended at 29 Ill. Reg. 14987, effective September 30, 2005; amended at 30 Ill. Reg. 8845, effective May 1, 2006; amended at 31 Ill. Reg. 5589, effective April 1, 2007; emergency amendment at 31 Ill. Reg. 5876, effective April 1, 2007, for a maximum of 150 days; amended at 31 Ill. Reg. 11681, effective August 1, 2007; amended at 33 Ill. Reg. 11803, effective August 1, 2009; emergency amendment at 36 Ill. Reg. 6751, effective April 13, 2012, for a maximum of 150 days; amended at 36 Ill. Reg. 13885, effective August 27, 2012; amended at 37 Ill. Reg. 17624, effective October 28, 2013; expedited correction at 38 Ill. Reg. 4518, effective October 28, 2013; amended at 38 Ill. Reg. 13255, effective June 11, 2014; amended at 38 Ill. Reg. 13893, effective June 23, 2014; amended at 38 Ill. Reg. 15152, effective July 2, 2014; emergency amendment at 38 Ill. Reg. 15713, effective July 7, 2014, for a maximum of 150 days; amended at 38 Ill. Reg. 23768, effective December 2, 2014; emergency amendment at 39 Ill. Reg. 6945, effective May 1, 2015 through June 30, 2015; emergency amendment at 42 Ill. Reg. 13733, effective July 2, 2018, for a maximum of 150 days; emergency amendment to emergency rule at 42 Ill. Reg. 16311, effective August 13, 2018, for the remainder of the 150 days; emergency expired November 28, 2018; amended at 42 Ill. Reg. 16731, effective August 28, 2018; emergency amendment at 42 Ill. Reg. 17935, effective September 24, 2018, for a maximum of 150 days; emergency expired February 20, 2019; amended at 43 Ill. Reg. 6803, effective May 28, 2019; Subpart B and Subpart E recodified at 43 Ill. Reg. 7014; amended at 44 Ill. Reg. 2331, effective January 15, 2020; emergency amendment at 44 Ill. Reg. 12825, effective July 17, 2020, for a maximum of 150 days; amended at 44 Ill. Reg. 19760, effective December 11, 2020; amended at 45 Ill. Reg. ______, effective ______.

SUBPART G: SPECIALIZED MENTAL HEALTH REHABILITATION FACILITIES

Section 146.910 Reimbursement

a) Facilities licensed under Specialized Mental Health Rehabilitation Act of 2013 shall be reimbursed at:

1) the rate in effect on June 30, 2014, less $7.07 for each facility previously licensed under the Nursing Home Care Act on June 30, 2013;

2) the rate in effect on June 30, 2013 for each facility licensed under the Specialized Mental Health Rehabilitation Act on June 30, 2013;

3) effective for services provided on or after July 1, 2017, the rate in effect on June 30, 2017 increased by 2.8%; or

ILLINOIS REGISTER 1102 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

4) effective for services provided on or after July 1, 2018, the rate in effect on June 30, 2018 increased by 4%. b) Any adjustment in the support component or the capital component for facilities licensed by the Department of Public Health under the Nursing Home Care Act shall apply equally to facilities licensed by the Department of Public Health under the Specialized Mental Health Rehabilitation Act of 2013. c) Notwithstanding the provisions set forth in 89 Ill. Adm. Code 153, facilities licensed under the Specialized Mental Health Rehabilitation Act of 2013 shall receive a payment in the amount of $29.43 per licensed bed, per day, for the period beginning June 1, 2014 and ending June 30, 2014. d) Facilities licensed or provisionally licensed under the Specialized Mental Health Rehabilitation Act of 2013 on or before June 1, 2018 will be reimbursed for therapeutic visits that have been indicated by an interdisciplinary team as therapeutically beneficial at the following:

1) Effective for dates of service June 4, 2018 through July 26, 2018, therapeutic visits are reimbursed at a rate of 75% of the facility's rate as of June 4, 2018.

2) Effective for dates of service on or after July 27, 2018 through June 30, 2020, therapeutic visits are reimbursed at a rate of 75% of the facility's rate as of July 27, 2018.

3) Effective for dates of service on or after July 1, 2020, therapeutic visits are reimbursed at a rate of 75% of the facility's current rate.

43) Facilities may not be reimbursed for more than 10 consecutive days of therapeutic visits and no more than 20 days of therapeutic visits per State fiscal year.

(Source: Amended at 45 Ill. Reg. ______, effective ______)

ILLINOIS REGISTER 1103 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

1) Heading of the Part: Reimbursement for Nursing Costs for Geriatric Facilities

2) Code Citation: 89 Ill. Adm. Code 147

3) Section Number: Proposed Action: 147.310 Amendment

4) Statutory Authority: Section 12-13 of the Illinois Public Aid Code [305 ILCS 5/12-13]

5) Complete Description of the Subjects and Issues Involved: This amendment proposes a change to the long term care regional wage adjustor.

6) Published studies or reports, and sources of underlying data, used to compose this rulemaking: None

7) Will this rulemaking replace any emergency rule currently in effect? No

8) Does this rulemaking contain an automatic repeal date? No

9) Does this rulemaking contain incorporations by reference? No

10) Are there any other rulemakings pending on this Part? No

11) Statement of Statewide Policy Objective: This rulemaking does not affect units of local government.

Steffanie Garrett General Counsel Illinois Department of Healthcare and Family Services 201 South Grand Avenue East, 3rd Floor Springfield IL 62763-0002

[email protected]

ILLINOIS REGISTER 1104 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

13) Initial Regulatory Flexibility Analysis:

A) Types of small businesses, small municipalities and not-for-profit corporations affected: None

B) Reporting, bookkeeping or other procedures required for compliance: None

C) Types of professional skills necessary for compliance: None

14) Small Business Impact Analysis: None

15) Regulatory Agenda on which this rulemaking was summarized: This rulemaking was not anticipated by the Department when the most recent Regulatory Agendas were published.

The full text of the Proposed Amendment begins on the next page:

ILLINOIS REGISTER 1105 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

TITLE 89: SOCIAL SERVICES CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES SUBCHAPTER d: MEDICAL PROGRAMS

PART 147 REIMBURSEMENT FOR NURSING COSTS FOR GERIATRIC FACILITIES

Section 147.5 Minimum Data Set-Mental Health (MDS-MH) Based Reimbursement System (Repealed) 147.15 Comprehensive Resident Assessment (Repealed) 147.25 Functional Needs and Restorative Care (Repealed) 147.50 Service Needs (Repealed) 147.75 Definitions (Repealed) 147.100 Reconsiderations (Repealed) 147.105 Midnight Census Report 147.125 Nursing Facility Resident Assessment Instrument (Repealed) 147.150 Minimum Data Set (MDS) Based Reimbursement System (Repealed) 147.175 Minimum Data Set (MDS) Integrity (Repealed) 147.200 Minimum Data Set (MDS) On-Site Review Documentation (Repealed) 147.205 Reimbursement for Ventilator Dependent Residents (Repealed) 147.250 Costs Associated with the Omnibus Budget Reconciliation Act of 1987 (P.L. 100- 203) (Repealed) 147.300 Payment to Nursing Facilities Serving Persons with Mental Illness 147.301 Sanctions for Noncompliance 147.305 Psychiatric Rehabilitation Service Requirements for Individuals With Mental Illness in Residential Facilities (Repealed) 147.310 Implementation of a Case Mix System 147.315 Nursing Facility Resident Assessment Instrument 147.320 Definitions 147.325 Resident Reimbursement Classifications and Requirements 147.330 Resource Utilization Groups (RUGs) Case Mix Requirements 147.335 Enhanced Care Rates 147.340 Minimum DataDate Set On-Site Reviews 147.345 Quality Incentives 147.346 Appeals of Nursing Rate Determination 147.350 Reimbursement for Additional Program Costs Associated Withwith Providing Specialized Services for Individuals with Developmental Disabilities in Nursing Facilities

ILLINOIS REGISTER 1106 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

147.355 Reimbursement for Residents with Exceptional Needs (Repealed)

147.TABLE A Staff Time (in Minutes) and Allocation by Need Level (Repealed) 147.TABLE B MDS-MH Staff Time (in Minutes and Allocation by Need Level) (Repealed) 147.TABLE C Comprehensive Resident Assessment (Repealed) 147.TABLE D Functional Needs and Restorative Care (Repealed) 147.TABLE E Service (Repealed) 147.TABLE F Social Services (Repealed) 147.TABLE G Therapy Services (Repealed) 147.TABLE H Determinations (Repealed) 147.TABLE I Activities (Repealed) 147.TABLE J Signatures (Repealed) 147.TABLE K Rehabilitation Services (Repealed) 147.TABLE L Personal Information (Repealed)

AUTHORITY: Implementing and authorized by Articles III, IV, V, VI and Section 12-13 of the Illinois Public Aid Code [305 ILCS 5/Arts. III, IV, V, VI and 12-13].

SOURCE: Recodified from 89 Ill. Adm. Code 140.900 thru 140.912 and 140.Table H and 140.Table I at 12 Ill. Reg. 6956; amended at 13 Ill. Reg. 559, effective January 1, 1989; amended at 13 Ill. Reg. 7043, effective April 24, 1989; emergency amendment at 13 Ill. Reg. 10999, effective July 1, 1989, for a maximum of 150 days; emergency expired November 28, 1989; amended at 13 Ill. Reg. 16796, effective October 13, 1989; amended at 14 Ill. Reg. 210, effective December 21, 1989; emergency amendment at 14 Ill. Reg. 6915, effective April 19, 1990, for a maximum of 150 days; emergency amendment at 14 Ill. Reg. 9523, effective June 4, 1990, for a maximum of 150 days; emergency expired November 1, 1990; emergency amendment at 14 Ill. Reg. 14203, effective August 16, 1990, for a maximum of 150 days; emergency expired January 13, 1991; emergency amendment at 14 Ill. Reg. 15578, effective September 11, 1990, for a maximum of 150 days; emergency expired February 8, 1991; amended at 14 Ill. Reg. 16669, effective September 27, 1990; amended at 15 Ill. Reg. 2715, effective January 30, 1991; amended at 15 Ill. Reg. 3058, effective February 5, 1991; amended at 15 Ill. Reg. 6238, effective April 18, 1991; amended at 15 Ill. Reg. 7162, effective April 30, 1991; amended at 15 Ill. Reg. 9001, effective June 17, 1991; amended at 15 Ill. Reg. 13390, effective August 28, 1991; emergency amendment at 15 Ill. Reg. 16435, effective October 22, 1991, for a maximum of 150 days; amended at 16 Ill. Reg. 4035, effective March 4, 1992; amended at 16 Ill. Reg. 6479, effective March 20, 1992; emergency amendment at 16 Ill. Reg. 13361, effective August 14, 1992, for a maximum of 150 days; amended at 16 Ill. Reg. 14233, effective August 31, 1992; amended at 16 Ill. Reg. 17332, effective November 6, 1992; amended at 17 Ill. Reg. 1128, effective January 12, 1993; amended at 17 Ill. Reg. 8486, effective June 1, 1993; amended at 17

ILLINOIS REGISTER 1107 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

Ill. Reg. 13498, effective August 6, 1993; emergency amendment at 17 Ill. Reg. 15189, effective September 2, 1993, for a maximum of 150 days; amended at 18 Ill. Reg. 2405, effective January 25, 1994; amended at 18 Ill. Reg. 4271, effective March 4, 1994; amended at 19 Ill. Reg. 7944, effective June 5, 1995; amended at 20 Ill. Reg. 6953, effective May 6, 1996; amended at 21 Ill. Reg. 12203, effective August 22, 1997; amended at 26 Ill. Reg. 3093, effective February 15, 2002; emergency amendment at 27 Ill. Reg. 10863, effective July 1, 2003, for a maximum of 150 days; amended at 27 Ill. Reg. 18680, effective November 26, 2003; expedited correction at 28 Ill. Reg. 4992, effective November 26, 2003; emergency amendment at 29 Ill. Reg. 10266, effective July 1, 2005, for a maximum of 150 days; amended at 29 Ill. Reg. 18913, effective November 4, 2005; amended at 30 Ill. Reg. 15141, effective September 11, 2006; expedited correction at 31 Ill. Reg. 7409, effective September 11, 2006; amended at 31 Ill. Reg. 8654, effective June 11, 2007; emergency amendment at 32 Ill. Reg. 415, effective January 1, 2008, for a maximum of 150 days; emergency amendment suspended at 32 Ill. Reg. 3114, effective February 13, 2008; emergency suspension withdrawn in part at 32 Ill. Reg. 4399, effective February 26, 2008 and 32 Ill. Reg. 4402, effective March 11, 2008 and 32 Ill. Reg. 9765, effective June 17, 2008; amended at 32 Ill. Reg. 8614, effective May 29, 2008; amended at 33 Ill. Reg. 9337, effective July 1, 2009; emergency amendment at 33 Ill. Reg. 14350, effective October 1, 2009, for a maximum of 150 days; emergency amendment modified in response to the objection of the Joint Committee on Administrative Rules at 34 Ill. Reg. 1421, effective January 5, 2010, for the remainder of the 150 days; emergency expired February 27, 2010; amended at 34 Ill. Reg. 3786, effective March 14, 2010; amended at 35 Ill. Reg. 19514, effective December 1, 2011; amended at 36 Ill. Reg. 7077, effective April 27, 2012; emergency amendment at 38 Ill. Reg. 1205, effective January 1, 2014, for a maximum of 150 days; Sections 147.335(a)(7)(B) and 147.355(b) of the emergency amendment suspended by the Joint Committee on Administrative Rules at 38 Ill. Reg. 3385, effective January 14, 2014; suspension withdrawn at 38 Ill. Reg. 5898, effective March 7, 2014; emergency amendment modified in response to JCAR Objection at 38 Ill. Reg. 6707, effective March 7, 2014, for the remainder of the 150 days; amended at 38 Ill. Reg. 12173, effective May 30, 2014; emergency amendment at 38 Ill. Reg. 15723, effective July 7, 2014, for a maximum of 150 days; amended at 38 Ill. Reg. 23778, effective December 2, 2014; amended at 45 Ill. Reg. ______, effective ______.

Section 147.310 Implementation of a Case Mix System

a) P.A. 98-0104 requires the Department to implement, effective January 1, 2014, an evidence-based payment methodology for the reimbursement of nursing services. The methodology shall take into consideration the needs of individual residents, as assessed and reported by the most current version of the nursing facility Minimum Data Set (MDS), adopted and in use by the federal government.

ILLINOIS REGISTER 1108 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT b) This Section establishes the method and criteria used to determine the resident reimbursement classification based upon the assessments of residents in nursing facilities. Resident reimbursement classification shall be established utilizing the 48-group, Resource Utilization Groups IV (RUG-IV) classification scheme and weights as published by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services (federal CMS). An Illinois specific default group is established in subsection (f)(3) and identified as AA1 with an assigned weight equal to the weight assigned to group PA1. c) The pool of funds available for distribution by case mix shall be determined using the formula contained below. Base rate spending pool shall be:

1) The base year resident days, which are calculated by multiplying the number of Medicaid residents in each nursing facility based on MDS comprehensive assessments for Medicaid residents on March 31, 2012, multiplied by 365 days.

2) Each facility's nursing component per diem in effect on July 1, 2012 shall be multiplied by the number determined in subsection (c)(1).

3) Thirteen million is added to the result of subsection (c)(2) of this Section, to adjust for the exclusion of nursing facilities defined as Class I IMDs. d) For each nursing facility with Medicaid residents as indicated by the MDS data defined in subsection (c)(1) of this Section, weighted days adjusted for case mix and regional wage adjustment shall be calculated. For each nursing facility this calculation is the product of:

1) Base year resident days as calculated in subsection (c)(1).

2) The nursing facility's regional wage adjustor based on the Health Service Areas (HSA) groupings and adjustors in effect on April 30, 2012.

3) Facility weighted case mix, which is the number of Medicaid residents as indicated by the MDS data defined in subsection (c)(1) multiplied by the associated case weight for the RUG-IV 48-group model using standard RUG-IV procedures for index maximization.

ILLINOIS REGISTER 1109 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

4) The sum of the products calculated for each nursing facility in subsections (d)(1) through (d)(3) shall be the base year case mix, rate adjusted weighted days. e) The statewide RUG-IV nursing base per diem rate effective on:

1) January 1, 2014 shall be the quotient of subsection (c) divided by the sum calculated under subsection (d)(4) and is $83.49.

2) July 1, 2014 shall be the rate calculated in subsection (e)(1) increased by $1.76. f) Nursing Component Per DiemFor services provided on or after:

1) For services provided on or after January 1, 2014, the Department shall compute and pay a facility-specific nursing component of the per diem rate as the arithmetic mean of the resident-specific nursing components, as determined in subsection (d), assigned to Medicaid-enrolled residents on record, as of 30 days prior to the beginning of the rate period, in the Department's Medicaid Management Information System (MMIS), or any successor system, as present in the facility on the last day of the second quarter preceding the rate period. The RUG-IV nursing component per diem for a nursing facility shall be the product of the statewide RUG-IV nursing base per diem rate, the facility average case mix index to be calculated quarterly, and the regional wage adjustor. Transition rates for services provided between January 1, 2014 and December 31, 2014 shall be as follows:

A) The transition RUG-IV per diem nursing rate for nursing facilities whose rate calculated in this subsection (f) is greater than the nursing component rate in effect July 1, 2012 shall be paid the sum of:

i) The nursing component rate in effect July 1, 2012; plus

ii) The difference of the RUG-IV nursing component per diem calculated for the current quarter minus the nursing component rate in effect July 1, 2012, multiplied by 0.88.

ILLINOIS REGISTER 1110 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

B) The transition RUG-IV per diem nursing rate for nursing facilities whose rate calculated in this subsection (f) is less than the nursing component rate in effect July 1, 2012 shall be paid the sum of:

i) The nursing component rate in effect July 1, 2012; plus

ii) The difference of the RUG-IV nursing component per diem calculated for the current quarter minus the nursing component rate in effect July 1, 2012, multiplied by 0.13.

C) Effective January 1, 2020, the regional wage adjustor referenced in this subsection (f)(1) cannot be lower than 0.95.

D) Effective July 1, 2020, the regional wage adjustor referenced in this subsection (f)(1) cannot be lower than 1.0.

2) Effective for dates of service on or after July 1, 2014, a per diem add-on to the RUGS methodology will be included as follows:

A) $0.63 for each resident who scores I4200 Alzheimer's Disease or I4800 non-Alzheimer's Dementia.

B) $2.67 for each resident who scores "1" or "2" in any items S1200A through S1200I and also scores in the RUG groups PA1, PA2, BA1 and BA2.

3) The Department shall determine the group to which a resident is assigned using the 48-group RUG-IV classification scheme with an index maximization approach. A resident for whom RUGs resident identification information is missing, or inaccurate, or for whom there is no current MDS record for that quarter, shall be assigned to default group AA1. A resident for whom an MDS assessment does not meet the federal CMS edit requirements as described in the Long Term Care Resident Assessment Instrument (RAI) Users Manual or for whom an MDS assessment has not been submitted within 14 calendar days after the time requirements in Section 147.315 shall be assigned to default group AA1.

ILLINOIS REGISTER 1111 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

4) The assessment used for the purpose of rate calculation shall be identified as an Omnibus Budget Reconciliation Act (OBRA) assessment on the MDS following the guidance in the RAI Manual.

5) The MDS used for the purpose of rate calculation shall be determined by the Assessment Reference Date (ARD) identified on the MDS assessment. g) The Department shall provide each nursing facility with information that identifies the group to which each resident has been assigned.

(Source: Amended at 45 Ill. Reg. ______, effective ______)

ILLINOIS REGISTER 1112 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

1) Heading of the Part: Long Term Care Reimbursement Changes

2) Code Citation: 89 Ill. Adm. Code 153

3) Section Number: Proposed Action: 153.125 Amendment

4) Statutory Authority: Section 12-13 of the Illinois Public Aid Code [305 ILCS 5/12-13]

5) Complete Description of the Subjects and Issues Involved: This proposed amendment implements medical assistance program reimbursement rate increases for facilities licensed under ID/DD Community Care Act and the MC/DD Act as required by PA 101- 636.

6) Published studies or reports, and sources of underlying data, used to compose this rulemaking: None

7) Will this rulemaking replace any emergency rule currently in effect? Yes

8) Does this rulemaking contain an automatic repeal date? No

9) Does this rulemaking contain incorporations by reference? No

10) Are there any other rulemakings pending on this Part? Yes

Section Number: Proposed Action: Illinois Register Citation: 140.80 Amendment 44 Ill. Reg 12721; July 31, 2020

11) Statement of Statewide Policy Objective: This rulemaking does not affect units of local government.

12) Time, Place, and Manner in which interested persons may comment on this proposed rulemaking: Any interested parties may submit comments, data, views, or arguments concerning this proposed rulemaking. All comments must be in writing and should be addressed to:

Steffanie Garrett General Counsel Illinois Department of Healthcare and Family Services

ILLINOIS REGISTER 1113 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF PROPOSED AMENDMENT

201 South Grand Avenue East, 3rd Floor Springfield IL 62763-0002 [email protected]

13) Initial Regulatory Flexibility Analysis:

A) Types of small businesses, small municipalities and not-for-profit corporations affected: Long Term Care facilities

B) Reporting, bookkeeping or other procedures required for compliance: None

C) Types of professional skills necessary for compliance: None

14) Small Business Impact Analysis: None

15) Regulatory Agenda on which this rulemaking was summarized: July 2020

The full text of the Proposed Amendment is identical to the Emergency Amendment that begins on page 1191.

ILLINOIS REGISTER 1114 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENT

1) Heading of the Part: Business Corporation Act

2) Code Citation: 14 Ill. Adm. Code 150

3) Section Number: Proposed Action: 150.740 Amendment

4) Statutory Authority: Implementing and authorized by the Business Corporation Act of 1983 [805 ILCS 5].

5) A Complete Description of the Subjects and Issues Involved: This amendment authorizes the Secretary of State to collect fees for late filings of materials required to be filed with the Secretary of State. New language is added stating that the statutory fees for the late filing of certain documents, including franchise tax, penalties, interest and filing fees are in full force and effect.

6) Published studies or reports, and sources of underlying data, used to compose this rulemaking: None

7) Will this rulemaking replace an emergency rule currently in effect? Yes

8) Does this rulemaking contain an automatic repeal date? No

9) Does this rulemaking contain incorporations by reference? No

10) Are there any other rulemakings pending on this Part? No

11) Statement of Statewide Policy Objective: This rulemaking does not create or enlarge a mandate as described in Section 3(b) of the State Mandates Act.

12) Time, Place, and Manner in which interested persons may comment on this proposed rulemaking:

Pamela Wright Office of the General Counsel 298 Howlett Building Springfield IL 62756

[email protected]

ILLINOIS REGISTER 1115 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENT

13) Initial Regulatory Flexibility Analysis:

A) Types of small businesses, small municipalities and not-for-profit corporations affected: All corporations with past due deadlines for the filing of documents.

B) Reporting, bookkeeping or other procedures required for compliance: None

C) Types of professional skills necessary for compliance: None

14) Small Business Impact Analysis: All corporations with past due deadlines for filing of documents.

A) Types of businesses subject to the proposed rule:

11 Agriculture, Forestry, Fishing and Hunting 21 Mining 22 Utilities 23 Construction 31-33 Manufacturing 42 Wholesale Trade 44-45 Retail Trade 48-49 Transportation and Warehousing 51 Information 52 Finance and Insurance 53 Real Estate Rental and Leasing 54 Professional, Scientific, and Technical Services 55 Management of Companies and Enterprises 56 Administrative and Support and Waste Management and Remediation Services 61 Educational Services 62 Health Care and Social Assistance 71 Arts, Entertainment, and Recreation 72 Accommodation and Food Services 81 Other Services (except Public Administration)

B) Categories that the Agency reasonably believes the rulemaking will impact, including:

ILLINOIS REGISTER 1116 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENT

ii. regulatory requirements; vii. record keeping;

15) Regulatory Agenda on which this rulemaking was summarized: This rulemaking was not included on either of the 2 most recent agendas because the Department did not anticipate this rulemaking at the time the agendas were filed.

The full text of the Proposed Amendment is identical to that of the text of the Emergency Amendment for this Part, and begins in this issue of the Illinois Register on page 1215.

ILLINOIS REGISTER 1117 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS

1) Heading of the Part: Issuance of Licenses

2) Code Citation: 92 Ill. Adm. Code 1030

3) Section Numbers: Proposed Actions: 1030.80 Amendment 1030.85 Amendment

4) Statutory Authority: Implementing Article I of the Illinois Driver Licensing Law of the Illinois Vehicle Code [625 ILCS 5] and authorized by Section 2-104(b) of the Illinois Vehicle Title and Registration Law of the Illinois Vehicle Code [625 ILCS 5].

5) A Complete Description of the Subjects and Issues Involved: This rulemaking makes no substantive changes, but moves the provision exempting certain veterans from CDL knowledge tests to the appropriate section of Part 1030.

6) Published studies or reports, and sources of underlying data, used to compose this rulemaking: None

7) Will this rulemaking replace any emergency rule currently in effect? No

8) Does this rulemaking contain an automatic repeal date? No

9) Does this rulemaking contain incorporations by reference? No

10) Are there any other rulemakings pending on this Part? No

11) Statement of Statewide Policy Objective: No expenditures by units of local government.

12) Time, Place, and Manner in which interested persons may comment on this rulemaking: Persons who wish to comment on this proposed rulemaking may submit written comments no later than 45 days after the publication of this Notice to:

Pamela Wright Office of the General Counsel 298 Howlett Building Springfield IL 62756

[email protected]

ILLINOIS REGISTER 1118 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS

13) Initial Regulatory Flexibility Analysis:

A) Types of small businesses, small municipalities and not-for-profit corporations affected: None

B) Reporting, bookkeeping or other procedures required for compliance: None

C) Types of professional skills necessary for compliance: None

14) Small Business Impact Analysis:

A) Types of businesses subject to the proposed rule: Any business which requires a CDL be held by an employee may be affected.

B) Categories that the Agency reasonably believes the rulemaking will impact, including:

i. hiring and additional staffing ii. regulatory requirements; iv. insurance charges; vii. training requirements; viii. record keeping ix. compensation and benefits; or x. other potential impacted categories

The full text of the Proposed Amendments begins on the next page:

ILLINOIS REGISTER 1119 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS

TITLE 92: TRANSPORTATION CHAPTER II: SECRETARY OF STATE

PART 1030 ISSUANCE OF LICENSES

Section 1030.1 Definitions 1030.5 Procedure for Obtaining a Standard Driver's License or Identification Card 1030.6 Procedure for Obtaining a Visa Status Temporary Visitor's Driver's License Pursuant to IVC Section 6-105.1(a) 1030.7 Procedure for Obtaining a Non-Visa Status Temporary Visitor's Driver's License Pursuant to IVC Section 6-105.1(a-5) 1030.8 Procedure for Obtaining a Real ID Compliant Driver's License or Identification Card 1030.10 What Persons Shall Not Be Licensed or Granted Permits 1030.11 Procedure for Obtaining a Driver's License/Temporary Visitor's Driver's License (Renumbered) 1030.12 Identification Cards for the Homeless 1030.13 Denial of License or Permit 1030.14 Emergency Contact Database 1030.15 Cite for Re-testing 1030.16 Physical and Mental Evaluation 1030.17 Errors in Issuance of Driver's License/Cancellation 1030.18 Medical Criteria Affecting Driver Performance 1030.20 Classification of Drivers – References (Repealed) 1030.22 Medical Examiner's Certificate − CLP or CDL Holders 1030.25 Safe Driver License Renewals 1030.26 Identification Cards for IDOC/IDJJ Applicants 1030.27 Identification Cards for Youth in Care 1030.30 Classification Standards 1030.40 Fifth Wheel Equipped Trucks 1030.50 Bus Driver's Authority, Religious Organization and Senior Citizen Transportation 1030.55 Commuter Van Driver Operating a For-Profit Ridesharing Arrangement 1030.60 Third-Party Certification Program 1030.63 Religious Exemption for Social Security Numbers (Repealed) 1030.65 Instruction Permits 1030.66 Adult Driver Education 1030.70 Driver's License Testing/Vision Screening

ILLINOIS REGISTER 1120 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS

1030.75 Driver's License Testing/Vision Screening With Vision Aid Arrangements Other Than Standard Eye Glasses or Contact Lenses 1030.80 Driver's License Testing/Written Test 1030.81 Endorsements 1030.82 Charter Bus Driver Endorsement Requirements 1030.83 Hazardous Material Endorsement 1030.84 Vehicle Inspection 1030.85 Driver's License Testing/Road Test 1030.86 Multiple Attempts − Written and/or Road Tests 1030.88 Exemption of Facility Administered Road Test 1030.89 Temporary Driver's Licenses and Temporary Instruction Permits 1030.90 Requirement for Photograph and Signature of Licensee on Driver's License 1030.91 Person with a Disability Identification Card 1030.92 Restrictions 1030.93 Restricted Local Licenses 1030.94 Duplicate or Corrected Driver's License or Instruction Permit 1030.95 Consular Licenses (Repealed) 1030.96 Seasonal Restricted Commercial Driver's License 1030.97 Invalidation of a Driver's License, Permit and/or Driving Privilege 1030.98 School Bus Endorsement or Learner's Permit 1030.100 Anatomical Gift Donor (Repealed) 1030.110 Emergency Medical Information Card 1030.115 Change-of-Address 1030.120 Issuance of a Probationary License 1030.130 Grounds for Cancellation of a Probationary License 1030.140 Use of Captured Images 1030.150 Veteran Designation on Driver's License or Identification Card 1030.160 Extension of Expiration Dates

1030.APPENDIX A Questions Asked of a Driver's License Applicant 1030.APPENDIX B Acceptable Identification Documents – Applicants for a Standard Identification Card, Driver's License, Instruction Permit, Visa Status Temporary Visitor's Driver's License Pursuant to IVC Section 6- 105.1(a) or Visa Status Temporary Visitor's Instruction Permit (Non- Real ID) 1030.APPENDIX C Acceptable Identification Documents – Applicants for a Non-Visa Status Temporary Visitor's Driver's License or Non-Visa Status Temporary Visitor's Instruction Permit Pursuant to IVC Section 6- 105.1(a-5)

ILLINOIS REGISTER 1121 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS

1030.APPENDIX D Acceptable Identification Documents – Applicants for a Real ID Compliant Driver's License or Identification Card

AUTHORITY: Implementing Article I of the Illinois Driver Licensing Law of the Illinois Vehicle Code [625 ILCS 5] and authorized by Section 2-104(b) of the Illinois Vehicle Title and Registration Law of the Illinois Vehicle Code [625 ILCS 5].

SOURCE: Filed March 30, 1971; amended at 3 Ill. Reg. 7, p. 13, effective April 2, 1979; amended at 4 Ill. Reg. 27, p. 422, effective June 23, 1980; amended at 6 Ill. Reg. 2400, effective February 10, 1982; codified at 6 Ill. Reg. 12674; amended at 9 Ill. Reg. 2716, effective February 20, 1985; amended at 10 Ill. Reg. 303, effective December 24, 1985; amended at 10 Ill. Reg. 15130, effective September 2, 1986; amended at 10 Ill. Reg. 18182, effective October 14, 1986; amended at 11 Ill. Reg. 9331, effective April 28, 1987; amended at 11 Ill. Reg. 18292, effective October 23, 1987; amended at 12 Ill. Reg. 3027, effective January 14, 1988; amended at 12 Ill. Reg. 13221, effective August 1, 1988; amended at 12 Ill. Reg. 16915, effective October 1, 1988; amended at 12 Ill. Reg. 19777, effective November 15, 1988; amended at 13 Ill. Reg. 5192, effective April 1, 1989; amended at 13 Ill. Reg. 7808, effective June 1, 1989; amended at 13 Ill. Reg. 12880, effective July 19, 1989; amended at 13 Ill. Reg. 12978, effective July 19, 1989; amended at 13 Ill. Reg. 13898, effective August 22, 1989; amended at 13 Ill. Reg. 15112, effective September 8, 1989; amended at 13 Ill. Reg. 17095, effective October 18, 1989; amended at 14 Ill. Reg. 4570, effective March 8, 1990; amended at 14 Ill. Reg. 4908, effective March 9, 1990; amended at 14 Ill. Reg. 5183, effective March 21, 1990; amended at 14 Ill. Reg. 8707, effective May 16, 1990; amended at 14 Ill. Reg. 9246, effective May 16, 1990; amended at 14 Ill. Reg. 9498, effective May 17, 1990; amended at 14 Ill. Reg. 10111, effective June 11, 1990; amended at 14 Ill. Reg. 10510, effective June 18, 1990; amended at 14 Ill. Reg. 12077, effective July 5, 1990; amended at 14 Ill. Reg. 15487, effective September 10, 1990; amended at 15 Ill. Reg. 15783, effective October 18, 1991; amended at 16 Ill. Reg. 2182, effective January 24, 1992; emergency amendment at 16 Ill. Reg. 12228, effective July 16, 1992, for a maximum of 150 days; emergency expired on December 13, 1992; amended at 16 Ill. Reg. 18087, effective November 17, 1992; emergency amendment at 17 Ill. Reg. 1219, effective January 13, 1993, for a maximum of 150 days; amended at 17 Ill. Reg. 2025, effective February 1, 1993; amended at 17 Ill. Reg. 7065, effective May 3, 1993; amended at 17 Ill. Reg. 8275, effective May 24, 1993; amended at 17 Ill. Reg. 8522, effective May 27, 1993; amended at 17 Ill. Reg. 19315, effective October 22, 1993; amended at 18 Ill. Reg. 1591, effective January 14, 1994; amended at 18 Ill. Reg. 7478, effective May 2, 1994; amended at 18 Ill. Reg. 16457, effective October 24, 1994; amended at 19 Ill. Reg. 10159, effective June 29, 1995; amended at 20 Ill. Reg. 3891, effective February 14, 1996; emergency amendment at 20 Ill. Reg. 8358, effective June 4, 1996, for a maximum of 150 days; emergency amendment repealed in response to an objection of the Joint Committee on Administrative Rules at 20 Ill. Reg. 14279; amended at 21 Ill. Reg. 6588,

ILLINOIS REGISTER 1122 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS effective May 19, 1997; amended at 21 Ill. Reg. 10992, effective July 29, 1997; amended at 22 Ill. Reg. 1466, effective January 1, 1998; emergency amendment at 23 Ill. Reg. 9552, effective August 1, 1999, for a maximum of 150 days; amended at 23 Ill. Reg. 13947, effective November 8, 1999; amended at 24 Ill. Reg. 1259, effective January 7, 2000; emergency amendment at 24 Ill. Reg. 1686, effective January 13, 2000, for a maximum of 150 days; amended at 24 Ill. Reg. 6955, effective April 24, 2000; emergency amendment at 24 Ill. Reg. 13044, effective August 10, 2000, for a maximum of 150 days; amended at 24 Ill. Reg. 18400, effective December 4, 2000; amended at 25 Ill. Reg. 959, effective January 5, 2001; amended at 25 Ill. Reg. 7742, effective June 5, 2001; amended at 25 Ill. Reg. 12646, effective September 24, 2001; emergency amendment at 25 Ill. Reg. 12658, effective September 24, 2001, for a maximum of 150 days; emergency expired February 20, 2002; amended at 26 Ill. Reg. 9961, effective June 24, 2002; amended at 27 Ill. Reg. 855, effective January 3, 2003; emergency amendment at 27 Ill. Reg. 7340, effective April 14, 2003, for a maximum of 150 days; emergency expired September 10, 2003; emergency amendment at 27 Ill. Reg. 16968, effective October 17, 2003, for a maximum of 150 days; emergency expired March 14, 2004; emergency amendment at 28 Ill. Reg. 384, effective January 1, 2004, for a maximum of 150 days; emergency expired May 29, 2004; amended at 28 Ill. Reg. 8895, effective June 14, 2004; amended at 28 Ill. Reg. 10776, effective July 13, 2004; amended at 29 Ill. Reg. 920, effective January 1, 2005; emergency amendment at 29 Ill. Reg. 2469, effective January 31, 2005, for a maximum of 150 days; emergency expired June 29, 2005; amended at 29 Ill. Reg. 9488, effective June 17, 2005; amended at 29 Ill. Reg. 12519, effective July 28, 2005; amended at 29 Ill. Reg. 13237, effective August 11, 2005; amended at 29 Ill. Reg. 13580, effective August 16, 2005; amended at 30 Ill. Reg. 910, effective January 6, 2006; amended at 30 Ill. Reg. 5621, effective March 7, 2006; amended at 30 Ill. Reg. 11365, effective June 15, 2006; emergency amendment at 30 Ill. Reg. 11409, effective June 19, 2006, for a maximum of 150 days; emergency expired November 15, 2006; amended at 31 Ill. Reg. 4782, effective March 12, 2007; amended at 31 Ill. Reg. 5096, effective March 15, 2007; amended at 31 Ill. Reg. 5864, effective March 29, 2007; amended at 31 Ill. Reg. 6370, effective April 12, 2007; amended at 31 Ill. Reg. 7643, effective May 16, 2007; amended at 31 Ill. Reg. 11342, effective July 18, 2007; amended at 31 Ill. Reg. 14547, effective October 9, 2007; amended at 31 Ill. Reg. 14849, effective October 22, 2007; amended at 31 Ill. Reg. 16543, effective November 27, 2007; amended at 31 Ill. Reg. 16843, effective January 1, 2008; emergency amendment at 32 Ill. Reg. 208, effective January 2, 2008, for a maximum of 150 days; amended at 32 Ill. Reg. 6544, effective April 4, 2008; amended at 33 Ill. Reg. 2391, effective January 21, 2009; amended at 33 Ill. Reg. 8489, effective June 5, 2009; amended at 33 Ill. Reg. 9794, effective June 29, 2009; amended at 33 Ill. Reg. 11620, effective July 22, 2009; amended at 33 Ill. Reg. 14185, effective September 28, 2009; amended at 34 Ill. Reg. 563, effective December 22, 2009; amended at 34 Ill. Reg. 9457, effective June 23, 2010; amended at 34 Ill. Reg. 15418, effective September 22, 2010; amended at 34 Ill. Reg. 19071, effective November 22, 2010; amended at 35 Ill. Reg. 2197, effective January 21, 2011; amended at 35 Ill.

ILLINOIS REGISTER 1123 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS

Reg. 4692, effective March 3, 2011; amended at 35 Ill. Reg. 19664, effective November 23, 2011; amended at 36 Ill. Reg. 3924, effective February 27, 2012; amended at 36 Ill. Reg. 7255, effective April 26, 2012; amended at 36 Ill. Reg. 14755, effective September 18, 2012; amended at 37 Ill. Reg. 7776, effective May 22, 2013; amended at 37 Ill. Reg. 14176, effective September 1, 2013; amended at 37 Ill. Reg. 19342, effective November 28, 2013; amended at 38 Ill. Reg. 7946, effective March 28, 2014; emergency amendment at 38 Ill. Reg. 8429, effective April 4, 2014, for a maximum of 150 days; amended at 38 Ill. Reg. 12515, effective July 1, 2014; amended at 38 Ill. Reg. 16366, effective July 21, 2014; amended at 38 Ill. Reg. 20039, effective October 1, 2014; amended at 39 Ill. Reg. 1182, effective January 5, 2015; amended at 39 Ill. Reg. 5083, effective March 23, 2015; amended at 39 Ill. Reg. 8028, effective May 21, 2015; amended at 39 Ill. Reg. 11531, effective July 28, 2015; amended at 39 Ill. Reg. 14930, effective October 29, 2015; amended at 40 Ill. Reg. 1882, effective January 12, 2016; amended at 40 Ill. Reg. 7330, effective May 2, 2016; amended at 40 Ill. Reg. 13637, effective September 19, 2016; amended at 40 Ill. Reg. 15397, effective October 26, 2016; amended at 41 Ill. Reg. 438, December 29, 2016; amended at 41 Ill. Reg. 3009, effective February 24, 2017; amended at 41 Ill. Reg. 13665, effective October 30, 2017; amended at 42 Ill. Reg. 1886, effective January 3, 2018; amended at 42 Ill. Reg. 2891, effective January 29, 2018; amended at 42 Ill. Reg. 4969, effective March 5, 2018; amended at 42 Ill. Reg. 11499, effective June 8, 2018; amended at 42 Ill. Reg. 20548, effective October 30, 2018; amended at 43 Ill. Reg. 3724, effective March 4, 2019; amended at 43 Ill. Reg. 5322, effective April 24, 2019; amended at 44 Ill. Reg. 2041, effective December 31, 2019; emergency amendment at 44 Ill. Reg. 5477, effective March 16, 2020, for a maximum of 150 days; emergency amendment at 44 Ill. Reg. 5839, effective March 17, 2020, for a maximum of 150 days; emergency amendment to emergency rule at 44 Ill. Reg. 6650, effective April 9, 2020, for the remainder of the 150 days; emergency amendment at 44 Ill. Reg. 10011, effective May 21, 2020, for a maximum of 150 days; amended at 44 Ill. Reg. 16818, effective September 29, 2020; emergency amendment effective March 17, 2020, as amended April 9, 2020, repealed at 44 Ill. Reg. 11603, effective June 30, 2020; emergency amendment at 44 Ill. Reg. 11898, effective June 30, 2020, for a maximum of 150 days; emergency amendment to emergency rule at 44 Ill. Reg. 13823, effective August 7, 2020, for the remainder of the 150 days; emergency amendment to emergency rule at 44 Ill. Reg 16534, effective September 22, 2020, for the remainder of the 150 days; amended at 44 Ill. Reg. 12607, effective July 7, 2020; amended at 44 Ill. Reg. 16818, effective September 29, 2020; amended at 44 Ill. Reg. 18951, effective November 19, 2020; amended at 45 Ill. Reg. 732, effective December 23, 2020; amended at 45 Ill. Reg. ______, effective ______.

Section 1030.80 Driver's License Testing/Written Test

Any applicant for an initial or renewal driver's license who is required to take a written test pursuant to IVC Section 6-109 shall comply with the following provisions:

ILLINOIS REGISTER 1124 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS

a) Classification of licenses is established in Sections 1030.30 through 1030.40. b) An applicant for a Class D license shall be required to take a written test consisting of a minimum of 35 questions, of which 80% percent must be answered correctly in order to be eligible for a Class D license. c) An applicant for a Class C, B, A or L-M license shall be required to take the written test as set forth in subsection (b). The applicant shall also take a written test established by the Secretary of State for the classifications and/or endorsements applied for. The number of questions required to be answered is dependent upon the classifications and/or endorsements applied for. Each written classification and/or endorsement test shall consist of a minimum of 35 questions, of which 80% percent must be answered correctly in order for the applicant to be eligible for the classifications and/or endorsements applied for. d) The written tests set forth in subsections (b) and (c) shall be in the English language, and may be in any other languages deemed necessary by the Secretary of State, based upon an identifiable demand. e) An applicant who is illiterate may be given the written test orally. f) An applicant who cannot read or write in the English language, or other available foreign language, shall be eligible to take the written test. The Driver Services Facility supervisor or designee may provide or recommend use of an interpreter for the applicant's language if an interpreter is readily available. If an interpreter is not readily available, it will be the responsibility of the applicant to obtain the services of an interpreter. The CDL knowledge test shall be administered only in the English language. An interpreter shall not be used when the applicant is attempting to complete the CDL knowledge tests. g) An applicant shall demonstrate the ability to read and understand official traffic control devices. h) Any licensee who wants to change a classification and/or endorsements prior to renewal of a license shall be required to take the written test for the classification or classifications and/or endorsements the applicant wants to obtain. i) Prior to obtaining a Commercial Learner's Permit, an applicant must successfully

ILLINOIS REGISTER 1125 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS

complete the appropriate CDL knowledge tests specific to the learner's permit classification. j) An applicant for a permit to operate a school bus must have in his/her possession an application for Illinois School Bus Driver's Permit Letter of Intent or its superseding form. The applicant shall be given a special test consisting of not more than 24 questions, of which 22 or 90% must be answered correctly in order to be eligible for a permit. k) Any person found cheating on any portion of a written test will be deemed to have failed that portion of the test. In addition, that person will be prohibited from retaking the written test for a period of 30 days. For purposes of this subsection, "cheating" shall be defined as receiving or using unauthorized assistance in the taking of any portion of a test. This includes, but is not limited to, the use of any notes, books or written information. l) All persons with a valid out-of-state CDL applying for an Illinois CDL shall be required to successfully complete the written tests set forth in subsections (b) and (c), pursuant to IVC Section 6-508(a)(1). m) Qualified and eligible military service members with certain MOS/Ratings (U.S. armed forces specialist designations) are exempt from the CDL administered general knowledge written exam (excluding school bus endorsement) if the applicant:

1) Is a current resident of this State;

2) Is a current or former member of the military services, including a member of any reserve component or National Guard unit;

3) Within one year prior to the date of application, was regularly employed in a military position that requires the operation of large trucks;

4) Received formal military training in the operation of a vehicle similar to the commercial motor vehicle the applicant expects to operate; and

ILLINOIS REGISTER 1126 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS

commanding officer certifying that the applicant qualifies for the general knowledge written exam waiver.

