Sen. Iris Y. Martinez

Filed: 5/23/2017

 

 


 

 


 
10000HB0313sam001LRB100 04130 SMS 26839 a

1
AMENDMENT TO HOUSE BILL 313

2    AMENDMENT NO. ______. Amend House Bill 313 on page 286,
3line 22, after "nurses", by inserting "without full practice
4authority"; and
 
5on page 290, immediately below line 16, by inserting the
6following:
7    "(j) As set forth in Section 22.2 of this Act, a licensee
8under this Act may not directly or indirectly divide, share, or
9split any professional fee or other form of compensation for
10professional services with anyone in exchange for a referral or
11otherwise, other than as provided in Section 22.2."; and
 
12on page 290, line 23, after "65-55,", by inserting "65-60,";
13and
 
14on page 291, line 2, after "60-11", by inserting "65-43,"; and
 

 

 

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1on page 294, immediately below line 1, by inserting the
2following:
3    ""Full practice authority" means the authority of an
4advanced practice registered nurse licensed in Illinois and
5certified as a nurse practitioner, clinical nurse specialist,
6or nurse midwife to practice without a written collaborative
7agreement and:
8        (1) to be fully accountable to patients for the quality
9    of advanced nursing care rendered;
10        (2) to be fully accountable for recognizing limits of
11    knowledge and experience and for planning for the
12    management of situations beyond the advanced practice
13    registered nurse's expertise; the full practice authority
14    for advanced practice registered nurses includes accepting
15    referrals from, consulting with, collaborating with, or
16    referring to other health care professionals as warranted
17    by the needs of the patient; and
18        (3) to possess the authority to prescribe medications,
19    including Schedule II through V controlled substances, as
20    provided in Section 65-43."; and
 
21on page 365, on line 14, by replacing "2018" with "2023 2018";
22and
 
23on page 376, line 21, by replacing "practice," with "practice
24prior to meeting the requirements of Section 65-43,"; and
 

 

 

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1on page 376, line 22, by replacing "authorized" with
2"privileged authorized"; and
 
3on page 377, line 2, by replacing "authorized" with "privileged
4authorized"; and
 
5on page 377, line 3, after "agreement", by inserting ", except
6as set forth in Section 65-43"; and
 
7on page 377, line 6, by replacing "or podiatric physician" with
8"or podiatric physician"; and
 
9on page 377, line 10, after "Section.", by inserting "A
10collaborative agreement with a podiatric physician must be in
11accordance with subsection (c-5) of this Section."; and
 
12on page 377, by replacing line 12 with "physician or podiatric
13physician and the advanced practice"; and
 
14on page 377, by replacing line 16 with "collaborating physician
15or podiatric physician at the place where services"; and
 
16on page 377, lines 18 and 19, by replacing "or podiatric
17physician" with "or podiatric physician"; and
 

 

 

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1on page 380, by replacing lines 12 through 14 with "Nothing in
2this Act shall be construed to authorize an advanced practice
3nurse to provide health care services required by law or rule
4to be performed by a physician."; and
 
5on page 380, immediately below line 14, by inserting the
6following:
7    "(e-5) Nothing in this Act shall be construed to authorize
8an advanced practice registered nurse to provide health care
9services required by law or rule to be performed by a
10physician, including those acts to be performed by a physician
11in Section 3.1 of the Illinois Abortion Law of 1975."; and
 
12on page 381, line 3, by replacing "or collaborating podiatrist"
13with "or collaborating podiatrist"; and
 
14on page 381, line 15, by replacing "or podiatric physician"
15with "or podiatric physician"; and
 
16on page 382, lines 1 and 2, by replacing "or podiatric
17physician" with "or podiatric physician"; and
 
18on page 382, lines 9 and 10, by replacing "or podiatric
19physician" each time it appears with "or podiatric physician";
20and
 

 

 

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1on page 382, line 11, after "Department", by inserting "and the
2Prescription Monitoring Program"; and
 
