State of Illinois
90th General Assembly
Legislation

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90_SB1585eng

      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
SB1585 Engrossed                               LRB9011272NTsb
 1        AN ACT concerning medicine.
 2        Be it enacted by the People of  the  State  of  Illinois,
 3    represented in the General Assembly:
 4        Section  5.   The  Illinois Clinical Laboratory and Blood
 5    Bank Act is amended by changing Section 7-101 as follows:
 6        (210 ILCS 25/7-101) (from Ch. 111 1/2, par. 627-101)
 7        Sec.  7-101.  Examination  of   specimens.   A   clinical
 8    laboratory shall examine specimens only at the request of (i)
 9    a  licensed  physician,  (ii)  a  licensed  dentist,  (iii) a
10    licensed  podiatrist,  (iv)  a  therapeutic  optometrist  for
11    diagnostic or therapeutic purposes  related  to  the  use  of
12    diagnostic   topical  or  therapeutic  ocular  pharmaceutical
13    agents, as defined in subsections (c) and (d) of Section 15.1
14    of the Illinois Optometric Practice  Act  of  1987,    (v)  a
15    licensed  physician  assistant in accordance with the written
16    guidelines required under subdivision (3) of  Section  4  and
17    under  Section 7.5 of the Physician Assistant Practice Act of
18    1987,  (v-A) an advanced practice nurse  in  accordance  with
19    the  written  collaborative  agreement required under Section
20    15-15 of the Nursing and Advanced Practice  Nursing  Act,  or
21    (vi)  an authorized law enforcement agency or, in the case of
22    blood alcohol, at the request of the individual for whom  the
23    test  is  to  be performed in compliance with Sections 11-501
24    and 11-501.1 of the Illinois Vehicle Code.   If  the  request
25    to  a  laboratory  is oral, the physician or other authorized
26    person shall submit  a  written  request  to  the  laboratory
27    within  48  hours.   If  the  laboratory does not receive the
28    written request within that period, it shall note  that  fact
29    in its records.
30    (Source: P.A.  90-116,  eff.  7-14-97;  90-322,  eff. 1-1-98;
31    revised 10-23-97.)
SB1585 Engrossed            -2-                LRB9011272NTsb
 1        Section 10.  The Medical Practice Act of 1987 is  amended
 2    by  changing  Sections  20  and 22 and adding Section 54.5 as
 3    follows:
 4        (225 ILCS 60/20) (from Ch. 111, par. 4400-20)
 5        Sec. 20.  Continuing  education.   The  Department  shall
 6    promulgate rules of continuing education for persons licensed
 7    under  this  Act  that  require  150  50  hours of continuing
 8    education per license renewal cycle each year.   These  rules
 9    shall   be   consistent   with   requirements   of   relevant
10    professional  associations,  speciality societies, or boards.
11    The  rules  shall  also  address  variances  for  illness  or
12    hardship. In establishing these rules, the  Department  shall
13    consider   educational   requirements   for  medical  staffs,
14    requirements for specialty society board certification or for
15    continuing  education  requirements   as   a   condition   of
16    membership  in  societies  representing  the  2 categories of
17    licensee under this  Act.   These  rules  shall  assure  that
18    licensees  are  given the opportunity to participate in those
19    programs  sponsored  by   or   through   their   professional
20    associations   or  hospitals  which  are  relevant  to  their
21    practice.   Each  licensee  is  responsible  for  maintaining
22    records of completion of continuing education  and  shall  be
23    prepared  to  produce  the  records  when  requested  by  the
24    Department.
25    (Source: P.A. 89-702, eff. 7-1-97.)
26        (225 ILCS 60/22) (from Ch. 111, par. 4400-22)
27        Sec. 22.  Disciplinary action.
28        (A)  The   Department   may  revoke,  suspend,  place  on
29    probationary status, or take any other disciplinary action as
30    the Department may deem proper with regard to the license  or
31    visiting professor permit of any person issued under this Act
32    to  practice medicine, or to treat human ailments without the
SB1585 Engrossed            -3-                LRB9011272NTsb
 1    use of drugs and without operative surgery upon  any  of  the
 2    following grounds:
 3             (1)  Performance  of  an  elective  abortion  in any
 4        place, locale, facility, or institution other than:
 5                  (a)  a  facility  licensed  pursuant   to   the
 6             Ambulatory Surgical Treatment Center Act;
 7                  (b)  an institution licensed under the Hospital
 8             Licensing Act; or
 9                  (c)  an ambulatory surgical treatment center or
10             hospitalization  or  care facility maintained by the
11             State or any agency thereof, where  such  department
12             or  agency  has authority under law to establish and
13             enforce  standards  for  the   ambulatory   surgical
14             treatment    centers,   hospitalization,   or   care
15             facilities under its management and control; or
16                  (d)  ambulatory  surgical  treatment   centers,
17             hospitalization or care facilities maintained by the
18             Federal Government; or
19                  (e)  ambulatory   surgical  treatment  centers,
20             hospitalization or care facilities maintained by any
21             university or college established under the laws  of
22             this State and supported principally by public funds
23             raised by taxation.
24             (2)  Performance  of  an  abortion  procedure  in  a
25        wilful  and wanton manner on a woman who was not pregnant
26        at the time the abortion procedure was performed.
27             (3)  The conviction of a felony in this or any other
28        jurisdiction, except as otherwise provided in  subsection
29        B  of  this  Section,  whether or not related to practice
30        under this  Act,  or  the  entry  of  a  guilty  or  nolo
31        contendere plea to a felony charge.
32             (4)  Gross negligence in practice under this Act.
33             (5)  Engaging    in   dishonorable,   unethical   or
34        unprofessional conduct of a character likely to  deceive,
SB1585 Engrossed            -4-                LRB9011272NTsb
 1        defraud or harm the public.
 2             (6)  Obtaining   any   fee   by  fraud,  deceit,  or
 3        misrepresentation.
 4             (7)  Habitual or excessive use  or  abuse  of  drugs
 5        defined  in  law as controlled substances, of alcohol, or
 6        of any other substances which results in the inability to
 7        practice with reasonable judgment, skill or safety.
 8             (8)  Practicing under a false or, except as provided
 9        by law, an assumed name.
10             (9)  Fraud or misrepresentation in applying for,  or
11        procuring, a license under this Act or in connection with
12        applying for renewal of a license under this Act.
13             (10)  Making   a   false   or  misleading  statement
14        regarding their skill or the efficacy  or  value  of  the
15        medicine,  treatment,  or  remedy  prescribed  by them at
16        their direction in the treatment of any disease or  other
17        condition of the body or mind.
18             (11)  Allowing another person or organization to use
19        their license, procured under this Act, to practice.
20             (12)  Disciplinary   action   of  another  state  or
21        jurisdiction against a license or other authorization  to
22        practice  as  a  medical  doctor,  doctor  of osteopathy,
23        doctor of osteopathic medicine or doctor of chiropractic,
24        a certified copy of the record of the action taken by the
25        other state or jurisdiction being  prima  facie  evidence
26        thereof.
27             (13)  Violation  of  any provision of this Act or of
28        the Medical Practice Act prior to the repeal of that Act,
29        or violation of the  rules,  or  a  final  administrative
30        action  of  the  Director,  after  consideration  of  the
31        recommendation of the Disciplinary Board.
32             (14)  Dividing  with  anyone  other  than physicians
33        with  whom  the  licensee  practices  in  a  partnership,
34        Professional Association, limited liability  company,  or
SB1585 Engrossed            -5-                LRB9011272NTsb
 1        Medical  or Professional Corporation any fee, commission,
 2        rebate or other form of compensation for any professional
 3        services not actually and  personally  rendered.  Nothing
 4        contained  in  this  subsection prohibits persons holding
 5        valid and current licenses under this Act from practicing
 6        medicine in partnership under  a  partnership  agreement,
 7        including  a  limited liability partnership, in a limited
 8        liability company under  the  Limited  Liability  Company
 9        Act,   in   a   corporation  authorized  by  the  Medical
10        Corporation Act, as  an  association  authorized  by  the
11        Professional  Association  Act, or in a corporation under
12        the  Professional  Corporation  Act  or   from   pooling,
13        sharing,  dividing  or  apportioning  the fees and monies
14        received by them or by the  partnership,  corporation  or
15        association  in accordance with the partnership agreement
16        or  the  policies  of  the  Board  of  Directors  of  the
17        corporation or association.  Nothing  contained  in  this
18        subsection prohibits 2 or more corporations authorized by
19        the  Medical  Corporation Act, from forming a partnership
20        or joint venture  of  such  corporations,  and  providing
21        medical,  surgical  and scientific research and knowledge
22        by employees of these corporations if such employees  are
23        licensed  under  this  Act,  or  from  pooling,  sharing,
24        dividing, or apportioning the fees and monies received by
25        the  partnership  or joint venture in accordance with the
26        partnership  or   joint   venture   agreement.    Nothing
27        contained  in this subsection shall abrogate the right of
28        2 or more persons, holding  valid  and  current  licenses
29        under this Act, to each receive adequate compensation for
30        concurrently rendering professional services to a patient
31        and   divide  a  fee;  provided,  the  patient  has  full
32        knowledge  of  the  division,  and,  provided,  that  the
33        division is made in proportion to the services  performed
34        and responsibility assumed by each.
SB1585 Engrossed            -6-                LRB9011272NTsb
 1             (15)  A  finding  by  the Medical Disciplinary Board
 2        that the registrant  after  having  his  or  her  license
 3        placed  on probationary status or subjected to conditions
 4        or restrictions violated the terms of  the  probation  or
 5        failed to comply with such terms or conditions.
 6             (16)  Abandonment of a patient.
 7             (17)  Prescribing,      selling,      administering,
 8        distributing,   giving  or  self-administering  any  drug
 9        classified as a controlled substance (designated product)
10        or narcotic for other than medically accepted therapeutic
11        purposes.
12             (18)  Promotion  of  the  sale  of  drugs,  devices,
13        appliances or goods provided for a patient in such manner
14        as to exploit the  patient  for  financial  gain  of  the
15        physician.
16             (19)  Offering,  undertaking  or agreeing to cure or
17        treat disease by a secret method, procedure, treatment or
18        medicine, or the treating, operating or  prescribing  for
19        any human condition by a method, means or procedure which
20        the  licensee  refuses  to  divulge  upon  demand  of the
21        Department.
22             (20)  Immoral conduct in the commission of  any  act
23        including,  but  not  limited to, commission of an act of
24        sexual misconduct related to the licensee's practice.
25             (21)  Wilfully making or  filing  false  records  or
26        reports in his or her practice as a physician, including,
27        but  not  limited  to,  false  records  to support claims
28        against the medical assistance program of the  Department
29        of Public Aid under the Illinois Public Aid Code.
30             (22)  Wilful omission to file or record, or wilfully
31        impeding  the  filing  or  recording, or inducing another
32        person to omit to file  or  record,  medical  reports  as
33        required  by  law,  or  wilfully  failing  to  report  an
34        instance  of  suspected  abuse  or neglect as required by
SB1585 Engrossed            -7-                LRB9011272NTsb
 1        law.
 2             (23)  Being named as a perpetrator in  an  indicated
 3        report  by the Department of Children and Family Services
 4        under the Abused and Neglected Child Reporting  Act,  and
 5        upon  proof  by  clear  and  convincing evidence that the
 6        licensee has caused a child to  be  an  abused  child  or
 7        neglected  child  as  defined in the Abused and Neglected
 8        Child Reporting Act.
 9             (24)  Solicitation of professional patronage by  any
10        corporation,  agents  or persons, or profiting from those
11        representing themselves to be agents of the licensee.
12             (25)  Gross and wilful  and  continued  overcharging
13        for   professional   services,   including  filing  false
14        statements for collection of fees for which services  are
15        not  rendered, including, but not limited to, filing such
16        false statements for collection of  monies  for  services
17        not  rendered  from the medical assistance program of the
18        Department of Public Aid under the  Illinois  Public  Aid
19        Code.
20             (26)  A  pattern of practice or other behavior which
21        demonstrates incapacity or incompetence to practice under
22        this Act.
23             (27)  Mental illness or disability which results  in
24        the  inability to practice under this Act with reasonable
25        judgment, skill or safety.
26             (28)  Physical illness, including, but  not  limited
27        to,  deterioration  through the aging process, or loss of
28        motor skill which results in a physician's  inability  to
29        practice  under  this Act with reasonable judgment, skill
30        or safety.
31             (29)  Cheating  on  or  attempt   to   subvert   the
32        licensing examinations administered under this Act.