(Source: Amended at 45 Ill. Reg. ______, effective ______)

Section 1030.85 Driver's License Testing/Road Test

a) Classification of licenses is established in Section 1030.30.

b) Persons applying for a Class C or Class D (CDL or Non-CDL) driver's license, a religious organization restriction, for-profit ridesharing arrangement restriction, or senior citizen transportation restriction in a First Division vehicle who are required by IVC Section 6-109 to complete a road test shall be evaluated on the following driving skills: start, posture, use of mirrors, steering, lane observance, right-of-way, left and right turns (signal, speed, lane, turn), attention (distraction level), following (too closely), speed (too fast/too slow), parking (up and/or down hill), starting (up and/or down hill), final park, signal (pulling into and away from curb, changing lanes), stop signs, other signs (yield, school, railroad, regulatory, warning, special), traffic lights, backing, turn about, and use of clutch or automatic transmission.

c) In addition to those maneuvers listed in subsection (b), persons applying for a Class A or B driver's license (CDL) shall also be evaluated on the following:

1) Pre-Trip Inspection − the applicant shall demonstrate skills necessary to conduct a pre-trip inspection, which include the ability to:

A) locate and verbally identify air brake operating controls and monitoring devices;

B) determine the motor vehicle's brake system condition for proper adjustments and that the air system connections between vehicles have been properly made and secured;

C) inspect low pressure warning devices to ensure they will activate in emergency situations;

D) ascertain, with the engine running, that the system contains an adequate supply of compressed air;

ILLINOIS REGISTER 1127 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS

E) determine that the required minimum air pressure build up at the time is within acceptable limits and that required alarms and emergency devices automatically deactivate at the proper pressure level; and

F) operationally check the brake system for proper performance.

2) Vehicle skills test that shall include dock parking, straight line backing, stop at marked line, and predetermined right turn.

3) Additional road test driving skills of use of gears, railroad crossing, expressway, bridge and underpass. d) In addition to those maneuvers listed in subsection (b), persons applying for a Class A or B driver's license (non-CDL) shall also be evaluated on straight line backing. e) In addition to those maneuvers listed in subsection (c), persons applying for a school bus driver permit must complete a road test in a representative vehicle, which shall consist of the following: use of gears, railroad crossing (stop and observation), curb bus (simulate loading/unloading passengers), use of stop arm, and use of flasher lights. f) Applicants for a Class L or Class M driver's license who are required to complete a road test shall be evaluated by using of the following drive tests: ALMOST – Alternate Motorcycle Operator Skill Test; 5 dot test; and Offstreet Illinois Department of Transportation Motorcycle Operator Skill Test.

1) Test exercises for the ALMOST and Offstreet Illinois Department of Transportation Motorcycle Operation Skill Test, for both Class L and Class M, shall consist of the following: stalling (improper shift, failure to shift), sharp turn (path, foot down), normal stop (skid, position), cone weave (skips, hits, foot down), U-Turn (path, foot down), quick stop (distance), obstacle turn (path), slow drive (time, path, foot down).

2) Test exercises for the 5 dot test, for both Class L and Class M, shall consist of the following: knowledge of controls, figure U Walk (walk vehicle without engine running), start from rest, slow drive, gear shifting

ILLINOIS REGISTER 1128 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS

skill, figure 8 ride, serpentine ride (balanced cone weave), posture, mounting/dismounting. g) Test exercises and skills are evaluated on a point system. When the applicant commits an error, a point or points are assessed based upon the severity of the error. Applicants for a CDL or Non-CDL Class A, B, C or D license or a religious organization vehicle restriction, for-profit ridesharing arrangement restriction or senior citizen transportation restriction are allowed 36 points. Applicants for a Second Division school bus permit are allowed 40 points. Applicants for a First Division school bus permit are allowed 36 points. Applicants for a Class L or M license taking the ALMOST or Offstreet Illinois Department of Transportation Motorcycle Operation Skill Test evaluation shall be allowed 11 points. Applicants for an L or M license taking the 5 dot test shall be allowed seven points. h) The following acts will result in immediate disqualification: violation in which an applicant receives a ticket; dangerous action; lack of cooperation or refusal to perform; or letting the cycle fall or falling off a cycle. i) A road test will be considered incomplete for the following reasons: the applicant becomes ill or disabled and is unable to continue the road test; the vehicle develops mechanical problems after the road test has begun; weather conditions make the continuation of the road test hazardous; or an accident occurs for which the applicant does not receive a ticket. j) No persons are allowed to accompany the applicant and examiner on the road test. When necessary, exceptions may be made for any applicants who may require a translator and for the training and evaluation of facility personnel. k) Any applicant who is suspected by a Driver Services Facility employee of having consumed alcohol and/or drugs must seek the approval of a Driver Services Facility manager prior to being administered the road test. If a Driver Services Facility manager has reasonable cause to believe that an applicant has consumed alcohol and/or drugs, the applicant shall not be administered the road test. Evidence of alcohol and/or drug consumption shall include, but not be limited to, one or more of the following conditions:

1) the applicant admits he/she has consumed alcohol and/or drugs;

ILLINOIS REGISTER 1129 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS

2) the applicant has a strong odor of alcohol on his/her breath;

3) the applicant's eyes are red and the pupils are dilated;

4) the applicant's speech is slurred; or

5) the applicant is unsteady when walking. l) All persons applying for a CDL, with the exception of those persons renewing their Illinois CDL, or those persons holding an Illinois CLP who successfully completed federally approved CDL training and testing in another CDL certified state, shall be required to successfully complete the examinations set forth in subsections (c) and (d) pursuant to IVC Section 6-508(a)(1). m) Military personnel are exempt from the CDL administered pre-trip, skills and road test (excluding school bus and passenger endorsements) if:

1) In the two-year period immediately prior to application for a CDL the applicant has not:

A) had more than one license, except for a military-issued driver's license;

B) had any driver's license suspended, revoked or cancelled;

C) had any convictions in any type of motor vehicle for the disqualifying offenses contained in 49 CFR 383.51(b) (October 1, 2012);

D) had more than one conviction in any type of motor vehicle for a serious traffic violation contained in 49 CFR 383.51(c) (October 1, 2012); and

E) had any conviction for a violation of military, State or local law relating to motor vehicle traffic control (other than a parking violation) arising in connection with any traffic accident and has no record of an accident in which the applicant was at fault.

2) The applicant certifies that:

ILLINOIS REGISTER 1130 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS

A) he/she is regularly employed or was regularly employed within the last 12 months in a military position requiring operation of a commercial motor vehicle;

B) he/she was exempted from the CDL requirements of 49 CFR 383.3(c) (October 1, 2012); and

C) he/she was operating a vehicle representative of the commercial motor vehicle the applicant operates or expects to operate for at least the two years immediately preceding discharge from the military.

3) The applicant submits a completed Secretary of State CDL-ST WVR form, including signature of the applicant's commanding officer. n) The use of any recording device, including but not limited to cell phones, cameras, tape recorders or video recorders, is prohibited during the administration of a road test. If an examiner discovers a recording device is in use during the road test, the examiner shall request the applicant to stop the recording device and delete any recordings of the road test. If the applicant refuses to do so, the examiner shall immediately terminate the road test and the applicant will be deemed to have failed the road test. o) Qualified and eligible military service members with certain MOS/Ratings (U.S. armed forces specialist designations) are exempt from the CDL administered general knowledge written exam (excluding school bus endorsement) if the applicant:

1) Is a current resident of this State;

2) Is a current or former member of the military services, including a member of any reserve component or National Guard unit;

3) Within one year prior to the date of application, was regularly employed in a military position that requires the operation of large trucks;

4) Received formal military training in the operation of a vehicle similar to the commercial motor vehicle the applicant expects to operate; and

ILLINOIS REGISTER 1131 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENTS

5) Provides the Secretary of State with a State of Illinois Application for Exchange of US Military Commercial Driving Experience for Commercial Driver's License (CDL) signed by the applicant and his or her commanding officer certifying that the applicant qualifies for the general knowledge written exam waiver.

(Source: Amended at 45 Ill. Reg. ______, effective ______)

ILLINOIS REGISTER 1132 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENT

1) Heading of the Part: School Bus Driver Permit

2) Code Citation: 92 Ill. Adm. Code 1035

3) Section Number: Proposed Action: 1035.30 Amendment

4) Statutory Authority: Implementing Section 6-106.1 and authorized by Section 6-521 of the Illinois Vehicle Code [625 ILCS 5].

5) A Complete Description of the Subjects and Issues Involved: Due to COVID-19 mitigations, annual refresher training for school bus permit holders provided by Regional Superintendents of Education have been postponed until Spring of 2021. This rulemaking will provide an additional 90 days for school bus permit holders to complete their annual refresher training. All other requirements for renewal of a school bus permit remain in effect.

6) Published studies or reports, and sources of underlying data, used to compose this rulemaking: None

7) Will this rulemaking replace an emergency rule currently in effect? Yes

8) Does this rulemaking contain an automatic repeal date? No

9) Does this rulemaking contain incorporations by reference? No

10) Are there any other rulemakings pending on this Part? No

11) Statement of Statewide Policy Objective: No expenditures by units of local government.

Pamela Wright Office of the General Counsel 298 Howlett Building Springfield IL 62756

ILLINOIS REGISTER 1133 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF PROPOSED AMENDMENT

[email protected]

13) Initial Regulatory Flexibility Analysis:

A) Types of small businesses, small municipalities and not-for-profit corporations affected: School bus companies and school districts

B) Reporting, bookkeeping or other procedures required for compliance: None

C) Types of professional skills necessary for compliance: None

14) Small Business Impact Analysis:

A) Types of businesses subject to the proposed rule:

48-49 Transportation and Warehousing 61 Educational Services 92 Public Administration

B) Categories that the Agency reasonably believes the rulemaking will impact, including:

vii. record keeping;

The full text of the Proposed Amendment is identical to the text of the Emergency Amendment for this Part, and begins in this issue of the Illinois Register on page 1222.

ILLINOIS REGISTER 1134 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

1) Heading of the Part: Skilled Nursing and Intermediate Care Facilities Code

2) Code Citation: 77 Ill. Adm. Code 300

3) Section Numbers: Adopted Actions: 300.230 Amendment 300.650 Amendment 300.686 Amendment 300.1230 Amendment 300.1231 New Section 300.1232 New Section 300.1233 New Section 300.1234 New Section 300.Appendix A New Section 300.Appendix B New Section

4) Statutory Authority: Nursing Home Care Act [210 ILCS 45]

5) Effective Date of Rules: January 8, 2021

6) Does this rulemaking contain an automatic repeal date? No

7) Does this rulemaking contain incorporations by reference? No

8) A copy of the adopted rules, including any material incorporated by reference, is on file in the Agency's principal office and is available for public inspection.

9) Notice of Proposal published in Illinois Register: 44 Ill. Reg. 435; January 10, 2020

10) Has JCAR issued a Statement of Objection to this rulemaking? No

11) Differences between Proposal and Final Version: In response to First Notice comments, lists of what constitutes skilled care and intermediate care were removed from subsections 300.1230(b) and (c), respectively. As a result of negotiations between the Department and stakeholders, subsection 300.1230(b)(2) was redrafted for the sake of clarity during Second Notice. In subsection 300.1230(l)(1), "duty or duties" was changed to "job title or titles" in response to a question from JCAR during Second Notice.

ILLINOIS REGISTER 1135 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

In Section 300.1232, a requirement to tie staffing waivers to violations was deleted in response to First Notice comments.

In subsection 300.1234(a)(7), "unforeseen circumstances" and "six times" were defined in response to First Notice comments. A new subsection (d), defining wages and benefits and describing the calculation of penalties for staffing violations, was added to Section 300.1234 in response to First Notice Comments. Subsection (d) was revised during Second Notice as a result of negotiations between the Department and stakeholders. A new subsection (e), describing sanctions the Department may take against facilities for non-compliance with a written demand for payment of fines, was added to Section 300.1234 in response to First Notice comments.

In addition, various typographical, grammatical, and form changes were made in response to comments from JCAR.

12) Have all the changes agreed upon by the Agency and JCAR been made as indicated in the agreements issued by JCAR? Yes

13) Will this rulemaking replace an emergency rule currently in effect? No

14) Are there any rulemakings pending on this Part? No

15) Summary and Purpose of Rulemaking: These adopted amendments implement amendments to the Nursing Home Care Act (the Act) contained in PA 101-10. The amendments provide for increased Department oversight, including increased penalties, for facilities licensed under the Act and 77 Ill. Adm. Code 300 in obtaining informed consent from residents prior to administering psychotropic drugs. PA 101-10 and this rulemaking also provide for increased oversight and fines for violations of the minimum staffing ratios in the Act, and for signage in facilities found in violation of the staffing requirements.

These adopted amendments also implement PA 100-217, which provides for facilities to apply for a waiver from minimum registered nurse staffing ratios under certain conditions.

16) Information and questions regarding these adopted rules shall be directed to:

Elizabeth Paton Acting Rules Coordinator

ILLINOIS REGISTER 1136 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

Illinois Department of Public Health Division of Legal Services 535 W. Jefferson St., 5th Floor Springfield IL 62761

217/782-2043 [email protected]

The full text of the Adopted Amendments begins on the next page:

ILLINOIS REGISTER 1137 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

TITLE 77: PUBLIC HEALTH CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER c: LONG-TERM CARE FACILITIES

PART 300 SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE

SUBPART A: GENERAL PROVISIONS

Section 300.110 General Requirements 300.120 Application for License 300.130 Licensee 300.140 Issuance of an Initial License for a New Facility 300.150 Issuance of an Initial License Due to a Change of Ownership 300.160 Issuance of a Renewal License 300.163 Alzheimer's Special Care Disclosure 300.165 Criteria for Adverse Licensure Actions 300.170 Denial of Initial License 300.175 Denial of Renewal of License 300.180 Revocation of License 300.190 Experimental Program Conflicting With Requirements 300.200 Inspections, Surveys, Evaluations and Consultation 300.210 Filing an Annual Attested Financial Statement 300.220 Information to Be Made Available to the Public By the Department 300.230 Information to Be Made Available to the Public byBy the Licensee 300.240 Municipal Licensing 300.250 Ownership Disclosure 300.260 Issuance of Conditional Licenses 300.270 Monitor and Receivership 300.271 Presentation of Findings 300.272 Determination to Issue a Notice of Violation or Administrative Warning 300.274 Determination of the Level of a Violation 300.276 Notice of Violation 300.277 Administrative Warning 300.278 Plans of Correction 300.280 Reports of Correction 300.282 Conditions for Assessment of Penalties 300.284 Calculation of Penalties (Repealed)

ILLINOIS REGISTER 1138 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

300.286 Notice of Penalty Assessment; Response by Facility 300.287 Consideration of Factors for Assessing Penalties 300.288 Reduction or Waiver of Penalties 300.290 Quarterly List of Violators (Repealed) 300.300 Alcoholism Treatment Programs In Long-Term Care Facilities 300.310 Department May Survey Facilities Formerly Licensed 300.315 Supported Congregate Living Arrangement Demonstration 300.320 Waivers 300.330 Definitions 300.340 Incorporated and Referenced Materials

SUBPART B: ADMINISTRATION

Section 300.510 Administrator

SUBPART C: POLICIES

Section 300.610 Resident Care Policies 300.615 Determination of Need Screening and Request for Resident Criminal History Record Information 300.620 Admission, Retention and Discharge Policies 300.624 Criminal History Background Checks for Persons Who Were Residents on May 10, 2006 (Repealed) 300.625 Identified Offenders 300.626 Discharge Planning for Identified Offenders 300.627 Transfer of an Identified Offender 300.630 Contract Between Resident and Facility 300.640 Residents' Advisory Council 300.650 Personnel Policies 300.651 Whistleblower Protection 300.655 Initial Health Evaluation for Employees 300.660 Nursing Assistants 300.661 Health Care Worker Background Check 300.662 Resident Attendants 300.663 Registry of Certified Nursing Assistants 300.665 Student Interns 300.670 Disaster Preparedness

ILLINOIS REGISTER 1139 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

300.680 Restraints 300.682 Nonemergency Use of Physical Restraints 300.684 Emergency Use of Physical Restraints 300.686 Unnecessary, Psychotropic, and Antipsychotic MedicationsDrugs 300.690 Incidents and Accidents 300.695 Contacting Local Law Enforcement 300.696 Infection Control

SUBPART D: PERSONNEL

Section 300.810 General 300.820 Categories of Personnel 300.830 Consultation Services 300.840 Personnel Policies

SUBPART E: MEDICAL AND DENTAL CARE OF RESIDENTS

Section 300.1010 Medical Care Policies 300.1020 Communicable Disease Policies 300.1025 Tuberculin Skin Test Procedures 300.1030 Medical Emergencies 300.1035 Life-Sustaining Treatments 300.1040 Care and Treatment of Sexual Assault Survivors 300.1050 Dental Standards 300.1060 Vaccinations

SUBPART F: NURSING AND PERSONAL CARE

Section 300.1210 General Requirements for Nursing and Personal Care 300.1220 Supervision of Nursing Services 300.1230 Direct Care Staffing 300.1231 Calculation of Direct Care Staffing During Inspections, Surveys and Evaluations 300.1232 Waiver of Registered Professional Nurse Staffing Requirements 300.1233 Quarterly Administrative Staffing Compliance Review 300.1234 Penalties and Notice of Violation 300.1240 Additional Requirements

ILLINOIS REGISTER 1140 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

SUBPART G: RESIDENT CARE SERVICES

Section 300.1410 Activity Program 300.1420 Specialized Rehabilitation Services 300.1430 Work Programs 300.1440 Volunteer Program 300.1450 Language Assistance Services

SUBPART H: MEDICATIONS

Section 300.1610 Medication Policies and Procedures 300.1620 Compliance with Licensed Prescriber's Orders 300.1630 Administration of Medication 300.1640 Labeling and Storage of Medications 300.1650 Control of Medications

SUBPART I: RESIDENT AND FACILITY RECORDS

Section 300.1810 Resident Record Requirements 300.1820 Content of Medical Records 300.1830 Records Pertaining to Residents' Property 300.1840 Retention and Transfer of Resident Records 300.1850 Other Resident Record Requirements 300.1860 Staff Responsibility for Medical Records 300.1870 Retention of Facility Records 300.1880 Other Facility Record Requirements

SUBPART J: FOOD SERVICE

Section 300.2010 Director of Food Services 300.2020 Dietary Staff in Addition to Director of Food Services 300.2030 Hygiene of Dietary Staff 300.2040 Diet Orders 300.2050 Meal Planning

ILLINOIS REGISTER 1141 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

300.2060 Therapeutic Diets (Repealed) 300.2070 Scheduling Meals 300.2080 Menus and Food Records 300.2090 Food Preparation and Service 300.2100 Food Handling Sanitation 300.2110 Kitchen Equipment, Utensils, and Supplies

SUBPART K: MAINTENANCE, HOUSEKEEPING, AND LAUNDRY

Section 300.2210 Maintenance 300.2220 Housekeeping 300.2230 Laundry Services

SUBPART L: FURNISHINGS, EQUIPMENT, AND SUPPLIES

Section 300.2410 Furnishings 300.2420 Equipment and Supplies 300.2430 Sterilization of Equipment and Supplies

SUBPART M: WATER SUPPLY AND SEWAGE DISPOSAL

Section 300.2610 Codes 300.2620 Water Supply 300.2630 Sewage Disposal 300.2640 Plumbing

SUBPART N: DESIGN AND CONSTRUCTION STANDARDS FOR NEW INTERMEDIATE CARE AND SKILLED NURSING FACILITIES

Section 300.2810 Applicability of these Standards 300.2820 Codes and Standards 300.2830 Preparation of Drawings and Specifications 300.2840 Site 300.2850 Administration and Public Areas 300.2860 Nursing Unit

ILLINOIS REGISTER 1142 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

300.2870 Dining, Living, Activities Rooms 300.2880 Therapy and Personal Care 300.2890 Service Departments 300.2900 General Building Requirements 300.2910 Structural 300.2920 Mechanical Systems 300.2930 Plumbing Systems 300.2940 Electrical Systems

SUBPART O: DESIGN AND CONSTRUCTION STANDARDS FOR EXISTING INTERMEDIATE CARE AND SKILLED NURSING FACILITIES

Section 300.3010 Applicability 300.3020 Codes and Standards 300.3030 Preparation of Drawings and Specifications 300.3040 Site 300.3050 Administration and Public Areas 300.3060 Nursing Unit 300.3070 Living, Dining, Activities Rooms 300.3080 Treatment and Personal Care 300.3090 Service Departments 300.3100 General Building Requirements 300.3110 Structural 300.3120 Mechanical Systems 300.3130 Plumbing Systems 300.3140 Electrical Requirements

SUBPART P: RESIDENT'S RIGHTS

Section 300.3210 General 300.3220 Medical Care 300.3230 Restraints (Repealed) 300.3240 Abuse and Neglect 300.3250 Communication and Visitation 300.3260 Resident's Funds 300.3270 Residents' Advisory Council 300.3280 Contract With Facility

ILLINOIS REGISTER 1143 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

300.3290 Private Right of Action 300.3300 Transfer or Discharge 300.3310 Complaint Procedures 300.3320 Confidentiality 300.3330 Facility Implementation

SUBPART Q: SPECIALIZED LIVING FACILITIES FOR THE MENTALLY ILL

Section 300.3410 Application of Other Sections of These Minimum Standards (Repealed) 300.3420 Administrator (Repealed) 300.3430 Policies (Repealed) 300.3440 Personnel (Repealed) 300.3450 Resident Living Services Medical and Dental Care (Repealed) 300.3460 Resident Services Program (Repealed) 300.3470 Psychological Services (Repealed) 300.3480 Social Services (Repealed) 300.3490 Recreational and Activities Services (Repealed) 300.3500 Individual Treatment Plan (Repealed) 300.3510 Health Services (Repealed) 300.3520 Medical Services (Repealed) 300.3530 Dental Services (Repealed) 300.3540 Optometric Services (Repealed) 300.3550 Audiometric Services (Repealed) 300.3560 Podiatric Services (Repealed) 300.3570 Occupational Therapy Services (Repealed) 300.3580 Nursing and Personal Care (Repealed) 300.3590 Resident Care Services (Repealed) 300.3600 Record Keeping (Repealed) 300.3610 Food Service (Repealed) 300.3620 Furnishings, Equipment and Supplies (New and Existing Facilities) (Repealed) 300.3630 Design and Construction Standards (New and Existing Facilities) (Repealed)

SUBPART R: DAYCARE PROGRAMS

Section 300.3710 Day Care in Long-Term Care Facilities

SUBPART S: PROVIDING SERVICES TO PERSONS WITH SERIOUS MENTAL ILLNESS

ILLINOIS REGISTER 1144 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

Section 300.4000 Applicability of Subpart S 300.4010 Comprehensive Assessments for Residents with Serious Mental Illness Residing in Facilities Subject to Subpart S 300.4020 Reassessments for Residents with Serious Mental Illness Residing in Facilities Subject to Subpart S 300.4030 Individualized Treatment Plan for Residents with Serious Mental Illness Residing in Facilities Subject to Subpart S 300.4040 General Requirements for Facilities Subject to Subpart S 300.4050 Psychiatric Rehabilitation Services for Facilities Subject to Subpart S 300.4060 Discharge Plans for Residents with Serious Mental Illness Residing in Facilities Subject to Subpart S 300.4070 Work Programs for Residents with Serious Mental Illness Residing in Facilities Subject to Subpart S 300.4080 Community-Based Rehabilitation Programs for Residents with Serious Mental Illness Residing in Facilities Subject to Subpart S 300.4090 Personnel for Providing Services to Persons with Serious Mental Illness for Facilities Subject to Subpart S

SUBPART T: FACILITIES PARTICIPATING IN ILLINOIS DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES' DEMONSTRATION PROGRAM FOR PROVIDING SERVICES TO PERSONS WITH SERIOUS MENTAL ILLNESS

Section 300.6000 Applicability of Subpart T (Repealed) 300.6005 Quality Assessment and Improvement for Facilities Subject to Subpart T (Repealed) 300.6010 Comprehensive Assessments for Residents of Facilities Subject to Subpart T (Repealed) 300.6020 Reassessments for Residents of Facilities Subject to Subpart T (Repealed) 300.6030 Individualized Treatment Plan for Residents of Facilities Subject to Subpart T (Repealed) 300.6040 General Requirements for Facilities Subject to Subpart T (Repealed) 300.6045 Serious Incidents and Accidents in Facilities Subject to Subpart T (Repealed) 300.6047 Medical Care Policies for Facilities Subject to Subpart T (Repealed) 300.6049 Emergency Use of Restraints for Facilities Subject to Subpart T (Repealed) 300.6050 Psychiatric Rehabilitation Services for Facilities Subject to Subpart T (Repealed)

ILLINOIS REGISTER 1145 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

300.6060 Discharge Plans for Residents of Facilities Subject to Subpart T (Repealed) 300.6070 Work Programs for Residents of Facilities Subject to Subpart T (Repealed) 300.6080 Community-Based Rehabilitation Programs for Residents of Facilities Subject to Subpart T (Repealed) 300.6090 Personnel for Providing Services to Residents of Facilities Subject to Subpart T (Repealed) 300.6095 Training and Continuing Education for Facilities Subject to Subpart T (Repealed)

SUBPART U: ALZHEIMER'S SPECIAL CARE UNIT OR CENTER PROVIDING CARE TO PERSONS WITH ALZHEIMER'S DISEASE OR OTHER DEMENTIA

Section 300.7000 Applicability 300.7010 Admission Criteria 300.7020 Assessment and Care Planning 300.7030 Ability-Centered Care 300.7040 Activities 300.7050 Staffing 300.7060 Environment 300.7070 Quality Assessment and Improvement 300.7080 Variances to Enhance Residents' Quality of Life

300.APPENDIX A Example of Staffing Calculations from Section 300.1230Interpretation, Components, and Illustrative Services for Intermediate Care Facilities and Skilled Nursing Facilities (Repealed) 300.APPENDIX B Crosswalk of Nursing Home Care Act Job Descriptions and Payroll Based Journal Job TitlesClassification of Distinct Part of a Facility for Different Levels of Service (Repealed) 300.APPENDIX C Federal Requirements Regarding Patients'/Residents' Rights (Repealed) 300.APPENDIX D Forms for Day Care in Long-Term Care Facilities 300.APPENDIX E Criteria for Activity Directors Who Need Only Minimal Consultation (Repealed) 300.APPENDIX F Guidelines for the Use of Various Drugs 300.APPENDIX G Facility Report 300.TABLE A Sound Transmission Limitations in New Skilled Nursing and Intermediate Care Facilities 300.TABLE B Pressure Relationships and Ventilation Rates of Certain Areas for New Intermediate Care Facilities and Skilled Nursing Facilities 300.TABLE C Construction Types and Sprinkler Requirements for Existing Skilled

ILLINOIS REGISTER 1146 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

Nursing Facilities/Intermediate Care Facilities 300.TABLE D Heat Index Table/Apparent Temperature

AUTHORITY: Implementing and authorized by the Nursing Home Care Act [210 ILCS 45].

SOURCE: Emergency rules adopted at 4 Ill. Reg. 10, p. 1066, effective March 1, 1980, for a maximum of 150 days; adopted at 4 Ill. Reg. 30, p. 311, effective July 28, 1980; emergency amendment at 6 Ill. Reg. 3229, effective March 8, 1982, for a maximum of 150 days; amended at 6 Ill. Reg. 5981, effective May 3, 1982; amended at 6 Ill. Reg. 6454, effective May 14, 1982; amended at 6 Ill. Reg. 8198, effective June 29, 1982; amended at 6 Ill. Reg. 11631, effective September 14, 1982; amended at 6 Ill. Reg. 14550 and 14554, effective November 8, 1982; amended at 6 Ill. Reg. 14684, effective November 15, 1982; amended at 7 Ill. Reg. 285, effective December 22, 1982; amended at 7 Ill. Reg. 1972, effective January 28, 1983; amended at 7 Ill. Reg. 8579, effective July 11, 1983; amended at 7 Ill. Reg. 15831, effective November 10, 1983; amended at 7 Ill. Reg. 15864, effective November 15, 1983; amended at 7 Ill. Reg. 16992, effective December 14, 1983; amended at 8 Ill. Reg. 15599, 15603, and 15606, effective August 15, 1984; amended at 8 Ill. Reg. 15947, effective August 17, 1984; amended at 8 Ill. Reg. 16999, effective September 5, 1984; codified at 8 Ill. Reg. 19766; amended at 8 Ill. Reg. 24186, effective November 29, 1984; amended at 8 Ill. Reg. 24668, effective December 7, 1984; amended at 8 Ill. Reg. 25102, effective December 14, 1984; amended at 9 Ill. Reg. 132, effective December 26, 1984; amended at 9 Ill. Reg. 4087, effective March 15, 1985; amended at 9 Ill. Reg. 11049, effective July 1, 1985; amended at 11 Ill. Reg. 16927, effective October 1, 1987; amended at 12 Ill. Reg. 1052, effective December 24, 1987; amended at 12 Ill. Reg. 16811, effective October 1, 1988; emergency amendment at 12 Ill. Reg. 18477, effective October 24, 1988, for a maximum of 150 days; emergency expired March 23, 1989; amended at 13 Ill. Reg. 4684, effective March 24, 1989; amended at 13 Ill. Reg. 5134, effective April 1, 1989; amended at 13 Ill. Reg. 20089, effective December 1, 1989; amended at 14 Ill. Reg. 14950, effective October 1, 1990; amended at 15 Ill. Reg. 554, effective January 1, 1991; amended at 16 Ill. Reg. 681, effective January 1, 1992; amended at 16 Ill. Reg. 5977, effective March 27, 1992; amended at 16 Ill. Reg. 17089, effective November 3, 1992; emergency amendment at 17 Ill. Reg. 2420, effective February 3, 1993, for a maximum of 150 days; emergency expired on July 3, 1993; emergency amendment at 17 Ill. Reg. 8026, effective May 6, 1993, for a maximum of 150 days; emergency expired on October 3, 1993; amended at 17 Ill. Reg. 15106, effective September 3, 1993; amended at 17 Ill. Reg. 16194, effective January 1, 1994; amended at 17 Ill. Reg. 19279, effective October 26, 1993; amended at 17 Ill. Reg. 19604, effective November 4, 1993; amended at 17 Ill. Reg. 21058, effective November 20, 1993; amended at 18 Ill. Reg. 1491, effective January 14, 1994; amended at 18 Ill. Reg. 15868, effective October 15, 1994; amended at 19 Ill. Reg. 11600, effective July 29, 1995; emergency amendment at 20 Ill. Reg. 567, effective January 1, 1996, for a maximum of 150 days; emergency expired May 29, 1996;

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NOTICE OF ADOPTED AMENDMENTS amended at 20 Ill. Reg. 10142, effective July 15, 1996; amended at 20 Ill. Reg. 12208, effective September 10, 1996; amended at 21 Ill. Reg. 15000, effective November 15, 1997; amended at 22 Ill. Reg. 4094, effective February 13, 1998; amended at 22 Ill. Reg. 7218, effective April 15, 1998; amended at 22 Ill. Reg. 16609, effective September 18, 1998; amended at 23 Ill. Reg. 1103, effective January 15, 1999; amended at 23 Ill. Reg. 8106, effective July 15, 1999; amended at 24 Ill. Reg. 17330, effective November 1, 2000; amended at 25 Ill. Reg. 4911, effective April 1, 2001; amended at 26 Ill. Reg. 3113, effective February 15, 2002; amended at 26 Ill. Reg. 4846, effective April 1, 2002; amended at 26 Ill. Reg. 10523, effective July 1, 2002; emergency amendment at 27 Ill. Reg. 2181, effective February 1, 2003, for a maximum of 150 days; emergency expired June 30, 2003; emergency amendment at 27 Ill. Reg. 5452, effective March 25, 2003, for a maximum of 150 days; emergency expired August 21, 2003; amended at 27 Ill. Reg. 5862, effective April 1, 2003; emergency amendment at 27 Ill. Reg. 14204, effective August 15, 2003, for a maximum of 150 days; emergency expired January 11, 2004; amended at 27 Ill. Reg. 15855, effective September 25, 2003; amended at 27 Ill. Reg. 18105, effective November 15, 2003; expedited correction at 28 Ill. Reg. 3528, effective November 15, 2003; amended at 28 Ill. Reg. 11180, effective July 22, 2004; amended at 28 Ill. Reg. 14623, effective October 20, 2004; amended at 29 Ill. Reg. 876, effective December 22, 2004; emergency amendment at 29 Ill. Reg. 11824, effective July 12, 2005, for a maximum of 150 days; emergency rule modified in response to JCAR Recommendation at 29 Ill. Reg. 15101, effective September 23, 2005, for the remainder of the maximum 150 days; emergency amendment expired December 8, 2005; amended at 29 Ill. Reg. 12852, effective August 2, 2005; amended at 30 Ill. Reg. 1425, effective January 23, 2006; amended at 30 Ill. Reg. 5213, effective March 2, 2006; amended at 31 Ill. Reg. 6044, effective April 3, 2007; amended at 31 Ill. Reg. 8813, effective June 6, 2007; amended at 33 Ill. Reg. 9356, effective June 17, 2009; amended at 34 Ill. Reg. 19182, effective November 23, 2010; amended at 35 Ill. Reg. 3378, effective February 14, 2011; amended at 35 Ill. Reg. 11419, effective June 29, 2011; expedited correction at 35 Ill. Reg. 17468, effective June 29, 2011; amended at 36 Ill. Reg. 14090, effective August 30, 2012; amended at 37 Ill. Reg. 2298, effective February 4, 2013; amended at 37 Ill. Reg. 4954, effective March 29, 2013; amended at 38 Ill. Reg. 22851, effective November 21, 2014; amended at 39 Ill. Reg. 5456, effective March 25, 2015; amended at 41 Ill. Reg. 14811, effective November 15, 2017; amended at 43 Ill. Reg. 3536, effective February 28, 2019; emergency amendment at 44 Ill. Reg. 8521, effective May 5, 2020, for a maximum of 150 days; emergency amendment to emergency rule at 44 Ill. Reg. 16264, effective September 15, 2020, for the remainder of the 150 days; emergency rule as amended expired October 1, 2020; emergency amendment at 44 Ill. Reg. 10217, effective May 28, 2020, for a maximum of 150 days; amended by emergency amendment to emergency rule at 44 Ill. Reg. 12931, effective July 14, 2020, for the remainder of the 150 days; emergency rule as amended repealed at 44 Ill. Reg. 17790, effective October 23, 2020; emergency amendment at 44 Ill. Reg. 16894, effective October 2, 2020, for a maximum of 150 days; emergency amendment at 44 Ill. Reg. 18462, effective October 23, 2020, for a

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NOTICE OF ADOPTED AMENDMENTS maximum of 150 days; emergency amendment at 44 Ill. Reg. 19551, effective December 2, 2020, for a maximum of 150 days; emergency amendment to emergency rule at 45 Ill. Reg. 393, effective December 18, 2020, for the remainder of the 150 days; amended at 45 Ill. Reg. 1134, effective January 8, 2021.

SUBPART A: GENERAL PROVISIONS

Section 300.230 Information to Be Made Available to the Public byBy the Licensee

a) Every facility shall conspicuously post foror display in an area of its offices accessible to residents, employees, and visitors the following:

1) Its current license;

2) A description, provided by the Department of complaint procedures established under the Act and the name, address, and telephone number of a person authorized by the Department to receive complaints;

3) A copy of any order pertaining to the facility issued by the Department or a court; and

4) A list of the material available for public inspection under subsection (b) andsubsection (b) of this Section and Section 3-210 of the Act. (Section 3- 209 of the Act)

b) A facility shall retain the following for public inspection:

1) A complete copy of every inspection report of the facility received from the Department during the past five years;

2) A copy of every order pertaining to the facility issued by the Department or a court during the past five years;

3) A description of the services provided by the facility and the rates charged for those services and items for which a resident may be separately charged;

4) A copy of the statement of ownershipStatement of Ownership required by Section 3-207 of the Act;

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5) A record of personnel employed or retained by the facility who are licensed, certified or registered by the Department of Financial and Professional Regulation; and

6) A complete copy of the most recent inspection report of the facility received from the Department; and. (Section 3-210 of the Act)

7) A copy of the current Consumer Choice Information Report required by Section 2-214 of the Act. (Section 3-210 of the Act)

c) A facility that has received a notice of violation for a violation of the minimum staffing requirements under Section 3-202.05 of the Act and Section 300.1230 of this Part shall display, during the period of time the facility is out of compliance, a notice stating in Calibri (body) font and 26-point type in black letters on an 8.5 by 11 inch white paper the following:

"Notice Dated: ...... This facility does not currently meet the minimum staffing ratios required by law. Posted at the direction of the Illinois Department of Public Health."

1) The notice shall be posted, at a minimum, at all publicly used exterior entryways into the facility, inside the main entrance lobby, and next to any registration desk for easily accessible viewing. The notice shall also be posted on the main page of the facility's website.

2) Pursuant to Section 300.1234(a)(5), the Department shall have the discretion to determine the gravity of any violation and, taking into account mitigating and aggravating circumstances and facts, may reduce the requirement of, and amount of time for, posting the notice. (Section 3- 209 of the Act)

(Source: Amended at 45 Ill. Reg. 1134, effective January 8, 2021)

SUBPART C: POLICIES

Section 300.650 Personnel Policies

a) Each facility shall develop and maintain written personnel policies that are

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followed in the operation of the facility. These policies shall include, at a minimum, each of the following requirements of this Section. b) Employee Records

1) Employment application forms shall be completed for each employee and kept on file in the facility. Completed forms shall be available to Department personnel for review.

2) Individual personnel files for each employee shall contain date of birth; home address; educational background; experience, including types and places of employment; date of employment and position employed to fill in this facility; and (if no longer employed in this facility) last date employed and reasons for leaving.

3) Individual personnel files for each employee shall also contain health records, including the initial health evaluation and the results of the tuberculin skin test required under Section 300.655, and any other pertinent health records.

4) Individual personnel records for each employee shall also contain records of evaluation of performance. c) Prior to employing any individual in a position that requires a State license, the facility shall contact the Illinois Department of Financial and Professional Regulation to verify that the individual's license is active. A copy of the license shall be placed in the individual's personnel file. d) The facility shall check the status of all applicants with the Health Care Worker Registry prior to hiring. e) All personnel shall have either training or experience, or both, in the job assigned to them. f) Orientation and In-Service Training

1) All new employees, including student interns, shall complete an orientation program covering, at a minimum, the following: general facility and resident orientation; job orientation, emphasizing allowable

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duties of the new employee; resident safety, including fire and disaster, emergency care and basic resident safety; and understanding and communicating with the type of residents being cared for in the facility. In addition, all new direct care staff, including student interns, shall complete an orientation program covering the facility's policies and procedures for resident care services before being assigned to provide direct care to residents. This orientation program shall include information on the prevention and treatment of decubitus ulcers and the importance of nutrition in general health care.

2) All employees, except student interns shall attend in-service training programs pertaining to their assigned duties at least annually. These in- service training programs shall include the facility's policies, skill training and ongoing education to enable all personnel to perform their duties effectively. The in-service training sessions regarding personal care, nursing and restorative services shall include information on the prevention and treatment of decubitus ulcers. In-service training concerning dietary services shall include information on the effects of diet in treatment of various diseases or medical conditions and the importance of laboratory test results in determining therapeutic diets. Written records of program content for each session and of personnel attending each session shall be kept.

3) All facilities shall provide training and education on the requirements of Section 2-106.1 of the Act and Section 300.686 of this Part to all personnel involved in providing care to residents, and train and educate those personnel on the methods and procedures to effectively implement the facility's policies. Training and education provided under Section 2-106.1 of the Act and Section 300.686 shall be documented in each personnel file. (Section 2-106.1(b-15) of the Act) g) Employees shall be assigned duties that are directly related to their functions, as identified in their job descriptions. Exceptions may be made in emergencies. h) Personnel policies shall include a plan to provide personnel coverage for regular staff when they are absent. i) Every facility shall have a current, dated weekly employee time schedule posted where employees may refer to it. This schedule shall contain the employee's

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name, job title, job duty (identifying the duty or duties listed in Section 300.1230(f)(1) through (10), if applicable), shift assignment, hours of work, and days off. If an employee works in two different job duties during the same week, specifically including those job duties listed in Section 300.1230(f), if applicable, the facility shall separately state the hours of work for each job duty. The schedule shall be kept on file in the facility for one year after the week for which the schedule was used.

j) Time spent in scheduled breaks and scheduled in-service training when staff are not providing direct care shall be documented.

(Source: Amended at 45 Ill. Reg. 1134, effective January 8, 2021)

Section 300.686 Unnecessary, Psychotropic, and Antipsychotic MedicationsDrugs

a) For the purposes of this Section, the following definitions shall apply:

1) "Adverse consequence" – unwanted, uncomfortable, or dangerous effects that a medication may have, such as impairment or decline in an individual's mental or physical condition or functional or psychosocial status. It may include, but is not limited to, various types of adverse medication reactions and interactions (e.g., medication-medication, medication-food, and medication-disease).

2) "Antipsychotic medication" – a medication that is used to treat symptoms of psychosis such as delusions, hearing voices, hallucinations, paranoia, or confused thoughts. Antipsychotic medications are used in the treatment of schizophrenia, severe depression, and severe anxiety. Older antipsychotic medications tend to be called typical antipsychotics. Those developed more recently are called atypical antipsychotics.

3) "Dose" – the total amount/strength/concentration of a medication given at one time or over a period of time. The individual dose is the amount/strength/concentration received at each administration. The amount received over a 24-hour period may be referred to as the daily dose.

4) "Duplicative therapy" – multiple medications of the same pharmacological class or category or any medication therapy that substantially duplicates a

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particular effect of another medication that the individual is taking.

5) "Emergency" – has the same meaning as in Section 1-112 of the Act and Section 300.330 of this Part. (Section 2-106.1(b) of the Act)

6) "Excessive dose" – the total amount of any medication (including duplicative therapy) given at one time or over a period of time that is greater than the amount recommended by the manufacturer's label, package or insert, and the accepted standards of practice for a resident's age and condition.

