State of Illinois
90th General Assembly
Legislation

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90_SB1585

      SEE INDEX
          Amends the Illinois Nursing Act of 1987.  Renames the Act
      as  the  Nursing   and   Advanced   Practice   Nursing   Act.
      Reorganizes  certain provisions and renumbers Sections within
      the Act.  Adds the Advanced Practice Registered Nurses  Title
      to  provide for the licensure of advanced practice registered
      nurses  meeting  specified   requirements.    Restricts   the
      practice of advanced practice registered nursing to the terms
      of  written  collaborative  and  interactive  team agreements
      entered into with physicians licensed to practice medicine in
      all its branches.  Makes other changes.  Amends  the  Medical
      Practice  Act  of  1987  to set forth the circumstances under
      which a physician licensed to practice medicine  in  all  its
      branches  may delegate certain duties to physician assistants
      and advanced practice registered nurses.  Amends the Pharmacy
      Practice Act of 1987 and the Illinois  Controlled  Substances
      Act to expand the definition of "prescription" under each Act
      to  include  orders  for  drugs  issued  by advanced practice
      registered nurses under  specified  conditions.   Amends  the
      Physician  Assistant Practice Act of 1987 to provide that the
      delegation of physician duties to a physician assistant shall
      not limit the delegation of duties by a  physician  to  other
      personnel.  Amends the Illinois Clinical Laboratory and Blood
      Bank Act to add advanced practice registered  nurses  to  the
      list  of  persons  at whose request a clinical laboratory may
      examine specimens.  Effective July 1, 1998.
                                                     LRB9011272NTsb
                                               LRB9011272NTsb
 1        AN ACT concerning advanced practice  registered  nursing,
 2    amending named Acts.
 3        Be  it  enacted  by  the People of the State of Illinois,
 4    represented in the General Assembly:
 5        Section 5.  The Illinois Clinical  Laboratory  and  Blood
 6    Bank Act is amended by changing Section 7-101 as follows:
 7        (210 ILCS 25/7-101) (from Ch. 111 1/2, par. 627-101)
 8        Sec.   7-101.   Examination   of  specimens.  A  clinical
 9    laboratory shall examine specimens only at the request of (i)
10    a licensed  physician,  (ii)  a  licensed  dentist,  (iii)  a
11    licensed  podiatrist,  (iv)  a  therapeutic  optometrist  for
12    diagnostic  or  therapeutic  purposes  related  to the use of
13    diagnostic  topical  or  therapeutic  ocular   pharmaceutical
14    agents, as defined in subsections (c) and (d) of Section 15.1
15    of  the  Illinois  Optometric  Practice  Act  of 1987,  (v) a
16    licensed physician assistant in accordance with  the  written
17    guidelines  required  under  subdivision (3) of Section 4 and
18    under Section 7.5 of the Physician Assistant Practice Act  of
19    1987,    (v-A)  an  advanced  practice  registered  nurse  in
20    accordance  with  the  written  collaborative and interactive
21    team agreement required under Section 15-15  of  the  Nursing
22    and  Advanced Practice Nursing Act, or (vi) an authorized law
23    enforcement agency or, in the case of blood alcohol,  at  the
24    request  of  the  individual  for  whom  the  test  is  to be
25    performed in compliance with Sections 11-501 and 11-501.1  of
26    the  Illinois  Vehicle Code.   If the request to a laboratory
27    is oral, the  physician  or  other  authorized  person  shall
28    submit  a  written request to the laboratory within 48 hours.
29    If the laboratory does not receive the written request within
30    that period, it shall note that fact in its records.
31    (Source: P.A. 90-116,  eff.  7-14-97;  90-322,  eff.  1-1-98;
                            -2-                LRB9011272NTsb
 1    revised 10-23-97.)
 2        Section  10.  The Medical Practice Act of 1987 is amended
 3    by adding Section 54.5 as follows:
 4        (225 ILCS 60/54.5 new)
 5        Sec. 54.5.  Physician delegation of authority.
 6        (a)  Physicians licensed to practice medicine in all  its
 7    branches   may  delegate  care  and  treatment  duties  to  a
 8    physician assistant under guidelines in accordance  with  the
 9    requirements  of   the  Physician  Assistant  Practice Act of
10    1987.  A physician licensed to practice medicine in  all  its
11    branches may enter into supervising physician agreements with
12    no  more  than  2  physician  assistants  or  their full time
13    equivalents.
14        (b)  A physician licensed to practice medicine in all its
15    branches may collaborate with an advanced practice registered
16    nurse in accordance with the requirements of Title 15 of  the
17    Nursing  and Advanced Practice Nursing Act.  Collaboration is
18    for the purpose of providing  medical  direction  in  a  team
19    relationship  and  no employment relationship is required.  A
20    written collaborative and interactive  team  agreement  shall
21    conform  to  the requirements of Section 15-15 of the Nursing
22    and Advanced Practice Nursing Act.  The  agreement  shall  be
23    for  services  the collaborating physician generally provides
24    to his or her  patients  in  the  normal  course  of  medical
25    practice.
26             (1)  Except   as  provided  in  subdivision  (2),  a
27        physician  licensed  to  practice  medicine  in  all  its
28        branches  may  enter  into  written   collaborative   and
29        interactive  team agreements with no more than 2 advanced
30        practice registered nurses or their full time equivalents
31        at any one time. Physician  medical  direction  shall  be
32        adequate if a collaborating physician:
                            -3-                LRB9011272NTsb
 1                  (A)  is  responsible  for  the  formulation  or
 2             approval of the physician's orders, standing medical
 3             orders,  standing delegation orders, or other orders
 4             or protocols and if he or she  periodically  reviews
 5             the  orders and the services provided patients under
 6             the orders;
 7                  (B)  is on site at least once a week to provide
 8             medical direction and consultation;
 9                  (C)  receives a daily status  report  from  the
10             advanced  practice  registered nurse on any problems
11             or complications encountered; and
12                  (D)  is      available      through      direct
13             telecommunications for consultation, assistance with
14             medical emergencies, or patient referral.
15             (2)  An anesthesiologist may enter  into  a  written
16        collaborative and interactive team agreement with no more
17        than  4  certified registered nurse anesthetists or their
18        full-time equivalents in accordance with Section 15-25 of
19        the Nursing and Advanced Practice Nursing Act. A formally
20        organized group of anesthesiologists may enter into these
21        agreements with a number of  certified  registered  nurse
22        anesthetists   not  to  exceed  4  times  the  number  of
23        anesthesiologists within  the  group.  Physician  medical
24        direction  for  a  certified registered nurse anesthetist
25        shall be adequate if:
26                  (A)  a collaborating physician  is  responsible
27             for  the  formulation or approval of the physician's
28             orders, standing medical orders, standing delegation
29             orders, or other orders or protocols and he  or  she
30             periodically  reviews  the  orders  and the services
31             provided patients under the orders; or
32                  (B)  the      responsible      anesthesiologist
33             personally participates in the anesthesia  plan  and
34             is  physically  present  and available for immediate
                            -4-                LRB9011272NTsb
 1             diagnosis and treatment of emergencies in accordance
 2             with  the  medical  staff  bylaws  of  the  licensed
 3             hospital or licensed ambulatory  surgical  treatment
 4             centers.
 5        (c)  The  supervising  physician shall have access to the
 6    medical records of  all  patients  attended  by  a  physician
 7    assistant.   The collaborating physician shall have access to
 8    the medical  records  of  all  patients  attended  to  by  an
 9    advanced practice registered nurse.
10        (d)  Nothing  in this Act shall be construed to limit the
11    delegation of tasks or duties  by  a  physician  licensed  to
12    practice  medicine  in  all  its branches to a nurse or other
13    personnel.
14        (e)  A physician shall not be  liable  for  the  acts  or
15    omissions  of  a  physician  assistant  or  advanced practice
16    registered nurse solely on  the  basis  of  having  signed  a
17    supervision  agreement  or  guidelines or a collaborative and
18    interactive team agreement,  an  order,  a  standing  medical
19    order,  a  standing  delegation  order,  or  other  order  or
20    protocols  authorizing  a  physician  assistant  or  advanced
21    practice   registered  nurse  to  perform  acts,  unless  the
22    physician has reason to believe the  physician  assistant  or
23    advanced  practice  registered nurse lacked the competency to
24    perform the act or acts.
25        Section 15.  The Illinois Nursing Act of 1987 is  amended
26    by renumbering and changing Sections 1, 2, 3, 4, 4.1, 4.5, 5,
27    5.1,  6,  7,  12, 14, 16, 17, 18, 21, 22, 23, 24, 26, 27, 29,
28    30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42,  43,  44,
29    45,  46,  47,  48,  and  49 and adding Sections 10-10, 10-15,
30    10-20, 10-40, 10-45, 10-50, 15-5, 15-10, 15-15, 15-20, 15-25,
31    15-30, 15-35, 15-40, 15-45, 15-50, 15-55, and  20-2  and  new
32    Title headings as follows:
                            -5-                LRB9011272NTsb
 1        (225 ILCS 65/Title 5 heading new)
 2                     TITLE 5. GENERAL PROVISIONS
 3        (225 ILCS 65/5-1, formerly 65/1)
 4        Sec.  5-1.  1.  This Article may be cited as the Illinois
 5    Nursing and Advanced Practice  Nursing  Act,  and  throughout
 6    this  Article, references to this Act shall mean this Article
 7    of 1987.
 8    (Source: P.A. 85-981; 86-1475.)
 9        (225 ILCS 65/5-5, formerly 65/2)
10        Sec.  5-5.  2.  Legislative  purpose.   The  practice  of
11    professional and practical nursing in the State  of  Illinois
12    is  hereby  declared to affect the public health, safety, and
13    welfare and to be subject to regulation and  control  in  the
14    public  interest.   It  is further declared to be a matter of
15    public interest and concern that the practice of nursing,  as
16    defined  in this Act, merit and receive the confidence of the
17    public and that only qualified persons be  authorized  to  so
18    practice  in  the  State  of  Illinois.   This  Act  shall be
19    liberally construed to best  carry  out  these  subjects  and
20    purposes.
21    (Source: P.A. 85-981.)
22        (225 ILCS 65/5-10, formerly 65/3)
23        Sec. 5-10. 3.  Definitions.  Each of the following terms,
24    when used in this Act, shall have  the meaning ascribed to it
25    in  this  Section, except where the context clearly indicates
26    otherwise:
27        (a)  "Department" means the  Department  of  Professional
28    Regulation.
29        (b)  "Director"   means   the  Director  of  Professional
30    Regulation.
31        (c)  "Board" means the Board of Nursing appointed by  the
                            -6-                LRB9011272NTsb
 1    Director.
 2        (d)  "Academic  year" means the customary annual schedule
 3    of courses at a  college,  university,  or  approved  school,
 4    customarily regarded as the school year as distinguished from
 5    the calendar year.
 6        (e)  "Approved program of professional nursing education"
 7    and  "approved  program  of  practical nursing education" are
 8    programs of professional or practical nursing,  respectively,
 9    approved by the Department under the provisions of this Act.
10        (f)  "Nursing   Act   Coordinator"   means  a  registered
11    professional nurse appointed by the Director to carry out the
12    administrative policies of the Department.
13        (g)  "Assistant  Nursing   Act   Coordinator"   means   a
14    registered  professional  nurse  appointed by the Director to
15    assist in carrying out the  administrative  policies  of  the
16    Department.
17        (h)  "Registered" is the equivalent of "licensed".
18        (i)  "Practical  nurse"  or  "licensed  practical  nurse"
19    means  a  person  who  is licensed as a practical nurse under
20    this Act  and  practices  practical  nursing  as  defined  in
21    paragraph  (j)  of  this  Section.   Only  a  practical nurse
22    licensed  under  this  Act  is  entitled  to  use  the  title
23    "licensed practical nurse" and the abbreviation "L.P.N.".
24        (j)  "Practical nursing" means the performance of nursing
25    acts requiring the basic nursing  knowledge,  judgement,  and
26    skill   acquired  by  means  of  completion  of  an  approved
27    practical  nursing  education  program.   Practical   nursing
28    includes assisting in the nursing process as delegated by and
29    under  the direction of a registered professional nurse.  The
30    practical nurse may work under the direction  of  a  licensed
31    physician,   dentist,   podiatrist,   or  other  health  care
32    professional determined by the Department.
