102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB5776

 

Introduced 11/16/2022, by Rep. Maurice A. West, II

 

SYNOPSIS AS INTRODUCED:
 
225 ILCS 15/2  from Ch. 111, par. 5352
225 ILCS 15/4.3
720 ILCS 570/303.05

    Amends the Clinical Psychologist Licensing Act. In provisions concerning written collaborative agreements, deletes a provision prohibiting a prescribing psychologist from prescribing medications to patients who are less than 17 years of age or over 65 years of age. Provides that no prescriptive authority for any Schedule II opioid shall be delegated. Provides that after the collaborating physician files a notice delegating authority to prescribe any nonnarcotic, nonopioid Schedule II through V controlled substances (rather than any nonnarcotic Schedule III through V controlled substances), the licensed clinical psychologist shall be eligible to register for a mid-level practitioner controlled substance license under the Illinois Controlled Substances Act. Defines "opioid". Makes corresponding changes in the Illinois Controlled Substances Act. Effective immediately.


LRB102 28323 AMQ 40194 b

 

 

A BILL FOR

 

HB5776LRB102 28323 AMQ 40194 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Clinical Psychologist Licensing Act is
5amended by changing Sections 2 and 4.3 as follows:
 
6    (225 ILCS 15/2)  (from Ch. 111, par. 5352)
7    (Section scheduled to be repealed on January 1, 2027)
8    Sec. 2. Definitions. As used in this Act:
9        (1) "Department" means the Department of Financial and
10    Professional Regulation.
11        (2) "Secretary" means the Secretary of Financial and
12    Professional Regulation.
13        (3) "Board" means the Clinical Psychologists Licensing
14    and Disciplinary Board appointed by the Secretary.
15        (4) (Blank).
16        (5) "Clinical psychology" means the independent
17    evaluation, classification, diagnosis, and treatment of
18    mental, emotional, behavioral or nervous disorders or
19    conditions, developmental disabilities, alcoholism and
20    substance abuse, disorders of habit or conduct, and the
21    psychological aspects of physical illness. The practice of
22    clinical psychology includes psychoeducational
23    evaluation, therapy, remediation and consultation, the use

 

 

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1    of psychological and neuropsychological testing,
2    assessment, psychotherapy, psychoanalysis, hypnosis,
3    biofeedback, and behavioral modification when any of these
4    are used for the purpose of preventing or eliminating
5    psychopathology, or for the amelioration of psychological
6    disorders of individuals or groups. "Clinical psychology"
7    does not include the use of hypnosis by unlicensed persons
8    pursuant to Section 3.
9        (6) A person represents himself or herself to be a
10    "clinical psychologist" or "psychologist" within the
11    meaning of this Act when he or she holds himself or herself
12    out to the public by any title or description of services
13    incorporating the words "psychological", "psychologic",
14    "psychologist", "psychology", or "clinical psychologist"
15    or under such title or description offers to render or
16    renders clinical psychological services as defined in
17    paragraph (7) of this Section to individuals or the public
18    for remuneration.
19        (7) "Clinical psychological services" refers to any
20    services under paragraph (5) of this Section if the words
21    "psychological", "psychologic", "psychologist",
22    "psychology" or "clinical psychologist" are used to
23    describe such services by the person or organization
24    offering to render or rendering them.
25        (8) "Collaborating physician" means a physician
26    licensed to practice medicine in all of its branches in

 

 

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1    Illinois who generally prescribes medications for the
2    treatment of mental health disease or illness to his or
3    her patients in the normal course of his or her clinical
4    medical practice.
5        (9) "Prescribing psychologist" means a licensed,
6    doctoral level psychologist who has undergone specialized
7    training, has passed an examination as determined by rule,
8    and has received a current license granting prescriptive
9    authority under Section 4.2 of this Act that has not been
10    revoked or suspended from the Department.
11        (10) "Prescriptive authority" means the authority to
12    prescribe, administer, discontinue, or distribute drugs or
13    medicines.
14        (11) "Prescription" means an order for a drug,
15    laboratory test, or any medicines, including controlled
16    substances as defined in the Illinois Controlled
17    Substances Act.
18        (12) "Drugs" has the meaning given to that term in the
19    Pharmacy Practice Act.
20        (13) "Medicines" has the meaning given to that term in
21    the Pharmacy Practice Act.
22        (14) "Address of record" means the designated address
23    recorded by the Department in the applicant's application
24    file or the licensee's license file maintained by the
25    Department's licensure maintenance unit.
26        (15) "Opioid" means a narcotic drug or substance that

 

 

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1    is a Schedule II controlled substance under paragraph (1),
2    (2), (3), or (5) of subsection (b) or under subsection (c)
3    of Section 206 of the Illinois Controlled Substances Act.
4    This Act shall not apply to persons lawfully carrying on
5their particular profession or business under any valid
6existing regulatory Act of the State.
7(Source: P.A. 98-668, eff. 6-25-14; 99-572, eff. 7-15-16.)
 
