Text of IL HB 3515 (2020)

101ST GENERAL ASSEMBLY State of Illinois 2019 and 2020 HB3515 Introduced , by Rep. Thomas Morrison SYNOPSIS AS INTRODUCED: New Act 225 ILCS 60/22 from Ch. 111, par. 4400-22 Creates the Youth Health Protection Act. Provides that a medical doctor shall not prescribe, provide, administer, or deliver puberty-suppressing drugs or cross-sex hormones and shall not perform surgical orchiectomy or castration, urethroplasty, vaginoplasty, mastectomy, phalloplasty, or metoidioplasty on biologically healthy and anatomically normal persons under the age of 18 for the purpose of treating the subjective, internal psychological condition of gender dysphoria or gender discordance. Provides that any efforts to modify the anatomy, physiology, or biochemistry of a biologically healthy person under the age of 18 who experiences gender dysphoria or gender discordance shall be considered unprofessional conduct and shall be subject to discipline by the licensing entity or disciplinary review board. Provides that no medical doctor or mental health provider shall refer any person under the age of 18 to any medical doctor for chemical or surgical interventions to treat gender dysphoria or gender discordance. Contains definitions, a statement of purpose, and legislative findings. Amends the Medical Practice Act of 1987 to make related changes. LRB101 11160 CPF 56398 b A BILL FOR HB3515LRB101 11160 CPF 56398 b 1 AN ACT concerning regulation. 2 Be it enacted by the People of the State of Illinois, 3represented in the General Assembly: 4 Section 1. Short title. This Act may be cited as the Youth 5Health Protection Act. 6 Section 5. Legislative findings. The General Assembly 7finds and declares the following: 8 (1) At birth, doctors identify the sex of babies. They do 9not assign them a "gender." 10 (2) Being biologically male or biologically female is not a 11disorder, illness, deficiency, shortcoming, or error. 12Scientists and other medical professionals have recognized 13that biological sex is a neutral, objective, and immutable fact 14of human nature. 15 (3) Puberty is not a disease or a disorder. 16 (4) There is no conclusive, research-based evidence 17proving that if there is incongruence between one's objective 18and immutable biological sex (and its attendant healthy and 19normally functioning anatomy and physiology) and one's 20subjective, internal sense of being male or female that the 21problem resides in the body rather than the mind. 22 (5) The May 19, 2014 issue of the highly respected Hayes 23Directory reports that the practice of using hormones and HB3515- 2 -LRB101 11160 CPF 56398 b 1surgery to treat gender dysphoria in adults is based on "very 2low quality of evidence" and goes on to discuss the "serious 3limitations to the evidence" in great detail. It reports 4further that the use of hormones and surgery to treat gender 5dysphoria in children and adolescents has no evidence base. 6 (6) Health risks and complications of puberty suppression: 7The use of puberty-suppression medications for the treatment of 8gender-dysphoric minors is "off-label." The health risks 9include the arrest of bone growth, a decrease in bone 10accretion, the prevention of sex-steroid-dependent 11organization and maturation of the adolescent brain, and the 12inhibition of fertility by preventing the development of 13gonadal tissue and mature gametes for the duration of 14treatment. 15 (7) Self-fulfilling nature of puberty suppression: "There 16is an obvious self-fulfilling nature to encouraging a young boy 17with [gender dysphoria] to socially impersonate a girl and then 18institute pubertal suppression. Given the well-established 19phenomenon of neuroplasticity, the repeated behavior of 20impersonating a girl alters the structure and function of the 21boy's brain in some way-potentially in a way that will make 22identity alignment with his biologic sex less likely. This, 23together with the suppression of puberty that prevents further 24endogenous masculinization of his brain, causes him to remain a 25gender non-conforming prepubertal boy disguised as a 26prepubertal girl." HB3515- 3 -LRB101 11160 CPF 56398 b 1 (8) Cross-sex hormones risks and effects: The use of 2cross-sex hormones for the treatment of gender dysphoria in 3minors is "off-label," and long-term risks are unknown. 4 Sterility and voice changes are permanent for both men and 5women. 6 An interagency statement published by the World Health 7Organization states that "sterilization should only be 8provided with the full, free and informed consent of the 9individual" and that "sterilization refers not just to 10interventions where the intention is to limit fertility ... but 11also to situations where loss of fertility is a secondary 12outcome. ... Sterilization without full, free and informed 13consent has been variously described by international, 14regional and national human rights bodies as an involuntary, 15coercive and/or forced practice, and as a violation of 16fundamental human rights, including the right to health, the 17right to information, the right to privacy." 18 Since parents or guardians must provide consent for 19hormonal interventions, and since parents and guardians are not 20being made aware of the experimental nature of the off-label 21use of hormones for the treatment of gender dysphoria or of the 22fact that most children with gender dysphoria outgrow it by 23late adolescence if otherwise supported through natural 24puberty, parents and guardians are unable to provide fully 25informed consent. 26 Breast tissue growth in men who take estrogen is permanent. HB3515- 4 -LRB101 11160 CPF 56398 b 1"Male"-pattern baldness and body and facial hair growth in 2women who take testosterone are permanent. 3 For biologically healthy men who take estrogen to treat 4their subjective, internal feelings about their sex, there is 5an "increased risk of liver disease, increased risk of blood 6clots, (risk of death or permanent damage), increased risk of 7diabetes and of headaches/migraines heart disease, increased 8risk of gallstones, may be increased risk of noncancerous 9[tumor] of pituitary gland." 