33        (k)  "Registered  Nurse"  or   "Registered   Professional
34    Nurse" means a person who is licensed as a professional nurse
                            -7-                LRB9011272NTsb
 1    under  this Act and practices nursing as defined in paragraph
 2    (l) of this Section.  Only a registered nurse licensed  under
 3    this Act is entitled to use the titles "registered nurse" and
 4    "registered professional nurse" and the abbreviation, "R.N.".
 5        (l)  "Registered  professional nursing practice" includes
 6    all nursing specialities and means  the  performance  of  any
 7    nursing  act based upon professional knowledge, judgment, and
 8    skills  acquired  by  means  of  completion  of  an  approved
 9    registered  professional  nursing   education   program.    A
10    registered   professional   nurse   provides   nursing   care
11    emphasizing   the   importance   of   the   whole   and   the
12    interdependence  of  its parts through the nursing process to
13    individuals, groups, families, or communities, that  includes
14    but  is  not  limited  to:  (1)  the assessment of healthcare
15    needs,  nursing  diagnosis,  planning,  implementation,   and
16    nursing  evaluation;  (2)  the  promotion,  maintenance,  and
17    restoration  of  health;  (3)  counseling, patient education,
18    health   education,   and   patient   advocacy;    (4)    the
19    administration of medications and treatments as prescribed by
20    a  physician  licensed  to  practice  medicine  in all of its
21    branches, a licensed dentist, a  licensed  podiatrist,  or  a
22    licensed   optometrist   or  as  prescribed  by  a  physician
23    assistant in  accordance  with  written  guidelines  required
24    under  the  Physician Assistant Practice Act of 1987 or by an
25    advanced practice  registered  nurse  in  accordance  with  a
26    written collaborative and interactive team agreement required
27    under  the Nursing and Advanced Practice Nursing Act; (5) the
28    coordination and management of the nursing plan of care;  (6)
29    the  delegation  to and supervision of individuals who assist
30    the registered professional nurse implementing  the  plan  of
31    care;  and  (7) teaching and supervision of nursing students.
32    in  The foregoing shall not be deemed to include  those  acts
33    of  medical  diagnosis  or  prescription  of  therapeutic  or
34    corrective  measures  that  are  properly  performed  only by
                            -8-                LRB9011272NTsb
 1    physicians licensed in the State of Illinois.
 2        (m)  "Current nursing practice  update  course"  means  a
 3    planned   nursing   education   curriculum  approved  by  the
 4    Department consisting of  activities  that  have  educational
 5    objectives, instructional methods, content or subject matter,
 6    clinical  practice,  and evaluation methods, related to basic
 7    review and updating  content  and  specifically  planned  for
 8    those  nurses previously licensed in the United States or its
 9    territories and preparing for reentry into nursing practice.
10        (n)  "Professional assistance program for nurses" means a
11    professional   assistance   program   that   meets   criteria
12    established by the Board of Committee on Nursing and approved
13    by the Director, which provides a non-disciplinary  treatment
14    approach  for nurses licensed under this Act whose ability to
15    practice is compromised  by  alcohol  or  chemical  substance
16    addiction.
17    (Source:  P.A.  90-61,  eff.  12-30-97;  90-248, eff. 1-1-98;
18    revised 8-12-97.)
19        (225 ILCS 65/5-15, formerly 65/4)
20        Sec.  5-15.  4.  Policy;  application  of  Act.  For  the
21    protection of life and  the  promotion  of  health,  and  the
22    prevention  of  illness and communicable diseases, any person
23    practicing or offering to practice professional and practical
24    nursing in Illinois shall submit evidence that he or  she  is
25    qualified  to  practice,  and  shall  be licensed as provided
26    under this  Act.   No  person  shall  practice  or  offer  to
27    practice professional or practical nursing in Illinois or use
28    any  title,  sign,  card  or  device  to indicate that such a
29    person is practicing professional or practical nursing unless
30    such person has been licensed under the  provisions  of  this
31    Act.
32        This Act does not prohibit the following:
33        (a)  The practice of nursing in Federal employment in the
                            -9-                LRB9011272NTsb
 1    discharge  of  the  employee's  duties  by  a  person  who is
 2    employed by the  United  States  government  or  any  bureau,
 3    division  or  agency  thereof  and is a legally qualified and
 4    licensed nurse of another  state  or  territory  and  not  in
 5    conflict  with  Sections 10-5, 10-30, and 10-45 6, 12, and 25
 6    of this Act.;
 7        (b)  Nursing that is included in their program  of  study
 8    by  students  enrolled  in  programs of nursing or in current
 9    nurse practice update courses approved by the Department.;
10        (c)  The  furnishing  of   nursing   assistance   in   an
11    emergency.;
12        (d)  The  practice  of  nursing  by  a nurse who holds an
13    active license in another state when  providing  services  to
14    patients  in  Illinois  during  a  bonafide  emergency  or in
15    immediate preparation for or during interstate transit.;
16        (e)  The incidental care of the sick by  members  of  the
17    family,  domestic  servants  or  housekeepers, or care of the
18    sick where treatment is by prayer or spiritual means.;
19        (f)  Persons  from  being  employed  as  nursing   aides,
20    attendants, orderlies, and other auxiliary workers in private
21    homes,  long  term  care  facilities, nurseries, hospitals or
22    other institutions.;
23        (g)  The practice of practical nursing  by  one  who  has
24    applied  in  writing  to the Department in form and substance
25    satisfactory to the Department, for a license as  a  licensed
26    practical  nurse and who has complied with all the provisions
27    under Section 10-30 12, except the passing of an  examination
28    to  be eligible to receive such license, until:  the decision
29    of the Department that the applicant has failed to  pass  the
30    next  available  examination authorized by the Department, or
31    has failed, without an approved  excuse,  to  take  the  next
32    available  examination authorized by the Department, or until
33    the withdrawal of  the  application,  but  not  to  exceed  3
34    months.   No  applicant  for  licensure  practicing under the
                            -10-               LRB9011272NTsb
 1    provisions of this paragraph shall practice practical nursing
 2    except  under  the  direct  supervision   of   a   registered
 3    professional  nurse  licensed  under  this  Act or a licensed
 4    physician, dentist or podiatrist.  In no instance  shall  any
 5    such  applicant  practice  or  be employed in any supervisory
 6    capacity.;
 7        (h)  The practice of practical nursing by one  who  is  a
 8    licensed  practical  nurse  under  the  laws  of another U.S.
 9    jurisdiction and has applied in writing to the Department, in
10    form and substance satisfactory  to  the  Department,  for  a
11    license as a licensed practical nurse and who is qualified to
12    receive  such  license under Section 10-30 12, until: (1) the
13    expiration of 6 months  after  the  filing  of  such  written
14    application,  or  (2)  the withdrawal of such application, or
15    (3) the denial of such application by the Department.;
16        (i)  The practice of professional nursing by one who  has
17    applied  in  writing  to the Department in form and substance
18    satisfactory to the Department for a license as a  registered
19    professional  nurse  and has complied with all the provisions
20    under Section 10-30 12 except the passing of  an  examination
21    to  be eligible to receive such license, until:  the decision
22    of the Department that the applicant has failed to  pass  the
23    next  available  examination authorized by the Department, or
24    has failed, without an approved  excuse,  to  take  the  next
25    available  examination  authorized by the Department or until
26    the withdrawal of  the  application,  but  not  to  exceed  3
27    months.  No  applicant  for  licensure  practicing  under the
28    provisions of  this  paragraph  shall  practice  professional
29    nursing  except  under the direct supervision of a registered
30    professional nurse licensed under this Act.  In  no  instance
31    shall  any  such  applicant  practice  or  be employed in any
32    supervisory capacity.;
33        (j)  The practice of professional nursing by one who is a
34    registered professional  nurse  under  the  laws  of  another
                            -11-               LRB9011272NTsb
 1    state,  territory  of  the  United  States or country and has
 2    applied in writing to the Department, in form  and  substance
 3    satisfactory to the Department, for a license as a registered
 4    professional  nurse  and  who  is  qualified  to receive such
 5    license under Section 10-30 12, until:  (1)   the  expiration
 6    of  6 months after the filing of such written application, or
 7    (2) the withdrawal of such application, or (3) the denial  of
 8    such application by the Department.;
 9        (k)  The   practice   of  professional  nursing  that  is
10    included in a program of study by one  who  is  a  registered
11    professional  nurse  under  the  laws  of  another  state  or
12    territory  of the United States or foreign country, territory
13    or province  and  who  is  enrolled  in  a  graduate  nursing
14    education  program  or  a  program  for  the  completion of a
15    baccalaureate nursing degree in  this  State,  which  program
16    includes clinical supervision by faculty as determined by the
17    educational  institution  offering the program and the health
18    care organization where the practice of nursing occurs.   The
19    educational  institution  will  file with the Department each
20    academic term a list of the names and origin  of  license  of
21    all  professional  nurses practicing nursing as part of their
22    programs under this provision.; or
23        (l)  Any person licensed in this State  under  any  other
24    Act  from  engaging  in  the  practice for which she or he is
25    licensed.
26        An applicant for license practicing under the  exceptions
27    set  forth  in  subparagraphs  (g), (h), (i), and (j) of this
28    Section shall use the title R.N. Lic. Pend.  or  L.P.N.  Lic.
29    Pend. respectively and no other.
30    (Source:  P.A.  90-61,  eff.  12-30-97;  90-248, eff. 1-1-98;
31    revised 8-12-97.)
32        (225 ILCS 65/5-17, formerly 65/4.1)
33        Sec. 5-17. 4.1.  Task Force.  The Governor shall  appoint
                            -12-               LRB9011272NTsb
 1    a  task  force  to  be convened by the Illinois Department of
 2    Professional Regulation to study the roles, responsibilities,
 3    training, competency, and  supervision  of  persons  who  are
 4    employed   to   assist  a  nurse,  including  nursing  aides,
 5    attendants, orderlies, and other auxiliary workers in private
 6    homes, long term care facilities, nurseries,  hospitals,  and
 7    other  institutions.   The purpose of the task force shall be
 8    to determine if there  is  a  need  for  regulation  of  such
 9    persons by the Department.
10        The  task  force  shall  be comprised of 11 members.  The
11    task  force  shall  include  one  representative   from   the
12    Department  of  Professional  Regulation,  one representative
13    from  the  Department  of  Public  Health,  and   9   persons
14    representing   various   nursing  and  health  care  provider
15    organizations in Illinois, including, but not limited  to,  a
16    representative from the Illinois Nurses Association, Illinois
17    Organization  of  Nurse Leaders, Illinois Hospital and Health
18    Systems  Association,  Illinois  Health   Care   Association,
19    Illinois  Coalition  of  Nursing Organizations, Life Services
20    Network, Licensed Practical Nursing Association of  Illinois,
21    Certified   Nurse   Aide  Educators,  and  Illinois  Homecare
22    Council.
23        The  task   force   shall   report   its   findings   and
24    recommendations to the Governor by January 1, 1999.
25    (Source: P.A. 90-248, eff. 1-1-98.)
26        (225 ILCS 65/5-22, formerly 65/4.2)
27        Sec.   5-22.  4.2.  Social  Security  Number  on  license
28    application.  In addition  to any other information  required
29    to be contained in the application, every  application for an
30    original,  renewal,  or restored license under this Act shall
31    include the applicant's Social Security Number.
32    (Source: P.A. 90-144, eff. 7-23-97.)
                            -13-               LRB9011272NTsb
 1        (225 ILCS 65/5-20, formerly 65/4.5)
 2        Sec. 5-20. 4.5.  Unlicensed  practice;  violation;  civil
 3    penalty.
 4        (a)  Any   person  who  practices,  offers  to  practice,
 5    attempts to  practice,  or  holds  oneself  out  to  practice
 6    nursing  without  being  licensed  under  this  Act shall, in
 7    addition to any other penalty provided by law,  pay  a  civil
 8    penalty  to  the Department in an amount not to exceed $5,000
 9    for each offense as determined by the Department.  The  civil
10    penalty  shall  be assessed by the Department after a hearing
11    is held in accordance with the provisions set forth  in  this
12    Act  regarding  the provision of a hearing for the discipline
13    of a licensee.
14        (b)  The  Department  has  the  authority  and  power  to
15    investigate any and all unlicensed activity.
16        (c)  The civil penalty shall be paid within 60 days after
17    the effective date of the order imposing the  civil  penalty.
18    The  order  shall  constitute a judgment and may be filed and
19    execution had thereon in the same manner as any judgment from
20    any court of record.