33             (30)  Wilfully    or   negligently   violating   the
34        confidentiality between physician and patient  except  as
SB1585 Engrossed            -8-                LRB9011272NTsb
 1        required by law.
 2             (31)  The use of any false, fraudulent, or deceptive
 3        statement  in  any document connected with practice under
 4        this Act.
 5             (32)  Aiding and abetting an individual not licensed
 6        under this Act in the practice of a  profession  licensed
 7        under this Act.
 8             (33)  Violating state or federal laws or regulations
 9        relating to controlled substances.
10             (34)  Failure   to  report  to  the  Department  any
11        adverse  final  action  taken  against  them  by  another
12        licensing jurisdiction (any other state or any  territory
13        of the United States or any foreign state or country), by
14        any  peer review body, by any health care institution, by
15        any  professional  society  or  association  related   to
16        practice  under  this Act, by any governmental agency, by
17        any law enforcement agency, or by any court for  acts  or
18        conduct similar to acts or conduct which would constitute
19        grounds for action as defined in this Section.
20             (35)  Failure  to report to the Department surrender
21        of a license or authorization to practice  as  a  medical
22        doctor,  a  doctor of osteopathy, a doctor of osteopathic
23        medicine, or doctor of chiropractic in another  state  or
24        jurisdiction,  or  surrender of membership on any medical
25        staff or in any medical or  professional  association  or
26        society, while under disciplinary investigation by any of
27        those  authorities or bodies, for acts or conduct similar
28        to acts or conduct which  would  constitute  grounds  for
29        action as defined in this Section.
30             (36)  Failure   to  report  to  the  Department  any
31        adverse judgment, settlement, or  award  arising  from  a
32        liability  claim  related  to  acts or conduct similar to
33        acts or conduct which would constitute grounds for action
34        as defined in this Section.
SB1585 Engrossed            -9-                LRB9011272NTsb
 1             (37)  Failure to transfer copies of medical  records
 2        as required by law.
 3             (38)  Failure   to   furnish   the  Department,  its
 4        investigators or representatives,  relevant  information,
 5        legally  requested  by  the Department after consultation
 6        with the Chief Medical Coordinator or the Deputy  Medical
 7        Coordinator.
 8             (39)  Violating the Health Care Worker Self-Referral
 9        Act.
10             (40)  Willful  failure to provide notice when notice
11        is required under the Parental Notice of Abortion Act  of
12        1995.
13             (41)  Failure  to  establish and maintain records of
14        patient care and treatment as required by this law.
15             (42)  Entering into an excessive number  of  written
16        collaborative  agreements with licensed advanced practice
17        nurses  resulting   in   an   inability   to   adequately
18        collaborate and provide medical direction.
19             (43)  Repeated  failure  to  adequately  collaborate
20        with  or provide medical direction to a licensed advanced
21        practice nurse.
22        All proceedings to suspend, revoke, place on probationary
23    status,  or  take  any  other  disciplinary  action  as   the
24    Department  may  deem proper, with regard to a license on any
25    of the foregoing grounds, must be commenced  within  3  years
26    next  after receipt by the Department of a complaint alleging
27    the commission of or notice of the conviction order  for  any
28    of  the  acts  described  herein.   Except  for  the  grounds
29    numbered (8), (9) and (29), no action shall be commenced more
30    than 5 years after the date of the incident or act alleged to
31    have  violated  this Section.  In the event of the settlement
32    of any claim or cause of action in favor of the  claimant  or
33    the  reduction to final judgment of any civil action in favor
34    of the plaintiff, such claim, cause of action or civil action
SB1585 Engrossed            -10-               LRB9011272NTsb
 1    being grounded on the allegation that a person licensed under
 2    this Act was negligent  in  providing  care,  the  Department
 3    shall  have an additional period of one year from the date of
 4    notification to the Department under Section 23 of  this  Act
 5    of  such settlement or final judgment in which to investigate
 6    and commence formal disciplinary proceedings under Section 36
 7    of this Act, except as otherwise provided by law.   The  time
 8    during  which the holder of the license was outside the State
 9    of Illinois shall not be included within any period  of  time
10    limiting  the  commencement  of  disciplinary  action  by the
11    Department.
12        The entry of an order or judgment by  any  circuit  court
13    establishing that any person holding a license under this Act
14    is  a  person  in  need  of  mental  treatment  operates as a
15    suspension of that license.  That  person  may  resume  their
16    practice  only  upon  the entry of a Departmental order based
17    upon a finding by the Medical Disciplinary  Board  that  they
18    have  been  determined to be recovered from mental illness by
19    the court and upon the  Disciplinary  Board's  recommendation
20    that they be permitted to resume their practice.
21        The  Department  may refuse to issue or take disciplinary
22    action concerning the license of any person who fails to file
23    a return, or to pay the tax, penalty or interest shown  in  a
24    filed  return, or to pay any final assessment of tax, penalty
25    or interest, as required by any tax Act administered  by  the
26    Illinois  Department  of  Revenue,  until  such  time  as the
27    requirements of any such tax Act are satisfied as  determined
28    by the Illinois Department of Revenue.
29        The   Department,   upon   the   recommendation   of  the
30    Disciplinary  Board,  shall  adopt  rules  which  set   forth
31    standards to be used in determining:
32             (a)  when  a  person  will  be  deemed  sufficiently
33        rehabilitated to warrant the public trust;
34             (b)  what  constitutes  dishonorable,  unethical  or
SB1585 Engrossed            -11-               LRB9011272NTsb
 1        unprofessional  conduct of a character likely to deceive,
 2        defraud, or harm the public;
 3             (c)  what  constitutes  immoral   conduct   in   the
 4        commission  of  any  act,  including, but not limited to,
 5        commission of an act of sexual misconduct related to  the
 6        licensee's practice; and
 7             (d)  what   constitutes   gross  negligence  in  the
 8        practice of medicine.
 9        However, no such rule shall be admissible  into  evidence
10    in any civil action except for review of a licensing or other
11    disciplinary action under this Act.
12        In  enforcing  this  Section,  the  Medical  Disciplinary
13    Board, upon a showing of a possible violation, may compel any
14    individual  licensed  to  practice under this Act, or who has
15    applied for licensure or a permit pursuant to  this  Act,  to
16    submit  to  a  mental  or  physical  examination, or both, as
17    required by and  at  the  expense  of  the  Department.   The
18    examining physician or physicians shall be those specifically
19    designated   by   the   Disciplinary   Board.   The   Medical
20    Disciplinary  Board or the Department may order the examining
21    physician to present  testimony  concerning  this  mental  or
22    physical  examination  of  the  licensee  or  applicant.   No
23    information  shall be excluded by reason of any common law or
24    statutory privilege relating  to  communication  between  the
25    licensee  or  applicant  and  the  examining  physician.  The
26    individual  to  be  examined  may  have,  at  his  or her own
27    expense, another physician  of  his  or  her  choice  present
28    during  all  aspects  of  the  examination.    Failure of any
29    individual to submit to mental or physical examination,  when
30    directed,  shall  be  grounds  for  suspension  of his or her
31    license until such time as  the  individual  submits  to  the
32    examination if the Disciplinary Board finds, after notice and
33    hearing,  that  the  refusal to submit to the examination was
34    without reasonable cause.  If the Disciplinary Board finds  a
SB1585 Engrossed            -12-               LRB9011272NTsb
 1    physician unable to practice because of the reasons set forth
 2    in  this  Section,  the Disciplinary Board shall require such
 3    physician to submit to  care,  counseling,  or  treatment  by
 4    physicians  approved or designated by the Disciplinary Board,
 5    as  a  condition  for  continued,  reinstated,   or   renewed
 6    licensure  to  practice.   Any  physician,  whose license was
 7    granted pursuant to Sections 9, 17, or 19 of  this  Act,  or,
 8    continued,  reinstated,  renewed,  disciplined or supervised,
 9    subject to such terms, conditions or restrictions  who  shall
10    fail  to  comply with such terms, conditions or restrictions,
11    or to complete a required program  of  care,  counseling,  or
12    treatment,  as determined by the Chief Medical Coordinator or
13    Deputy  Medical  Coordinators,  shall  be  referred  to   the
14    Director for a determination as to whether the licensee shall
15    have  their  license suspended immediately, pending a hearing
16    by  the  Disciplinary  Board.   In  instances  in  which  the
17    Director immediately suspends a license under this Section, a
18    hearing upon such person's license must be  convened  by  the
19    Disciplinary  Board  within 15 days after such suspension and
20    completed without appreciable delay.  The Disciplinary  Board
21    shall  have  the  authority to review the subject physician's
22    record of treatment and counseling regarding the  impairment,
23    to  the  extent  permitted by applicable federal statutes and
24    regulations  safeguarding  the  confidentiality  of   medical
25    records.
26        An  individual  licensed  under  this Act, affected under
27    this Section, shall be afforded an opportunity to demonstrate
28    to the Disciplinary Board that they can  resume  practice  in
29    compliance with acceptable and prevailing standards under the
30    provisions of their license.
31        The Department may promulgate rules for the imposition of
32    fines  in  disciplinary  cases, not to exceed $5,000 for each
33    violation of this Act.  Fines may be imposed  in  conjunction
34    with other forms of disciplinary action, but shall not be the
SB1585 Engrossed            -13-               LRB9011272NTsb
 1    exclusive  disposition of any disciplinary action arising out
 2    of conduct resulting in death or injury to  a  patient.   Any
 3    funds  collected  from  such  fines shall be deposited in the
 4    Medical Disciplinary Fund.
 5        (B)  The Department shall revoke the license or  visiting
 6    permit  of  any  person  issued  under  this  Act to practice
 7    medicine or to treat human ailments without the use of  drugs
 8    and  without  operative  surgery,  who  has  been convicted a
 9    second time of  committing  any  felony  under  the  Illinois
10    Controlled Substances Act, or who has been convicted a second
11    time  of  committing a Class 1 felony under Sections 8A-3 and
12    8A-6 of the Illinois Public Aid Code.  A person whose license
13    or visiting permit is revoked  under  this  subsection  B  of
14    Section  22  of  this Act shall be prohibited from practicing
15    medicine or treating human ailments without the use of  drugs
16    and without operative surgery.
17        (C)  The  Medical  Disciplinary  Board shall recommend to
18    the Department civil  penalties  and  any  other  appropriate
19    discipline  in disciplinary cases when the Board finds that a
20    physician  willfully  performed  an  abortion   with   actual
21    knowledge  that  the  person  upon whom the abortion has been
22    performed is a minor or an incompetent person without  notice
23    as  required  under  the  Parental  Notice of Abortion Act of
24    1995.  Upon the Board's recommendation, the Department  shall
25    impose,  for  the  first violation, a civil penalty of $1,000
26    and for a second or subsequent violation, a civil penalty  of
27    $5,000.
28    (Source: P.A.   89-18,  eff.  6-1-95;  89-201,  eff.  1-1-96;
29    89-626, eff. 8-9-96; 89-702, eff. 7-1-97.)
30        (225 ILCS 60/54.5 new)
31        Sec. 54.5.  Physician delegation of authority.
32        (a)  Physicians licensed to practice medicine in all  its
33    branches  may delegate care and treatment responsibilities to
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 1    a physician assistant under guidelines in accordance with the
 2    requirements of  the  Physician  Assistant  Practice  Act  of
 3    1987.   A  physician licensed to practice medicine in all its
 4    branches may enter into supervising physician agreements with
 5    no more than 2 physician assistants.
 6        (b)  A physician licensed to practice medicine in all its
 7    branches in active clinical practice may collaborate with  an
 8    advanced  practice  nurse in accordance with the requirements
 9    of Title 15 of the Nursing and Advanced Practice Nursing Act.
10    Collaboration  is  for  the  purpose  of  providing   medical
11    direction   in   a   team  relationship,  and  no  employment
12    relationship is required.  A written collaborative  agreement
13    shall conform to the requirements of Sections 15-15 and 15-20
14    of  the  Nursing  and  Advanced  Practice  Nursing  Act.  The
15    agreement shall be for services the  collaborating  physician
16    generally  provides  to  his  or  her  patients in the normal
17    course of  clinical  medical  practice.    Physician  medical
18    direction  shall  be  adequate  with respect to collaboration
19    with certified nurse practitioners, certified nurse midwives,
20    and clinical nurse specialists if a collaborating physician:
21             (1)  participates in the joint formulation and joint
22        approval  of  orders  or  guidelines  with  the  advanced
23        practice nurse and periodically reviews such  orders  and
24        the  services  provided  patients  under  such  orders in
25        accordance with accepted standards  of  medical  practice
26        and advanced practice nursing practice;
27             (2)  is  on  site  at  least once a month to provide
28        medical direction and consultation; and
29             (3)  is  available  through  telecommunications  for
30        consultation  on  medical  problems,  complications,   or
31        emergencies or patient referral.
