Sen. Heather A. Steans

Filed: 5/9/2017

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 642

2    AMENDMENT NO. ______. Amend Senate Bill 642 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Medical Practice Act of 1987 is amended by
5changing Section 54.5 as follows:
 
6    (225 ILCS 60/54.5)
7    (Section scheduled to be repealed on December 31, 2017)
8    Sec. 54.5. Physician delegation of authority to physician
9assistants, advanced practice registered nurses without full
10practice authority, and prescribing psychologists.
11    (a) Physicians licensed to practice medicine in all its
12branches may delegate care and treatment responsibilities to a
13physician assistant under guidelines in accordance with the
14requirements of the Physician Assistant Practice Act of 1987. A
15physician licensed to practice medicine in all its branches may
16enter into supervising physician agreements with no more than 5

 

 

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1physician assistants as set forth in subsection (a) of Section
27 of the Physician Assistant Practice Act of 1987.
3    (b) A physician licensed to practice medicine in all its
4branches in active clinical practice may collaborate with an
5advanced practice registered nurse in accordance with the
6requirements of the Nurse Practice Act. Collaboration is for
7the purpose of providing medical consultation, and no
8employment relationship is required. A written collaborative
9agreement shall conform to the requirements of Section 65-35 of
10the Nurse Practice Act. The written collaborative agreement
11shall be for services in the same area of practice or specialty
12as the collaborating physician in his or her clinical medical
13practice. A written collaborative agreement shall be adequate
14with respect to collaboration with advanced practice
15registered nurses if all of the following apply:
16        (1) The agreement is written to promote the exercise of
17    professional judgment by the advanced practice registered
18    nurse commensurate with his or her education and
19    experience.
20        (2) The advance practice registered nurse provides
21    services based upon a written collaborative agreement with
22    the collaborating physician, except as set forth in
23    subsection (b-5) of this Section. With respect to labor and
24    delivery, the collaborating physician must provide
25    delivery services in order to participate with a certified
26    nurse midwife.

 

 

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1        (3) Methods of communication are available with the
2    collaborating physician in person or through
3    telecommunications for consultation, collaboration, and
4    referral as needed to address patient care needs.
5    (b-5) An anesthesiologist or physician licensed to
6practice medicine in all its branches may collaborate with a
7certified registered nurse anesthetist in accordance with
8Section 65-35 of the Nurse Practice Act for the provision of
9anesthesia services. With respect to the provision of
10anesthesia services, the collaborating anesthesiologist or
11physician shall have training and experience in the delivery of
12anesthesia services consistent with Department rules.
13Collaboration shall be adequate if:
14        (1) an anesthesiologist or a physician participates in
15    the joint formulation and joint approval of orders or
16    guidelines and periodically reviews such orders and the
17    services provided patients under such orders; and
18        (2) for anesthesia services, the anesthesiologist or
19    physician participates through discussion of and agreement
20    with the anesthesia plan and is physically present and
21    available on the premises during the delivery of anesthesia
22    services for diagnosis, consultation, and treatment of
23    emergency medical conditions. Anesthesia services in a
24    hospital shall be conducted in accordance with Section 10.7
25    of the Hospital Licensing Act and in an ambulatory surgical
26    treatment center in accordance with Section 6.5 of the

 

 

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1    Ambulatory Surgical Treatment Center Act.
2    (b-10) The anesthesiologist or operating physician must
3agree with the anesthesia plan prior to the delivery of
4services.
5    (c) The supervising physician shall have access to the
6medical records of all patients attended by a physician
7assistant. The collaborating physician shall have access to the
8medical records of all patients attended to by an advanced
9practice registered nurse.
10    (d) (Blank).
11    (e) A physician shall not be liable for the acts or
12omissions of a prescribing psychologist, physician assistant,
13or advanced practice registered nurse solely on the basis of
14having signed a supervision agreement or guidelines or a
15collaborative agreement, an order, a standing medical order, a
16standing delegation order, or other order or guideline
17authorizing a prescribing psychologist, physician assistant,
18or advanced practice registered nurse to perform acts, unless
19the physician has reason to believe the prescribing
20psychologist, physician assistant, or advanced practice
21registered nurse lacked the competency to perform the act or
22acts or commits willful and wanton misconduct.
23    (f) A collaborating physician may, but is not required to,
24delegate prescriptive authority to an advanced practice
25registered nurse as part of a written collaborative agreement,
26and the delegation of prescriptive authority shall conform to

 

 

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1the requirements of Section 65-40 of the Nurse Practice Act.
2    (g) A supervising physician may, but is not required to,
3delegate prescriptive authority to a physician assistant as
4part of a written supervision agreement, and the delegation of
5prescriptive authority shall conform to the requirements of
6Section 7.5 of the Physician Assistant Practice Act of 1987.
7    (h) (Blank).
8    (i) A collaborating physician shall delegate prescriptive
9authority to a prescribing psychologist as part of a written
10collaborative agreement, and the delegation of prescriptive
11authority shall conform to the requirements of Section 4.3 of
12the Clinical Psychologist Licensing Act.
13    (j) As set forth in Section 22.2 of this Act, a licensee
14under this Act may not directly or indirectly divide, share, or
15split any professional fee or other form of compensation for
16professional services with anyone in exchange for a referral or
17otherwise, other than as provided in Section 22.2.
18(Source: P.A. 98-192, eff. 1-1-14; 98-668, eff. 6-25-14;
1999-173, eff. 7-29-15.)
 
20    Section 10. The Nurse Practice Act is amended by changing
21Sections 50-10, 65-30, 65-35, 65-35.1, 65-40, 65-45, 65-50,
2265-55, 65-60, and 65-65 and by adding Section 65-43 as follows:
 
23    (225 ILCS 65/50-10)   (was 225 ILCS 65/5-10)
24    (Section scheduled to be repealed on January 1, 2018)

 

 

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1    Sec. 50-10. Definitions. Each of the following terms, when
2used in this Act, shall have the meaning ascribed to it in this
3Section, except where the context clearly indicates otherwise:
4    "Academic year" means the customary annual schedule of
5courses at a college, university, or approved school,
6customarily regarded as the school year as distinguished from
7the calendar year.
8    "Advanced practice registered nurse" or "APRN" "APN" means
9a person who has met the qualifications for a (i) certified
10nurse midwife (CNM); (ii) certified nurse practitioner (CNP);
11(iii) certified registered nurse anesthetist (CRNA); or (iv)
12clinical nurse specialist (CNS) and has been licensed by the
13Department. All advanced practice registered nurses licensed
14and practicing in the State of Illinois shall use the title
15APRN APN and may use specialty credentials CNM, CNP, CRNA, or
16CNS after their name. All advanced practice registered nurses
17may only practice in accordance with national certification and
18this Act.
19    "Approved program of professional nursing education" and
20"approved program of practical nursing education" are programs
21of professional or practical nursing, respectively, approved
22by the Department under the provisions of this Act.
23    "Board" means the Board of Nursing appointed by the
24Secretary.
25    "Collaboration" means a process involving 2 or more health
26care professionals working together, each contributing one's

 

 