21    (Source: P.A. 89-474, eff. 6-18-96.)
22        (225 ILCS 65/5-25, formerly 65/5)
23        Sec.  5-25.  5.    Emergency   care;   civil   liability.
24    Exemption  from  civil  liability  for  emergency  care is as
25    provided in the Good Samaritan Act.
26    (Source: P.A. 89-607, eff. 1-1-97.)
27        (225 ILCS 65/5-30, formerly 65/5.1)
28        Sec. 5-30. 5.1.  Services rendered without  compensation;
29    civil liability.  Exemption from civil liability for services
30    rendered  without  compensation  is  as  provided in the Good
31    Samaritan Act.
32    (Source: P.A. 89-607, eff. 1-1-97.)
                            -14-               LRB9011272NTsb
 1        (225 ILCS 65/Title 10 heading new)
 2                    TITLE 10.  REGISTERED NURSES
 3                    AND LICENSED PRACTICAL NURSES
 4        (225 ILCS 65/10-5, formerly 65/6)
 5        Sec. 10-5. Prohibited acts. 6.  No person shall:
 6        (a)  Practice  professional  nursing  without   a   valid
 7    license as a registered professional nurse except as provided
 8    in paragraphs (i) and (j) of Section 5-15 4 of this Act;
 9        (b)  Practice  practical  nursing without a valid license
10    as a licensed practical nurse; or practice practical  nursing
11    other  than  under  the  direction  of  a licensed physician,
12    licensed dentist, or registered professional nurse; except as
13    provided in paragraphs (g), (h), and (j) of Section 5-15 4 of
14    this Act;
15        (c)  Practice  nursing  under  cover  of   any   diploma,
16    license,  or  record  illegally  or  fraudulently obtained or
17    signed   or   issued   unlawfully   or    under    fraudulent
18    representation;
19        (d)  Practice  nursing during the time her or his license
20    is suspended, revoked, expired or on inactive status;
21        (e)  Use  any  words,  abbreviations,  figures,  letters,
22    title, sign, card, or device tending to imply that she or  he
23    is  a  registered professional nurse, including the titles or
24    initials,   "Registered   Nurse,"    "Professional    Nurse,"
25    "Registered  Professional Nurse," "Certified Nurse," "Trained
26    Nurse," "Graduate Nurse," "P.N.," or "R.N.," or  "R.P.N."  or
27    similar  titles  or  initials  with  intention  of indicating
28    practice without a valid license as a registered professional
29    nurse;
30        (f)  Use  any  words,  abbreviations  figures,   letters,
31    title,  sign, card, or device tending to imply that she or he
32    is  a  licensed  practical  nurse  including  the  titles  or
33    initials  "Practical  Nurse,"  "Licensed  Practical   Nurse,"
                            -15-               LRB9011272NTsb
 1    "P.N.,"  or  "L.P.N.,"  or  similar  titles  or initials with
 2    intention of indicated practice as a licensed practical nurse
 3    without a valid license as a licensed practical  nurse  under
 4    this Act;
 5        (g)  Obtain  or  furnish a license by or for money or any
 6    other thing of value other than the fees required by  Section
 7    20-35 23, or by any fraudulent representation or act;
 8        (h)  Make any wilfully false oath or affirmation required
 9    by this Act;
10        (i)  Conduct   a   nursing  education  program  preparing
11    persons for licensure that  has  not  been  approved  by  the
12    Department;
13        (j)  Represent  that  any school or course is approved or
14    accredited as  a  school  or  course  for  the  education  of
15    registered  professional  nurses or licensed practical nurses
16    unless such school or course is approved  by  the  Department
17    under the provisions of this Act;
18        (k)  Attempt or offer to do any of the acts enumerated in
19    this Section, or  knowingly aid, abet, assist in the doing of
20    any  such  acts  or in the attempt or offer to do any of such
21    acts;
22        (l)  Seek employment as a registered  professional  nurse
23    under  the  terms of paragraphs (i) and (j) of Section 5-15 4
24    of this Act without possessing a written authorization  which
25    has  been  issued  by  the  Department  or designated testing
26    service  and  which  evidences  the  filing  of  the  written
27    application referred to in paragraphs paragraph (i)  and  (j)
28    of Section 5-15 4 of this Act;
29        (m)  Seek  employment as a licensed practical nurse under
30    the terms of paragraphs (g) and (h) of Section 5-15 4 of this
31    Act without possessing a written authorization which has been
32    issued by the Department or designated  testing  service  and
33    which   evidences  the  filing  of  the  written  application
34    referred to in paragraphs paragraph (g) and  (h)  of  Section
                            -16-               LRB9011272NTsb
 1    5-15 4 of this Act;
 2        (n)  Employ  or  utilize  persons not licensed under this
 3    Act to practice professional nursing  or  practical  nursing;
 4    and
 5        (o)  Otherwise  intentionally  violate  any  provision of
 6    this Act.
 7        Any person, including a firm, association or  corporation
 8    who violates any provision of this Section shall be guilty of
 9    a Class A misdemeanor.
10    (Source: P.A. 85-981.)
11        (225 ILCS 65/10-10 new)
12        Sec. 10-10. Department powers and duties.
13        (a)  The  Department shall exercise the powers and duties
14    prescribed by the Civil Administrative Code of  Illinois  for
15    administration  of  licensing  acts  and shall exercise other
16    powers and duties necessary for effectuating the  purpose  of
17    this  Act.   None  of the functions, powers, or duties of the
18    Department with respect to licensure and examination shall be
19    exercised by the Department except upon review by the  Board.
20    The  Department shall adopt rules to implement, interpret, or
21    make specific  the  provisions  and  purposes  of  this  Act;
22    however  no  such  rules  shall  be adopted by the Department
23    except upon review by the Board.
24        (b)  The Department shall:
25             (1)  prepare  and  maintain  a  list   of   approved
26        programs  of  professional nursing education and programs
27        of practical  nursing  education  in  this  State,  whose
28        graduates,    if    they   have   the   other   necessary
29        qualifications provided in this Act, shall be eligible to
30        apply for a license to practice nursing in this State;
31             (2)  promulgate rules defining what  constitutes  an
32        approved  program  of  professional nursing education and
33        what constitutes an approved program of practical nursing
                            -17-               LRB9011272NTsb
 1        education; and
 2             (3)  adopt rules for examination of  candidates  for
 3        licenses   and   for  issuance  of  licenses  authorizing
 4        candidates upon passing an examination to practice  under
 5        this Act.
 6        (225 ILCS 65/10-15 new)
 7        Sec.  10-15.   Nursing  Act  Coordinator.  The Department
 8    shall obtain, pursuant to the Personnel Code, a  Nursing  Act
 9    Coordinator  and  assistants.    The  Nursing Coordinator and
10    assistants shall be  professional  nurses  licensed  in  this
11    State and graduated from approved schools of nursing and each
12    shall  have  been  actively  engaged in nursing education not
13    less than one year prior to  appointment.   The  Nursing  Act
14    Coordinator  shall hold at least a master's degree in nursing
15    from an approved college or  university  and  shall  have  at
16    least  5  years  experience since graduation in progressively
17    responsible positions in nursing education.   Each  assistant
18    shall  hold  at  least  a  master's degree in nursing from an
19    approved college or university and  shall  have  at  least  3
20    years    experience   since   graduation   in   progressively
21    responsible positions in nursing education.  The Nursing  Act
22    Coordinator  and assistants shall perform such administrative
23    functions as may be delegated to them by the Director.
24        (225 ILCS 65/10-25, formerly 65/7)
25        Sec. 10-25. 7. Board.
26        (a)  The Director shall  appoint  the  Board  of  Nursing
27    which  shall be composed of 9 registered professional nurses,
28    2 licensed practical nurses and one public member  who  shall
29    also be a voting member and who is not a licensed health care
30    provider.  Two  registered  nurses  shall  hold  at  least  a
31    master's  degree  in nursing and be educators in professional
32    nursing  programs,  one  representing  baccalaureate  nursing
                            -18-               LRB9011272NTsb
 1    education,  one   representing   associate   degree   nursing
 2    education;  one  registered  nurse  shall  hold  at  least  a
 3    bachelor's  degree with a major in nursing and be an educator
 4    in a licensed practical nursing program; one registered nurse
 5    shall hold a master's degree in nursing  and shall  represent
 6    nursing  service  administration;  2  registered nurses shall
 7    represent clinical nursing practice, one of whom  shall  have
 8    at  least  a  master's  degree  in  nursing; and 2 registered
 9    nurses shall represent advanced specialty practice.  Each  of
10    the  11 nurses shall have had a minimum of 5 years experience
11    in nursing, 3 of which shall be in the area they represent on
12    the Board and be actively engaged in the area of nursing they
13    represent at the time of appointment and during their  tenure
14    on  the  Board.   Members  shall be appointed for a term of 3
15    years.  No member shall be eligible for appointment  to  more
16    than  2  consecutive  terms  and  any  appointment  to fill a
17    vacancy shall be for the unexpired portion of the  term.   In
18    making   Board   appointments,   the   Director   shall  give
19    consideration  to  recommendations   submitted   by   nursing
20    organizations.     Consideration  shall  be  given  to  equal
21    geographic representation.  The Board  shall  receive  actual
22    and  necessary  expenses incurred in the performance of their
23    duties.
24        In making the initial appointments,  the  Director  shall
25    appoint  all  new  members for terms of 2, 3, and 4 years and
26    such terms  shall  be  staggered  as  follows:   3  shall  be
27    appointed  for  terms  of  2  years; 3 shall be appointed for
28    terms of 3 years; and 3 shall be appointed  for  terms  of  4
29    years.
30        The  Director  may  remove  any  member  of the Board for
31    misconduct, incapacity, or neglect  of  duty.   The  Director
32    shall reduce to writing any causes for removal.
33        The  Board shall meet annually to elect a chairperson and
34    vice chairperson.  The Board may  hold  such  other  meetings
                            -19-               LRB9011272NTsb
 1    during  the year as may be necessary to conduct its business.
 2    Six voting members of the Board shall constitute a quorum  at
 3    any  meeting.   Any  action taken by the Board must be on the
 4    affirmative vote of 6 members.  Voting by proxy shall not  be
 5    permitted.
 6        The Board shall submit an annual report to the Director.
 7        The members of the Board shall be immune from suit in any
 8    action  based upon any disciplinary proceedings or other acts
 9    performed in good faith as members of the Board.
10        (b)  The Board is authorized to:
11             (1)  recommend the adoption and, from time to  time,
12        the revision of such rules that may be necessary to carry
13        out the provisions of this Act;
14             (2)  conduct  hearings  and disciplinary conferences
15        upon charges calling for  discipline  of  a  licensee  as
16        provided in Section 10-45 25;
17             (3)  report  to the Department, upon completion of a
18        hearing, the disciplinary actions recommended to be taken
19        against persons violating this Act;
20             (4)  recommend the  approval,  denial  of  approval,
21        withdrawal   of   approval,   or  discipline  of  nursing
22        education programs;
23             (5)  participate in a national organization of state
24        boards of nursing; and
25             (6)  recommend a list of the  registered  nurses  to
26        serve  as  Nursing  Act Coordinator and Assistant Nursing
27        Act Coordinator, respectively.
28    (Source: P.A. 90-61, eff. 12-30-97.)
29        (225 ILCS 65/10-30, formerly 65/12)
30        Sec. 10-30. 12. Qualifications for licensure.
31        (a)  Each   applicant   who   successfully   meets    the
32    requirements  of  this Section shall be entitled to licensure
33    as a Registered Nurse or Licensed Practical Nurse,  whichever
                            -20-               LRB9011272NTsb
 1    is applicable.
 2        (b)  An   applicant   for  licensure  by  examination  to
 3    practice as a registered nurse or  licensed  practical  nurse
 4    shall:
 5             (1)  submit  a  completed  written  application,  on
 6        forms  provided by the Department and fees as established
 7        by the Department;
 8             (2)  for registered nurse licensure, have  completed
 9        an approved professional nursing education program of not
10        less  than  2  academic years and have graduated from the
11        program; for licensed  practical  nurse  licensure,  have
12        completed an approved practical nursing education program
13        of  not  less  than  one academic year and have graduated
14        from the program;
15             (3)  have not violated  the  provisions  of  Section
16        10-45  25  of  this  Act.   The  Department may take into
17        consideration any felony conviction of the applicant, but
18        such a conviction shall not operate as an absolute bar to
19        licensure;
20             (4)  meet all other requirements as  established  by
21        rule;
22             (5)  pay, either to the Department or its designated
23        testing service, a fee covering the cost of providing the
24        examination. Failure to appear for the examination on the
25        scheduled  date at the time and place specified after the
26        applicant's application for examination has been received
27        and acknowledged by  the  Department  or  the  designated
28        testing  service  shall  result  in the forfeiture of the
29        examination fee.