8    (225 ILCS 15/4.3)
9    (Section scheduled to be repealed on January 1, 2027)
10    Sec. 4.3. Written collaborative agreements.
11    (a) A written collaborative agreement is required for all
12prescribing psychologists practicing under a prescribing
13psychologist license issued pursuant to Section 4.2 of this
14Act.
15    (b) A written delegation of prescriptive authority by a
16collaborating physician may only include medications for the
17treatment of mental health disease or illness the
18collaborating physician generally provides to his or her
19patients in the normal course of his or her clinical practice
20with the exception of the following:
21        (1) (blank); patients who are less than 17 years of
22    age or over 65 years of age;
23        (2) patients during pregnancy;
24        (3) patients with serious medical conditions, such as
25    heart disease, cancer, stroke, or seizures, and with

 

 

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1    developmental disabilities and intellectual disabilities;
2    and
3        (4) prescriptive authority for benzodiazepine Schedule
4    III controlled substances; and .
5        (5) prescriptive authority for any Schedule II opioid.
6    (c) The collaborating physician shall file with the
7Department notice of delegation of prescriptive authority and
8termination of the delegation, in accordance with rules of the
9Department. Upon receipt of this notice delegating authority
10to prescribe any nonnarcotic, nonopioid Schedule II III
11through V controlled substances, the licensed clinical
12psychologist shall be eligible to register for a mid-level
13practitioner controlled substance license under Section 303.05
14of the Illinois Controlled Substances Act.
15    (d) All of the following shall apply to delegation of
16prescriptive authority:
17        (1) Any delegation of Schedule II III through V
18    controlled substances shall identify the specific
19    controlled substance by brand name or generic name. No
20    controlled substance to be delivered by injection may be
21    delegated. No Schedule II opioid controlled substance
22    shall be delegated.
23        (2) A prescribing psychologist shall not prescribe
24    narcotic drugs, as defined in Section 102 of the Illinois
25    Controlled Substances Act.
26    Any prescribing psychologist who writes a prescription for

 

 

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1a controlled substance without having valid and appropriate
2authority may be fined by the Department not more than $50 per
3prescription and the Department may take any other
4disciplinary action provided for in this Act.
5    All prescriptions written by a prescribing psychologist
6must contain the name of the prescribing psychologist and his
7or her signature. The prescribing psychologist shall sign his
8or her own name.
9    (e) The written collaborative agreement shall describe the
10working relationship of the prescribing psychologist with the
11collaborating physician and shall delegate prescriptive
12authority as provided in this Act. Collaboration does not
13require an employment relationship between the collaborating
14physician and prescribing psychologist. Absent an employment
15relationship, an agreement may not restrict third-party
16payment sources accepted by the prescribing psychologist. For
17the purposes of this Section, "collaboration" means the
18relationship between a prescribing psychologist and a
19collaborating physician with respect to the delivery of
20prescribing services in accordance with (1) the prescribing
21psychologist's training, education, and experience and (2)
22collaboration and consultation as documented in a jointly
23developed written collaborative agreement.
24    (f) The agreement shall promote the exercise of
25professional judgment by the prescribing psychologist
26corresponding to his or her education and experience.

 

 

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1    (g) The collaborative agreement shall not be construed to
2require the personal presence of a physician at the place
3where services are rendered. Methods of communication shall be
4available for consultation with the collaborating physician in
5person or by telecommunications in accordance with established
6written guidelines as set forth in the written agreement.
7    (h) Collaboration and consultation pursuant to all
8collaboration agreements shall be adequate if a collaborating
9physician does each of the following:
10        (1) participates in the joint formulation and joint
11    approval of orders or guidelines with the prescribing
12    psychologist and he or she periodically reviews the
13    prescribing psychologist's orders and the services
14    provided patients under the orders in accordance with
15    accepted standards of medical practice and prescribing
16    psychologist practice;
17        (2) provides collaboration and consultation with the
18    prescribing psychologist in person at least once a month
19    for review of safety and quality clinical care or
20    treatment;
21        (3) is available through telecommunications for
22    consultation on medical problems, complications,
23    emergencies, or patient referral; and
24        (4) reviews medication orders of the prescribing
25    psychologist no less than monthly, including review of
26    laboratory tests and other tests as available.