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1respective area of expertise to provide more comprehensive
2patient care.
3    "Consultation" means the process whereby an advanced
4practice registered nurse seeks the advice or opinion of
5another health care professional.
6    "Credentialed" means the process of assessing and
7validating the qualifications of a health care professional.
8    "Current nursing practice update course" means a planned
9nursing education curriculum approved by the Department
10consisting of activities that have educational objectives,
11instructional methods, content or subject matter, clinical
12practice, and evaluation methods, related to basic review and
13updating content and specifically planned for those nurses
14previously licensed in the United States or its territories and
15preparing for reentry into nursing practice.
16    "Dentist" means a person licensed to practice dentistry
17under the Illinois Dental Practice Act.
18    "Department" means the Department of Financial and
19Professional Regulation.
20    "Full practice authority" means the authority of an
21advanced practice registered nurse licensed in Illinois and
22certified as a nurse practitioner, clinical nurse specialist,
23or nurse midwife to practice without a written collaborative
24agreement and:
25        (1) to be fully accountable to patients for the quality
26    of advanced nursing care rendered;

 

 

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1        (2) to be fully accountable for recognizing limits of
2    knowledge and experience and for planning for the
3    management of situations beyond the advanced practice
4    registered nurse's expertise; the full practice authority
5    for advanced practice registered nurses includes accepting
6    referrals from, consulting with, collaborating with, or
7    referring to other health care professionals as warranted
8    by the needs of the patient; and
9        (3) to possess the authority to prescribe medications,
10    including Schedule II through V controlled substances, as
11    provided in Section 65-43.
12    "Hospital affiliate" means a corporation, partnership,
13joint venture, limited liability company, or similar
14organization, other than a hospital, that is devoted primarily
15to the provision, management, or support of health care
16services and that directly or indirectly controls, is
17controlled by, or is under common control of the hospital. For
18the purposes of this definition, "control" means having at
19least an equal or a majority ownership or membership interest.
20A hospital affiliate shall be 100% owned or controlled by any
21combination of hospitals, their parent corporations, or
22physicians licensed to practice medicine in all its branches in
23Illinois. "Hospital affiliate" does not include a health
24maintenance organization regulated under the Health
25Maintenance Organization Act.
26    "Impaired nurse" means a nurse licensed under this Act who

 

 

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1is unable to practice with reasonable skill and safety because
2of a physical or mental disability as evidenced by a written
3determination or written consent based on clinical evidence,
4including loss of motor skills, abuse of drugs or alcohol, or a
5psychiatric disorder, of sufficient degree to diminish his or
6her ability to deliver competent patient care.
7    "License-pending advanced practice registered nurse" means
8a registered professional nurse who has completed all
9requirements for licensure as an advanced practice registered
10nurse except the certification examination and has applied to
11take the next available certification exam and received a
12temporary license from the Department.
13    "License-pending registered nurse" means a person who has
14passed the Department-approved registered nurse licensure exam
15and has applied for a license from the Department. A
16license-pending registered nurse shall use the title "RN lic
17pend" on all documentation related to nursing practice.
18    "Physician" means a person licensed to practice medicine in
19all its branches under the Medical Practice Act of 1987.
20    "Podiatric physician" means a person licensed to practice
21podiatry under the Podiatric Medical Practice Act of 1987.
22    "Practical nurse" or "licensed practical nurse" means a
23person who is licensed as a practical nurse under this Act and
24practices practical nursing as defined in this Act. Only a
25practical nurse licensed under this Act is entitled to use the
26title "licensed practical nurse" and the abbreviation

 

 

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1"L.P.N.".
2    "Practical nursing" means the performance of nursing acts
3requiring the basic nursing knowledge, judgment, and skill
4acquired by means of completion of an approved practical
5nursing education program. Practical nursing includes
6assisting in the nursing process as delegated by a registered
7professional nurse or an advanced practice registered nurse.
8The practical nurse may work under the direction of a licensed
9physician, dentist, podiatric physician, or other health care
10professional determined by the Department.
11    "Prescription monitoring program" means the entity that
12collects, tracks, and stores reported data on controlled
13substances and select drugs pursuant to Section 316 of the
14Illinois Controlled Substances Act.
15    "Privileged" means the authorization granted by the
16governing body of a healthcare facility, agency, or
17organization to provide specific patient care services within
18well-defined limits, based on qualifications reviewed in the
19credentialing process.
20    "Registered Nurse" or "Registered Professional Nurse"
21means a person who is licensed as a professional nurse under
22this Act and practices nursing as defined in this Act. Only a
23registered nurse licensed under this Act is entitled to use the
24titles "registered nurse" and "registered professional nurse"
25and the abbreviation, "R.N.".
26    "Registered professional nursing practice" is a scientific

 

 

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1process founded on a professional body of knowledge; it is a
2learned profession based on the understanding of the human
3condition across the life span and environment and includes all
4nursing specialties and means the performance of any nursing
5act based upon professional knowledge, judgment, and skills
6acquired by means of completion of an approved professional
7nursing education program. A registered professional nurse
8provides holistic nursing care through the nursing process to
9individuals, groups, families, or communities, that includes
10but is not limited to: (1) the assessment of healthcare needs,
11nursing diagnosis, planning, implementation, and nursing
12evaluation; (2) the promotion, maintenance, and restoration of
13health; (3) counseling, patient education, health education,
14and patient advocacy; (4) the administration of medications and
15treatments as prescribed by a physician licensed to practice
16medicine in all of its branches, a licensed dentist, a licensed
17podiatric physician, or a licensed optometrist or as prescribed
18by a physician assistant or by an advanced practice registered
19nurse; (5) the coordination and management of the nursing plan
20of care; (6) the delegation to and supervision of individuals
21who assist the registered professional nurse implementing the
22plan of care; and (7) teaching nursing students. The foregoing
23shall not be deemed to include those acts of medical diagnosis
24or prescription of therapeutic or corrective measures.
25    "Professional assistance program for nurses" means a
26professional assistance program that meets criteria

 

 

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1established by the Board of Nursing and approved by the
2Secretary, which provides a non-disciplinary treatment
3approach for nurses licensed under this Act whose ability to
4practice is compromised by alcohol or chemical substance
5addiction.
6    "Secretary" means the Secretary of Financial and
7Professional Regulation.
8    "Unencumbered license" means a license issued in good
9standing.
10    "Written collaborative agreement" means a written
11agreement between an advanced practice registered nurse and a
12collaborating physician, dentist, or podiatric physician
13pursuant to Section 65-35.
14(Source: P.A. 98-214, eff. 8-9-13; 99-173, eff. 7-29-15;
1599-330, eff. 1-1-16; 99-642, eff. 7-28-16.)
 
16    (225 ILCS 65/65-30)
17    (Section scheduled to be repealed on January 1, 2018)
18    Sec. 65-30. APRN APN scope of practice.
19    (a) Advanced practice registered nursing by certified
20nurse practitioners, certified nurse anesthetists, certified
21nurse midwives, or clinical nurse specialists is based on
22knowledge and skills acquired throughout an advanced practice
23registered nurse's nursing education, training, and
24experience.
25    (b) Practice as an advanced practice registered nurse means

 

 

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1a scope of nursing practice, with or without compensation, and
2includes the registered nurse scope of practice.
3    (c) The scope of practice of an advanced practice
4registered nurse includes, but is not limited to, each of the
5following:
6        (1) Advanced registered nursing patient assessment and
7diagnosis.
8        (2) Ordering diagnostic and therapeutic tests and
9procedures, performing those tests and procedures when using
10health care equipment, and interpreting and using the results
11of diagnostic and therapeutic tests and procedures ordered by
12the advanced practice registered nurse or another health care
13professional.
14        (3) Ordering treatments, ordering or applying
15appropriate medical devices, and using nursing medical,
16therapeutic, and corrective measures to treat illness and
17improve health status.
18        (4) Providing palliative and end-of-life care.
19        (5) Providing advanced counseling, patient education,
20health education, and patient advocacy.
21        (6) Prescriptive authority as defined in Section 65-40
22of this Act.
23        (7) Delegating selected nursing activities or tasks to
24a licensed practical nurse, a registered professional nurse, or
25other personnel.
26(Source: P.A. 95-639, eff. 10-5-07.)
 