30        If an applicant neglects, fails, or refuses  to  take  an
31    examination  or  fails  to  pass an examination for a license
32    under this Act within 3 years after filing  the  application,
33    the  application shall be denied.  However, the applicant may
34    make a new application accompanied by the  required  fee  and
                            -21-               LRB9011272NTsb
 1    provide  evidence of meeting the requirements in force at the
 2    time of the new application.
 3        An applicant  shall  have  one  year  from  the  date  of
 4    notification  of  successful completion of the examination to
 5    apply to the Department for a license.  If an applicant fails
 6    to apply within one year, the applicant shall be required  to
 7    again  take  and  pass  the  examination  unless  licensed in
 8    another jurisdiction of the United States within 2  years  of
 9    passing the examination.
10        (c)  An  applicant  for  licensure  who  is  a registered
11    professional nurse or a licensed practical nurse licensed  by
12    examination  under  the laws of another state or territory of
13    the United States shall:
14             (1)  submit  a  completed  written  application,  on
15        forms supplied by the Department, and fees as established
16        by the Department;
17             (2)  for registered nurse licensure, have  completed
18        an approved professional nursing education program of not
19        less  than  2  academic years and have graduated from the
20        program; for licensed  practical  nurse  licensure,  have
21        completed an approved practical nursing education program
22        of  not  less  than  one academic year and have graduated
23        from the program;
24             (3)  submit   verification   of   licensure   status
25        directly  from  the   United   States   jurisdiction   of
26        licensure;
27             (4)  have  passed  the examination authorized by the
28        Department;
29             (5)  meet all other requirements as  established  by
30        rule.
31        (d)  All   applicants  for  licensure  pursuant  to  this
32    Section who are graduates of nursing educational programs  in
33    a  country  other  than  the United States or its territories
34    must submit to the  Department  certification  of  successful
                            -22-               LRB9011272NTsb
 1    completion  of the Commission of Graduates of Foreign Nursing
 2    Schools (CGFNS) examination. An applicant, who is  unable  to
 3    provide  appropriate documentation to satisfy CGFNS of her or
 4    his educational qualifications  for  the  CGFNS  examination,
 5    shall  be  required to pass an examination to test competency
 6    in the English language which  shall  be  prescribed  by  the
 7    Department, if the applicant is determined by the Board to be
 8    educationally  prepared  in  nursing.   The  Board shall make
 9    appropriate  inquiry  into  the  reasons  for   any   adverse
10    determination by CGFNS before making its own decision.
11        An  applicant  licensed in another state or territory who
12    is applying  for  licensure  and  has  received  her  or  his
13    education  in  a  country other than the United States or its
14    territories shall  be  exempt  from  the  completion  of  the
15    Commission  of  Graduates  of Foreign Nursing Schools (CGFNS)
16    examination if the  applicant  meets  all  of  the  following
17    requirements:
18             (1)  successful passage of the licensure examination
19        authorized by the Department;
20             (2)  holds   an   active,  unencumbered  license  in
21        another state; and
22             (3)  has been actively practicing for a minimum of 2
23        years in another state.
24        (e)  No  applicant  shall  be  issued  a  license  as   a
25    registered nurse or practical nurse under this Section unless
26    he  or  she  has  passed  the  examination  authorized by the
27    Department within 3 years of completion and  graduation  from
28    an  approved nursing education program, unless such applicant
29    submits    proof    of    successful    completion    of    a
30    Department-authorized remedial nursing education  program  or
31    recompletion  of  an  approved  registered nursing program or
32    licensed practical nursing program, as appropriate.
33        (f)  Pending the issuance of a license  under  subsection
34    (b)  of this Section, the Department may grant an applicant a
                            -23-               LRB9011272NTsb
 1    temporary license to practice nursing as a  registered  nurse
 2    or  as  a  licensed  practical  nurse  if  the  Department is
 3    satisfied that the applicant holds  an  active,  unencumbered
 4    license  in  good  standing  in another jurisdiction.  If the
 5    applicant holds more than one current active license, or  one
 6    or  more  active temporary licenses from other jurisdictions,
 7    the Department shall not issue a temporary license  until  it
 8    is  satisfied  that  each  current active license held by the
 9    applicant is  unencumbered.   The  temporary  license,  which
10    shall  be  issued  no  later  than  14 working days following
11    receipt by the Department of an application for the temporary
12    license,  shall  be  granted  upon  the  submission  of   the
13    following to the Department:
14             (1)  a   signed   and   completed   application  for
15        licensure under subsection  (a)  of  this  Section  as  a
16        registered nurse or a licensed practical nurse;
17             (2)  proof  of a current, active license in at least
18        one other jurisdiction and proof that each current active
19        license or temporary license held  by  the  applicant  is
20        unencumbered;
21             (3)  a   signed  and  completed  application  for  a
22        temporary license; and
23             (4)  the required permit fee.
24        (g)  The Department may refuse to issue  an  applicant  a
25    temporary  license  authorized  pursuant  to this Section if,
26    within  14  working  days  following  its   receipt   of   an
27    application   for   a   temporary   license,  the  Department
28    determines that:
29             (1)  the applicant has been  convicted  of  a  crime
30        under  the  laws  of a jurisdiction of the United States:
31        (i) which is a felony; or (ii)  which  is  a  misdemeanor
32        directly  related  to  the  practice  of  the profession,
33        within the last 5 years;
34             (2)  within the last 5 years the applicant has had a
                            -24-               LRB9011272NTsb
 1        license or permit related  to  the  practice  of  nursing
 2        revoked,  suspended,  or  placed  on probation by another
 3        jurisdiction,  if  at  least  one  of  the  grounds   for
 4        revoking, suspending, or placing on probation is the same
 5        or substantially equivalent to grounds in Illinois; or
 6             (3)  it intends to deny licensure by endorsement.
 7        For  purposes  of this Section, an "unencumbered license"
 8    means a license against which no disciplinary action has been
 9    taken or is pending and for which all fees  and  charges  are
10    paid and current.
11        (h)  The Department may revoke a temporary license issued
12    pursuant to this Section if:
13             (1)  it  determines  that  the  applicant  has  been
14        convicted of a crime under the law of any jurisdiction of
15        the  United  States  that  is  (i)  a  felony  or  (ii) a
16        misdemeanor directly  related  to  the  practice  of  the
17        profession, within the last 5 years;
18             (2)  it  determines that within the last 5 years the
19        applicant has had a license  or  permit  related  to  the
20        practice  of  nursing  revoked,  suspended,  or placed on
21        probation by another jurisdiction, if at least one of the
22        grounds for revoking, suspending, or placing on probation
23        is the same or substantially  equivalent  to  grounds  in
24        Illinois; or
25             (3)  it determines that it intends to deny licensure
26        by endorsement.
27        A  temporary  license  or renewed temporary license shall
28    expire (i) upon issuance of an Illinois license or (ii)  upon
29    notification that the Department intends to deny licensure by
30    endorsement.   A temporary license shall expire 6 months from
31    the date of issuance.  Further renewal may be granted by  the
32    Department in hardship cases, as defined by rule.  However, a
33    temporary license shall automatically expire upon issuance of
34    the Illinois license or upon notification that the Department
                            -25-               LRB9011272NTsb
 1    intends  to  deny  licensure,  whichever  occurs  first.   No
 2    extensions  shall be granted beyond the 6-month period unless
 3    approved by the Director.   Notification  by  the  Department
 4    under this Section shall be by certified or registered mail.
 5    (Source: P.A. 90-61, eff. 12-30-97.)
 6        (225 ILCS 65/10-35, formerly 65/14)
 7        Sec.  10-35. 14.  Concurrent theory and clinical practice
 8    education requirements.  Except for those applicants who have
 9    received  advanced  graduate  degrees  in  nursing  from   an
10    approved   program   with   concurrent  theory  and  clinical
11    practice, the educational requirements of  Section  10-30  12
12    relating  to  registered  professional  nursing  and licensed
13    practical nursing shall not be deemed to have been  satisfied
14    by the completion of any correspondence course or any program
15    of  nursing  that  does not require coordinated or concurrent
16    theory and clinical practice.
17    (Source: P.A. 90-61, eff. 12-30-97.)
18        (225 ILCS 65/10-40 new)
19        Sec. 10-40.  Endorsement. Upon payment  of  the  required
20    fee, an applicant who is a registered professional nurse or a
21    licensed practical nurse educated and licensed under the laws
22    of  a  foreign country, territory or province shall write and
23    pass an examination conducted by the Department to  determine
24    her or his fitness for licensure as a registered professional
25    nurse or a licensed practical nurse:
26        (a)  whenever the requirements of such country, territory
27    or  province  were at the date of license substantially equal
28    to the requirements then in force in  this  State;  and  with
29    respect  to  practical  nursing, if prior to the enactment of
30    this Act, substantially equal to the requirements of this Act
31    at the time of its enactment; or
32        (b)  whenever  such  requirements  of  another   country,
                            -26-               LRB9011272NTsb
 1    territory   or   province   together   with  educational  and
 2    professional qualifications, as distinguished from  practical
 3    experience,  of  the applicant since obtaining a license as a
 4    registered professional nurse or a licensed  practical  nurse
 5    in  such  country,  territory  or  province are substantially
 6    equal to the requirements in force in Illinois at the time of
 7    application for licensure as a registered nurse or a licensed
 8    practical nurse in Illinois;
 9        The examination shall be the same  as  that  required  of
10    other applicants for licensure by examination.
11        Applicants  have  3 years from the date of application to
12    complete the application process.  If  the  process  has  not
13    been  completed  in 3 years, the application shall be denied,
14    the fee forfeited and the applicant must reapply and meet the
15    requirements in effect at the time of reapplication.
16        (225 ILCS 65/10-45 new)
17        Sec. 10-45.  Grounds for disciplinary action.
18        (a)  The  Department  may,  upon  recommendation  of  the
19    Board, refuse to issue or to renew, or may  revoke,  suspend,
20    place  on  probation,  reprimand,  or take other disciplinary
21    action as the Department may deem appropriate with regard  to
22    a  license for any one or combination of the causes set forth
23    in subsection (b) below.  Fines up to $2,500 may  be  imposed
24    in  conjunction  with  other forms of disciplinary action for
25    those  violations  that  result  in  monetary  gain  for  the
26    licensee. Fines shall not be the exclusive disposition of any
27    disciplinary action arising out of conduct resulting in death
28    or injury to a patient.   Fines  shall  not  be  assessed  in
29    disciplinary  actions involving mental or physical illness or
30    impairment.  All fines collected under this Section shall  be
31    deposited in the Nursing Dedicated and Professional Fund.
32        (b)  Grounds   for   disciplinary   action   include  the
33    following:
                            -27-               LRB9011272NTsb
 1             (1)  Material deception in furnishing information to
 2        the Department.
 3             (2)  Material violations of any  provision  of  this
 4        Act  or violation of the rules of or final administrative
 5        action  of  the  Director,  after  consideration  of  the
 6        recommendation of the Board.
 7             (3)  Conviction of any crime under the laws  of  any
 8        jurisdiction of the United States: (i) which is a felony;
 9        or  (ii)  which is a misdemeanor, an essential element of
10        which is dishonesty, or  (iii)  of  any  crime  which  is
11        directly related to the practice of the profession.
12             (4)  A  pattern  of practice or other behavior which
13        demonstrates incapacity or incompetency to practice under
14        this Act.
15             (5)  Knowingly aiding or assisting another person in
16        violating any provision of this Act or rules.
17             (6)  Failing, within 90 days, to provide a  response
18        to  a  request  for  information in response to a written
19        request made by the Department by certified mail.
20             (7)  Engaging   in   dishonorable,   unethical    or
21        unprofessional  conduct of a character likely to deceive,
22        defraud or harm the public, as defined by rule.
23             (8)  Unlawful sale  or  distribution  of  any  drug,
24        narcotic,  or prescription device, or unlawful conversion
25        of any drug, narcotic or prescription device.