10 For biologically healthy women who take testosterone to 11treat their subjective, internal feelings about their sex, 12there is an increased risk of heart disease, stroke, diabetes, 13breast cancer, ovarian cancer, and uterine cancer. Taking 14testosterone can have a "destabilizing effect" on "bipolar 15disorder, schizoaffective disorder, and schizophrenia." 16 (9) The Christian Medical and Dental Associations 17"[believe] that prescribing hormonal treatments to children or 18adolescents to disrupt normal sexual development for the 19purpose of gender reassignment is ethically impermissible, 20whether requested by the child or the parent." 21 (10) The Catholic Medical Association "urges health care 22professionals to adhere to genetic science and sexual 23complementarity over ideology in the treatment of gender 24dysphoria (GD) in children. This includes especially avoiding 25puberty suppression and the use of cross-sex hormones in 26children with GD. One's sex is not a social construct, but an HB3515- 5 -LRB101 11160 CPF 56398 b 1unchangeable biological reality." 2 (11) Surgery (e.g., mastectomy and orchiectomy) is 3irreversible. 4 (12) Teen brain: Neuroscientist, Professor of Neurology at 5the University of Pennsylvania, and author of The Teenage 6Brain, Dr. Frances Jensen, explains that: 7 Teenagers do have frontal lobes, which are the seat of our 8executive, adult-like functioning like impulse control, 9judgment and empathy. But the frontal lobes haven't been 10connected with fast-acting connections yet. ... 11 But there is another part of the brain that is fully active 12in adolescents, and that's the limbic system. And that is the 13seat of risk, reward, impulsivity, sexual behavior and emotion. 14 So they are built to be novelty-seeking at this point in 15their lives. 16 (13) Suicide rate: The oft-cited suicide rate of 41% for 17those who identify as "trans" is based on an erroneous 18understanding of a study by the Williams Institute, an 19understanding that ignores the acknowledged and serious 20limitations of the study. 21 (14) There is no evidence that surgery or chemical 22disruption of normal, natural, and healthy development or 23processes reduces the incidence of suicide. 24 (15) Dr. J. Michael Bailey, Professor of Psychology at 25Northwestern University, and Dr. Raymond Blanchard, former 26psychologist in the Adult Gender Identity Clinic of Toronto's HB3515- 6 -LRB101 11160 CPF 56398 b 1Centre for Addiction and Mental Health (CAMH) from 1980-1995 2and the Head of CAMH's Clinical Sexology Services from 31995-2010, have written the following: 4 (a) Children (most commonly, adolescents) who threaten 5 to commit suicide rarely do so, although they are more 6 likely to kill themselves than children who do not threaten 7 suicide. 8 (b) Mental health problems, including suicide, are 9 associated with some forms of gender dysphoria. But suicide 10 is rare even among gender dysphoric persons. 11 (c) There is no persuasive evidence that gender 12 transition reduces gender dysphoric children's likelihood 13 of suicide. 14 (d) The idea that mental health problems, including 15 suicidality, are caused by gender dysphoria rather than the 16 other way around (i.e., mental health and personality 17 issues cause a vulnerability to experience gender 18 dysphoria) is currently popular and politically correct. 19 It is, however, unproven and as likely to be false as true. 20 (16) There is no phenomenon of women trapped in men's 21bodies or vice versa, or of men having women's brains or vice 22versa: Science has not proven that the brains of transgender 23individuals are "wired differently" than others with the same 24biological sex. In other words, there is no conclusive evidence 25of a "female brain" being contained in a male body or vice 26versa. In fact, it is impossible for an opposite sexed brain to HB3515- 7 -LRB101 11160 CPF 56398 b 1be "trapped" in the wrong body. Every brain cell of a male 2fetus has a Y chromosome; female fetal brains do not. This 3makes their brains forever intrinsically different. 4Additionally, at 8 weeks gestation, male fetuses have every 5cell of their body, including every brain cell, bathed by a 6testosterone surge secreted by their testes. Female fetuses 7lack testes; none of their cells, including their brain cells, 8experience this endogenous testosterone surge. [Reyes FI, 9Winter JS, Faiman C. "Studies on human sexual development Fetal 10gonadal and adrenal sex steroids"; J Clin Endocrinol Metab. 111973 Jul; 37(1):74-8; Lombardo, M. "Fetal Testosterone 12Influences Sexually Dimorphic Gray Matter in the Human Brain"; 13The Journal of Neuroscience, 11 January 2012, 32(2); Campano, 14A. [ed]. Geneva Foundation for Medical Education and Research: 15human sexual differentiation (2016).] 16 (17) Brain-sex theories: "[C]urrent studies on 17associations between brain structure and transgender identity 18are small, methodologically limited, inconclusive, and 19sometimes contradictory. Even if they were more 20methodologically reliable, they would be insufficient to 21demonstrate that brain structure is a cause, rather than an 22effect, of the gender-identity behavior. They would likewise 23lack predictive power, the real challenge for any theory in 24science." 25 (18) Desistance: The best research to date suggests that 26without social or medical "transition" most (60-90%) HB3515- 8 -LRB101 11160 CPF 56398 b 1gender-dysphoric children will come to accept their biological 2sex after passing naturally through puberty. While "12-27% of 3'gender variant' children persist in gender dysphoria; that 4percentage rises to 40% amongst those who visit gender 5clinics." Research shows that desistance rates rise 6significantly among those who are given puberty-blockers and 7"gender-affirmative psychotherapy," thus suggesting that such 8interventions lead minors "to commit more strongly to sex 9reassignment than they might have if they had received a 10different diagnosis or a different course of treatment." 11 (19) The American College of Pediatricians confirms what 12"detransitioners" assert: There are many possible post-natal, 13environmental causes for gender dysphoria: 14 Family and peer relationships, one's school and 15neighborhood, the experience of any form of abuse, media 16exposure, chronic illness, war, and natural disasters are all 17examples of environmental factors that impact an individual's 18emotional, social, and psychological development. 