 

 

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1    (225 ILCS 65/65-35)   (was 225 ILCS 65/15-15)
2    (Section scheduled to be repealed on January 1, 2018)
3    Sec. 65-35. Written collaborative agreements.
4    (a) A written collaborative agreement is required for all
5advanced practice registered nurses engaged in clinical
6practice prior to meeting the requirements of Section 65-43,
7except for advanced practice registered nurses who are
8privileged authorized to practice in a hospital, hospital
9affiliate, or ambulatory surgical treatment center.
10    (a-5) If an advanced practice registered nurse engages in
11clinical practice outside of a hospital, hospital affiliate, or
12ambulatory surgical treatment center in which he or she is
13privileged authorized to practice, the advanced practice
14registered nurse must have a written collaborative agreement,
15except as set forth in Section 65-43.
16    (b) A written collaborative agreement shall describe the
17relationship of the advanced practice registered nurse with the
18collaborating physician or podiatric physician and shall
19describe the categories of care, treatment, or procedures to be
20provided by the advanced practice registered nurse. A
21collaborative agreement with a dentist must be in accordance
22with subsection (c-10) of this Section. A collaborative
23agreement with a podiatric physician must be in accordance with
24subsection (c-5) of this Section. Collaboration does not
25require an employment relationship between the collaborating

 

 

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1physician or podiatric physician and the advanced practice
2registered nurse.
3    The collaborative relationship under an agreement shall
4not be construed to require the personal presence of a
5collaborating physician or podiatric physician at the place
6where services are rendered. Methods of communication shall be
7available for consultation with the collaborating physician or
8podiatric physician in person or by telecommunications or
9electronic communications as set forth in the written
10agreement.
11    (b-5) Absent an employment relationship, a written
12collaborative agreement may not (1) restrict the categories of
13patients of an advanced practice registered nurse within the
14scope of the advanced practice registered nurses training and
15experience, (2) limit third party payors or government health
16programs, such as the medical assistance program or Medicare
17with which the advanced practice registered nurse contracts, or
18(3) limit the geographic area or practice location of the
19advanced practice registered nurse in this State.
20    (c) In the case of anesthesia services provided by a
21certified registered nurse anesthetist, an anesthesiologist, a
22physician, a dentist, or a podiatric physician must participate
23through discussion of and agreement with the anesthesia plan
24and remain physically present and available on the premises
25during the delivery of anesthesia services for diagnosis,
26consultation, and treatment of emergency medical conditions.

 

 

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1    (c-5) A certified registered nurse anesthetist, who
2provides anesthesia services outside of a hospital or
3ambulatory surgical treatment center shall enter into a written
4collaborative agreement with an anesthesiologist or the
5physician licensed to practice medicine in all its branches or
6the podiatric physician performing the procedure. Outside of a
7hospital or ambulatory surgical treatment center, the
8certified registered nurse anesthetist may provide only those
9services that the collaborating podiatric physician is
10authorized to provide pursuant to the Podiatric Medical
11Practice Act of 1987 and rules adopted thereunder. A certified
12registered nurse anesthetist may select, order, and administer
13medication, including controlled substances, and apply
14appropriate medical devices for delivery of anesthesia
15services under the anesthesia plan agreed with by the
16anesthesiologist or the operating physician or operating
17podiatric physician.
18    (c-10) A certified registered nurse anesthetist who
19provides anesthesia services in a dental office shall enter
20into a written collaborative agreement with an
21anesthesiologist or the physician licensed to practice
22medicine in all its branches or the operating dentist
23performing the procedure. The agreement shall describe the
24working relationship of the certified registered nurse
25anesthetist and dentist and shall authorize the categories of
26care, treatment, or procedures to be performed by the certified

 

 

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1registered nurse anesthetist. In a collaborating dentist's
2office, the certified registered nurse anesthetist may only
3provide those services that the operating dentist with the
4appropriate permit is authorized to provide pursuant to the
5Illinois Dental Practice Act and rules adopted thereunder. For
6anesthesia services, an anesthesiologist, physician, or
7operating dentist shall participate through discussion of and
8agreement with the anesthesia plan and shall remain physically
9present and be available on the premises during the delivery of
10anesthesia services for diagnosis, consultation, and treatment
11of emergency medical conditions. A certified registered nurse
12anesthetist may select, order, and administer medication,
13including controlled substances, and apply appropriate medical
14devices for delivery of anesthesia services under the
15anesthesia plan agreed with by the operating dentist.
16    (d) A copy of the signed, written collaborative agreement
17must be available to the Department upon request from both the
18advanced practice registered nurse and the collaborating
19physician, dentist, or podiatric physician.
20    (e) Nothing in this Act shall be construed to limit the
21delegation of tasks or duties by a physician to a licensed
22practical nurse, a registered professional nurse, or other
23persons in accordance with Section 54.2 of the Medical Practice
24Act of 1987. Nothing in this Act shall be construed to limit
25the method of delegation that may be authorized by any means,
26including, but not limited to, oral, written, electronic,

 

 

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1standing orders, protocols, guidelines, or verbal orders.
2Nothing in this Act shall be construed to authorize an advanced
3practice registered nurse to provide health care services
4required by law or rule to be performed by a physician.
5    (f) An advanced practice registered nurse shall inform each
6collaborating physician, dentist, or podiatric physician of
7all collaborative agreements he or she has signed and provide a
8copy of these to any collaborating physician, dentist, or
9podiatric physician upon request.
10    (g) (Blank).
11(Source: P.A. 98-192, eff. 1-1-14; 98-214, eff. 8-9-13; 98-756,
12eff. 7-16-14; 99-173, eff. 7-29-15.)
 
13    (225 ILCS 65/65-35.1)
14    (Section scheduled to be repealed on January 1, 2018)
15    Sec. 65-35.1. Written collaborative agreement; temporary
16practice. Any advanced practice registered nurse required to
17enter into a written collaborative agreement with a
18collaborating physician or collaborating podiatrist is
19authorized to continue to practice for up to 90 days after the
20termination of a collaborative agreement provided the advanced
21practice registered nurse seeks any needed collaboration at a
22local hospital and refers patients who require services beyond
23the training and experience of the advanced practice registered
24nurse to a physician or other health care provider.
25(Source: P.A. 99-173, eff. 7-29-15.)
 