26             (9)  Habitual  or  excessive  use  or  addiction  to
27        alcohol, narcotics, stimulants,  or  any  other  chemical
28        agent  or drug which results in a licensee's inability to
29        practice with reasonable judgment, skill or safety.
30             (10)  Discipline by  another  U.S.  jurisdiction  or
31        foreign  nation,  if  at least one of the grounds for the
32        discipline is the same  or  substantially  equivalent  to
33        those set forth in this Section.
34             (11)  A  finding that the licensee, after having her
                            -28-               LRB9011272NTsb
 1        or  his  license  placed  on  probationary  status,   has
 2        violated the terms of probation.
 3             (12)  Being  named  as a perpetrator in an indicated
 4        report by the Department of Children and Family  Services
 5        and  under  the Abused and Neglected Child Reporting Act,
 6        and upon proof by clear and convincing evidence that  the
 7        licensee  has  caused  a  child  to be an abused child or
 8        neglected child as defined in the  Abused  and  Neglected
 9        Child Reporting Act.
10             (13)  Willful   omission   to  file  or  record,  or
11        willfully impeding the filing or  recording  or  inducing
12        another  person to omit to file or record medical reports
13        as required by law or  willfully  failing  to  report  an
14        instance  of suspected child abuse or neglect as required
15        by the Abused and Neglected Child Reporting Act.
16             (14)  Gross negligence in the practice of nursing.
17             (15)  Holding oneself out to be  practicing  nursing
18        under any name other than one's own.
19             (16)  Fraud, deceit or misrepresentation in applying
20        for   or  procuring  a  license  under  this  Act  or  in
21        connection with applying for renewal of a  license  under
22        this Act.
23             (17)  Allowing another person or organization to use
24        the licensees' license to deceive the public.
25             (18)  Willfully  making  or  filing false records or
26        reports in the licensee's  practice,  including  but  not
27        limited  to  false  records to support claims against the
28        medical assistance program of the  Department  of  Public
29        Aid under the Illinois Public Aid Code.
30             (19)  Attempting  to  subvert  or  cheat  on a nurse
31        licensing examination administered under this Act.
32             (20)  Immoral conduct in the commission of  an  act,
33        such  as  sexual  abuse,  sexual  misconduct,  or  sexual
34        exploitation, related to the licensee's practice.
                            -29-               LRB9011272NTsb
 1             (21)  Willfully   or   negligently   violating   the
 2        confidentiality  between  nurse  and  patient  except  as
 3        required by law.
 4             (22)  Practicing  under  a  false  or  assumed name,
 5        except as provided by law.
 6             (23)  The use of any false, fraudulent, or deceptive
 7        statement in any document connected with  the  licensee's
 8        practice.
 9             (24)  Directly  or indirectly giving to or receiving
10        from  a  person,  firm,  corporation,   partnership,   or
11        association  a  fee, commission, rebate, or other form of
12        compensation for professional services  not  actually  or
13        personally rendered.
14             (25)  Failure   of  a  licensee  to  report  to  the
15        Department any adverse final action  taken  against  such
16        licensee  by  another  licensing  jurisdiction (any other
17        jurisdiction of the United States or any foreign state or
18        country), by any peer review body,  by  any  health  care
19        institution,  by  any  professional or nursing society or
20        association, by  any  governmental  agency,  by  any  law
21        enforcement   agency,  or  by  any  court  or  a  nursing
22        liability claim related to acts  or  conduct  similar  to
23        acts  or conduct that would constitute grounds for action
24        as defined in this Section.
25             (26)  Failure  of  a  licensee  to  report  to   the
26        Department  surrender  by  the  licensee  of a license or
27        authorization to practice nursing  in  another  state  or
28        jurisdiction,  or  current  surrender  by the licensee of
29        membership on any nursing staff  or  in  any  nursing  or
30        professional   association   or   society   while   under
31        disciplinary investigation by any of those authorities or
32        bodies  for  acts  or  conduct similar to acts or conduct
33        that would constitute grounds for action  as  defined  by
34        this Section.
                            -30-               LRB9011272NTsb
 1             (27)  A   violation   of   the  Health  Care  Worker
 2        Self-Referral Act.
 3             (28)  Physical illness, including but not limited to
 4        deterioration through the aging process or loss of  motor
 5        skill,  mental illness, or disability that results in the
 6        inability to  practice  the  profession  with  reasonable
 7        judgment, skill, or safety.
 8        (c)  The determination by a circuit court that a licensee
 9    is  subject to involuntary admission or judicial admission as
10    provided in the Mental Health and Developmental  Disabilities
11    Code,  as  amended,  operates as an automatic suspension. The
12    suspension will end only upon a finding by a court  that  the
13    patient  is  no  longer  subject  to involuntary admission or
14    judicial  admission  and  issues  an  order  so  finding  and
15    discharging the patient; and upon the recommendation  of  the
16    Board  to the Director that the licensee be allowed to resume
17    his or her practice.
18        (d)  The Department may refuse to issue  or  may  suspend
19    the  license  of any person who fails to file a return, or to
20    pay the tax, penalty or interest shown in a filed return,  or
21    to  pay any final assessment of the tax, penalty, or interest
22    as required by any  tax  Act  administered  by  the  Illinois
23    Department of Revenue, until such time as the requirements of
24    any such tax Act are satisfied.
25        (e)  In  enforcing  this Section, the Department or Board
26    upon  a  showing  of  a  possible  violation  may  compel  an
27    individual licensed to practice under this Act,  or  who  has
28    applied  for  licensure under this Act, to submit to a mental
29    or physical examination, or both, as required by and  at  the
30    expense  of the Department. The Department or Board may order
31    the examining physician to present testimony  concerning  the
32    mental  or physical examination of the licensee or applicant.
33    No information shall be excluded by reason of any common  law
34    or statutory privilege relating to communications between the
                            -31-               LRB9011272NTsb
 1    licensee  or  applicant  and  the  examining  physician.  The
 2    examining  physicians shall be specifically designated by the
 3    Board or Department. The individual to be examined may  have,
 4    at  his  or  her own expense, another physician of his or her
 5    choice  present  during  all  aspects  of  this  examination.
 6    Failure of an individual to submit to a  mental  or  physical
 7    examination,  when  directed, shall be grounds for suspension
 8    of his or her license until the  individual  submits  to  the
 9    examination   if  the  Department  finds,  after  notice  and
10    hearing, that the refusal to submit to  the  examination  was
11    without reasonable cause.
12        If  the Department or Board finds an individual unable to
13    practice because of the reasons set forth  in  this  Section,
14    the Department or Board may require that individual to submit
15    to  care,  counseling, or treatment by physicians approved or
16    designated by the Department or Board, as a condition,  term,
17    or   restriction   for   continued,  reinstated,  or  renewed
18    licensure to practice; or, in lieu of  care,  counseling,  or
19    treatment,   the  Department  may  file,  or  the  Board  may
20    recommend  to  the  Department  to  file,  a   complaint   to
21    immediately  suspend,  revoke,  or  otherwise  discipline the
22    license of the individual. An individual  whose  license  was
23    granted,   continued,  reinstated,  renewed,  disciplined  or
24    supervised   subject   to   such   terms,   conditions,    or
25    restrictions,  and  who  fails  to  comply  with  such terms,
26    conditions,  or  restrictions,  shall  be  referred  to   the
27    Director  for  a  determination  as to whether the individual
28    shall have his or her license suspended immediately,  pending
29    a hearing by the Department.
30        In instances in which the Director immediately suspends a
31    person's  license  under  this  Section,  a  hearing  on that
32    person's license must be convened by the Department within 15
33    days after the suspension and completed  without  appreciable
34    delay.  The  Department and Board shall have the authority to
                            -32-               LRB9011272NTsb
 1    review the  subject  individual's  record  of  treatment  and
 2    counseling  regarding  the impairment to the extent permitted
 3    by applicable federal statutes and  regulations  safeguarding
 4    the confidentiality of medical records.
 5        An  individual licensed under this Act and affected under
 6    this Section shall be afforded an opportunity to  demonstrate
 7    to the Department or Board that he or she can resume practice
 8    in  compliance with acceptable and prevailing standards under
 9    the provisions of his or her license.
10        (225 ILCS 65/10-50 new)
11        Sec. 10-50.  Intoxication and drug abuse.
12        (a)  A professional assistance program for  nurses  shall
13    be established by January 1, 1999.
14        (b)  The Director shall appoint a task force to advise in
15    the creation of the assistance program.  The task force shall
16    include  members  of  the Department and professional nurses,
17    and shall report its  findings  and  recommendations  to  the
18    Committee on Nursing.
19        (c)  Any   registered   professional   nurse  who  is  an
20    administrator or officer in any hospital, nursing home, other
21    health care agency or  facility,  or  nurse  agency  and  has
22    knowledge   of  any  action  or  condition  which  reasonably
23    indicates to her or him that a registered professional  nurse
24    or licensed practical nurse employed by or practicing nursing
25    in  such  hospital, nursing home, other health care agency or
26    facility,  or  nurse  agency  is  habitually  intoxicated  or
27    addicted to the use of habit-forming drugs to the extent that
28    such intoxication or addiction adversely affects such nurses'
29    professional  performance,  or  unlawfully  possesses,  uses,
30    distributes or converts habit-forming drugs belonging to  the
31    hospital,  nursing  home  or  other  health  care  agency  or
32    facility  for  such  nurses'  own  use, shall promptly file a
33    written report thereof to the Department;  provided  however,
                            -33-               LRB9011272NTsb
 1    an  administrator  or officer need not file the report if the
 2    nurse participates  in  a  course  of  remedial  professional
 3    counseling  or medical treatment for substance abuse, as long
 4    as  such  nurse  actively  pursues   such   treatment   under
 5    monitoring   by  the  administrator  or  officer  or  by  the
 6    hospital, nursing home, health care agency  or  facility,  or
 7    nurse  agency  and the nurse continues to be employed by such
 8    hospital, nursing home, health care agency  or  facility,  or
 9    nurse  agency.    The  Department  shall  review  all reports
10    received by it in a timely manner.  Its initial review  shall
11    be  completed  no  later  than  60  days after receipt of the
12    report.  Within this 60 day period, the Department shall,  in
13    writing,  make  a  determination  as  to  whether  there  are
14    sufficient facts to warrant further investigation or action.
15        Should  the Department find insufficient facts to warrant
16    further  investigation,  or  action,  the  report  shall   be
17    accepted for filing and the matter shall be deemed closed and
18    so reported.
19        Should  the  Department  find sufficient facts to warrant
20    further investigation, such investigation shall be  completed
21    within 60 days of the date of the determination of sufficient
22    facts  to  warrant  further  investigation  or action.  Final
23    action shall be determined no later than 30  days  after  the
24    completion of the investigation.  If there is a finding which
25    verifies   habitual  intoxication  or  drug  addiction  which
26    adversely affects professional performance  or  the  unlawful
27    possession,  use, distribution or conversion of habit-forming
28    drugs by the reported nurse, the  Department  may  refuse  to
29    issue  or renew or may suspend or revoke that nurse's license
30    as a registered professional nurse or  a  licensed  practical
31    nurse.
32        Any of the aforementioned actions or a determination that
33    there are insufficient facts to warrant further investigation
34    or  action  shall  be  considered  a final action.  The nurse
                            -34-               LRB9011272NTsb
 1    administrator or officer who filed  the  original  report  or
 2    complaint,  and  the  nurse who is the subject of the report,
 3    shall be notified in writing by the Department within 15 days
 4    of any final action taken by the Department.
 5        Each year on March 1, commencing with the effective  date
 6    of  this  Act,  the  Department  shall submit a report to the
 7    General Assembly.  The report shall  include  the  number  of
 8    reports  made under this Section to the Department during the
 9    previous year, the  number  of  reports  reviewed  and  found
10    insufficient  to warrant further investigation, the number of
11    reports not completed and the reasons for incompletion.  This
12    report shall be made available also to nurses requesting  the
13    report.
14        Any  person making a report under this Section or in good
15    faith assisting another person in making such a report  shall
16    have  immunity  from any liability, either criminal or civil,
17    that might result by reason of such action.  For the  purpose
18    of  any legal proceeding, criminal or civil, there shall be a
19    rebuttable presumption that any person making a report  under
20    his Section or assisting another person in making such report
21    was   acting  in  good  faith.   All  such  reports  and  any
22    information disclosed  to  or  collected  by  the  Department
23    pursuant to this Section shall remain confidential records of
24    the  Department  and shall not be disclosed nor be subject to
25    any law or regulation of this State relating  to  freedom  of
26    information or public disclosure of records.