 

 

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1    (i) The written collaborative agreement shall contain
2provisions detailing notice for termination or change of
3status involving a written collaborative agreement, except
4when the notice is given for just cause.
5    (j) A copy of the signed written collaborative agreement
6shall be available to the Department upon request to either
7the prescribing psychologist or the collaborating physician.
8    (k) Nothing in this Section shall be construed to limit
9the authority of a prescribing psychologist to perform all
10duties authorized under this Act.
11    (l) A prescribing psychologist shall inform each
12collaborating physician of all collaborative agreements he or
13she has signed and provide a copy of these to any collaborating
14physician.
15    (m) No collaborating physician shall enter into more than
163 collaborative agreements with prescribing psychologists.
17(Source: P.A. 101-84, eff. 7-19-19.)
 
18    Section 10. The Illinois Controlled Substances Act is
19amended by changing Section 303.05 as follows:
 
20    (720 ILCS 570/303.05)
21    Sec. 303.05. Mid-level practitioner registration.
22    (a) The Department of Financial and Professional
23Regulation shall register licensed physician assistants,
24licensed advanced practice registered nurses, and prescribing

 

 

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1psychologists licensed under Section 4.2 of the Clinical
2Psychologist Licensing Act to prescribe and dispense
3controlled substances under Section 303 and euthanasia
4agencies to purchase, store, or administer animal euthanasia
5drugs under the following circumstances:
6        (1) with respect to physician assistants,
7            (A) the physician assistant has been delegated
8        written authority to prescribe any Schedule III
9        through V controlled substances by a physician
10        licensed to practice medicine in all its branches in
11        accordance with Section 7.5 of the Physician Assistant
12        Practice Act of 1987; and the physician assistant has
13        completed the appropriate application forms and has
14        paid the required fees as set by rule; or
15            (B) the physician assistant has been delegated
16        authority by a collaborating physician licensed to
17        practice medicine in all its branches to prescribe or
18        dispense Schedule II controlled substances through a
19        written delegation of authority and under the
20        following conditions:
21                (i) Specific Schedule II controlled substances
22            by oral dosage or topical or transdermal
23            application may be delegated, provided that the
24            delegated Schedule II controlled substances are
25            routinely prescribed by the collaborating
26            physician. This delegation must identify the

 

 

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1            specific Schedule II controlled substances by
2            either brand name or generic name. Schedule II
3            controlled substances to be delivered by injection
4            or other route of administration may not be
5            delegated;
6                (ii) any delegation must be of controlled
7            substances prescribed by the collaborating
8            physician;
9                (iii) all prescriptions must be limited to no
10            more than a 30-day supply, with any continuation
11            authorized only after prior approval of the
12            collaborating physician;
13                (iv) the physician assistant must discuss the
14            condition of any patients for whom a controlled
15            substance is prescribed monthly with the
16            delegating physician;
17                (v) the physician assistant must have
18            completed the appropriate application forms and
19            paid the required fees as set by rule;
20                (vi) the physician assistant must provide
21            evidence of satisfactory completion of 45 contact
22            hours in pharmacology from any physician assistant
23            program accredited by the Accreditation Review
24            Commission on Education for the Physician
25            Assistant (ARC-PA), or its predecessor agency, for
26            any new license issued with Schedule II authority

 

 

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1            after the effective date of this amendatory Act of
2            the 97th General Assembly; and
3                (vii) the physician assistant must annually
4            complete at least 5 hours of continuing education
5            in pharmacology;
6        (2) with respect to advanced practice registered
7    nurses who do not meet the requirements of Section 65-43
8    of the Nurse Practice Act,
9            (A) the advanced practice registered nurse has
10        been delegated authority to prescribe any Schedule III
11        through V controlled substances by a collaborating
12        physician licensed to practice medicine in all its
13        branches or a collaborating podiatric physician in
14        accordance with Section 65-40 of the Nurse Practice
15        Act. The advanced practice registered nurse has
16        completed the appropriate application forms and has
17        paid the required fees as set by rule; or
18            (B) the advanced practice registered nurse has
19        been delegated authority by a collaborating physician
20        licensed to practice medicine in all its branches to
21        prescribe or dispense Schedule II controlled
22        substances through a written delegation of authority
23        and under the following conditions:
24                (i) specific Schedule II controlled substances
25            by oral dosage or topical or transdermal
26            application may be delegated, provided that the

 

 

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1            delegated Schedule II controlled substances are
2            routinely prescribed by the collaborating
3            physician. This delegation must identify the
4            specific Schedule II controlled substances by
5            either brand name or generic name. Schedule II
6            controlled substances to be delivered by injection
7            or other route of administration may not be
8            delegated;
9                (ii) any delegation must be of controlled
10            substances prescribed by the collaborating
11            physician;
12                (iii) all prescriptions must be limited to no
13            more than a 30-day supply, with any continuation
14            authorized only after prior approval of the
15            collaborating physician;
16                (iv) the advanced practice registered nurse
17            must discuss the condition of any patients for
18            whom a controlled substance is prescribed monthly
19            with the delegating physician or in the course of
20            review as required by Section 65-40 of the Nurse
21            Practice Act;
22                (v) the advanced practice registered nurse
23            must have completed the appropriate application
24            forms and paid the required fees as set by rule;
25                (vi) the advanced practice registered nurse
26            must provide evidence of satisfactory completion