32        (c)  The  supervising  physician shall have access to the
33    medical records of  all  patients  attended  by  a  physician
34    assistant.   The collaborating physician shall have access to
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 1    the medical  records  of  all  patients  attended  to  by  an
 2    advanced practice nurse.
 3        (d)  Nothing  in this Act shall be construed to limit the
 4    delegation of tasks or duties  by  a  physician  licensed  to
 5    practice medicine in all its branches to a licensed practical
 6    nurse, a registered professional nurse, or other personnel.
 7        (e)  A  physician  shall  not  be  liable for the acts or
 8    omissions of a physician assistant or advanced practice nurse
 9    solely on the basis of having signed a supervision  agreement
10    or  guidelines  or  a  collaborative  agreement,  an order, a
11    standing medical order, a standing delegation order, or other
12    order or  guideline  authorizing  a  physician  assistant  or
13    advanced practice nurse to perform acts, unless the physician
14    has  reason  to  believe  the physician assistant or advanced
15    practice nurse lacked the competency to perform  the  act  or
16    acts.
17        Section  15.  The Illinois Nursing Act of 1987 is amended
18    by renumbering and changing Sections 1, 2, 3,  4,  4.1,  4.2,
19    4.5,  5,  5.1,  6, 7, 12, 14, 16, 17, 18, 21, 22, 23, 24, 26,
20    27, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40,  41,  42,
21    43,  44,  45,  46,  47, 48, and 49 and adding Sections 10-10,
22    10-15, 10-40, 10-45, 10-50, 15-5, 15-10, 15-15, 15-20, 15-30,
23    15-35, 15-40, 15-45, 15-50, 15-55, and  20-2  and  new  Title
24    headings as follows:
25        (225 ILCS 65/Title 5 heading new)
26                     TITLE 5. GENERAL PROVISIONS
27        (225 ILCS 65/5-1, formerly 65/1)
28        Sec.  5-1.  1.  This Article may be cited as the Illinois
29    Nursing and Advanced Practice  Nursing  Act,  and  throughout
30    this  Article, references to this Act shall mean this Article
31    of 1987.
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 1    (Source: P.A. 85-981; 86-1475.)
 2        (225 ILCS 65/5-5, formerly 65/2)
 3        Sec.  5-5.  2.  Legislative  purpose.   The  practice  of
 4    professional and practical nursing in the State  of  Illinois
 5    is  hereby  declared to affect the public health, safety, and
 6    welfare and to be subject to regulation and  control  in  the
 7    public  interest.   It  is further declared to be a matter of
 8    public interest and concern that the practice of nursing,  as
 9    defined  in this Act, merit and receive the confidence of the
10    public and that only qualified persons be  authorized  to  so
11    practice  in  the  State  of  Illinois.   This  Act  shall be
12    liberally construed to best  carry  out  these  subjects  and
13    purposes.
14    (Source: P.A. 85-981.)
15        (225 ILCS 65/5-10, formerly 65/3)
16        Sec. 5-10. 3.  Definitions.  Each of the following terms,
17    when used in this Act, shall have  the meaning ascribed to it
18    in  this  Section, except where the context clearly indicates
19    otherwise:
20        (a)  "Department" means the  Department  of  Professional
21    Regulation.
22        (b)  "Director"   means   the  Director  of  Professional
23    Regulation.
24        (c)  "Board" means the Board of Nursing appointed by  the
25    Director.
26        (d)  "Academic  year" means the customary annual schedule
27    of courses at a  college,  university,  or  approved  school,
28    customarily regarded as the school year as distinguished from
29    the calendar year.
30        (e)  "Approved program of professional nursing education"
31    and  "approved  program  of  practical nursing education" are
32    programs of professional or practical nursing,  respectively,
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 1    approved by the Department under the provisions of this Act.
 2        (f)  "Nursing   Act   Coordinator"   means  a  registered
 3    professional nurse appointed by the Director to carry out the
 4    administrative policies of the Department.
 5        (g)  "Assistant  Nursing   Act   Coordinator"   means   a
 6    registered  professional  nurse  appointed by the Director to
 7    assist in carrying out the  administrative  policies  of  the
 8    Department.
 9        (h)  "Registered" is the equivalent of "licensed".
10        (i)  "Practical  nurse"  or  "licensed  practical  nurse"
11    means  a  person  who  is licensed as a practical nurse under
12    this Act  and  practices  practical  nursing  as  defined  in
13    paragraph  (j)  of  this  Section.   Only  a  practical nurse
14    licensed  under  this  Act  is  entitled  to  use  the  title
15    "licensed practical nurse" and the abbreviation "L.P.N.".
16        (j)  "Practical nursing" means the performance of nursing
17    acts requiring the basic nursing  knowledge,  judgement,  and
18    skill   acquired  by  means  of  completion  of  an  approved
19    practical  nursing  education  program.   Practical   nursing
20    includes assisting in the nursing process as delegated by and
21    under  the direction of a registered professional nurse.  The
22    practical nurse may work under the direction  of  a  licensed
23    physician,   dentist,   podiatrist,   or  other  health  care
24    professional determined by the Department.
25        (k)  "Registered  Nurse"  or   "Registered   Professional
26    Nurse" means a person who is licensed as a professional nurse
27    under  this Act and practices nursing as defined in paragraph
28    (l) of this Section.  Only a registered nurse licensed  under
29    this Act is entitled to use the titles "registered nurse" and
30    "registered professional nurse" and the abbreviation, "R.N.".
31        (l)  "Registered  professional nursing practice" includes
32    all nursing specialities and means  the  performance  of  any
33    nursing  act based upon professional knowledge, judgment, and
34    skills  acquired  by  means  of  completion  of  an  approved
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 1    registered  professional  nursing   education   program.    A
 2    registered   professional   nurse   provides   nursing   care
 3    emphasizing   the   importance   of   the   whole   and   the
 4    interdependence  of  its parts through the nursing process to
 5    individuals, groups, families, or communities, that  includes
 6    but  is  not  limited  to:  (1)  the assessment of healthcare
 7    needs,  nursing  diagnosis,  planning,  implementation,   and
 8    nursing  evaluation;  (2)  the  promotion,  maintenance,  and
 9    restoration  of  health;  (3)  counseling, patient education,
10    health   education,   and   patient   advocacy;    (4)    the
11    administration of medications and treatments as prescribed by
12    a  physician  licensed  to  practice  medicine  in all of its
13    branches, a licensed dentist, a  licensed  podiatrist,  or  a
14    licensed   optometrist   or  as  prescribed  by  a  physician
15    assistant in  accordance  with  written  guidelines  required
16    under  the  Physician Assistant Practice Act of 1987 or by an
17    advanced  practice  nurse  in  accordance  with   a   written
18    collaborative   agreement  required  under  the  Nursing  and
19    Advanced Practice  Nursing  Act;  (5)  the  coordination  and
20    management of the nursing plan of care; (6) the delegation to
21    and  supervision  of  individuals  who  assist the registered
22    professional nurse implementing the plan  of  care;  and  (7)
23    teaching   and  supervision  of  nursing  students.  in   The
24    foregoing shall not  be  deemed  to  include  those  acts  of
25    medical   diagnosis   or   prescription   of  therapeutic  or
26    corrective measures  that  are  properly  performed  only  by
27    physicians licensed in the State of Illinois.
28        (m)  "Current  nursing  practice  update  course" means a
29    planned  nursing  education  curriculum   approved   by   the
30    Department  consisting  of  activities  that have educational
31    objectives, instructional methods, content or subject matter,
32    clinical practice, and evaluation methods, related  to  basic
33    review  and  updating  content  and  specifically planned for
34    those nurses previously licensed in the United States or  its
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 1    territories and preparing for reentry into nursing practice.
 2        (n)  "Professional assistance program for nurses" means a
 3    professional   assistance   program   that   meets   criteria
 4    established by the Board of Committee on Nursing and approved
 5    by  the Director, which provides a non-disciplinary treatment
 6    approach for nurses licensed under this Act whose ability  to
 7    practice  is  compromised  by  alcohol  or chemical substance
 8    addiction.
 9    (Source: P.A. 90-61,  eff.  12-30-97;  90-248,  eff.  1-1-98;
10    revised 8-12-97.)
11        (225 ILCS 65/5-15, formerly 65/4)
12        Sec.  5-15.  4.  Policy;  application  of  Act.  For  the
13    protection  of  life  and  the  promotion  of health, and the
14    prevention of illness and communicable diseases,  any  person
15    practicing or offering to practice professional and practical
16    nursing  in  Illinois shall submit evidence that he or she is
17    qualified to practice, and  shall  be  licensed  as  provided
18    under  this  Act.   No  person  shall  practice  or  offer to
19    practice professional or practical nursing in Illinois or use
20    any title, sign, card or  device  to  indicate  that  such  a
21    person is practicing professional or practical nursing unless
22    such  person  has  been licensed under the provisions of this
23    Act.
24        This Act does not prohibit the following:
25        (a)  The practice of nursing in Federal employment in the
26    discharge of  the  employee's  duties  by  a  person  who  is
27    employed  by  the  United  States  government  or any bureau,
28    division or agency thereof and is  a  legally  qualified  and
29    licensed  nurse  of  another  state  or  territory and not in
30    conflict with Sections 10-5, 10-30, and 10-45 6, 12,  and  25
31    of this Act.;
32        (b)  Nursing  that  is included in their program of study
33    by students enrolled in programs of  nursing  or  in  current
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 1    nurse practice update courses approved by the Department.;
 2        (c)  The   furnishing   of   nursing   assistance  in  an
 3    emergency.;
 4        (d)  The practice of nursing by  a  nurse  who  holds  an
 5    active  license  in  another state when providing services to
 6    patients in  Illinois  during  a  bonafide  emergency  or  in
 7    immediate preparation for or during interstate transit.;
 8        (e)  The  incidental  care  of the sick by members of the
 9    family, domestic servants or housekeepers,  or  care  of  the
10    sick where treatment is by prayer or spiritual means.;
11        (f)  Persons   from  being  employed  as  nursing  aides,
12    attendants, orderlies, and other auxiliary workers in private
13    homes, long term care  facilities,  nurseries,  hospitals  or
14    other institutions.;
15        (g)  The  practice  of  practical  nursing by one who has
16    applied in writing to the Department in  form  and  substance
17    satisfactory  to  the Department, for a license as a licensed
18    practical nurse and who has complied with all the  provisions
19    under  Section 10-30 12, except the passing of an examination
20    to be eligible to receive such license, until:  the  decision
21    of  the  Department that the applicant has failed to pass the
22    next available examination authorized by the  Department,  or
23    has  failed,  without  an  approved  excuse, to take the next
24    available examination authorized by the Department, or  until
25    the  withdrawal  of  the  application,  but  not  to exceed 3
26    months.  No applicant  for  licensure  practicing  under  the
27    provisions of this paragraph shall practice practical nursing
28    except   under   the   direct  supervision  of  a  registered
29    professional nurse licensed under  this  Act  or  a  licensed
30    physician,  dentist  or podiatrist.  In no instance shall any
31    such applicant practice or be  employed  in  any  supervisory
32    capacity.;
33        (h)  The  practice  of  practical nursing by one who is a
34    licensed practical nurse  under  the  laws  of  another  U.S.