27        (225 ILCS 65/Title 15 heading new)
28                     TITLE 15. ADVANCED PRACTICE
29                          REGISTERED NURSES
30        (225 ILCS 65/15-5 new)
31        Sec. 15-5.  Definitions. As used in this Title:
32        "APRN Board" means the Advanced Practice Registered Nurse
                            -35-               LRB9011272NTsb
 1    Board.
 2        "Advanced  practice  registered  nurse" or "APRN" means a
 3    person who:  (1)  is licensed as  a  registered  professional
 4    nurse  under  this  Act;    (2)   meets  the requirements for
 5    licensure as an  advanced  practice  registered  nurse  under
 6    Section 15-10;  (3)  has a collaborative and interactive team
 7    agreement  with a collaborating physician in the diagnosis of
 8    illness and management of wellness and  other  conditions  as
 9    appropriate to the level and area of his or her practice; and
10    (4)  cares  for  patients  (A)  by  using advanced diagnostic
11    skills,  the  results  of  diagnostic  tests  and  procedures
12    ordered  by  the  advanced  practice  registered   nurse,   a
13    physician assistant, a dentist, a podiatrist, or a physician,
14    and professional judgment to initiate and coordinate the care
15    of  patients;  (B)  by ordering diagnostic tests, prescribing
16    medications and drugs in accordance with Section  15-20,  and
17    dispensing  and  administering medications and drugs;  (C) by
18    using medical, therapeutic, and corrective measures to  treat
19    illness  and  improve  health  status;  and  (D) by providing
20    preventive care in accordance with  a  written  collaborative
21    and  interactive  team  agreement  between the  collaborating
22    physician and advanced  practice  registered  nurse  required
23    under Section 15-15.
24        "Advanced  practice  registered  nurse" means a certified
25    nurse midwife  (CNM),  certified  nurse  practitioner  (CNP),
26    certified  registered  nurse anesthetist (CRNA), or certified
27    clinical nurse specialist (CNS).
28        "Collaborating physician" means  a  physician  who  works
29    with  an  advanced  practice  registered  nurse  and provides
30    medical direction as documented in  a  written  collaborative
31    and interactive team agreement required under Section 15-15.
32        "Licensed  hospital"  means a hospital licensed under the
33    Hospital Licensing Act or organized under the  University  of
34    Illinois Hospital Act.
                            -36-               LRB9011272NTsb
 1        "Physician"  means a person licensed to practice medicine
 2    in all its branches under the Medical Practice Act of 1987.
 3        (225 ILCS 65/15-10 new)
 4        Sec.  15-10.    Advanced   practice   registered   nurse;
 5    qualifications; roster.
 6        (a)  A  person  shall  be  qualified  for licensure as an
 7    advanced practice registered nurse if that person:
 8             (1)  has applied in writing in  form  and  substance
 9        satisfactory  to  the  Department  and has not violated a
10        provision of this Act or the  rules  adopted  under  this
11        Act.  The  Department  may  take  into  consideration any
12        felony conviction of the applicant but a conviction shall
13        not operate as an absolute bar to licensure;
14             (2)  holds  a  current  license  to  practice  as  a
15        registered nurse in Illinois;
16             (3)  has  successfully  completed  requirements   to
17        practice  as, and holds a current, national certification
18        as,  a  nurse   midwife,   clinical   nurse   specialist,
19        registered  nurse  practitioner,  or certified registered
20        nurse   anesthetist   from   the   appropriate   national
21        accreditation  body  as  determined  by   rule   of   the
22        Department;
23             (4)  has paid the required fees as set by rule; and
24             (5)  has   successfully   completed   a   post-basic
25        advanced practice formal education program in the area of
26        his or her nursing specialty.
27        (b)  In   addition   to   meeting   the  requirements  of
28    subsection (a), except item (5) of that subsection, beginning
29    July 1, 2000, new applicants shall have a graduate degree  in
30    an advanced practice nursing specialty.
31        (c)  The  Department  shall  provide  by  rule  for  APRN
32    licensure of registered professional nurses who (1) apply for
33    licensure  before  July  1,  2000  and (2) submit evidence of
                            -37-               LRB9011272NTsb
 1    completion of a program described in item (5)  of  subsection
 2    (a)  or  in  subsection  (b)  and evidence of practice for at
 3    least 10 years as a certified nurse midwife, certified  nurse
 4    practitioner,  certified  registered  nurse  anesthetist,  or
 5    certified clinical nurse specialist.
 6        (d)  The  Department  shall maintain a separate roster of
 7    advanced practice registered nurses licensed under this Title
 8    and their licenses shall indicate "Registered  Nurse/Advanced
 9    Practice Registered Nurse".
10        (225 ILCS 65/15-15 new)
11        Sec.  15-15.   Written collaborative and interactive team
12    agreements.
13        (a)  No person shall engage in the practice  of  advanced
14    practice  registered  nursing except when licensed under this
15    Title and pursuant to a written collaborative and interactive
16    team agreement with a collaborating physician.
17        (b)  A  written  collaborative   and   interactive   team
18    agreement  shall explain the team working relationship of the
19    advanced practice registered  nurse  with  the  collaborating
20    physician  and  shall  authorize and detail the categories of
21    care,  treatment,  or  procedures  to  be  performed  by  the
22    advanced practice registered nurse.  Collaboration  does  not
23    require  an employment relationship between the collaborating
24    physician   and   advanced   practice    registered    nurse.
25    Collaboration  and  interaction  means the relationship under
26    which an advanced practice  registered  nurse  works  with  a
27    collaborating  physician  to  deliver health care services in
28    accordance with (i) the advanced practice registered  nurse's
29    training,   education,   and   experience  and  (ii)  medical
30    direction  as  documented  in  a  jointly  developed  written
31    collaborative and interactive team agreement.
32        The agreement shall be defined to promote the exercise of
33    professional judgment by  the  advanced  practice  registered
                            -38-               LRB9011272NTsb
 1    nurse  commensurate with his or her education and experience.
 2    The  services  to  be  provided  by  the  advanced   practice
 3    registered  nurse  shall  be  services that the collaborating
 4    physician generally provides to his or her  patients  in  the
 5    normal  course  of  his or her medical practice, but need not
 6    describe the exact steps that an advanced practice registered
 7    nurse must take with  respect  to  each  specific  condition,
 8    disease,  or  symptom.   The  agreement  must  specify  which
 9    authorized  procedures  require a physician's presence as the
10    procedures  are  being  performed.   The  collaborative   and
11    interactive  relationship  under  an  agreement  shall not be
12    construed to require the personal presence of a  physician at
13    all times at the place where services are rendered except  as
14    specified  under  Section  15-25.   Methods  of communication
15    shall be available for consultation  with  the  collaborating
16    physician  by  radio,  telephone,  or  telecommunications  in
17    accordance  with  established written guidelines as set forth
18    in the written agreement.
19        (c)  Physician medical direction under an agreement shall
20    be adequate if a collaborating physician:
21             (1)  is responsible for the formulation or  approval
22        of  his or her physician orders, standing medical orders,
23        standing delegation orders, or other orders or  protocols
24        and  he  or  she  periodically reviews the orders and the
25        services provided patients under the orders;
26             (2)  is on site at least  once  a  week  to  provide
27        medical direction and consultation;
28             (3)  receives   a   daily  status  report  from  the
29        advanced practice registered nurse  on  any  problems  or
30        complications encountered; and
31             (4)  is  available  through direct telecommunication
32        for consultation, assistance with medical emergencies, or
33        patient referral.
34        (d)  The Department  shall  adopt  rules  specifying  the
                            -39-               LRB9011272NTsb
 1    minimum   requirements  for  the  written  collaborative  and
 2    interactive team agreement required by this Section.
 3        (e)  A copy of  the  signed,  written  collaborative  and
 4    interactive   team   agreement  shall  be  available  to  the
 5    Department upon  request  from  both  the  advanced  practice
 6    registered nurse and the collaborating physician and shall be
 7    updated  annually.   An  advanced  practice  registered nurse
 8    shall provide a copy of  all  collaborative  and  interactive
 9    team agreements to each collaborating physician.
10        (225 ILCS 65/15-20 new)
11        Sec. 15-20.   Prescriptive authority.
12        (a)  Except as provided in Section 15-25, a collaborating
13    physician  may,  but  is  not  required to,  delegate limited
14    prescriptive authority to  an  advanced  practice  registered
15    nurse.   This  authority may, but is not required to, include
16    prescription of legend drugs categorized as Schedule III, IV,
17    or V controlled substances, as defined in Article II  of  the
18    Illinois   Controlled   Substances  Act,  under  the  written
19    collaborative and  interactive  team  agreement  required  by
20    Section 15-15.
21        (b)  To  prescribe  Schedule  III,  IV,  or  V controlled
22    substances  under  this   Section,   an   advanced   practice
23    registered  nurse  shall  affix the collaborating physician's
24    DEA  number  to,  and  individually  sign,  the   appropriate
25    prescription   form  containing  the  printed  names  of  the
26    advanced  practice   registered   nurse   and   collaborating
27    physician  in  accordance  with the written collaborative and
28    interactive team  agreement.    Medication  orders  shall  be
29    reviewed periodically by the collaborating physician.
30        (c)  The  collaborating  physician  shall  file  with the
31    Department notice of delegation of prescriptive authority and
32    termination  of  delegation,  as  required  by  rule  of  the
33    Department.
                            -40-               LRB9011272NTsb
 1        (d)  Nothing in this Act shall be construed to limit  the
 2    delegation  of  tasks  or duties by a physician to a nurse or
 3    other personnel.
 4        (225 ILCS 65/15-25 new)
 5        Sec. 15-25.   CRNA agreements; prescriptive authority.
 6        (a)  A certified registered nurse anesthetist shall enter
 7    into a written collaborative and interactive team  agreement,
 8    as described in Section 15-15 of this Act and Section 54.5 of
 9    the  Medical  Practice  Act of 1987, with an anesthesiologist
10    who has privileges at the  licensed  hospital  or  ambulatory
11    surgical  treatment  center  where  the  certified registered
12    nurse  anesthetist  proposes  to   provide   care.     During
13    anesthesia    and    related    services,   the   responsible
14    anesthesiologist  shall   personally   participate   in   the
15    anesthesia  plan  and remain physically present and available
16    for immediate diagnosis and treatment  of  emergencies.   The
17    medical  staffs of licensed hospitals and licensed ambulatory
18    surgical treatment centers may adopt alternative requirements
19    concerning   the   presence   and    availability    of    an
20    anesthesiologist  when  no anesthesiologist has medical staff
21    privileges.   An   alternate   policy   shall   require   the
22    participation,  presence, and availability of a physician and
23    shall be developed by the medical staff and included  in  the
24    medical staff bylaws.
25        (b)  Certified    registered   nurse   anesthetists   are
26    authorized to select, order, and administer drugs  and  apply
27    the   appropriate   medical   devices  in  the  provision  of
28    anesthesia  and   anesthesia-related   services   under   the
29    anesthesia  plan approved by the responsible anesthesiologist
30    or, in the absence of an available anesthesiologist on staff,
31    approved by the operating physician in  accordance  with  the
32    medical  staff  bylaws  of  a  licensed  hospital or licensed
33    ambulatory surgical treatment center.
                            -41-               LRB9011272NTsb
 1        (225 ILCS 65/15-30 new)
 2        Sec. 15-30.  Title; corporate practice.
 3        (a)  No  person  shall  use  any  words,   abbreviations,
 4    figures,  letters,  title,  sign,  card, or device tending to
 5    imply that he or  she  is  an  advanced  practice  registered
 6    nurse,  including  but  not  limited  to  using the titles or
 7    initials  "Advanced Practice  Registered  Nurse",  "Certified
 8    Nurse  Midwife",  "Certified  Nurse Practitioner", "Certified
 9    Registered Nurse Anesthetist", "Clinical  Nurse  Specialist",
10    "A.P.R.N.",   "C.N.M.",  "C.N.P.",  "C.R.N.A.",  "C.N.S.", or
11    similar titles or initials, with the intention of  indicating
12    practice  as  an  advanced  practice  registered  nurse   (i)
13    without  meeting the requirements of this Act or (ii) without
14    practicing  as  an  advanced  practice  registered  nurse  in
15    accordance with a written collaborative and interactive  team
16    agreement  as  required  under  Section  15-15.  No  advanced
17    practice  registered  nurse  shall use the title of doctor or
18    associate with his or her name or any other term  that  would
19    indicate  to  other  persons  that  he or she is qualified to
20    engage in the general practice of medicine.