 

 

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1    (225 ILCS 65/65-40)   (was 225 ILCS 65/15-20)
2    (Section scheduled to be repealed on January 1, 2018)
3    Sec. 65-40. Written collaborative agreement; prescriptive
4authority.
5    (a) A collaborating physician or podiatric physician may,
6but is not required to, delegate prescriptive authority to an
7advanced practice registered nurse as part of a written
8collaborative agreement. This authority may, but is not
9required to, include prescription of, selection of, orders for,
10administration of, storage of, acceptance of samples of, and
11dispensing over the counter medications, legend drugs, medical
12gases, and controlled substances categorized as any Schedule
13III through V controlled substances, as defined in Article II
14of the Illinois Controlled Substances Act, and other
15preparations, including, but not limited to, botanical and
16herbal remedies. The collaborating physician or podiatric
17physician must have a valid current Illinois controlled
18substance license and federal registration to delegate
19authority to prescribe delegated controlled substances.
20    (b) To prescribe controlled substances under this Section,
21an advanced practice registered nurse must obtain a mid-level
22practitioner controlled substance license. Medication orders
23shall be reviewed periodically by the collaborating physician
24or podiatric physician.
25    (c) The collaborating physician or podiatric physician

 

 

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1shall file with the Department notice of delegation of
2prescriptive authority and termination of such delegation, in
3accordance with rules of the Department. Upon receipt of this
4notice delegating authority to prescribe any Schedule III
5through V controlled substances, the licensed advanced
6practice registered nurse shall be eligible to register for a
7mid-level practitioner controlled substance license under
8Section 303.05 of the Illinois Controlled Substances Act.
9    (d) In addition to the requirements of subsections (a),
10(b), and (c) of this Section, a collaborating physician or
11podiatric physician may, but is not required to, delegate
12authority to an advanced practice registered nurse to prescribe
13any Schedule II controlled substances, if all of the following
14conditions apply:
15        (1) Specific Schedule II controlled substances by oral
16    dosage or topical or transdermal application may be
17    delegated, provided that the delegated Schedule II
18    controlled substances are routinely prescribed by the
19    collaborating physician or podiatric physician. This
20    delegation must identify the specific Schedule II
21    controlled substances by either brand name or generic name.
22    Schedule II controlled substances to be delivered by
23    injection or other route of administration may not be
24    delegated.
25        (2) Any delegation must be controlled substances that
26    the collaborating physician or podiatric physician

 

 

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1    prescribes.
2        (3) Any prescription must be limited to no more than a
3    30-day supply, with any continuation authorized only after
4    prior approval of the collaborating physician or podiatric
5    physician.
6        (4) The advanced practice registered nurse must
7    discuss the condition of any patients for whom a controlled
8    substance is prescribed monthly with the delegating
9    physician.
10        (5) The advanced practice registered nurse meets the
11    education requirements of Section 303.05 of the Illinois
12    Controlled Substances Act.
13    (e) Nothing in this Act shall be construed to limit the
14delegation of tasks or duties by a physician to a licensed
15practical nurse, a registered professional nurse, or other
16persons. Nothing in this Act shall be construed to limit the
17method of delegation that may be authorized by any means,
18including, but not limited to, oral, written, electronic,
19standing orders, protocols, guidelines, or verbal orders.
20    (f) Nothing in this Section shall be construed to apply to
21any medication authority including Schedule II controlled
22substances of an advanced practice registered nurse for care
23provided in a hospital, hospital affiliate, or ambulatory
24surgical treatment center pursuant to Section 65-45.
25    (g) (Blank). Any advanced practice nurse who writes a
26prescription for a controlled substance without having a valid

 

 

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1appropriate authority may be fined by the Department not more
2than $50 per prescription, and the Department may take any
3other disciplinary action provided for in this Act.
4    (h) Nothing in this Section shall be construed to prohibit
5generic substitution.
6    (i) Nothing in this Section shall be construed to apply to
7an advanced practice registered nurse who meets the
8requirements of Section 65-43.
9(Source: P.A. 97-358, eff. 8-12-11; 98-214, eff. 8-9-13.)
 
10    (225 ILCS 65/65-43 new)
11    Sec. 65-43. Full practice authority.
12    (a) An Illinois-licensed advanced practice registered
13nurse certified as a nurse practitioner, nurse midwife, or
14clinical nurse specialist shall be deemed by law to possess the
15ability to practice without a written collaborative agreement
16as set forth in this Section.
17    (b) An advanced practice registered nurse certified as a
18nurse midwife, clinical nurse specialist, or nurse
19practitioner who files with the Department a notarized
20attestation of completion of at least 4,000 hours of clinical
21experience after first attaining national certification shall
22not require a written collaborative agreement, except as
23specified in subsection (c). Documentation of successful
24completion shall be provided to the Department upon request.
25    The clinical experience must be in the advanced practice

 

 

10000SB0642sam001- 23 -LRB100 04152 SMS 25934 a

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

 

 

10000SB0642sam001- 24 -LRB100 04152 SMS 25934 a

1nurse does not include operative surgery.
2    (d) Before issuing a prescription for Schedule II, III, IV,
3or V controlled substances, the advanced practice registered
4nurse or her or his designee shall access the prescription
5monitoring program as set forth under Section 314.5 of the
6Illinois Controlled Substances Act for each patient and
7document in the medical record that:
8        (1) the prescription monitoring program was accessed
9    and relevant data was reviewed prior to prescribing a
10    scheduled drug; and
11        (2) risk factors were evaluated (or identified) and
12    discussed with the patient based on current federal Centers
13    for Disease Control and Prevention guidelines.
 
14    (225 ILCS 65/65-45)   (was 225 ILCS 65/15-25)
15    (Section scheduled to be repealed on January 1, 2018)
16    Sec. 65-45. Advanced practice registered nursing in
17hospitals, hospital affiliates, or ambulatory surgical
18treatment centers.
19    (a) An advanced practice registered nurse may provide
20services in a hospital or a hospital affiliate as those terms
21are defined in the Hospital Licensing Act or the University of
22Illinois Hospital Act or a licensed ambulatory surgical
23treatment center without a written collaborative agreement
24pursuant to Section 65-35 of this Act. An advanced practice
25registered nurse must possess clinical privileges recommended

 

 

10000SB0642sam001- 25 -LRB100 04152 SMS 25934 a

1by the hospital medical staff and granted by the hospital or
2the consulting medical staff committee and ambulatory surgical
3treatment center in order to provide services. The medical
4staff or consulting medical staff committee shall periodically
5review the services of all advanced practice registered nurses
6granted clinical privileges, including any care provided in a
7hospital affiliate. Authority may also be granted when
8recommended by the hospital medical staff and granted by the
9hospital or recommended by the consulting medical staff
10committee and ambulatory surgical treatment center to
11individual advanced practice registered nurses to select,
12order, and administer medications, including controlled
13substances, to provide delineated care. In a hospital, hospital
14affiliate, or ambulatory surgical treatment center, the
15attending physician shall determine an advanced practice
16registered nurse's role in providing care for his or her
17patients, except as otherwise provided in the medical staff
18bylaws or consulting committee policies.
19    (a-2) An advanced practice registered nurse privileged
20granted authority to order medications, including controlled
21substances, may complete discharge prescriptions provided the
22prescription is in the name of the advanced practice registered
23nurse and the attending or discharging physician.
24    (a-3) Advanced practice registered nurses practicing in a
25hospital or an ambulatory surgical treatment center are not
26required to obtain a mid-level controlled substance license to

 

 

10000SB0642sam001- 26 -LRB100 04152 SMS 25934 a

1order controlled substances under Section 303.05 of the
2Illinois Controlled Substances Act.
3    (a-4) An advanced practice registered nurse meeting the
4requirements of Section 65-43 may be privileged to complete
5discharge orders and prescriptions under the advanced practice
6registered nurse's name.
7    (a-5) For anesthesia services provided by a certified
8registered nurse anesthetist, an anesthesiologist, physician,
9dentist, or podiatric physician shall participate through
10discussion of and agreement with the anesthesia plan and shall
11remain physically present and be available on the premises
12during the delivery of anesthesia services for diagnosis,
13consultation, and treatment of emergency medical conditions,
14unless hospital policy adopted pursuant to clause (B) of
15subdivision (3) of Section 10.7 of the Hospital Licensing Act
16or ambulatory surgical treatment center policy adopted
17pursuant to clause (B) of subdivision (3) of Section 6.5 of the
18Ambulatory Surgical Treatment Center Act provides otherwise. A
19certified registered nurse anesthetist may select, order, and
20administer medication for anesthesia services under the
21anesthesia plan agreed to by the anesthesiologist or the
22physician, in accordance with hospital alternative policy or
23the medical staff consulting committee policies of a licensed
24ambulatory surgical treatment center.
25    (b) An advanced practice registered nurse who provides
26services in a hospital shall do so in accordance with Section

