https://www.ilga.gov/legislation/PublicActs/View/103-0890 is the link to the Public Act which amends Administrative Rule 116.  Text is pasted here as well.  Please be aware of this law that makes changes to AR 116.  

Public Act 103-0890

SB0860 Enrolled LRB103 03319 KTG 48325 b

AN ACT concerning State government.

Be it enacted by the People of the State of Illinois,

represented in the General Assembly:

Section 5. The Mental Health and Developmental

Disabilities Administrative Act is amended by changing Section

15.4 as follows:

(20 ILCS 1705/15.4)

Sec. 15.4. Authorization for nursing delegation to permit

direct care staff to administer medications.

(a) This Section applies to (i) all residential programs

for persons with a developmental disability in settings of 16

persons or fewer that are funded or licensed by the Department

of Human Services and that distribute or administer

medications, (ii) all intermediate care facilities for persons

with developmental disabilities with 16 beds or fewer that are

licensed by the Department of Public Health, and (iii) all day

programs certified to serve persons with developmental

disabilities by the Department of Human Services. The

Department of Human Services shall develop a training program

for authorized direct care staff to administer medications

under the supervision and monitoring of a registered

professional nurse. The training program for authorized direct

care staff shall include educational and oversight components

for staff who work in day programs that are similar to those

for staff who work in residential programs. This training

program shall be developed in consultation with professional

associations representing (i) physicians licensed to practice

medicine in all its branches, (ii) registered professional

nurses, and (iii) pharmacists.

(b) For the purposes of this Section:

"Authorized direct care staff" means non-licensed persons

who have successfully completed a medication administration

training program approved by the Department of Human Services

and conducted by a nurse-trainer. This authorization is

specific to an individual receiving service in a specific

agency and does not transfer to another agency.

"Medications" means oral, injectable, auto-injectable, and

topical medications, insulin in an injectable form, oxygen,

epinephrine auto-injectors, and vaginal and rectal creams and

suppositories. "Oral" includes inhalants and medications

administered through enteral tubes, utilizing aseptic

technique. "Topical" includes eye, ear, and nasal medications.

Any controlled substances must be packaged specifically for an

identified individual.

"Insulin in an injectable or auto-injectable form" means a

subcutaneous injection, auto-injection, or other technology

including, but not limited to: (i) an insulin pump; (ii) an

insulin pod; (iii) via an insulin pen pre-filled by the

manufacturer; and (iv) a syringe.

"GLP-1 receptor agonists in an injectable or

auto-injectable form" means medication used for the treatment

of type 1 and type 2 diabetes and obesity. Authorized direct

care staff may administer insulin or GLP-1 receptor agonists

via auto-injection or an insulin pen pre-filled by the

manufacturer as delegated by the registered nurse and , as

ordered by a physician, advanced practice registered nurse, or

physician assistant, if: (i) the staff has successfully

completed a Department-approved advanced training program

specific to insulin or GLP-1 receptor agonist administration

developed in consultation with professional associations

listed in subsection (a) of this Section, and (ii) the staff

consults with the registered nurse, prior to administration,

of any insulin or GLP-1 receptor agonist dose that is

determined based on a blood glucose test result. The

authorized direct care staff shall not: (i) calculate the

insulin or GLP-1 receptor agonist dosage needed when the dose

is dependent upon a blood glucose test result, or (ii)

administer insulin or GLP-1 receptor agonists to individuals

who require blood glucose monitoring greater than 3 times

daily, without consultation with and unless directed to do so

by the registered nurse. An individual may self-administer

insulin or GLP-1 receptor agonists in any form if the

individual is deemed independent by the nurse-trainer through

the use of the Department's required standardized screening

and assessment instruments.

"Nurse-trainer training program" means a standardized,

competency-based medication administration train-the-trainer

program provided by the Department of Human Services and

conducted by a Department of Human Services master

nurse-trainer for the purpose of training nurse-trainers to

train persons employed or under contract to provide direct

care or treatment to individuals receiving services to

administer medications and provide self-administration of

medication training to individuals under the supervision and

monitoring of the nurse-trainer. The program incorporates

adult learning styles, teaching strategies, classroom

management, and a curriculum overview, including the ethical

and legal aspects of supervising those administering

medications.

"Self-administration of medications" means an individual

administers his or her own medications or a portion of his or

her own medications. To be considered capable to

self-administer their own medication, individuals must, at a

minimum, be able to identify their medication by size, shape,

or color, know when they should take the medication, and know

the amount of medication to be taken each time. The use of

assistive or enabling technologies can be used to demonstrate

a person's capability to administer his or her own

medications.

"Training program" means a standardized medication

administration training program approved by the Department of

Human Services and conducted by a registered professional

nurse for the purpose of training persons employed or under

contract to provide direct care or treatment to individuals

receiving services to administer medications and provide

self-administration of medication training to individuals

under the delegation and supervision of a nurse-trainer. The

program incorporates adult learning styles, teaching

strategies, classroom management, curriculum overview,

including ethical-legal aspects, and standardized

competency-based evaluations on administration of medications

and self-administration of medication training programs.

(c) Training and authorization of non-licensed direct care

staff by nurse-trainers must meet the requirements of this

subsection.

(1) Prior to training non-licensed direct care staff

to administer medication, the nurse-trainer shall perform

the following for each individual to whom medication will

be administered by non-licensed direct care staff:

(A) An assessment of the individual's health

history and physical and mental status.

(B) An evaluation of the medications prescribed.

(2) Non-licensed authorized direct care staff shall

meet the following criteria:

(A) Be 18 years of age or older.

(B) Have completed high school or have a State of

Illinois High School Diploma.

(C) Have demonstrated functional literacy.