21        (b)  An advanced practice registered nurse shall verbally
22    identify  himself  or  herself  as   an   advanced   practice
23    registered  nurse  including  specialty certification to each
24    patient.  An advanced practice registered nurse shall not  in
25    any  way  practice independent of a written collaborative and
26    interactive team agreement with  a  collaborating  physician.
27    An  alternate  collaborating physician may be designated by a
28    collaborating physician to collaborate and interact  with  an
29    advanced  practice  registered  nurse  when  a  collaborating
30    physician is unable to provide medical direction for a period
31    not to exceed 30 days.
32        (c)  No  corporation,  partnership,  or association shall
33    practice advanced practice registered  nursing,  hold  itself
34    out   as   being   entitled  to  practice  advanced  practice
                            -42-               LRB9011272NTsb
 1    registered  nursing,  furnish  advanced  practice  registered
 2    nursing services, advertise under the  name  of  an  advanced
 3    practice   registered  nurse,  or  solicit  patients  through
 4    itself,  its  agents,  officers,  employees,  directors,   or
 5    trustees  on behalf of an advanced practice registered nurse,
 6    except as provided in this Section.
 7        The following persons or entities may employ an  advanced
 8    practice  registered  nurse in accordance with the provisions
 9    of this Section:
10             (1)  A physician or  physician  group  organized  in
11        accordance with item (14) of subsection (A) of Section 22
12        of the Medical Practice Act of 1987.
13             (2)  A  professional  service  corporation organized
14        under  the  Professional  Service  Corporation   Act   by
15        physicians or advanced practice registered nurses.
16             (3)  An   ambulatory   surgical   treatment   center
17        licensed  under  the Ambulatory Surgical Treatment Center
18        Act.
19             (4)  A nursing home licensed under the Nursing  Home
20        Care Act.
21             (5)  A  home  health  agency licensed under the Home
22        Health Agency Licensing Act.
23             (6)  A local or county health  department  certified
24        by the Illinois Department of Public  Health.
25             (7)  A  federally  qualified  health center or rural
26        health clinic certified by the Secretary  of  Health  and
27        Human Services.
28             (8)  A  free  medical clinic organized in accordance
29        with the Good Samaritan Act.
30             (9)  A  university  health  service   organized   in
31        accordance with Illinois law.
32             (10)  A visiting nurse association.
33             (11)  A   hospital   licensed   under  the  Hospital
34        Licensing  Act  or  organized  under  the  University  of
                            -43-               LRB9011272NTsb
 1        Illinois Hospital Act.
 2             (12)  Any other licensed  health  care  facility  as
 3        defined by rule.
 4        (d)  A  person or health care entity authorized to employ
 5    an advanced practice registered nurse under subsection (c) or
 6    rules adopted under that subsection  shall  comply  with  the
 7    following  requirements:
 8             (1)  Establish  written  procedures  consistent with
 9        this Act and rules adopted under this Act recognizing the
10        collaborative and interactive  relationship  between  the
11        collaborating  physician and advanced practice registered
12        nurse.  In a hospital and ambulatory  surgical  treatment
13        center,  those  procedures  shall  be  developed  by  the
14        medical staff and included in the medical staff bylaws.
15             (2)  With   the   exception   of  collaborative  and
16        interactive  agreements  with  an  employer,  the   chief
17        operating officer or his or her designee and the advanced
18        practice   registered   nurse   shall  sign  a  statement
19        acknowledging the advanced  practice  registered  nurse's
20        authority to exercise professional judgment in accordance
21        with  the  written  collaborative  and  interactive  team
22        agreement and medical staff bylaws.  This statement shall
23        at a minimum include the following provisions:
24                  As   the   employer  of  an  advanced  practice
25             registered nurse, [employer's name] shall  not  have
26             or  exercise  control  or  direction over the means,
27             manner,  or  method  that  the   advanced   practice
28             registered  nurse or collaborating physician uses in
29             the  exercise  and   execution   of   his   or   her
30             professional  judgment,  skill, and practice, except
31             as such control or direction may be exercised by the
32             medical  staff  in  accordance  with   bylaws.   The
33             physician-patient  or  advanced  practice registered
34             nurse-patient relationship shall be maintained.
                            -44-               LRB9011272NTsb
 1             or
 2                  As  the  employer  of  an   advanced   practice
 3             registered  nurse, [employer's name] shall impose no
 4             restriction on an advanced practice registered nurse
 5             or  collaborating  physician  as   to   methods   of
 6             diagnosis  or  treatment or exercise of professional
 7             judgment,  except  for  restrictions  that  may   be
 8             established  by the medical staff in accordance with
 9             bylaws.  The physician-patient or advanced  practice
10             registered   nurse-patient   relationship  shall  be
11             maintained.
12        The signed statement shall be retained  by  the  employer
13    and  advanced  practice registered nurse and available to the
14    Department upon request.
15        The Department may prepare a model statement by rule.
16        (d)  Nothing in this Act shall be construed to relieve  a
17    physician  of  professional  or  legal responsibility for the
18    care and treatment of persons attended by him or  her  or  to
19    relieve   an   advanced  practice  registered  nurse  of  the
20    professional  or  legal  responsibility  for  the  care   and
21    treatment of persons attended by him or her.
22        (225 ILCS 65/15-35 new)
23        Sec. 15-35.  Advanced Practice Registered Nurse Board.
24        (a)  There  is  hereby  established  an Advanced Practice
25    Registered Nurse Board, hereinafter referred to as the  "APRN
26    Board".  The APRN Board shall review and make recommendations
27    to the Department regarding matters relating to licensure and
28    discipline  of advanced practice registered nurses.  The APRN
29    Board shall be composed of 9 members to be appointed  by  the
30    Governor,  4  of  whom  shall be advanced practice registered
31    nurses and 4  of  whom  shall  be  physicians.   Two  of  the
32    physician  members  shall  be  collaborating physicians.  One
33    member, not employed or having any material interest  in  any
                            -45-               LRB9011272NTsb
 1    health   care   field,   shall  represent  the  public.   The
 2    chairperson of the APRN Board shall be a member elected by  a
 3    majority  vote  of the APRN Board.  The APRN Board shall meet
 4    and report  to  the  Department  quarterly  and  as  advanced
 5    practice registered nurse issues arise.
 6        Initial  appointments  to  the  APRN  Board shall be made
 7    within 90 days after the effective date  of  this  amendatory
 8    Act  of  1997.   The  terms of office of each of the original
 9    members shall be at staggered intervals.  One  physician  and
10    one  advanced  practice registered nurse shall serve one-year
11    terms.  One physician and one  advanced  practice  registered
12    nurse  shall  serve  2-year  terms.   One  physician  and one
13    advanced practice registered nurse shall serve 3-year  terms.
14    One  physician,  one  advanced practice registered nurse, and
15    the  public  member  shall  serve  4-year  terms.   Upon  the
16    expiration of the term of  an  initial  member,  his  or  her
17    successor shall be appointed for a term of 4 years. No member
18    shall  serve more than 2 consecutive terms, excluding initial
19    appointment terms.  An appointment to fill a vacancy shall be
20    for the unexpired portion of the term.   Members of the  APRN
21    Board  shall  be reimbursed for all authorized legitimate and
22    necessary expenses incurred in attending the meetings of  the
23    APRN  Board.   A majority of the APRN Board members appointed
24    shall constitute a quorum.  A vacancy in  the  membership  of
25    the  APRN  Board  shall  not  impair the right of a quorum to
26    perform all of the duties of the APRN Board.    A  member  of
27    the  APRN  Board  shall  have no liability in an action based
28    upon a disciplinary proceeding or other activity performed in
29    good faith as a member of the APRN Board.
30        (b)  Complaints  received  concerning  advanced  practice
31    registered nurses  shall  be  reviewed  by  the  APRN  Board.
32    Complaints received concerning collaborating physicians shall
33    be reviewed by the Medical Disciplinary Board.
                            -46-               LRB9011272NTsb
 1        (225 ILCS 65/15-40 new)
 2        Sec. 15-40.  Advertising.
 3        (a)  A person licensed under this Title may advertise the
 4    availability  of professional services in the public media or
 5    on the premises where the professional services are rendered.
 6    The  advertising  shall   be   limited   to   the   following
 7    information:
 8             (1)  publication of the person's name, title, office
 9        hours, address, and telephone number;
10             (2)  information pertaining to the person's areas of
11        specialization,  including but not limited to appropriate
12        board  certification  or   limitation   of   professional
13        practice;
14             (3)  publication   of   the  person's  collaborating
15        physician's name, title, and areas of specialization;
16             (4)  information on usual  and  customary  fees  for
17        routine   professional   services  offered,  which  shall
18        include notification that fees may  be  adjusted  due  to
19        complications or unforeseen circumstances;
20             (5)  announcements  of  the  opening  of, change of,
21        absence 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
26    Title to use testimonials or claims of  superior  quality  of
27    care to entice the public.  It shall be unlawful to advertise
28    fee  comparisons  of  available  services with those of other
29    licensed persons.
30        (c)  This Title does not  authorize  the  advertising  of
31    professional services that the offeror of the services is not
32    licensed  or  authorized to render.  Nor shall the advertiser
33    use statements that contain false, fraudulent, deceptive,  or
34    misleading material or guarantees of success, statements that
                            -47-               LRB9011272NTsb
 1    play  upon  the  vanity or fears of the public, or statements
 2    that promote or produce unfair competition.
 3        (d)  It is unlawful  and  punishable  under  the  penalty
 4    provisions of this Act for a person licensed under this Title
 5    to  knowingly  advertise  that  the  licensee  will accept as
 6    payment for services rendered by assignment  from  any  third
 7    party  payor  the  amount  the  third  party  payor covers as
 8    payment in full, if the effect is to give the  impression  of
 9    eliminating  the  need  of  payment  by  the  patient  of any
10    required deductible or copayment applicable in the  patient's
11    health benefit plan.
12        (e)  As   used   in   this   Section,  "advertise"  means
13    solicitation by the licensee or  through  another  person  or
14    entity  by  means  of  handbills,  posters, circulars, motion
15    pictures, radio,  newspapers,  or  television  or  any  other
16    manner.
17        (225 ILCS 65/15-45 new)
18        Sec.  15-45.  Continuing education.  The Department shall
19    adopt rules of  continuing  education  for  persons  licensed
20    under this Title that require {Annual number multiplied by 2}
21    hours  of  continuing  education  per  2-year license renewal
22    cycle.  The rules shall be consistent  with  requirements  of
23    relevant  professional  associations, specialty societies, or
24    boards. The rules shall also address variances for illness or
25    hardship.  In establishing the rules,  the  Department  shall
26    consider  education  requirements  for  specialty  society or
27    board certification. The  continuing  education  rules  shall
28    assure   that   licensees   are   given  the  opportunity  to
29    participate  in   programs  sponsored  by  or  through  their
30    professional associations or hospitals that are  relevant  to
31    their practice.  Each licensee is responsible for maintaining
32    records  of  completion  of continuing education and shall be
33    prepared  to  produce  the  records  when  requested  by  the
                            -48-               LRB9011272NTsb
 1    Department.
 2        (225 ILCS 65/15-50 new)
 3        Sec. 15-50.  Grounds for disciplinary action.
 4        (a)  The Department may, upon the recommendation  of  the
 5    APRN  Board,  refuse  to  issue  or  to renew, or may revoke,
 6    suspend, place on probation, censure or  reprimand,  or  take
 7    other   disciplinary   action  as  the  Department  may  deem
 8    appropriate with regard to a license issued under this Title,
 9    including the issuance of fines not to exceed $5,000 for each
10    violation, for any one or  combination  of  the  grounds  for
11    discipline  set forth in Section 10-45 of this Act or for any
12    one or combination of the following causes:
13             (1)  Gross negligence in the  practice  of  advanced
14        practice registered nursing.
15             (2)  Exceeding the authority delegated to him or her
16        by  his  or  her  collaborating  physician  or  alternate
17        collaborating physician in guidelines established under a
18        written collaborative and interactive team agreement.
