Illinois General Assembly - Full Text of SB0339
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Full Text of SB0339  100th General Assembly


Sen. Toi W. Hutchinson

Filed: 2/27/2018





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2    AMENDMENT NO. ______. Amend Senate Bill 339 by replacing
3everything after the enacting clause with the following:
4    "Section 5. The Nurse Practice Act is amended by changing
5Sections 50-10, 50-75, and 60-35 and by adding Section 80-65 as
7    (225 ILCS 65/50-10)   (was 225 ILCS 65/5-10)
8    (Section scheduled to be repealed on January 1, 2028)
9    Sec. 50-10. Definitions. Each of the following terms, when
10used in this Act, shall have the meaning ascribed to it in this
11Section, except where the context clearly indicates otherwise:
12    "Academic year" means the customary annual schedule of
13courses at a college, university, or approved school,
14customarily regarded as the school year as distinguished from
15the calendar year.
16    "Address of record" means the designated address recorded



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1by the Department in the applicant's or licensee's application
2file or license file as maintained by the Department's
3licensure maintenance unit.
4    "Advanced practice registered nurse" or "APRN" means a
5person who has met the qualifications for a (i) certified nurse
6midwife (CNM); (ii) certified nurse practitioner (CNP); (iii)
7certified registered nurse anesthetist (CRNA); or (iv)
8clinical nurse specialist (CNS) and has been licensed by the
9Department. All advanced practice registered nurses licensed
10and practicing in the State of Illinois shall use the title
11APRN and may use specialty credentials CNM, CNP, CRNA, or CNS
12after their name. All advanced practice registered nurses may
13only practice in accordance with national certification and
14this Act.
15    "Advisory Board" means the Illinois Nursing Workforce
16Center Advisory Board.
17    "Approved program of professional nursing education" and
18"approved program of practical nursing education" are programs
19of professional or practical nursing, respectively, approved
20by the Department under the provisions of this Act.
21    "Board" means the Board of Nursing appointed by the
23    "Center" means the Illinois Nursing Workforce Center.
24    "Collaboration" means a process involving 2 or more health
25care professionals working together, each contributing one's
26respective area of expertise to provide more comprehensive



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1patient care.
2    "Competence" means an expected and measurable level of
3performance that integrates knowledge, skills, abilities, and
4judgment based on established scientific knowledge and
5expectations for nursing practice.
6    "Comprehensive nursing assessment" means the gathering of
7information about the patient's physiological, psychological,
8sociological, and spiritual status on an ongoing basis by a
9registered professional nurse and is the first step in
10implementing and guiding the nursing plan of care.
11    "Consultation" means the process whereby an advanced
12practice registered nurse seeks the advice or opinion of
13another health care professional.
14    "Credentialed" means the process of assessing and
15validating the qualifications of a health care professional.
16    "Dentist" means a person licensed to practice dentistry
17under the Illinois Dental Practice Act.
18    "Department" means the Department of Financial and
19Professional Regulation.
20    "Email address of record" means the designated email
21address recorded by the Department in the applicant's
22application file or the licensee's license file, as maintained
23by the Department's licensure maintenance unit.
24    "Focused nursing assessment" means an appraisal of an
25individual's status and current situation, contributing to the
26comprehensive nursing assessment performed by the registered



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1professional nurse or advanced practice registered nurse or the
2assessment by the physician assistant, physician, dentist,
3podiatric physician, or other licensed health care
4professional, as determined by the Department, supporting
5ongoing data collection, and deciding who needs to be informed
6of the information and when to inform.
7    "Full practice authority" means the authority of an
8advanced practice registered nurse licensed in Illinois and
9certified as a nurse practitioner, clinical nurse specialist,
10or nurse midwife to practice without a written collaborative
11agreement and:
12        (1) to be fully accountable to patients for the quality
13    of advanced nursing care rendered;
14        (2) to be fully accountable for recognizing limits of
15    knowledge and experience and for planning for the
16    management of situations beyond the advanced practice
17    registered nurse's expertise; the full practice authority
18    for advanced practice registered nurses includes accepting
19    referrals from, consulting with, collaborating with, or
20    referring to other health care professionals as warranted
21    by the needs of the patient; and
22        (3) to possess the authority to prescribe medications,
23    including Schedule II through V controlled substances, as
24    provided in Section 65-43.
25    "Hospital affiliate" means a corporation, partnership,
26joint venture, limited liability company, or similar