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 1    jurisdiction and has applied in writing to the Department, in
 2    form  and  substance  satisfactory  to  the Department, for a
 3    license as a licensed practical nurse and who is qualified to
 4    receive such license under Section 10-30 12, until:  (1)  the
 5    expiration  of  6  months  after  the  filing of such written
 6    application, or (2) the withdrawal of  such  application,  or
 7    (3) the denial of such application by the Department.;
 8        (i)  The  practice of professional nursing by one who has
 9    applied in writing to the Department in  form  and  substance
10    satisfactory  to the Department for a license as a registered
11    professional nurse and has complied with all  the  provisions
12    under  Section  10-30 12 except the passing of an examination
13    to be eligible to receive such license, until:  the  decision
14    of  the  Department that the applicant has failed to pass the
15    next available examination authorized by the  Department,  or
16    has  failed,  without  an  approved  excuse, to take the next
17    available examination authorized by the Department  or  until
18    the  withdrawal  of  the  application,  but  not  to exceed 3
19    months. No  applicant  for  licensure  practicing  under  the
20    provisions  of  this  paragraph  shall  practice professional
21    nursing except under the direct supervision of  a  registered
22    professional  nurse  licensed under this Act.  In no instance
23    shall any such applicant  practice  or  be  employed  in  any
24    supervisory capacity.;
25        (j)  The practice of professional nursing by one who is a
26    registered  professional  nurse  under  the  laws  of another
27    state, territory of the United  States  or  country  and  has
28    applied  in  writing to the Department, in form and substance
29    satisfactory to the Department, for a license as a registered
30    professional nurse and  who  is  qualified  to  receive  such
31    license  under  Section 10-30 12, until:  (1)  the expiration
32    of 6 months after the filing of such written application,  or
33    (2)  the withdrawal of such application, or (3) the denial of
34    such application by the Department.;
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 1        (k)  The  practice  of  professional  nursing   that   is
 2    included  in  a  program  of study by one who is a registered
 3    professional  nurse  under  the  laws  of  another  state  or
 4    territory of the United States or foreign country,  territory
 5    or  province  and  who  is  enrolled  in  a  graduate nursing
 6    education program or  a  program  for  the  completion  of  a
 7    baccalaureate  nursing  degree  in  this State, which program
 8    includes clinical supervision by faculty as determined by the
 9    educational institution offering the program and  the  health
10    care  organization where the practice of nursing occurs.  The
11    educational institution will file with  the  Department  each
12    academic  term  a  list of the names and origin of license of
13    all professional nurses practicing nursing as part  of  their
14    programs under this provision.; or
15        (l)  Any  person  licensed  in this State under any other
16    Act from engaging in the practice for  which  she  or  he  is
17    licensed.
18        An  applicant for license practicing under the exceptions
19    set forth in subparagraphs (g), (h), (i),  and  (j)  of  this
20    Section  shall  use  the title R.N. Lic. Pend. or L.P.N. Lic.
21    Pend. respectively and no other.
22    (Source: P.A. 90-61,  eff.  12-30-97;  90-248,  eff.  1-1-98;
23    revised 8-12-97.)
24        (225 ILCS 65/5-17, formerly 65/4.1)
25        Sec.  5-17. 4.1.  Task Force.  The Governor shall appoint
26    a task force to be convened by  the  Illinois  Department  of
27    Professional Regulation to study the roles, responsibilities,
28    training,  competency,  and  supervision  of  persons who are
29    employed  to  assist  a  nurse,  including   nursing   aides,
30    attendants, orderlies, and other auxiliary workers in private
31    homes,  long  term care facilities, nurseries, hospitals, and
32    other institutions.  The purpose of the task force  shall  be
33    to  determine  if  there  is  a  need  for regulation of such
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 1    persons by the Department.
 2        The task force shall be comprised  of  11  members.   The
 3    task   force   shall  include  one  representative  from  the
 4    Department of  Professional  Regulation,  one  representative
 5    from   the   Department  of  Public  Health,  and  9  persons
 6    representing  various  nursing  and  health   care   provider
 7    organizations  in  Illinois, including, but not limited to, a
 8    representative from the Illinois Nurses Association, Illinois
 9    Organization of Nurse Leaders, Illinois Hospital  and  Health
10    Systems   Association,   Illinois  Health  Care  Association,
11    Illinois Coalition of Nursing  Organizations,  Life  Services
12    Network,  Licensed Practical Nursing Association of Illinois,
13    Certified  Nurse  Aide  Educators,  and   Illinois   Homecare
14    Council.
15        The   task   force   shall   report   its   findings  and
16    recommendations to the Governor by January 1, 1999.
17    (Source: P.A. 90-248, eff. 1-1-98.)
18        (225 ILCS 65/5-22, formerly 65/4.2)
19        Sec.  5-22.  4.2.  Social  Security  Number  on   license
20    application.   In addition  to any other information required
21    to be contained in the application, every  application for an
22    original, renewal, or restored license under this  Act  shall
23    include the applicant's Social Security Number.
24    (Source: P.A. 90-144, eff. 7-23-97.)
25        (225 ILCS 65/5-20, formerly 65/4.5)
26        Sec.  5-20.  4.5.  Unlicensed  practice; violation; civil
27    penalty.
28        (a)  Any  person  who  practices,  offers  to   practice,
29    attempts  to  practice,  or  holds  oneself  out  to practice
30    nursing without being  licensed  under  this  Act  shall,  in
31    addition  to  any  other penalty provided by law, pay a civil
32    penalty to the Department in an amount not to  exceed  $5,000
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 1    for  each  offense as determined by the Department. The civil
 2    penalty shall be assessed by the Department after  a  hearing
 3    is  held  in accordance with the provisions set forth in this
 4    Act regarding the provision of a hearing for  the  discipline
 5    of a licensee.
 6        (b)  The  Department  has  the  authority  and  power  to
 7    investigate any and all unlicensed activity.
 8        (c)  The civil penalty shall be paid within 60 days after
 9    the  effective  date of the order imposing the civil penalty.
10    The order shall constitute a judgment and may  be  filed  and
11    execution had thereon in the same manner as any judgment from
12    any court of record.
13    (Source: P.A. 89-474, eff. 6-18-96.)
14        (225 ILCS 65/5-25, formerly 65/5)
15        Sec.   5-25.   5.    Emergency   care;  civil  liability.
16    Exemption from civil  liability  for  emergency  care  is  as
17    provided in the Good Samaritan Act.
18    (Source: P.A. 89-607, eff. 1-1-97.)
19        (225 ILCS 65/5-30, formerly 65/5.1)
20        Sec.  5-30. 5.1.  Services rendered without compensation;
21    civil liability.  Exemption from civil liability for services
22    rendered without compensation is  as  provided  in  the  Good
23    Samaritan Act.
24    (Source: P.A. 89-607, eff. 1-1-97.)
25        (225 ILCS 65/Title 10 heading new)
26                    TITLE 10.  REGISTERED NURSES
27                    AND LICENSED PRACTICAL NURSES
28        (225 ILCS 65/10-5, formerly 65/6)
29        Sec. 10-5. Prohibited acts. 6.  No person shall:
30        (a)  Practice   professional   nursing  without  a  valid
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 1    license as a registered professional nurse except as provided
 2    in paragraphs (i) and (j) of Section 5-15 4 of this Act;
 3        (b)  Practice practical nursing without a  valid  license
 4    as  a licensed practical nurse; or practice practical nursing
 5    other than under  the  direction  of  a  licensed  physician,
 6    licensed dentist, or registered professional nurse; except as
 7    provided in paragraphs (g), (h), and (j) of Section 5-15 4 of
 8    this Act;
 9        (c)  Practice   nursing   under  cover  of  any  diploma,
10    license, or record  illegally  or  fraudulently  obtained  or
11    signed    or    issued   unlawfully   or   under   fraudulent
12    representation;
13        (d)  Practice nursing during the time her or his  license
14    is suspended, revoked, expired or on inactive status;
15        (e)  Use  any  words,  abbreviations,  figures,  letters,
16    title,  sign, card, or device tending to imply that she or he
17    is a registered professional nurse, including the  titles  or
18    initials,    "Registered    Nurse,"   "Professional   Nurse,"
19    "Registered Professional Nurse," "Certified Nurse,"  "Trained
20    Nurse,"  "Graduate  Nurse," "P.N.," or "R.N.," or "R.P.N." or
21    similar titles  or  initials  with  intention  of  indicating
22    practice without a valid license as a registered professional
23    nurse;
24        (f)  Use   any  words,  abbreviations  figures,  letters,
25    title, sign, card, or device tending to imply that she or  he
26    is  a  licensed  practical  nurse  including  the  titles  or
27    initials   "Practical  Nurse,"  "Licensed  Practical  Nurse,"
28    "P.N.," or "L.P.N.,"  or  similar  titles  or  initials  with
29    intention of indicated practice as a licensed practical nurse
30    without  a  valid license as a licensed practical nurse under
31    this Act;
32        (g)  Obtain or furnish a license by or for money  or  any
33    other  thing of value other than the fees required by Section
34    20-35 23, or by any fraudulent representation or act;
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 1        (h)  Make any wilfully false oath or affirmation required
 2    by this Act;
 3        (i)  Conduct  a  nursing  education   program   preparing
 4    persons  for  licensure  that  has  not  been approved by the
 5    Department;
 6        (j)  Represent that any school or course is  approved  or
 7    accredited  as  a  school  or  course  for  the  education of
 8    registered professional nurses or licensed  practical  nurses
 9    unless  such  school  or course is approved by the Department
10    under the provisions of this Act;
11        (k)  Attempt or offer to do any of the acts enumerated in
12    this Section, or  knowingly aid, abet, assist in the doing of
13    any such acts or in the attempt or offer to do  any  of  such
14    acts;
15        (l)  Seek  employment  as a registered professional nurse
16    under the terms of paragraphs (i) and (j) of Section  5-15  4
17    of  this Act without possessing a written authorization which
18    has been issued  by  the  Department  or  designated  testing
19    service  and  which  evidences  the  filing  of  the  written
20    application  referred  to in paragraphs paragraph (i) and (j)
21    of Section 5-15 4 of this Act;
22        (m)  Seek employment as a licensed practical nurse  under
23    the terms of paragraphs (g) and (h) of Section 5-15 4 of this
24    Act without possessing a written authorization which has been
25    issued  by  the  Department or designated testing service and
26    which  evidences  the  filing  of  the  written   application
27    referred  to  in  paragraphs paragraph (g) and (h) of Section
28    5-15 4 of this Act;
29        (n)  Employ or utilize persons not  licensed  under  this
30    Act  to  practice  professional nursing or practical nursing;
31    and
32        (o)  Otherwise intentionally  violate  any  provision  of
33    this Act.
34        Any  person, including a firm, association or corporation
SB1585 Engrossed            -27-               LRB9011272NTsb
 1    who violates any provision of this Section shall be guilty of
 2    a Class A misdemeanor.
 3    (Source: P.A. 85-981.)
 4        (225 ILCS 65/10-10 new)
 5        Sec. 10-10. Department powers and duties.
 6        (a)  The Department shall exercise the powers and  duties
 7    prescribed  by  the Civil Administrative Code of Illinois for
 8    administration of licensing acts  and  shall  exercise  other
 9    powers  and  duties necessary for effectuating the purpose of
10    this Act.  None of the functions, powers, or  duties  of  the
11    Department with respect to licensure and examination shall be
12    exercised  by the Department except upon review by the Board.
13    The Department shall adopt rules to implement, interpret,  or
14    make  specific  the  provisions  and  purposes  of  this Act;
15    however no such rules shall  be  adopted  by  the  Department
16    except upon review by the Board.
17        (b)  The Department shall:
18             (1)  prepare   and   maintain  a  list  of  approved
19        programs of professional nursing education  and  programs
20        of  practical  nursing  education  in  this  State, whose
21        graduates,   if   they   have   the    other    necessary
22        qualifications provided in this Act, shall be eligible to
23        apply for a license to practice nursing in this State;
24             (2)  promulgate  rules  defining what constitutes an
25        approved program of professional  nursing  education  and
26        what constitutes an approved program of practical nursing
27        education; and
28             (3)  adopt  rules  for examination of candidates for
29        licenses  and  for  issuance  of   licenses   authorizing
30        candidates  upon passing an examination to practice under
31        this Act.
32        (225 ILCS 65/10-15 new)
SB1585 Engrossed            -28-               LRB9011272NTsb
 1        Sec. 10-15.  Nursing  Act  Coordinator.   The  Department
 2    shall  obtain,  pursuant to the Personnel Code, a Nursing Act
 3    Coordinator and assistants.    The  Nursing  Coordinator  and
 4    assistants  shall  be  professional  nurses  licensed in this
 5    State and graduated from approved schools of nursing and each
 6    shall have been actively engaged  in  nursing  education  not
 7    less  than  one  year  prior to appointment.  The Nursing Act
 8    Coordinator shall hold at least a master's degree in  nursing
 9    from  an  approved  college  or  university and shall have at
10    least 5 years experience since  graduation  in  progressively
11    responsible  positions  in nursing education.  Each assistant
12    shall hold at least a master's  degree  in  nursing  from  an
13    approved  college  or  university  and  shall have at least 3
14    years   experience   since   graduation   in    progressively
15    responsible  positions in nursing education.  The Nursing Act
16    Coordinator and assistants shall perform such  administrative
17    functions as may be delegated to them by the Director.