7) "Gradual dose reduction" – the stepwise tapering of a dose to determine if symptoms, conditions or risks can be managed by a lower dose or if the dose or medication can be discontinued.

8) "Informed consent" – documented, written permission for specific medications, given freely, without coercion or deceit, by a capable resident, or by a resident's surrogate decision maker, after the resident, or the resident's surrogate decision maker, has been fully informed of, and had an opportunity to consider, the nature of the medications, the likely benefits and most common risks to the resident of receiving the medications, any other likely and most common consequences of receiving or not receiving the medications, and possible alternatives to the proposed medications.

9) "Licensed nurse" – an advanced practice registered nurse or a registered professional nurse, as defined in the Nurse Practice Act.

10) "Psychotropic medication" – medication that is used for or listed as used for psychotropic, antidepressant, antimanic or antianxiety behavior modification or behavior management purposes in the Prescribers Digital Reference database, the Lexicomp-online database, or the American Society of Health-System Pharmacists database. Psychotropic medication also includes any medication listed in 42 CFR 483.45(c)(3).

11) "Surrogate decision maker" – an individual representing the resident's interests in regard to consent to receive psychotropic medications, as permitted by Section 2-106.1(b) of the Act and this Section. (Section 2- 106.1(b) of the Act)

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ba) A resident shall not be given unnecessary medicationsdrugs in accordance with Section 300.Appendix F. AnIn addition, an unnecessary medicationdrug is any drug used:

1) Inin an excessive dose, including in duplicative therapy;

2) Forfor excessive duration;

3) Withoutwithout adequate monitoring;

4) Withoutwithout adequate indications for its use; or

5) Inin the presence of adverse consequences that indicate the medicationsdrugs should be reduced or discontinued. (Section 2-106.1(a) of the Act); or

6) Any combination of the circumstances stated in subsections (b)(1) through (5). c) Residents shall not be given antipsychotic medications unless antipsychotic medication therapy is ordered by a physician or an authorized prescribing professional, as documented in the resident's comprehensive assessment, to treat a specific symptom or suspected condition as diagnosed and documented in the clinical record or to rule out the possibility of one of the conditions in accordance with Appendix F. d) Residents who use antipsychotic medications shall receive gradual dose reductions and behavior interventions, unless clinically contraindicated, in an effort to discontinue these medications in accordance with Appendix F. In compliance with subsection 2-106.1(b) of the Act and this Section, the facility shall obtain informed consent for each dose reduction. eb) Except in the case of an emergency, psychotropicPsychotropic medication shall not be administeredprescribed or administered without the informed consent of the resident or, the resident's surrogate decision makerguardian, or other authorized representative. (Section 2-106.1(b) of the Act) Additional informed consent is not required for reductions in dosage level or deletion of a specific medication, pursuant to subsection (f)(9). Informed consent is requiredThe

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informed consent may provide for a medication administration program of sequentially increased doses or a combination of medications to establish the lowest effective dose that will achieve the desired therapeutic outcome, pursuant to subsection (f)(9). The most common sideSide effects of the medications shall be described. In an emergency, a facility shall:

1) Document the alleged emergency in detail, including the facts surrounding the medication's need, pursuant to the requirements of Section 300.1820; and

2) Present this documentation to the resident and the resident's representative or other surrogate decision maker no later than 24 hours after the administration of emergency psychotropic medication. (Section 2-106.1(b) of the Act) c) Residents shall not be given antipsychotic drugs unless antipsychotic drug therapy is necessary, as documented in the resident's comprehensive assessment, to treat a specific or suspected condition as diagnosed and documented in the clinical record or to rule out the possibility of one of the conditions in accordance with Section 300.Appendix F. d) Residents who use antipsychotic drugs shall receive gradual dose reductions and behavior interventions, unless clinically contraindicated, in an effort to discontinue these drugs in accordance with Section 300.Appendix F. e) For the purposes of this Section:

1) "Duplicative drug therapy" means any drug therapy that duplicates a particular drug effect on the resident without any demonstrative therapeutic benefit. For example, any two or more drugs, whether from the same drug category or not, that have a sedative effect.

2) "Psychotropic medication" means medication that is used for or listed as used for antipsychotic, antidepressant, antimanic or antianxiety behavior modification or behavior management purposes in the latest edition of the AMA Drug Evaluations (Drug Evaluation Subscription, American Medical Association, Vols. I-III, Summer 1993), United States Pharmacopoeia Dispensing Information Volume I (USP DI) (United States Pharmacopoeial Convention, Inc., 15th Edition, 1995), American Hospital

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Formulary Service Drug Information 1995 (American Society of Health Systems Pharmacists, 1995), or the Physician's Desk Reference (Medical Economics Data Production Company, 49th Edition, 1995) or the United States Food and Drug Administration approved package insert for the psychotropic medication. (Section 2-106.1(b) of the Act)

3) "Antipsychotic drug" means a neuroleptic drug that is helpful in the treatment of psychosis and has a capacity to ameliorate thought disorders. f) Protocol for Securing Informed Consent for Psychotropic Medication

1) Except in the case of an emergency as described in subsection (e), no resident shall be administered psychotropic medication prior to a discussion between the resident or the resident's surrogate decision maker, or both, and the resident's physician or a physician the resident was referred to, a registered pharmacist who is not a dispensing pharmacist for the facility where the resident lives, or a licensed nurse about the most common possible risks and benefits of a recommended medication and the use of standardized consent forms designated by the Department. (Section 2-106.1(b) of the Act)

2) Prior to initiating any detailed discussion designed to secure informed consent, a licensed health care professional shall inform the resident or the resident's surrogate decision maker that the resident's physician has prescribed a psychotropic medication for the resident, and that informed consent is required from the resident or the resident's surrogate decision maker before the resident may be given the medication.

3) The discussion shall include information about:

A) The name of the medication;

B) The condition or symptoms that the medication is intended to treat, and how the medication is expected to treat those symptoms;

C) How the medication is intended to affect those symptoms;

D) Other common effects or side effects of the medication, and any reasons (e.g., age, health status, other medications) that the resident

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is more or less likely to experience side effects;

E) Dosage information, including how much medication would be administered, how often, and the method of administration (e.g., orally or by injection; with, before, or after food);

F) Any tests and related procedures that are required for the safe and effective administration of the medication;

G) Any food or activities the resident should avoid while taking the medication;

H) Any possible alternatives to taking the medication that could accomplish the same purpose; and

I) Any possible consequences to the resident of not taking the medication.

4) Pursuant to Section 2-105 of the Act, the discussion designed to secure informed consent shall be private, between the resident or the resident's surrogate decision maker and the resident's physician, or a physician the resident was referred to, or a registered pharmacist who is not a dispensing pharmacist for the facility where the resident lives, or a licensed nurse.

5) In addition to the oral discussion, the resident or his or her surrogate decision maker shall be given the information in subsection (f)(3) in writing. The information shall be in plain language, understandable to the resident or his or her surrogate decision maker. If the written information is in a language not understood by the resident or his or her surrogate decision maker, the facility, in compliance with the Language Assistance Services Act and the Language Assistance Services Code, shall provide, at no cost to the resident or the resident's surrogate decision maker, an interpreter capable of communicating with the resident or his or her surrogate decision maker and the authorized prescribing professional conducting the discussion. The authorized prescribing professional shall guide the resident through the written information. The written information shall include a place for the resident or his or her surrogate decision maker to give, or to refuse to give, informed consent. The written information shall be placed in the resident's record. Informed consent is

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not secured until the resident or surrogate decision maker has given written informed consent. If the resident has dementia and the facility is unable to contact the resident's surrogate decision maker, the facility shall not administer psychotropic medication to the resident except in an emergency as provided by subsection (e).

6) Informed consent shall be sought first from a resident, then from a surrogate decision maker, in the following order or priority:

A) The resident's guardian of the person if one has been named by a court of competent jurisdiction.

B) In the absence of a court-ordered guardian, informed consent shall be sought from a health care agent under the Illinois Power of Attorney Act [755 ILCS 45] who has authority to give consent.

C) If neither a court-ordered guardian of the person, nor a health care agent under the Power of Attorney Act, is available, and the attending physician determines that the resident lacks capacity to make decisions, informed consent shall be sought from the resident's attorney-in-fact designated under the Mental Health Treatment Preference Declaration Act [755 ILCS 43], if applicable, or the resident's representative. (Section 2-106.1(b) of the Act)

7) Regardless of the availability of a surrogate decision maker, the resident may be notified and present at any discussion required by this Section. Upon request, the resident or the resident's surrogate decision maker shall be given, at a minimum, written information about the medication and an oral explanation of common side effects of the medication to facilitate the resident in identifying the medication and in communicating the existence of side effects to the direct care staff.

8) The facility shall inform the resident, surrogate decision maker, or both of the existence of a copy of:

A) The resident's care plan;

B) The facility policies and procedures adopted in compliance with

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Section 2-106.1(b-15) of the Act, and this Section; and

C) A notification that the most recent of the resident's care plans and the facility's policies are available to the resident or surrogate decision maker upon request.

9) The maximum possible period for informed consent shall be until:

A) A change in the prescription occurs, either as to type of psychotropic medication or dosage; or

B) A resident's care plan changes in a way that affects the prescription or dosage of the psychotropic medication. (Section 2- 106.1(b) of the Act).

10) A resident or his or her surrogate decision maker shall not be asked to consent to the administration of a new psychotropic medication in a dosage or frequency that exceeds the maximum recommended daily dosage as found in the Prescribers Digital Reference database, the Lexicomp-online database, or the American Society of Health-System Pharmacists database unless the reason for exceeding the recommended daily dosage is explained to the resident or his or her surrogate decision maker by a licensed medical professional, and the reason for exceeding the recommended daily dosage is justified by the prescribing professional in the clinical record. The dosage and frequency shall be reviewed and re- justified by the licensed prescriber on a weekly basis and reviewed by a consulting pharmacist. The justification for exceeding the recommended daily dosage shall be recorded in the resident's record and shall be approved within seven calendar days after obtaining informed consent, in writing, by the medical director of the facility.

11) Pursuant to Section 2-104(c) of the Act, the resident or the resident's surrogate decision maker shall be informed, at the time of the discussion required by subsection (f)(1), that his or her informed consent may be withdrawn at any time, and that, even with informed consent, the resident may refuse to take the medication.

12) The facility shall obtain informed consent using forms provided by the Department on its official website, or on forms approved by the

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Department, pursuant to Section 2-106.1(b) of the Act. The facility shall document on the consent form whether the resident is capable of giving informed consent for medication therapy, including for receiving psychotropic medications. If the resident is not capable of giving informed consent, the identity of the resident's surrogate decision maker shall be placed in the resident's record.

13) No facility shall deny continued residency to a person on the basis of the person's or resident's, or the person's or resident's surrogate decision maker's, refusal of the administration of psychotropic medication, unless the facility can demonstrate that the resident's refusal would place the health and safety of the resident, the facility staff, other residents, or visitors at risk. A facility that alleges that the resident's refusal to consent to the administration of psychotropic medication will place the health and safety of the resident, the facility staff, other residents, or visitors at risk shall:

A) Document the alleged risk in detail, along with a description of all nonpharmacological or alternative care options attempted and why they were unsuccessful;

B) Present this documentation to the resident or the resident's surrogate decision maker, to the Department, and to the Office of the State Long Term Care Ombudsman; and

C) Inform the resident or his or her surrogate decision maker of his or her right to appeal an involuntary transfer or discharge to the Department as provided in the Act and this Part. (Section 2- 106.1(b-10) of the Act) g) By April 10, 2021, all facilities shall implement written policies and procedures for compliance with Section 2-106.1 of the Act and this Section. A facility's failure to make available to the Department the documentation required under this subsection is sufficient to demonstrate its intent to not comply with Section 2- 106.1 of the Act and this Section and shall be grounds for review by the Department. (Section 2-106.1(b-15) of the Act) h) Upon the receipt of a report of any violation of Section 2-106.1 of the Act and this Section, the Department will investigate and, upon finding sufficient evidence of a

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violation of Section 2-106.1 of the Act and this Section, may proceed with disciplinary action against the licensee of the facility. In any administrative disciplinary action under this subsection, the Department will have the discretion to determine the gravity of the violation and, taking into account mitigating and aggravating circumstances and facts, may adjust the disciplinary action accordingly. (Section 2-106.1(b-20) of the Act) i) A violation of informed consent that, for an individual resident, lasts for seven days or more under this Section is, at a minimum, a Type "B" violation. A second violation of informed consent within a year from a previous violation in the same facility regardless of the duration of the second violation is, at a minimum, a Type "B" violation. (Section 2-106.1(b-25) of the Act) j) Any violation of Section 2-106.1 of the Act and this Section by a facility may be enforced by an action brought by the Department in the name of the People of Illinois for injunctive relief, civil penalties, or both injunctive relief and civil penalties. The Department may initiate the action upon its own complaint or the complaint of any other interested party. (Section 2-106.1(b-30) of the Act) k) Any resident who has been administered a psychotropic medication in violation of Section 2-106.1 of the Act and this Section may bring an action for injunctive relief, civil damages, and costs and attorney's fees against any facility responsible for the violation. (Section 2-106.1(b-35) of the Act) l) An action under this Section shall be filed within two years after either the date of discovery of the violation that gave rise to the claim or the last date of an instance of a noncompliant administration of psychotropic medication to the resident, whichever is later. (Section 2-106.1(b-40) of the Act) m) A facility subject to action under Section 2-106.1 of the Act and this Section shall be liable for damages of up to $500 for each day, after discovery of a violation, that the facility violates the requirements of Section 2-106.1 of the Act and this Section. (Section 2-106.1(b-45) of the Act) n) The rights provided for in Section 2-106.1 of the Act and this Section are cumulative to existing resident rights. No part of this Section shall be interpreted as abridging, abrogating, or otherwise diminishing existing resident rights or causes of action at law or equity. (Section 2-106.1(b-55) of the Act)

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o) In addition to the penalties described in this Section and any other penalty prescribed by law, a facility that is found to have violated Section 2-106.1 of the Act and this Section, or the federal certification requirement that informed consent be obtained before administering a psychotropic medication, shall thereafter be required to obtain the signatures of two licensed health care professionals on every form purporting to give informed consent for the administration of a psychotropic medication, certifying the personal knowledge of each health care professional that the consent was obtained in compliance with the requirements of Section 2-106.1 of the Act and this Section. (Section 2- 106.1(b) of the Act)

(Source: Amended at 45 Ill. Reg. 1134, effective January 8, 2021)

SUBPART F: NURSING AND PERSONAL CARE

Section 300.1230 Direct Care Staffing

a) For purposes of the minimum staffing ratios in Section 3-202.05 of the Act and this Section, all residents shall be classified as requiring either skilled care or intermediate care. (Section 3-202.05(b-5) of the Act)

ba) For the purposes of this Section, the following definitions shall apply:

1) "Direct care" − is the provision of nursing care or personal care as defined in Section 300.330, therapies, and care provided by staff listed in subsection (if). Direct care staff are those individuals who, through interpersonal contact with residents or resident care management, provide care and services to allow residents to attain or maintain the highest practicable physical, mental and psychosocial well-being. Direct care staff does not include individuals whose primary duty is maintaining the physical environment of the facility (e.g., housekeeping).

2) "Skilled care" – skilled nursing care, continuous skilled nursing observations, restorative nursing, and other services under professional direction with frequent medical supervision. (Section 3-202.05(b-5) of the Act) Skilled nursing services are either nursing or therapy care services, furnished pursuant to physician orders, that require the skills of a licensed nurse to treat, manage, and observe a resident's condition and evaluate a resident's care. The skilled nursing services may be provided by a CNA,

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under the supervision of a licensed nurse to ensure the safety of the patient and to achieve the medically desired result. A resident in a skilled nursing facility is classified as receiving skilled care if:

A) The resident is receiving care covered by Medicare under any arrangement allowed by Title XVIII of the Social Security Act;

B) The resident is receiving care that would be covered by Medicare, but the resident has exhausted his or her Medicare benefits; or

C) The resident is not Medicare eligible, but is receiving care that would be covered by Medicare if the resident were eligible.Skilled care is skilled nursing care, continuous skilled nursing observations, restorative nursing, and other services under professional direction with frequent medical supervision.

3) "Intermediate care" – basic nursing care and other restorative services under periodic medical direction. (Section 3-202.05(b-5) of the Act) Services not classified as skilled care will be classified as intermediate care.Intermediate care is basic nursing care and other restorative services under periodic medical direction.

c) A minimum of 25% of nursing and personal care time shall be provided by licensed nurses, with at least 10% of nursing and personal care time provided by registered nurses. Registered nurses and licensed practical nurses employed by a facility in excess of these requirements may be used to satisfy the remaining 75% of the nursing and personal care time requirements. (Section 3-202.05(e) of the Act)

d) The minimum staffing ratios shall be 3.8 hours of nursing and personal care each day for a resident needing skilled care and 2.5 hours of nursing and personal care each day for a resident needing intermediate care. (Section 3-202.05(d) of the Act) For the purpose of this subsection, "nursing care" and "personal care" mean direct care provided by staff listed in subsection (i).

e) The facility shall schedule nursing personnel so that the nursing needs of all residents are met. fb) The number of staff who provide direct care who are needed at any time in the

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facility shall be based on the needs of the residents, and shall be determined by figuring the number of hours of direct care each resident needs peron each shift of the day. c) If residents participate in regularly scheduled therapeutic programs outside the facility, such as school or sheltered workshops, the minimum hours per day of direct care staffing in the facility are reduced for the hours the residents are not in the facility. gd) Each facility shall provide minimum direct care staff by complying with subsection (f) and meeting the minimum direct care staffing ratios set forth in this Section.:

1) Determining the amount of direct care staffing needed to meet the needs of its residents; and

2) Meeting the minimum direct care staffing ratios set forth in this Section. he) The direct care staffing calculationsrequirements in this Section shall include only apply to the number of staffpersons actually on duty on siteand not to the number of persons scheduled to be on duty. The following shall not be included in direct care staffing calculations:

1) Meal and break times (paid or unpaid);

2) Scheduled training; and

3) When a facility is utilized as a clinical site for nurse aide training, if the facility is not paying the employee for the services provided. if) For the purpose of computing staff to resident ratios, direct care staff shall include the following:, as long as the person is assigned to duties consistent with the identified job title and documented in employee time schedules as required by Section 300.650(i):

1) Registered professionalregistered nurses;

2) Licensedlicensed practical nurses;

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3) Certifiedcertified nurse assistants;

4) Psychiatricpsychiatric services rehabilitation aides (see Section 300.4090);

5) Rehabilitationrehabilitation and therapy aides;

6) Psychiatricpsychiatric services rehabilitation coordinators (see Section 300.4090);

7) Assistantassistant directors of nursing;

8) 50% of the Director of Nurses' time;

9) 30% of the Social Services Directors' time (Section 3-202.05 of the Act); and

10) Licensedlicensed physical, occupational, speech and respiratory therapists. jg) Facilities subject to Subpart S may utilize specialized clinical staff, as defined in Section 300.4090(c) and (f), to count towards the staffing ratios. (Section 3- 202.05(a) of the Act) h) Care Determinations When differences of opinion occur between facility staff and Department surveyors regarding the care an individual resident may require, the surveyor shall determine whether the resident is receiving appropriate care. If the resident is receiving appropriate care, the surveyor will accept the facility's determination of the number of direct care hours the facility shall provide. i) The facility shall schedule nursing personnel so that the nursing needs of all residents are met. j) Skilled Nursing and Intermediate Care For the purpose of this subsection, "nursing care" and "personal care" mean direct care provided by staff listed in subsection (f).

1) Effective July 1, 2010, for each resident needing skilled care, a minimum staffing ratio of 2.5 hours of nursing and personal care each day must be

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provided; for each resident needing intermediate care, 1.7 hours of nursing and personal care each day must be provided.

2) Effective January 1, 2011, the minimum staffing ratios shall be increased to 2.7 hours of nursing and personal care each day for a resident needing skilled care and 1.9 hours of nursing and personal care each day for a resident needing intermediate care.

3) Effective January 1, 2012, the minimum staffing ratios shall be increased to 3.0 hours of nursing and personal care each day for a resident needing skilled care and 2.1 hours of nursing and personal care each day for a resident needing intermediate care.

4) Effective January 1, 2013, the minimum staffing ratios shall be increased to 3.4 hours of nursing and personal care each day for a resident needing skilled care and 2.3 hours of nursing and personal care each day for a resident needing intermediate care.

5) Effective January 1, 2014, the minimum staffing ratios shall be increased to 3.8 hours of nursing and personal care each day for a resident needing skilled care and 2.5 hours of nursing and personal care each day for a resident needing intermediate care. (Section 3-202.05(d) of the Act) k) Effective September 12, 2012, a minimum of 25% of nursing and personal care time shall be provided by licensed nurses, with at least 10% of nursing and personal care time provided by registered nurses. Registered nurses and licensed practical nurses employed by a facility in excess of these requirements may be used to satisfy the remaining 75% of the nursing and personal care time requirements. (Section 3-202.05(e) of the Act) k) To determine the direct care staffing required to meet daily minimum staffing ratios for skilled care and intermediate care, the following staffing formula shall be used:

1) Determine the number of residents requiring skilled care and the number of residents requiring intermediate care.

2) Calculate the total daily required nursing and personal care hours for each level of care:

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A) The number of residents requiring skilled care shall be multiplied by the required number of hours (3.8) per resident.

B) The number of residents requiring intermediate care shall be multiplied by the required number of hours (2.5) per resident.

3) Add the total number of hours of direct care required for each level of care to determine the total number of hours required to provide direct care for all residents in the facility.

4) Multiplying the total minimum hours of direct care hours required for all residents, determined under subsection (k)(3), by 25% results in the minimum amount of licensed nurse hours that shall be provided during a 24-hour period.

5) Multiplying the total minimum hours of direct care time required for all residents, determined under subsection (k)(3), by 10% results in the minimum amount of registered nurse hours that shall be provided during a 24-hour period.

6) The remaining 75% of the minimum required direct care hours may also be fulfilled by other staff identified in subsection (i) as long as it can be documented that those staff provide direct care, and that nursing care and nursing delegation is in accordance with the Nurse Practice Act.

7) The amount of time determined in subsections (k)(4), (5) and (6) is expressed in hours.

8) See Appendix A for an example of staffing calculations. l) A written work schedule shall be posted at least 10 days prior to the first day on the schedule. The work schedule shall be posted in a location conspicuous and accessible only to employees.

1) This work schedule shall contain the employee's name, job title, (identifying the job title or titles listed in subsection (i), if applicable), shift assignment, hours of work, and days off.

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2) If an employee works in more than one job during the same week, specifically including those job duties listed in subsection (i), if applicable, the facility shall separately state the hours of work for each job duty.

3) The work schedule, whether a hard copy or in an electronic format, shall be kept on file in the facility in the administrator's office for a minimum of three years after the week for which the schedule was used. m) Time spent in scheduled breaks and mealtimes, and scheduled training, when staff are not providing direct care shall be documented. n) A facility operating under a waiver from the minimum registered professional nurse staffing requirements (see Section 300.1232) shall provide written documentation of the waiver to the Department upon request. l) To determine the numbers of direct care personnel needed to staff any facility, the following procedures shall be used:

1) The facility shall determine the number of residents needing skilled or intermediate care.

2) The number of residents in each category shall be multiplied by the overall hours of direct care needed each day for each category.

3) Adding the hours of direct care needed for the residents in each category will give the total hours of direct care needed by all residents in the facility.

4) Multiplying the total minimum hours of direct care needed by 25% will give the minimum amount of licensed nurse time that shall be provided during a 24-hour period. Multiplying the total minimum hours of direct care needed by 10% will give the minimum amount of registered nurse time that shall be provided during a 24-hour period.

5) Additional Direct Care Hours Equal to at Least 75% of the Minimum Required The remaining 75% of the minimum required direct care hours may be fulfilled by other staff identified in subsection (f) as long as it can be documented that they provide direct care and as long as nursing care is

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provided in accordance with the Nurse Practice Act.

6) The amount of time determined in subsections (l)(4) and (5) is expressed in hours. Dividing the total number of hours needed by the number of hours each person works per shift (usually 7.5 or 8 hours) will give the number of persons needed to staff each shift. Calculations shall not include time for scheduled breaks or scheduled in-service training. The number of residents used to calculate staff ratios shall be based on the facility's midnight census. m) Example of Staffing Calculations

1) Following is an example of this computation assuming a l00-bed Skilled Nursing Facility that has 25 residents needing skilled care and 75 residents needing intermediate care, and assuming that the identified needs of the residents have led the facility to assign 45% of the staff to the day shift; 35% to the evening shift and 20% to the night shift.

2) Under the subsection (j) requirements for January 1, 2014, staffing would be computed as follows:

A) Total Minimum Hours of Care Needed

Total Hrs. Total Hrs. Level of # of Needed/Day Needed/Day Care Residents Per Resident Per Facility

Skilled 25 [times] 3.8 = 95.0

Intermediate 75 [times] 2.5 = 187.5

Total hours needed 282.5

B) Minimum Total Hours Needed Per Shift

Total Hrs. Minimum Total Hrs. Shift Per Day Percent Needed

7-3 282.5 [times] 45% = 127.125

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3-11 282.5 [times] 35% = 98.875 11-7 282.5 [times] 20% = 56.500 100% 282.500

C) Licensed Nurse Time Per Shift

Minimum Lic. Minimum Hrs. Minimum Nurse Hrs. Shift Per Shift Percent Required 7-3 127.125 [times] 25% = 31.781 3-11 98.875 [times] 25% = 24.719 11-7 56.500 [times] 25% = 14.125

D) Licensed Nurses Required

Minimum # of Lic. Nurse Hrs. Hrs. Worked Nurses Shift Required Per Shift Needed

7-3 31.781 [divided by] 8 = 3.973 3-11 24.719 [divided by] 8 = 3.090 11-7 14.125 [divided by] 8 = 1.766

E) Registered Nurse Time

Minimum Minimum Registered Registered Nurse Hrs. Minimum Nurse Hrs. Shift Per Shift Percent Required

7-3 127.125 [times] 10% = 12.712 3-11 98.875 [times] 10% = 9.887 11-7 56.500 [times] 10% = 5.650

F) Registered Nurses Required

Minimum Registered Hrs. Worked # of Registered Shift Nurse Hrs. Per Shift Nurses Needed

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Required

7-3 12.712 [divided by] 8 = 1.589 3-11 9.887 [divided by] 8 = 1.236 11-7 5.650 [divided by] 8 = .706

G) Additional Direct Care Hours*

# of Minimum Lic. Nurse Additional Total Hrs. Time Direct Care Needed Per Worked Per Staff Hrs.* Shift Shift Shift Needed

7-3 127.125 [minus] 31.781 = 95.344 3-11 98.875 [minus] 24.719 = 74.156 11-7 56.500 [minus] 14.125 = 42.375

H) Additional Direct Care Staff* Required

Minimum Additional Direct Care Hrs. # of Additional Hrs. Worked Per Direct Care Shift Required Shift Staff* Needed

7-3 95.344 [divided by] 8 = 11.918 3-11 74.156 [divided by] 8 = 9.270 11-7 42.375 [divided by] 8 = 5.300

*See subsection (l)(5).

(Source: Amended at 45 Ill. Reg. 1134, effective January 8, 2021)

Section 300.1231 Calculation of Direct Care Staffing During Inspections, Surveys and Evaluations

a) Calculation of direct care staffing during inspections, surveys and evaluations will be based on the finalized working schedule and daily census report totals for the two-week period preceding the first day of the inspection. The work schedule

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shall be determined as outlined in Section 300.1230(k) and shall be provided upon request.

b) For certified facilities, copies of nurse staffing information required by 42 CFR 483.35(g) for the two-week period preceding the first day of the inspection shall be provided upon request.

(Source: Added at 45 Ill. Reg. 1134, effective January 8, 2021)

Section 300.1232 Waiver of Registered Professional Nurse Staffing Requirements

a) Upon application by a facility, the Director may grant or renew a waiver, in whole or in part, of the registered professional nurse staffing requirements contained in Section 3-202.05(e) of the Act and Section 300.1230(c) of this Part, considering the criteria in Section 300.320, if the facility demonstrates to the Director's satisfaction that the facility is unable, despite diligent efforts, including offering wages at a competitive rate for registered professional nurses in the community, to employ the required number of registered professional nurses and that the waivers will not endanger the health or safety of residents of the facility.

b) A facility in compliance with the terms of a waiver granted under Section 3- 303.1(c) of the Act and this Section will not be subject to fines or penalties imposed by the Department for violating the registered professional nurse staffing requirements of Section 3-202.05(e) of the Act and Section 300.1230(c). Nothing in the Act or this Section allows the Director to grant or renew a waiver of the minimum registered professional nurse staffing requirements provided in 42 CFR 483.35(b) to a facility that is Medicare-certified or to a facility that is both Medicare-certified and Medicaid-certified.

c) Waivers granted under the Act and this Section will be reviewed quarterly by the Department, including requiring a demonstration by the facility that it has continued to make diligent efforts to employ the required number of registered professional nurses, and shall be revoked for noncompliance with any of the following requirements:

1) For periods in which the number of registered professional nurses required by law is not in the facility, a physician or registered professional nurse shall respond immediately to a telephone call from the facility.

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2) The facility to notify the following of the waiver: the Office of the State Long Term Care Ombudsman, the residents of the facility, the residents' guardians, and the residents' representatives. (Section 3-303.1(c) of the Act) d) A copy of each waiver application and each waiver granted or renewed by the Department will be on file with the Department and available for public inspection. The Director will annually review the file and recommend to the Long-Term Care Facility Advisory Board any modification in this Part suggested by the number and nature of waivers requested and granted and the difficulties faced in compliance by similarly situated facilities. (Section 3-303.1(d) of the Act) e) If the Department grants a waiver to a facility under this Section, the facility shall immediately notify the following of the waiver:

1) The Office of the State Long Term Care Ombudsman;

2) The residents of the facility;

3) The residents' guardians;

4) The residents' representatives (Section 3-303.1(c)(2) of the Act);

5) Individuals seeking information from the facility prior to admission to the facility; and

6) The Illinois Department of Healthcare and Family Services Bureau of Long-Term Care. f) A request for a waiver from the registered professional nurse staffing requirements shall be made in writing to the Department, specifying the following:

1) A detailed explanation of why the facility is unable, despite diligent efforts, including offering wages at a competitive rate for registered professional nurses in the community, to employ the required number of registered professional nurses (Section 3-303.1(c) of the Act);

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2) A detailed description of the programs or services offered by the facility for which the waiver is requested;

3) A detailed explanation of why the waiver will not endanger the health or safety of residents of the facility (Section 3-303.1(c) of the Act);

4) The number of residents in the facility and the level of care they require, the location and number of ambulatory and non-ambulatory residents, and residents' decision making capacity; and

5) The time period for which the waiver is requested. g) The Department may revoke a waiver granted to a facility if the facility fails to comply with any of the requirements in the Act and this Section. h) A facility operating under an initial license shall not be eligible for a waiver of registered professional nurse staffing requirements. i) A facility that has been subject to any of the following actions by the Department in the three years prior to application shall not be eligible for a waiver of registered professional nurse staffing requirements:

1) Issuance of one or more Type "AA" violations if operated by the same owner at the time of the waiver application;

2) Issuance of two or more Type "A" violations if operated by the same owner at the time of the waiver application; or

3) Issuance of two consecutive annual or bi-annual certification surveys with substantiated substandard quality of care deficiencies. j) No waiver shall exceed the duration of the current license or, in the case of an application for license renewal, the duration of the renewal period. (Section 3- 303.1(a) of the Act) For facilities with two-year licenses, no waiver shall be granted for a period that exceeds one year. Waivers shall not be transferable. k) The Department will post on its website a list of facilities with approved waivers by no later than June 30 of each year.

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(Source: Added at 45 Ill. Reg. 1134, effective January 8, 2021)

Section 300.1233 Quarterly Administrative Staffing Compliance Review

a) The Department will determine compliance quarterly by comparing the number of hours provided per resident per day using the Centers for Medicare and Medicaid Services' payroll-based journal (PBJ) and the facility's daily census. (Section 3- 202.05(f) of the Act) PBJ data that is utilized for compliance shall not be contested. For a crosswalk of job titles from Section 300.1230(i) versus PBJ job titles, see Appendix B.

b) The quarterly deadlines for submitting PBJ data to the Department are as follows:

1) For the first fiscal quarter reporting period of October 1 through December 31, quarterly PBJ data is due to the Department on March 1.

2) For the second fiscal quarter reporting period of January 1 through March 31, quarterly PBJ data is due to the Department on June 1.

3) For the third fiscal quarter reporting period of April 1 through June 30, quarterly PBJ data is due to the Department on September 1.

4) For the fourth fiscal quarter reporting period of July 1 through September 30, quarterly PBJ data is due to the Department on December 1.

c) Licensed-only facilities are not required to submit PBJ data to the Department but shall submit quarterly staffing data to the Department in a format and manner determined by the Department, adhering to the same deadlines as in subsection (b).

d) The facility's daily census report shall be broken down by intermediate and skilled care. (Section 3-202.05(f) of the Act) Required information for each day listed on the report is as follows:

1) The date;

2) The total number of residents requiring skilled care for the date;

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3) The total number of residents requiring intermediate care for the date; and

4) The total census for the date.

e) Facilities shall submit to [email protected] a separate daily census report for each day of the month of the quarter, adhering to the same deadlines as in subsection (b).

f) Failure to submit a required daily census report by the submission deadline shall result in calculations based on skilled care direct care staffing requirements for any of the missing information.

(Source: Added at 45 Ill. Reg. 1134, effective January 8, 2021)

Section 300.1234 Penalties and Notice of Violation

a) Notwithstanding any other provision of the Act or this Part, the Department will impose penalties for violations of the minimum staffing requirements of the Act and Section 300.1230, as follows:

1) No monetary penalty will be issued for noncompliance during the implementation period, which will be July 1, 2020 through September 30, 2020. If a facility is found to be noncompliant during the implementation period, the Department will provide a written notice identifying the staffing deficiencies. The facility shall provide a sufficiently detailed correction plan to meet the statutory minimum staffing levels.

2) Monetary penalties will be imposed by the Department beginning no later than January 1, 2021, and quarterly thereafter, and shall be based on the latest quarter for which the Department has data.

3) Monetary penalties shall be established based on a formula that calculates, on a daily basis, the cost of wages and benefits for the missing staffing hours. All notices of noncompliance issued by the Department will include the computations used to determine noncompliance and establishing the variance between minimum staffing ratios and the Department's computations.

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4) The penalty for the first offense shall be 125% of the cost of wages and benefits for the missing staffing hours. The penalty will increase to 150% of the cost of wages and benefits for the missing staffing hours for the second offense and 200% of the cost of wages and benefits for the missing staffing hours for the third and all subsequent offenses.

5) The penalty shall be imposed regardless of whether the facility has committed other violations of the Act and this Part during the same period that the staffing offense occurred.

6) The penalty may not be waived, but the Department may determine the gravity of the violation in situations in which there is no more than a 10% deviation from the staffing requirements and make appropriate adjustments to the penalty.

A) A facility shall have 30 days from the receipt of the notice of violation to request an adjustment to the penalty pursuant to this subsection (a)(6).

B) This subsection does not apply to deviations due to a waiver granted under Section 300.1232.

7) The Department may waive the penalty when unforeseen circumstances have occurred that resulted in call-offs of scheduled staff. This provision will be applied no more than 6 times per quarter. (Section 3-202.05(g) of the Act) A facility shall have 30 days from the receipt of the notice of violation to request a waiver of the penalty pursuant to this subsection (a)(7). If the Department declines to waive the penalty, it will inform the facility of the reasons why. For the purposes of this Section:

A) An unforeseen circumstance includes, but is not limited to, a disaster as defined in Section 300.670(a), labor unrest, civil unrest, a viral epidemic or pandemic, family emergency, or any cause beyond the reasonable control of the facility.

B) "Six Times" means 6 unforeseen circumstances. If an unforeseen circumstance occurs, the facility shall document the type of unforeseen circumstance, the beginning and end dates of the unforeseen circumstance, and how many scheduled staff called off

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during the unforeseen circumstance. The facility shall submit the report to the Department within 24 hours after the end of the unforeseen circumstance. If the unforeseen circumstance is a viral epidemic or pandemic, the facility shall submit regular reports to the Department pursuant to Section 300.696. b) Nothing in the Act or this Section diminishes a facility's right to appeal a Department finding of non-compliance with the minimum staffing requirements of Section 300.1230. (Section 3-202.05(g) of the Act) A facility shall have 30 days from the receipt of the notice of violation to file an appeal on a Department finding of non-compliance. c) The Department will notify the facility of non-compliance with the minimum staffing requirements within 30 days after the latest quarter for which the Department has complete staffing data. The notice shall contain, at a minimum:

1) The year and quarter the staffing shortfall occurred;

2) A summary breakdown of the total penalty showing results of calculations made pursuant to subsection (d);

3) Citations to the Act and this Part relative to the violation;

4) The total amount of the fine, if any, the date by which payment is due to be paid, and accepted forms of payment;

5) An explanation of consequences for nonpayment, incomplete payment, or late payment (see subsection (e));

6) A statement of the facility's right to file an appeal of the violation, to request an adjustment of the penalty when there is no more than a 10% deviation from the staffing requirements, or request a waiver of the penalty for an unforeseen circumstance; and

7) The process for filing an appeal or requesting an adjustment or a waiver of the penalty. d) The Department will use the following procedures to determine penalties for facilities that fail to meet minimum direct care staffing ratios:

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1) The Department will calculate penalties for unmet direct care staffing hours using the most current median hourly wage data reported by U.S. Department of Labor Bureau of Labor Statistics (BLS) in the BLS' Occupational Employment Statistics' metropolitan and nonmetropolitan Area Occupational Employment and Wage Estimates for the State of Illinois, which is published at https://www.bls.gov/oes/current/ oessrcma.htm.

A) The hourly wage for unmet registered professional nurse hours will be determined by the most current median hourly wage available for RNs (defined as "registered nurses" with the BLS occupational code 29-1141) in the metropolitan area in which the nursing facility is located.

B) The hourly wage for unmet licensed practical nurse hours will be determined by the most recent median hourly wage available for LPNs (defined as "licensed practical and licensed vocational nurses" with the BLS occupational code 29-2061) in the metropolitan area in which the nursing facility is located.

C) The hourly wage for unmet hours of direct care staff who are not registered nurses or licensed practical nurses will be determined by the most recent median hourly wage available for CNAs (defined as "nursing assistants" with the BLS occupational code 31-1014) in the metropolitan area in which the nursing facility is located.

2) The Department will use the following formulas to determine the wage cost for each day's unmet direct care staffing hours when a staffing-hours shortfall is greater than zero. For the purposes of this Section, "median wage" refers to the BLS wage rate for the metropolitan or nonmetropolitan area in which the facility is located.

A) The cost of RN hours shortfall = the RN hours shortfall x the median RN wage.

B) The cost of LPN hours shortfall = the LPN hours shortfall x the median LPN wage.

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C) The cost of direct care hours shortfall = the direct care hours shortfall x the median CNA wage.

3) The Department will use the following procedures to add the cost of benefits to the cost of hourly wages identified in subsection (d)(2):

A) The Department will use a multiplier of 120% of the hourly wage that would have been paid for each hour of deficiency in skilled, intermediate or direct care. When calculating, under this subsection (d)(3), the combined wage and benefit value basis to determine a penalty for each violation, the wage per hour values shall be determined by the most recent cost reports filed with the Department of Healthcare and Family Services by facilities licensed under the Nursing Home Care Act.

B) The Department will calculate the total compensation costs (employee wages and benefits) of unmet direct care staffing hours using the following formula, which applies a multiplier based on the percentage identified in subsection (d)(3)(A) to the total direct care staffing hour shortfalls identified in subsections (d)(2)(A), (B), and (C):

Total Compensation Cost of Unmet Direct Care Staffing Hours = (1.0 + (the Cost of Benefits Per Hour Worked/the Cost of Wages Per Hour Worked)) X (Cost of RN Hours Shortfall + Cost of LPN Hours Shortfall + Cost of Direct Care Hours Shortfall)

4) The total penalty amount will be calculated based on the total compensation cost of unmet direct care staffing hours calculated in subsection (d)(3)(B), as follows:

A) If the violation is the facility's first violation for unmet direct care staffing hours, the Total Compensation Cost for Unmet Direct Care Staffing Hours will be multiplied by 125%.

B) If the violation is the facility's second violation for unmet direct care staffing hours, the Total Compensation Cost for Unmet Direct Care Staffing Hours will be multiplied by 150%.

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C) If the violation is the facility's third violation or any violation beyond the third, the Total Compensation Cost for Unmet Direct Care Staffing Hours will be multiplied by 200%.

D) Any shortfall of hours within a quarter, regardless of whether the shortfall is in all or only one direct care staff category, constitutes one violation. e) If the person or facility against whom a penalty has been assessed does not comply with a written demand for payment within 30 days after receiving a notice of violation, the Department will issue an order to do any of the following:

1) Direct the State Treasurer or Comptroller to deduct the amount of the fine from amounts otherwise due from the State for the penalty and remit that amount to the Department;

2) Add the amount of the penalty to the facility's licensing fee. If the licensee refuses to make the payment at the time of application for renewal of its license, the license shall not be renewed; or

3) Bring an action in circuit court to recover the amount of the penalty. (Section 3-310 of the Act)

(Source: Added at 45 Ill. Reg. 1134, effective January 8, 2021)

ILLINOIS REGISTER 1182 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

Section 300.APPENDIX A Example of Staffing Calculations from Section 300.1230Interpretation, Components, and Illustrative Services for Intermediate Care Facilities and Skilled Nursing Facilities: (Repealed)

A. Following is an example of staffing calculations assuming a 100-bed Skilled Nursing Facility that has 25 residents needing skilled care and 75 residents needing intermediate care.

Under Section 300.1230(d) requirements, staffing would be computed as follows:

1. Total Minimum Hours of Care Needed

Total Hrs. Total Hrs. Needed Per Needed Per Level of # of Day Per Day Per Care Residents Resident Facility

Skilled 25 [times] 3.8 = 95.0

Intermediate 75 [times] 2.5 = 187.5

Total Hours Needed 282.5

2. Licensed Practical Nurse (LPN) Hours Required

Total Hrs. Needed Per Minimum Level of Day Per Minimum LPN Hrs. Care Facility Percent Required Skilled 95.0 [times] 25% = 23.75 Intermediate 187.5 [times] 25% = 46.875

Total LPN Hours Needed 70.625

3. Registered Professional Nurse (RN) Hours Required

ILLINOIS REGISTER 1183 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

Total Hrs. Needed Per Minimum Level of Day Per Minimum RN Hrs. Care Facility Percent Required Skilled 95.0 [times] 10% = 9.5 Intermediate 187.5 [times] 10% = 18.75

Total RN Hours Needed 28.25

4. Additional Direct Care Hours*

# of Additional Total Hrs. Direct Care Needed Per Licensed Staff Hrs.* Level of Day Per Nurse Needed Care Facility Hours Per Day Skilled 95.0 [minus] 23.75 = 71.25 Intermediate 187.5 [minus] 46.875 = 140.625

Additional Direct Care Hours Needed 211.875

*See Section 300.1230(k).