19 (20) Autism: "Mounting evidence over the last decade points 20to increased rates of autism spectrum disorders (ASD) and 21autism traits among children and adults with gender dysphoria, 22or incongruence between a person's experienced or expressed 23gender and the gender assigned to them at birth. ... It is 24possible that some of the psychological characteristics common 25in children with ASD-including cognitive deficits, tendencies 26toward obsessive preoccupations, or difficulties learning from HB3515- 9 -LRB101 11160 CPF 56398 b 1other people-complicate the formation of gender identity." 2 (21) A study published in May 2018 "further confirmed a 3possible association between ASD and the wish to be of the 4opposite gender by establishing increased endorsement of this 5wish in adolescents and adults with ASD compared to the general 6population controls." 7 (22) "Rapid-onset gender dysphoria" (ROGD): Dr. J. Michael 8Bailey, Professor of Psychology at Northwestern University, 9and Dr. Raymond Blanchard, former psychologist in the Adult 10Gender Identity Clinic of Toronto's Centre for Addiction and 11Mental Health (CAMH) from 1980-1995 and the Head of CAMH's 12Clinical Sexology Services from 1995-2010, explain the 13phenomenon of ROGD: 14 The typical case of ROGD involves an adolescent or young 15adult female whose social world outside the family glorifies 16transgender phenomena and exaggerates their prevalence. 17Furthermore, it likely includes a heavy dose of internet 18involvement. The adolescent female acquires the conviction 19that she is transgender. (Not uncommonly, others in her peer 20group acquire the same conviction.) These peer groups 21encouraged each other to believe that all unhappiness, anxiety, 22and life problems are likely due to their being transgender, 23and that gender transition is the only solution. Subsequently, 24there may be a rush towards gender transition. ... We believe 25that ROGD is a socially contagious phenomenon in which a young 26person-typically a natal female-comes to believe that she has a HB3515- 10 -LRB101 11160 CPF 56398 b 1condition that she does not have. ROGD is not about discovering 2gender dysphoria that was there all along; rather, it is about 3falsely coming to believe that one's problems have been due to 4gender dysphoria previously hidden (from the self and others). 5Let us be clear: People with ROGD do have a kind of gender 6dysphoria, but it is gender dysphoria due to persuasion of 7those especially vulnerable to a false idea. 8 (23) Brown University Researcher, Dr. Lisa Littman, 9conducted a survey of parents whose children developed Rapid 10Onset Gender Dysphoria. Littman wrote that the "worsening of 11mental well-being and parent-child relationships and behaviors 12that isolate [adolescents and young adults] from their parents, 13families, non-transgender friends and mainstream sources of 14information are particularly concerning. More research is 15needed to better understand this phenomenon, its implications 16and scope." 17 (24) The number of children "being referred for 18transitioning treatment" in England has increased 4,400% for 19girls and 1,250% for boys, which has resulted in calls from 20members of Parliament for an investigation. 21 (25) Body Integrity Identity Disorder (BIID) shares in 22common several features with gender dysphoria. BIID is a 23condition in which "[s]ufferers from BIID experience a mismatch 24between their physically healthy body and the body with which 25they identify. They identify as disabled. They often desire a 26specific amputation to achieve the disabled body they want." As HB3515- 11 -LRB101 11160 CPF 56398 b 1with some cases of gender dysphoria, scientists say there is 2evidence for neurological involvement as a cause of the 3experience of BIID, and yet physicians largely oppose elective 4amputations of healthy anatomical parts: 5 According to the principle of nonmaleficence physicians 6must not perform amputations without a medical indication 7because amputations bear great risks and often have severe 8consequences besides the disability ... for example, 9infections [or] thromboses. Even though some physicians 10perform harmful surgeries as breast enlargement surgeries, 11this cannot justify surgeries that are even more harmful. Even 12if amputations would be a possible therapy for BIID, they would 13be risky experimental therapies that could be justified only if 14they promised lifesaving or the cure of severe diseases and if 15an alternative therapy would not be available. At least the 16first condition is not fulfilled in the case of BIID, and 17probably the second is not fulfilled either. Above all, an 18amputation causes an irreversible damage that could not be 19healed, even if the patient's body image would be restored 20spontaneously or through a new therapy. ... But since all 21psychiatrists who have investigated BIID patients found that 22the amputation desire is either obsessive or based on a 23monothematic delusion, and since neurological studies support 24the hypothesis of a brain disorder (which is also supported by 25the most influential advocates of elective amputations), 26elective amputations have to be regarded as severe bodily HB3515- 12 -LRB101 11160 CPF 56398 b 1injuries of patients. 2 (26) The American College of Pediatricians (ACPeds), "a 3national medical association of licensed physicians and 4healthcare professionals who specialize in the care of infants, 5children, and adolescents" that split from the American Academy 6of Pediatrics because of its politicization of the practice of 7medicine, describes puberty-suppression, cross-sex hormone, 8and surgeries variously referred to as sex-change, sex 9reassignment, gender reassignment and gender confirmation 10surgeries as child abuse." 11 (27) Dr. Lisa Simons, pediatrician at Robert H. Lurie 12Children's Hospital of Chicago, stated in a PBS Frontline 13documentary that "'The bottom line is we don't really know how 14sex hormones impact any adolescent's brain development.' ... 15What's lacking, she said, are specific studies that look at the 16neurocognitive effects of puberty blockers." 