18        (225 ILCS 65/10-25, formerly 65/7)
19        Sec. 10-25. 7. Board.
20        (a)  The  Director  shall  appoint  the  Board of Nursing
21    which shall be composed of 9 registered professional  nurses,
22    2  licensed  practical nurses and one public member who shall
23    also be a voting member and who is not a licensed health care
24    provider.  Two  registered  nurses  shall  hold  at  least  a
25    master's degree in nursing and be educators  in  professional
26    nursing  programs,  one  representing  baccalaureate  nursing
27    education,   one   representing   associate   degree  nursing
28    education;  one  registered  nurse  shall  hold  at  least  a
29    bachelor's degree with a major in nursing and be an  educator
30    in a licensed practical nursing program; one registered nurse
31    shall  hold a master's degree in nursing  and shall represent
32    nursing service administration;  2  registered  nurses  shall
33    represent  clinical  nursing practice, one of whom shall have
SB1585 Engrossed            -29-               LRB9011272NTsb
 1    at least a master's  degree  in  nursing;  and  2  registered
 2    nurses  shall  represent advanced specialty practice. Each of
 3    the 11 nurses shall have had a minimum of 5 years  experience
 4    in nursing, 3 of which shall be in the area they represent on
 5    the Board and be actively engaged in the area of nursing they
 6    represent  at the time of appointment and during their tenure
 7    on the Board.  Members shall be appointed for  a  term  of  3
 8    years.   No  member shall be eligible for appointment to more
 9    than 2 consecutive  terms  and  any  appointment  to  fill  a
10    vacancy  shall  be for the unexpired portion of the term.  In
11    making  Board   appointments,   the   Director   shall   give
12    consideration   to   recommendations   submitted  by  nursing
13    organizations.    Consideration  shall  be  given  to   equal
14    geographic  representation.   The  Board shall receive actual
15    and necessary expenses incurred in the performance  of  their
16    duties.
17        In  making  the  initial appointments, the Director shall
18    appoint all new members for terms of 2, 3, and  4  years  and
19    such  terms  shall  be  staggered  as  follows:   3  shall be
20    appointed for terms of 2 years;  3  shall  be  appointed  for
21    terms  of  3  years;  and 3 shall be appointed for terms of 4
22    years.
23        The Director may remove  any  member  of  the  Board  for
24    misconduct,  incapacity,  or  neglect  of duty.  The Director
25    shall reduce to writing any causes for removal.
26        The Board shall meet annually to elect a chairperson  and
27    vice  chairperson.   The  Board  may hold such other meetings
28    during the year as may be necessary to conduct its  business.
29    Six  voting members of the Board shall constitute a quorum at
30    any meeting.  Any action taken by the Board must  be  on  the
31    affirmative  vote of 6 members.  Voting by proxy shall not be
32    permitted.
33        The Board shall submit an annual report to the Director.
34        The members of the Board shall be immune from suit in any
SB1585 Engrossed            -30-               LRB9011272NTsb
 1    action based upon any disciplinary proceedings or other  acts
 2    performed in good faith as members of the Board.
 3        (b)  The Board is authorized to:
 4             (1)  recommend  the adoption and, from time to time,
 5        the revision of such rules that may be necessary to carry
 6        out the provisions of this Act;
 7             (2)  conduct hearings and  disciplinary  conferences
 8        upon  charges  calling  for  discipline  of a licensee as
 9        provided in Section 10-45 25;
10             (3)  report to the Department, upon completion of  a
11        hearing, the disciplinary actions recommended to be taken
12        against persons violating this Act;
13             (4)  recommend  the  approval,  denial  of approval,
14        withdrawal  of  approval,  or   discipline   of   nursing
15        education programs;
16             (5)  participate in a national organization of state
17        boards of nursing; and
18             (6)  recommend  a  list  of the registered nurses to
19        serve as Nursing Act Coordinator  and  Assistant  Nursing
20        Act Coordinator, respectively.
21    (Source: P.A. 90-61, eff. 12-30-97.)
22        (225 ILCS 65/10-30, formerly 65/12)
23        Sec. 10-30. 12. Qualifications for licensure.
24        (a)  Each    applicant   who   successfully   meets   the
25    requirements of this Section shall be entitled  to  licensure
26    as  a Registered Nurse or Licensed Practical Nurse, whichever
27    is applicable.
28        (b)  An  applicant  for  licensure  by   examination   to
29    practice  as  a  registered nurse or licensed practical nurse
30    shall:
31             (1)  submit  a  completed  written  application,  on
32        forms provided by the Department and fees as  established
33        by the Department;
SB1585 Engrossed            -31-               LRB9011272NTsb
 1             (2)  for  registered nurse licensure, have completed
 2        an approved professional nursing education program of not
 3        less than 2 academic years and have  graduated  from  the
 4        program;  for  licensed  practical  nurse licensure, have
 5        completed an approved practical nursing education program
 6        of not less than one academic  year  and  have  graduated
 7        from the program;
 8             (3)  have  not  violated  the  provisions of Section
 9        10-45 25 of this  Act.   The  Department  may  take  into
10        consideration any felony conviction of the applicant, but
11        such a conviction shall not operate as an absolute bar to
12        licensure;
13             (4)  meet  all  other requirements as established by
14        rule;
15             (5)  pay, either to the Department or its designated
16        testing service, a fee covering the cost of providing the
17        examination. Failure to appear for the examination on the
18        scheduled date at the time and place specified after  the
19        applicant's application for examination has been received
20        and  acknowledged  by  the  Department  or the designated
21        testing service shall result in  the  forfeiture  of  the
22        examination fee.
23        If  an  applicant  neglects, fails, or refuses to take an
24    examination or fails to pass an  examination  for  a  license
25    under  this  Act within 3 years after filing the application,
26    the application shall be denied.  However, the applicant  may
27    make  a  new  application accompanied by the required fee and
28    provide evidence of meeting the requirements in force at  the
29    time of the new application.
30        An  applicant  shall  have  one  year  from  the  date of
31    notification of successful completion of the  examination  to
32    apply to the Department for a license.  If an applicant fails
33    to  apply within one year, the applicant shall be required to
34    again take  and  pass  the  examination  unless  licensed  in
SB1585 Engrossed            -32-               LRB9011272NTsb
 1    another  jurisdiction  of the United States within 2 years of
 2    passing the examination.
 3        (c)  An applicant  for  licensure  who  is  a  registered
 4    professional  nurse or a licensed practical nurse licensed by
 5    examination under the laws of another state or  territory  of
 6    the United States shall:
 7             (1)  submit  a  completed  written  application,  on
 8        forms supplied by the Department, and fees as established
 9        by the Department;
10             (2)  for  registered nurse licensure, have completed
11        an approved professional nursing education program of not
12        less than 2 academic years and have  graduated  from  the
13        program;  for  licensed  practical  nurse licensure, have
14        completed an approved practical nursing education program
15        of not less than one academic  year  and  have  graduated
16        from the program;
17             (3)  submit   verification   of   licensure   status
18        directly   from   the   United   States  jurisdiction  of
19        licensure;
20             (4)  have passed the examination authorized  by  the
21        Department;
22             (5)  meet  all  other requirements as established by
23        rule.
24        (d)  All  applicants  for  licensure  pursuant  to   this
25    Section  who are graduates of nursing educational programs in
26    a country other than the United  States  or  its  territories
27    must  submit  to  the  Department certification of successful
28    completion of the Commission of Graduates of Foreign  Nursing
29    Schools  (CGFNS)  examination. An applicant, who is unable to
30    provide appropriate documentation to satisfy CGFNS of her  or
31    his  educational  qualifications  for  the CGFNS examination,
32    shall be required to pass an examination to  test  competency
33    in  the  English  language  which  shall be prescribed by the
34    Department, if the applicant is determined by the Board to be
SB1585 Engrossed            -33-               LRB9011272NTsb
 1    educationally prepared in  nursing.   The  Board  shall  make
 2    appropriate   inquiry   into  the  reasons  for  any  adverse
 3    determination by CGFNS before making its own decision.
 4        An applicant licensed in another state or  territory  who
 5    is  applying  for  licensure  and  has  received  her  or his
 6    education in a country other than the United  States  or  its
 7    territories  shall  be  exempt  from  the  completion  of the
 8    Commission of Graduates of Foreign  Nursing  Schools  (CGFNS)
 9    examination  if  the  applicant  meets  all  of the following
10    requirements:
11             (1)  successful passage of the licensure examination
12        authorized by the Department;
13             (2)  holds  an  active,  unencumbered   license   in
14        another state; and
15             (3)  has been actively practicing for a minimum of 2
16        years in another state.
17        (e)  No   applicant  shall  be  issued  a  license  as  a
18    registered nurse or practical nurse under this Section unless
19    he or she  has  passed  the  examination  authorized  by  the
20    Department  within  3 years of completion and graduation from
21    an approved nursing education program, unless such  applicant
22    submits    proof    of    successful    completion    of    a
23    Department-authorized  remedial  nursing education program or
24    recompletion of an approved  registered  nursing  program  or
25    licensed practical nursing program, as appropriate.
26        (f)  Pending  the  issuance of a license under subsection
27    (b) of this Section, the Department may grant an applicant  a
28    temporary  license  to practice nursing as a registered nurse
29    or as  a  licensed  practical  nurse  if  the  Department  is
30    satisfied  that  the  applicant holds an active, unencumbered
31    license in good standing in  another  jurisdiction.   If  the
32    applicant  holds more than one current active license, or one
33    or more active temporary licenses from  other  jurisdictions,
34    the  Department  shall not issue a temporary license until it
SB1585 Engrossed            -34-               LRB9011272NTsb
 1    is satisfied that each current active  license  held  by  the
 2    applicant  is  unencumbered.   The  temporary  license, which
 3    shall be issued no  later  than  14  working  days  following
 4    receipt by the Department of an application for the temporary
 5    license,   shall  be  granted  upon  the  submission  of  the
 6    following to the Department:
 7             (1)  a  signed   and   completed   application   for
 8        licensure  under  subsection  (a)  of  this  Section as a
 9        registered nurse or a licensed practical nurse;
10             (2)  proof of a current, active license in at  least
11        one other jurisdiction and proof that each current active
12        license  or  temporary  license  held by the applicant is
13        unencumbered;
14             (3)  a  signed  and  completed  application  for   a
15        temporary license; and
16             (4)  the required permit fee.
17        (g)  The  Department  may  refuse to issue an applicant a
18    temporary license authorized pursuant  to  this  Section  if,
19    within   14   working   days  following  its  receipt  of  an
20    application  for  a   temporary   license,   the   Department
21    determines that:
22             (1)  the  applicant  has  been  convicted of a crime
23        under the laws of a jurisdiction of  the  United  States:
24        (i)  which  is  a  felony; or (ii) which is a misdemeanor
25        directly related  to  the  practice  of  the  profession,
26        within the last 5 years;
27             (2)  within the last 5 years the applicant has had a
28        license  or  permit  related  to  the practice of nursing
29        revoked, suspended, or placed  on  probation  by  another
30        jurisdiction,   if  at  least  one  of  the  grounds  for
31        revoking, suspending, or placing on probation is the same
32        or substantially equivalent to grounds in Illinois; or
33             (3)  it intends to deny licensure by endorsement.
34        For purposes of this Section, an  "unencumbered  license"
SB1585 Engrossed            -35-               LRB9011272NTsb
 1    means a license against which no disciplinary action has been
 2    taken  or  is  pending and for which all fees and charges are
 3    paid and current.
 4        (h)  The Department may revoke a temporary license issued
 5    pursuant to this Section if:
 6             (1)  it  determines  that  the  applicant  has  been
 7        convicted of a crime under the law of any jurisdiction of
 8        the United  States  that  is  (i)  a  felony  or  (ii)  a
 9        misdemeanor  directly  related  to  the  practice  of the
10        profession, within the last 5 years;
11             (2)  it determines that within the last 5 years  the
12        applicant  has  had  a  license  or permit related to the
13        practice of nursing  revoked,  suspended,  or  placed  on
14        probation by another jurisdiction, if at least one of the
15        grounds for revoking, suspending, or placing on probation
16        is  the  same  or  substantially equivalent to grounds in
17        Illinois; or
18             (3)  it determines that it intends to deny licensure
19        by endorsement.
20        A temporary license or renewed  temporary  license  shall
21    expire  (i) upon issuance of an Illinois license or (ii) upon
22    notification that the Department intends to deny licensure by
23    endorsement.  A temporary license shall expire 6 months  from
24    the  date of issuance.  Further renewal may be granted by the
25    Department in hardship cases, as defined by rule.  However, a
26    temporary license shall automatically expire upon issuance of
27    the Illinois license or upon notification that the Department
28    intends  to  deny  licensure,  whichever  occurs  first.   No
29    extensions shall be granted beyond the 6-month period  unless
30    approved  by  the  Director.   Notification by the Department
31    under this Section shall be by certified or registered mail.