(D) Have satisfactorily completed the Health and

Safety component of a Department of Human Services

authorized direct care staff training program.

(E) Have successfully completed the training

program, pass the written portion of the comprehensive

exam, and score 100% on the competency-based

assessment demonstrating proficiency in the skill of

administering medication specific to the individual

and his or her medications.

(F) Have received additional competency-based

assessment or training by the nurse-trainer when the

nurse-trainer determines additional skill development

is needed to administer medication by the

nurse-trainer as deemed necessary by the nurse-trainer

whenever a change of medication occurs or a new

individual that requires medication administration

enters the program.

(3) Authorized direct care staff shall be re-evaluated

by a nurse-trainer at least annually or more frequently at

the discretion of the registered professional nurse. Any

necessary retraining shall be to the extent that is

necessary to ensure competency of the authorized direct

care staff to administer medication.

(4) Authorization of direct care staff to administer

medication shall be revoked if, in the opinion of the

registered professional nurse, the authorized direct care

staff is no longer competent to administer medication.

(5) The registered professional nurse shall assess an

individual's health status at least annually or more

frequently at the discretion of the registered

professional nurse.

This subsection only applies to settings where the

registered professional nurse has jurisdiction. If direct care

staff move to other settings, they shall consult with the

registered professional nurse who has jurisdiction of that

setting.

(d) Medication self-administration shall meet the

following requirements:

(1) As part of the normalization process, in order for

each individual to attain the highest possible level of

independent functioning, all individuals shall be

permitted to participate in their total health care

program. This program shall include, but not be limited

to, individual training in preventive health and

self-administration of medication self-medication

procedures.

(A) Every program shall adopt written policies and

procedures for assisting individuals who choose to

obtain in obtaining preventative health and

self-administration of medication self-medication

skills in consultation with a registered professional

nurse, advanced practice registered nurse, physician

assistant, or physician licensed to practice medicine

in all its branches.

(B) If an individual desires to gain independence

in self-administration of medication, the individual

Individuals shall be evaluated to determine the

individual's their ability to self-administer

medication self-medicate by the nurse-trainer through

the use of the Department's required, standardized

screening and assessment instruments.

(C) (Blank). When the results of the screening and

assessment indicate an individual not to be capable to

self-administer his or her own medications, programs

shall be developed in consultation with the Community

Support Team or Interdisciplinary Team to provide

individuals with self-medication administration.

(2) Each individual shall be presumed to be competent

to self-administer medications if:

(A) authorized by an order of a physician licensed

to practice medicine in all its branches, an advanced

practice registered nurse, or a physician assistant;

and

(B) approved to self-administer medication by the

individual's Community Support Team or

Interdisciplinary Team, which includes a registered

professional nurse or an advanced practice registered

nurse.

(e) Quality Assurance.

(1) A registered professional nurse, advanced practice

registered nurse, licensed practical nurse, physician

licensed to practice medicine in all its branches,

physician assistant, or pharmacist shall review the

following for all individuals:

(A) Medication orders.

(B) Medication labels, including medications

listed on the medication administration record for

persons who are not self-administering medication

self-medicating to ensure the labels match the orders

issued by the physician licensed to practice medicine

in all its branches, advanced practice registered

nurse, or physician assistant.

(C) Medication administration records for persons

who are not self-administering medication

self-medicating to ensure that the records are

completed appropriately for:

(i) medication administered as prescribed;

(ii) refusal by the individual; and

(iii) full signatures provided for all

initials used.

(2) Reviews shall occur at least quarterly, but may be

done more frequently at the discretion of the registered

professional nurse or advanced practice registered nurse.

(3) A quality assurance review of medication errors

and data collection for the purpose of monitoring and

recommending corrective action shall be conducted within 7

days and included in the required annual review.

(f) Programs using authorized direct care staff to

administer medications are responsible for documenting and

maintaining records on the training that is completed.

(g) The absence of this training program constitutes a

threat to the public interest, safety, and welfare and

necessitates emergency rulemaking by the Departments of Human

Services and Public Health under Section 5-45 of the Illinois

Administrative Procedure Act.

(h) Direct care staff who fail to qualify for delegated

authority to administer medications pursuant to the provisions

of this Section shall be given additional education and

testing to meet criteria for delegation authority to

administer medications. Any direct care staff person who fails

to qualify as an authorized direct care staff after initial

training and testing must within 3 months be given another

opportunity for retraining and retesting. A direct care staff

person who fails to meet criteria for delegated authority to

administer medication, including, but not limited to, failure

of the written test on 2 occasions shall be given

consideration for shift transfer or reassignment, if possible.

No employee shall be terminated for failure to qualify during

the 3-month time period following initial testing. Refusal to

complete training and testing required by this Section may be

grounds for immediate dismissal.

(i) No authorized direct care staff person delegated to

administer medication shall be subject to suspension or

discharge for errors resulting from the staff person's acts or

omissions when performing the functions unless the staff

person's actions or omissions constitute willful and wanton

conduct. Nothing in this subsection is intended to supersede

paragraph (4) of subsection (c).

(j) A registered professional nurse, advanced practice

registered nurse, physician licensed to practice medicine in

all its branches, or physician assistant shall be on duty or on

call at all times in any program covered by this Section.

(k) The employer shall be responsible for maintaining

liability insurance for any program covered by this Section.

(l) Any direct care staff person who qualifies as

authorized direct care staff pursuant to this Section shall be

granted consideration for a one-time additional salary

differential. The Department shall determine and provide the

necessary funding for the differential in the base. This

subsection (l) is inoperative on and after June 30, 2000.

(Source: P.A. 102-1100, eff. 1-1-23.)