19             (3)  Making   a   false   or   misleading  statement
20        regarding his or her skill or the efficacy  or  value  of
21        the  medicine,  treatment, or remedy prescribed by him or
22        her in the course of treatment.
23             (4)  Prescribing,      selling,       administering,
24        distributing,   giving,   or  self-administering  a  drug
25        classified as a controlled substance (designated product)
26        or narcotic for other than medically-accepted therapeutic
27        purposes.
28             (5)  Promotion  of  the  sale  of  drugs,   devices,
29        appliances,  or  goods provided for a patient in a manner
30        to exploit the patient for financial gain.
31             (6)  Violating State or federal laws or  regulations
32        relating to controlled substances.
33             (7)  Willfully  failing to file or record, willfully
                            -49-               LRB9011272NTsb
 1        impeding the filing or  recording,  or  inducing  another
 2        person  to  fail  to  file  or  record medical reports as
 3        required by law.
 4             (8)  Willfully   or   negligently   violating    the
 5        confidentiality   between  advanced  practice  registered
 6        nurse, collaborating physician, and  patient,  except  as
 7        required by law.
 8             (9)  Failure   of   a  licensee  to  report  to  the
 9        Department any adverse final  action  taken  against  the
10        licensee  by  another  licensing  jurisdiction (any other
11        jurisdiction of the United States or any foreign state or
12        country), a peer review body, a health care  institution,
13        a professional or nursing or advanced practice registered
14        nursing society or association, a governmental agency,  a
15        law  enforcement agency, or  a court or a liability claim
16        relating to acts or conduct similar to  acts  or  conduct
17        that  would  constitute  grounds for action as defined in
18        this Section.
19             (10)  Failure  of  a  licensee  to  report  to   the
20        Department  surrender  by  the  licensee  of a license or
21        authorization to practice nursing  or  advanced  practice
22        registered  nursing  in another state or jurisdiction, or
23        current surrender by the licensee of  membership  on  any
24        nursing staff or organized health care professional staff
25        or  in any nursing, advanced practice registered nursing,
26        or  professional  association  or  society  while   under
27        disciplinary investigation by any of those authorities or
28        bodies  for  acts  or  conduct similar to acts or conduct
29        what would constitute grounds for action  as  defined  in
30        this Section.
31             (11)  Dividing   with  anyone  other  than  advanced
32        practice registered nurses or physicians  with  whom  the
33        licensee  practices in a professional service corporation
34        or as an employee any fee, commission, rebate,  or  other
                            -50-               LRB9011272NTsb
 1        form  of  compensation  for any professional services not
 2        actually or personally rendered.   Nothing  contained  in
 3        this  subsection  prohibits  persons  holding  valid  and
 4        current  licenses  under  this  Title in a partnership or
 5        professional  service  corporation   with   an   advanced
 6        practice   registered   nurse   from   pooling,  sharing,
 7        dividing, or apportioning the fees and moneys received by
 8        them or by the partnership or corporation  in  accordance
 9        with  the  partnership  agreement  or the policies of the
10        board of directors of the corporation.  Nothing contained
11        in this subsection shall abrogate the right of 2 or  more
12        persons,  holding  valid  and current licenses under this
13        Title  to  each   receive   adequate   compensation   for
14        concurrently rendering professional services to a patient
15        and  divide a fee, provided that (i) the patient has full
16        knowledge of the division and (ii) the division  is  made
17        in    proportion    to   the   services   performed   and
18        responsibility assumed by each.
19             (12)  Failing,   within   60   days,   to    provide
20        information  in response to a written request made by the
21        Department.
22             (13)  A violation of any Section of  this  Title  or
23        Act.
24        When   the   Department   has  received  written  reports
25    concerning incidents required to be reported in items (9) and
26    (10),  the licensee's failure to report the incident  to  the
27    Department  under  those  items shall not be the sole grounds
28    for disciplinary action.
29        (b)  Any action taken by the Department or APRN Board  on
30    an  individual's  advanced  practice registered nurse license
31    shall also be taken on the  individual's  registered  nursing
32    license under Title 10 of this Act.
33        (c)  The  Department  may  refuse to issue or may suspend
34    the license of any person who fails to file a return, to  pay
                            -51-               LRB9011272NTsb
 1    the  tax, penalty, or interest shown in a filed return, or to
 2    pay any final assessment of the tax, penalty, or interest  as
 3    required  by  a  tax  Act  administered  by the Department of
 4    Revenue, until the requirements of the tax Act are satisfied.
 5        (d)  In enforcing this Section, the  Department  or  APRN
 6    Board,  upon a showing of a possible violation, may compel an
 7    individual licensed to practice under this Title, or who  has
 8    applied for licensure under this Title, to submit to a mental
 9    or  physical  examination  or both, as required by and at the
10    expense of the Department.  The Department or APRN Board  may
11    order the examining physician to present testimony concerning
12    the  mental  or  physical  examination  of  the  licensee  or
13    applicant.  No information shall be excluded by reason of any
14    common  law or statutory privilege relating to communications
15    between  the  licensee  or  applicant   and   the   examining
16    physician.   The  examining  physician  shall be specifically
17    designated by the APRN Board or Department.   The  individual
18    to  be  examined may have, at his or her own expense, another
19    physician of his or her choice present during all aspects  of
20    this  examination.  Failure  of  an individual to submit to a
21    mental or physical examination when directed shall be grounds
22    for suspension of his or her  license  until  the  individual
23    submits  to  the  examination  if the Department finds, after
24    notice and  hearing,  that  the  refusal  to  submit  to  the
25    examination was without reasonable cause.
26        If  the  Department  or  APRN  Board  finds an individual
27    unable to practice because of the reasons set forth  in  this
28    Section,  the  Department  or  APRN  Board  may  require that
29    individual to submit to care,  counseling,  or  treatment  by
30    physicians  approved  or designated by the Department or APRN
31    Board as a condition, term,  or  restriction  for  continued,
32    reinstated,  or renewed licensure to practice; or, in lieu of
33    care, counseling, or treatment, the Department may  file,  or
34    the  APRN  Board  may  recommend to the Department to file, a
                            -52-               LRB9011272NTsb
 1    complaint  to  immediately  suspend,  revoke,  or   otherwise
 2    discipline  the  license  of  the  individual.  An individual
 3    whose license was granted,  continued,  reinstated,  renewed,
 4    disciplined  or  supervised  subject to terms, conditions, or
 5    restrictions,  and  who  fails  to  comply  with  the  terms,
 6    conditions,  or  restrictions,  shall  be  referred  to   the
 7    Director  for  a  determination  as to whether the individual
 8    shall have his or her license suspended immediately,  pending
 9    a hearing by the Department.
10        In instances in which the Director immediately suspends a
11    person's  license  under  this  Section,  a  hearing  on that
12    person's license shall be convened by the  Department  within
13    15  days  after the suspension and shall be completed without
14    appreciable delay.  The Department and APRN Board shall  have
15    the  authority  to  review the subject individual's record of
16    treatment and counseling  regarding  the  impairment  to  the
17    extent   permitted   by   applicable   federal  statutes  and
18    regulations  safeguarding  the  confidentiality  of   medical
19    records.
20        An  individual  licensed  under  this  Title and affected
21    under this  Section  shall  be  afforded  an  opportunity  to
22    demonstrate  to  the  Department or APRN Board that he or she
23    can  resume  practice  in  compliance  with  acceptable   and
24    prevailing  standards  under  the  provisions  of  his or her
25    license.
26        (225 ILCS 65/15-55 new)
27        Sec. 15-55. Reports relating to professional conduct  and
28    capacity.
29        (a)  Entities Required to Report.
30             (1)  Health    Care    Institutions.     The   chief
31        administrator or  executive  officer  of  a  health  care
32        institution  licensed by the Department of Public Health,
33        which provides the  minimum  due  process  set  forth  in
                            -53-               LRB9011272NTsb
 1        Section  10.4 of the Hospital Licensing Act, shall report
 2        to  the  APRN   Board   when   a   licensee's   organized
 3        professional  staff clinical privileges are terminated or
 4        are  restricted  based  on  a  final  determination,   in
 5        accordance  with  that institution's by-laws or rules and
 6        regulations, that (i) a person has  either  committed  an
 7        act  or  acts that may directly threaten patient care and
 8        that are not of an administrative nature or (ii)  that  a
 9        person may be mentally or physically disabled in a manner
10        that may endanger patients under that person's care.  The
11        chief  administrator  or  officer  shall also report if a
12        licensee accepts voluntary termination or restriction  of
13        clinical  privileges  in lieu of formal action based upon
14        conduct related directly to patient care and  not  of  an
15        administrative  nature,  or  in  lieu  of  formal  action
16        seeking  to determine whether a person may be mentally or
17        physically  disabled  in  a  manner  that  may   endanger
18        patients  under that person's care.  The APRN Board shall
19        provide by rule for the reporting to it of all  instances
20        in  which  a  person  licensed  under  this Title, who is
21        impaired by reason of age,  drug,  or  alcohol  abuse  or
22        physical  or mental impairment, is under supervision and,
23        where appropriate, is in  a  program  of  rehabilitation.
24        Reports submitted under this subsection shall be strictly
25        confidential  and  may be reviewed and considered only by
26        the members of the APRN  Board  or  authorized  staff  as
27        provided  by rule of the APRN Board.  Provisions shall be
28        made for the periodic report of the status  of  any  such
29        reported  person  not  less  than twice annually in order
30        that the APRN Board shall have current  information  upon
31        which  to  determine  the status of that person.  Initial
32        and  periodic  reports  of  impaired  advanced   practice
33        registered  nurses shall not be considered records within
34        the meaning  of  the  State  Records  Act  and  shall  be
                            -54-               LRB9011272NTsb
 1        disposed  of, following a determination by the APRN Board
 2        that such reports are no longer required, in a manner and
 3        at  an appropriate time as the APRN Board shall determine
 4        by rule. The  filing  of  reports  submitted  under  this
 5        subsection  shall  be construed as the filing of a report
 6        for purposes of subsection (c) of this Section.
 7             (2)  Professional Associations.   The  President  or
 8        chief  executive  officer of an association or society of
 9        persons licensed under this Title, operating within  this
10        State,   shall   report   to  the  APRN  Board  when  the
11        association or society renders a final determination that
12        a  person  licensed  under  this  Title   has   committed
13        unprofessional  conduct  related directly to patient care
14        or that a person may be mentally or  physically  disabled
15        in a manner that may endanger patients under the person's
16        care.
17             (3)  Professional    Liability    Insurers.    Every
18        insurance company that offers  policies  of  professional
19        liability insurance to persons licensed under this Title,
20        or   any   other  entity  that  seeks  to  indemnify  the
21        professional liability of a person  licensed  under  this
22        Title,  shall  report to the APRN Board the settlement of
23        any claim or cause of action, or final judgment  rendered
24        in  any  cause  of action, that alleged negligence in the
25        furnishing of patient  care  by  the  licensee  when  the
26        settlement   or   final  judgment  is  in  favor  of  the
27        plaintiff.
28             (4)  State's Attorneys.   The  State's  Attorney  of
29        each  county shall report to the APRN Board all instances
30        in which a person licensed under this Title is  convicted
31        or otherwise found guilty of the commission of a felony.
32             (5)  State    Agencies.    All   agencies,   boards,
33        commissions, departments, or other  instrumentalities  of
34        the  government  of  this  State shall report to the APRN
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 1        Board  any  instance  arising  in  connection  with   the
 2        operations of the agency, including the administration of
 3        any  law  by the agency, in which a person licensed under
 4        this Title has either committed an act or acts  that  may
 5        constitute a violation of this Title, that may constitute
 6        unprofessional  conduct related directly to patient care,
 7        or that indicates that a person licensed under this Title
 8        may be mentally or physically disabled in a  manner  that
 9        may endanger patients under that person's care.
10        (b)  Mandatory  Reporting.   All  reports  required under
11    items (9) and (10) of subsection (a)  of  Section  15-50  and
12    under  this Section shall be submitted to the APRN Board in a
13    timely fashion.  The reports shall be filed in writing within
14    60 days after a determination that a report is required under
15    this  Title.   All  reports  shall  contain   the   following
16    information:
17               (1)  The  name,  address,  and telephone number of
18        the person making the report.
19               (2)  The name, address, and  telephone  number  of
20        the person who is the subject of the report.
21               (3)  The  name or other means of identification of
22        any patient or patients whose treatment is a  subject  of
23        the  report,  except  that  no  medical  records  may  be