32    (Source: P.A. 90-61, eff. 12-30-97.)
33        (225 ILCS 65/10-35, formerly 65/14)
SB1585 Engrossed            -36-               LRB9011272NTsb
 1        Sec. 10-35. 14.  Concurrent theory and clinical  practice
 2    education requirements.  Except for those applicants who have
 3    received   advanced  graduate  degrees  in  nursing  from  an
 4    approved  program  with  concurrent   theory   and   clinical
 5    practice,  the  educational  requirements of Section 10-30 12
 6    relating to  registered  professional  nursing  and  licensed
 7    practical  nursing shall not be deemed to have been satisfied
 8    by the completion of any correspondence course or any program
 9    of nursing that does not require  coordinated  or  concurrent
10    theory and clinical practice.
11    (Source: P.A. 90-61, eff. 12-30-97.)
12        (225 ILCS 65/10-40 new)
13        Sec.  10-40.   Endorsement.  Upon payment of the required
14    fee, an applicant who is a registered professional nurse or a
15    licensed practical nurse educated and licensed under the laws
16    of a foreign country, territory or province shall  write  and
17    pass  an examination conducted by the Department to determine
18    her or his fitness for licensure as a registered professional
19    nurse or a licensed practical nurse:
20        (a)  whenever the requirements of such country, territory
21    or province were at the date of license  substantially  equal
22    to  the  requirements  then  in force in this State; and with
23    respect to practical nursing, if prior to  the  enactment  of
24    this Act, substantially equal to the requirements of this Act
25    at the time of its enactment; or
26        (b)  whenever   such  requirements  of  another  country,
27    territory  or  province   together   with   educational   and
28    professional  qualifications, as distinguished from practical
29    experience, of the applicant since obtaining a license  as  a
30    registered  professional  nurse or a licensed practical nurse
31    in such country,  territory  or  province  are  substantially
32    equal to the requirements in force in Illinois at the time of
33    application for licensure as a registered nurse or a licensed
SB1585 Engrossed            -37-               LRB9011272NTsb
 1    practical nurse in Illinois.
 2        The  examination  shall  be  the same as that required of
 3    other applicants for licensure by examination.
 4        Applicants have 3 years from the date of  application  to
 5    complete  the  application  process.   If the process has not
 6    been completed in 3 years, the application shall  be  denied,
 7    the fee forfeited and the applicant must reapply and meet the
 8    requirements in effect at the time of reapplication.
 9        (225 ILCS 65/10-45 new)
10        Sec. 10-45.  Grounds for disciplinary action.
11        (a)  The  Department  may,  upon  recommendation  of  the
12    Board,  refuse  to issue or to renew, or may revoke, suspend,
13    place on probation, reprimand,  or  take  other  disciplinary
14    action  as the Department may deem appropriate with regard to
15    a license for any one or combination of the causes set  forth
16    in  subsection  (b) below.  Fines up to $2,500 may be imposed
17    in conjunction with other forms of  disciplinary  action  for
18    those  violations  that  result  in  monetary  gain  for  the
19    licensee. Fines shall not be the exclusive disposition of any
20    disciplinary action arising out of conduct resulting in death
21    or  injury  to  a  patient.   Fines  shall not be assessed in
22    disciplinary actions involving mental or physical illness  or
23    impairment.   All fines collected under this Section shall be
24    deposited in the Nursing Dedicated and Professional Fund.
25        (b)  Grounds  for   disciplinary   action   include   the
26    following:
27             (1)  Material deception in furnishing information to
28        the Department.
29             (2)  Material  violations  of  any provision of this
30        Act or violation of the rules of or final  administrative
31        action  of  the  Director,  after  consideration  of  the
32        recommendation of the Board.
33             (3)  Conviction  of  any crime under the laws of any
SB1585 Engrossed            -38-               LRB9011272NTsb
 1        jurisdiction of the United States: (i) which is a felony;
 2        or (ii) which is a misdemeanor, an essential  element  of
 3        which  is  dishonesty,  or  (iii)  of  any crime which is
 4        directly related to the practice of the profession.
 5             (4)  A pattern of practice or other  behavior  which
 6        demonstrates incapacity or incompetency to practice under
 7        this Act.
 8             (5)  Knowingly aiding or assisting another person in
 9        violating any provision of this Act or rules.
10             (6)  Failing,  within 90 days, to provide a response
11        to a request for information in  response  to  a  written
12        request made by the Department by certified mail.
13             (7)  Engaging    in   dishonorable,   unethical   or
14        unprofessional conduct of a character likely to  deceive,
15        defraud or harm the public, as defined by rule.
16             (8)  Unlawful  sale  or  distribution  of  any drug,
17        narcotic, or prescription device, or unlawful  conversion
18        of any drug, narcotic or prescription device.
19             (9)  Habitual  or  excessive  use  or  addiction  to
20        alcohol,  narcotics,  stimulants,  or  any other chemical
21        agent or drug which results in a licensee's inability  to
22        practice with reasonable judgment, skill or safety.
23             (10)  Discipline  by  another  U.S.  jurisdiction or
24        foreign nation, if at least one of the  grounds  for  the
25        discipline  is  the  same  or substantially equivalent to
26        those set forth in this Section.
27             (11)  A finding that the licensee, after having  her
28        or   his  license  placed  on  probationary  status,  has
29        violated the terms of probation.
30             (12)  Being named as a perpetrator in  an  indicated
31        report  by the Department of Children and Family Services
32        and under the Abused and Neglected Child  Reporting  Act,
33        and  upon proof by clear and convincing evidence that the
34        licensee has caused a child to  be  an  abused  child  or
SB1585 Engrossed            -39-               LRB9011272NTsb
 1        neglected  child  as  defined in the Abused and Neglected
 2        Child Reporting Act.
 3             (13)  Willful  omission  to  file  or   record,   or
 4        willfully  impeding  the  filing or recording or inducing
 5        another person to omit to file or record medical  reports
 6        as  required  by  law  or  willfully failing to report an
 7        instance of suspected child abuse or neglect as  required
 8        by the Abused and Neglected Child Reporting Act.
 9             (14)  Gross negligence in the practice of nursing.
10             (15)  Holding  oneself  out to be practicing nursing
11        under any name other than one's own.
12             (16)  Fraud, deceit or misrepresentation in applying
13        for  or  procuring  a  license  under  this  Act  or   in
14        connection  with  applying for renewal of a license under
15        this Act.
16             (17)  Allowing another person or organization to use
17        the licensees' license to deceive the public.
18             (18)  Willfully making or filing  false  records  or
19        reports  in  the  licensee's  practice, including but not
20        limited to false records to support  claims  against  the
21        medical  assistance  program  of the Department of Public
22        Aid under the Illinois Public Aid Code.
23             (19)  Attempting to subvert  or  cheat  on  a  nurse
24        licensing examination administered under this Act.
25             (20)  Immoral  conduct  in the commission of an act,
26        such  as  sexual  abuse,  sexual  misconduct,  or  sexual
27        exploitation, related to the licensee's practice.
28             (21)  Willfully   or   negligently   violating   the
29        confidentiality  between  nurse  and  patient  except  as
30        required by law.
31             (22)  Practicing under  a  false  or  assumed  name,
32        except as provided by law.
33             (23)  The use of any false, fraudulent, or deceptive
34        statement  in  any document connected with the licensee's
SB1585 Engrossed            -40-               LRB9011272NTsb
 1        practice.
 2             (24)  Directly or indirectly giving to or  receiving
 3        from   a   person,  firm,  corporation,  partnership,  or
 4        association a fee, commission, rebate, or other  form  of
 5        compensation  for  professional  services not actually or
 6        personally rendered.
 7             (25)  Failure  of  a  licensee  to  report  to   the
 8        Department  any  adverse  final action taken against such
 9        licensee by another  licensing  jurisdiction  (any  other
10        jurisdiction of the United States or any foreign state or
11        country),  by  any  peer  review body, by any health care
12        institution, by any professional or  nursing  society  or
13        association,  by  any  governmental  agency,  by  any law
14        enforcement  agency,  or  by  any  court  or  a   nursing
15        liability  claim  related  to  acts or conduct similar to
16        acts or conduct that would constitute grounds for  action
17        as defined in this Section.
18             (26)  Failure   of  a  licensee  to  report  to  the
19        Department surrender by the  licensee  of  a  license  or
20        authorization  to  practice  nursing  in another state or
21        jurisdiction, or current surrender  by  the  licensee  of
22        membership  on  any  nursing  staff  or in any nursing or
23        professional   association   or   society   while   under
24        disciplinary investigation by any of those authorities or
25        bodies for acts or conduct similar  to  acts  or  conduct
26        that  would  constitute  grounds for action as defined by
27        this Section.
28             (27)  A  violation  of  the   Health   Care   Worker
29        Self-Referral Act.
30             (28)  Physical illness, including but not limited to
31        deterioration  through the aging process or loss of motor
32        skill, mental illness, or disability that results in  the
33        inability  to  practice  the  profession  with reasonable
34        judgment, skill, or safety.
SB1585 Engrossed            -41-               LRB9011272NTsb
 1        (c)  The determination by a circuit court that a licensee
 2    is subject to involuntary admission or judicial admission  as
 3    provided  in the Mental Health and Developmental Disabilities
 4    Code, as amended, operates as an  automatic  suspension.  The
 5    suspension  will  end only upon a finding by a court that the
 6    patient is no longer  subject  to  involuntary  admission  or
 7    judicial  admission  and  issues  an  order  so  finding  and
 8    discharging  the  patient; and upon the recommendation of the
 9    Board to the Director that the licensee be allowed to  resume
10    his or her practice.
11        (d)  The  Department  may  refuse to issue or may suspend
12    the license of any person who fails to file a return,  or  to
13    pay  the tax, penalty or interest shown in a filed return, or
14    to pay any final assessment of the tax, penalty, or  interest
15    as  required  by  any  tax  Act  administered by the Illinois
16    Department of Revenue, until such time as the requirements of
17    any such tax Act are satisfied.
18        (e)  In enforcing this Section, the Department  or  Board
19    upon  a  showing  of  a  possible  violation  may  compel  an
20    individual  licensed  to  practice under this Act, or who has
21    applied for licensure under this Act, to submit to  a  mental
22    or  physical  examination, or both, as required by and at the
23    expense of the Department. The Department or Board may  order
24    the  examining  physician to present testimony concerning the
25    mental or physical examination of the licensee or  applicant.
26    No  information shall be excluded by reason of any common law
27    or statutory privilege relating to communications between the
28    licensee  or  applicant  and  the  examining  physician.  The
29    examining physicians shall be specifically designated by  the
30    Board  or Department. The individual to be examined may have,
31    at his or her own expense, another physician of  his  or  her
32    choice  present  during  all  aspects  of  this  examination.
33    Failure  of  an  individual to submit to a mental or physical
34    examination, when directed, shall be grounds  for  suspension
SB1585 Engrossed            -42-               LRB9011272NTsb
 1    of  his  or  her  license until the individual submits to the
 2    examination  if  the  Department  finds,  after  notice   and
 3    hearing,  that  the  refusal to submit to the examination was
 4    without reasonable cause.
 5        If the Department or Board finds an individual unable  to
 6    practice  because  of  the reasons set forth in this Section,
 7    the Department or Board may require that individual to submit
 8    to care, counseling, or treatment by physicians  approved  or
 9    designated  by the Department or Board, as a condition, term,
10    or  restriction  for  continued,   reinstated,   or   renewed
11    licensure  to  practice;  or, in lieu of care, counseling, or
12    treatment,  the  Department  may  file,  or  the  Board   may
13    recommend   to   the  Department  to  file,  a  complaint  to
14    immediately suspend,  revoke,  or  otherwise  discipline  the
15    license  of  the  individual. An individual whose license was
16    granted,  continued,  reinstated,  renewed,  disciplined   or
17    supervised    subject   to   such   terms,   conditions,   or
18    restrictions, and  who  fails  to  comply  with  such  terms,
19    conditions,   or  restrictions,  shall  be  referred  to  the
20    Director for a determination as  to  whether  the  individual
21    shall  have his or her license suspended immediately, pending
22    a hearing by the Department.
