Sen. Graciela Guzmán

Amends the Delinquent Minors Article of the Juvenile Court Act of 1987. Adds a Part concerning Fitness to Stand Trial. Specifies the unfitness standard for a minor. Sets forth procedures to raise the issue of the unfitness of a minor. Specifies the burden of proof and a presumption. Provides requirements for a fitness evaluation and hearing to determine the fitness of a minor. Provides the requirements for the services to attain fitness, the period to obtain fitness, initial and subsequent progress reports, periodic hearings, and in-court assistance to render a minor fit. Specifies time credit and sentencing guidelines for a minor who attains fitness. Provides for the legal disposition of a minor if fitness cannot be attained. Creates the Juvenile Discharge Hearing Task Force to examine the juvenile discharge hearing process, compare Illinois' process with those of other states with juvenile fitness standards, and recommend reforms to the process that ensures minors receive meaningful treatment for existing mental health needs. Provides that the recommendations shall include statutory language to update the juvenile hearing discharge process and whether the juvenile discharge hearing should take place on the same timeframe as discharge hearings for adult offenders. Provides that the Task Force may meet in person or virtually and shall issue a written report of its findings and recommendations to the General Assembly on or before July 1, 2027. Repeals task force provisions on January 1, 2028. Contains other provisions. Contains a severability provision. Effective July 1, 2026.

Creates the Operating Room Patient Safety Act. Provides that each surgical technologist hired or contracted by a health care facility on or after January 1, 2028 shall meet specified educational, certification, or experiential requirements. Provides that health care facilities located in a Health Professional Shortage Area or Medically Underserved Area, as determined by the federal government, shall be exempt as provided but shall have a hiring preference for surgical technologists who graduated from nationally accredited surgical technology programs and are certified through the National Board of Surgical Technology and Surgical Assisting or the National Center for Competency Testing. Provides that nothing in the Act prohibits a person licensed in the State under any other Act from engaging in the practice for which the person is licensed, including, but not limited to, a physician licensed to practice medicine in all its branches, a physician assistant, an advanced practice registered nurse, or a nurse performing surgery-related tasks within the scope of the nurse's license or registration; or a student or intern from performing surgical technology services under direct supervision, as defined in the Registered Surgical Assistant and Registered Surgical Technologist Title Protection Act.

Amends the Ambulatory Surgical Treatment Center Act and the Hospital Licensing Act. Removes the requirement that an anesthesiologist must remain physically present during the delivery of anesthesia services. Amends the Medical Practice Act of 1987. In provisions concerning delegation of authority, removes the requirement that an anesthesiologist or physician must remain physically present during the delivery of anesthesia services by a certified registered nurse anesthetist. Amends the Nurse Practice Act. Removes the requirement that an anesthesiologist, physician, dentist, or podiatric physician must remain physically present during the delivery of anesthesia services by a certified registered nurse anesthetist.

Amends the Fair Patient Billing Act. Makes changes to findings and defined terms provisions. Provides that a hospital shall not deny any protection or benefit of the Act on the basis of a patient's citizenship or immigration status or assets or prospective assets. Provides that a patient who inquires about a denial of financial assistance in whole or in part must be permitted to appeal the decision within at least 90 days. Requires a hospital to use only a uniform financial assistance form developed and provided by the Attorney General no later than December 31, 2026. Provides that every hospital bill and every collection notice must notify the patient, in the patient's preferred language, of the availability of hospital financial assistance and charity care. Establishes further provisions concerning hospitals pursuing collection actions; outsourced health care services; patient responsibilities; and applicability of the Act. Amends the Hospital Uninsured Patient Discount Act. Sets forth provisions concerning uninsured patient discounts for specified income levels. Prohibits hospitals from making the availability of a discount under the Act contingent upon the uninsured patient first applying for coverage under public health insurance programs. Provides that patients may not be denied a discount under the Act on the basis of citizenship or immigration status or assets or prospective assets. Makes other changes concerning uninsured patient discounts, outsourcing health care services, and patient responsibilities. Effective immediately.

Creates the Extremely High Wealth Mark-to-Market Tax Act. Provides that a resident taxpayer with net assets worth $1,000,000,000 or more shall recognize gains or losses as if each asset owned by that taxpayer had been sold for its fair market value on December 31 of the taxable year. Contains provisions concerning the calculation of the amount of tax due from those gains or losses. Amends the Illinois Income Tax Act to make conforming changes. Effective immediately.

Amends the Adult Education Act and the Public Community College Act. With respect to the annual report on adult education for the preceding school year by the Illinois Community College Board, removes the requirement to include a summary of State reimbursement for adult basic education, adult secondary education, English language acquisition, high school credit, integrated English literacy and civics education, and bridge and integrated education and training programs in coordination with vocational skills training. Provides that any public community college district maintaining adult educations classes for the instruction of those persons who, among other requirements, are 17 (rather than 16) years of age or older are entitled to claim an apportionment of State reimbursement. Allows classes in adult education to include digital literacy. Removes language providing that the maximum generation rate for reimbursement per credit hour or per unit of instruction shall be equal to the community college system reimbursement rate for adult education divided by one-third. Provides that State adult education funds, other than matching funds, are not subject to the authorizing federal law. Removes language providing that approved programs for adult education may assess students up to $6 per credit hour or unit of instruction per semester per student. Removes language requiring an education plan to be established for each adult learning participating in the instructional programs. Requires each adult learner participating in the instructional programs to complete an assessment of foundational skills to appropriately place the adult learner in an instructional program. Makes other and conforming changes.

Amends the Medical Assistance Article of the Illinois Public Aid Code. Removes provisions requiring the Department of Healthcare and Family Services to: (i) establish benchmarks for hospitals to measure and align payments to reduce potentially preventable hospital readmissions, inpatient complications, and unnecessary emergency room visits; (ii) publish provider-specific historical readmission data and anticipated potentially preventable targets 60 days prior to the start of the program; and (iii) adopt policies and rates of reimbursement for readmission services and other payments.

Amends the Nurse Practice Act. Provides that an advanced practice registered nurse licensed under the Act may administer radiation to a human being and may supervise the administration of radiation by a person accredited to administer radiation to a human being by the Illinois Emergency Management Agency and Office of Homeland Security. Amends the Radiation Protection Act of 1990. In provisions concerning the limitations on the application of radiation to human beings, adds advanced practice registered nurses licensed under the Nurse Practice Act to the professionals who may intentionally administer radiation to a human being and to the professionals who may supervise a physician assistant, a technologist, a nurse, or other assistant administering radiation. Makes conforming changes in provisions concerning the accreditation of administrators of radiation.

Amends the Cook County Forest Preserve District Act and the River Conservancy Districts Act. Makes changes to the competitive bidding thresholds for contracts entered into by River Conservancy Districts or the Cook County Forest Preserve District for supplies, materials, or work. Changes the bid threshold to $60,000 for contracts related to supplies or materials, $30,000 for contracts involving work, or a lower amount for any contract for supplies, materials, or work, if required by board policy. Effective immediately.

Amends the Assisted Living and Shared Housing Act, the MC/DD Act, and the ID/DD Community Care Act. Provides that notice of closure of an establishment or facility licensed under those Acts shall be given to the Office of the State Long Term Care Ombudsman.