 

 

10000SB0642sam001- 27 -LRB100 04152 SMS 25934 a

110.7 of the Hospital Licensing Act and, in an ambulatory
2surgical treatment center, in accordance with Section 6.5 of
3the Ambulatory Surgical Treatment Center Act. Nothing in this
4Act shall be construed to require an advanced practice
5registered nurse to have a collaborative agreement to practice
6in a hospital, hospital affiliate, or ambulatory surgical
7treatment center.
8    (c) Advanced practice registered nurses certified as nurse
9practitioners, nurse midwives, or clinical nurse specialists
10practicing in a hospital affiliate may be, but are not required
11to be, privileged granted authority to prescribe Schedule II
12through V controlled substances when such authority is
13recommended by the appropriate physician committee of the
14hospital affiliate and granted by the hospital affiliate. This
15authority may, but is not required to, include prescription of,
16selection of, orders for, administration of, storage of,
17acceptance of samples of, and dispensing over-the-counter
18medications, legend drugs, medical gases, and controlled
19substances categorized as Schedule II through V controlled
20substances, as defined in Article II of the Illinois Controlled
21Substances Act, and other preparations, including, but not
22limited to, botanical and herbal remedies.
23    To prescribe controlled substances under this subsection
24(c), an advanced practice registered nurse certified as a nurse
25practitioner, nurse midwife, or clinical nurse specialist must
26obtain a mid-level practitioner controlled substance license.

 

 

10000SB0642sam001- 28 -LRB100 04152 SMS 25934 a

1Medication orders shall be reviewed periodically by the
2appropriate hospital affiliate physicians committee or its
3physician designee.
4    The hospital affiliate shall file with the Department
5notice of a grant of prescriptive authority consistent with
6this subsection (c) and termination of such a grant of
7authority, in accordance with rules of the Department. Upon
8receipt of this notice of grant of authority to prescribe any
9Schedule II through V controlled substances, the licensed
10advanced practice registered nurse certified as a nurse
11practitioner, nurse midwife, or clinical nurse specialist may
12register for a mid-level practitioner controlled substance
13license under Section 303.05 of the Illinois Controlled
14Substances Act.
15    In addition, a hospital affiliate may, but is not required
16to, privilege grant authority to an advanced practice
17registered nurse certified as a nurse practitioner, nurse
18midwife, or clinical nurse specialist to prescribe any Schedule
19II controlled substances, if all of the following conditions
20apply:
21        (1) specific Schedule II controlled substances by oral
22    dosage or topical or transdermal application may be
23    designated, provided that the designated Schedule II
24    controlled substances are routinely prescribed by advanced
25    practice registered nurses in their area of certification;
26    the privileging documents this grant of authority must

 

 

10000SB0642sam001- 29 -LRB100 04152 SMS 25934 a

1    identify the specific Schedule II controlled substances by
2    either brand name or generic name; authority to prescribe
3    or dispense Schedule II controlled substances to be
4    delivered by injection or other route of administration may
5    not be granted;
6        (2) any privilege grant of authority must be controlled
7    substances limited to the practice of the advanced practice
8    registered nurse;
9        (3) any prescription must be limited to no more than a
10    30-day supply;
11        (4) the advanced practice registered nurse must
12    discuss the condition of any patients for whom a controlled
13    substance is prescribed monthly with the appropriate
14    physician committee of the hospital affiliate or its
15    physician designee; and
16        (5) the advanced practice registered nurse must meet
17    the education requirements of Section 303.05 of the
18    Illinois Controlled Substances Act.
19    (d) An advanced practice registered nurse meeting the
20requirements of Section 65-43 may be privileged to prescribe
21controlled substances categorized as Schedule II through V in
22accordance with Section 65-43.
23(Source: P.A. 98-214, eff. 8-9-13; 99-173, eff. 7-29-15.)
 
24    (225 ILCS 65/65-50)   (was 225 ILCS 65/15-30)
25    (Section scheduled to be repealed on January 1, 2018)

 

 

10000SB0642sam001- 30 -LRB100 04152 SMS 25934 a

1    Sec. 65-50. APRN APN title.
2    (a) No person shall use any words, abbreviations, figures,
3letters, title, sign, card, or device tending to imply that he
4or she is an advanced practice registered nurse, including but
5not limited to using the titles or initials "Advanced Practice
6Registered Nurse", "Advanced Practice Nurse", "Certified Nurse
7Midwife", "Certified Nurse Practitioner", "Certified
8Registered Nurse Anesthetist", "Clinical Nurse Specialist",
9"A.P.R.N.", "A.P.N.", "C.N.M.", "C.N.P.", "C.R.N.A.",
10"C.N.S.", or similar titles or initials, with the intention of
11indicating practice as an advanced practice registered nurse
12without meeting the requirements of this Act.
13    (b) No advanced practice registered nurse shall indicate to
14other persons that he or she is qualified to engage in the
15practice of medicine.
16    (c) An advanced practice registered nurse shall verbally
17identify himself or herself as an advanced practice registered
18nurse, including specialty certification, to each patient.
19    (d) Nothing in this Act shall be construed to relieve an
20advanced practice registered nurse of the professional or legal
21responsibility for the care and treatment of persons attended
22by him or her.
23(Source: P.A. 95-639, eff. 10-5-07.)
 
24    (225 ILCS 65/65-55)   (was 225 ILCS 65/15-40)
25    (Section scheduled to be repealed on January 1, 2018)

 

 

10000SB0642sam001- 31 -LRB100 04152 SMS 25934 a

1    Sec. 65-55. Advertising as an APRN APN.
2    (a) A person licensed under this Act as an advanced
3practice registered nurse may advertise the availability of
4professional services in the public media or on the premises
5where the professional services are rendered. The advertising
6shall be limited to the following information:
7        (1) publication of the person's name, title, office
8    hours, address, and telephone number;
9        (2) information pertaining to the person's areas of
10    specialization, including, but not limited to, appropriate
11    national board certification or limitation of professional
12    practice;
13        (3) publication of the person's collaborating
14    physician's or , dentist's, or podiatric physician's name,
15    title, if such is required, and areas of specialization;
16        (4) information on usual and customary fees for routine
17    professional services offered, which shall include
18    notification that fees may be adjusted due to complications
19    or unforeseen circumstances;
20        (5) announcements of the opening of, change of, absence
21    from, or return to business;
22        (6) announcement of additions to or deletions from
23    professional licensed staff; and
24        (7) the issuance of business or appointment cards.
25    (b) It is unlawful for a person licensed under this Act as
26an advanced practice nurse to use testimonials or claims of

 

 

10000SB0642sam001- 32 -LRB100 04152 SMS 25934 a

1superior quality of care to entice the public. It shall be
2unlawful to advertise fee comparisons of available services
3with those of other licensed persons.
4    (c) This Article does not authorize the advertising of
5professional services that the offeror of the services is not
6licensed or authorized to render. Nor shall the advertiser use
7statements that contain false, fraudulent, deceptive, or
8misleading material or guarantees of success, statements that
9play upon the vanity or fears of the public, or statements that
10promote or produce unfair competition.
11    (d) It is unlawful and punishable under the penalty
12provisions of this Act for a person licensed under this Article
13to knowingly advertise that the licensee will accept as payment
14for services rendered by assignment from any third party payor
15the amount the third party payor covers as payment in full, if
16the effect is to give the impression of eliminating the need of
17payment by the patient of any required deductible or copayment
18applicable in the patient's health benefit plan.
19    (e) A licensee shall include in every advertisement for
20services regulated under this Act his or her title as it
21appears on the license or the initials authorized under this
22Act.
23    (f) As used in this Section, "advertise" means solicitation
24by the licensee or through another person or entity by means of
25handbills, posters, circulars, motion pictures, radio,
26newspapers, or television or any other manner.