17 (28) Dr. Kenneth Zucker, one of the world's leading 18authorities on gender dysphoria, states that: 19 "Identity is a process. It is complicated. It takes a long 20period of time ... to know who a child really is. ... There are 21different pathways that can lead to gender dysphoria. ... It's 22an intellectual and clinical mistake to think that there's one 23single cause that explains all gender dysphoria. ... Just 24because little kids say something doesn't necessarily mean that 25you accept it, or that it's true, or that it's in the best 26interest of the child. ... Little kids can present with extreme HB3515- 13 -LRB101 11160 CPF 56398 b 1gender dysphoria, but that doesn't mean they're all going to 2grow up to continue to have gender dysphoria. 3 (29) Dr. Eric Vilain, a geneticist at UCLA who specializes 4in sexual development and sex differences in the brain, says 5the studies on twins are mixed and that, on the whole, "there 6is no evidence of a biological influence on transsexualism 7yet." 8 (30) Sheila Jeffreys, lesbian feminist scholar, warns 9against the "transgendering" of children: "Those who do not 10conform to correct gender stereotypes are being sterilized and 11they're being sterilized as children." 12 (31) Heather Brunskell-Evans Heather, social theorist, 13philosopher, and Senior Research Fellow at King's College, 14London, UK, and Michele Moore, Professor of Inclusive Education 15and Editor-in-Chief of the world-leading journal Disability & 16Society, critique the "transgender" ideology: 17 [O]ur central contention is that transgender children 18don't exist. Although we argue that 'the transgender child' is 19a fabrication, we do not disavow that some children and 20adolescents experience gender dysphoria and that concerned and 21loving parents will do anything to alleviate their children's 22distress. It is because of children's bodily discomfort that we 23argue it is important families and support services are 24informed by appropriate models for understanding gender. Our 25analysis of transgenderism demonstrates it is a new phenomenon, 26since dissatisfaction with assigned gender takes different HB3515- 14 -LRB101 11160 CPF 56398 b 1forms in different historical contexts. The 'transgender 2child' is a relatively new historical figure, brought into 3being by a coalition of pressure groups, political activists 4and knowledge makers. ... Bizarrely, in transgender theory, 5biology is said to be a social construct but gender is regarded 6as an inherent property located 'somewhere' in the brain or 7soul or other undefined area of the body. We reverse these 8propositions with the concept that it is gender, not biology, 9which is a social construct. From our theoretical perspective, 10the sexed body is material and biological, and gender is the 11externally imposed set of norms that prescribe and proscribe 12desirable [behaviors] for children. Our objection to 13transgenderism is that it confines children to traditional 14views about gender. 15 (32) Stephanie Davies-Arias, writer, communication skills 16expert, and pediatric transition critic, writes that "changing 17your sex to match your 'gender identity' reinforces the very 18stereotypes which [transgender organizations] claim to be 19challenging ... as, in increasing numbers, boys who love 20princess culture become 'girls' and short-haired 21football-loving girls become 'boys'. Promoted as a 22'progressive' social justice movement based on 'accepting 23difference', transgender ideology in fact takes that 24difference and stamps it out. It says that the sexist 25stereotypes of 'gender' are the true distinction between boys 26and girls and biological sex is an illusion." HB3515- 15 -LRB101 11160 CPF 56398 b 1 (33) Sex-change regret/De-transitioning: Increasing 2numbers of young men and women experience "sex-change regret" 3and are "detransitioning." Unfortunately, some effects of 4"medical transitions" are irreversible. A BBC documentary 5titled "Luke" includes a young biological woman who regrets 6taking cross-sex hormones and having a double mastectomy at age 720 and shares her experience. 8 Section 10. Purpose. The purpose of this Act is to protect 9gender-dysphoric, gender-discordant, and gender-non-conforming 10minors or minors who experience rapid onset gender dysphoria 11from medical procedures or the off-label use of chemicals that 12have not been studied for these purposes and that permanently 13alter anatomy, biochemistry, or physiology. 14 The State has a moral duty and legal right to step in and 15regulate medical practices that are found in violation of the 16principles that inhere in the Nuremberg Code, including the 17principle that experiments should be based on previous 18knowledge (e.g., an expectation derived from animal 19experiments) that justifies the experiment. 20 Section 15. Definitions. As used in this Act: 21 "Biological sex" means a person's objective, immutable 22biological sex, which may be understood according to the 23following: In biology, an organism is male or female if it is 24structured to perform one of the respective roles in HB3515- 16 -LRB101 11160 CPF 56398 b 1reproduction. This definition does not require any arbitrary 2measurable or quantifiable physical characteristics or 3behaviors; it requires understanding the reproductive system 4and the reproduction process. Different animals have different 5reproductive systems, but sexual reproduction occurs when the 6sex cells from the male and female of the species come together 7to form newly fertilized embryos. It is these reproductive 8roles that provide the conceptual basis for the differentiation 9of animals into the biological categories of male and female. 10There is no other widely accepted biological classification for 11the sexes. 12 "Desistance" means the tendency for gender dysphoria to 13resolve itself as a child gets older and older. 14 "Detransition" means the process by which someone who has 15been identifying as the opposite sex, presenting himself or 16herself as the opposite sex, taking cross-sex hormones, and may 17or may not have had surgery rejects his or her "trans" identity 18and accepts his or her objective, immutable biological sex. 19 "Gender" means the psychological, behavioral, social, and 20cultural aspects of being male or female. 