(Source: Former Appendix A repealed at 23 Ill. Reg. 8106, effective July 15, 1999; new Appendix A added at 45 Ill. Reg. 1134, effective January 8, 2021)

ILLINOIS REGISTER 1184 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

Section 300.APPENDIX B Crosswalk of Nursing Home Care Act Job Descriptions and Payroll Based Journal Job TitlesClassification of Distinct Part of a Facility for Different Levels of Service (Repealed)

Nursing Staff Illinois Category PBJ Job Title Code PBJ Job Description Section 300.1230(i) Section 300.1230(i)(1) Job Titles 5, 7, 13 and 14 Registered Nurse Registered Nurses Registered Nurse, DON Section 300.1230(i)(7) Nurse Practitioner Assistant Directors of Clinical Nurse Specialist Nursing (DON) and (i)(8) 50% DON Section 300.1230(i)(2) Job Title 9 Licensed Practical/Vocational Licensed Practical Nurse Nurse Section 300.1230(i)(3) Job Titles 10, 11 and 12 Certified Nurse Aide Certified Nurse Assistants Nurse Aide in Training Medication Aide/Technician

Non-Nurse Direct Care Staff Illinois Category PBJ Job Title Code PBJ Job Description Section 300.1230(i) Section 300.1230(i)(4) Job Title 34 Mental Health Service Psychiatric Services Worker Rehabilitation Aide Section 300.1230(i)(6) Psychiatric Services Rehabilitation Coordinator Section 300.1230(i)(5) Job Titles 19, 20, 22, 23, 25 Occupational Therapy Rehabilitation and Therapy and 29 Assistant Aides Occupational Therapy Aide Physical Therapy Assistant Physical Therapy Aide Respiratory Therapy Technician Other Activities Staff Section 300.1230(i)(9) Job Titles 28 and 30 Qualified Activities 30% of Social Services Professional

ILLINOIS REGISTER 1185 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF ADOPTED AMENDMENTS

Director Qualified Social Worker Section 300.1230(i)(10) Job Titles 18, 21, 24, 26 Occupational Therapist Licensed Physical, Physical Therapy Therapist Occupational, Speech, and Respiratory Therapist Respiratory Therapists Speech/Language Pathologist

(Source: Former Appendix B repealed at 16 Ill. Reg. 17089, effective November 3, 1992; new Appendix B added at 45 Ill. Reg. 1134, effective January 8, 2021)

ILLINOIS REGISTER 1186 21 DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

NOTICE OF EMERGENCY AMENDMENT

1) Heading of the Part: Illinois Credit Union Act

2) Code Citation: 38 Ill. Adm. Code 190

3) Section Number: Emergency Action: 190.230 New Section

4) Statutory Authority: Implementing and authorized by the Illinois Credit Union Act [205 ILCS 305].

5) Effective Date of Rule: January 8, 2021

6) If this emergency rule is to expire before the end of the 150-day period, please specify the date on which it is to expire: The Department has not set a date for the emergency to expire before the end of the 150-day period.

7) Date Filed with Index Department: January 8, 2021

8) A copy of the emergency rule, including any material incorporated by reference, is on file in the Division of Financial and Professional Regulation's principal office of the Division of Professional Regulation and is available for public inspection.

9) Reason for Emergency: The Department finds that the COVID-19 pandemic reasonably constitutes a threat to the public interest, safety, or welfare and that members physically attending meetings poses risks to public health. Remote meetings promote social distancing and reduce the risk of virus transmission. The amendment is also consistent with flexibility provided by the National Credit Union Association due to the COVID-19 pandemic.

10) A Complete Description of the Subjects and Issues Involved: The amendment permits the Board of Directors of Credit Unions to provide by resolution that all members may attend, participate in, act, and vote at the annual meeting or special meeting of the members through audio or video conference or other communication technology that enables meeting participants to communicate with each other. The rule provides that attendance through such means shall constitute in person attendance. Permitting remote meeting eliminates unnecessary travel and will likely lead to greater member participation. The Board of Directors is in the best position to determine whether remote meetings are appropriate for a specific credit union. Remote meetings are commonly permitted in other contexts (e.g. shareholder meetings) under Illinois law. This

ILLINOIS REGISTER 1187 21 DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

NOTICE OF EMERGENCY AMENDMENT

amendment also modernizes the Act by removing ambiguity regarding the permissibility of remote meetings.

The language is materially consistent with language in many other Illinois laws including the General Not For Profit Corporation Act of 1986 and the Business Incorporation Act of 1983.

11) Are there any other rulemakings pending on this Part? No

12) Statement of Statewide Policy Objective: This rulemaking will not require a local government to establish, expand or modify its activities in such a way as to necessitate additional expenditures from local revenues.

13) Information and questions regarding this emergency rule shall be directed to: Persons who wish to comment on this emergency rule may submit written comments no later than 45 days after the publication of this Notice to:

Department of Financial and Professional Regulation Attention: Craig Cellini 320 West Washington, 2nd Floor Springfield IL 62786

217/785-0813 fax: 217/557-445

The full text of the Emergency Amendment begins on the next page:

ILLINOIS REGISTER 1188 21 DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

NOTICE OF EMERGENCY AMENDMENT

TITLE 38: FINANCIAL INSTITUTIONS CHAPTER I: DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

PART 190 ILLINOIS CREDIT UNION ACT

SUBPART A: GENERAL PROVISIONS

Section 190.2 Definitions 190.5 Credit Union Service Organizations 190.10 Field of Membership Procedures 190.15 Civil Penalty 190.20 Hearings 190.25 Regulatory Examination Consistency and Due Process 190.30 Cease and Desist Procedures 190.40 Removal or Suspension Procedures 190.50 Fees 190.60 General Accounting Procedures 190.70 Loan Loss Accounting Procedures 190.80 Use of Electronic Data Processing 190.90 Fixed Asset Investments 190.100 Classes of Share and Special Purpose Share Accounts 190.110 Share Drafts 190.120 Bond and Insurance Requirements 190.130 Verification of Share and Loan Accounts 190.140 Real Estate Lending 190.150 Reverse Mortgage (Repealed) 190.160 Lending Limits – Consumer Loans 190.165 Business Loans 190.170 Group Purchasing 190.180 Investments 190.185 Investment in "Other Financial Institutions" 190.190 Liquidation 190.200 Conversion of Charter 190.210 Reimbursement for Financial Records 190.220 Registration of Out of State Credit Unions 190.230 Remote Meetings EMERGENCY

ILLINOIS REGISTER 1189 21 DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

NOTICE OF EMERGENCY AMENDMENT

SUBPART B: HIGH RISK HOME LOANS

Section 190.500 Definitions (Repealed) 190.505 Applicability of Rule (Repealed) 190.510 Good Faith Requirements (Repealed) 190.515 Fraudulent or Deceptive Practices (Repealed) 190.520 Prohibited Refinances (Repealed) 190.525 Negative Amortization (Repealed) 190.530 Negative Equity (Repealed) 190.535 Balloon Payments (Repealed) 190.540 Financing of Certain Points and Fees (Repealed) 190.545 Financing of Single Premium Insurance Products (Repealed) 190.550 Lending Without Due Regard to Ability to Repay (Repealed) 190.555 Verification of Ability to Repay (Repealed) 190.560 Payments to Contractors (Repealed) 190.565 Counseling Prior to Perfecting Foreclosure (Repealed) 190.570 Mortgage Awareness Program (Repealed) 190.575 Offer of Mortgage Awareness Program (Repealed) 190.580 Third Party Review (Repealed)

SUBPART C: PAYDAY LOANS

Section 190.600 Definitions 190.601 Purpose and Scope 190.605 Applicability of Rule 190.610 Issuance of Payday Loans by Credit Unions

190.APPENDIX A Estimated Monthly Income and Expenses Worksheet (Repealed) 190.APPENDIX B Mortgage Ratio Worksheet (Repealed)

AUTHORITY: Implementing and authorized by the Illinois Credit Union Act [205 ILCS 305].

SOURCE: Adopted at 4 Ill. Reg. 20, p. 17, effective May 7, 1980; amended at 6 Ill. Reg. 11154, effective September 7, 1982; amended and codified at 7 Ill. Reg. 14973, effective October 26, 1983; emergency amendment at 9 Ill. Reg. 14378, effective September 11, 1985, for a maximum of 150 days; amended at 9 Ill. Reg. 16231, effective October 10, 1985; amended at 10 Ill. Reg.

ILLINOIS REGISTER 1190 21 DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

NOTICE OF EMERGENCY AMENDMENT

14667, effective August 27, 1986; amended at 12 Ill. Reg. 10464, effective June 7, 1988; amended at 12 Ill. Reg. 17383, effective October 24, 1988; amended at 13 Ill. Reg. 3793, effective March 10, 1989; amended at 13 Ill. Reg. 15998, effective October 2, 1989; emergency amendment at 16 Ill. Reg. 12781, effective July 29, 1992, for a maximum of 150 days; amended at 16 Ill. Reg. 17073, effective October 26, 1992; amended at 19 Ill. Reg. 2826, effective February 24, 1995; amended at 20 Ill. Reg. 5803, effective April 8, 1996; emergency amendment at 20 Ill. Reg. 13093, effective September 27, 1996, for a maximum of 150 days; emergency expired February 17, 1997; amended at 22 Ill. Reg. 17317, effective September 15, 1998; emergency amendment at 23 Ill. Reg. 3086, effective February 23, 1999, for a maximum of 150 days; emergency expired July 22, 1999; amended at 23 Ill. Reg. 12614, effective October 4, 1999; amended at 23 Ill. Reg. 14031, effective November 12, 1999; amended at 25 Ill. Reg. 6244, effective May 17, 2001; amended at 25 Ill. Reg. 13278, effective October 19, 2001; amended at 26 Ill. Reg. 17999, effective December 9, 2002; amended at 28 Ill. Reg. 11699, effective July 29, 2004; amended at 29 Ill. Reg. 10579, effective July 8, 2005; amended at 30 Ill. Reg. 18919, effective December 4, 2006; amended at 32 Ill. Reg. 1377, effective January 16, 2008; amended at 34 Ill. Reg. 10500, effective July 12, 2010; amended at 37 Ill. Reg. 12450, effective July 16, 2013; amended at 38 Ill. Reg. 19910, effective October 17, 2014; amended at 41 Ill. Reg. 4764, effective May 1, 2017; amended at 41 Ill. Reg. 11307, effective August 28, 2017; amended at 43 Ill. Reg. 303, effective January 1, 2019; amended at 44 Ill. Reg. 18320, effective November 13, 2020; emergency amendment at 45 Ill. Reg. 1186, effective January 8, 2021, for a maximum of 150 days.

SUBPART A: GENERAL PROVISIONS

Section 190.230 Remote Meetings EMERGENCY

Unless expressly prohibited by the articles of incorporation or bylaws and subject to requirements of the Illinois Credit Union Act, the Board of Directors of a Credit Union may provide by resolution that members may attend, participate in, act, and vote at any annual meetings or special meetings through the use of a conference telephone or interactive technology, including but not limited to electronic transmission, internet usage, or remote communication, by means of which persons participating in the meeting can communicate with each other. Participation through the use of a conference telephone or interactive technology shall constitute attendance, presence, and representation in person at the annual meeting or special meeting of the person or persons so participating and count towards quorum.

(Source: Added by emergency rulemaking at 45 Ill. Reg. 1186, effective January 8, 2021, for a maximum of 150 days)

ILLINOIS REGISTER 1191 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF EMERGENCY AMENDMENT

1) Heading of the Part: Long Term Care Reimbursement Changes

2) Code Citation: 89 Ill. Adm. Code 153

3) Section Number: Emergency Action: 153.125 Amendment

4) Statutory Authority: Section 12-13 of the Illinois Public Aid Code [305 ILCS 5/12-13]

5) Effective Date of Rule: January 6, 2021

6) If this emergency amendment is to expire before the end of the 150-day period, please specify the date on which it is to expire: Upon adoption of the proposed general rulemaking.

7) Date Filed with the Index Department: January 6, 2021

8) A copy of the emergency rule, including any materials incorporated by reference, is on file in the Agency's principal office and is available for public inspection.

9) Reason for Emergency: PA 101-636 amends Section 5.5.4 of the Illinois Public Aid Code and requires the Department to increase reimbursement rates under the medical assistance program for ID/DD facilities and MC/DD facilities and to adopt emergency rules to implement the provisions of this Section. The General Assembly deems the adoption of these emergency rules to be necessary for the public interest, safety, and welfare.

10) Complete Description of the Subjects and Issues Involved: This emergency amendment implements medical assistance program reimbursement rate increases for facilities licensed under ID/DD Community Care Act and the MC/DD Act as required by PA 101- 636.

11) Are there any other rulemakings pending on this Part? No

12) Statement of Statewide Policy Objective: This rulemaking is not anticipated to create nor expand a State mandate on units of local government.

13) Information and questions regarding this emergency rule shall be directed to:

ILLINOIS REGISTER 1192 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF EMERGENCY AMENDMENT

Steffanie Garrett General Counsel Illinois Department of Healthcare and Family Services 201 South Grand Avenue E., 3rd Floor Springfield IL 62763-0002

[email protected]

The full text of the Emergency Amendment begins on the next page:

ILLINOIS REGISTER 1193 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF EMERGENCY AMENDMENT

TITLE 89: SOCIAL SERVICES CHAPTER I: DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES SUBCHAPTER e: GENERAL TIME-LIMITED CHANGES

PART 153 LONG TERM CARE REIMBURSEMENT CHANGES

Section 153.100 Reimbursement for Long Term Care Services 153.125 Long Term Care Facility Rate Adjustments EMERGENCY 153.126 Long Term Care Facility Medicaid Per Diem Adjustments 153.150 Quality Assurance Review (Repealed)

AUTHORITY: Implementing and authorized by Articles III, IV, V, VI and Section 12-13 of the Illinois Public Aid Code [305 ILCS 5/Arts. III, IV, V and VI and 12-13].

SOURCE: Emergency rules adopted at 18 Ill. Reg. 2159, effective January 18, 1994, for maximum of 150 days; adopted at 18 Ill. Reg. 10154, effective June 17, 1994; emergency amendment at 18 Ill. Reg. 11380, effective July 1, 1994, for a maximum of 150 days; amended at 18 Ill. Reg. 16669, effective November 1, 1994; emergency amendment at 19 Ill. Reg. 10245, effective June 30, 1995, for a maximum of 150 days; amended at 19 Ill. Reg. 16281, effective November 27, 1995; emergency amendment at 20 Ill. Reg. 9306, effective July 1, 1996, for a maximum of 150 days; amended at 20 Ill. Reg. 14840, effective November 1, 1996; emergency amendment at 21 Ill. Reg. 9568, effective July 1, 1997, for a maximum of 150 days; amended at 21 Ill. Reg. 13633, effective October 1, 1997; emergency amendment at 22 Ill. Reg. 13114, effective July 1, 1998, for a maximum of 150 days; amended at 22 Ill. Reg. 16285, effective August 28, 1998; amended at 22 Ill. Reg. 19872, effective October 30, 1998; emergency amendment at 23 Ill. Reg. 8229, effective July 1, 1999, for a maximum of 150 days; emergency amendment at 23 Ill. Reg. 12794, effective October 1, 1999, for a maximum of 150 days; amended at 23 Ill. Reg. 13638, effective November 1, 1999; emergency amendment at 24 Ill. Reg. 10421, effective July 1, 2000, for a maximum of 150 days; amended at 24 Ill. Reg. 15071, effective October 1, 2000; emergency amendment at 25 Ill. Reg. 8867, effective July 1, 2001, for a maximum of 150 days; amended at 25 Ill. Reg. 14952, effective November 1, 2001; emergency amendment at 26 Ill. Reg. 6003, effective April 11, 2002, for a maximum of 150 days; emergency amendment repealed at 26 Ill. Reg. 12791, effective August 9, 2002, for a maximum of 150 days; emergency amendment at 26 Ill. Reg. 11087, effective July 1, 2002, for a maximum of 150 days; amended at 26 Ill. Reg. 17817, effective November 27, 2002; emergency amendment at 27 Ill. Reg. 11088, effective July 1, 2003, for a maximum of 150 days; amended at

ILLINOIS REGISTER 1194 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF EMERGENCY AMENDMENT

27 Ill. Reg. 18880, effective November 26, 2003; emergency amendment at 28 Ill. Reg. 10218, effective July 1, 2004, for a maximum of 150 days; amended at 28 Ill. Reg. 15584, effective November 24, 2004; emergency amendment at 29 Ill. Reg. 1026, effective January 1, 2005, for a maximum of 150 days; emergency amendment at 29 Ill. Reg. 4740, effective March 18, 2005, for a maximum of 150 days; amended at 29 Ill. Reg. 6979, effective May 1, 2005; amended at 29 Ill. Reg. 12452, effective August 1, 2005; emergency amendment at 30 Ill. Reg. 616, effective January 1, 2006, for a maximum of 150 days; emergency amendment modified pursuant to the Joint Committee on Administrative Rules Objection at 30 Ill. Reg. 7817, effective April 7, 2006, for the remainder of the maximum 150 days; amended at 30 Ill. Reg. 10417, effective May 26, 2006; emergency amendment at 30 Ill. Reg. 11853, effective July 1, 2006, for a maximum of 150 days; emergency expired November 27, 2006; amended at 30 Ill. Reg. 14315, effective August 18, 2006; emergency amendment at 30 Ill. Reg. 18779, effective November 28, 2006, for a maximum of 150 days; amended at 31 Ill. Reg. 6954, effective April 26, 2007; emergency amendment at 32 Ill. Reg. 535, effective January 1, 2008, for a maximum of 150 days; emergency amendment at 32 Ill. Reg. 4105, effective March 1, 2008, for a maximum of 150 days; amended at 32 Ill. Reg. 7761, effective May 5, 2008; amended at 32 Ill. Reg. 9972, effective June 27, 2008; amended at 33 Ill. Reg. 9347, effective July 1, 2009; emergency amendment at 34 Ill. Reg. 17462, effective November 1, 2010, for a maximum of 150 days; amended at 35 Ill. Reg. 6171, effective March 28, 2011; amended at 35 Ill. Reg. 19524, effective December 1, 2011; emergency amendment at 36 Ill. Reg. 10416, effective July 1, 2012 through June 30, 2013; amended at 36 Ill. Reg. 17405, effective December 1, 2012; amended at 37 Ill. Reg. 10529, effective June 27, 2013; emergency amendment at 38 Ill. Reg. 15732, effective July 7, 2014, for a maximum of 150 days; amended at 38 Ill. Reg. 23799, effective December 2, 2014; emergency amendment at 39 Ill. Reg. 6956, effective May 1, 2015 through June 30, 2015; emergency amendment at 41 Ill. Reg. 12632, effective September 25, 2017, for a maximum of 150 days; amended at 42 Ill. Reg. 4594, effective February 20, 2018; emergency amendment at 42 Ill. Reg. 16562, effective August 27, 2018, for a maximum of 150 days; emergency expired January 23, 2019; amended at 43 Ill. Reg. 2253, effective February 4, 2019; emergency amendment at 45 Ill. Reg. 1191, effective January 6, 2021, for a maximum of 150 days.

Section 153.125 Long Term Care Facility Rate Adjustments EMERGENCY

a) Notwithstanding the provisions set forth in Section 153.100, long term care facility (SNF/ICF and ICF/MR) rates established on July 1, 1996 shall be increased by 6.8 percent for services provided on or after January 1, 1997.

b) Notwithstanding the provisions set forth in Section 153.100, long term care facility (SNF/ICF and ICF/MR) rates and developmental training rates established

ILLINOIS REGISTER 1195 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF EMERGENCY AMENDMENT

on July 1, 1998, for services provided on or after that date, shall be increased by three percent. For nursing facilities (SNF/ICF) only, $1.10 shall also be added to the nursing component of the rate. c) Notwithstanding the provisions set forth in Section 153.100, long term care facility (SNF/ICF and ICF/MR) rates and developmental training rates established on July 1, 1999, for services provided on or after that date, shall include:

1) an increase of 1.6 percent for SNF/ICF, ICF/MR and developmental training rates;

2) an additional increase of $3.00 per resident day for ICF/MR rates; and

3) an increase of $10.02 per person, per month for developmental training rates. d) Notwithstanding the provisions set forth in Section 153.100, SNF/ICF rates shall be increased by $4.00 per resident day for services provided on or after October 1, 1999. e) Notwithstanding the provisions set forth in Section 153.100, SNF/ICF, ICF/MR and developmental training rates shall be increased 2.5 percent per resident day for services provided on or after July 1, 2000. f) Notwithstanding the provisions set forth in Section 153.100, nursing facility (SNF/ICF) rates effective on July 1, 2001 shall be computed using the most recent cost reports on file with the Department no later than April 1, 2000, updated for inflation to January 1, 2001.

1) The Uniform Building Value shall be as defined in 89 Ill. Adm. Code 140.570(b)(10), except that, as of July 1, 2001, the definition of current year is the year 2000.

2) The real estate tax bill that was due to be paid in 1999 by the nursing facility shall be used in determination of the capital component of the rate. The real estate tax component shall be removed from the capital rate if the facility's status changes so as to be exempt from assessment to pay real estate taxes.

ILLINOIS REGISTER 1196 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF EMERGENCY AMENDMENT

3) For rates effective July 1, 2001 only, rates shall be the greater of the rate computed for July 1, 2001 or the rate effective on June 30, 2001.

4) All accounting records and other documentation necessary to support the costs and other information reported on the cost report to be used in accordance with rate setting under Section 153.125(f) shall be kept for a minimum of two years after the Department's final payment using rates that were based in part on that cost report. g) Notwithstanding the provisions set forth in Section 153.100, intermediate care facilities for persons with developmental disabilities (ICF/MR), including skilled nursing facilities for persons under 22 years of age (SNF/Ped), shall receive an increase in rates for residential services equal to a statewide average of 7.85 percent. Residential rates taking effect March 1, 2001, for services provided on or after that date, shall include an increase of 11.01 percent to the residential program rate component and an increase of 3.33 percent to the residential support rate component, each of which shall be adjusted by the geographical area adjuster, as defined by the Department of Human Services (DHS). h) For developmental training services provided on or after March 1, 2001, for residents of long term care facilities, rates shall include an increase of 9.05 percent and rates shall be adjusted by the geographical area adjuster, as defined by DHS. i) Notwithstanding the provisions set forth in Section 153.100, daily rates for intermediate care facilities for persons with developmental disabilities (ICF/MR), including skilled long term care facilities for persons under 22 years of age (SNF/Ped), shall be increased by 2.247 percent for services provided during the period beginning on April 11, 2002, and ending on June 30, 2002. j) Notwithstanding the provisions set forth in Section 153.100, daily rates effective on July 1, 2002, for intermediate care facilities for persons with developmental disabilities (ICF/MR), including skilled long term care facilities for persons under 22 years of age (SNF/Ped), shall be reduced to the level of the rates in effect on April 10, 2002. k) Notwithstanding the provisions set forth in Section 153.100, nursing facility (SNF/ICF) rates effective on July 1, 2002 will be 5.9 percent less than the rates in effect on June 30, 2002.

ILLINOIS REGISTER 1197 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF EMERGENCY AMENDMENT

l) Notwithstanding the provisions set forth in Section 153.100, daily rates effective on July 1, 2003, for intermediate care facilities for persons with developmental disabilities (ICF/MR), including skilled long term care facilities for persons under 22 years of age (SNF/Ped), shall be increased by 3.59 percent. m) Notwithstanding the provisions set forth in Section 153.100, developmental training rates effective on July 1, 2003 shall be increased by 4 percent. n) Notwithstanding the provisions set forth in Section 153.100, pending the approvals described in this subsection (n), nursing facility (SNF/ICF) rates effective July 1, 2004 shall be 3.0 percent greater than the rates in effect on June 30, 2004. The increase is contingent on approval of both the payment methodologies required under Article 5A-12 of the Public Aid Code [305 ILCS 5/5A-12] and the waiver granted under 42 CFR 433.68. o) Notwithstanding the provisions set forth in Section 153.100, the "Original Building Base Cost" for nursing facilities (SNF/ICF) which have been rented continuously from an unrelated party since prior to January 1, 1978, effective on July 1, 2004, shall be added to the capital rate calculation using the most recent cost reports on file with the Department no later than June 30, 2004. The "Original Building Base Cost" as defined in 89 Ill. Adm. Code 140.570 shall be calculated from the original lease information that is presently on file with the Department. This original lease information will be used to capitalize the oldest available lease payment from the unrelated party lease that has been in effect since prior to January 1, 1978, and continued to be in effect on December 31, 1999. Before the lease payment is capitalized, a 15 percent portion will be removed from the oldest available lease payment for movable equipment costs. After the lease payment is capitalized, a portion of the capitalized amount will be removed for land cost. The land cost portion is 4.88 percent. The remaining amount will be the facility's building cost. The construction/acquisition year for the building will be the date the pre-1978 lease began. The allowable cost of subsequent improvements to the building will be included in the original building base cost. The original building base cost will not change due to sales or leases of the facility after January 1, 1978. p) Notwithstanding the provisions set forth in Section 153.100, nursing facility (SNF/ICF) rates effective on January 1, 2005 will be 3.0 percent more than the rates in effect on December 31, 2004.

ILLINOIS REGISTER 1198 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF EMERGENCY AMENDMENT

q) Notwithstanding the provisions set forth in Section 153.100, nursing facility (SNF/ICF) rates shall be increased by the difference between a facility's per diem property, liability and malpractice insurance costs as reported in the cost report that was filed with the Department and used to establish rates effective July 1, 2001, and those same costs as reported in the facility's 2002 cost report. These costs shall be passed through to the facility without caps or limitations. r) Notwithstanding the provisions set forth in Section 153.100, daily rates effective on January 1, 2006 for intermediate care facilities for persons with developmental disabilities (ICF/MR), including skilled long term care facilities for persons under 22 years of age (SNF/Ped), shall be increased by 3 percent. s) Notwithstanding the provisions set forth in Section 153.100, developmental training rates for intermediate care facilities for persons with developmental disabilities (ICF/MR), including skilled long term care facilities for persons under 22 years of age (SNF/Ped), effective on January 1, 2006 shall be increased by 3 percent. t) Notwithstanding the provisions set forth in Section 153.100, for facilities that are federally defined as Institutions for Mental Disease (see Section 145.30), a socio-development component rate equal to 6.6% of the nursing component rate as of January 1, 2006 shall be established and paid effective July 1, 2006. This rate shall become a part of the facility's nursing component of the Medicaid rate. While this rate may be adjusted by the Department, the rate shall not be reduced. u) Notwithstanding any other provision of this Section, for facilities licensed by the Department of Public Health under the Nursing Home Care Act as skilled nursing facilities or intermediate care facilities, the support component of the rates taking effect on January 1, 2008 shall be computed using the most recent cost reports on file with the Department of Healthcare and Family Services no later than April 1, 2005, updated for inflation to January 1, 2006.

1) Support rates taking effect on January 1, 2008 shall be adjusted based on audits of cost report data in accordance with 89 Ill. Adm. Code 140.582(b) and 140.590. The audited cost report data will be used to retroactively update the resulting support rate effective January 1, 2008, after the 45-day appeal period from Section 140.582(b) has passed.

ILLINOIS REGISTER 1199 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF EMERGENCY AMENDMENT

2) All accounting records and other documentation necessary to support the costs and other information reported on the cost report to be used in accordance with rate setting under this subsection (u) shall be kept for a minimum of two years after the Department's final payment using rates that were based in part on that cost report. v) Notwithstanding the provisions set forth in Section 153.100, pursuant to Public Act 95-0744, for services beginning August 1, 2008, the socio-development component for facilities that are federally defined as Institutions for Mental Disease (see 89 Ill. Adm. Code 145.30) shall equal 6.6% of the facility's nursing component rate as of January 1, 2006, multiplied by a factor of 3.53. w) Notwithstanding the provisions set forth in Section 153.100, pursuant to Public Act 95-0744, for services beginning January 1, 2009, the support component for skilled and intermediate care facilities that was effective on January 1, 2008, computed using the most recent cost reports on file with the Department of Healthcare and Family Services no later than April 1, 2005, updated for inflation to January 1, 2006, shall be increased to the amount that would have been derived using standard Department of Healthcare and Family Services methods, procedures and inflators described in Sections 140.533, 140.551, 140.553 and 140.561. x) Notwithstanding the provisions set forth in Section 153.100, effective November 1, 2010, the program and support components of the per diem rate for ICF/MR qualifying under 89 Ill. Adm. Code 144.102 shall be adjusted in accordance with that Section. y) Notwithstanding the provisions set forth in Section 153.100, pursuant to Public Act 96-1530, for services beginning May 1, 2011, the socio-development component for facilities that are federally defined as Institutions for Mental Disease (IMD) (see 89 Ill. Adm. Code 145.30) and that are Medicaid certified will have the nursing component of their rate fully funded using the MDS methodology and will also receive an increase to their socio-development component rate. The socio-development component rate increase will be equal to two-thirds of the difference between the highest nursing rate among the Medicaid certified IMD facilities and the individual IMD's nursing rate. This rate change is subject to approval by the Centers for Medicare and Medicaid Services of the U.S. Department of Health and Human Services.

ILLINOIS REGISTER 1200 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF EMERGENCY AMENDMENT z) Notwithstanding the provisions set forth in Section 153.100, effective for services beginning May 1, 2011, facilities that are federally defined as Institutions for Mental Disease (see 89 Ill. Adm. Code 145.30) and determined to be Subpart T facilities (see 89 Ill. Adm. Code 145.10) will receive an increase to their socio-development component rate of $.50 per day, per resident. aa) Notwithstanding the provisions set forth in Section 153.100, effective for services beginning August 1, 2017, facilities licensed by the Department of Public Health under the ID/DD Community Care Act [210 ILCS 47] as an ID/DD facility and medically complex for the developmentally disabled facilities licensed under the MC/DD Act [210 ILCS 46] as an MC/DD facility will receive an increase to their reimbursement rates sufficient to provide a $0.75 per hour wage increase for non- executive staff. This increase shall apply to the facility per diem rates and developmental training rates. bb) Notwithstanding the provisions set forth in Section 153.100, effective for services beginning July 1, 2018, facilities licensed by the Department of Public Health under the ID/DD Community Care Act [210 ILCS 47] or MC/DD Act [210 ILCS 46] will receive an increase to the facility per diem rates and developmental training rates as follows:

1) Facilities outside the geographic boundaries of the City of Chicago will receive an increase to their reimbursement rates sufficient to provide a $0.50 per hour wage increase for front-line personnel.

2) Facilities inside the geographic boundaries of the City of Chicago will receive an increase to their reimbursement rates sufficient to provide a $0.54 per hour wage increase for front-line personnel. cc) Notwithstanding the provisions set forth in Section 153.100, pursuant to 305 ILCS 5/5-5.4(j), effective for services beginning July 1, 2018, the per diem rate will be increased by $21.15 for facilities with more than 16 beds licensed by the Department of Public Health under the ID/DD Community Care Act [210 ILCS 47] and located in the Department of Public Health's Planning Area 7-B. dd) Notwithstanding the provisions set forth in Section 153.100, facilities licensed by the Department of Public Health under ID/DD Community Care Act [210 ILCS 47] or MC/DD Act [210 ILCS 46] will receive an increase to their facility rate:

ILLINOIS REGISTER 1201 21 DEPARTMENT OF HEALTHCARE AND FAMILY SERVICES

NOTICE OF EMERGENCY AMENDMENT

1) Effective June 1, 2020, facilities will receive an increase to their reimbursement rates sufficient to provide a $0.26 per hour wage increase for non-executive staff.

2) Effective July 1, 2020, facilities will receive an increase to their reimbursement rates sufficient to provide a $1.00 per hour wage increase for non-executive staff. Facilities shall use these additional funds to provide a direct increase to wages for non-executive staff by at least $0.80 per hour, with priority given to direct care staff wages.

3) Effective January 1, 2021, facilities will receive an increase to their reimbursement rates sufficient to provide a $0.50 per hour wage increase for non-executive staff. Facilities shall use these additional funds to provide a direct increase to wages for non-executive staff by at least $0.40 per hour, with priority given to direct care staff wages.

(Source: Amended by emergency rulemaking at 45 Ill. Reg. 1191, effective January 6, 2021, for a maximum of 150 days)

ILLINOIS REGISTER 1202 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF EMERGENCY AMENDMENT

1) Heading of the Part: Hospital Licensing Requirements

2) Code Citation: 77 Ill. Adm. Code 250

3) Section Number: Emergency Action: 250.3 New Section

4) Statutory Authority: Hospital Licensing Act [210 ILCS 85]

5) Effective Date of Rule: January 8, 2021

6) If this emergency rule is to expire before the end of the 150-day period, please specify the date on which they are to expire: The emergency amendment will expire at the end of the 150-day period or upon repeal of the emergency rule.

7) Date Filed with the Index Department: January 8, 2021

8) A copy of the emergency rule, including any material incorporated by reference, is on file in the Agency's principal office and is available for public inspection.

9) Reason for Emergency: This emergency rule is adopted in response to Governor JB Pritzker's Gubernatorial Disaster Proclamations issued during 2020 related to COVID-19.

Section 5-45 of the Illinois Administrative Procedure Act [5 ILCS 100/5-45] defines "emergency" as "the existence of any situation that any agency finds reasonably constitutes a threat to the public interest, safety, or welfare." The COVID-19 outbreak in Illinois is a significant public health crisis that warrants these emergency rules.

10) A Complete Description of the Subjects and Issues Involved: This emergency amendment implements a new waiver from the Centers for Medicare and Medicaid Services (CMMS) that exempts qualifying hospitals from compliance with subsections 482.23(b) and (b)(1) of the Hospital Conditions of Participation (42 CFR 482). Qualifying hospitals will be permitted to provide limited inpatient services directly in a patient's home. The purpose of the CMMS waiver is to alleviate the strain on hospitals from increased hospitalizations and the consequent lack of resources due to the COVID- 19 pandemic, and to safely protect those with comorbidities from contracting COVID-19.

11) Are there any other rulemakings pending on this Part? No

ILLINOIS REGISTER 1203 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF EMERGENCY AMENDMENT

12) Statement of Statewide Policy Objective: This rulemaking will not create or expand a State mandate.

13) Information and questions regarding this emergency rule shall be directed to:

Elizabeth Paton Acting Rules Coordinator Division of Legal Services Illinois Department of Public Health 535 W. Jefferson St., 5th floor Springfield IL 62761

217/782-2043 [email protected]

The full text of the Emergency Amendment begins on the next page:

ILLINOIS REGISTER 1204 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF EMERGENCY AMENDMENT

TITLE 77: PUBLIC HEALTH CHAPTER I: DEPARTMENT OF PUBLIC HEALTH SUBCHAPTER b: HOSPITALS AND AMBULATORY CARE FACILITIES

PART 250 HOSPITAL LICENSING REQUIREMENTS

SUBPART A: GENERAL PROVISIONS

Section 250.1 COVID-19 Emergency Provisions EMERGENCY 250.2 COVID-19 Emergency Provisions for Hospitals, Hospital Alternate Care Facilities, and State Alternate Care Facilities EMERGENCY 250.3 COVID-19 Emergency Provisions – At-Home Patient Care EMERGENCY 250.100 Definitions 250.105 Incorporated and Referenced Materials 250.110 Application for and Issuance of Permit to Establish a Hospital 250.120 Application for and Issuance of a License to Operate a Hospital 250.130 Administration by the Department 250.140 Hearings 250.150 Definitions (Renumbered) 250.160 Incorporated and Referenced Materials (Renumbered)

SUBPART B: ADMINISTRATION AND PLANNING

Section 250.210 The Governing Board 250.220 Accounting 250.230 Planning 250.240 Admission and Discharge 250.245 Failure to Initiate Criminal Background Checks 250.250 Visiting Rules 250.260 Patients' Rights 250.265 Language Assistance Services 250.270 Manuals of Procedure 250.280 Agreement with Designated Organ Procurement Agencies

ILLINOIS REGISTER 1205 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF EMERGENCY AMENDMENT

250.285 Smoking Restrictions 250.290 Safety Alert Notifications

SUBPART C: THE MEDICAL STAFF

Section 250.310 Organization 250.315 House Staff Members 250.320 Admission and Supervision of Patients 250.330 Orders for Medications and Treatments 250.340 Availability for Emergencies

SUBPART D: PERSONNEL SERVICE

Section 250.410 Organization 250.420 Personnel Records 250.430 Duty Assignments 250.435 Health Care Worker Background Check 250.440 Education Programs 250.445 Workplace Violence Prevention Program 250.450 Personnel Health Requirements 250.460 Benefits

SUBPART E: LABORATORY

Section 250.510 Laboratory Services 250.520 Blood and Blood Components 250.525 Designated Blood Donor Program 250.530 Proficiency Survey Program (Repealed) 250.540 Laboratory Personnel (Repealed) 250.550 Western Blot Assay Testing Procedures (Repealed)

SUBPART F: RADIOLOGICAL SERVICES

Section 250.610 General Diagnostic Procedures and Treatments 250.620 Radioactive Isotopes

ILLINOIS REGISTER 1206 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF EMERGENCY AMENDMENT

250.630 General Policies and Procedures Manual

SUBPART G: GENERAL HOSPITAL EMERGENCY SERVICES

Section 250.710 Classification of Emergency Services 250.720 General Requirements 250.725 Notification of Emergency Personnel 250.730 Community or Areawide Planning 250.740 Disaster and Mass Casualty Program 250.750 Medical Forensic Services for Sexual Assault Survivors

SUBPART H: RESTORATIVE AND REHABILITATION SERVICES

Section 250.810 Applicability of Other Parts of These Requirements 250.820 General 250.830 Classifications of Restorative and Rehabilitation Services 250.840 General Requirements for all Classifications 250.850 Specific Requirements for Comprehensive Physical Rehabilitation Services 250.860 Medical Direction 250.870 Nursing Care 250.880 Additional Allied Health Services 250.890 Animal-Assisted Therapy

SUBPART I: NURSING SERVICE AND ADMINISTRATION

Section 250.910 Nursing Services 250.920 Organizational Plan 250.930 Role in hospital planning 250.940 Job descriptions 250.950 Nursing committees 250.960 Specialized nursing services 250.970 Nursing Care Plans 250.980 Nursing Records and Reports 250.990 Unusual Incidents 250.1000 Meetings 250.1010 Education Programs

ILLINOIS REGISTER 1207 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF EMERGENCY AMENDMENT

250.1020 Licensure 250.1030 Policies and Procedures 250.1035 Domestic Violence Standards 250.1040 Patient Care Units 250.1050 Equipment for Bedside Care 250.1060 Drug Services on Patient Unit 250.1070 Care of Patients 250.1075 Use of Restraints 250.1080 Admission Procedures Affecting Care 250.1090 Sterilization and Processing of Supplies 250.1100 Infection Control 250.1110 Mandatory Overtime Prohibition 250.1120 Staffing Levels 250.1130 Nurse Staffing by Patient Acuity

SUBPART J: SURGICAL AND RECOVERY ROOM SERVICES

Section 250.1210 Surgery 250.1220 Surgery Staff 250.1230 Policies & Procedures 250.1240 Surgical Privileges 250.1250 Surgical Emergency Care 250.1260 Operating Room Register and Records 250.1270 Surgical Patients 250.1280 Equipment 250.1290 Safety 250.1300 Operating Room 250.1305 Visitors in Operating Room 250.1310 Cleaning of Operating Room 250.1320 Postanesthesia Care Units

SUBPART K: ANESTHESIA SERVICES

Section 250.1410 Anesthesia Service

SUBPART L: RECORDS AND REPORTS

ILLINOIS REGISTER 1208 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF EMERGENCY AMENDMENT

Section 250.1510 Medical Records 250.1520 Reports

SUBPART M: FOOD SERVICE

Section 250.1610 Dietary Department Administration 250.1620 Facilities 250.1630 Menus and Nutritional Adequacy 250.1640 Diet Orders 250.1650 Frequency of Meals 250.1660 Therapeutic (Modified) Diets 250.1670 Food Preparation and Service 250.1680 Sanitation

SUBPART N: HOUSEKEEPING AND LAUNDRY SERVICES

Section 250.1710 Housekeeping 250.1720 Garbage, Refuse and Solid Waste Handling and Disposal 250.1730 Insect and Rodent Control 250.1740 Laundry Service 250.1750 Soiled Linen 250.1760 Clean Linen

SUBPART O: OBSTETRIC AND NEONATAL SERVICE

Section 250.1810 Applicability of Other Provisions of this Part 250.1820 Obstetric and Neonatal Service (Perinatal Service) 250.1830 General Requirements for All Obstetric Departments 250.1840 Discharge of Newborn Infants from Hospital 250.1845 Caesarean Birth 250.1850 Single Room Postpartum Care of Mother and Infant 250.1860 Special Programs (Repealed) 250.1870 Labor, Delivery, Recovery and Postpartum Care

SUBPART P: ENGINEERING AND MAINTENANCE OF THE PHYSICAL PLANT, SITE,

ILLINOIS REGISTER 1209 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF EMERGENCY AMENDMENT

EQUIPMENT, AND SYSTEMS – HEATING, COOLING, ELECTRICAL, VENTILATION, PLUMBING, WATER, SEWER, AND SOLID WASTE DISPOSAL

Section 250.1910 Maintenance 250.1920 Emergency electric service 250.1930 Water Supply 250.1940 Ventilation, Heating, Air Conditioning, and Air Changing Systems 250.1950 Grounds and Buildings Shall be Maintained 250.1960 Sewage, Garbage, Solid Waste Handling and Disposal 250.1970 Plumbing 250.1980 Fire and Safety

SUBPART Q: CHRONIC DISEASE HOSPITALS

Section 250.2010 Definition 250.2020 Requirements

SUBPART R: PHARMACY OR DRUG AND MEDICINE SERVICE

Section 250.2110 Service Requirements 250.2120 Personnel Required 250.2130 Facilities for Services 250.2140 Pharmacy and Therapeutics Committee

SUBPART S: PSYCHIATRIC SERVICES

Section 250.2210 Applicability of other Parts of these Regulations 250.2220 Establishment of a Psychiatric Service 250.2230 The Medical Staff 250.2240 Nursing Service 250.2250 Allied Health Personnel 250.2260 Staff and Personnel Development and Training 250.2270 Admission, Transfer and Discharge Procedures 250.2280 Care of Patients 250.2290 Special Medical Record Requirements for Psychiatric Hospitals and Psychiatric

ILLINOIS REGISTER 1210 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF EMERGENCY AMENDMENT

Units of General Hospitals or General Hospitals Providing Psychiatric Care 250.2300 Diagnostic, Treatment and Physical Facilities and Services

SUBPART T: DESIGN AND CONSTRUCTION STANDARDS

Section 250.2410 Applicability of these Standards 250.2420 Submission of Plans for New Construction, Alterations or Additions to Existing Facility 250.2430 Preparation of Drawings and Specifications – Submission Requirements 250.2440 General Hospital Standards 250.2442 Fees 250.2443 Advisory Committee 250.2450 Details 250.2460 Finishes 250.2470 Structural 250.2480 Mechanical 250.2490 Plumbing and Other Piping Systems 250.2500 Electrical Requirements

SUBPART U: CONSTRUCTION REQUIREMENTS FOR EXISTING HOSPITALS

Section 250.2610 Applicability of Subpart U 250.2620 Codes and Standards 250.2630 Existing General Hospital Requirements 250.2640 Details 250.2650 Finishes 250.2660 Mechanical 250.2670 Plumbing and Other Piping Systems 250.2680 Electrical Requirements

SUBPART V: SPECIAL CARE AND/OR SPECIAL SERVICE UNITS

Section 250.2710 Special Care and/or Special Service Units 250.2720 Day Care for Mildly Ill Children

SUBPART W: ALCOHOLISM AND INTOXICATION TREATMENT SERVICES

ILLINOIS REGISTER 1211 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF EMERGENCY AMENDMENT

Section 250.2810 Applicability of Other Parts of These Requirements 250.2820 Establishment of an Alcoholism and Intoxication Treatment Service 250.2830 Classification and Definitions of Service and Programs 250.2840 General Requirements for all Hospital Alcoholism Program Classifications 250.2850 The Medical and Professional Staff 250.2860 Medical Records 250.2870 Referral 250.2880 Client Legal and Human Rights

250.APPENDIX A Codes and Standards (Repealed) 250.EXHIBIT A Codes (Repealed) 250.EXHIBIT B Standards (Repealed) 250.EXHIBIT C Addresses of Sources (Repealed) 250.ILLUSTRATION A Seismic Zone Map 250.TABLE A Measurements Essential for Level I, II, III Hospitals 250.TABLE B Sound Transmission Limitations in General Hospitals 250.TABLE C Filter Efficiencies for Central Ventilation and Air Conditioning Systems in General Hospitals (Repealed) 250.TABLE D General Pressure Relationships and Ventilation of Certain Hospital Areas (Repealed) 250.TABLE E Piping Locations for Oxygen, Vacuum and Medical Compressed Air 250.TABLE F General Pressure Relationships and Ventilation of Certain Hospital Areas 250.TABLE G Insulation/Building Perimeter

AUTHORITY: Implementing and authorized by the Hospital Licensing Act [210 ILCS 85] and authorized by the Department of Public Health Act [20 ILCS 2305].