 

 

10000SB0642sam001- 33 -LRB100 04152 SMS 25934 a

1(Source: P.A. 98-214, eff. 8-9-13.)
 
2    (225 ILCS 65/65-60)   (was 225 ILCS 65/15-45)
3    (Section scheduled to be repealed on January 1, 2018)
4    Sec. 65-60. Continuing education. The Department shall
5adopt rules of continuing education for persons licensed under
6this Article as advanced practice registered nurses that
7require 80 50 hours of continuing education per 2-year license
8renewal cycle. Completion of the 80 50 hours of continuing
9education shall be deemed to satisfy the continuing education
10requirements for renewal of a registered professional nurse
11license as required by this Act. A minimum of 50 hours of
12required continuing education shall be obtained in formal
13category 1 continuing education programs that shall include no
14less than 20 hours of pharmacotherapeutics, including 10 hours
15on opioid prescribing or substance abuse education. Such formal
16education programs approved by the Department may be conducted
17or endorsed by hospitals, specialist associations, facilities,
18or other organizations approved to offer continuing education
19or continuing medical education credit, and shall be in the
20advanced practice registered nurse's clinical specialty.
21Category 2 continuing education shall be a maximum of 30 hours
22of credit and may be obtained by: presentations in clinical
23specialty, evidence-based practice or quality improvement
24projects, publications, research projects, or preceptor hours
25as determined by the Department. The rules shall not be

 

 

10000SB0642sam001- 34 -LRB100 04152 SMS 25934 a

1inconsistent with requirements of relevant national certifying
2bodies or State or national professional associations. The
3rules shall also address variances in part or in whole for good
4cause, including but not limited to illness or hardship. The
5continuing education rules shall assure that licensees are
6given the opportunity to participate in programs sponsored by
7or through their State or national professional associations,
8hospitals, or other providers of continuing education. Each
9licensee is responsible for maintaining records of completion
10of continuing education and shall be prepared to produce the
11records when requested by the Department.
12(Source: P.A. 95-639, eff. 10-5-07.)
 
13    (225 ILCS 65/65-65)   (was 225 ILCS 65/15-55)
14    (Section scheduled to be repealed on January 1, 2018)
15    Sec. 65-65. Reports relating to APRN APN professional
16conduct and capacity.
17    (a) Entities Required to Report.
18        (1) Health Care Institutions. The chief administrator
19    or executive officer of a health care institution licensed
20    by the Department of Public Health, which provides the
21    minimum due process set forth in Section 10.4 of the
22    Hospital Licensing Act, shall report to the Board when an
23    advanced practice registered nurse's organized
24    professional staff clinical privileges are terminated or
25    are restricted based on a final determination, in

 

 

10000SB0642sam001- 35 -LRB100 04152 SMS 25934 a

1    accordance with that institution's bylaws or rules and
2    regulations, that (i) a person has either committed an act
3    or acts that may directly threaten patient care and that
4    are not of an administrative nature or (ii) that a person
5    may have a mental or physical disability that may endanger
6    patients under that person's care. The chief administrator
7    or officer shall also report if an advanced practice
8    registered nurse accepts voluntary termination or
9    restriction of clinical privileges in lieu of formal action
10    based upon conduct related directly to patient care and not
11    of an administrative nature, or in lieu of formal action
12    seeking to determine whether a person may have a mental or
13    physical disability that may endanger patients under that
14    person's care. The Board shall provide by rule for the
15    reporting to it of all instances in which a person licensed
16    under this Article, who is impaired by reason of age, drug,
17    or alcohol abuse or physical or mental impairment, is under
18    supervision and, where appropriate, is in a program of
19    rehabilitation. Reports submitted under this subsection
20    shall be strictly confidential and may be reviewed and
21    considered only by the members of the Board or authorized
22    staff as provided by rule of the Board. Provisions shall be
23    made for the periodic report of the status of any such
24    reported person not less than twice annually in order that
25    the Board shall have current information upon which to
26    determine the status of that person. Initial and periodic

 

 

10000SB0642sam001- 36 -LRB100 04152 SMS 25934 a

1    reports of impaired advanced practice registered nurses
2    shall not be considered records within the meaning of the
3    State Records Act and shall be disposed of, following a
4    determination by the Board that such reports are no longer
5    required, in a manner and at an appropriate time as the
6    Board shall determine by rule. The filing of reports
7    submitted under this subsection shall be construed as the
8    filing of a report for purposes of subsection (c) of this
9    Section.
10        (2) Professional Associations. The President or chief
11    executive officer of an association or society of persons
12    licensed under this Article, operating within this State,
13    shall report to the Board when the association or society
14    renders a final determination that a person licensed under
15    this Article has committed unprofessional conduct related
16    directly to patient care or that a person may have a mental
17    or physical disability that may endanger patients under the
18    person's care.
19        (3) Professional Liability Insurers. Every insurance
20    company that offers policies of professional liability
21    insurance to persons licensed under this Article, or any
22    other entity that seeks to indemnify the professional
23    liability of a person licensed under this Article, shall
24    report to the Board the settlement of any claim or cause of
25    action, or final judgment rendered in any cause of action,
26    that alleged negligence in the furnishing of patient care

 

 

10000SB0642sam001- 37 -LRB100 04152 SMS 25934 a

1    by the licensee when the settlement or final judgment is in
2    favor of the plaintiff.
3        (4) State's Attorneys. The State's Attorney of each
4    county shall report to the Board all instances in which a
5    person licensed under this Article is convicted or
6    otherwise found guilty of the commission of a felony.
7        (5) State Agencies. All agencies, boards, commissions,
8    departments, or other instrumentalities of the government
9    of this State shall report to the Board any instance
10    arising in connection with the operations of the agency,
11    including the administration of any law by the agency, in
12    which a person licensed under this Article has either
13    committed an act or acts that may constitute a violation of
14    this Article, that may constitute unprofessional conduct
15    related directly to patient care, or that indicates that a
16    person licensed under this Article may have a mental or
17    physical disability that may endanger patients under that
18    person's care.
19    (b) Mandatory Reporting. All reports required under items
20(16) and (17) of subsection (a) of Section 70-5 shall be
21submitted to the Board in a timely fashion. The reports shall
22be filed in writing within 60 days after a determination that a
23report is required under this Article. All reports shall
24contain the following information:
25        (1) The name, address, and telephone number of the
26    person making the report.