 

 

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1            of at least 45 graduate contact hours in
2            pharmacology for any new license issued with
3            Schedule II authority after the effective date of
4            this amendatory Act of the 97th General Assembly;
5            and
6                (vii) the advanced practice registered nurse
7            must annually complete 5 hours of continuing
8            education in pharmacology;
9        (2.5) with respect to advanced practice registered
10    nurses certified as nurse practitioners, nurse midwives,
11    or clinical nurse specialists who do not meet the
12    requirements of Section 65-43 of the Nurse Practice Act
13    practicing in a hospital affiliate,
14            (A) the advanced practice registered nurse
15        certified as a nurse practitioner, nurse midwife, or
16        clinical nurse specialist has been privileged to
17        prescribe any Schedule II through V controlled
18        substances by the hospital affiliate upon the
19        recommendation of the appropriate physician committee
20        of the hospital affiliate in accordance with Section
21        65-45 of the Nurse Practice Act, has completed the
22        appropriate application forms, and has paid the
23        required fees as set by rule; and
24            (B) an advanced practice registered nurse
25        certified as a nurse practitioner, nurse midwife, or
26        clinical nurse specialist has been privileged to

 

 

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1        prescribe any Schedule II controlled substances by the
2        hospital affiliate upon the recommendation of the
3        appropriate physician committee of the hospital
4        affiliate, then the following conditions must be met:
5                (i) specific Schedule II controlled substances
6            by oral dosage or topical or transdermal
7            application may be designated, provided that the
8            designated Schedule II controlled substances are
9            routinely prescribed by advanced practice
10            registered nurses in their area of certification;
11            the privileging documents must identify the
12            specific Schedule II controlled substances by
13            either brand name or generic name; privileges to
14            prescribe or dispense Schedule II controlled
15            substances to be delivered by injection or other
16            route of administration may not be granted;
17                (ii) any privileges must be controlled
18            substances limited to the practice of the advanced
19            practice registered nurse;
20                (iii) any prescription must be limited to no
21            more than a 30-day supply;
22                (iv) the advanced practice registered nurse
23            must discuss the condition of any patients for
24            whom a controlled substance is prescribed monthly
25            with the appropriate physician committee of the
26            hospital affiliate or its physician designee; and

 

 

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1                (v) the advanced practice registered nurse
2            must meet the education requirements of this
3            Section;
4        (3) with respect to animal euthanasia agencies, the
5    euthanasia agency has obtained a license from the
6    Department of Financial and Professional Regulation and
7    obtained a registration number from the Department; or
8        (4) with respect to prescribing psychologists, the
9    prescribing psychologist has been delegated authority to
10    prescribe any nonnarcotic, nonopioid Schedule II III
11    through V controlled substances by a collaborating
12    physician licensed to practice medicine in all its
13    branches in accordance with Section 4.3 of the Clinical
14    Psychologist Licensing Act, and the prescribing
15    psychologist has completed the appropriate application
16    forms and has paid the required fees as set by rule.
17    (b) The mid-level practitioner shall only be licensed to
18prescribe those schedules of controlled substances for which a
19licensed physician has delegated prescriptive authority,
20except that an animal euthanasia agency does not have any
21prescriptive authority. A physician assistant and an advanced
22practice registered nurse are prohibited from prescribing
23medications and controlled substances not set forth in the
24required written delegation of authority or as authorized by
25their practice Act.
26    (c) Upon completion of all registration requirements,

 

 

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1physician assistants, advanced practice registered nurses, and
2animal euthanasia agencies may be issued a mid-level
3practitioner controlled substances license for Illinois.
4    (d) A collaborating physician may, but is not required to,
5delegate prescriptive authority to an advanced practice
6registered nurse as part of a written collaborative agreement,
7and the delegation of prescriptive authority shall conform to
8the requirements of Section 65-40 of the Nurse Practice Act.
9    (e) A collaborating physician may, but is not required to,
10delegate prescriptive authority to a physician assistant as
11part of a written collaborative agreement, and the delegation
12of prescriptive authority shall conform to the requirements of
13Section 7.5 of the Physician Assistant Practice Act of 1987.
14    (f) Nothing in this Section shall be construed to prohibit
15generic substitution.
16(Source: P.A. 99-173, eff. 7-29-15; 100-453, eff. 8-25-17;
17100-513, eff. 1-1-18; 100-863, eff. 8-14-18.)
 
18    Section 99. Effective date. This Act takes effect upon
19becoming law.