SOURCE: Rules repealed and new rules adopted August 27, 1978; emergency amendment at 2 Ill. Reg. 31, p. 73, effective July 24, 1978, for a maximum of 150 days; amended at 2 Ill. Reg. 21, p. 49, effective May 16, 1978; emergency amendment at 2 Ill. Reg. 31, p. 73, effective July 24, 1978, for a maximum of 150 days; amended at 2 Ill. Reg. 45, p. 85, effective November 6, 1978; amended at 3 Ill. Reg. 17, p. 88, effective April 22, 1979; amended at 4 Ill. Reg. 22, p. 233, effective May 20, 1980; amended at 4 Ill. Reg. 25, p. 138, effective June 6, 1980; amended at 5 Ill. Reg. 507, effective December 29, 1980; amended at 6 Ill. Reg. 575, effective December 30, 1981; amended at 6 Ill. Reg. 1655, effective January 27, 1982; amended at 6 Ill. Reg. 3296, effective March 15, 1982; amended at 6 Ill. Reg. 7835 and 7838, effective June 17, 1982; amended at 7 Ill. Reg. 962, effective January 6, 1983; amended at 7 Ill. Reg. 5218 and 5221,

ILLINOIS REGISTER 1212 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF EMERGENCY AMENDMENT effective April 4, 1983 and April 5, 1983; amended at 7 Ill. Reg. 6964, effective May 17, 1983; amended at 7 Ill. Reg. 8546, effective July 12, 1983; amended at 7 Ill. Reg. 9610, effective August 2, 1983; codified at 8 Ill. Reg. 19752; amended at 8 Ill. Reg. 24148, effective November 29, 1984; amended at 9 Ill. Reg. 4802, effective April 1, 1985; amended at 10 Ill. Reg. 11931, effective September 1, 1986; amended at 11 Ill. Reg. 10283, effective July 1, 1987; amended at 11 Ill. Reg. 10642, effective July 1, 1987; amended at 12 Ill. Reg. 15080, effective October 1, 1988; amended at 12 Ill. Reg. 16760, effective October 1, 1988; amended at 13 Ill. Reg. 13232, effective September 1, 1989; amended at 14 Ill. Reg. 2342, effective February 15, 1990; amended at 14 Ill. Reg. 13824, effective September 1, 1990; amended at 15 Ill. Reg. 5328, effective May 1, 1991; amended at 15 Ill. Reg. 13811, effective October 1, 1991; amended at 17 Ill. Reg. 1614, effective January 25, 1993; amended at 17 Ill. Reg. 17225, effective October 1, 1993; amended at 18 Ill. Reg. 11945, effective July 22, 1994; amended at 18 Ill. Reg. 15390, effective October 10, 1994; amended at 19 Ill. Reg. 13355, effective September 15, 1995; emergency amendment at 20 Ill. Reg. 474, effective January 1, 1996, for a maximum of 150 days; emergency expired May 29, 1996; amended at 20 Ill. Reg. 3234, effective February 15, 1996; amended at 20 Ill. Reg. 10009, effective July 15, 1996; amended at 22 Ill. Reg. 3932, effective February 13, 1998; amended at 22 Ill. Reg. 9342, effective May 20, 1998; amended at 23 Ill. Reg. 1007, effective January 15, 1999; emergency amendment at 23 Ill. Reg. 3508, effective March 4, 1999, for a maximum of 150 days; amended at 23 Ill. Reg. 9513, effective August 1, 1999; amended at 23 Ill. Reg. 13913, effective November 15, 1999; amended at 24 Ill. Reg. 6572, effective April 11, 2000; amended at 24 Ill. Reg. 17196, effective November 1, 2000; amended at 25 Ill. Reg. 3241, effective February 15, 2001; amended at 27 Ill. Reg. 1547, effective January 15, 2003; amended at 27 Ill. Reg. 13467, effective July 25, 2003; amended at 28 Ill. Reg. 5880, effective March 29, 2004; amended at 28 Ill. Reg. 6579, effective April 15, 2004; amended at 29 Ill. Reg. 12489, effective July 27, 2005; amended at 31 Ill. Reg. 4245, effective February 20, 2007; amended at 31 Ill. Reg. 14530, effective October 3, 2007; amended at 32 Ill. Reg. 3756, effective February 27, 2008; amended at 32 Ill. Reg. 4213, effective March 10, 2008; amended at 32 Ill. Reg. 7932, effective May 12, 2008; amended at 32 Ill. Reg. 14336, effective August 12, 2008; amended at 33 Ill. Reg. 8306, effective June 2, 2009; amended at 34 Ill. Reg. 2528, effective January 27, 2010; amended at 34 Ill. Reg. 3331, effective February 24, 2010; amended at 34 Ill. Reg. 19031, effective November 17, 2010; amended at 34 Ill. Reg. 19158, effective November 23, 2010; amended at 35 Ill. Reg. 4556, effective March 4, 2011; amended at 35 Ill. Reg. 6386, effective March 31, 2011; amended at 35 Ill. Reg. 13875, effective August 1, 2011; amended at 36 Ill. Reg. 17413, effective December 3, 2012; amended at 38 Ill. Reg. 13280, effective June 10, 2014; amended at 39 Ill. Reg. 5443, effective March 25, 2015; amended at 39 Ill. Reg. 13041, effective September 3, 2015; amended at 41 Ill. Reg. 7154, effective June 12, 2017; amended at 41 Ill. Reg. 14945, effective November 27, 2017; amended at 42 Ill. Reg. 9507, effective May 24, 2018; amended at 43 Ill. Reg. 3889, effective March 18, 2019; amended at 43 Ill. Reg. 12990, effective October 22, 2019; emergency amendment at 44

ILLINOIS REGISTER 1213 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF EMERGENCY AMENDMENT

Ill. Reg. 5934, effective March 25, 2020, for a maximum of 150 days; emergency expired August 21, 2020; emergency amendment at 44 Ill. Reg. 7788, effective April 16, 2020, for a maximum of 150 days; emergency repeal of emergency amendment at 44 Ill. Reg. 14333, effective August 24, 2020; emergency amendment at 44 Ill. Reg. 14804, effective August 24, 2020, for a maximum of 150 days; amended at 44 Ill. Reg. 18379, effective October 29, 2020; emergency amendment at 45 Ill. Reg. 1202, effective January 8, 2021, for a maximum of 150 days.

SUBPART A: GENERAL PROVISIONS

Section 250.3 COVID-19 Emergency Provisions – At-Home Patient Care EMERGENCY

a) To adequately respond to COVID-19, a hospital may apply for an Acute Hospital Care at Home waiver from the requirements of 42 CFR 482.23(b) and (b)(1) to provide limited inpatient services directly in a patient's home. The waiver application may be found at https://qualitynet.cms.gov/acute-hospital-care-at- home.

b) A participating hospital with an approved waiver from the Centers for Medicare and Medicaid Services (CMMS) shall provide the Department with the following:

1) A copy of the CMMS-approved Medicare waiver;

2) A copy of the participating hospital's screening protocol to determine patient eligibility for the at-home inpatient services; and

3) A copy of the participating hospital's policy and procedures for clinical management of inpatients at home.

c) The Department will conduct any complaint investigation, survey, or inspection of the participating hospital, request any documentation, and require corrective action pursuant to its State licensure authority.

d) A participating hospital also shall meet the following requirements:

1) Provide safe and quality care to each patient in his or her home;

2) Prohibit all abuse of a patient by an administrator, agent, employee, or member of its medical staff and, in addition, comply with the abuse and

ILLINOIS REGISTER 1214 21 DEPARTMENT OF PUBLIC HEALTH

NOTICE OF EMERGENCY AMENDMENT

neglect reporting requirements of Section 250.260 for suspected occurrences;

3) Ensure access to health care information and services for limited English- speaking or non-English-speaking patients, in compliance with Section 250.265;

4) Administer no medication, treatment, or diagnostic test to a patient except on a written or verbal order, if necessary, by a licensed medical professional acting within his or her scope of practice;

5) Ensure nursing services are under the direction of a registered nurse who has qualifications in nursing administration;

6) Maintain an adequate, timely, and complete medical record for each patient receiving at-home care in compliance with Section 250.1510;

7) Comply with incident reporting requirements in Section 250.1520(f);

8) Ensure all drugs and medicines are stored and dispensed in compliance with Section 250.2110(f) and (g); and

9) Comply with all directives and guidance related to COVID-19 diagnosis and treatment from the Centers for Disease Control and Prevention, the Department, other State of Illinois agencies, and any applicable local public health departments.

(Source: Added by emergency rulemaking at 45 Ill. Reg. 1202, effective January 8, 2021, for a maximum of 150 days)

ILLINOIS REGISTER 1215 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF EMERGENCY AMENDMENT

1) Heading of the Part: Business Corporation Act

2) Code Citation: 14 Ill. Adm. Code 150

3) Section Number: Emergency Action: 150.740 Amendment

4) Statutory Authority: Implementing and authorized by the Business Corporation Act of 1983 [805 ILCS 5].

5) Effective Date of Emergency Rule: January 8, 2021

6) If this emergency rule will expire before the end of the 150-day period, please specify the date on which it is to expire: This emergency rule will expire at the end of 150 days or the date on which the permanent rulemaking is adopted, whichever occurs first.

7) Date Filed with the Index Department: January 8, 2021

8) A copy of the emergency rule, including any material incorporated by reference, is on file in the Agency's principal office and is available for public inspection.

9) Reason for Emergency: Upon the expiration of the 150 days stated in the Emergency Amendment to the Emergency Rule of Section 150.740 of the Administrative Rules, filed and effective on April 27, 2020, the Department of Business Services (the "Department") of the Office of the Secretary of State believed that the waiver of any fees for the late filing of materials and documents, i.e., annual reports and other documents, was no longer in effect. The Department acted accordingly, reinstituting its normal practices and procedures, including numerous and time-consuming computer programming changes. Until the discovery of the existing language, the Department has been enforcing the fees for the late filing of documents.

10) A Complete Description of the Subjects and Issues Involved: New language is added stating that the statutory fees for the late filing of certain documents, including franchise tax, penalties, interest and filing fees are in full force and effect.

11) Are there any rulemakings to this Part pending? No

12) Statement of Statewide Policy Objective: This rulemaking does not create or enlarge a mandate as described in Section 3(b) of the State Mandates Act.

ILLINOIS REGISTER 1216 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF EMERGENCY AMENDMENT

13) Information and questions regarding this emergency rule shall be directed to:

Terrence J. McConville Senior Legal Advisor 100 W. Randolph St. #5-400 Chicago IL 60601

[email protected]

The full text of the Emergency Amendment begins on the next page:

ILLINOIS REGISTER 1217 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF EMERGENCY AMENDMENT

TITLE 14: COMMERCE SUBTITLE A: REGULATION OF BUSINESS CHAPTER I: SECRETARY OF STATE

PART 150 BUSINESS CORPORATION ACT

SUBPART A: HEARING PROCEDURES

Section 150.10 Applicability 150.20 Definitions 150.30 Right to Counsel 150.40 Appearance of Attorney 150.50 Special Appearance 150.60 Substitution of Parties or Attorneys 150.70 Commencement of Action; Notice of Hearing 150.80 Motions 150.90 Form of Papers 150.100 Conduct of Hearings 150.110 Orders 150.120 Record of Hearings 150.130 Invalidity

SUBPART B: SALE AND RELEASE OF INFORMATION

Section 150.200 Annual List of Corporations 150.210 Monthly List of Corporations 150.220 Daily List of Corporations 150.230 Computer Access to Information 150.240 Abstracts of Corporate Record 150.250 Invalidity

SUBPART C: ERRORS, REFUNDS, CORRECTIONS, ADJUSTMENTS, OBJECTIONS, AND OTHER RELIEF

Section 150.300 Errors or Defects

ILLINOIS REGISTER 1218 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF EMERGENCY AMENDMENT

150.305 Financial Data as Support Documentation 150.310 Invalidity

SUBPART D: NAMES

Section 150.400 Preliminary Determination of Availability 150.405 Final Determination of Availability 150.410 Response as to Basis of Unavailability 150.415 Reconsideration Procedure 150.420 Effect of Final Determination 150.425 Applicability 150.430 Availability of Names: Statutory Requirements 150.435 Standards − Conflicting Names 150.440 Distinguishable − Defined 150.445 Matters Not Considered 150.450 Differences 150.455 Surnames 150.460 Alphabet Names 150.465 Government Affiliation 150.470 Restricted and Professional Words 150.475 Acceptable Characters of Print 150.480 Invalidity 150.485 Improper Names

SUBPART E: SERVICE OF PROCESS ON THE SECRETARY OF STATE

Section 150.500 Preamble 150.510 Manner of Service 150.520 Place of Service 150.530 Payment of Fees 150.540 Invalidity

SUBPART F: FEES, FRANCHISE TAX AND LICENSE FEES: ANNUAL REPORT

Section 150.600 Payment of Fees, Franchise Tax and License Fee 150.610 Definitions

ILLINOIS REGISTER 1219 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF EMERGENCY AMENDMENT

150.620 Annual Report 150.621 Confidentiality of Annual Report Financial Data 150.630 Shares Having a Par Value 150.631 Amended Annual Report 150.640 Invalidity

SUBPART G: INTERPRETIVE COMMENTS AND GENERAL PROVISIONS

Section 150.700 Interpretive Comments Applicable Generally 150.705 Paid-In Capital 150.710 Advice to the Public 150.720 Incorporating Licensed Professionals 150.725 Corporation Acting as an Incorporator 150.730 Business Hours 150.735 Electronic Filing 150.740 Extension of Filing and Secretary of State Deadlines EMERGENCY

AUTHORITY: Implementing and authorized by the Business Corporation Act of 1983 [805 ILCS 5].

SOURCE: Adopted at 9 Ill. Reg. 1433, effective February 1, 1985; amended at 10 Ill. Reg. 5146, effective March 21, 1986; amended at 11 Ill. Reg. 10302, effective June 1, 1987; amended at 17 Ill. Reg. 11571, effective July 15, 1993; amended at 18 Ill. Reg. 7783, effective May 15, 1994; amended at 20 Ill. Reg. 7026, effective May 8, 1996; amended at 21 Ill. Reg. 16173, effective December 1, 1997; amended at 27 Ill. Reg. 550, effective December 27, 2002; amended at 28 Ill. Reg. 3504, effective February 3, 2004; amended at 29 Ill. Reg. 14047, effective September 1, 2005; amended at 30 Ill. Reg. 12961, effective July 11, 2006; amended at 31 Ill. Reg. 9469, effective July 16, 2007; amended at 32 Ill. Reg. 12039, effective July 16, 2008; emergency amendment at 42 Ill. Reg. 807, effective December 29, 2017, for a maximum of 150 days; emergency amendment to emergency rule at 42 Ill. Reg. 2073, effective January 9, 2018, for the remainder of 150 days; emergency expired May 27, 2018; emergency amendment at 44 Ill. Reg. 5786, effective March 20, 2020, for a maximum of 150 days; emergency amendment to emergency rule at 44 Ill. Reg. 6601, effective April 9, 2020, for the remainder of the 150 days; emergency amendment to emergency rule at 44 Ill. Reg. 7944, effective April 27, 2020, for the remainder of the 150 days; emergency amendment to emergency rule effective April 27, 2020 suspended by the Joint Committee on Administrative Rules at 44 Ill. Reg. 10029, effective May 20, 2020; suspension withdrawn at 44 Ill. Reg. 14082, effective August 11, 2020; emergency

ILLINOIS REGISTER 1220 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF EMERGENCY AMENDMENT rule effective March 20, 2020, as amended April 9, 2020 and April 27, 2020, expired August 16, 2020; amended at 44 Ill. Reg. 14019, effective August 17, 2020; emergency amendment at 45 Ill. Reg. 1215, effective January 8, 2021, for a maximum of 150 days.

SUBPART G: INTERPRETIVE COMMENTS AND GENERAL PROVISIONS

Section 150.740 Extension of Filing and Secretary of State Deadlines EMERGENCY

Filing of Organizational Documents, Annual Reports, and Other Business Entity Materials

a) All organizational documents, annual reports, and other business entity materials required to be filed with the Secretary of State pursuant to Chapter 805 of the Illinois Compiled Statutes shall be filed with the Business Services Department, Howlett Building, Room 350, Springfield IL 62756 or 69 West Washington, Suite 1240, Chicago IL 60602.

b) Pursuant to the powers vested in him by Section 5(7) of the Secretary of State Act, the Secretary of State hereby extends for the duration of the disaster proclaimed by the Governor in Gubernatorial Proclamation number 2020-038, issued on March 9, 2020, as extended by subsequent proclamations, and for a period of 90 days thereafter, the filing deadlines for materials required to be filed with the Secretary of State pursuant to Chapter 805 of the Illinois Compiled Statutes and that were due to be filed on or after March 17, 2020. This extension period may be rescinded by the Secretary of State through the adoption of an emergency rule. Business organizations are required to pay the statutory amounts to the Secretary of State when materials are filed, including franchise tax, penalties, interest, filing fees, and other charges required to be paid, without regard to the application of the filing extension deadline of this Section.Any fees for late filings of materials shall be waived for materials subject to this Section.

c) Pursuant to the terms of Executive Order 2020-39, as extended by Executive Order 2020-44, and as may be further extended by subsequent Executive Orders, the provisions of Section 1.45 of the Business Corporations Act (BCA) that require the Secretary of State to, within 10 days after any of the documents subject to Section 1.45 are delivered to the Secretary for filing, give written notice of his or her disapproval of the documents are suspended for the duration of the disaster proclaimed in Gubernatorial Proclamation 2020-44, as extended, and for

ILLINOIS REGISTER 1221 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF EMERGENCY AMENDMENT

30 days thereafter. During this period of suspension, the Secretary shall process these documents as expeditiously as possible. d) Pursuant to the terms of Executive Order 2020-39, as extended by Executive Order 2020-44, and as may be further extended by subsequent Executive Orders, the provisions of Section 15.95 of the BCA that require the Secretary of State to provide expedited services upon request are suspended for the duration of the disaster proclaimed in the Gubernatorial Proclamation 2020-44, as extended, and for 30 days thereafter. During this period of suspension, the Secretary shall process the expedited documents within 24 hours or as soon as possible thereafter. For purposes of filing dates, the date the document was submitted for filing will be the document's filing date.

(Source: Amended by emergency rulemaking at 45 Ill. Reg. 1215, effective January 8, 2021, for a maximum of 150 days)

ILLINOIS REGISTER 1222 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF EMERGENCY AMENDMENT

1) Heading of the Part: School Bus Driver Permit

2) Code Citation: 92 Ill. Adm. Code 1035

3) Section Number: Emergency Action: 1035.30 Amendment

4) Statutory Authority: Implementing Section 6-106.1 and authorized by Section 6-521 of the Illinois Vehicle Code [625 ILCS 5].

5) Effective Date of Emergency Rule: January 6, 2021

6) If this emergency rule will expire before the end of the 150-day period, please specify the date on which it is to expire: January 6, 2021

7) Date Filed with the Index Department: January 6, 2021

8) A copy of the emergency rule, including any material incorporated by reference, is on file in the Agency's principal office and is available for public inspection.

9) Reason for Emergency: Due to COVID-19 mitigations, annual refresher training for school bus permit holders provided by Regional Superintendents of Education have been postponed until Spring of 2021.

10) A Complete Description of the Subjects and Issues Involved: This rulemaking will provide an additional 90 days for school bus permit holders to complete their annual refresher training. All other requirements for renewal of a school bus permit remain in effect.

11) Are there any other rulemakings to the Part pending? No

12) Statement of Statewide Policy Objective: No expenditures by units of local government.

13) Information and questions regarding this emergency rule shall be directed to:

Brenda Glahn Senior Legal Advisor 298 Howlett Building Springfield IL 62756

ILLINOIS REGISTER 1223 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF EMERGENCY AMENDMENT

217/785-3094 [email protected]

The full text of the Emergency Amendment begins on the next page:

ILLINOIS REGISTER 1224 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF EMERGENCY AMENDMENT

TITLE 92: TRANSPORTATION CHAPTER II: SECRETARY OF STATE

PART 1035 SCHOOL BUS DRIVER PERMIT

Section 1035.10 Definitions 1035.15 Requirements of Applicants for a School Bus Driver Permit 1035.20 Annual Medical Examination and Certificate 1035.25 Permit Application Process 1035.30 Training EMERGENCY 1035.32 Random Drug Testing for Alcohol and Controlled Substances 1035.35 Denial, Cancellation, or Suspension of a School Bus Driver Permit 1035.40 Notice 1035.45 Employer Responsibility 1035.46 Military Deferrals 1035.50 Hearings

1035.APPENDIX A School Bus Driver Permit Medical Examiner's Certificate

AUTHORITY: Implementing Section 6-106.1 and authorized by Section 6-521 of the Illinois Vehicle Code [625 ILCS 5].

SOURCE: Adopted at 19 Ill. Reg. 10716, effective July 11, 1995; amended at 24 Ill. Reg. 1269, effective January 10, 2000; amended at 24 Ill. Reg. 12092, effective July 31, 2000; amended at 26 Ill. Reg. 12045, effective July 22, 2002; amended at 33 Ill. Reg. 17093, effective December 1, 2009; amended at 34 Ill. Reg. 7750, effective May 20, 2010; amended at 34 Ill. Reg. 19082, effective November 22, 2010; amended at 35 Ill. Reg. 7412, effective April 21, 2011; amended at 36 Ill. Reg. 2384, effective January 30, 2012; amended at 39 Ill. Reg. 5101, effective March 23, 2015; amended at 39 Ill. Reg. 11633, effective July 28, 2015; amended at 40 Ill. Reg. 9646, effective July 1, 2016; amended at 45 Ill. Reg. 750, effective December 28, 2020; emergency amendment at 45 Ill. Reg. 1222, effective January 6, 2021, for a maximum of 150 days.

Section 1035.30 Training EMERGENCY

ILLINOIS REGISTER 1225 21 OFFICE OF THE SECRETARY OF STATE

NOTICE OF EMERGENCY AMENDMENT a) The initial course and annual refresher training courses are required for each school bus driver permit holder and shall be:

1) Approved by the Secretary of State and the agency or organization conducting the course;

2) Taught by an instructor certified by the Illinois State Board of Education; and

3) A minimum of two hours in length, part of which must include first aid training. b) The date of the annual refresher training shall be computed as follows:

1) The first refresher training following initial training must be completed within one year (365 days) from the date of initial training. The date of the first refresher training will be known as the refresher date.

2) In the event that an individual completes subsequent refresher training between the actual refresher date and 60 days prior to that refresher date, the next annual refresher date will not change. In the event refresher training is completed more than 60 days prior to the refresher date, the date the driver completes the refresher training will become the new annual refresher date.

3) In recognition of the disaster proclaimed by the Governor in Gubernatorial Proclamation number 2020-038 issued on March 9, 2020, as extended by subsequent disaster proclamations and of the Tier 3 mitigations currently in place, refresher dates for those individuals whose current refresher date falls in December 2020, January 2021, February 2021 or March 2021 are extended for a period of 90 days.

(Source: Amended by emergency rulemaking at 45 Ill. Reg. 1222, effective January 6, 2021, for a maximum of 150 days)

ILLINOIS REGISTER 1226 21 JOINT COMMITTEE ON ADMINISTRATIVE RULES

SECOND NOTICES RECEIVED

The following second notices were received during the period of January 5, 2021 through January 11, 2021. These rulemakings are scheduled for the February 16, 2021 meeting. Other items not contained in this published list may also be considered. Members of the public wishing to express their views with respect to a rulemaking should submit written comments to the Committee at the following address: Joint Committee on Administrative Rules, 700 Stratton Bldg., Springfield IL 62706.

Second Start JCAR Notice of First Meeting Expires Agency and Rule Notice

2/17/21 Department of Financial and Professional 10/16/20 2/16/21 Regulation, Real Estate License Act of 44 Ill. Reg. 2000 (68 Ill. Adm. Code 1450) 16584

2/20/21 Department of Financial and Professional 11/20/20 2/16/21 Regulation, Optometric Practice Act of 44 Ill. Reg. 1987 (68 Ill. Adm. Code 1320) 18543

2/20/21 Department of Financial and Professional 11/13/20 2/16/21 Regulation, Illinois Certified Shorthand 44 Ill. Reg. Reporters Act of 1984 (68 Ill. Adm. Code 17839 1200)

2/20/21 Department of Financial and Professional 11/13/20 2/16/21 Regulation, Electrologist Licensing Act (68 44 Ill. Reg. Ill. Adm. Code 1246) 17853

2/20/21 Department of Financial and Professional 11/13/20 2/16/21 Regulation, Funeral Directors and 44 Ill. Reg. Embalmers Licensing Code (68 Ill. Adm. 17859 Code 1250)

2/20/21 Department of Financial and Professional 11/13/20 2/16/21 Regulation, Illinois Physical Therapy Act 44 Ill. Reg. (68 Ill. Adm. Code 1340) 17879

ILLINOIS REGISTER 1227 21 JOINT COMMITTEE ON ADMINISTRATIVE RULES

SECOND NOTICES RECEIVED

2/20/21 Department of Financial and Professional 11/13/20 2/16/21 Regulation, Nursing Home Administrators 44 Ill. Reg. Licensing and Disciplinary Act (68 Ill. 17868 Adm. Code 1310)

2/24/21 Department of Financial and Professional 11/20/20 2/16/21 Regulation, Illinois Roofing Industry 44 Ill. Reg. Licensing Act (68 Ill. Adm. Code 1460) 18546

2/19/21 Department of Transportation, Port 10/16/20 2/16/21 Facilities Capital Investment Grant 44 Ill. Reg. Program (92 Ill. Adm. Code 600) 16745

2/19/21 Illinois Gaming Board, Video Gaming 11/6/20 2/16/21 (General) (11 Ill. Adm. Code 1800) 44 Ill. Reg. 17542

2/24/21 State Board of Education, Standards for All 9/11/20 2/16/21 Illinois Teachers (23 Ill. Adm. Code 24) 44 Ill. Reg. 14574

2/24/21 State Board of Education, Special 9/11/20 2/16/21 Education (23 Ill. Adm. Code 226) 44 Ill. Reg. 14630

ILLINOIS REGISTER 1228 21 ILLINOIS EDUCATIONAL LABOR RELATIONS BOARD

AGENCY RESPONSE TO JOINT COMMITTEE STATEMENT OF OBJECTION TO EMERGENCY RULEMAKING

Date: January 7, 2021

Agency: Illinois Educational Labor Relations Board

Heading of the Part: General Procedures

Code Citation: 80 Ill. Adm. Code 1100

Agency Response to Specific Joint Committee Objections:

At its meeting on October 14, 2020, the Joint Committee on Administrative Rules (JCAR) considered the above-cited emergency rulemaking and objected to the ",,, Board's use of emergency rulemaking to adopt rules titled General Procedures (80 Ill. Adm. Code 1100; 44 Ill. Reg. 15998 - 9/25/20) because it allows service of documents by email when that is not one of the three acceptable methods for service specified in Section 5(h) of the Illinois Educational Labor Relations Act [115 ILCS 5]."

The Board has reviewed the statement of objection from JCAR regarding the above-cited emergency rulemaking. The Board did not attempt or intend to circumvent the Illinois Educational Labor Relations Act (IELRA). The Board reasonably and in good faith undertook the emergency and subsequent proposed rulemakings based upon the history of its laws and rulemaking, as well as the COVID-19 pandemic. JCAR reviewed the Board's predraft of this emergency rulemaking and the JCAR Executive Director returned it on July 21, 2020 without noting that the rulemaking was inconsistent with the IELRA. While the review of the predraft of the rulemaking does not preclude JCAR’s current objection, the JCAR review before filing the emergency rulemaking evidences the Board's good faith.

The Board filed proposed rulemaking on October 22, 2020 that was published at 44 Ill. Reg. 17536 on November 6, 2020. The proposed rulemaking mirrors the emergency rulemaking predraft reviewed by JCAR. The Board asserts that the emergency and the proposed rulemakings are permissible pursuant to and authorized by Section 5(i) of the Illinois Educational Labor Relations Act [115 ILCS 5/5(i)] and by Section 10-75 of the Illinois Administrative Procedure Act (IAPA) [5 ILCS 100/10-75].

The Board asserts that subsections (h) and (i) of Section 5 of the IELRA are intended to be read together [115 ILCS 5/5(h and i)]. At the time of the enactment of the IELRA, tracking of various

ILLINOIS REGISTER 1229 21 ILLINOIS EDUCATIONAL LABOR RELATIONS BOARD

AGENCY RESPONSE TO JOINT COMMITTEE STATEMENT OF OBJECTION TO EMERGENCY RULEMAKING types of mail delivery, proof of delivery and reading of emails, and third-party courier tracking options were nonexistent or less developed. The legislative direction in Section 5(i) of the IELRA to the Illinois Administrative Procedure Act (IAPA) includes the ability to use the multiple proposed methods of service of documents set out in various sections, as well as the rulemaking requirements regarding safeguards pertaining to verifiable electronic service set out in Section 10-75 of the IAPA [5 ILCS 100/10-75].

The Board has used certified mail since during or about 1984, consistent with the Board's adopted rulemaking and without objection by JCAR that such was an unacceptable method per Section (h) the IELRA [115 ILCS 5/5(h)]. Certified mail "is not one of the three acceptable methods for service specified in Section 5(h) of the Illinois Educational Labor Relations Act [115 ILCS 5/5]."

In 2017, the Board filed Notices proposing and adopting amendments to its service of documents, citing Section 5(i) of the IELRA as its authority to do such [115 ILCS 5/5(i)]. JCAR did not object. The Board proposed and adopted the following amendments to subsections (c) and (d) of 80 Ill. Adm. Code 1100.20 that expanded the methods of service:

"c) The Board will serve final Board opinions, complaints and notices of hearing, petitions, intervening claims, and unfair labor practice charges, and fair share fee objections on the appropriate parties by personal service, registered or certified mail, or by leaving a copy at the principal office or place of business of the person required to be served. A party may agree to service of the above documents by other means by giving written consent. The Board may serve other documents by other means.

d) All documents, except those listed in subsection (c), will be served on the appropriate parties by the party propounding the document by means calculated to provide proper service. When a party is represented in a proceeding before the Board, service shall be on the party's representative. When a party is not represented, service shall be on the party. Subpoenas will be served by the party requesting the subpoena by personal service, registered or certified mail, or leaving a copy at the principal office or place of business of the person required to be served."

80 Ill. Adm. Code 1100.20 amended at 41 Ill. Reg. 10566, effective August 1, 2017.

ILLINOIS REGISTER 1230 21 ILLINOIS EDUCATIONAL LABOR RELATIONS BOARD

AGENCY RESPONSE TO JOINT COMMITTEE STATEMENT OF OBJECTION TO EMERGENCY RULEMAKING

The Board asserts that it has had the ability to use electronic service of its documents since on or before the 2017 amendment to its rules. The need for the use of electronic service became an unforeseeable necessity during the pandemic. The Board was compelled to assure the safety and best interest of its employees and the parties that appear before the Board. The Board has and continues to explore JCAR-suggested options of obtaining an Executive Order and legislative amendment as evidence of its good faith. While the use of this emergency rulemaking has been extremely helpful during the pandemic, the pandemic is outlasting the six months allowed for emergency rules, resulting in the proposed rulemaking being an absolute necessity to continue, assuring the safety of said employees and parties, as well as providing prompt due process notice to the parties with respect to Board decisions and orders.

Regardless of whether the Board is able to obtain an Executive Order and/or a statutory amendment, the electronic service rulemaking setting out safeguards to verify service will still be required pursuant to Section 10-75 of the IAPA [5 ILCS 100/10-75]. The IAPA requires the Board to adopt rules to specify how the Board will ensure delivery of service by email or other electronic methods and how the Board will accomplish service when electronic service fails. The rulemaking language is required to achieve the goal that electronic service is verifiable and how the Board will proceed when the electronic service is undeliverable.

In summation, the Board responds to the JCAR objection to its rulemaking as follows:

1. Subsections (h) and (i) of Section 5 of the IELRA are consistent with each other and intended to be read together [115 ILCS 5/5(h and i)].

2. Section (h) of the IELRA states that service of documents may be served personally, by registered mail or by leaving a copy at the principal office of the respondent required to be served as forms of service of documents [115 ILCS 5/5(h)]. Legislature listed personal service separately and "leaving" is not defined in the subsequent method to require personally leaving a copy. Verifiable electronic service such as email is one of the most reliable methods of service of documents as it ensures that the intended recipient timely receives service of documents and satisfies due process requirements.

3. The Board proposed other rulemakings regarding service of documents and had a history of no JCAR objections. The Board has not had any indication that JCAR interpreted Section 5(h) of the IELRA to preclude the Board's ability to use other forms of service of documents [115 ILCS 5/5(h)].

ILLINOIS REGISTER 1231 21 ILLINOIS EDUCATIONAL LABOR RELATIONS BOARD

AGENCY RESPONSE TO JOINT COMMITTEE STATEMENT OF OBJECTION TO EMERGENCY RULEMAKING

4. The Board had no indication that it must seek legislative amendment to the IELRA or an Executive Order prior to the instant JCAR objection. The ongoing and increasingly dangerous pandemic hinders or otherwise delays the ability for prompt legislative changes. An Executive Order during the pandemic would only be temporary. The pandemic has outlasted the time permitted for the effectiveness of emergency rulemaking. The Board has been exemplary in its discharge of its duties per the IELRA and its use of verifiable electronic service of documents during the pandemic.

5. The emergency and the proposed rulemakings are required under the IAPA regardless of how the issue of acceptable avenues (IELRA, Executive Order, and/or the Board's rulemaking)for use of electronic service is determined. The Board is required to propose and adopt this rulemaking to be consistent with and provide the safeguards required per the IAPA [5 ILCS 100/10-75].

The Board prays that JCAR will remove its objection for the reasons stated herein. The Board will continue to seek an Executive Order for service during the pandemic and a legislative amendment to Section (h) of the IELRA to provide clarification to all concerned regarding the intended methods of service of documents [115 ILCS 5/5(h)].

______Victor E. Blackwell Executive Director

ILLINOIS REGISTER 1232 21 EXECUTIVE ORDER

2021-1 EXECUTIVE ORDER 2021-01 (COVID-19 EXECUTIVE ORDER NO. 71)

WHEREAS, since early March 2020, Illinois has faced a pandemic that has caused extraordinary sickness and loss of life, infecting over 1,000,000, and taking the lives of more than 17,000 residents; and,

WHEREAS, as Illinois adapts and responds to the public health disaster caused by Coronavirus Disease 2019 (COVID-19), a novel severe acute respiratory illness that spreads rapidly through respiratory transmissions and that continues to be without an effective treatment or vaccine, the burden on residents, healthcare providers, first responders, and governments throughout the State is unprecedented; and,

WHEREAS, at all times but especially during a public health crisis, protecting the health and safety of Illinoisans is among the most important functions of State government; and,

WHEREAS, public health research and guidance indicates the necessity and efficacy of wearing cloth face coverings in public settings where social distancing measures are difficult to maintain, and indicates that the risk of transmission outdoors is less than the risk of transmission indoors; and,

WHEREAS, public health guidance advises that minimizing physical interactions between people who do not reside in the same household is critical to slowing the spread of COVID-19; and,

WHEREAS, as COVID-19 has spread in Illinois over the course of the Gubernatorial Disaster Proclamations, the circumstances causing a disaster throughout the State have changed and continue to change, making definitive predictions of the course the virus will take over the coming months extremely difficult; and,

WHEREAS, in addition to causing the tragic loss of more than 17,000 Illinoisans and wreaking havoc on the physical health of tens of thousands more, COVID-19 has caused extensive economic loss and continues to threaten the financial welfare of a significant number of individuals and businesses across the nation and the State; and,

WHEREAS, many executive agencies in the State have focused their limited resources on the ongoing response to the COVID-19 pandemic; and,

ILLINOIS REGISTER 1233 21 EXECUTIVE ORDER

WHEREAS, the COVID-19 pandemic has required the Illinois Department of Agriculture (IDOA) to address the outbreak's impact on the State's food supply chain through regulation and oversight of meat and poultry facilities and livestock management facilities; and,

WHEREAS, the COVID-19 pandemic's disruption to the livestock market has required IDOA to concentrate its resources on working with livestock owners and producers in addressing safe and environmental animal disposal concerns through its oversight and regulation of the Dead Animal Disposal Act; and,

WHEREAS, IDOA regulates and investigates many other industries that have been directly impacted by the COVID-19 pandemic including, but not limited to, pesticide applicators, animal shelters, pet shops, and gas stations, and the continued, proper regulation of these industries requires IDOA to commit additional time and resources into creating new procedures for conducting remote investigations and trainings; and,

WHEREAS, the COVID-19 pandemic's detrimental impact to IDOA's regulated industries has required IDOA to place additional time and resources into organizing and managing the timely implementation of the Business Interruption Grant Program; and,

WHEREAS, on January 8, 2021, considering the expected continuing spread of COVID-19 and the ongoing health and economic impacts that that will be felt over the coming month by people across the State, I declared all counties in the State of Illinois as a disaster area; and,

WHEREAS, in response to the epidemic emergency and public health emergency described above, I find it necessary to re-issue Executive Orders 2020-03, 2020-04, 2020-07, 2020-08, 2020-09, 2020-11, 2020-12, 2020-15, 2020-16, 2020-17, 2020-20, 2020-21, 2020-22, 2020-23, 2020-24, 2020-25, 2020-26, 2020-27, 2020-28, 2020-29, 2020-30, 2020-34, 2020-35, 2020-36, 2020-40, 2020-41, 2020-42, 2020-45, 2020-47, 2020-50, 2020-53, 2020-56, 2020-57, 2020-60, 2020-61, 2020-62, 2020-63, 2020-64, 2020-65, 2020-66, 2020-67, 2020-68, 2020-69, 2020-70, 2020-72, and 2020-73 and hereby incorporate the WHEREAS clauses of those Executive Orders;

THEREFORE, by the powers vested in me as the Governor of the State of Illinois, pursuant to the Illinois Constitution and Sections 7(1), 7(2), 7(3), 7(8), 7(9), and 7(12) of the Illinois Emergency Management Agency Act, 20 ILCS 3305, and consistent with the powers in public health laws, I hereby order the following, effective January 8, 2021:

Part 1: Re-Issue of Executive Orders.

Executive Orders 2020-03, 2020-04, 2020-07, 2020-08, 2020-09, 2020-11, 2020-12, 2020-15, 2020-16, 2020-17, 2020-20, 2020-21, 2020-22, 2020-23, 2020-24, 2020-25, 2020-26, 2020-27, 2020-28, 2020-29, 2020-30, 2020-34, 2020-35, 2020-36, 2020-40, 2020-41, 2020-42, 2020-45,

ILLINOIS REGISTER 1234 21 EXECUTIVE ORDER

2020-47, 2020-50, 2020-53, 2020-56, 2020-57, 2020-60, 2020-61, 2020-62, 2020-63, 2020-64, 2020-65, 2020-66, 2020-67, 2020-68, 2020-69, 2020-70, 2020-72, and 2020-73 as follows:

Executive Order 2020-04 (Closure of James R. Thompson Center; waiver of sick leave requirement for State employees):

Sections 2 and 3 of Executive Order 2020-04 are re-issued and extended through February 6, 2021. Nothing in Section 2 precludes the Department of Central Management Services from designating specific points of ingress and egress and controlling traffic flow in the James R. Thompson Center for State employees, members of the public attending to State business, and members of the public patronizing the businesses and food court.

Executive Order 2020-07 (In-person meeting requirements):

Section 6 of Executive Order 2020-07, as amended by Executive Order 2020-33 and Executive Order 2020-44, is re-issued and extended through February 6, 2021.

Executive Order 2020-08 (Secretary of State operations):

Sections 3, 4, 5, and 6 of Executive Order 2020-08, as amended by Executive Order 2020-39, Executive Order 2020-44, and Executive Order 2020-74, are re-issued and extended through February 6, 2021.

Executive Order 2020-09 (Telehealth):

Executive Order 2020-09, as amended by Executive Order 2020-52, is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-11 (Illinois Department of Corrections notification period):

Section 4 of Executive Order 2020-11 is re-issued and extended through February 6, 2021.

Executive Order 2020-12 (Health care worker background checks; Illinois Department of Juvenile Justice notification period):

Sections 1 and 3 of Executive Order 2020-12 are re-issued and extended through February 6, 2021.

Executive Order 2020-15 (Suspending provisions of the Illinois School Code):

ILLINOIS REGISTER 1235 21 EXECUTIVE ORDER

Sections 5, 6, 7, 8, and 9 of Executive Order 2020-15 are re-issued and extended through February 6, 2021.

Executive Order 2020-16 (Suspension of classroom training requirement for security services):

Section 2 of Executive Order 2020-16 is re-issued and extended through February 6, 2021.

Executive Orders 2020-03 and 2020-17 (Cannabis deadlines and applications):

Executive Orders 2020-03 and 2020-17, as modified by Executive Order 2020-18, are re- issued and shall remain in effect as specified by Executive Order 2020-18.

Executive Order 2020-20 (Public assistance requirements):

Executive Order 2020-20 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-21 (Furlough of Illinois Department of Corrections inmates):

Executive Order 2020-21 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-22 (Placements under the Child Care Act of 1969; fingerprint submissions under Health Care Worker Background Check Act):

Sections 4, 5, and the Savings Clause of Executive Order 2020-22 are re-issued and extended through February 6, 2021.

Executive Order 2020-23 (Actions by the Illinois Department of Financial and Professional Regulation for licensed professionals engaged in disaster response):

Executive Order 2020-23 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-24 (Illinois Department of Human Services Forensic Treatment Program; investigations of Illinois Department of Human Services employees):

ILLINOIS REGISTER 1236 21 EXECUTIVE ORDER

Executive Order 2020-24 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-25 (Garnishment and wage deductions):

Executive Order 2020-25, as amended by Executive Order 2020-55, is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-26 (Hospital capacity):

Executive Order 2020-26 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-27 (Cadavers testing positive for COVID-19):

Executive Order 2020-27 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-28 (Industrial radiography certifications):

Executive Order 2020-28, as amended by Executive Order 2020-55, is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-28 is further amended and revised as follows:

Section 2. For any industrial radiography certification or industrial radiography trainee certification that expired during the period of the Gubernatorial Disaster Proclamations issued in 2020, IEMA-DNS may administratively extend terms of existing certifications for industrial radiographers and industrial radiographer trainees in 90-day increments, not to exceed a maximum period of nine months beyond the initial 5 or 2 year term, to allow individuals time to meet the examination criteria. For those certifications expiring in January 2021 or later, IEMA-DNS may extend terms of existing certifications for a period of 90 days. Industrial radiographers and industrial radiographer trainees shall meet all other requirements as set forth by IEMA-DNS.