21 "Gender dysphoria" means one's persistent discomfort with 22his or her sex or sense of inappropriateness in the gender role 23of that sex. 24 "Gender identity" means one's sense of oneself as male, 25female, or transgender. "Gender identity" also means one's 26innermost concept of self as male, female, a blend of both male HB3515- 17 -LRB101 11160 CPF 56398 b 1and female, or neither male nor female. 2 Section 20. Prohibition on treatment of persons under the 3age of 18 for gender dysphoria or gender discordance. 4 (a) A medical doctor shall not prescribe, provide, 5administer, or deliver puberty-suppressing drugs or cross-sex 6hormones and shall not perform surgical orchiectomy or 7castration, urethroplasty, vaginoplasty, mastectomy, 8phalloplasty, or metoidioplasty on biologically healthy and 9anatomically normal persons under the age of 18 for the purpose 10of treating the subjective, internal psychological condition 11of gender dysphoria or gender discordance. 12 (b) Any efforts to modify the anatomy, physiology, or 13biochemistry of a biologically healthy person under the age of 1418 who experiences gender dysphoria or gender discordance shall 15be considered unprofessional conduct and shall be subject to 16discipline by the licensing entity or disciplinary review board 17with competent jurisdiction. 18 (c) No medical doctor or mental health provider shall refer 19any person under the age of 18 to any medical doctor for 20chemical or surgical interventions to treat gender dysphoria or 21gender discordance. 22 Section 90. The Medical Practice Act of 1987 is amended by 23changing Section 22 as follows: HB3515- 18 -LRB101 11160 CPF 56398 b 1 (225 ILCS 60/22) (from Ch. 111, par. 4400-22) 2 (Section scheduled to be repealed on December 31, 2019) 3 Sec. 22. Disciplinary action. 4 (A) The Department may revoke, suspend, place on probation, 5reprimand, refuse to issue or renew, or take any other 6disciplinary or non-disciplinary action as the Department may 7deem proper with regard to the license or permit of any person 8issued under this Act, including imposing fines not to exceed 9$10,000 for each violation, upon any of the following grounds: 10 (1) Performance of an elective abortion in any place, 11 locale, facility, or institution other than: 12 (a) a facility licensed pursuant to the Ambulatory 13 Surgical Treatment Center Act; 14 (b) an institution licensed under the Hospital 15 Licensing Act; 16 (c) an ambulatory surgical treatment center or 17 hospitalization or care facility maintained by the 18 State or any agency thereof, where such department or 19 agency has authority under law to establish and enforce 20 standards for the ambulatory surgical treatment 21 centers, hospitalization, or care facilities under its 22 management and control; 23 (d) ambulatory surgical treatment centers, 24 hospitalization or care facilities maintained by the 25 Federal Government; or 26 (e) ambulatory surgical treatment centers, HB3515- 19 -LRB101 11160 CPF 56398 b 1 hospitalization or care facilities maintained by any 2 university or college established under the laws of 3 this State and supported principally by public funds 4 raised by taxation. 5 (2) Performance of an abortion procedure in a willful 6 and wanton manner on a woman who was not pregnant at the 7 time the abortion procedure was performed. 8 (3) A plea of guilty or nolo contendere, finding of 9 guilt, jury verdict, or entry of judgment or sentencing, 10 including, but not limited to, convictions, preceding 11 sentences of supervision, conditional discharge, or first 12 offender probation, under the laws of any jurisdiction of 13 the United States of any crime that is a felony. 14 (4) Gross negligence in practice under this Act. 15 (5) Engaging in dishonorable, unethical or 16 unprofessional conduct of a character likely to deceive, 17 defraud or harm the public. 18 (6) Obtaining any fee by fraud, deceit, or 19 misrepresentation. 20 (7) Habitual or excessive use or abuse of drugs defined 21 in law as controlled substances, of alcohol, or of any 22 other substances which results in the inability to practice 23 with reasonable judgment, skill or safety. 24 (8) Practicing under a false or, except as provided by 25 law, an assumed name. 26 (9) Fraud or misrepresentation in applying for, or HB3515- 20 -LRB101 11160 CPF 56398 b 1 procuring, a license under this Act or in connection with 2 applying for renewal of a license under this Act. 3 (10) Making a false or misleading statement regarding 4 their skill or the efficacy or value of the medicine, 5 treatment, or remedy prescribed by them at their direction 6 in the treatment of any disease or other condition of the 7 body or mind. 8 (11) Allowing another person or organization to use 9 their license, procured under this Act, to practice. 10 (12) Adverse action taken by another state or 11 jurisdiction against a license or other authorization to 12 practice as a medical doctor, doctor of osteopathy, doctor 13 of osteopathic medicine or doctor of chiropractic, a 14 certified copy of the record of the action taken by the 15 other state or jurisdiction being prima facie evidence 16 thereof. This includes any adverse action taken by a State 17 or federal agency that prohibits a medical doctor, doctor 18 of osteopathy, doctor of osteopathic medicine, or doctor of 19 chiropractic from providing services to the agency's 20 participants. 21 (13) Violation of any provision of this Act or of the 22 Medical Practice Act prior to the repeal of that Act, or 23 violation of the rules, or a final administrative action of 24 the Secretary, after consideration of the recommendation 25 of the Disciplinary Board. 26 (14) Violation of the prohibition against fee HB3515- 21 -LRB101 11160 CPF 56398 b 1 splitting in Section 22.2 of this Act. 2 (15) A finding by the Disciplinary Board that the 3 registrant after having his or her license placed on 4 probationary status or subjected to conditions or 5 restrictions violated the terms of the probation or failed 6 to comply with such terms or conditions. 7 (16) Abandonment of a patient. 8 (17) Prescribing, selling, administering, 9 distributing, giving or self-administering any drug 10 classified as a controlled substance (designated product) 11 or narcotic for other than medically accepted therapeutic 12 purposes. 13 (18) Promotion of the sale of drugs, devices, 14 appliances or goods provided for a patient in such manner 15 as to exploit the patient for financial gain of the 16 physician. 