 

 

10000SB0642sam001- 38 -LRB100 04152 SMS 25934 a

1        (2) The name, address, and telephone number of the
2    person who is the subject of the report.
3        (3) The name or other means of identification of any
4    patient or patients whose treatment is a subject of the
5    report, except that no medical records may be revealed
6    without the written consent of the patient or patients.
7        (4) A brief description of the facts that gave rise to
8    the issuance of the report, including but not limited to
9    the dates of any occurrences deemed to necessitate the
10    filing of the report.
11        (5) If court action is involved, the identity of the
12    court in which the action is filed, the docket number, and
13    date of filing of the action.
14        (6) Any further pertinent information that the
15    reporting party deems to be an aid in the evaluation of the
16    report.
17    Nothing contained in this Section shall be construed to in
18any way waive or modify the confidentiality of medical reports
19and committee reports to the extent provided by law. Any
20information reported or disclosed shall be kept for the
21confidential use of the Board, the Board's attorneys, the
22investigative staff, and authorized clerical staff and shall be
23afforded the same status as is provided information concerning
24medical studies in Part 21 of Article VIII of the Code of Civil
25Procedure.
26    (c) Immunity from Prosecution. An individual or

 

 

10000SB0642sam001- 39 -LRB100 04152 SMS 25934 a

1organization acting in good faith, and not in a wilful and
2wanton manner, in complying with this Section by providing a
3report or other information to the Board, by assisting in the
4investigation or preparation of a report or information, by
5participating in proceedings of the Board, or by serving as a
6member of the Board shall not, as a result of such actions, be
7subject to criminal prosecution or civil damages.
8    (d) Indemnification. Members of the Board, the Board's
9attorneys, the investigative staff, advanced practice
10registered nurses or physicians retained under contract to
11assist and advise in the investigation, and authorized clerical
12staff shall be indemnified by the State for any actions (i)
13occurring within the scope of services on the Board, (ii)
14performed in good faith, and (iii) not wilful and wanton in
15nature. The Attorney General shall defend all actions taken
16against those persons unless he or she determines either that
17there would be a conflict of interest in the representation or
18that the actions complained of were not performed in good faith
19or were wilful and wanton in nature. If the Attorney General
20declines representation, the member shall have the right to
21employ counsel of his or her choice, whose fees shall be
22provided by the State, after approval by the Attorney General,
23unless there is a determination by a court that the member's
24actions were not performed in good faith or were wilful and
25wanton in nature. The member shall notify the Attorney General
26within 7 days of receipt of notice of the initiation of an

 

 

10000SB0642sam001- 40 -LRB100 04152 SMS 25934 a

1action involving services of the Board. Failure to so notify
2the Attorney General shall constitute an absolute waiver of the
3right to a defense and indemnification. The Attorney General
4shall determine within 7 days after receiving the notice
5whether he or she will undertake to represent the member.
6    (e) Deliberations of Board. Upon the receipt of a report
7called for by this Section, other than those reports of
8impaired persons licensed under this Article required pursuant
9to the rules of the Board, the Board shall notify in writing by
10certified mail the person who is the subject of the report. The
11notification shall be made within 30 days of receipt by the
12Board of the report. The notification shall include a written
13notice setting forth the person's right to examine the report.
14Included in the notification shall be the address at which the
15file is maintained, the name of the custodian of the reports,
16and the telephone number at which the custodian may be reached.
17The person who is the subject of the report shall submit a
18written statement responding to, clarifying, adding to, or
19proposing to amend the report previously filed. The statement
20shall become a permanent part of the file and shall be received
21by the Board no more than 30 days after the date on which the
22person was notified of the existence of the original report.
23The Board shall review all reports received by it and any
24supporting information and responding statements submitted by
25persons who are the subject of reports. The review by the Board
26shall be in a timely manner but in no event shall the Board's

 

 

10000SB0642sam001- 41 -LRB100 04152 SMS 25934 a

1initial review of the material contained in each disciplinary
2file be less than 61 days nor more than 180 days after the
3receipt of the initial report by the Board. When the Board
4makes its initial review of the materials contained within its
5disciplinary files, the Board shall, in writing, make a
6determination as to whether there are sufficient facts to
7warrant further investigation or action. Failure to make that
8determination within the time provided shall be deemed to be a
9determination that there are not sufficient facts to warrant
10further investigation or action. Should the Board find that
11there are not sufficient facts to warrant further investigation
12or action, the report shall be accepted for filing and the
13matter shall be deemed closed and so reported. The individual
14or entity filing the original report or complaint and the
15person who is the subject of the report or complaint shall be
16notified in writing by the Board of any final action on their
17report or complaint.
18    (f) Summary Reports. The Board shall prepare, on a timely
19basis, but in no event less than one every other month, a
20summary report of final actions taken upon disciplinary files
21maintained by the Board. The summary reports shall be made
22available to the public upon request and payment of the fees
23set by the Department. This publication may be made available
24to the public on the Department's Internet website.
25    (g) Any violation of this Section shall constitute a Class
26A misdemeanor.

 

 

10000SB0642sam001- 42 -LRB100 04152 SMS 25934 a

1    (h) If a person violates the provisions of this Section, an
2action may be brought in the name of the People of the State of
3Illinois, through the Attorney General of the State of
4Illinois, for an order enjoining the violation or for an order
5enforcing compliance with this Section. Upon filing of a
6verified petition in court, the court may issue a temporary
7restraining order without notice or bond and may preliminarily
8or permanently enjoin the violation, and if it is established
9that the person has violated or is violating the injunction,
10the court may punish the offender for contempt of court.
11Proceedings under this subsection shall be in addition to, and
12not in lieu of, all other remedies and penalties provided for
13by this Section.
14(Source: P.A. 99-143, eff. 7-27-15.)
 
15    Section 15. The Illinois Controlled Substances Act is
16amended by changing Section 303.05 and by adding Section 303.03
17as follows:
 
18    (720 ILCS 570/303.03 new)
19    Sec. 303.03. Advanced practice registered nurse with full
20practice authority.
21    (a) The Department of Financial and Professional
22Regulation shall license a licensed advanced practice
23registered nurse certified as a nurse practitioner, nurse
24midwife, or clinical nurse specialist who meets the

 

 

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1requirements of Section 65-43 of the Nurse Practice Act to
2prescribe and dispense controlled substances under Section 303
3if the advanced practice registered nurse certified as a nurse
4practitioner, nurse midwife, or clinical nurse specialist has
5been granted authority to prescribe any legend drug and
6Schedule II through V controlled substances.
7    (b) Nothing in this Act shall be construed to require an
8advanced practice registered nurse meeting the requirements of
9Section 65-43 of the Nurse Practice Act to have a written
10collaborative agreement.
 
11    (720 ILCS 570/303.05)
12    Sec. 303.05. Mid-level practitioner registration.
13    (a) The Department of Financial and Professional
14Regulation shall register licensed physician assistants,
15licensed advanced practice registered nurses, and prescribing
16psychologists licensed under Section 4.2 of the Clinical
17Psychologist Licensing Act to prescribe and dispense
18controlled substances under Section 303 and euthanasia
19agencies to purchase, store, or administer animal euthanasia
20drugs under the following circumstances:
21        (1) with respect to physician assistants,
22            (A) the physician assistant has been delegated
23        written authority to prescribe any Schedule III
24        through V controlled substances by a physician
25        licensed to practice medicine in all its branches in

 

 

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1        accordance with Section 7.5 of the Physician Assistant
2        Practice Act of 1987; and the physician assistant has
3        completed the appropriate application forms and has
4        paid the required fees as set by rule; or
5            (B) the physician assistant has been delegated
6        authority by a supervising physician licensed to
7        practice medicine in all its branches to prescribe or
8        dispense Schedule II controlled substances through a
9        written delegation of authority and under the
10        following conditions:
11                (i) Specific Schedule II controlled substances
12            by oral dosage or topical or transdermal
13            application may be delegated, provided that the
14            delegated Schedule II controlled substances are
15            routinely prescribed by the supervising physician.
16            This delegation must identify the specific
17            Schedule II controlled substances by either brand
18            name or generic name. Schedule II controlled
19            substances to be delivered by injection or other
20            route of administration may not be delegated;
21                (ii) any delegation must be of controlled
22            substances prescribed by the supervising
23            physician;
24                (iii) all prescriptions must be limited to no
25            more than a 30-day supply, with any continuation
26            authorized only after prior approval of the