Executive Order 2020-29 (In-person education or exams for professional insurance licenses):

Executive Order 2020-29 is re-issued in its entirety and extended through February 6, 2021.

ILLINOIS REGISTER 1237 21 EXECUTIVE ORDER

Executive Order 2020-30 (Expired consular identification documents; electronic filings for the Illinois Human Rights Commission):

Sections, 1, 4, 5, and 6 of Executive Order 2020-30 are re-issued and extended through February 6, 2021.

Executive Order 2020-34 (Cannabis requirements):

Executive Order 2020-34 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-35 (Illinois Department of Public Health regulatory activities):

Sections 14, 15, 16, and 17 of Executive Order 2020-35 are re-issued and extended through February 6, 2021.

Executive Order 2020-36 (Marriage licenses):

Executive Order 2020-36 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-40 (Child Labor Law):

Sections 2 and 4 of Executive Order 2020-40 are re-issued and extended through February 6, 2021.

Executive Order 2020-41 (Sports wagering):

Executive Order 2020-41 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-42 (State Fairs):

Executive Order 2020-42 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-45 (Cannabis licenses):

Executive Order 2020-45 is re-issued in its entirety and shall remain in effect as specified by Executive Order 2020-45.

ILLINOIS REGISTER 1238 21 EXECUTIVE ORDER

Executive Order 2020-47 (In-person instruction at preK-12 schools):

Executive Order 2020-47 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-50 (Resuming transfers from county jails to Illinois Department of Corrections):

Executive Order 2020-50 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-53 (Region 7 mitigations):

Executive Order 2020-53 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-56 (Region 1 mitigations):

Executive Order 2020-56 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-57 (Cannabis identification cards):

Executive Order 2020-57 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-60 (Region 5 mitigations):

Executive Order 2020-60 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-61 (Regions 7 and 8 mitigations):

Executive Order 2020-61 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-62 (Region 1 Tier 2 mitigations):

Executive Order 2020-62 is re-issued in its entirety and extended through February 6, 2021.

ILLINOIS REGISTER 1239 21 EXECUTIVE ORDER

Executive Order 2020-63 (Regions 4 and 10 mitigations):

Executive Order 2020-63 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-64 (Region 11 mitigations):

Executive Order 2020-64 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-65 (Region 9 mitigations):

Executive Order 2020-65 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-66 (Region 3 mitigations):

Executive Order 2020-66 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-67 (Region 6 mitigations):

Executive Order 2020-67 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-68 (Cannabis registry identification card renewals):

Executive Order 2020-68 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-69 (Region 2 mitigations):

Executive Order 2020-69 is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-70 (Regions 5, 7, and 8 Tier 2 mitigations):

Executive Order 2020-70 is re-issued in its entirety and extended through February 6, 2021.

ILLINOIS REGISTER 1240 21 EXECUTIVE ORDER

Executive Order 2020-72 (Residential eviction moratorium):

Executive Order 2020-72, as amended by Executive Order 2020-74, is re-issued in its entirety and extended through February 6, 2021.

Executive Order 2020-72 is further amended and revised as follows: Section 6. A person or entity may not commence a residential eviction action pursuant to or arising under 735 ILCS 5/9-101 et seq. against a tenant who does not owe rent unless the tenant poses a direct threat to the health and safety of other tenants or an immediate and severe risk to property. A tenant shall not be required to provide a Declaration if they are covered by this section.

Executive Order 2020-73 (Tier 3 mitigations):

Executive Order 2020-73 is re-issued in its entirety and extended through February 6, 2021.

Part 2: Savings Clause. If any provision of this Executive Order or its application to any person or circumstance is held invalid by any court of competent jurisdiction, this invalidity does not affect any other provision or application of this Executive Order, which can be given effect without the invalid provision or application. To achieve this purpose, the provisions of this Executive Order are declared to be severable.

Issued by the Governor January 8, 2021 Filed by the Secretary of State January 8, 2021

ILLINOIS REGISTER 1241 21 PROCLAMATIONS

2020-76 National Problem Gambling Awareness Month

WHEREAS, on behalf of the residents of Illinois, I am pleased to join the Illinois Department of Human Services' division of substance Use Prevention and Recovery in promoting March as National Problem Gambling Awareness Month in Illinois; and,

WHEREAS, promoting awareness provides individuals in the problem gambling community an opportunity to educate the public and policymakers about the social and financial effectiveness of services available for problem gambling; and,

WHEREAS, problem gambling is treatable, and treatment is effective in minimizing the harm to both individuals and society as a whole; and,

WHEREAS, the state offers a myriad of services aimed at treating problem gambling, including outpatient treatment programs for gambling disorders throughout the state, a toll-free Hotline at 1-800-Gambler, and a website aimed at providing resources for problem gambling at www.WeKnowTheFeeling.org; and,

WHEREAS, problem gambling is a public health issue affecting millions of Americans of all ages, races, and ethnic backgrounds in all communities and has a significant societal and economic cost; and,

WHEREAS, numerous individuals, professionals and organizations have dedicated their efforts to educating the public about problem gambling and the availability and effectiveness of treatment; and,

WHEREAS, the Illinois Department of Human Services and the Division of Substance Use Prevention and Recovery invite all residents of Illinois to participate in National Problem Gambling Awareness Month.

THEREFORE, I, JB Pritzker, Governor of Illinois, do hereby proclaim the month of March 2020 as National Problem Gambling Awareness Month in Illinois and encourage all citizens to support the men, women, and youth who are in treatment and recovery for problem gambling behavior and support their families.

Issued by the Governor March 2, 2020 Filed by the Secretary of State January 8, 2021

2020-77 Gerald M. Brookhart Arts in Education Spring Celebration Months

ILLINOIS REGISTER 1242 21 PROCLAMATIONS

WHEREAS, the arts are the personification of beauty in the world and help to preserve our cultural heritage; and,

WHEREAS, arts education, which includes dance, drama, music, and visual arts, is an essential part of basic instruction for all students, providing them with a balanced education that will aid in developing their full potential; and,

WHEREAS, the Peoria County Regional Office of Education is committed to the establishment and continuation of school programs that provide students with the opportunity to achieve academic excellence, and to the promotion of fine and applied arts programs; and,

WHEREAS, the Gerald M. Brookhart Arts in Education Spring Celebration is held at the Peoria County Courthouse Plaza and provides a venue for students in pre-Kindergarten through 12th grade to showcase their works and talents; and,

WHEREAS, the 35th annual Gerald M. Brookhart Arts in Education Spring Celebration will be held April 15th - May 15th, 2020; and,

WHEREAS, the State of Illinois supports events such as the Gerald M. Brookhart Arts in Education Spring Celebration and commends the students and teachers who work to bring the beauty of art to this great state;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby recognize April and May 2020 as Gerald M. Brookhart Arts in Education Spring Celebration Months in Illinois. Issued by the Governor March 5, 2020

Filed by the Secretary of State January 8, 2021

2020-78 Prevent Child Abuse Illinois Day

WHEREAS, Prevent Child Abuse Illinois is a not-for-profit charitable organization incorporated under the laws of the State of Illinois on October 25, 1990 and is the chartered Illinois chapter of Prevent Child Abuse America; and,

WHEREAS, Prevent Child Abuse Illinois is the only statewide organization in Illinois dedicated solely to the prevention of child abuse and neglect; and,

ILLINOIS REGISTER 1243 21 PROCLAMATIONS

WHEREAS, Prevent Child Abuse Illinois envisions an Illinois where all children grow up in healthy, nurturing homes and communities free of abuse, neglect, violence, or endangerment of any kind; and,

WHEREAS, Prevent Child Abuse Illinois provides substantial leadership in Illinois to prevent one of the most tragic social issues of our time – the abuse and neglect of children, which touches the lives of tens of thousands of Illinois children each year: and,

WHEREAS, Prevent Child Abuse Illinois is a strong partner with state government organizations, social service agencies, schools, religious organizations, law enforcement agencies, businesses, civic groups, and individual citizens in making child abuse prevention programs effective in Illinois: and,

WHEREAS, 2020 is the 30th anniversary of the founding of Prevent Child Abuse Illinois;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois do hereby proclaim October 25, 2020 as Prevent Child Abuse Illinois Day for its contributions to the well-being of Illinois children and families, and I offer my congratulations on the occasion of its 30th Anniversary and my best wishes for continued success in its efforts.

Issued by the Governor March 5, 2020 Filed by the Secretary of State January 8, 2021

2020-79 AmeriCorps Week

WHEREAS, service to others is a hallmark of the American character, and, throughout the county's history, residents have stepped up to meet our challenges by volunteering in their communities; and,

WHEREAS, since its creation in 1994, the AmeriCorps national service program has proven to be a highly effective way to engage Americans of all ages and backgrounds in meeting a wide range of community needs and to promote the ethic of service and volunteering; and,

WHEREAS, each year AmeriCorps programs, including AmeriCorps*State and National, AmeriCorps*VISTA and AmeriCorps*NCCC, provide opportunities for nearly 75,000 residents across the nation, including more than 2,300 in Illinois, to give back in an intensive way to our communities, our state, and our country; and,

WHEREAS, more than 1,000,000 people across the nation, including more than 45,000 from Illinois, have taken the AmeriCorps pledge to "get things done" since 1994; and,

ILLINOIS REGISTER 1244 21 PROCLAMATIONS

WHEREAS, those Illinois AmeriCorps Members have served more than 64 million hours; which equates to over $1.7 billion in impact for Illinois, by helping improve the lives of our state's most vulnerable residents, strengthening our educational system, protecting our environment, and contributing to our public safety; and,

WHEREAS, last year AmeriCorps Members in Illinois recruited over 18,000 volunteers, served over 366,000 Illinoisans, provided more than 2.1 million hours of service valued at over $59 million, and helped to leverage more than $42 million in cash and in-kind resources; and,

WHEREAS, residents of Illinois have earned more than $157 million in Segal AmeriCorps Education Awards to help pay for college or pay back student loans since 1994; and,

WHEREAS, AmeriCorps members, after their terms of service, remain engaged in our communities as volunteers, teachers, public servants, and nonprofit leaders in disproportionately high levels; and,

WHEREAS, the Serve Illinois Commission on Volunteerism and Community Service and the federal Corporation for National and Community Service play a key role in determining where AmeriCorps resources should be directed to meet state and local needs;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim March 8-14, 2020 as AmeriCorps Week in Illinois and urge residents to thank AmeriCorps Members and alumni for their service and to find ways to give back to their communities at www.Serve.Illinois.gov.

Issued by the Governor March 9, 2020 Filed by the Secretary of State January 8, 2021

2020-80 Peripartum Cardiomyopathy Awareness Week

WHEREAS, Save the Mommies, established in 2017, is a dedicated non-profit organization to help raise awareness of peripartum cardiomyopathy (PPCM), a pregnancy related heart failure; and,

WHEREAS, Illinoisans would like to lead the efforts to increase such awareness; and,

WHEREAS, increasing awareness of this condition could result in saving lives of young mothers and families in Illinois and worldwide by bringing attention to this important condition that greatly contributes to the rising maternal mortality rate; and,

ILLINOIS REGISTER 1245 21 PROCLAMATIONS

WHEREAS, PPCM is not yet given the awareness it needs by other national organizations, Save The Mommies attempts to bridge the gap in much needed awareness for one of the leading causes, if not the leading cause, of death in pregnant or postpartum women; and,

WHEREAS, survivors of PPCM − including the president and founder of Save The Mommies and its board members − have been personally affected by a misdiagnosis of this deadly pregnancy heart failure condition due to lack of awareness and education in society and the medical community; and,

WHEREAS, Save The Mommies and PPCM survivors are committed to educating and raising awareness and aid in research to save women from a diagnosis of PPCM to assist in the awareness of this condition so they can better advocate for themselves during and after pregnancy; and,

WHEREAS, PPCM affects women worldwide and therefore requires global attention and mandatory education of existing medical staff and in medical schools around the world;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim May 3-9, 2020 as Peripartum Cardiomyopathy Awareness Week in Illinois.

Issued by the Governor March 10, 2020 Filed by the Secretary of State January 8, 2021

2020-81 ¡Vive tu Vida! Get Up! Get Moving! Wellness Day

WHEREAS, Hispanic communities in Illinois and throughout the United States are faced with many challenges every day, including maintaining health and wellness; and,

WHEREAS, with a Hispanic population of nearly 16.9 percent, Illinois recognizes the need to confront the challenges the community faces with a proactive strategy to strengthen community alliance and networks; and,

WHEREAS, it is important to ensure the state's Hispanic communities receive culturally- proficient and linguistically-appropriate service, with the goal of promoting healthy behaviors and reducing the risk of illness and injury; and,

WHEREAS, to maximize and coordinate efforts among city and state organizations to promote healthy lifestyle awareness in Chicago's Hispanic communities, the Chicago Hispanic Health Coalition, Illinois Department of Human Service, and Illinois Department of Public Health are

ILLINOIS REGISTER 1246 21 PROCLAMATIONS joining together with its member agencies and the National Alliance for Hispanic Health to sponsor "Vive tu Vida! Get Up! Get Moving!"; and,

WHEREAS, thousands of people are expected to attend "Vive tu Vida! Get Up! Get Moving!" events in cities across the country; and,

WHEREAS, this year, Chicago will host a "Vive tu Vida! Get Up! Get Moving! event on May 30th;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim May 30th, 2020 as ¡Vive tu Vida! Get Up! Get Moving! Wellness Day in Illinois and encourage all residents to recognize the need to increase health awareness in the Hispanic community and to support the efforts of those participating in this important event.

Issued by the Governor March 10, 2020 Filed by the Secretary of State January 8, 2021

2020-82 Apraxia Awareness Day

WHEREAS, May 14th, 2020 marks the seventh annual Childhood Apraxia of Speech Day during which awareness will be raised throughout Illinois about childhood apraxia of speech (CAS), an extremely challenging speech disorder in children; and,

WHEREAS, CAS causes children to have significant difficulty learning to speak and is among the most severe speech deficits in children; and,

WHEREAS, the act of learning to speak comes effortlessly to most children, those with apraxia endure an incredible and lengthy struggle; and,

WHEREAS, without appropriate speech therapy intervention, children with apraxia are placed at high risk for secondary impacts in reading, writing, spelling, and other school-related skills; and,

WHEREAS, that such primary and secondary impacts diminish future independence and employment opportunities if not resolved or improved; and,

WHEREAS, most children with apraxia of speech will learn to communicate with their voices only if they receive early intervention, appropriate, intensive, and frequent speech therapy; and,

ILLINOIS REGISTER 1247 21 PROCLAMATIONS

WHEREAS, funders such as insurance providers, schools, and policy makers are encouraged to recognize the critical need to provide adequate speech therapy and other services, so that the impact of this disorder is minimized and so that thousands of affected children can grow into productive, contributing adult citizens; and,

WHEREAS, our highest respect goes to these children, as well as their families, for their effort, determination and resilience in the face of such obstacles;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby recognize May 14th, 2020 as Apraxia Awareness Day in Illinois and encourage all Illinois residents and citizens of Illinois to work within their communities to increase awareness and understanding of childhood apraxia of speech.

Issued by the Governor March 11, 2020 Filed by the Secretary of State January 8, 2021

2020-83 Blount's Disease Day

WHEREAS, there are nearly 7,000 diseases and conditions considered rare (each affecting fewer than 200,000 Americans) in the United States, according to the National Institutes of Health (NIH); and,

WHEREAS, Blount's disease is considered a rare disease affecting less than one percent of the population in the US, with no supporting organization and not enough research; and,

WHEREAS, Blount's disease is a developmental disorder characterized by abnormality in the growth plate in the upper part of the tibia that causes pain and can lead to deformity and arthritis issues in the future; and,

WHEREAS, individuals affected by Blount's disease often experience problems such as difficulty finding a medical expert, and lack of access to research and treatment; and,

WHEREAS, the cause of Blount's disease is unknown and patients and caregivers who have this rare disease will now participate in this observance;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim April 2, 2020 Blount's Disease Day.

Issued by the Governor March 11, 2020 Filed by the Secretary of State January 8, 2021

ILLINOIS REGISTER 1248 21 PROCLAMATIONS

2020-84 Fabry Disease Awareness Month

WHEREAS, Fabry disease is a progressive, destructive, inherited disorder that causes children and adults to experience many symptoms that diminish their quality of life and may lead to premature death in adults due to strokes, kidney failure, and heart failure; and,

WHEREAS, Fabry disease is caused by deficient activity of the lysosomal enzyme alpha- galactosidase A that results in buildup of lipids in the body causing cell and organ damage; and,

WHEREAS, there are two approved treatments available, but because the disease is severely under-diagnosed, many people live without an accurate diagnosis or opportunity for treatment until after irreversible organ damage occurs; and,

WHEREAS, newborn screening has now been performed in several countries, yielding a prevalence ranging from 1:1,368 to 1:8,882. This is in contrast to earlier presumed prevalence of 1:40,000-1:117,000; and,

WHEREAS, health care providers and families should be aware of the many Fabry disease symptoms and if warranted, obtain a GLA gene test that can definitively assess the presence of this treatable disorder;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby declare April 2020 as "Fabry Disease Awareness Month" in Illinois and urge the residents of this state to learn about Fabry disease and assess their family's risk.

Issued by Governor March 11, 2020 Filed by the Secretary of State January 8, 2021

2020-85 National School Breakfast Week

WHEREAS, the School Breakfast Program has served our nation admirably since it was permanently established in 1975; and,

WHEREAS, the state of Illinois is dedicated to expanding access to and enhancing current school breakfast programs throughout the state to ensure our children are provided with the means to succeed; and,

ILLINOIS REGISTER 1249 21 PROCLAMATIONS

WHEREAS, frequent studies have shown meals provided at school not only contribute to the nutritional needs of students, but also significantly increase and enhance their ability to learn; and,

WHEREAS, Breakfast After the Bell programs, which make breakfast part of the school day, are desirable and effective ways of ensuring more students realize the benefits of breakfast; and,

WHEREAS, the Community Eligibility Provision offers high-need Illinois schools the opportunity to serve breakfast to all students at no cost. This provision has the added benefits to schools of reducing administrative costs, eliminating the collection of paper applications, streamlining meal service operations, and increasing the reimbursements schools receive from federal child nutrition programs; and,

WHEREAS, more than 74 million school breakfast are served yearly to students at more than 3,400 schools in Illinois;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim March 2-6, 2020, as National School Breakfast Week and I encourage all residents to recognize the efforts made by schools, their school food service professionals, and school administrators to ensure the health, safety, and success of our children.

Issued by the Governor March 11, 2020 Filed by the Secretary of State January 8, 2021

2020-86 Public Health Week

WHEREAS, the week of April 6-12, 2020 is National Public Health Week, and the theme is "NPHW@25: Looking Back, Moving Forward"; and,

WHEREAS, the observation is a cooperative effort of the American Public Health Association, the Illinois Public Health Association, state and local health departments, academic institutions, allied organizations, community groups, and professional and trade associations which have joined together to promote a common interest in public health; and,

WHEREAS, inside health departments in every corner of the state, public health workers ensure the basic foundations necessary for good health − clean water, safe food, breathable air, and access to life-saving vaccines; and,

ILLINOIS REGISTER 1250 21 PROCLAMATIONS

WHEREAS, public health action, together with scientific and technologic advances, has played a major role in reducing, and in some cases eliminating, the spread of infectious disease and in establishing today's disease surveillance and control systems; and,

WHEREAS, strong and consistent funding levels are necessary for the public health system to respond to both everyday health threats and unexpected health emergencies;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim the week of April 6-12, 2020 as Public Health Week in Illinois and call upon residents to observe this week by helping our families, friends, neighbors, co-workers, and leaders better understand the value of public health and to celebrate public health's accomplishments in light of this year's theme, NPHW@25: Looking Back, Moving Forward.

Issued by the Governor March 11, 2020 Filed by the Secretary of State January 8, 2021

2020-87 Women Veterans Recognition Month

WHEREAS, women have a long and often unrecognized history of serving in the Armed Forces; and,

WHEREAS, throughout our history, women have been among the patriots who have defended our land and liberty from every enemy; and,

WHEREAS, women have served in occupations from pilot to nurse, in both peacetime and war; we owe all of them a special debt of gratitude for their part in advancing the promise of freedom; and,

WHEREAS, women have demonstrated great skill, sacrifice, and commitment to defending the principles upon which our nation was founded; and,

WHEREAS, we do well to recall that we owe appreciation to our many veterans of military service who are women; and,

WHEREAS, there are approximately 2.2 million living women veterans in the United States and its territories with an estimated 50,000 women veterans who call the state of Illinois home; and,

WHEREAS, the state of Illinois is proud to honor women veterans throughout the month of March, to recognize the courage, honor, and dignity with which women have served and continue to serve in defense of our nation;

ILLINOIS REGISTER 1251 21 PROCLAMATIONS

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim March 2020 as Women Veterans Recognition Month in Illinois, and encourage all residents to honor those women veterans who have courageously served their country.

Issued by the Governor March 11, 2020 Filed by the Secretary of State January 8, 2021

2020-88 Day of Prayer

WHEREAS, the 69th annual observance of the National Day of Prayer will be held on Thursday, May 7, 2020; and,

WHEREAS, the First Continental Congress proposed a day of public prayer in 1775 in support of building the nation, a tradition that informally guided the United States for over one hundred years until the U.S. Congress approved a joint resolution setting aside an annual day to honor the act of prayer in 1952; and,

WHEREAS, Public Law 100-307 directs the President of the United States to set aside and annually proclaim the first Thursday of May as a National Day of Prayer; and,

WHEREAS, leaders and all people of our nation are afforded the privilege of prayer, as well as the freedom to choose how and if they honor a guiding faith; and,

WHEREAS, a Day of Prayer serves as a reminder of the values of compassion and goodwill that tie us to one another, a shared day to honor prayer as means by which we can consider the struggle of others,

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim, May 7, 2020, as a Day of Prayer throughout the state of Illinois.

Issued by the Governor May 4, 2020 Filed by the Secretary of State January 8, 2021

2020-89 Foster Parent Appreciation Month

WHEREAS, each year more than 4,000 Illinois children who have been abused or neglected cannot remain with their families safely, and these children need and deserve the temporary safe haven of a family home where they can be protected, nurtured and loved; and,

ILLINOIS REGISTER 1252 21 PROCLAMATIONS

WHEREAS, without volunteer foster families, the Illinois Department of Children and Family Services would not be able to fulfill its mission to provide for the well-being of the nearly 17,000 children currently in its care; and,

WHEREAS, the department and its nonprofit partners provide a wide range of supports to assist foster families in meeting not only a child's basic physical needs but to also ensure their educational, emotional and social well-being needs are met, none of which can be achieved without the dedication of foster families; and,

WHEREAS, foster families answer a noble calling to devote their time and energy to children, to reunite families when possible, support other permanency options and create opportunities for a successful transition to adulthood; and,

WHEREAS, it is impossible to quantify the ways foster parents change lives, and they deserve the utmost respect and gratitude for the lasting impact they have in the life of a child, in their communities and on the next generation of this state;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do proclaim May 2020 as FOSTER PARENT APPRECIATION MONTH in Illinois, extending thanks on behalf of all the people of Illinois to the thousands of Illinois foster families, and encouraging all to consider joining them in their noble service to children, communities and our state.

Issued by the Governor May 8, 2020 Filed by the Secretary of State January 8, 2021

2020-90 National Nurses Week and National Nurses Day

WHEREAS, the year 2020 marks the 200th birthday of Florence Nightingale the founder of modern nursing and a leader in establishing infection control and general healthcare protocols; and,

WHEREAS, nurses work collaboratively with physicians, other healthcare clinicians, and wellness practitioners to serve and care for individuals, families, and communities; and,

WHEREAS, professional nursing has been demonstrated to be a crucial component of safe and high-quality care, with nurses accounting for the majority of patient contact with healthcare workers; and,

ILLINOIS REGISTER 1253 21 PROCLAMATIONS

WHEREAS, nurses play a vital role in providing health services − devoting their lives to caring for others; giving lifesaving immunizations and health advice; looking after older people and generally meeting everyday essential health needs; and,

WHEREAS, nurses worked tirelessly and selflessly to see the world through the 1918 flu pandemic, the Polio epidemic, the Ebola crisis, and now the COVID-19 pandemic, once again demonstrating their immeasurable value and critical role in building a strong health system; and,

WHEREAS, while nurses face the daily threat of contracting the illnesses they fight, their role is critical in processing, assessing and triaging patients efficiently, managing medical supplies and equipment, enforcing sanitation, and educating their patients and the general public on how to stay healthy; and,

WHEREAS, despite the risks associated with their jobs, nurses remain strong and steadfast in their dedication to their patients who will forever appreciate their help, and as the global need for nurses continues to rise, we should do everything in our power to recognize and appreciate the importance of the profession to all Illinoisans;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim May 6-12, 2020, NATIONAL NURSES WEEK in Illinois and May 12th as NATIONAL NURSES DAY in Illinois, and ask all residents of Illinois to join me in expressing our gratitude to these brave healthcare workers who, without hesitation, answer the call every single day − and let them know we see them, we honor them, we salute them, and we thank them for being our heroes.

Issued by the Governor May 11, 2020 Filed by the Secretary of State January 8, 2021

2020-91 Peace Officers Memorial Day

WHEREAS, the dedicated members of law enforcement selflessly serve to protect the lives and safety of Illinois residents as well as visitors to our great state; and,

WHEREAS, those who work in law enforcement face great risks and willingly put their lives on the line to keep our families and our communities safe; and,

WHEREAS, peace officers are skilled professionals who must act as counselors, communicators, and experts at crisis intervention; and,

WHEREAS, peace officers must protect and defend our lives, our personal safety and our property while maintaining a professional demeanor in stressful situations; and,

ILLINOIS REGISTER 1254 21 PROCLAMATIONS

WHEREAS, we could not live safely and comfortably in our communities without the hard work and sacrifices made each day by the peace officers employed by state, county and municipal governmental units; and,

WHEREAS, it is our duty to recognize peace officers for their hard work and dedication, and to honor the memory of those officers who have given their lives in the performance of their duties;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby declare May 15, 2020, as PEACE OFFICERS MEMORIAL DAY in Illinois, and order all persons or entities governed by the Illinois Flag Display Act to fly their flags at half-staff from sunrise to sunset on this day in honor of the heroism of all our law enforcement officers, especially those who have given their lives in the service of their communities.

Issued by the Governor May 15, 2020 Filed by the Secretary of State January 8, 2021

2020-92 Congenital Diaphragmatic Hernia Awareness Month

WHEREAS, a congenital diaphragmatic hernia (CDH) is a birth defect that occurs during fetal development causing a hole in an infant's diaphragm, allowing organs to migrate through the hole and crowding the abdomen, and ultimately may cause the infant's lungs to be small and underdeveloped; and,

WHEREAS, since the year 2000 an estimated 700,000 babies worldwide have been born with CDH; and,

WHEREAS, 1,600 newborns are affected by CDH in the United States every year with only about half surviving past infancy; and,

WHEREAS, CDH is as common as spina bifida and cystic fibrosis but is not as well-known; and,

WHEREAS, those with CDH often endure multiple surgeries and possible medical complications, which can include heart defects, pulmonary complications, gastric and intestinal problems, developmental delays, and may require respiratory and medicinal support for years; and,

ILLINOIS REGISTER 1255 21 PROCLAMATIONS

WHEREAS, raising awareness of this congenital defect will help bring about acceptance and support for those suffering with CDH and their families, and will lead to urgently needed research and medical advances;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim April 2020, to be Congenital Diaphragmatic Hernia Awareness Month, and urge all residents of Illinois to take cognizance of this event and participate fittingly in its observance.

Issued by the Governor May 19, 2020 Filed by the Secretary of State January 8, 2021

2020-93 Parkinson's Disease Awareness Month in Illinois

WHEREAS, Parkinson's Disease is a chronic, progressive disorder of the nervous system that affects movement for which there is currently no cure; and,

WHEREAS, one million people in the United States are currently living with Parkinson's disease, with an additional 50,000-60,000 new cases diagnosed each year; making Parkinson's disease the 14th leading cause of death in the US according to the Centers for Disease Control; and,

WHEREAS, every day the American Parkinson Disease Association provides the support, education, and research that helps everyone impacted by Parkinson's disease live life to the fullest, through research, patient and family services, education and more; and,

WHEREAS, increased efforts and awareness are desperately needed to help expedite the research efforts into better treatments, medications and ultimately a cure, as well as enhanced programs and services to help those impacted by Parkinson's disease live life to the fullest until a cure is found; and,

WHEREAS, the world, the nation, and the state of Illinois observe Parkinson's Disease Awareness Month in April 2020; and,

WHEREAS, the state of Illinois recognizes the efforts of the Midwest Chapter to raise funds and promote awareness to fight Parkinson's disease, thereby improving the quality of life for those living with the disease;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, in recognition of more than 55 years of indispensable services of the American Parkinson Disease Association and to the

ILLINOIS REGISTER 1256 21 PROCLAMATIONS residents of Illinois do hereby proclaim April 2019 Parkinson's Disease Awareness Month in Illinois.

Issued by the Governor May 19, 2020 Filed by the Secretary of State January 8, 2021

2020-94 Illinois Community College Month

WHEREAS, America's first public community college was established in Joliet, Illinois, in 1901; and,

WHEREAS, today the Illinois Community College System is the third largest in the nation, with 48 community colleges and 39 college districts located throughout the state; and,

WHEREAS, according to the Illinois Community College Board, Illinois community colleges educate 60 percent of the students enrolled in Illinois public higher education; and,

WHEREAS, Illinois is #1 in the nation in bachelor's degree completion rates among community college students of whom 58 percent transfer; and,

WHEREAS, nine out of 10 of the state's community college graduates live, work, pay taxes, and raise their families in Illinois; and,

WHEREAS, earning an Associate of Applied Science or long-term certificate from an Illinois community college adds more than $570,000 in lifetime earnings; and,

WHEREAS, nearly 74 percent of Illinois employers have hired a community college graduate; and,

WHEREAS, Illinois community colleges have partnered with local school districts to offer 10,994 dual credit courses to 58,000 high school students; and,

WHEREAS, Illinois community colleges share a common mission to prepare people for the workforce, to transfer students to other colleges and universities, and to continually respond to the communities they serve through adult, literacy, and continuing education services;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim April 2020 to be Illinois Community College Month in honor of the Illinois Community College System and the significant contribution these institutions are making to the strength, vitality, and prosperity of our state.

ILLINOIS REGISTER 1257 21 PROCLAMATIONS

Issued by the Governor June 4, 2020 Filed by the Secretary of State January 8, 2021

2020-95 Illinois Pollinator Week

WHEREAS, pollinator species such as birds and insects are essential partners of farmers and ranchers in producing much of our food supply; and,

WHEREAS, pollination plays a vital role in the health of our national forests and grasslands, which provide forage, fish and wildlife, timber, water, mineral resources, and recreational opportunities as well as enhanced economic development opportunities for communities; and,

WHEREAS, pollinator species provide significant environmental benefits that are necessary for maintaining healthy, biodiverse ecosystems; and,

WHEREAS, the state of Illinois has managed wildlife habitats and public lands such as Illinois prairies, wetlands and forests for decades; and,

WHEREAS, the state of Illinois provides farmers and ranchers with conservation assistance to promote wise conservation stewardship, including the protection and maintenance of pollinators and their habitats on working lands and wildlands; and,

WHEREAS, the Illinois Environmental Protection Agency, Illinois Department of Natural Resources, Illinois Department of Agriculture and Illinois Department of Transportation are overseeing the Illinois Monarch Project and the creation of the Illinois Monarch Action Plan;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim the week of June 22-28, 2020 as ILLINOIS POLLINATOR WEEK throughout the state of Illinois, and urge all residents to recognize this observance.

Issued by the Governor June 4, 2020 Filed by the Secretary of State January 8, 2021

2020-96 American Eagle Day

WHEREAS, the bald eagle was designated as the United States of America's national emblem on June 20, 1782, by the founding fathers at the Second Continental Congress; and,

ILLINOIS REGISTER 1258 21 PROCLAMATIONS

WHEREAS, the bald eagle is unique to North America and represents such American values and attributes as freedom, courage, strength, spirit, justice, equality, and excellence; and,

WHEREAS, the bald eagle is the central image used in the Great Seal of the United States and in the logos of many branches of the U.S. government, including the Presidency; Congress; Departments of Commerce, Defense, Justice, State, and Treasury; and U.S. Postal Service; and,

WHEREAS, the bald eagle was federally classified as an "endangered species" in the lower 48 states under the Endangered Species Act in 1973, was upgraded to a less imperiled "threatened" status under that Act in 1995, and is currently making a gradual comeback to America's skies; and,

WHEREAS, the Department of Interior and U.S. Fish and Wildlife Service delisted the bald eagle from Endangered Species Act protection in 2007, but the bald eagle continues to be protected under the Bald and Golden Eagle Act of 1940 and the Migratory Bird Treaty Act of 1918;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim June 20, 2019, as American Eagle Day in Illinois and encourage all residents to join in support of the majestic bald eagle's continuing recovery and protection of its precious natural habitat, and in commemorating the living and symbolic presence of our national bird.

Issued by the Governor June 12, 2020 Filed by the Secretary of State January 8, 2021

2020-97 Pollution Control Board Day

WHEREAS, the Pollution Control Board was created in 1970 with the enactment of Illinois' Environmental Protection Act; and,

WHEREAS, the Board is charged with developing environmental rules and standards, adjudicating complaints alleging violation of the Act and regulations; considering requests for regulatory relief, and providing a forum to appeal specified administrative actions; and,

WHEREAS, in the 50 years since its creation, more than 50 persons have served on the Board, providing expertise in law, science, and engineering as well as experience in state and local government, educational institutions, environmental organizations, and the private sector; and,

WHEREAS, the Board encourages public participation in all its proceedings to ensure that its decisions consider the fullest possible range of information and positions; and,

ILLINOIS REGISTER 1259 21 PROCLAMATIONS

WHEREAS, the Board makes its decisions and other documents available to the public free of charge, and uses new technologies to make its work as accessible as possible; and,

WHEREAS, the Board works diligently in its rulemaking process to protect Illinois' environmental and public health while fully considering the technical feasibility and economic reasonableness of proposed regulation; and,

WHEREAS, the Board strives to maintain a fair and open process when adjudicating contested environmental cases including enforcement actions and permit appeals; and,

WHEREAS, the Board has played and will continue to play an important role in implementing Illinois' environmental programs;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, proclaim July 1, 2020, as Pollution Control Board Day on the occasion of its 50th anniversary and commend it for the important role it has played since 1970 in protecting the environment of Illinois and the health and well-being of its people.

Issued by the Governor June 12, 2020 Filed by the Secretary of State January 8, 2021

2020-98 Bob Molaro Day

WHEREAS, the State of Illinois, its Governor and its citizens, are grateful for the dedication of its elected public servants in advocating and working for the general good of the State, with integrity, selflessness and compassion; and,

WHEREAS, the State of Illinois, its Governor and its citizens, are reliant on and benefited by private agents of an engaged democracy to liaise in the cooperative relationship between lawmakers, local municipalities, businesses, community organizations and the public-at-large; and,

WHEREAS, Robert "Bob" Molaro served for a decade as a thrice-elected Illinois State Senator of the 12th district; and,

WHEREAS, during his three terms in the Senate, Senator Molaro served as Democratic spokesman of the Senate Licensed Activities Committee, the Higher Education Committee and as the Democratic spokesperson of the Senate Executive Committee; and,

ILLINOIS REGISTER 1260 21 PROCLAMATIONS

WHEREAS, Senator Molaro has also served on the Committees on Insurance, Pensions and Licensed Activities, Judiciary, and Transportation, and the Pension Laws Commission; and,

WHEREAS, upon retirement from the Illinois State Senate, Bob Molaro was elected to the Illinois House of Representatives to serve as legislator for the 21st district; and,

WHEREAS, during his three terms in the Illinois House, Representative Molaro chaired the Criminal Law Judiciary Committee, the Revenue Committee, and also served prominently on committees for Gaming, Public Safety Appropriations, Mass Transit and Executive Leadership; and,

WHEREAS, Bob Molaro achieved numerous legislative accomplishments as both a Senator and Representative which have enhanced the quality of life for the people of his culturally and racially diverse legislative districts; and,

WHEREAS, Bob Molaro was a compassionate advocate of criminal sentencing moderation, animal rights including a ban on shooting preserves and horse slaughter for human consumption, and protection for victims of child abuse and sex crimes; and,

WHEREAS, Bob Molaro was known and respected as a champion of Illinois horseracing and its attendant agribusinesses, who promoted legislation to modernize the sport and establish parity with other Illinois gaming interests, including advanced deposit mobile and online wagering, impact fee collection and distribution, and allowance for casino-style gaming at race tracks, thereby saving an historic Illinois industry; and,

WHEREAS, upon his retirement from Legislative service, Bob Molaro established a business of government relations to advocate for cooperation between public and private sectors of Illinois for the general betterment of the quality-of-life and working conditions within the State; and,

WHEREAS, Bob Molaro enlightened all with whom he worked with his studious understanding of complicated civic issues, his enduring respect for competing opinions, and his humble humor and general affection for all people;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, let it be resolved by declaration that henceforth June 29th, the day of his birth, be known as Bob Molaro Day to recognize his achievements as a trusted servant to the public of Illinois, and as a passionate citizen-advocate for the common good of our State.

Issued by the Governor June 24, 2020 Filed by the Secretary of State January 8, 2021

ILLINOIS REGISTER 1261 21 PROCLAMATIONS

2020-99 Honorary Poet Laureate

WHEREAS, John Prine's legendary musical career spanned five decades of writing songs that captured the human experience of everyday Americans leading to him being recognized as one of his generation's most influential singer/songwriters; and,

WHEREAS, he was born in Maywood, Illinois on October 10, 1946 and began playing the guitar at age 14; and,

WHEREAS, Prine worked as a mailman following high school and again upon returning from serving two years with the U.S. Army in Germany; he wrote many of his early songs while walking his mail route; and,

WHEREAS, he attended classes at Chicago's Old Town School of Folk Music and was an integral part of the city's folk revival scene in the late 1960s; and,

WHEREAS, in 1970 while playing at The Fifth Peg club, Prine received a fortuitous review by then Chicago Sun Times film critic Roger Ebert headlined 'Singing Mailman Delivers a Powerful Message in a Few Words;' this was his first publicity and it launched him onto the Chicago folk music scene; and,

WHEREAS, John Prine's self-titled debut album was released in 1971 and included some of his most well-known songs including "Illegal Smile," "Hello in There," "Sam Stone," "Paradise," and "Angel from Montgome,y;" the album was named on Rolling Stone magazine's list of 500 Greatest Albums of All Time (#452); and,

WHEREAS, his work has been recorded by artists such as Johnny Cash, Kris Kristofferson, and Bonnie Raitt and influenced the likes of Bob Dylan, Norah Jones, and Roger Waters; recently he was a mentor to a new generation of artists including Jason Isbell, Brandi Carlile, Sturgill Simpson, Dan Auerbach, and Kacey Musgraves; and,

WHEREAS, throughout his career Prine released 18 studio albums, won two Grammy Awards (11 nominations), was named Artist of the Year three times by the Americana Music Honors & Awards, received the 2020 Grammy Lifetime Achievement Award, and was inducted into the Songwriters Hall of Fame, among many other accolades; and,

WHEREAS, in 2005 he was the first singer-songwriter to read and perform at the Library of Congress by invitation of U.S. Poet Laureate Ted Kooser. Kooser spoke of Prine as a "truly original writer, unequaled, and a genuine poet of the American people" and that "he did a better

ILLINOIS REGISTER 1262 21 PROCLAMATIONS job of holding up the mirror of art to the '60s and '70s than any of our official literary poets;" and,

WHEREAS, on April 7, 2020, John Prine danced off life's stage at the age of 73 from complications related to COVID-19; and,

WHEREAS, he leaves behind an unparalleled musical legacy and was beloved by family and millions of fans.who hope that in Heaven he finds Paradise waitin' just as he longed for;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby bestow upon John Prine the designation of Honorary Poet Laureate to honor and celebrate his lifetime of contributions as a writer and poet.

Issued by the Governor June 30, 2020 Filed by the Secretary of State January 8, 2021

2020-100 Chronic Disease Awareness Day

WHEREAS, chronic disease affects millions of individuals throughout the nation and accounts for seven of the top 10 causes of premature death in Americans throughout the United States; and,

WHEREAS, hundreds of thousands of Americans suffer daily from unpreventable and costly chronic and rare conditions, as well as conditions such as cardiovascular disease, stroke, diabetes, cancer, and obesity; and,

WHEREAS, Chronic Disease Day promotes actionable resources to reduce individual risk and lower the rate of chronic disease in America and spreads awareness so to help patients make healthy choices and access preventative care; and,

WHEREAS, community advocacy organizations, healthcare professionals, and federal, state and local governments together recognize the 10th day of the year's 7th month as Chronic Disease Day in honor of the 7 in 10 people who will eventually lose their life to a chronic condition;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim July 10, 2020, as Chronic Disease Awareness Day in the state of Illinois.

Issued by the Governor July 9, 2020 Filed by the Secretary of State January 8, 2021

ILLINOIS REGISTER 1263 21 PROCLAMATIONS

2020-101 ISEPS 50 Years of Service Day

WHEREAS, most people rank sight as the most important of their senses with, according to the American Academy of Ophthalmology, as many as 70 percent of Americans saying they would miss eyesight more than any other sense while nearly 37 million Americans over the age of 40 suffer from potentially blinding eye diseases such as cataracts, glaucoma, age-related macular degeneration and diabetic retinopathy and some 2.4 million eye injuries occur in the United States every year; and,

WHEREAS, ophthalmologists are medical doctors who specialize in medical and surgical treatment of eye conditions and comprehensive vision care; and,

WHEREAS, the Illinois Society of Eye Physicians and Surgeons was established on July 20, 1970, by 16 pioneering ophthalmologists who saw a benefit in organizing the profession in Illinois for the purposes of education, research and advocating for improvements in quality care and safety of patients, and now represents the aspirations of more than 700 ophthalmologists practicing in the state, as well as 100 residents and fellows who are training in Illinois; and,

WHEREAS, the annual educational conference of the Illinois Society of Eye Physicians and Surgeons led by President Doctor Sohail Hasan, in partnership with the Chicago Ophthalmological Society, is one of the largest state conferences in the nation; and,

WHEREAS, the ISEPS Global Ophthalmology Foundation was recently established to support charitable projects for those in need of eye care here in Illinois and abroad;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim July 20, 2020, to be ISEPS 50 Years of Service Day in honor of the founding of the Illinois Society of Eye Physicians and Surgeons and congratulate all ophthalmologists in the State for their work every day to preserve the vision and eye health of Illinois citizens.