17 (19) Offering, undertaking or agreeing to cure or treat 18 disease by a secret method, procedure, treatment or 19 medicine, or the treating, operating or prescribing for any 20 human condition by a method, means or procedure which the 21 licensee refuses to divulge upon demand of the Department. 22 (20) Immoral conduct in the commission of any act 23 including, but not limited to, commission of an act of 24 sexual misconduct related to the licensee's practice. 25 (21) Willfully making or filing false records or 26 reports in his or her practice as a physician, including, HB3515- 22 -LRB101 11160 CPF 56398 b 1 but not limited to, false records to support claims against 2 the medical assistance program of the Department of 3 Healthcare and Family Services (formerly Department of 4 Public Aid) under the Illinois Public Aid Code. 5 (22) Willful omission to file or record, or willfully 6 impeding the filing or recording, or inducing another 7 person to omit to file or record, medical reports as 8 required by law, or willfully failing to report an instance 9 of suspected abuse or neglect as required by law. 10 (23) Being named as a perpetrator in an indicated 11 report by the Department of Children and Family Services 12 under the Abused and Neglected Child Reporting Act, and 13 upon proof by clear and convincing evidence that the 14 licensee has caused a child to be an abused child or 15 neglected child as defined in the Abused and Neglected 16 Child Reporting Act. 17 (24) Solicitation of professional patronage by any 18 corporation, agents or persons, or profiting from those 19 representing themselves to be agents of the licensee. 20 (25) Gross and willful and continued overcharging for 21 professional services, including filing false statements 22 for collection of fees for which services are not rendered, 23 including, but not limited to, filing such false statements 24 for collection of monies for services not rendered from the 25 medical assistance program of the Department of Healthcare 26 and Family Services (formerly Department of Public Aid) HB3515- 23 -LRB101 11160 CPF 56398 b 1 under the Illinois Public Aid Code. 2 (26) A pattern of practice or other behavior which 3 demonstrates incapacity or incompetence to practice under 4 this Act. 5 (27) Mental illness or disability which results in the 6 inability to practice under this Act with reasonable 7 judgment, skill or safety. 8 (28) Physical illness, including, but not limited to, 9 deterioration through the aging process, or loss of motor 10 skill which results in a physician's inability to practice 11 under this Act with reasonable judgment, skill or safety. 12 (29) Cheating on or attempt to subvert the licensing 13 examinations administered under this Act. 14 (30) Willfully or negligently violating the 15 confidentiality between physician and patient except as 16 required by law. 17 (31) The use of any false, fraudulent, or deceptive 18 statement in any document connected with practice under 19 this Act. 20 (32) Aiding and abetting an individual not licensed 21 under this Act in the practice of a profession licensed 22 under this Act. 23 (33) Violating state or federal laws or regulations 24 relating to controlled substances, legend drugs, or 25 ephedra as defined in the Ephedra Prohibition Act. 26 (34) Failure to report to the Department any adverse HB3515- 24 -LRB101 11160 CPF 56398 b 1 final action taken against them by another licensing 2 jurisdiction (any other state or any territory of the 3 United States or any foreign state or country), by any peer 4 review body, by any health care institution, by any 5 professional society or association related to practice 6 under this Act, by any governmental agency, by any law 7 enforcement agency, or by any court for acts or conduct 8 similar to acts or conduct which would constitute grounds 9 for action as defined in this Section. 10 (35) Failure to report to the Department surrender of a 11 license or authorization to practice as a medical doctor, a 12 doctor of osteopathy, a doctor of osteopathic medicine, or 13 doctor of chiropractic in another state or jurisdiction, or 14 surrender of membership on any medical staff or in any 15 medical or professional association or society, while 16 under disciplinary investigation by any of those 17 authorities or bodies, for acts or conduct similar to acts 18 or conduct which would constitute grounds for action as 19 defined in this Section. 20 (36) Failure to report to the Department any adverse 21 judgment, settlement, or award arising from a liability 22 claim related to acts or conduct similar to acts or conduct 23 which would constitute grounds for action as defined in 24 this Section. 25 (37) Failure to provide copies of medical records as 26 required by law. HB3515- 25 -LRB101 11160 CPF 56398 b 1 (38) Failure to furnish the Department, its 2 investigators or representatives, relevant information, 3 legally requested by the Department after consultation 4 with the Chief Medical Coordinator or the Deputy Medical 5 Coordinator. 6 (39) Violating the Health Care Worker Self-Referral 7 Act. 8 (40) Willful failure to provide notice when notice is 9 required under the Parental Notice of Abortion Act of 1995. 10 (41) Failure to establish and maintain records of 11 patient care and treatment as required by this law. 12 (42) Entering into an excessive number of written 13 collaborative agreements with licensed advanced practice 14 registered nurses resulting in an inability to adequately 15 collaborate. 16 (43) Repeated failure to adequately collaborate with a 17 licensed advanced practice registered nurse. 18 (44) Violating the Compassionate Use of Medical 19 Cannabis Pilot Program Act. 20 (45) Entering into an excessive number of written 21 collaborative agreements with licensed prescribing 22 psychologists resulting in an inability to adequately 23 collaborate. 24 (46) Repeated failure to adequately collaborate with a 25 licensed prescribing psychologist. 