23        In instances in which the Director immediately suspends a
24    person's license  under  this  Section,  a  hearing  on  that
25    person's license must be convened by the Department within 15
26    days  after  the suspension and completed without appreciable
27    delay. The Department and Board shall have the  authority  to
28    review  the  subject  individual's  record  of  treatment and
29    counseling regarding the impairment to the  extent  permitted
30    by  applicable  federal statutes and regulations safeguarding
31    the confidentiality of medical records.
32        An individual licensed under this Act and affected  under
33    this  Section shall be afforded an opportunity to demonstrate
34    to the Department or Board that he or she can resume practice
SB1585 Engrossed            -43-               LRB9011272NTsb
 1    in compliance with acceptable and prevailing standards  under
 2    the provisions of his or her license.
 3        (225 ILCS 65/10-50 new)
 4        Sec. 10-50.  Intoxication and drug abuse.
 5        (a)  A  professional  assistance program for nurses shall
 6    be established by January 1, 1999.
 7        (b)  The Director shall appoint a task force to advise in
 8    the creation of the assistance program.  The task force shall
 9    include members of the Department  and  professional  nurses,
10    and  shall  report  its  findings  and recommendations to the
11    Committee on Nursing.
12        (c)  Any  registered  professional  nurse   who   is   an
13    administrator or officer in any hospital, nursing home, other
14    health  care  agency  or  facility,  or  nurse agency and has
15    knowledge  of  any  action  or  condition  which   reasonably
16    indicates  to her or him that a registered professional nurse
17    or licensed practical nurse employed by or practicing nursing
18    in such hospital, nursing home, other health care  agency  or
19    facility,  or  nurse  agency  is  habitually  intoxicated  or
20    addicted to the use of habit-forming drugs to the extent that
21    such intoxication or addiction adversely affects such nurse's
22    professional  performance,  or  unlawfully  possesses,  uses,
23    distributes  or converts habit-forming drugs belonging to the
24    hospital,  nursing  home  or  other  health  care  agency  or
25    facility for such nurse's own  use,  shall  promptly  file  a
26    written  report  thereof to the Department; provided however,
27    an administrator or officer need not file the report  if  the
28    nurse  participates  in  a  course  of  remedial professional
29    counseling or medical treatment for substance abuse, as  long
30    as   such   nurse   actively  pursues  such  treatment  under
31    monitoring  by  the  administrator  or  officer  or  by   the
32    hospital,  nursing  home,  health care agency or facility, or
33    nurse agency and the nurse continues to be employed  by  such
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 1    hospital,  nursing  home,  health care agency or facility, or
 2    nurse agency.    The  Department  shall  review  all  reports
 3    received  by it in a timely manner.  Its initial review shall
 4    be completed no later than  60  days  after  receipt  of  the
 5    report.   Within this 60 day period, the Department shall, in
 6    writing,  make  a  determination  as  to  whether  there  are
 7    sufficient facts to warrant further investigation or action.
 8        Should the Department find insufficient facts to  warrant
 9    further   investigation,  or  action,  the  report  shall  be
10    accepted for filing and the matter shall be deemed closed and
11    so reported.
12        Should the Department find sufficient  facts  to  warrant
13    further  investigation, such investigation shall be completed
14    within 60 days of the date of the determination of sufficient
15    facts to warrant  further  investigation  or  action.   Final
16    action  shall  be  determined no later than 30 days after the
17    completion of the investigation.  If there is a finding which
18    verifies  habitual  intoxication  or  drug  addiction   which
19    adversely  affects  professional  performance or the unlawful
20    possession, use, distribution or conversion of  habit-forming
21    drugs  by  the  reported  nurse, the Department may refuse to
22    issue or renew or may suspend or revoke that nurse's  license
23    as  a  registered  professional nurse or a licensed practical
24    nurse.
25        Any of the aforementioned actions or a determination that
26    there are insufficient facts to warrant further investigation
27    or action shall be considered  a  final  action.   The  nurse
28    administrator  or  officer  who  filed the original report or
29    complaint, and the nurse who is the subject  of  the  report,
30    shall be notified in writing by the Department within 15 days
31    of any final action taken by the Department.
32        Each  year on March 1, commencing with the effective date
33    of this Act, the Department shall  submit  a  report  to  the
34    General  Assembly.   The  report  shall include the number of
SB1585 Engrossed            -45-               LRB9011272NTsb
 1    reports made under this Section to the Department during  the
 2    previous  year,  the  number  of  reports  reviewed and found
 3    insufficient to warrant further investigation, the number  of
 4    reports not completed and the reasons for incompletion.  This
 5    report  shall be made available also to nurses requesting the
 6    report.
 7        Any person making a report under this Section or in  good
 8    faith  assisting another person in making such a report shall
 9    have immunity from any liability, either criminal  or  civil,
10    that  might result by reason of such action.  For the purpose
11    of any legal proceeding, criminal or civil, there shall be  a
12    rebuttable  presumption that any person making a report under
13    this Section or  assisting  another  person  in  making  such
14    report  was  acting  in good faith.  All such reports and any
15    information disclosed  to  or  collected  by  the  Department
16    pursuant to this Section shall remain confidential records of
17    the  Department  and shall not be disclosed nor be subject to
18    any law or regulation of this State relating  to  freedom  of
19    information or public disclosure of records.
20        (225 ILCS 65/Title 15 heading new)
21                 TITLE 15. ADVANCED PRACTICE NURSES
22        (225 ILCS 65/15-5 new)
23        Sec. 15-5.  Definitions. As used in this Title:
24        "APN Board" means the Advanced Practice Nursing Board.
25        "Advanced  practice  nurse"  or "APN" means a person who:
26    (1)  is licensed as a  registered  professional  nurse  under
27    this  Act;    (2)  meets the requirements for licensure as an
28    advanced practice nurse under  Section  15-10;   (3)   has  a
29    written   collaborative   agreement   with   a  collaborating
30    physician in the  diagnosis  of  illness  and  management  of
31    wellness and other conditions as appropriate to the level and
32    area of his or her practice in accordance with Section 15-15;
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 1    and   (4) cares for patients (A) by using advanced diagnostic
 2    skills,  the  results  of  diagnostic  tests  and  procedures
 3    ordered  by  the  advanced  practice   nurse,   a   physician
 4    assistant,  a  dentist,  a  podiatrist,  or  a physician, and
 5    professional judgment to initiate and coordinate the care  of
 6    patients;  (B)  by  ordering  diagnostic  tests,  prescribing
 7    medications  and  drugs in accordance with Section 15-20, and
 8    administering  medications  and  drugs;   and  (C)  by  using
 9    medical,  therapeutic,  and  corrective  measures  to   treat
10    illness  and  improve  health  status.    Categories  include
11    certified  nurse  midwife (CNM), certified nurse practitioner
12    (CNP), or certified clinical nurse specialist (CNS).
13        "Collaborating physician" means  a  physician  who  works
14    with   an   advanced  practice  nurse  and  provides  medical
15    direction as documented in a written collaborative  agreement
16    required under Section 15-15.
17        "Licensed  hospital"  means a hospital licensed under the
18    Hospital Licensing Act or organized under the  University  of
19    Illinois Hospital Act.
20        "Physician"  means a person licensed to practice medicine
21    in all its branches under the Medical Practice Act of 1987.
22        (225 ILCS 65/15-10 new)
23        Sec. 15-10.   Advanced  practice  nurse;  qualifications;
24    roster.
25        (a)  A  person  shall  be  qualified  for licensure as an
26    advanced practice nurse if that person:
27             (1)  has applied in writing in  form  and  substance
28        satisfactory  to  the  Department  and has not violated a
29        provision of this Act or the  rules  adopted  under  this
30        Act.  The  Department  may  take  into  consideration any
31        felony conviction of the applicant but a conviction shall
32        not operate as an absolute bar to licensure;
33             (2)  holds  a  current  license  to  practice  as  a
SB1585 Engrossed            -47-               LRB9011272NTsb
 1        registered nurse in Illinois;
 2             (3)  has  successfully  completed  requirements   to
 3        practice  as, and holds a current, national certification
 4        as, a nurse midwife, clinical nurse specialist, or  nurse
 5        practitioner  from  the  appropriate  national certifying
 6        body as determined by rule of the Department;
 7             (4)  has paid the required fees as set by rule; and
 8             (5)  has   successfully   completed   a   post-basic
 9        advanced practice formal education program in the area of
10        his or her nursing specialty.
11        (b)  In  addition  to   meeting   the   requirements   of
12    subsection (a), except item (5) of that subsection, beginning
13    July  1,  2001 or 12 months after the adoption of final rules
14    to implement this Section, whichever  is  sooner,  applicants
15    for   initial   licensure   shall   have  a  graduate  degree
16    appropriate for national certification in a clinical advanced
17    practice nursing specialty.
18        (c)  The  Department  shall  provide  by  rule  for   APN
19    licensure of registered professional nurses who (1) apply for
20    licensure  before  July  1,  2001  and (2) submit evidence of
21    completion of a program described in item (5)  of  subsection
22    (a)  or  in  subsection  (b)  and evidence of practice for at
23    least 10 years as a nurse practitioner.
24        (d)  The Department shall maintain a separate  roster  of
25    advanced  practice nurses licensed under this Title and their
26    licenses shall indicate "Registered  Nurse/Advanced  Practice
27    Nurse".
28        (225 ILCS 65/15-15 new)
29        Sec. 15-15.  Written collaborative agreements.
30        (a)  No  person  shall engage in the practice of advanced
31    practice nursing except when licensed under  this  Title  and
32    pursuant   to   a  written  collaborative  agreement  with  a
33    collaborating physician.
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 1        (b)  A written collaborative agreement shall describe the
 2    working relationship of the advanced practice nurse with  the
 3    collaborating physician and shall authorize the categories of
 4    care,  treatment,  or  procedures  to  be  performed  by  the
 5    advanced  practice  nurse.  Collaboration does not require an
 6    employment relationship between the  collaborating  physician
 7    and   advanced   practice  nurse.   Collaboration  means  the
 8    relationship under which an  advanced  practice  nurse  works
 9    with a collaborating physician in an active clinical practice
10    to  deliver  health  care services in accordance with (i) the
11    advanced practice nurse's training, education, and experience
12    and  (ii)  medical  direction  as  documented  in  a  jointly
13    developed written collaborative agreement.
14        The agreement shall be defined to promote the exercise of
15    professional  judgment  by  the   advanced   practice   nurse
16    commensurate  with  his  or her education and experience. The
17    services to be provided by the advanced practice nurse  shall
18    be   services  that  the  collaborating  physician  generally
19    provides to his or her patients in the normal course  of  his
20    or  her  clinical  medical  practice.  The agreement need not
21    describe the exact steps that an advanced practice nurse must
22    take with respect to each  specific  condition,  disease,  or
23    symptom  but must specify which authorized procedures require
24    a physician's presence as the procedures are being performed.
25    The collaborative relationship under an agreement  shall  not
26    be construed to require the personal presence of a  physician
27    at  all  times  at  the  place  where  services are rendered.
28    Methods of communication shall be available for  consultation
29    with   the   collaborating   physician   in   person   or  by
30    telecommunications in  accordance  with  established  written
31    guidelines as set forth in the written agreement.
32        (c)  Physician medical direction under an agreement shall
33    be adequate if a collaborating physician:
34             (1)  participates in the joint formulation and joint
SB1585 Engrossed            -49-               LRB9011272NTsb
 1        approval  of  orders or guidelines with the APN and he or
 2        she periodically reviews such  orders  and  the  services
 3        provided  patients  under  such orders in accordance with
 4        accepted  standards  of  medical  practice  and  advanced
 5        practice nursing practice;
 6             (2)  is on site at least once  a  month  to  provide
 7        medical direction and consultation; and
 8             (3)  is  available  through  telecommunications  for
 9        consultation   on  medical  problems,  complications,  or
10        emergencies or patient referral.
11        (d)  A  copy  of  the   signed,   written   collaborative
12    agreement  must  be  available to the Department upon request
13    from both the advanced practice nurse and  the  collaborating
14    physician   and  shall  be  annually  updated.   An  advanced
15    practice nurse shall inform each collaborating  physician  of
16    all collaborative agreements he or she has signed and provide
17    a copy of these to any collaborating physician, upon request.
18        (225 ILCS 65/15-20 new)
19        Sec. 15-20.   Prescriptive authority.
20        (a)  A  collaborating  physician may, but is not required
21    to,  delegate limited prescriptive authority to  an  advanced
22    practice  nurse as part of a written collaborative agreement.