 

 

10000SB0642sam001- 45 -LRB100 04152 SMS 25934 a

1            supervising physician;
2                (iv) the physician assistant must discuss the
3            condition of any patients for whom a controlled
4            substance is prescribed monthly with the
5            delegating physician;
6                (v) the physician assistant must have
7            completed the appropriate application forms and
8            paid the required fees as set by rule;
9                (vi) the physician assistant must provide
10            evidence of satisfactory completion of 45 contact
11            hours in pharmacology from any physician assistant
12            program accredited by the Accreditation Review
13            Commission on Education for the Physician
14            Assistant (ARC-PA), or its predecessor agency, for
15            any new license issued with Schedule II authority
16            after the effective date of this amendatory Act of
17            the 97th General Assembly; and
18                (vii) the physician assistant must annually
19            complete at least 5 hours of continuing education
20            in pharmacology;
21        (2) with respect to advanced practice registered
22    nurses who do not meet the requirements of Section 65-43 of
23    the Nurse Practice Act,
24            (A) the advanced practice registered nurse has
25        been delegated authority to prescribe any Schedule III
26        through V controlled substances by a collaborating

 

 

10000SB0642sam001- 46 -LRB100 04152 SMS 25934 a

1        physician licensed to practice medicine in all its
2        branches or a collaborating podiatric physician in
3        accordance with Section 65-40 of the Nurse Practice
4        Act. The advanced practice registered nurse has
5        completed the appropriate application forms and has
6        paid the required fees as set by rule; or
7            (B) the advanced practice registered nurse has
8        been delegated authority by a collaborating physician
9        licensed to practice medicine in all its branches or
10        collaborating podiatric physician to prescribe or
11        dispense Schedule II controlled substances through a
12        written delegation of authority and under the
13        following conditions:
14                (i) specific Schedule II controlled substances
15            by oral dosage or topical or transdermal
16            application may be delegated, provided that the
17            delegated Schedule II controlled substances are
18            routinely prescribed by the collaborating
19            physician or podiatric physician. This delegation
20            must identify the specific Schedule II controlled
21            substances by either brand name or generic name.
22            Schedule II controlled substances to be delivered
23            by injection or other route of administration may
24            not be delegated;
25                (ii) any delegation must be of controlled
26            substances prescribed by the collaborating

 

 

10000SB0642sam001- 47 -LRB100 04152 SMS 25934 a

1            physician or podiatric physician;
2                (iii) all prescriptions must be limited to no
3            more than a 30-day supply, with any continuation
4            authorized only after prior approval of the
5            collaborating physician or podiatric physician;
6                (iv) the advanced practice registered nurse
7            must discuss the condition of any patients for whom
8            a controlled substance is prescribed monthly with
9            the delegating physician or podiatric physician or
10            in the course of review as required by Section
11            65-40 of the Nurse Practice Act;
12                (v) the advanced practice registered nurse
13            must have completed the appropriate application
14            forms and paid the required fees as set by rule;
15                (vi) the advanced practice registered nurse
16            must provide evidence of satisfactory completion
17            of at least 45 graduate contact hours in
18            pharmacology for any new license issued with
19            Schedule II authority after the effective date of
20            this amendatory Act of the 97th General Assembly;
21            and
22                (vii) the advanced practice registered nurse
23            must annually complete 5 hours of continuing
24            education in pharmacology;
25        (2.5) with respect to advanced practice registered
26    nurses certified as nurse practitioners, nurse midwives,

 

 

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1    or clinical nurse specialists practicing in a hospital
2    affiliate,
3            (A) the advanced practice registered nurse
4        certified as a nurse practitioner, nurse midwife, or
5        clinical nurse specialist has been granted authority
6        to prescribe any Schedule II through V controlled
7        substances by the hospital affiliate upon the
8        recommendation of the appropriate physician committee
9        of the hospital affiliate in accordance with Section
10        65-45 of the Nurse Practice Act, has completed the
11        appropriate application forms, and has paid the
12        required fees as set by rule; and
13            (B) an advanced practice registered nurse
14        certified as a nurse practitioner, nurse midwife, or
15        clinical nurse specialist has been granted authority
16        to prescribe any Schedule II controlled substances by
17        the hospital affiliate upon the recommendation of the
18        appropriate physician committee of the hospital
19        affiliate, then the following conditions must be met:
20                (i) specific Schedule II controlled substances
21            by oral dosage or topical or transdermal
22            application may be designated, provided that the
23            designated Schedule II controlled substances are
24            routinely prescribed by advanced practice
25            registered nurses in their area of certification;
26            this grant of authority must identify the specific

 

 

10000SB0642sam001- 49 -LRB100 04152 SMS 25934 a

1            Schedule II controlled substances by either brand
2            name or generic name; authority to prescribe or
3            dispense Schedule II controlled substances to be
4            delivered by injection or other route of
5            administration may not be granted;
6                (ii) any grant of authority must be controlled
7            substances limited to the practice of the advanced
8            practice registered nurse;
9                (iii) any prescription must be limited to no
10            more than a 30-day supply;
11                (iv) the advanced practice registered nurse
12            must discuss the condition of any patients for whom
13            a controlled substance is prescribed monthly with
14            the appropriate physician committee of the
15            hospital affiliate or its physician designee; and
16                (v) the advanced practice registered nurse
17            must meet the education requirements of this
18            Section;
19        (3) with respect to animal euthanasia agencies, the
20    euthanasia agency has obtained a license from the
21    Department of Financial and Professional Regulation and
22    obtained a registration number from the Department; or
23        (4) with respect to prescribing psychologists, the
24    prescribing psychologist has been delegated authority to
25    prescribe any nonnarcotic Schedule III through V
26    controlled substances by a collaborating physician

 

 

10000SB0642sam001- 50 -LRB100 04152 SMS 25934 a

1    licensed to practice medicine in all its branches in
2    accordance with Section 4.3 of the Clinical Psychologist
3    Licensing Act, and the prescribing psychologist has
4    completed the appropriate application forms and has paid
5    the required fees as set by rule.
6    (b) The mid-level practitioner shall only be licensed to
7prescribe those schedules of controlled substances for which a
8licensed physician or licensed podiatric physician has
9delegated prescriptive authority, except that an animal
10euthanasia agency does not have any prescriptive authority. A
11physician assistant and an advanced practice registered nurse
12are prohibited from prescribing medications and controlled
13substances not set forth in the required written delegation of
14authority or as authorized by their practice Act.
15    (c) Upon completion of all registration requirements,
16physician assistants, advanced practice registered nurses, and
17animal euthanasia agencies may be issued a mid-level
18practitioner controlled substances license for Illinois.
19    (d) A collaborating physician or podiatric physician may,
20but is not required to, delegate prescriptive authority to an
21advanced practice registered nurse as part of a written
22collaborative agreement, and the delegation of prescriptive
23authority shall conform to the requirements of Section 65-40 of
24the Nurse Practice Act.
25    (e) A supervising physician may, but is not required to,
26delegate prescriptive authority to a physician assistant as

 

 

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1part of a written supervision agreement, and the delegation of
2prescriptive authority shall conform to the requirements of
3Section 7.5 of the Physician Assistant Practice Act of 1987.
4    (f) Nothing in this Section shall be construed to prohibit
5generic substitution.
6(Source: P.A. 98-214, eff. 8-9-13; 98-668, eff. 6-25-14;
799-173, eff. 7-29-15.)
 
8    Section 99. Effective date. This Act takes effect upon
9becoming law.".