3on page 382, lines 20 and 21, by replacing "or podiatric
4physician" with "or podiatric physician"; and
 
5on page 383, lines 3 and 10, by replacing "or podiatric
6physician" each time it appears with "or podiatric physician";
7and
 
8on page 383, lines 14 and 15, by replacing "or podiatric
9physician" with "or podiatric physician"; and
 
10on page 384, by replacing lines 9 through 13 with the
11following:
12    "(g) (Blank). Any advanced practice nurse who writes a
13prescription for a controlled substance without having a valid
14appropriate authority may be fined by the Department not more
15than $50 per prescription, and the Department may take any
16other disciplinary action provided for in this Act."; and
 
17on page 384, immediately below line 15, by inserting the
18following:
19    "(i) Nothing in this Section shall be construed to apply to
20an advanced practice registered nurse who meets the
21requirements of Section 65-43."; and
 

 

 

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1on page 384, immediately below line 16, by inserting the
2following:
 
3    "(225 ILCS 65/65-43 new)
4    Sec. 65-43. Full practice authority.
5    (a) An Illinois-licensed advanced practice registered
6nurse certified as a nurse practitioner, nurse midwife, or
7clinical nurse specialist shall be deemed by law to possess the
8ability to practice without a written collaborative agreement
9as set forth in this Section.
10    (b) An advanced practice registered nurse certified as a
11nurse midwife, clinical nurse specialist, or nurse
12practitioner who files with the Department a notarized
13attestation of completion of at least 250 hours of continuing
14education or training and at least 4,000 hours of clinical
15experience after first attaining national certification shall
16not require a written collaborative agreement, except as
17specified in subsection (c). Documentation of successful
18completion shall be provided to the Department upon request.
19    Continuing education or training hours required by
20subsection (b) shall be in the advanced practice registered
21nurse's area of certification as set forth by Department rule.
22    The clinical experience must be in the advanced practice
23registered nurse's area of certification. The clinical
24experience shall be in collaboration with a physician or

 

 

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1physicians. Completion of the clinical experience must be
2attested to by the collaborating physician or physicians and
3the advanced practice registered nurse.
4    (c) The scope of practice of an advanced practice
5registered nurse with full practice authority includes:
6        (1) all matters included in subsection (c) of Section
7    65-30 of this Act;
8        (2) practicing without a written collaborative
9    agreement in all practice settings consistent with
10    national certification;
11        (3) authority to prescribe both legend drugs and
12    Schedule II through V controlled substances; this
13    authority includes prescription of, selection of, orders
14    for, administration of, storage of, acceptance of samples
15    of, and dispensing over the counter medications, legend
16    drugs, and controlled substances categorized as any
17    Schedule II through V controlled substances, as defined in
18    Article II of the Illinois Controlled Substances Act, and
19    other preparations, including, but not limited to,
20    botanical and herbal remedies;
21        (4) prescribing benzodiazepines or Schedule II
22    narcotic drugs, such as opioids, only in a consultation
23    relationship with a physician; this consultation
24    relationship shall be recorded in the Prescription
25    Monitoring Program website, pursuant to Section 316 of the
26    Illinois Controlled Substances Act, by the physician and

 

 

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1    advanced practice registered nurse with full practice
2    authority and is not required to be filed with the
3    Department; the specific Schedule II narcotic drug must be
4    identified by either brand name or generic name; the
5    specific Schedule II narcotic drug, such as an opioid, may
6    be administered by oral dosage or topical or transdermal
7    application; delivery by injection or other route of
8    administration is not permitted; at least monthly, the
9    advanced practice registered nurse and the physician must
10    discuss the condition of any patients for whom a
11    benzodiazepine or opioid is prescribed; nothing in this
12    subsection shall be construed to require a prescription by
13    an advanced practice registered nurse with full practice
14    authority to require a physician name;
15        (5) authority to obtain an Illinois controlled
16    substance license and a federal Drug Enforcement
17    Administration number; and
18        (6) use of only local anesthetic.
19    The scope of practice of an advanced practice registered
20nurse does not include operative surgery.
21    (d) The Department may adopt rules necessary to administer
22this Section, including, but not limited to, requiring the
23completion of forms and the payment of fees.
24    (e) Nothing in this Act shall be construed to authorize an
25advanced practice registered nurse with full practice
26authority to provide health care services required by law or