23    This  authority  may,  but  is  not  required   to,   include
24    prescription of legend drugs and legend controlled substances
25    categorized  as Schedule III, IV, or V controlled substances,
26    as  defined  in  Article  II  of  the   Illinois   Controlled
27    Substances Act.
28        (b)  To  prescribe  Schedule  III,  IV,  or  V controlled
29    substances under this Section,  an  advanced  practice  nurse
30    shall  affix the collaborating physician's DEA number to, and
31    individually  sign,   the   appropriate   prescription   form
32    containing  the  printed names of the advanced practice nurse
33    and collaborating physician in accordance  with  the  written
SB1585 Engrossed            -50-               LRB9011272NTsb
 1    collaborative agreement.  Medication orders shall be reviewed
 2    periodically by the collaborating physician.
 3        (c)  The  collaborating  physician  shall  file  with the
 4    Department notice of delegation of prescriptive authority and
 5    termination of such delegation, in accordance with  rules  of
 6    the Department.
 7        (d)  Nothing  in this Act shall be construed to limit the
 8    delegation of tasks or duties by a physician  to  a  licensed
 9    practical  nurse,  a  registered professional nurse, or other
10    personnel.
11        (225 ILCS 65/15-30 new)
12        Sec. 15-30.  Title.
13        (a)  No  person  shall  use  any  words,   abbreviations,
14    figures,  letters,  title,  sign,  card, or device tending to
15    imply that he or she is an advanced practice nurse, including
16    but not limited to using the titles  or  initials   "Advanced
17    Practice  Nurse", "Certified Nurse Midwife", "Certified Nurse
18    Practitioner",   "Clinical   Nurse   Specialist",   "A.P.N.",
19    "C.N.M.", "C.N.P.", "C.N.S.", or similar titles or  initials,
20    with  the  intention  of  indicating  practice as an advanced
21    practice nurse without meeting the requirements of this  Act.
22    No  advanced  practice nurse shall use the title of doctor or
23    associate with his or her name or any other term to  indicate
24    to other persons that he or she is qualified to engage in the
25    general practice of medicine.
26        (b)  An  advanced  practice nurse shall verbally identify
27    himself or herself as an advanced  practice  nurse  including
28    specialty certification to each patient.
29        (c)  Nothing  in this Act shall be construed to relieve a
30    physician of professional or  legal  responsibility  for  the
31    care  and  treatment  of persons attended by him or her or to
32    relieve an advanced practice nurse  of  the  professional  or
33    legal  responsibility  for  the care and treatment of persons
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 1    attended by him or her.
 2        (225 ILCS 65/15-35 new)
 3        Sec. 15-35.  Advanced Practice Nursing Board.
 4        (a)  There is hereby  established  an  Advanced  Practice
 5    Nursing  Board,  hereinafter  referred to as the "APN Board".
 6    The APN Board shall review and make  recommendations  to  the
 7    Department   regarding  matters  relating  to  licensure  and
 8    discipline of advanced practice nurses.  The APN Board  shall
 9    be  composed  of 9 members to be appointed by the Governor, 4
10    of whom shall be advanced practice nurses and 3 of whom shall
11    be collaborating physicians.  In making appointments  to  the
12    APN  Board,  the  Governor  shall  give  due consideration to
13    recommendations by  statewide  professional  associations  or
14    societies  representing  nurses  and  physicians in Illinois.
15    Two members, not employed or having any material interest  in
16    any  health  care  field,  shall  represent  the public.  The
17    chairperson of the APN Board shall be a member elected  by  a
18    majority vote of the APN Board.  The APN Board shall meet and
19    report  to  the Department quarterly and as advanced practice
20    nurse issues arise.
21        Initial appointments to  the  APN  Board  shall  be  made
22    within  90  days  after the effective date of this amendatory
23    Act of 1998.  The terms of office of  each  of  the  original
24    members  shall  be at staggered intervals.  One physician and
25    one advanced practice nurse shall serve one-year terms.   One
26    physician  and one advanced practice nurse shall serve 2-year
27    terms.  One physician and one advanced practice  nurse  shall
28    serve  3-year  terms.  One  advanced  practice  nurse and the
29    public members shall serve 4-year terms.  Upon the expiration
30    of the term of an initial member, his or her successor  shall
31    be  appointed  for  a  term of 4 years. No member shall serve
32    more than 2 consecutive terms, excluding initial  appointment
33    terms.   An  appointment  to  fill a vacancy shall be for the
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 1    unexpired portion of the term.   Members  of  the  APN  Board
 2    shall   be  reimbursed  for  all  authorized  legitimate  and
 3    necessary expenses incurred in attending the meetings of  the
 4    APN  Board.   A  majority  of the APN Board members appointed
 5    shall constitute a quorum.  A vacancy in  the  membership  of
 6    the  APN  Board  shall  not  impair  the right of a quorum to
 7    perform all of the duties of the APN Board.  A member of  the
 8    APN  Board  shall have no liability in an action based upon a
 9    disciplinary proceeding or other activity performed  in  good
10    faith as a member of the APN Board.
11        (b)  Complaints  received  concerning  advanced  practice
12    nurses  shall  be  reviewed  by  the  APN  Board.  Complaints
13    received  concerning  collaborating   physicians   shall   be
14    reviewed by the Medical Disciplinary Board.
15        (225 ILCS 65/15-40 new)
16        Sec. 15-40.  Advertising.
17        (a)  A person licensed under this Title may advertise the
18    availability  of professional services in the public media or
19    on the premises where the professional services are rendered.
20    The  advertising  shall   be   limited   to   the   following
21    information:
22             (1)  publication of the person's name, title, office
23        hours, address, and telephone number;
24             (2)  information pertaining to the person's areas of
25        specialization,  including but not limited to appropriate
26        board  certification  or   limitation   of   professional
27        practice;
28             (3)  publication   of   the  person's  collaborating
29        physician's name, title, and areas of specialization;
30             (4)  information on usual  and  customary  fees  for
31        routine   professional   services  offered,  which  shall
32        include notification that fees may  be  adjusted  due  to
33        complications or unforeseen circumstances;
SB1585 Engrossed            -53-               LRB9011272NTsb
 1             (5)  announcements  of  the  opening  of, change of,
 2        absence from, or return to business;
 3             (6)  announcement of additions to or deletions  from
 4        professional licensed staff; and
 5             (7)  the issuance of business or appointment cards.
 6        (b)  It  is  unlawful  for  a  person licensed under this
 7    Title to use testimonials or claims of  superior  quality  of
 8    care to entice the public.  It shall be unlawful to advertise
 9    fee  comparisons  of  available  services with those of other
10    licensed persons.
11        (c)  This Title does not  authorize  the  advertising  of
12    professional services that the offeror of the services is not
13    licensed  or  authorized to render.  Nor shall the advertiser
14    use statements that contain false, fraudulent, deceptive,  or
15    misleading material or guarantees of success, statements that
16    play  upon  the  vanity or fears of the public, or statements
17    that promote or produce unfair competition.
18        (d)  It is unlawful  and  punishable  under  the  penalty
19    provisions of this Act for a person licensed under this Title
20    to  knowingly  advertise  that  the  licensee  will accept as
21    payment for services rendered by assignment  from  any  third
22    party  payor  the  amount  the  third  party  payor covers as
23    payment in full, if the effect is to give the  impression  of
24    eliminating  the  need  of  payment  by  the  patient  of any
25    required deductible or copayment applicable in the  patient's
26    health benefit plan.
27        (e)  As   used   in   this   Section,  "advertise"  means
28    solicitation by the licensee or  through  another  person  or
29    entity  by  means  of  handbills,  posters, circulars, motion
30    pictures, radio,  newspapers,  or  television  or  any  other
31    manner.
32        (225 ILCS 65/15-45 new)
33        Sec.  15-45.  Continuing education.  The Department shall
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 1    adopt rules of  continuing  education  for  persons  licensed
 2    under   this  Title  that  require  50  hours  of  continuing
 3    education per 2-year license renewal cycle.  The rules  shall
 4    not  be  inconsistent  with requirements of relevant national
 5    certifying  bodies  or   State   or   national   professional
 6    associations.  The  rules  shall  also  address variances for
 7    illness or hardship.  The continuing  education  rules  shall
 8    assure   that   licensees   are   given  the  opportunity  to
 9    participate in  programs sponsored by or through their  State
10    or  national  professional  associations, hospitals, or other
11    providers  of  continuing  education.    Each   licensee   is
12    responsible   for   maintaining   records  of  completion  of
13    continuing education and shall be  prepared  to  produce  the
14    records when requested by the Department.
15        (225 ILCS 65/15-50 new)
16        Sec. 15-50.  Grounds for disciplinary action.
17        (a)  The  Department  may, upon the recommendation of the
18    APN Board, refuse to  issue  or  to  renew,  or  may  revoke,
19    suspend,  place  on  probation, censure or reprimand, or take
20    other  disciplinary  action  as  the  Department   may   deem
21    appropriate with regard to a license issued under this Title,
22    including the issuance of fines not to exceed $5,000 for each
23    violation,  for  any  one  or  combination of the grounds for
24    discipline set forth in Section 10-45 of this Act or for  any
25    one or combination of the following causes:
26             (1)  Gross  negligence  in  the practice of advanced
27        practice nursing.
28             (2)  Exceeding  the   terms   of   a   collaborative
29        agreement  or the prescriptive authority delegated to him
30        or her by his or her collaborating physician or alternate
31        collaborating physician in guidelines established under a
32        written collaborative agreement.
33             (3)  Making  a   false   or   misleading   statement
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 1        regarding  his  or  her skill or the efficacy or value of
 2        the medicine, treatment, or remedy prescribed by  him  or
 3        her in the course of treatment.
 4             (4)  Prescribing,       selling,      administering,
 5        distributing,  giving,  or  self-administering   a   drug
 6        classified as a controlled substance (designated product)
 7        or narcotic for other than medically accepted therapeutic
 8        purposes.
 9             (5)  Promotion   of  the  sale  of  drugs,  devices,
10        appliances, or goods provided for a patient in  a  manner
11        to exploit the patient for financial gain.
12             (6)  Violating  State or federal laws or regulations
13        relating to controlled substances.
14             (7)  Willfully   or   negligently   violating    the
15        confidentiality    between   advanced   practice   nurse,
16        collaborating physician, and patient, except as  required
17        by law.
18             (8)  Failure   of   a  licensee  to  report  to  the
19        Department any adverse final action  taken  against  such
20        licensee  by  another  licensing  jurisdiction (any other
21        jurisdiction of the United States or any foreign state or
22        country),  any  peer  review  body,   any   health   care
23        institution,   a  professional  or  nursing  or  advanced
24        practice nursing society or association,  a  governmental
25        agency,  a  law  enforcement  agency,  or  a  court  or a
26        liability claim relating to acts or  conduct  similar  to
27        acts  or conduct that would constitute grounds for action
28        as defined in this Section.
29             (9)  Failure  of  a  licensee  to  report   to   the
30        Department  surrender  by  the  licensee  of a license or
31        authorization to practice nursing  or  advanced  practice
32        nursing  in  another  state  or  jurisdiction, or current
33        surrender by the licensee of membership  on  any  nursing
34        staff  or  organized health care professional staff or in
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 1        any nursing, advanced  practice  nurse,  or  professional
 2        association   or   society   while   under   disciplinary
 3        investigation  by  any of those authorities or bodies for
 4        acts or conduct similar to acts  or  conduct  that  would
 5        constitute grounds for action as defined in this Section.
 6             (10)  Failing,    within   60   days,   to   provide
 7        information in response to a written request made by  the
 8        Department.
 9             (11)  Failure  to  establish and maintain records of
10        patient care and treatment as required by law.
11             (12)  Any violation of any Section of this Title  or
12        Act.
13        When   the   Department   has  received  written  reports
14    concerning incidents required to be reported in items (8) and
15    (9),  the licensee's failure to report the  incident  to  the
16    Department  under  those  items shall not be the sole grounds
17    for disciplinary action.
18        (b)  The Department may refuse to issue  or  may  suspend
19    the  license of any person who fails to file a return, to pay
20    the tax, penalty, or interest shown in a filed return, or  to
21    pay  any final assessment of the tax, penalty, or interest as
22    required by a tax  Act  administered  by  the  Department  of
23    Revenue, until the requirements of the tax Act are satisfied.
24        (c)  In  enforcing  this  Section,  the Department or APN
25    Board, upon a showing of a possible violation, may compel  an
26    individual  licensed to practice under this Title, or who has
27    applied for licensure under this Title, to submit to a mental
28    or physical examination or both, as required by  and  at  the
29    expense  of  the Department.  The Department or APN Board may
30    order the examining physician to