Issued by the Governor July 13, 2020 Filed by the Secretary of State January 8, 2021

2020-102 Wind Week in Illinois

WHEREAS, wind energy is the largest provider of renewable energy in the country; and,

ILLINOIS REGISTER 1264 21 PROCLAMATIONS

WHEREAS, Illinois is the 3rd fastest growing state for new wind production, ranks sixth in the nation for installed wind capacity and became the sixth state to exceed 5,000 MW of operating wind in 2019 according to the American Wind Energy Association; and,

WHEREAS, Illinois is home to 34 active wind energy manufacturing facilities and almost 14,000 total jobs supported by wind and solar, cementing our ranking as third in the nation in wind industry employment; and,

WHEREAS, wind powers opportunity in cities and communities all across Illinois, generating in $49 million in annual state and local tax payments and $37 million in annual lease payments to Illinois farmers; and,

WHEREAS, wind farms in Illinois have attracted nearly $11.4 billion in investment to date, helping to spur critical investments in communities that fund manufacturing jobs, education programs, and local economic development projects; and,

WHEREAS, the advancements in wind power will greatly enhance our ability to attract new businesses and talent to our state and community, and will continue to grow as a major force in the U.S. economy;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, hereby proclaim August 9th-15th Wind Week in Illinois in recognition of American Wind Week, and encourage all Illinois citizens to learn more about the benefits of wind energy in our communities and celebrate Illinois' leadership in renewable energy production.

Issued by the Governor July 27, 2020 Filed by the Secretary of State January 8, 2021

2020-103 Gastroparesis Awareness Month

WHEREAS, gastroparesis is a chronic illness which, according to National Institutes of Health (NIH) estimates, affects more than five million people in the United States, yet is little known or understood; and,

WHEREAS, gastroparesis is "paralysis of the stomach" which is characterized by sometimes debilitating pain, nausea, vomiting, and early satiety, and can lead to serious complications such as malnourishment, dehydration, extreme weight fluctuations, esophageal damage, and dangerously erratic blood sugar levels; and,

ILLINOIS REGISTER 1265 21 PROCLAMATIONS

WHEREAS, there is little awareness, no known cure, and few consistently safe, reliable, and effective medications or treatments; and,

WHEREAS, we seek further research, improved medications, additional treatment options, better support, and hope for our future; and,

WHEREAS, we seek to educate the citizens of our state, the medical community, and the general public regarding the devastating effects of this disorder and promote awareness of our condition for the good of the public health;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim the month of August 2020, Gastroparesis Awareness Month.

Issued by the Governor August 7, 2020 Filed by the Secretary of State January 8, 2021

2020-104 Immunization Awareness Week in Illinois

WHEREAS, vaccines are one of the safest and most effective methods to protect children and adults from more than a dozen vaccine-preventable diseases such as chickenpox and whooping cough, which remain common in the United States, and to prevent rare infectious diseases, such as measles, from spreading quickly; and,

WHEREAS, every year thousands of adults in the U.S. are hospitalized due to vaccine- preventable diseases; and,

WHEREAS, adults should also receive certain vaccines, such as an influenza vaccine each year, as well as tetanus and diphtheria boosters every 10 years; additionally, it is recommended that adults over the age of 50 receive the shingles vaccine and adults over the age of 65 are recommended to receive both pneumococcal vaccines; and,

WHEREAS, it has only become more important during the COVID-19 pandemic for all adults and children to maintain the recommended vaccine schedule to help prevent resurgences of preventable diseases; and,

WHEREAS, in 2019, 58.9 percent of children had received the full doses of the standard childhood vaccine series, and all children should receive these vital immunizations; and,

WHEREAS, influenza has many similar symptoms to COVID-19, it remains important for adults and children to receive the flu shot during the COVID-19 pandemic to protect themselves

ILLINOIS REGISTER 1266 21 PROCLAMATIONS from a vaccine-preventable disease and to reduce the amount of healthcare resources dedicated to caring for flu patients;

THEREFORE, I, JB Pritzker, do hereby declare August 2020 as Immunization Awareness Month in the State of Illinois and urge residents of all ages to talk with their health care provider about the vaccines necessary to help keep themselves and their communities safe.

Issued by the Governor August 26, 2020 Filed by the Secretary of State January 8, 2021

2020-105 IARF Membership Appreciation Week

WHEREAS, IARF member agencies provide services and supports in more than 900 locations across the state of Illinois to adults and children with intellectual and developmental disabilities and serious mental illness; and,

WHEREAS, IARF members serve the entire state of Illinois from Galena to Karnak, Chicago to Metro East St. Louis, and Quincy to Danville; and,

WHEREAS, the hard work that is done day in and day out and the dedication to the development and improvement of services in Illinois from IARF members is remarkable; and,

WHEREAS, the state of Illinois is proud to stand with all of you and applaud the critical work you are doing during this difficult point in history;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim August 24- 28, 2020 as IARF Membership Appreciation Week to recognize the dedication and vital role IARF members play in enhancing the lives of adults and children with intellectual and developmental disabilities and serious mental illness. On behalf of the people of Illinois, I offer my best wishes for a safe, enjoyable, and fun, 2020 IARF Membership Appreciation Week.

Issued by the Governor August 27, 2020 Filed by the Secretary of State January 8, 2021

2020-106 Illinois Rail Safety Week

WHEREAS, 104 crashes occurred at public highway-rail grade crossings, resulting in 26 personal injuries and 19 fatalities in the State of Illinois during 2019; and,

ILLINOIS REGISTER 1267 21 PROCLAMATIONS

WHEREAS, 48 trespassing incidents occurred in the State of Illinois during 2019, resulting in the deaths of 29 pedestrians and the injuries of 20 others while trespassing on railroad property rights of way; and,

WHEREAS, Illinois ranks fourth in the nation in grade crossing fatalities and fourth in trespass fatalities for 2019; and,

WHEREAS, more than 81 percent of crashes at public grade crossings in Illinois occur where active warning devices exist; and,

WHEREAS, educating and informing the public about rail safety, reminding the public that railroad rights of way are private property, enhancing public awareness of the dangers associated with highway-rail grade crossing, ensuring pedestrians and motorists are looking and listening while near railways, and obeying established traffic laws will reduce the number of fatalities and injuries to Illinoisans; and,

WHEREAS, the Illinois Association of Chiefs of Police (ILACP), partnered with Metra Railroad and supported by the American Automobile Association, Illinois Commerce Commission, Illinois Department of Transportation, Illinois Operation Lifesaver, Illinois State Police, Illinois Tollway Authority, Illinois Sheriff's Association, Illinois Secretary of State, Illinois Truck Enforcement Association, Illinois High School and College Driver's Education Association, DuPage Rail Safety Council, and local and railroad law enforcement, first responders and area railroad companies commit to partnering together in an effort to educate Illinois residents on all aspects of railroad safety, to enforce applicable state laws, and to support Illinois Rail Safety Week; and,

WHEREAS, the Illinois Commerce Commission continues to develop partnerships designed to create a strong, supportive rail safety culture throughout Illinois to reduce the number of railroad related incidents;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim September 21-27, 2020 as Illinois Rail Safety Week, and encourage all citizens to recognize the importance of rail safety education.

Issued by the Governor September 15, 2020 Filed by the Secretary of State January 8, 2021

2020-107 Chiropractic Health Care Month

ILLINOIS REGISTER 1268 21 PROCLAMATIONS

WHEREAS, every year, more than 30 million Americans throughout the country, including two million in Illinois, visit chiropractic physicians who locate and help correct joint and spinal problems; and,

WHEREAS, chiropractic physicians have long stressed that exercise, good posture, and balanced nutrition are essentials to proper growth, development, and health maintenance; and,

WHEREAS, Illinois chiropractic physicians are dedicated to protecting and promoting patient rights, the practice of chiropractic medicine, and fostering the growth of chiropractic through ongoing training and a commitment to safe and ethical practice; and,

WHEREAS, chiropractic is a safe, conservative approach to pain relief and wellness, and it is the most popular form of natural healthcare in the world; and,

WHEREAS, the science of chiropractic and the physicians who practice it contribute greatly to the health and wellbeing of the people of Illinois;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim October 2020 as Chiropractic Health Care Month in Illinois to raise awareness about chiropractic care.

Issued by the Governor September 16, 2020 Filed by the Secretary of State January 8, 2021

2020-108 Direct Support Professionals Week

WHEREAS, direct support professionals, direct care workers, and in-home support workers are the primary providers of publicly-funded, long-term services and support for individuals with intellectual/developmental disabilities; and,

WHEREAS, direct support professionals must build close, respectful, and trusted relationships with the persons they serve and support; and,

WHEREAS, direct support professionals help those with intellectual/developmental disabilities participate fully in their communities and remain connected to family and friends; and,

WHEREAS, direct support professionals provide a broad range of support to help enable individuals with intellectual/developmental disabilities live meaningful lives; and,

WHEREAS, direct support professionals play an important role in supporting individuals with intellectual/developmental disabilities in helping them avoid more costly institutional care; and,

ILLINOIS REGISTER 1269 21 PROCLAMATIONS

WHEREAS, without direct support professionals, there are no community-based services and support for individuals with intellectual/developmental disabilities; and,

WHEREAS, Illinois is experiencing a severe workforce crisis due to the inability of community- based providers to retain and recruit direct support professionals and addressing this will require a myriad of solutions; and,

WHEREAS, Illinoisans recognize and celebrate the contributions of direct support professionals that help strengthen our communities by fostering greater inclusion of persons with intellectual/developmental disabilities;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim September 8-14, as Direct Support Professionals Recognition Week in Illinois to recognize the dedication and vital role of direct support professionals in enhancing the lives of individuals of all ages with intellectual/developmental disabilities.

Issued by the Governor September 17, 2020 Filed by the Secretary of State January 8, 2021

2020-109 Gold Star Mother's Day

WHEREAS, many times our nation has the made call to action, there have been men and women who didn't flinch and proudly raised their right hand in service to their country; and,

WHEREAS, these heroes served with great honor and distinction, we cannot forget who bears the brunt of the loss when they don't return home, the courage of their sons and daughters has ensured the continued freedom of our state and nation, we are only able to sit here today, because bravery flowed from the hearts of your children; and,

WHEREAS, we remember our commitment to the Gold Star Mothers who go on with their days with the same honor and courage as their children despite living with an unfillable void; and,

WHEREAS, we recall our sacred obligation to those who gave their lives so we could live ours; and,

WHEREAS, the United States 74th Congress proclaimed the last Sunday in September to be known as "Gold Star Mother's Day";

ILLINOIS REGISTER 1270 21 PROCLAMATIONS

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim September 27, 2020 as Gold Star Mother's Day in Illinois to recognize the mothers who suffered the supreme tragedy in the loss of their sons and daughters in wars and remember the sacrifice they have made.

Issued by the Governor September 22, 2020 Filed by the Secretary of State January 8, 2021

2020-110 Principals Week and Principals Day

WHEREAS, school principals play an integral role in the education and growth of children in elementary, middle, and secondary schools across the State of Illinois; and,

WHEREAS, school principals are responsible for promoting education and building relationships with parents and teachers to ensure that each child receives services that meet their needs to excel in the classroom; and,

WHEREAS, it is the primary responsibility of the State of Illinois to preserve and improve resources for schools so that all students have access to a quality education and foundation for a successful future; and,

WHEREAS, the Illinois Principals Association, which represents over 5,800 educational leaders statewide, believes that learning is a lifelong process and that the education of our children is the highest priority; and,

WHEREAS, for that reason, the Illinois Principals Association is dedicated to developing, supporting, and advocating for innovative school leaders; and,

WHEREAS, educational leaders face many challenges in supporting and educating our young people and it is through their perseverance and passion that Illinois continues to produce quality, career-ready students; and,

WHEREAS, school principals and learning leaders have faced unprecedented challenges related to COVID-19 during the 2019-2020 school year and preparing to reopen schools for the 2020- 2021 school year during a continuing pandemic; and,

WHEREAS, we must continue to encourage, support, and recognize our school leaders who have a positive impact on Illinois students and the educational system in the Land of Lincoln; and,

ILLINOIS REGISTER 1271 21 PROCLAMATIONS

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim the week of October 18-24, 2020 as Principals Week and Friday, October 23, 2020 as Principals Day in Illinois, to recognize principals and the Illinois Principals Association for all that they do to help our children learn and succeed.

Issued by the Governor September 22, 2020 Filed by the Secretary of State January 8, 2021

2020-111 Family Meals Month

WHEREAS, Family Meals Month is a national effort to encourage families to pledge to share more meals at home per week; and,

WHEREAS, 92 percent of U.S. consumers say they want to eat healthier meals, yet only 30 percent of American families share dinner every night; and,

WHEREAS, conversations around dinner tables establish closer relationships and increase parental involvement; and,

WHEREAS, regular family meals are linked to kids earning higher grades, improving self- esteem and resisting negative peer pressure; and,

WHEREAS, children who grow up sharing family meals are more likely to exhibit prosocial behavior as adults, such as sharing, fairness, and respect; and,

WHEREAS, 90 percent of supermarkets offer fresh, prepared foods, 95 percent offer cooking demos, 86 percent offer cooking classes, and 100 percent offer recipes and meal ideas;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim September 2020 be recognized as Family Meals Month, and encourage Illinois residents to add one more family meal per week during this month and throughout the year.

Issued by the Governor September 25, 2020 Filed by the Secretary of State January 8, 2021

2020-112 Manufacturing Month in Illinois

WHEREAS, manufacturing has historically represented the largest single sector in the Illinois economy and contributes more than $108 billion in economic output annually; and,

ILLINOIS REGISTER 1272 21 PROCLAMATIONS

WHEREAS, more than 18,000 companies call Illinois home and provide employment for more than 550,000 of our family and neighbors; and,

WHEREAS, Illinois and communities around the World face the most unique challenges in more than a century with the presence of the Novel Coronavirus, COVID-19; and,

WHEREAS, in response to the pandemic, nearly 1,000 manufacturers and distributors voluntarily came forward to provide the state of Illinois with critically indispensable protective supplies and equipment needed by frontline medical and public safety personnel; development of life•saving medicine and diagnostic tools; and with many who took extraordinary steps to ensure our food supply remained safe and plentiful, and our homes and businesses stayed safeguarded; and,

WHEREAS, the growing manufacturing industry with an array of careers offered allows anyone the opportunity to be an integral participant in rising to meet future challenges and create new and innovative products that move our state into the future; and,

WHEREAS, manufacturers continue to struggle to keep pace with filling more than 25,000 ongoing vacancies in production and engineering careers that represent high-quality, high-paying opportunities for every individual; and,

WHEREAS, this pandemic casts limitations on our annual celebration of manufacturing in our state and its great career opportunities, we nonetheless recognize with deep appreciation the vital role of manufacturing in every Illinois community and its ongoing contributions to our economy;

THEREFORE, I, JB Pritzker, Governor of Illinois, due hereby proclaim October 2020 as MANUFACTURING MONTH IN ILLINOIS and encourage local collaborative efforts be safely designed to expand knowledge about and improve general public perception of manufacturing careers and industry's overall value to Illinois and our economy; and,

BE IT FURTHER RESOLVED, that Manufacturing Month is for students and their parents, educators, and all citizens to celebrate the contributions manufacturers make to the fabric of our state's communities and assure continued success of local events highlighting Manufacturing Month in Illinois.

Issued by the Governor September 28, 2020 Filed by the Secretary of State January 8, 2021

2020-113 Suicide Prevention Month

ILLINOIS REGISTER 1273 21 PROCLAMATIONS

WHEREAS, suicide is a major public health issue that can have lasting, harmful effects on individuals, families, and communities; its causes are complex and determined by multiple factors; and,

WHEREAS, in the United States, one person completes suicide every 10.9 minutes and one suicide attempt occurs every 26 seconds. It is estimated that 5.4 million people in the United States are loss survivors of suicide − those who have lost a loved one to suicide; and,

WHEREAS, in 2017, suicide resulted in nearly 479,000 emergency department visits for self- inflicted injury and more than 48,000 deaths nationally; and in 2018 more than 1,400 deaths in Illinois. Illinois residents who've died of suicide, 38.5 percent use a firearm, 34.6 percent died of asphyxiation, and 11.6 percent died of drug poisoning; and,

WHEREAS, suicide affects all ages and is a problem throughout the life span; suicide is the 10th leading cause of all deaths in the United States and the second leading cause of death among individuals between the ages of 10 and 34. In Illinois, suicide is the 11th leading cause of all deaths, second among people 10 to 14 years of age, third among 15 to 25 years of age, and fourth among 35 to 54 years of age; and,

WHEREAS, suicide rates vary by race/ethnicity, age, and other population characteristics, such as non-Hispanic, American Indian/Alaska Native, non-Hispanic White, veterans and other military personnel, workers in certain occupational groups, and sexual minority youth; and,

WHEREAS, of the Illinoisans who died of suicide in a single year, 15 percent were defined as reporting ever serving in the U.S. Armed Forces and the latest statistics show that the Veteran suicide rate in Illinois is significantly higher than the national suicide rate leading to the Illinois General Assembly forming the Veteran Suicide Task Force to study and evaluate how the State of Illinois can become a partner and collaborate in reducing Veteran suicide; and,

WHEREAS, the stigma associated with mental illness and suicidality discourages persons at risk for suicide from seeking lifesaving help and further traumatizes survivors of suicide; and,

WHEREAS, the coronavirus disease 2019 (COVID-19) pandemic can be stressful for people with many Americans experiencing impacts on their mental and emotional well-being, issues such as job loss, financial strain, and social isolation – all risks factors for suicide. Mental health is an important part of overall health and well-being. It is importance to support individuals in seeking personal counseling or treatment anytime it is needed. Those experiencing a suicidal crisis, can call the National Suicide Prevention Lifeline (1-800-273-8255), or text HOME to 741741 for the Crisis Text Line; and,

ILLINOIS REGISTER 1274 21 PROCLAMATIONS

WHEREAS, a great many suicides are preventable, individuals and prevention organizations are working to address prevention at all levels of influence − individual, relationship, community, and societal, to promote awareness of suicide and encourage a commitment to social change;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, hereby proclaim September 2020 as Suicide Prevention Month and encourage Illinois residents and stakeholders to join statewide suicide prevention efforts.

Issued by the Governor September 30, 2020 Filed by the Secretary of State January 8, 2021

2020-114 Cybersecurity Awareness Month

WHEREAS, the State of Illinois recognizes that it plays a vital role in identifying, protecting its citizens from, and responding to cyber threats that may have a significant impact on our individual and collective security and privacy; and,

WHEREAS, critical infrastructure sectors are increasingly reliant on information systems and technology to support financial services, energy, telecommunications, transportation, utilities, health care, and emergency response systems; and,

WHEREAS, the National Cybersecurity Awareness campaign focuses on raising awareness of the importance of cybersecurity and ensuring that all Americans have the resources they need to be safer and more secure online; and,

WHEREAS, the emphasis for this year is encouraging individuals and organizations to own their role in protecting their part of cyberspace, stressing personal accountability and the importance of proactive steps to enhance cybersecurity; and,

WHEREAS, the line between our online and offline lives is indistinguishable in these tech- fueled times, our homes, societal well-being, economic prosperity and nation's security are impacted by the internet; and,

WHEREAS, the Illinois Department of Innovation & Technology, the U.S. Department of Homeland Security, The National Cyber Security Alliance, and the Multi-State Information Sharing and Analysis Center all recognize October as National Cybersecurity Awareness Month;

WHEREAS, all citizens are encouraged to visit the staysafeonline.org and the stop.think.connect.org websites to learn about cybersecurity and put that knowledge into practice in their homes, schools, workplaces, and businesses;

ILLINOIS REGISTER 1275 21 PROCLAMATIONS

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim October 2020 as Cybersecurity Awareness Month in Illinois.

Issued by the Governor September 30, 2020 Filed by the Secretary of State January 8, 2021

2020-115 Domestic Violence Awareness Month

WHEREAS, domestic violence is a prevalent social problem that not only harms the victim but affects family, friends and the community at large; and,

WHEREAS, domestic violence exists in all neighborhoods and cities, affects people of all ages, genders, racial and ethnic, religious and socioeconomic backgrounds; and,

WHEREAS, the health-related costs of rape, physical assault, stalking, trafficking, and homicide by intimate partners exceeds $8.3 billion every year; and,

WHEREAS, the annual cost of lost productivity in the workplace due to domestic violence exceeds $5.8 billion every year; and,

WHEREAS, through the month of October, Illinois Coalition Against Domestic Violence and its 52 member programs will recognize and honor all those who have experienced domestic violence and highlight the additional dangers brought on by COVID-19 and the economic downturn in 2020;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim the month of October 2020 Domestic Violence Awareness Month.

Issued by the Governor September 30, 2020 Filed by the Secretary of State January 8, 2021

2020-116 Fire Prevention Week

WHEREAS, the State of Illinois is committed to ensuring the safety and security of all those living in and visiting our state; and,

WHEREAS, fire is a serious public safety concern both locally and nationally, and homes are the locations where people are at greatest risk from fire; and,

ILLINOIS REGISTER 1276 21 PROCLAMATIONS

WHEREAS, home fires killed more than 2,630 people in the United States in 2017, according to the National Fire Protection Association® (NFPA®), and fire departments in the United States responded to 357,000 home fires; and,

WHEREAS, cooking is the leading cause of home fires in the United States where fire departments responded to more than 173,200 annually between 2013 and 2017; and,

WHEREAS, according to the National Fire Incident Reporting System (NFIRS), Illinois fire departments responded to 6,437 fires that originated in the kitchen or were caused by cooking in 2019; and,

WHEREAS, two of every five home fires start in the kitchen with 31% of these fires resulting from unattended cooking; and,

WHEREAS, more than half of reported non-fatal home cooking fire injuries occurred when the victims tried to fight the fire themselves; and,

WHEREAS, children under five face a higher risk of non-fire burns associated with cooking than being burned in a cooking fire; and,

WHEREAS, Illinois residents should stay in the kitchen when frying food on the stovetop, keep a three-foot kid-free zone around cooking areas and keep anything that can catch fire away from stove tops; and,

WHEREAS, residents who have planned and practiced a home fire escape plan are more prepared and will therefore be more likely to survive a fire; and,

WHEREAS, working smoke alarms cut the risk of dying in reported home fires in half; and,

WHEREAS, Illinois' first responders are dedicated to reducing the occurrence of home fires and home fire injuries through prevention and protection education; and,

WHEREAS, Illinois' residents are responsive to public education measures and are able to take personal steps to increase their safety from fire, especially in their homes; and,

WHEREAS, the 2020 Fire Prevention Week theme TM, "Serve Up Fire Safety in the Kitchen!!" effectively serves to remind us to stay alert and use caution when cooking to reduce the risk of kitchen fire;

ILLINOIS REGISTER 1277 21 PROCLAMATIONS

THEREFORE, I JB Pritzker Governor of Illinois, do hereby proclaim October 4-10, 2020, as Fire Prevention Week throughout this state, and I urge all the people of Illinois to check their kitchens for fire hazards and use safe cooking practices during Fire Prevention Week 2020, and to support the many public safety activities and efforts of Illinois' fire and emergency services.

Issued by the Governor October 2, 2020 Filed by the Secretary of State January 8, 2021

2020-117 Malnutrition Awareness Week

WHEREAS, experts agree that nutrition status is a direct measure of patient health and that good nutrition can keep people healthy and out of healthcare institutions, thus reducing healthcare costs which can be up to $42 billion annually for hospital stays involving malnutrition; and,

WHEREAS, inadequate or unbalanced nutrition, known as malnutrition, is particularly prevalent in vulnerable populations, such as hospitalized patients, older adults, and minority populations, and those populations statistically shoulder the highest incidences of the most severe chronic illnesses such as diabetes, kidney disease, cancer, and cardiovascular disease that are also impacted by nutrition; and,

WHEREAS, malnutrition is exacerbated by the global COVID-19 health pandemic that has intensified disparities and social isolation and is further compounded by food insecurity and federal legislation has allocated supplemental funding for federal community nutrition programs; and,

WHEREAS, illness, injury, and malnutrition can result in the loss of lean body mass, leading to complications that impact good patient health outcomes, including recovery from surgery, illness, or disease; and,

WHEREAS, Enhanced Recovery After Surgery (ERAS®) care plans implemented by a team of multidisciplinary healthcare professionals can improve patient nutrition to support a strong recovery and help reduce risk of complications from elective surgeries; and,

WHEREAS, despite the recognized link between good nutrition and good health, nutrition screening and intervention have not been systematically incorporated across the continuum of care; and,

WHEREAS, clinical quality measures can help improve nutrition screening and intervention, and the Centers for Medicare & Medicaid Services (CMS) for the first time has approved

ILLINOIS REGISTER 1278 21 PROCLAMATIONS multiple malnutrition-specific clinical quality measures for two CMS qualified clinical data registries; and,

WHEREAS, a collaborative effort among key stakeholders in the public and private sectors continues to be required to increase awareness of, reduce, and prevent malnutrition and the National Blueprint: Achieving Quality Malnutrition Care for Older Adults, 2020 Update serves as a template for such collaboration;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, join with the Illinois Department on Aging recognizing that an important step toward identifying and treating malnutrition is raising awareness about it and thus join with The American Society for Parenteral and Enteral Nutrition (ASPEN), proclaim October 5-9, 2020 is recognized as Malnutrition Awareness Week™ in Illinois.

Issued by the Governor October 2, 2020 Filed by the Secretary of State January 8, 2021

2020-118 Filipino American History Awareness Month

WHEREAS, the Filipino American National Historical Society established Filipino American History Month (FAHM) in 1988, choosing October to commemorate the arrival of the first Filipinos who landed in what is now Morro Bay, California on October 18, 1587; and,

WHEREAS, Filipino Americans are now the second most populous Asian American group in both the State of Illinois and the United States; and,

WHEREAS, Filipino Americans have been, and continue to be, are an integral part of the Illinois essential front-line workers and healthcare system as nurses, doctors, other medical professionals, home health and domestic care workers, farm workers, postal service workers and other essential industry workers; and,

WHEREAS, Filipino American servicemen and servicewomen have a longstanding history serving within the Armed Services of the United States from the Civil War to the present-day, including the 250,000 Filipinos who fought under the United States flag during World War II to protect and defend this great state and country; and,

WHEREAS, efforts should continue to promote the study of Filipino-American history and culture, as mandated in the mission statement of the Filipino American National Historical Society, because the roles of Filipino Americans and other people of color have been overlooked in the writing, teaching, and learning of United States history; and,

ILLINOIS REGISTER 1279 21 PROCLAMATIONS

WHEREAS, the State of Illinois recognizes the civic engagement of Filipino Americans in the State of Illinois October 2020 national theme of, "History of Filipino American Activism" that specifically recognizes the history of Filipino American solidarity with other communities in their fights for equity and justice, including the Black Lives Matter Movement, American Indian Movement, Civil Rights and Voting Rights, Women's Rights, LGBTQ Rights, and Environmental Justice;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby recognize October 2020 as Filipino American History Month as a study of the advancement of Filipino Americans, as a time of reflection and remembrance, and as a time to renew efforts toward the research and examination of history and culture to provide an opportunity for all people in Illinois to learn and appreciate more about Filipino Americans and their historic contributions in this great state and to the nation.

Issued by the Governor October 5, 2020 Filed by the Secretary of State January 8, 2021

2020-119 St. Augustine College 40th Anniversary

WHEREAS, St. Augustine College has served more than 10,000 students since its inception 40 years ago and continues to serve a diverse and steadily increasing student population each year; and,

WHEREAS, for 40 years, St. Augustine College has continued to help people strive for a brighter future for themselves and their families by helping them train for higher-paying jobs; and,

WHEREAS, St. Augustine College is the first and only fully Spanish/English bilingual institution of higher education of its kind in the Midwest; and,

WHEREAS, St. Augustine College offers educational opportunities at low tuition rates for all residents of Illinois − from bachelor's degrees to certificate programs to adult education, economic development opportunities, and lifelong learning − and whose students come from all backgrounds and walks of life; and,

WHEREAS, all St. Augustine College faculty, professional support staff, and administrators begin celebrating the college's 40th anniversary during St. Augustine College's 40th Anniversary Day Celebration;

ILLINOIS REGISTER 1280 21 PROCLAMATIONS

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim Wednesday, October 7, 2020, as St. Augustine College's 40th Anniversary Day in the State of Illinois, and urge all residents to join me in recognizing the tremendous influence St. Augustine College has had on the State since opening 40 years ago.

Issued by the Governor October 5, 2020 Filed by the Secretary of State January 8, 2021

2020-120 Infant Safe Sleep Awareness Month

WHEREAS, hundreds of infants die each year because they are placed in unsafe sleeping environments; and,

WHEREAS, Sudden Unexpected Infant Deaths (SUID) is the sudden and unexpected death of an infant, birth to age one year, in which the manner and cause of death are not immediately obvious prior to investigation; and,

WHEREAS, Sudden Infant Death Syndrome (SIDS) is a subset of SUID and remains the number one cause of infant death between the age of 28 days to one year; and,

WHEREAS, the tragedy of SUID can happen to any family, regardless of race, ethnic or economic group; and,

WHEREAS, babies sleep safest when sleeping alone, on their backs, not in adult beds nor couches nor chairs, but in a bassinet or crib with a firm mattress and tightly fitted sheets free of pillows, bumpers, blankets and other items, in a smoke-free environment; and,

WHEREAS, Illinois law requires hospitals to provide education and materials regarding SIDS prevention and safe sleep practices to parents of newborns; and,

WHEREAS, during the month of October we raise awareness of the important steps parents can take to ensure the safety of their infant children while sleeping;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim October 2020 as Infant Safe Sleep Awareness Month in Illinois to raise awareness about sudden unexplained infant death and to encourage infant safe sleep practices so that no parent will have to endure the tragedy of infant death.

Issued by the Governor October 13, 2020 Filed by the Secretary of State January 8, 2021

ILLINOIS REGISTER 1281 21 PROCLAMATIONS

2020-121 Adoption Awareness Month

WHEREAS, thanks to thousands of adoptive parents across the state, 17,547 children have found permanent homes over the last decade, including 1,523 children in the last year alone; and,

WHEREAS, all children need and deserve the love, nurturing and sense of security that can only come from being a part of a loving, permanent family; and,

WHEREAS, adoption provides a unique joy and a special opportunity for individuals, whether or not they are already parents, married, in a civil union, single or divorced, to open their hearts and their homes for the rest of their lives to children; and,

WHEREAS, the Illinois Department of Children and Family Services and its nonprofit partners strive to reunite children with their birth families, but when that simply is not possible, they are equally committed to ensuring every child has the safe, loving family they deserve and need to reach their fullest potential; and,

WHEREAS, Illinois has made great strides in recent years in strengthening and improving the child welfare system: reducing the number of children in temporary substitute care from 52,000 to 18,000; establishing a Bill of Rights for both birth parents and adoptive parents; and strengthening licensing requirements for adoption agencies to prevent the exploitation of birth parents, adoptive parents and children; and,

WHEREAS, we are committed to improving the child welfare system even further, especially by reducing the length of time children remain in temporary foster care; and,

WHEREAS, currently there are nearly 1,400 children awaiting adoption across the state, of all ages, backgrounds and needs;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim November 2020 as Adoption Awareness Month in Illinois, and encourage all Illinoisans to express their gratitude to the thousands of families across the state that have opened their homes and their hearts to children, and encourage others to consider joining them in making a life-changing difference for children.

Issued by the Governor October 15, 2020 Filed by the Secretary of State January 8, 2021

2020-122

ILLINOIS REGISTER 1282 21 PROCLAMATIONS

Breast Cancer Awareness Month and Mammography Day

WHEREAS, October 2020 marks the 35th anniversary of National Breast Cancer Awareness Month, a season to educate women about breast cancer and the importance of early detection through mammography; and,

WHEREAS, breast cancer is the most common cancer diagnosed in women other than skin cancer and is the second leading cause of cancer deaths for women; and,

WHEREAS, in the United States, one in eight women will be diagnosed with breast cancer in their lifetime; and,

WHEREAS, a projected 276,480 new cases of breast cancer will be diagnosed in women across the United States in 2020; and,

WHEREAS, the Illinois Breast and Cervical Cancer Program (IBCCP) offers free breast exams and mammograms to uninsured and underinsured women; and,

WHEREAS, the best chance for detecting breast cancer early is through mammography screening, and since 1993, the United States has recognized the third Friday in October as National Mammography Day;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim October 2020 as BREAST CANCER AWARENESS MONTH and October 16, 2020, as MAMMOGRAPHY DAY in Illinois, and encourage all citizens to join me in the continued fight against breast cancer.

Issued by the Governor October 15, 2020 Filed by the Secretary of State January 8, 2021

2020-123 Women's Small Business Month in Illinois

WHEREAS, Illinois women entrepreneurs are innovators who think big, take risks and work strategically. Women own businesses that provide essential services to their communities and are the backbone of our economy; and,

WHEREAS, Illinois women, like their peers across the nation, have experienced an unprecedented amount of economic impact on their business due to the ongoing COVID-19 pandemic; and,

ILLINOIS REGISTER 1283 21 PROCLAMATIONS

WHEREAS, per a recent survey taken by the U.S. Chamber of Commerce, the number of women-owned businesses that rank their overall business' health as "somewhat or very good" has fallen by 13 points during the pandemic compared to their male counterpart business owners who only fell by five points. Also, women-owned small businesses were found to have less optimistic revenue, investment and hiring plans compared to male-owned small businesses; and,

WHEREAS, women-owned businesses received over $19 million from the first round of Illinois' Business Interruption Grant Program − or BIG Program − and over half of that amount was received by women of color; and,

WHEREAS, the State of Illinois is administering $270m in grants through BIG that are dedicated to support childcare providers – an industry predominantly comprised of women entrepreneurs who provide a critical service to working mothers and fathers; and,

WHEREAS, the State of Illinois is committed to empowering women business owners across the State, knowing that when we support small business, jobs are created, and local communities maintain their distinct culture;

THEREFORE, we, JB Pritzker, Governor of the State of Illinois, and Juliana Stratton, Lieutenant Governor of the State of Illinois, hereby proclaim October 2020 as WOMEN'S SMALL BUSINESS MONTH IN ILLINOIS and encourage the people of the State of Illinois to frequent and support women-owned businesses with our resources so they may not only survive this time but thrive for years to come.

Issued by the Governor October 16, 2020 Filed by the Secretary of State January 8, 2021

2020-124 National Samosa Day

WHEREAS, Samosas have origins throughout the Middle East as conveniently encased meals ideal for traveling merchants; and,

WHEREAS, Samosas have evolved to become a popular food amongst South Asian communities, particularly Indian and Pakistani; and,

WHEREAS, the West Ridge community of Chicago has one of the highest concentrations of restaurants and households serving Samosas; and,

WHEREAS, the modern Samosa has evolved to become a fusion of American, Asian, European, and African cultures; and,

ILLINOIS REGISTER 1284 21 PROCLAMATIONS

WHEREAS, National Samosa Day shall be a representation of South Asian culture, and celebration thereof in the community;

THEREFORE, I, JB Pritzker, Governor of the state of Illinois, proclaim October 25th 2020 shall be declared National Samosa Day, and in conjunction be celebrated with a multitude of multicultural festivities, including restaurant promotions and ethnic dances and songs.

Issued by the Governor October 23, 2020 Filed by the Secretary of State January 8, 2021

2020-125 TAR Syndrome Awareness Month

WHEREAS, Thrombocytopenia-Absent Radius (TAR) syndrome is characterized by the absence of a bone called the radius in each forearm and a shortage of blood cells involved in clotting; and,

WHEREAS, this platelet deficiency (thrombocytopenia) usually appears during infancy and becomes less severe over time, in some cases the platelet levels become normal; and,

WHEREAS, thrombocytopenia prevents normal blood clotting, resulting in easy bruising and frequent nosebleeds with potentially life-threatening episodes of severe bleeding − hemorrhages − may occur in the brain and other organs, especially during the first year of life; and,

WHEREAS, hemorrhages can damage the brain and lead to intellectual disability; and affected children who survive this period and do not have damaging hemorrhages in the brain usually have a normal life expectancy and normal intellectual development; and,

WHEREAS, the severity of skeletal problems in TAR syndrome varies among affected individuals with the radius, which is the bone on the thumb side of the forearm, is almost always missing in both, and the other bone in the forearm, which is called the ulna, is sometimes underdeveloped or absent in one or both arms; and,

WHEREAS, TAR syndrome is unusual among similar malformations in that affected individuals have thumbs, while people with other conditions involving an absent radius typically do not. However, there may be other abnormalities of the hands, such as webbed or fused fingers (syndactyly) or curved pinky fingers (fifth finger clinodactyly). Some people with TAR syndrome also have skeletal abnormalities affecting the upper arms, legs, or hip sockets;

ILLINOIS REGISTER 1285 21 PROCLAMATIONS

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do herby proclaim November 2020 as TAR SYNDROME AWARENESS MONTH, and encourage awareness of this syndrome.

Issued by the Governor October 26, 2020 Filed by the Secretary of State January 8, 2021

2020-126 Election Hero Day

WHEREAS, the COVID-19 pandemic has had a far-reaching effect on the 2020 election, including requiring closures of some polling places, and causing some experienced poll workers to stay home instead of serving at the polls this year due to health risk; and,

WHEREAS, amidst all the changes, election administrators and poll workers, including many with experience and many stepping up for the first time, are playing a critical role in helping voters safely and securely access their ballots; and,

WHEREAS, to conduct an accessible and secure election requires the work of the Illinois State Board of Elections, their staff, 108 local election authorities and their permanent staff, and approximately 80,000 poll workers in every neighborhood and community in our state; and,

WHEREAS, making adjustments to election administration, educating the public, and recruiting and training additional poll workers has required long hours and creativity by these election staff; and,

WHEREAS, thanks to these heroic efforts, record numbers of voters are likely to participate in the 2020 general election; and,

WHEREAS, in order to recognize the heroic efforts made by election administrators and poll workers, the State of Illinois urges voters, businesses, organizations, public officials, and all candidates for public office across our state to join in celebrating and thanking these individuals;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim November 3, 2020, as "ELECTION HERO DAY" in Illinois, and commend its observance to all residents.

Issued by the Governor October 29, 2020 Filed by the Secretary of State January 8, 2021

2020-127 Disability Employment Awareness Month

ILLINOIS REGISTER 1286 21 PROCLAMATIONS

WHEREAS, individuals with disabilities bring a unique skillset and provide important and valuable contributions to the workforce across the State of Illinois; and,

WHEREAS, companies with jobs that are open and available to individuals of all abilities are an essential step to create an inclusive community and strong economy while also aiding in the State and Country's recovery from the COVID-19 pandemic; and,

WHEREAS, the Illinois Department of Human Services and other State agencies are working to show and reinforce the value and talent individuals with disabilities are adding and can add to the workforce and to affirm Illinois' commitment to an inclusive community that provides opportunities and access for all individuals, including those with disabilities; and,

WHEREAS, there are roughly 700,000 individuals with disabilities of working age in Illinois; and,

WHEREAS, of those Illinois residents with disabilities, there are over 250,000 employed in competitive integrated jobs which represents an employment rate of 38.1 percent; and,

WHEREAS, October is National Disability Employment Awareness Month – a national campaign, with 2020 marking its 75th observance, aimed at celebrating the many contributions of workers with disabilities across America and raising awareness about disability employment issues; and,

WHEREAS, 2020 marks the 30th anniversary of the passage of the Americans with Disabilities Act, a landmark civil rights bill that increases access and opportunities for individuals with disabilities across society, including in the workplace;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim October 2020 as DISABILITY EMPLOYMENT AWARENESS MONTH in Illinois, in support of the effort to celebrate individuals with disabilities working across Illinois, and to encourage companies to hire and support a diverse workforce that includes individuals of all abilities.

Issued by the Governor October 30, 2020 Filed by the Secretary of State January 8, 2021

2020-128 American Pharmacists Month

WHEREAS, pharmacy is one of the oldest of the health professions concerned with the health and well-being of all people; and,

ILLINOIS REGISTER 1287 21 PROCLAMATIONS

WHEREAS, today, there are over 321,700 pharmacists licensed in the United States and nearly 12,500 licensed pharmacists in Illinois providing services to assure the rational and safe use of all medications; and,

WHEREAS, the use of medication, as a cost-effective alternative to more expensive medical procedures, is becoming a major force in moderating overall health care costs; and,

WHEREAS, today's powerful medications require greater attention to the manner in which they are used by different patient population groups − both clinically and demographically; and,

WHEREAS, it is important that all users of prescription and nonprescription medications, or their caregivers, be knowledgeable about and share responsibility for their own drug therapy; and,

WHEREAS, pharmacists are specifically educated with a focus and level of expertise on medication therapy that exceeds that of other health care providers; and,

WHEREAS, pharmacists are ideally suited to work collaboratively with other health care providers and patients to improve medication use and outcomes by providing services through medication therapy management; and,

WHEREAS, pharmacists provide both expertise and accessibility which are crucial to patients fully optimizing access to medications that are not self-administered such as, but not limited to, immunizations; and,

WHEREAS, pharmacists are best positioned to be the health care professionals to help ensure patients are adherent to their medications and provide patient care that ensures optimal medication therapy outcomes; and,

WHEREAS, pharmacists, as front-line health care providers, answered the call to aid during the ongoing COVID-19 pandemic and have taken on additional responsibilities of care and practice in order to best serve the public health needs of the residents of the State of Illinois; and,

WHEREAS, the American Pharmacists Association and the Illinois Pharmacists Association have declared October as American Pharmacists Month with the theme Pharmacists: Easy to Reach, Ready to Help;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim October 2020 as American Pharmacists Month in Illinois and urge all our residents to acknowledge the

ILLINOIS REGISTER 1288 21 PROCLAMATIONS valuable services of pharmacists to provide safe, affordable, and beneficial pharmaceutical care services and products to all residents.

Issued by the Governor November 2, 2020 Filed by the Secretary of State January 8, 2021

2020-129 Illinois Rural Health Day

WHEREAS, the main emphasis of rural health care has always been providing affordable, holistic, primary care − a model for the rest of the country to follow as America transitions to a population, wellness/prevention-based system of health care; and,

WHEREAS, rural hospitals and health systems are often the economic foundation and largest employers of their communities; and,

WHEREAS, the health care needs of rural citizens are as unique as the communities in which they live and cannot be addressed by utilizing a "one size fits all" approach; and,

WHEREAS, addressing transportation, workforce, infrastructure, broadband/telecommunication needs, and geographic barriers is necessary to ensure that all rural safety net providers can adequately meet the basic health care needs of the residents they serve; and,

WHEREAS, the Illinois Department of Public Health, Center for Rural Health, the National Organization of State Offices of Rural Health, and other rural stakeholders provide services and resources and foster relationships that help rural communities address their unique health care needs; and,

THEREFORE, I, JB Pritzker, Governor of Illinois, do hereby proclaim November 19, 2020 to be ILLINOIS RURAL HEALTH DAY in honor of National Rural Health Day; and encourage residents of Illinois to recognize the unique contributions and selfless, "can do" attitudes of our rural communities.

Issued by the Governor November 6, 2020 Filed by the Secretary of State January 8, 2021

2020-130 Congenital Heart Defect Awareness Week

WHEREAS, the health and well-being of our congenital heart patients is of paramount importance; and,

ILLINOIS REGISTER 1289 21 PROCLAMATIONS

WHEREAS, each year in the United States, more than 40,000 babies are born with a congenital heart defect; and,

WHEREAS, the medical community has identified congenital heart defects as the leading cause of birth-defect related deaths; and,

WHEREAS, medical research can provide more identifiable means of the origins and symptoms of congenital heart defect; and,

WHEREAS, there is no cure for congenital heart defects and it is a lifelong disease requiring ongoing specialized care; and,

WHEREAS, fewer than ten percent of adults with congenital heart disease are receiving recommended care; and,

WHEREAS, it is crucial that individuals planning a family, fetal clinicians, obstetric physicians, pediatricians, and those in the medical field have a greater understanding of the potential for congenital heart defects; and,

WHEREAS, Congenital Heart Defect Awareness Week provides the opportunity for patients and families affected by this condition to share their experiences and knowledge so the general public may be aware of how this defect affects all our lives;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim February 7- 14, 2021, CONGENITAL HEART DEFECT AWARENESS WEEK in Illinois.