26 (47) Willfully failing to report an instance of HB3515- 26 -LRB101 11160 CPF 56398 b 1 suspected abuse, neglect, financial exploitation, or 2 self-neglect of an eligible adult as defined in and 3 required by the Adult Protective Services Act. 4 (48) Being named as an abuser in a verified report by 5 the Department on Aging under the Adult Protective Services 6 Act, and upon proof by clear and convincing evidence that 7 the licensee abused, neglected, or financially exploited 8 an eligible adult as defined in the Adult Protective 9 Services Act. 10 (49) Entering into an excessive number of written 11 collaborative agreements with licensed physician 12 assistants resulting in an inability to adequately 13 collaborate. 14 (50) Repeated failure to adequately collaborate with a 15 physician assistant. 16 (51) Violating the Youth Health Protection Act. 17 Except for actions involving the ground numbered (26), all 18proceedings to suspend, revoke, place on probationary status, 19or take any other disciplinary action as the Department may 20deem proper, with regard to a license on any of the foregoing 21grounds, must be commenced within 5 years next after receipt by 22the Department of a complaint alleging the commission of or 23notice of the conviction order for any of the acts described 24herein. Except for the grounds numbered (8), (9), (26), and 25(29), no action shall be commenced more than 10 years after the 26date of the incident or act alleged to have violated this HB3515- 27 -LRB101 11160 CPF 56398 b 1Section. For actions involving the ground numbered (26), a 2pattern of practice or other behavior includes all incidents 3alleged to be part of the pattern of practice or other behavior 4that occurred, or a report pursuant to Section 23 of this Act 5received, within the 10-year period preceding the filing of the 6complaint. In the event of the settlement of any claim or cause 7of action in favor of the claimant or the reduction to final 8judgment of any civil action in favor of the plaintiff, such 9claim, cause of action or civil action being grounded on the 10allegation that a person licensed under this Act was negligent 11in providing care, the Department shall have an additional 12period of 2 years from the date of notification to the 13Department under Section 23 of this Act of such settlement or 14final judgment in which to investigate and commence formal 15disciplinary proceedings under Section 36 of this Act, except 16as otherwise provided by law. The time during which the holder 17of the license was outside the State of Illinois shall not be 18included within any period of time limiting the commencement of 19disciplinary action by the Department. 20 The entry of an order or judgment by any circuit court 21establishing that any person holding a license under this Act 22is a person in need of mental treatment operates as a 23suspension of that license. That person may resume their 24practice only upon the entry of a Departmental order based upon 25a finding by the Disciplinary Board that they have been 26determined to be recovered from mental illness by the court and HB3515- 28 -LRB101 11160 CPF 56398 b 1upon the Disciplinary Board's recommendation that they be 2permitted to resume their practice. 3 The Department may refuse to issue or take disciplinary 4action concerning the license of any person who fails to file a 5return, or to pay the tax, penalty or interest shown in a filed 6return, or to pay any final assessment of tax, penalty or 7interest, as required by any tax Act administered by the 8Illinois Department of Revenue, until such time as the 9requirements of any such tax Act are satisfied as determined by 10the Illinois Department of Revenue. 11 The Department, upon the recommendation of the 12Disciplinary Board, shall adopt rules which set forth standards 13to be used in determining: 14 (a) when a person will be deemed sufficiently 15 rehabilitated to warrant the public trust; 16 (b) what constitutes dishonorable, unethical or 17 unprofessional conduct of a character likely to deceive, 18 defraud, or harm the public; 19 (c) what constitutes immoral conduct in the commission 20 of any act, including, but not limited to, commission of an 21 act of sexual misconduct related to the licensee's 22 practice; and 23 (d) what constitutes gross negligence in the practice 24 of medicine. 25 However, no such rule shall be admissible into evidence in 26any civil action except for review of a licensing or other HB3515- 29 -LRB101 11160 CPF 56398 b 1disciplinary action under this Act. 2 In enforcing this Section, the Disciplinary Board or the 3Licensing Board, upon a showing of a possible violation, may 4compel, in the case of the Disciplinary Board, any individual 5who is licensed to practice under this Act or holds a permit to 6practice under this Act, or, in the case of the Licensing 7Board, any individual who has applied for licensure or a permit 8pursuant to this Act, to submit to a mental or physical 9examination and evaluation, or both, which may include a 10substance abuse or sexual offender evaluation, as required by 11the Licensing Board or Disciplinary Board and at the expense of 12the Department. The Disciplinary Board or Licensing Board shall 13specifically designate the examining physician licensed to 14practice medicine in all of its branches or, if applicable, the 15multidisciplinary team involved in providing the mental or 16physical examination and evaluation, or both. The 17multidisciplinary team shall be led by a physician licensed to 18practice medicine in all of its branches and may consist of one 19or more or a combination of physicians licensed to practice 20medicine in all of its branches, licensed chiropractic 21physicians, licensed clinical psychologists, licensed clinical 22social workers, licensed clinical professional counselors, and 23other professional and administrative staff. Any examining 24physician or member of the multidisciplinary team may require 25any person ordered to submit to an examination and evaluation 26pursuant to this Section to submit to any additional HB3515- 30 -LRB101 11160 CPF 56398 b 1supplemental testing deemed necessary to complete any 2examination or evaluation process, including, but not limited 3to, blood testing, urinalysis, psychological testing, or 4neuropsychological testing. The Disciplinary Board, the 5Licensing Board, or the Department may order the examining 6physician or any member of the multidisciplinary team to 7provide to the Department, the Disciplinary Board, or the 8Licensing Board any and all records, including business 