 

 

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1rule to be performed by a physician, including, but not limited
2to, those acts to be performed by a physician in Section 3.1 of
3the Illinois Abortion Law of 1975."; and
 
4on page 385, line 8, after "services of", by inserting "all";
5and
 
6on page 385, line 22, by replacing "granted" with "privileged
7granted"; and
 
8on page 385, by replacing line 23 with "authority to order
9medications, including controlled substances,"; and
 
10on page 386, immediately below line 5, by inserting the
11following:
12    "(a-4) An advanced practice registered nurse meeting the
13requirements of Section 65-43 may be privileged to complete
14discharge orders and prescriptions under the advanced practice
15registered nurse's name."; and
 
16on page 387, line 2, after "Center Act.", by inserting "Nothing
17in this Act shall be construed to require an advanced practice
18registered nurse to have a collaborative agreement to practice
19in a hospital, hospital affiliate, or ambulatory surgical
20treatment center."; and
 

 

 

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1on page 387, line 6, by replacing "granted authority" with
2"privileged granted authority"; and
 
3on page 387, line 21, by replacing "mid-level practitioner"
4with "mid-level practitioner"; and
 
5on page 388, line 11, by replacing "grant authority to" with
6"privilege grant authority to"; and
 
7on page 388, line 20, by replacing "this grant of authority"
8with "the privileging documents this grant of authority"; and
 
9on page 388, line 22, by replacing "authority" with "privileges
10authority"; and
 
11on page 388, line 25, by replacing "grant of authority" with
12privileges grant of authority"; and
 
13on page 389, immediately below line 11, by inserting the
14following:
15    "(d) An advanced practice registered nurse meeting the
16requirements of Section 65-43 may be privileged to prescribe
17controlled substances categorized as Schedule II through V in
18accordance with Section 65-43."; and
 
19on page 389, line 19, after "initials", by inserting ""Advanced

 

 

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1Practice Registered Nurse","; and
 
2on page 390, line 3, after "(a).", by inserting "No advanced
3practice registered nurse licensed under this Act may use the
4title "doctor" or "physician" in paid or approved advertising.
5Any advertising must contain the appropriate advanced practice
6registered nurse credentials."; and
 
7on page 390, line 9, after "patient.", by inserting "If an
8advanced practice registered nurse has a doctorate degree, when
9identifying himself or herself as "doctor" in a clinical
10setting, the advanced practice registered nurse must clearly
11state that his or her educational preparation is not in
12medicine and that he or she is not a medical doctor or
13physician."; and
 
14on page 391, line 2, by replacing "board" with "national
15board"; and
 
16on page 391, by replacing line 5 with "physician's or ,
17dentist's, or podiatric physician's name,"; and
 
18on page 391, line 6, after "title,", by inserting "if such is
19required,"; and
 
20on page 391, line 16, by replacing "as" with "as"; and
 

 

 

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1on page 391, by replacing line 17 with "an advanced practice
2nurse to use testimonials or"; and
 
3on page 392, immediately below line 18, by inserting the
4following:
 