Issued by the Governor November 12, 2020 Filed by the Secretary of State January 8, 2021

2020-131 NET Cancer Awareness Day

WHEREAS, neuroendocrine tumors (NETs) often develop into cancer and, if left untreated, can result in serious illness and death; and,

WHEREAS, healthcare professionals sometimes underestimate the malignant and metastatic potential of neuroendocrine tumors; and,

WHEREAS, NET cancer patients are often misdiagnosed or receive a delayed diagnosis, which can have a negative impact on their chance of survival and quality of life; and,

ILLINOIS REGISTER 1290 21 PROCLAMATIONS

WHEREAS, survival for NET cancer patients is further compromised by fragmented care and lack of access to treatment by networks of specialists; and,

WHEREAS, although there have been advances in the detection and treatment of NET cancers, not all patients are benefiting quickly enough from scientific and medical progress in the field; and;

WHEREAS, with timely diagnosis and proper treatment, NET cancer patients can have significantly improved outcomes and quality of life;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim November 10th, 2019 as NET Cancer Awareness Day and encourage patients, caregivers, and healthcare professionals to raise awareness about NET cancers and the need for timely diagnosis and access to optimal treatment and care.

Issued by the Governor November 12, 2020 Filed by the Secretary of State January 8, 2021

2020-132 Volunteers of America Day

WHEREAS, Volunteers of America has served the needs of our nation's most vulnerable people in Illinois and through the United States since 1896; and,

WHEREAS, in Illinois, Volunteers of America serves 600 veterans at risk of homelessness each year, which includes providing 220 affordable homes for veterans and their families in Chicago and Joliet at its Hope Manor properties; and,

WHEREAS, Volunteers of America Illinois provides more than 500 units of affordable housing for the elderly and those with disabilities in the state; and,

WHEREAS, Volunteers of America Illinois is one of the leading providers of foster care services in the Chicago area, serving 200 children each year in its welfare service program while recruiting and managing a large network of foster care homes; and,

WHEREAS, volunteers working with Volunteers of America Illinois logged approximately 14,000 services hours last year; and,

WHEREAS, Volunteers of America nationally will celebrate the 125th anniversary of its founding on March 8, 2021;

ILLINOIS REGISTER 1291 21 PROCLAMATIONS

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim March 8, 2021, as VOLUNTEERS OF AMERICA DAY in Illinois.

Issued by the Governor November 13, 2020 Filed by the Secretary of State January 8, 2021

2020-133 Antibiotics Awareness Week

WHEREAS, the Illinois Department of Public Health seeks to promote the health of the people of Illinois through the prevention and control of disease and injury; and,

WHEREAS, antibiotic resistance is one of the most urgent threats to the public's health; and,

WHEREAS, the inappropriate use of antibiotics during the COVID-19 pandemic could accelerate the emergence and spread of drug resistant bacteria; and,

WHEREAS, inappropriate antibiotic use, including unnecessary use, inappropriate selection, dosing, and duration, may approach 50% of all outpatient antibiotic use; and,

WHEREAS, each year in the United States, more than 2.8 million people get infected with antibiotic-resistant bacteria, and more than 35,000 people die as a result; and,

WHEREAS, the Illinois Department of Public Health, local organizations, and stakeholders are partnering to help improve the way healthcare professionals prescribe antibiotics, how people take antibiotics, and help fight antibiotic resistance to ensure that these life-saving drugs will be available for future generations;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim the week of November 18-24, 2020 as ANTIBIOTICS AWARENESS WEEK in Illinois and encourage all Illinoisans to educate themselves, their families, and their communities about how to appropriately use antibiotics.

Issued by the Governor November 17, 2020 Filed by the Secretary of State January 8, 2021

2020-134 Manuel Barbosa Conference Room

ILLINOIS REGISTER 1292 21 PROCLAMATIONS

WHEREAS, the Honorable Manuel (Manny) Barbosa, the first chairman of the Illinois Human Rights Commission and pioneering federal bankruptcy judge, passed away on November 25, 2019; and,

WHEREAS, the Illinois Human Rights Act became law 40 years ago, with much of the early implementation shaped by Manny; and,

WHEREAS, his dedication to his fellow man was formed through his family's migration from Mexico; and,

WHEREAS, the Barbosa family settled on a cotton farm in Weslaco, Texas before moving to Illinois, where young Manny witnessed acts of dehumanization in the cotton fields, to which he attributed the birth of his empathy for those in need of a voice, a defender, or an advocate; and,

WHEREAS, his dedication to public service extended across an accomplished legal career and well into retirement, serving both his local community and the state as a whole; and,

WHEREAS, Governor James R. Thompson appointed Manny as Chairman of the Human Rights Commission, where he served 18 years at the helm of the Commission, followed by 14 years on a federal bankruptcy court in Rockford, Illinois; and,

WHEREAS, Manny had a lifelong passion for service and taught ESL and GED courses at the Universidad Popular to Chicago's Latino immigrants during his years at The John Marshall Law School, prosecuted criminal cases in Kane County, and served Elgin's Latino residents through private practice and the scholarship fundraising efforts of Club Guadalupano; and,

WHEREAS, in July 2019 Manny was invited to rejoin the Commission on which he served until his passing; and,

WHEREAS, the Illinois Human Rights Commission has dedicated its conference room in the James R. Thompson Center, and any subsequent Illinois Human Rights Commission conference rooms in other buildings, in Manny's name and honor;

THEREFORE, I, Governor JB Pritzker, Governor of the State of Illinois, do hereby proclaim the naming of the MANUEL BARBOSA CONFERENCE ROOM of the Illinois Human Rights Commission, to be dedicated on December 3, 2020.

Issued by the Governor November 17, 2020 Filed by the Secretary of State January 8, 2021

2020-135

ILLINOIS REGISTER 1293 21 PROCLAMATIONS

National Apprenticeship Week

WHEREAS, Illinois recognizes that the 21st century economy demands a highly-skilled workforce that supports our state economy and supports employers to cultivate high-quality talent pools that grow their businesses and address their workforce needs; and,

WHEREAS, the Office of the Governor is committed to preparing Illinois workers for high- demand careers by developing core academic, technical, and essential employability skills throughout their lifetimes, regardless of background, life circumstances, or education level; and,

WHEREAS, the importance of supporting and strengthening racial equity and diversity and expanding access to the apprenticeship system in Illinois is a core priority for this administration; and,

WHEREAS, apprenticeships are a strong career pathway that provide employees the opportunity to earn a salary while learning the skills necessary to succeed in high-demand careers and high-growth sectors and result in obtainment of an industry-recognized credential; and,

WHEREAS, today, over 16,800 registered apprentices are training in the state of Illinois in high skill careers that will provide lifetime experience and opportunity for achievement as well as contribute to the overall prosperity of our state and nation; and,

WHEREAS, National Apprenticeship Week is an opportunity to recognize the positive impact apprenticeships have on Illinois youth, adults, businesses, and the Illinois economy as a whole;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim November 11-15, 2019, as National Apprenticeship Week in Illinois in support of meaningful career pathways to promote jobs and economic prosperity.

Issued by the Governor November 17, 2020 Filed by the Secretary of State January 8, 2021

2020-136 First Generation Students' Day

WHEREAS, First-Generation students represent a third of all undergraduate students in the United States, and 31 percent of undergraduate students enrolled in Illinois colleges and universities; and,

ILLINOIS REGISTER 1294 21 PROCLAMATIONS

WHEREAS, First-Generation students' academic journey allows for the potential to alter the academic, social, and economic trajectory of their families and communities; and,

WHEREAS, we acknowledge the aptitude, brilliance, and courage of First-Generation students across the State of Illinois; and,

WHEREAS, we continue to support the access, retention and graduation of First-Generation students to and from Illinois colleges and universities;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim and annually celebrate November 8th as FIRST-GENERATION STUDENTS' DAY in the State of Illinois.

Issued by the Governor November 17, 2020 Filed by the Secretary of State January 8, 2021

2020-137 National Adoption Day

WHEREAS, every child deserves to grow up in a safe, stable family; and,

WHEREAS, more than 400,000 children in the United States are currently in foster care, including over 3,347 adoptable children in the care or custody of the Illinois Department of Children and Family Services; and,

WHEREAS, the state of Illinois recognizes the diligence and hard work that adoption professionals display every day in identifying forever families for its children in foster care; and,

WHEREAS, National Adoption Day occurs on Saturday, November 21, 2020, during National Adoption Month, and in order to help children find permanent forever homes, local courts in all 50 states, the District of Columbia, and Puerto Rico will open their doors to finalize the adoptions of children and join other organizations to celebrate these adoptions; and,

WHEREAS, Illinois' future depends on today's children, and it is important to heighten community awareness of the crucial needs of these children and of all those who work tirelessly to place them in loving families;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby recognize November 21, 2020 as NATIONAL ADOPTION DAY and encourage all Illinoisans to consider opening their hearts and homes to children in this state who are in need of a forever family.

ILLINOIS REGISTER 1295 21 PROCLAMATIONS

Issued by the Governor November 19, 2020 Filed by the Secretary of State January 8, 2021

2020-138 Wilton D. Gregory Day

WHEREAS, Archbishop Wilton Daniel Gregory was born in Chicago, Illinois in 1947 and attended St. Carthage Grammar School, Quigley Preparatory Seminary South, Niles College of Loyola University, and St. Mary of the Lake Seminary, and,

WHEREAS, Archbishop Gregory was ordained a priest of the Archdiocese of Chicago in 1973 and later returned to the state after earning a doctorate in sacred liturgy in Rome, and,

WHEREAS, Archbishop Gregory served as an associate pastor of Our Lady of Perpetual Help Parish in Glenview, a faculty member of St. Mary of the Lake Seminary in Mundelein, and as an auxiliary bishop of the Archdiocese of Chicago; and,

WHEREAS, Archbishop Gregory served as the seventh bishop of the Diocese of Belleville for 11 years; and,

WHEREAS, Archbishop Gregory served from 2001 to 2004 as the first African American president of the United States Conference of Catholic Bishops, and implemented the Charter for the Protection of Children and Young People; and,

WHEREAS, Archbishop Gregory was inducted in 2006 into the Martin Luther King Board of Preachers at Morehouse College in Atlanta, and,

WHEREAS, Archbishop Gregory served from 2005 to 2019 as the archbishop of Atlanta, leading that archdiocese through a period of growth; and,

WHEREAS, Archbishop Gregory in 2019 was appointed the seventh archbishop of Washington, D.C. where he created an anti-racism initiative to combat racial injustice; and,

WHEREAS, Archbishop Gregory has worked to establish truth as the guiding principle for his work as well as that of his congregations and communities; and,

WHEREAS, on October 25th of 2020, Pope Francis announced that Wilton D. Gregory would be raised to the position of cardinal at a consistory on November 28th of 2020; and,

WHEREAS, Archbishop Gregory is to be the first African American cardinal in the history of the Roman Catholic Church;

ILLINOIS REGISTER 1296 21 PROCLAMATIONS

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim November 28, 2020 as Wilton D. Gregory Day in the State of Illinois in recognition of his remarkable achievements.

Issued by the Governor November 23, 2020 Filed by the Secretary of State January 8, 2021

2020-139 Pearl Harbor Remembrance Day

WHEREAS, on Sunday morning, December 7, 1941, Japanese bombers and midget submarines attacked the U.S. Naval base at Pearl Harbor, Hawaii; and,

WHEREAS, in fewer than two hours, Japanese forces damaged or sank nearly 20 U.S. naval vessels and damaged or destroyed about 300 U.S. aircraft; and,

WHEREAS, more than 2,000 American military members were killed during the attack, including more than 1,000 aboard the doomed USS Arizona, and more than 1,000 were injured; and,

WHEREAS, upward of 50 of those killed at Pearl Harbor were from Illinois, and thousands of Illinoisans joined the subsequent war efforts; and,

WHEREAS, the surprise attack on Pearl Harbor outraged Illinoisans and Americans nationwide, solidifying the national resolve to defend the United States against all aggressors; and,

WHEREAS, one day after the attack, on December 8, 1941, President Franklin Roosevelt and the U.S. Congress declared war against Japan and its allies, thereby bringing the United States into World War II; and,

WHEREAS, United States' sailors, soldiers, and airmen – now remembered as our "greatest generation" − joined with allies from France, England, and Russia to conduct mass campaigns and operations within the Pacific, African, and European theaters; and,

WHEREAS, as a result of the valor and sacrifice of the "Grand Coalition," Germany surrendered on May 7, 1945, followed by the surrender of Japan on August 14th of that same year; and,

ILLINOIS REGISTER 1297 21 PROCLAMATIONS

WHEREAS, more American military were mobilized during World War II than at any other time in our history, and by the end of the war, more than eight million Americans were serving in the U.S. Army alone; and,

WHEREAS, more than 400,000 Americans died in the service of the country, and virtually no American family was left untouched by the sacrifices of war; and,

WHEREAS, this year marks the 79th anniversary of the "date that will live in infamy," and the 75th anniversary of the end of World War II; and,

WHEREAS, while we can never repay those men and women who faithfully served and sacrificed to make the world safer for liberty, freedom, and human rights, we are proud to honor their memory;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim December 7, 2020, as PEARL HARBOR REMEMBRANCE DAY in Illinois and order all persons or entities governed by the Illinois Flag Display Act to join the ongoing COVID-19 disaster proclamation and lower flags from sunrise to sunset on December 7, 2020, in honor of the memory of all the heroes who died in the attack on Pearl Harbor.

Issued by the Governor November 24, 2020 Filed by the Secretary of State January 8, 2021

2020-140 National Native American Heritage Month

WHEREAS, the original stewards of the land we now call Illinois are the Council of the Three Fires: The Odawa, Ojibwe and Potawatomi Nations, along with the Miami, Ho-Chunk, Menominee, Sac, Fox, and many other Tribes; and,

WHEREAS, Illinois currently enjoys the sixth largest urban Indian population in the United States with over 100 Tribal Nations; the largest Native American population in the Midwest is located in Chicago along with the first American Indian Center in the country, according to a University of Illinois at Chicago's Institute for Research on Race and Public Policy June 2019 report; and,

WHEREAS, Illinois has drawn upon and benefited from the profound influence of Native American culture and wisdom on our food, science, arts, military, and much more, which has strengthened and improved our State; and,

ILLINOIS REGISTER 1298 21 PROCLAMATIONS

WHEREAS, Illinois' history is tarnished by cruelty, tragedy, and injustice towards Native Americans, the damaging effects of which continue to degrade our entire State; Illinois must recognize, confront, and learn from our history if we are to thrive as a healthy and prosperous society; and,

WHEREAS, my administration is dedicated to reshaping our past by expanding opportunity and access to the State for Native Americans as I am determined that all of the children of Illinois be able to see someone who looks like them in my government; and,

WHEREAS, on August 23, 2019, I signed the historic Native American Employment Plan Act to improve delivery of State services; increase employment and promotion opportunities for Native Americans; establish the State's first Native American Employment Plan Advisory Council to gather Native American community leaders and subject matter experts to examine issues, barriers, and incentives regarding Native American access to State government; and direct the Department of Central Management Services to draft annual Native American Employment Plans to the General Assembly; and,

WHEREAS, the Native American community has been invisible for far too long and as written in a prior Presidential Proclamation for National Native American Heritage Month, "Native American voices have echoed through the mountains, valleys, and plains of our country for thousands of years, and it is now our time to listen;"

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim November 2020 as NATIONAL NATIVE AMERICAN HERITAGE MONTH in Illinois to recognize the rich contributions and tragic sacrifices of Native Americans and urge employers, schools, community organizations, and all the people of Illinois to learn more about Native American cultures.

Issued by the Governor November 24, 2020 Filed by the Secretary of State January 8, 2021

2020-141 Lois M. Moorman Day

WHEREAS, Lois M. Moorman has dedicated more than 40 years to serving and advocating for older Illinoisans and their caregivers by working in programs to improve their independence, dignity and quality of life; and,

WHEREAS, upon receiving her bachelor's degree in Social Welfare and Psychology from Southern Illinois University and master's degree from the University of Saint Francis, Lois put

ILLINOIS REGISTER 1299 21 PROCLAMATIONS her education into practice as Social Services Director at the Madison County Nursing Home; and,

WHEREAS, Lois' career continued to increase in responsibility in the 1970s and 1980s as she worked as Staff Supervisor in the Comprehensive Alternative Care Program for the Family Service and Visiting Nurse Association in Alton, as Community Care Coordinator and Care Manager for Project LIFE Area Agency on Aging in Springfield, and as Vice President of Program Operations and Program Specialist for Community Home Services Plus in Springfield, all of which laid the foundation for joining the Illinois Department on Aging in 1986; and,

WHEREAS, Lois worked as a Regional Coordinator and Supervisor of Planning for the Department's Older American Services before becoming Elder Abuse Program Coordinator for the Bureau of Elder Rights and being named Program Administrator for the Office of Adult Protective Services in 2004; and,

WHEREAS, under the auspices of Lois' leadership, the Office of Adult Protective Services ushered in monumental initiatives, including responding to self-neglect reports, implementing Fatality Review Teams statewide, and incorporating persons with disabilities ages 18-59 into the APS program; and,

WHEREAS, the National Adult Protective Services Association honored Lois with its President's Award in 2013 and Illinois TRIAD honored Lois with its Kathleen Quinn Award in 2017, demonstrating the esteem to which her colleagues hold her throughout the state and nationwide; and,

WHEREAS, Lois' tenure has resulted in incalculable contributions to protect and improve the lives of older adults and persons with disabilities for which all Illinoisans owe a debt of gratitude; and,

WHEREAS, Lois is a true Illinoisan, having been born in Centralia on the Fourth of July to Irvin and Erna Meinert, and reared in New Minden; and,

WHEREAS, Lois has been unfaltering in her support of the Fighting Illini and St. Louis Cardinals and will continue to enjoy games upon her retirement at the end of 2020; and,

WHEREAS, Lois looks forward to spending more time with her husband, Ron, children Nathaniel and Elizabeth, and grandchildren Stella, Sylvia, Mia and Ella;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim December 31, 2020 Lois M. Moorman Day.

ILLINOIS REGISTER 1300 21 PROCLAMATIONS

Issued by the Governor December 14, 2020 Filed by the Secretary of State January 8, 2021

2020-142 Move Over Day

WHEREAS, law enforcement officers, firefighters, emergency response personnel, tow truck drivers, and highway workers maintain the operations and safety of Illinois roadways daily and are continually exposed to the dangers of being hit by motorists; and,

WHEREAS, the evening of December 23, 2000, Scott Gillen of the Chicago Fire Department was struck and killed by a drunk driver while assisting at a crash site on a Chicago expressway; and,

WHEREAS, Scott's Law requires motorists to proceed with due caution, make and lane change or reduce the speed of their vehicle, upon the approach of a stationary authorized emergency vehicle; and,

WHEREAS, the State Commemorative Dates Act provides, December 23 of each year is designated as Scott's Law Day, to be observed throughout the State as a day to honor public safety workers and to remind motorists to slow down, change lanes away from a stationary authorized emergency vehicle, and proceed with due regard to safety and traffic conditions; and,

WHEREAS, in 2017, the law was expanded to include any stopped vehicle with flashing hazard lights; and,

WHEREAS, in 2020, the Illinois State Police have already had 15 Scott's Law related crashes, in 2019 they had 26 Scott's Law related crashes, which killed Troopers Christopher Lambert and Brooke Jones-Story;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby proclaim December 23, 2020, as MOVE OVER DAY in Illinois, and urge Illinoisans to move over and slow down when approaching stopped emergency vehicles along our highways.

Issued by the Governor December 23, 2020 Filed by the Secretary of State January 8, 2021

2020-143 FLAG LOWERING CPD TITUS THEOPSY MOORE

ILLINOIS REGISTER 1301 21 PROCLAMATIONS

WHEREAS, all residents owe a debt of gratitude to the law enforcement officers whose courage and sacrifice ensure the safety and security of Illinoisans; and,

WHEREAS, every day these men and women face great risks and often put their lives in danger to perform their duties; and,

WHEREAS, on September 5, 1974 Titus Theopsy Moore was born to the union of Doretha and Theopsy Moore as the third of four children; and,

WHEREAS, Titus was an avid student and voracious reader throughout his life, graduating from Whitney M. Young Magnet High School, where he played in the band, and receiving an Associate in Applied Science degree from Triton College; and,

WHEREAS, Titus always provided a funny, caring, and supportive presence for friends, family, and his cherished pets; and,

WHEREAS, this selfless and devoted spirit extended into Titus's long career in public service, as Titus proudly served as a Cook County Sheriff's Deputy, and later followed in his father's footsteps as an officer of the Chicago Police Department for 14 years, spending the last years as a Field Training Officer; and,

WHEREAS, on November 24, 2020 Titus died, leaving to cherish his memory his father Theopsy Moore, sisters Tonia Moore and Thea Moore (Michael), nephew Richard, nieces Taryn, Talya, Zuri and Zia, first cousins who thought of him as a brother, and a host of other cousins, aunts, uncles, and friends;

THEREFORE, I, JB Pritzker, Governor of the State of Illinois, do hereby order all persons or entities governed by the Illinois Flag Display Act to join the ongoing COVID-19 disaster proclamation in honor and remembrance of Titus Theopsy Moore, whose service shall forever be an inspiration to the people of Illinois.

Issued by the Governor December 8, 2020 Filed by the Secretary of State December 8, 2020

2021-1 Gubernatorial Disaster Proclamation

ILLINOIS REGISTER 1302 21 PROCLAMATIONS

WHEREAS, at all times but especially during a public health crisis, protecting the health and safety of Illinoisans is among the most important functions of State government; and,

WHEREAS, it is critical that Illinoisans who become sick have access to necessary care from medical professionals, including hospital beds, emergency room beds, or ventilators if needed; and,

WHEREAS, it is also critical that the State's health care and first responder workforce has adequate personal protective equipment (PPE) to safely treat patients, respond to public health disasters, and prevent the spread of communicable diseases; and,

WHEREAS, the World Health Organization declared COVID-19 a Public Health Emergency of International Concern on January 30, 2020, and the United States Secretary of Health and Human Services declared that COVID-19 presents a public health emergency on January 27, 2020; and,

WHEREAS, on March 11, 2020, the World Health Organization characterized the COVID-19 outbreak as a pandemic, and has now reported more than 86 million confirmed cases of COVID- 19 and nearly 1.9 million deaths attributable to COVID-19 globally; and,

WHEREAS, despite efforts to contain COVID-19, the virus has continued to spread rapidly, resulting in the need for federal and State governments to take significant steps; and,

WHEREAS, on March 9, 2020, I, JB Pritzker, Governor of Illinois, declared all counties in the State of Illinois as a disaster area in response to the outbreak of COVID-19; and,

WHEREAS, on March 13, 2020, the President declared a nationwide emergency pursuant to Section 501(b) of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, 42 U.S.C. 5121-5207 (the "Stafford Act"), covering all states and territories, including Illinois; and,

WHEREAS, on March 26, 2020, the President declared a major disaster in Illinois pursuant to Section 401 of the Stafford Act; and,

WHEREAS, on April 1, 2020, due to the exponential spread of COVID-19 in Illinois, I declared all counties in the State of Illinois as a disaster area; and,

ILLINOIS REGISTER 1303 21 PROCLAMATIONS

WHEREAS, on April 30, 2020, due to the continued spread of COVID-19 in Illinois, the threatened shortages of hospital beds, ER beds, and ventilators, and the inadequate testing capacity, I declared all counties in the State of Illinois as a disaster area; and,

WHEREAS, on May 29, 2020, due to the continued spread of COVID-19 in Illinois, and the resulting health and economic impacts of the virus, and the need to increase testing capacity, I declared all counties in the State of Illinois as a disaster area; and,

WHEREAS, on June 26, 2020, due to the further spread of COVID-19 in Illinois, the continuing health and economic impacts of the virus, and the need to continue to increase testing capacity and preserve our progress against the disease, I declared all counties in the State of Illinois as a disaster area; and,

WHEREAS, on July 24, 2020, due to the resurgence of COVID-19 in Illinois, the continuing health and economic impacts of the virus, and the need to continue to increase testing capacity and preserve our progress against the disease, I declared all counties in the State of Illinois as a disaster area; and,

WHEREAS, on August 21, 2020, due to the resurgence of COVID-19 in Illinois, the continuing health and economic impacts of the virus, and the need to continue to increase testing capacity and preserve our progress against the disease, I declared all counties in the State of Illinois as a disaster area; and,

WHEREAS, on September 18, 2020, due to the resurgence of COVID-19 in Illinois, the continuing health and economic impacts of the virus, and the need to continue to increase testing capacity and preserve our progress against the disease, I declared all counties in the State of Illinois as a disaster area; and,

WHEREAS, on October 16, 2020, due to the resurgence of COVID-19 in Illinois, the continuing health and economic impacts of the virus, and the need to continue to increase testing capacity and preserve our progress against the disease, I declared all counties in the State of Illinois as a disaster area; and,

WHEREAS, on November 13, 2020, due to the increased spread of COVID-19 in Illinois, the continuing health and economic impacts of the virus, and the need to continue to increase testing capacity and preserve our progress against the disease, I declared all counties in the State of Illinois as a disaster area; and,

WHEREAS, on December 11, 2020, due to the continued rapid spread of COVID-19 in Illinois, the health and economic impacts of the virus, and the need to continue to increase testing

ILLINOIS REGISTER 1304 21 PROCLAMATIONS capacity and preserve our progress against the disease, I declared all counties in the State of Illinois as a disaster area; and,

WHEREAS, as circumstances surrounding COVID-19 have evolved and new evidence emerges, there have been frequent changes in information and public health guidance; and,

WHEREAS, the unprecedented nature of COVID-19, including the health consequences it has on not just the respiratory system but the heart, brain, kidneys, and the body's immune response, has made the virus's effects and its path difficult to predict; and,

WHEREAS, from the outset, data suggested that older adults and those with serious underlying health conditions are more likely to experience severe and sometimes fatal complications from COVID-19; and,

WHEREAS, evidence has shown that young people, including infants and toddlers, are also at risk of such complications; and,

WHEREAS, young and middle-aged people have comprised a significant proportion of new COVID-19 cases and hospitalized COVID-19 patients, and there is evidence that COVID-19 causes blood clots and strokes, and has caused deadly strokes in young and middle-aged people who exhibited few symptoms; and,

WHEREAS, the understanding of spread from infected individuals who have not shown symptoms has changed and, on April 12, 2020, the federal Centers for Disease Control and Prevention (CDC) changed the period of exposure risk from "onset of symptoms" to "48 hours before symptom onset"; and, WHEREAS, some people infected by the virus remain asymptomatic but nonetheless may spread it to others; and,

WHEREAS, although the CDC initially recommended against wearing cloth face coverings or masks as protection, as a result of research on asymptomatic and pre-symptomatic transmission, the CDC revised its conclusions and recommends wearing cloth face coverings in public settings where social distancing measures are difficult to maintain; and,

WHEREAS, the CDC now advises that cloth face coverings or masks protect both the wearer and those around them from COVID-19; and,

WHEREAS, public health research and guidance now indicates the necessity and efficacy of wearing cloth face coverings in public settings where social distancing measures are difficult to maintain, and indicates that the risk of transmission outdoors is less than the risk of transmission indoors; and,

ILLINOIS REGISTER 1305 21 PROCLAMATIONS

WHEREAS, public health guidance advises that minimizing physical interactions between people who do not reside in the same household is critical to slowing the spread of COVID-19; and,

WHEREAS, at the time I issued the first Gubernatorial Disaster Proclamation, there were 11 confirmed cases of COVID-19 in one Illinois county; and,

WHEREAS, as of today, there have been over 1,000,000 confirmed cases of COVID-19 in all 102 Illinois counties; and,

WHEREAS, the first death attributed to COVID-19 in Illinois was announced on March 17, 2020; and,

WHEREAS, as of today, more than 17,000 residents of Illinois have died due to COVID-19; and,

WHEREAS, from the outset, studies have suggested that for every confirmed case there are many more unknown cases, some of which are asymptomatic individuals who can pass the virus to others without knowing; and,

WHEREAS, the CDC estimates that total cases of COVID-19 may be up to 13 times higher than currently reported for certain regions; and,

WHEREAS, the number of new COVID-19 cases in the State has remained high over the past several weeks, and the virus continues to infect thousands of individuals and claim the lives of too many Illinoisans each day; and,

WHEREAS, the COVID-19 pandemic is not limited to the most populous counties, and as of today, counties in all regions of the State are demonstrating significant increased COVID-19 risk; and,

WHEREAS, without precautions COVID-19 can spread exponentially, even in less populous areas; for example, in Jasper County, a single infected first responder visited a nursing home and instigated series of infections that resulted in one of highest infection rates in the State; and

ILLINOIS REGISTER 1306 21 PROCLAMATIONS similarly, in Randolph County, a single infected person attended an event in mid-March that caused that county likewise to suffer one of the State's highest infection rates; and,

WHEREAS, numerous counties all around the State have reported more than 75 cases per 100,000 people over the past 7 days; and,

WHEREAS, the State and the Illinois Department of Public Health have developed a mitigation plan to trigger additional precautions when regions meet certain risk levels; and,

WHEREAS, due to the significant spread of the virus and a surge in COVID-19 patients admitted to hospital beds and ICU beds, on November 20, 2020, I imposed a Tier 3 mitigation plan statewide; and,

WHEREAS, while the precautions taken by Illinoisans previously slowed the growth of COVID-19 cases and deaths in the State, the number of cases in the State remains high after a period of exponential growth; and,

WHEREAS, the U.S. has surpassed 21 million total cases and more than 359,000 deaths; and,

WHEREAS, COVID-19 has claimed the lives of and continues to impact the health of Black and Hispanic Illinoisans at a disproportionately high rate − magnifying significant health disparities and inequities; and,

WHEREAS, the Illinois Department of Public Health activated its Illinois Emergency Operations Plan and its Emergency Support Function 8 Plan to coordinate emergency response efforts by hospitals, local health departments, and emergency management systems in order to avoid a surge in the use of hospital resources and capacity; and,

WHEREAS, as the virus has progressed through Illinois, the crisis facing the State continues to develop and requires an evolving response to ensure hospitals, health care professionals and first responders are able to meet the health care needs of all Illinoisans and in a manner consistent with CDC guidance that continues to be updated; and,

WHEREAS, in order to ensure that health care professionals, first responders, hospitals and other facilities are able to meet the health care needs of all residents of Illinois, the State must have critical supplies, including PPE, such as masks, face shields, gowns, and gloves; and,

WHEREAS, the State of Illinois maintains a stockpile that supports the existing PPE supply chains and stocks at various healthcare facilities; and,

ILLINOIS REGISTER 1307 21 PROCLAMATIONS

WHEREAS, while the State continues to make every effort to procure PPE, if those procurement efforts are disrupted or Illinois experiences a surge in COVID-19 cases, the State faces a life-threatening shortage of respirators, masks, protective eyewear, face shields, gloves, gowns, and other protective equipment for health care workers and first responders; and,

WHEREAS, hospitalizations now are rapidly rising again; and Illinois is using a significant percentage of hospital beds and ICU beds; and, if COVID-19 cases continue to surge, the State could face a shortage of critical health care resources; and,

WHEREAS, over the course of the COVID-19 crisis, the State has been constrained in the number of COVID-19 tests that can be taken and processed due to a limited number of testing sites and labs, as well as a shortage of necessary supplies, including the swabs needed to take samples; and,

WHEREAS, at the time I issued the first Gubernatorial Disaster Proclamation, Illinois had capacity to test no more than a few hundred people per day for COVID-19 at a small number of testing sites; and,

WHEREAS, the State has developed testing sites throughout Illinois and recently has exceeded 100,000 tests per day, and the State continues to focus efforts on increasing testing capacity; and,

WHEREAS, Illinois now has tested nearly 14 million total specimens for COVID-19; and,

WHEREAS, national projections adjusted for Illinois' population suggest the State must continue to increase the number of tests processed per day as part of an effective effort to permanently slow and reduce the spread of COVID-19; and,

WHEREAS, nationwide, nearly 70 million people have filed unemployment claims since the start of the pandemic – representing approximately four in ten U.S. workers; and,

WHEREAS, the Illinois Department of Employment Security announced that the State's unemployment rate continues to be extremely high; and,

WHEREAS, the Illinois Department of Employment Security is responding to the economic crisis in a number of ways, including through the Pandemic Unemployment Assistance program; and,

ILLINOIS REGISTER 1308 21 PROCLAMATIONS

WHEREAS, the Department of Commerce and Economic Opportunity is working to address the economic crisis, including through assistance programs such as the Business Interruption Grants Program for businesses that experienced a limited ability to operate due to COVID-19 related closures; and,

WHEREAS, many executive agencies in the State have focused their limited resources on the ongoing response to the COVID-19 pandemic; and,

WHEREAS, the economic loss and insecurity caused by COVID-19 threatens the viability of business and the access to housing, medical care, food, and other critical resources that directly impact the health and safety of residents; and,

WHEREAS, access to housing helps prevent spread of COVID-19 because individuals with housing are able to minimize physical contact with those outside their households; and,

WHEREAS, temporarily halting eviction proceedings avoids numerous interactions associated with being evicted, including with law enforcement officers, courtroom personnel, landlords, movers, and friends and family who agree to provide temporary housing, as well as, for those who are forced into homelessness, the interactions associated with taking refuge in a shelter; and,

ILLINOIS REGISTER 1309 21 PROCLAMATIONS

WHEREAS, preventing spread by temporarily halting eviction proceedings thus also prevents spread of COVID-19 in the broader community; and,

WHEREAS, COVID-19 also has been extraordinarily disruptive to schools, and it is among the highest priorities of the State to ensure that students are able to obtain a quality education and that schools are able to provide an environment that is safe for students, teachers, and the community; and,

WHEREAS, based on the foregoing facts, and considering the rapid spread of COVID-19 and the ongoing health and economic impacts that will be felt over the coming month by people across the State, the current circumstances in Illinois surrounding the spread of COVID-19 constitute an epidemic emergency and a public health emergency under Section 4 of the Illinois Emergency Management Agency Act; and,

WHEREAS, based on the foregoing, the continuing burden on hospital resources, the ongoing potential that the State could face shortages of these resources in the event of a surge in infections, and the critical need to increase the purchase and distribution of PPE as well as to continue to expand COVID-19 testing capacity constitute a public health emergency under Section 4 of the Illinois Emergency Management Agency Act; and,

WHEREAS, it is the policy of the State of Illinois to be prepared to address any disasters and, therefore, it is necessary and appropriate to make additional State resources available to ensure that that our healthcare delivery system is capable of serving those who are sick and that Illinoisans remain safe and secure and able to obtain medical care; and,

WHEREAS, this proclamation will assist the State in facilitating economic recovery for individuals and businesses in an effort to prevent further devastating consequences from the economic instability COVID-19 has caused; and,

WHEREAS, this proclamation will assist Illinois agencies in coordinating State and Federal resources, including materials needed to test for COVID-19, personal protective equipment, and medicines, in an effort to support the State responses as well as the responses of local governments to the present public health emergency; and,

WHEREAS, these conditions provide legal justification under Section 7 of the Illinois Emergency Management Agency Act for the new issuance of a proclamation of disaster; and,

WHEREAS, the Illinois Constitution, in Article V, Section 8, provides that "the Governor shall have the supreme executive power, and shall be responsible for the faithful execution of the laws," and states, in the Preamble, that a central purpose of the Illinois Constitution is "provide for the health, safety, and welfare of the people";

ILLINOIS REGISTER 1310 21 PROCLAMATIONS

NOW, THEREFORE, in the interest of aiding the people of Illinois and the local governments responsible for ensuring public health and safety, I, JB Pritzker, Governor of the State of Illinois, hereby proclaim as follows:

Section 1. Pursuant to the provisions of Section 7 of the Illinois Emergency Management Agency Act, 20 ILCS 3305/7, I find that a disaster exists within the State of Illinois and specifically declare all counties in the State of Illinois as a disaster area. The proclamation authorizes the exercise of all of the emergency powers provided in Section 7 of the Illinois Emergency Management Agency Act, 20 ILCS 3305/7, including but not limited to those specific emergency powers set forth below.

Section 2. The Illinois Department of Public Health and the Illinois Emergency Management Agency are directed to coordinate with each other with respect to planning for and responding to the present public health emergency.

Section 3. The Illinois Department of Public Health is further directed to cooperate with the Governor, other State agencies and local authorities, including local public health authorities, in the development and implementation of strategies and plans to protect the public health in connection with the present public health emergency.

Section 4. The Illinois Emergency Management Agency is directed to implement the State Emergency Operations Plan to coordinate State resources to support local governments in disaster response and recovery operations.

Section 5. To aid with emergency purchases necessary for response and other emergency powers as authorized by the Illinois Emergency Management Agency Act, the provisions of the Illinois Procurement Code that would in any way prevent, hinder or delay necessary action in coping with the disaster are suspended to the extent they are not required by federal law. If necessary, and in accordance with Section 7(1) of the Illinois Emergency Management Agency Act, 20 ILCS 3305/7(1), the Governor may take appropriate executive action to suspend additional statutes, orders, rules, and regulations.

Section 6. Pursuant to Section 7(3) of the Illinois Emergency Management Agency Act, 20 ILCS 3305/7(3), this proclamation activates the Governor's authority, as necessary, to transfer the direction, personnel or functions of State departments and agencies or units thereof for the purpose of performing or facilitating emergency response programs.

Section 7. The Illinois Department of Public Health, Illinois Department of Insurance and the Illinois Department of Healthcare and Family Services are directed to recommend, and, as appropriate, take necessary actions to ensure expanded access to testing for COVID-19 and that

ILLINOIS REGISTER 1311 21 PROCLAMATIONS consumers do not face financial barriers in accessing diagnostic testing and treatment services for COVID-19.

Section 8. The Illinois State Board of Education is directed to recommend, and, as appropriate, take necessary actions to address any impact to learning associated with the present public health emergency and to continue to alleviate any barriers to the use of remote learning during the effect of this proclamation that exist in the Illinois School Code, 105 ILCS 5/1-1 et. seq.

Section 9. All State agencies are directed to cooperate with the Governor, other State agencies and local authorities in the development and implementation of strategies and plans to cope with and recover from the economic impact of the present public health emergency.

Section 10. Pursuant to Section 7(14) of the Illinois Emergency Management Agency Act, 20 ILCS 3305/7(14), increases in the selling price of goods or services, including medical supplies, protective equipment, medications and other commodities intended to assist in the prevention of or treatment and recovery of COVID-19, shall be prohibited in the State of Illinois while this proclamation is in effect.

Section 11. This proclamation can facilitate requests for federal emergency and/or disaster assistance if a complete and comprehensive assessment of damage indicates that effective recovery is beyond the capabilities of the State and affected local governments.

Section 12. For purposes of Public Act 101-0640, Article 15, section 15-5, amending the Open Meetings Act, new section 5 ILCS 120/7(e)(4), I find that the public health concerns at issue in this proclamation render in-person attendance of more than ten people at the regular meeting location not feasible.

Section 13. This proclamation shall be effective immediately and remain in effect for 30 days.

Issued by the Governor January 8, 2021 Filed by the Secretary of State January 8, 2021

ILLINOIS ADMINISTRATIVE CODE Issue Index - With Effective Dates Rules acted upon in Volume 45, Issue 4 are listed in the Issues Index by Title number, Part number, Volume and Issue. Inquiries about the Issue Index may be directed to the Administrative Code Division at (217) 782-7017/18.

PROPOSED RULES 38 - 190 ...... 1093 89 - 146 ...... 1096 89 - 147 ...... 1103 89 - 153 ...... 1112 14 - 150 ...... 1114 92 - 1030 ...... 1117 92 - 1035 ...... 1132

ADOPTED RULES 77 - 300 1/8/2021 ...... 1134

EMERGENCY RULES 38 - 190 1/8/2021 ...... 1186 89 - 153 1/6/2021 ...... 1191 77 - 250 1/8/2021 ...... 1202 14 - 150 1/8/2021 ...... 1215 92 - 1035 1/6/2021 ...... 1222

EXECUTIVE ORDERS AND PROCLAMATIONS 21 - 1 1/8/2021 ...... 1232 20 - 76 3/2/2020 ...... 1241 20 - 77 3/5/2020 ...... 1241 20 - 78 3/5/2020 ...... 1242 20 - 79 3/9/2020 ...... 1243 20 - 80 3/10/2020 ...... 1244 20 - 81 3/10/2020 ...... 1245 20 - 82 3/11/2020 ...... 1246 20 - 83 3/11/2020 ...... 1247 20 - 84 3/11/2020 ...... 1248 20 - 85 3/11/2020 ...... 1248 20 - 86 3/11/2020 ...... 1249 20 - 87 3/11/2020 ...... 1250 20 - 88 5/4/2020 ...... 1251 20 - 89 5/8/2020 ...... 1251 20 - 90 5/11/2020 ...... 1252 20 - 91 5/15/2020 ...... 1253 20 - 92 5/19/2020 ...... 1254 20 - 93 5/19/2020 ...... 1255 20 - 94 6/4/2020 ...... 1256 20 - 95 6/4/2020 ...... 1257 20 - 96 6/12/2020 ...... 1257 20 - 97 6/12/2020 ...... 1258 20 - 98 6/24/2020 ...... 1259 20 - 99 6/30/2020 ...... 1261 20 - 100 7/9/2020 ...... 1262 20 - 101 7/13/2020 ...... 1263 20 - 102 7/27/2020 ...... 1263 20 - 103 8/7/2020 ...... 1264 20 - 104 8/26/2020 ...... 1265 20 - 105 8/27/2020 ...... 1266 20 - 106 9/15/2020 ...... 1266 20 - 107 9/16/2020 ...... 1267 20 - 108 9/17/2020 ...... 1268 20 - 109 9/22/2020 ...... 1269 20 - 110 9/22/2020 ...... 1270 20 - 111 9/25/2020 ...... 1271 20 - 112 9/28/2020 ...... 1271 20 - 113 9/30/2020 ...... 1272 20 - 114 9/30/2020 ...... 1274 20 - 115 9/30/2020 ...... 1275 20 - 116 10/2/2020 ...... 1275 20 - 117 10/2/2020 ...... 1277 20 - 118 10/5/2020 ...... 1278 20 - 119 10/5/2020 ...... 1279 20 - 120 10/19/2020 ...... 1280 20 - 121 10/15/2020 ...... 1281 20 - 122 10/15/2020 ...... 1281 20 - 123 10/16/2020 ...... 1282 20 - 124 10/23/2020 ...... 1283 20 - 125 10/26/2020 ...... 1284 20 - 126 10/29/2020 ...... 1285 20 - 127 10/30/2020 ...... 1285 20 - 128 11/2/2020 ...... 1286 20 - 129 11/6/2020 ...... 1288 20 - 130 11/12/2020 ...... 1288 20 - 131 11/12/2020 ...... 1289 20 - 132 11/13/2020 ...... 1290 20 - 133 11/17/2020 ...... 1291 20 - 134 11/17/2020 ...... 1291 20 - 135 11/17/2020 ...... 1292 20 - 136 11/17/2020 ...... 1293 20 - 137 11/19/2020 ...... 1294 20 - 138 11/23/2020 ...... 1295 20 - 139 11/24/2020 ...... 1296 20 - 140 11/24/2020 ...... 1297 20 - 141 12/14/2020 ...... 1298 20 - 142 12/23/2020 ...... 1300 20 - 143 12/8/2020 ...... 1300 21 - 1 1/8/2021 ...... 1301

OTHER INFORMATION REQUIRED BY LAW TO BE PUBLISHED IN THE ILLINOIS REGISTER 80 - 1100 ...... 1228