9records, that relate to the examination and evaluation, 10including any supplemental testing performed. The Disciplinary 11Board, the Licensing Board, or the Department may order the 12examining physician or any member of the multidisciplinary team 13to present testimony concerning this examination and 14evaluation of the licensee, permit holder, or applicant, 15including testimony concerning any supplemental testing or 16documents relating to the examination and evaluation. No 17information, report, record, or other documents in any way 18related to the examination and evaluation shall be excluded by 19reason of any common law or statutory privilege relating to 20communication between the licensee, permit holder, or 21applicant and the examining physician or any member of the 22multidisciplinary team. No authorization is necessary from the 23licensee, permit holder, or applicant ordered to undergo an 24evaluation and examination for the examining physician or any 25member of the multidisciplinary team to provide information, 26reports, records, or other documents or to provide any HB3515- 31 -LRB101 11160 CPF 56398 b 1testimony regarding the examination and evaluation. The 2individual to be examined may have, at his or her own expense, 3another physician of his or her choice present during all 4aspects of the examination. Failure of any individual to submit 5to mental or physical examination and evaluation, or both, when 6directed, shall result in an automatic suspension, without 7hearing, until such time as the individual submits to the 8examination. If the Disciplinary Board or Licensing Board finds 9a physician unable to practice following an examination and 10evaluation because of the reasons set forth in this Section, 11the Disciplinary Board or Licensing Board shall require such 12physician to submit to care, counseling, or treatment by 13physicians, or other health care professionals, approved or 14designated by the Disciplinary Board, as a condition for 15issued, continued, reinstated, or renewed licensure to 16practice. Any physician, whose license was granted pursuant to 17Sections 9, 17, or 19 of this Act, or, continued, reinstated, 18renewed, disciplined or supervised, subject to such terms, 19conditions or restrictions who shall fail to comply with such 20terms, conditions or restrictions, or to complete a required 21program of care, counseling, or treatment, as determined by the 22Chief Medical Coordinator or Deputy Medical Coordinators, 23shall be referred to the Secretary for a determination as to 24whether the licensee shall have their license suspended 25immediately, pending a hearing by the Disciplinary Board. In 26instances in which the Secretary immediately suspends a license HB3515- 32 -LRB101 11160 CPF 56398 b 1under this Section, a hearing upon such person's license must 2be convened by the Disciplinary Board within 15 days after such 3suspension and completed without appreciable delay. The 4Disciplinary Board shall have the authority to review the 5subject physician's record of treatment and counseling 6regarding the impairment, to the extent permitted by applicable 7federal statutes and regulations safeguarding the 8confidentiality of medical records. 9 An individual licensed under this Act, affected under this 10Section, shall be afforded an opportunity to demonstrate to the 11Disciplinary Board that they can resume practice in compliance 12with acceptable and prevailing standards under the provisions 13of their license. 14 The Department may promulgate rules for the imposition of 15fines in disciplinary cases, not to exceed $10,000 for each 16violation of this Act. Fines may be imposed in conjunction with 17other forms of disciplinary action, but shall not be the 18exclusive disposition of any disciplinary action arising out of 19conduct resulting in death or injury to a patient. Any funds 20collected from such fines shall be deposited in the Illinois 21State Medical Disciplinary Fund. 22 All fines imposed under this Section shall be paid within 2360 days after the effective date of the order imposing the fine 24or in accordance with the terms set forth in the order imposing 25the fine. 26 (B) The Department shall revoke the license or permit HB3515- 33 -LRB101 11160 CPF 56398 b 1issued under this Act to practice medicine or a chiropractic 2physician who has been convicted a second time of committing 3any felony under the Illinois Controlled Substances Act or the 4Methamphetamine Control and Community Protection Act, or who 5has been convicted a second time of committing a Class 1 felony 6under Sections 8A-3 and 8A-6 of the Illinois Public Aid Code. A 7person whose license or permit is revoked under this subsection 8B shall be prohibited from practicing medicine or treating 9human ailments without the use of drugs and without operative 10surgery. 11 (C) The Department shall not revoke, suspend, place on 12probation, reprimand, refuse to issue or renew, or take any 13other disciplinary or non-disciplinary action against the 14license or permit issued under this Act to practice medicine to 15a physician: 16 (1) based solely upon the recommendation of the 17 physician to an eligible patient regarding, or 18 prescription for, or treatment with, an investigational 19 drug, biological product, or device; or 20 (2) for experimental treatment for Lyme disease or 21 other tick-borne diseases, including, but not limited to, 22 the prescription of or treatment with long-term 23 antibiotics. 24 (D) The Disciplinary Board shall recommend to the 25Department civil penalties and any other appropriate 26discipline in disciplinary cases when the Board finds that a HB3515- 34 -LRB101 11160 CPF 56398 b 1physician willfully performed an abortion with actual 2knowledge that the person upon whom the abortion has been 3performed is a minor or an incompetent person without notice as 4required under the Parental Notice of Abortion Act of 1995. 5Upon the Board's recommendation, the Department shall impose, 6for the first violation, a civil penalty of $1,000 and for a 7second or subsequent violation, a civil penalty of $5,000. 8(Source: P.A. 99-270, eff. 1-1-16; 99-933, eff. 1-27-17; 9100-429, eff. 8-25-17; 100-513, eff. 1-1-18; 100-605, eff. 101-1-19; 100-863, eff. 8-14-18; 100-1137, eff. 1-1-19; revised 1112-19-18.)