5    "(225 ILCS 65/65-60)   (was 225 ILCS 65/15-45)
6    (Section scheduled to be repealed on January 1, 2018)
7    Sec. 65-60. Continuing education. The Department shall
8adopt rules of continuing education for persons licensed under
9this Article as advanced practice registered nurses that
10require 80 50 hours of continuing education per 2-year license
11renewal cycle. Completion of the 80 50 hours of continuing
12education shall be deemed to satisfy the continuing education
13requirements for renewal of a registered professional nurse
14license as required by this Act.
15    The 80 hours of continuing education required under this
16Section shall be completed as follows:
17        (1) A minimum of 50 hours of the continuing education
18    shall be obtained in continuing education programs as
19    determined by rule that shall include no less than 20 hours
20    of pharmacotherapeutics, including 10 hours of opioid
21    prescribing or substance abuse education. Continuing
22    education programs may be conducted or endorsed by
23    educational institutions, hospitals, specialist

 

 

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1    associations, facilities, or other organizations approved
2    to offer continuing education under this Act or rules and
3    shall be in the advanced practice registered nurse's
4    specialty.
5        (2) A maximum of 30 hours of credit may be obtained by
6    presentations in the advanced practice registered nurse's
7    clinical specialty, evidence-based practice, or quality
8    improvement projects, publications, research projects, or
9    preceptor hours as determined by rule.
10    The rules adopted regarding continuing education shall be
11consistent to the extent possible with requirements of relevant
12national certifying bodies or State or national professional
13associations.
14    The rules shall not be inconsistent with requirements of
15relevant national certifying bodies or State or national
16professional associations. The rules shall also address
17variances in part or in whole for good cause, including but not
18limited to illness or hardship. The continuing education rules
19shall assure that licensees are given the opportunity to
20participate in programs sponsored by or through their State or
21national professional associations, hospitals, or other
22providers of continuing education. Each licensee is
23responsible for maintaining records of completion of
24continuing education and shall be prepared to produce the
25records when requested by the Department.
26(Source: P.A. 95-639, eff. 10-5-07.)"; and
 

 

 

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1on page 685, line 10, by replacing "or" with "or"; and
 
2on page 685, line 14, after "Section 303.05", by inserting ",
3or an advanced practice registered nurse certified as a nurse
4practitioner, nurse midwife, or clinical nurse specialist who
5has full practice authority pursuant to Section 65-43 of the
6Nurse Practice Act"; and
 
7on page 686, line 7, by replacing "or" with "or"; and
 
8on page 686, line 12, after "by law", by inserting ", or of an
9advanced practice registered nurse certified as a nurse
10practitioner, nurse midwife, or clinical nurse specialist who
11has full practice authority pursuant to Section 65-43 of the
12Nurse Practice Act"; and
 
13on page 694, line 13, after "nurses", by inserting "who do not
14meet the requirements of Section 65-43 of the Nurse Practice
15Act"; and
 
16on page 694, lines 25 and 26, by replacing "or collaborating
17podiatric physician" with "or collaborating podiatric
18physician"; and
 
19on page 695, lines 9 and 17, by replacing "or podiatric

 

 

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1physician" each time it appears with "or podiatric physician";
2and
 
3on page 695, lines 21 and 25, by replacing "or podiatric
4physician" each time it appears with "or podiatric physician";
5and
 
6on page 696, line 17, after "specialists" by inserting "who do
7not meet the requirements of Section 65-43 of the Nurse
8Practice Act"; and
 
9on page 696, line 21, by replacing "granted authority" with
10"privileged granted authority"; and
 
11on page 697, line 5, by replacing "granted authority" with
12"privileged granted authority"; and
 
13on page 697, line 16, by replacing "this grant of authority"
14with "the privileging documents this grant of authority"; and
 
15on page 697, line 18, by replacing "authority" with "privileges
16authority"; and
 
17on page 697, line 22, by replacing "grant of authority" with
18"privileges grant of authority"; and
 

 

 

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1on page 698, line 24, by replacing "or licensed podiatric
2physician" with "or licensed podiatric physician"; and
 
3on page 699, line 4, after "authority", by inserting "or as
4authorized by their practice Act"; and
 
5on page 699, line 9, by replacing "or podiatric physician" with
6"or podiatric physician"; and
 
7on page 737, line 25, after "effect", by inserting "January 1,
82018, except that this Section and Section 5 take effect".