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1organization, other than a hospital, that is devoted primarily
2to the provision, management, or support of health care
3services and that directly or indirectly controls, is
4controlled by, or is under common control of the hospital. For
5the purposes of this definition, "control" means having at
6least an equal or a majority ownership or membership interest.
7A hospital affiliate shall be 100% owned or controlled by any
8combination of hospitals, their parent corporations, or
9physicians licensed to practice medicine in all its branches in
10Illinois. "Hospital affiliate" does not include a health
11maintenance organization regulated under the Health
12Maintenance Organization Act.
13    "Impaired nurse" means a nurse licensed under this Act who
14is unable to practice with reasonable skill and safety because
15of a physical or mental disability as evidenced by a written
16determination or written consent based on clinical evidence,
17including loss of motor skills, abuse of drugs or alcohol, or a
18psychiatric disorder, of sufficient degree to diminish his or
19her ability to deliver competent patient care.
20    "License-pending advanced practice registered nurse" means
21a registered professional nurse who has completed all
22requirements for licensure as an advanced practice registered
23nurse except the certification examination and has applied to
24take the next available certification exam and received a
25temporary permit from the Department.
26    "License-pending registered nurse" means a person who has



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1passed the Department-approved registered nurse licensure exam
2and has applied for a license from the Department. A
3license-pending registered nurse shall use the title "RN lic
4pend" on all documentation related to nursing practice.
5    "Nursing intervention" means any treatment based on
6clinical nursing judgment or knowledge that a nurse performs.
7An individual or entity shall not mandate that a registered
8professional nurse delegate nursing interventions if the
9registered professional nurse determines it is inappropriate
10to do so. A nurse shall not be subject to disciplinary or any
11other adverse action for refusing to delegate a nursing
12intervention based on patient safety.
13    "Physician" means a person licensed to practice medicine in
14all its branches under the Medical Practice Act of 1987.
15    "Podiatric physician" means a person licensed to practice
16podiatry under the Podiatric Medical Practice Act of 1987.
17    "Practical nurse" or "licensed practical nurse" means a
18person who is licensed as a practical nurse under this Act and
19practices practical nursing as defined in this Act. Only a
20practical nurse licensed under this Act is entitled to use the
21title "licensed practical nurse" and the abbreviation
23    "Practical nursing" means the performance of nursing
24interventions requiring the nursing knowledge, judgment, and
25skill acquired by means of completion of an approved practical
26nursing education program. Practical nursing includes



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1assisting in the nursing process under the guidance of a
2registered professional nurse or an advanced practice
3registered nurse. The practical nurse may work under the
4direction of a licensed physician, dentist, podiatric
5physician, or other health care professional determined by the
7    "Privileged" means the authorization granted by the
8governing body of a healthcare facility, agency, or
9organization to provide specific patient care services within
10well-defined limits, based on qualifications reviewed in the
11credentialing process.
12    "Registered Nurse" or "Registered Professional Nurse"
13means a person who is licensed as a professional nurse under
14this Act and practices nursing as defined in this Act. Only a
15registered nurse licensed under this Act is entitled to use the
16titles "registered nurse" and "registered professional nurse"
17and the abbreviation, "R.N.".
18    "Registered professional nursing practice" means a
19scientific process founded on a professional body of knowledge
20that includes, but is not limited to, the protection,
21promotion, and optimization of health and abilities,
22prevention of illness and injury, the administration of
23medications and treatments prescribed by a physician, dentist,
24podiatric physician, licensed optometrist, physician
25assistant, or advanced practice registered nurse, development
26and implementation of the nursing plan of care, facilitation of



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1nursing interventions to alleviate suffering, care
2coordination, and advocacy in the care of individuals,
3families, groups, communities, and populations. "Registered
4professional nursing practice" does not include the act of
5medical diagnosis or prescription of medical therapeutic or
6corrective measures.
7    "Professional assistance program for nurses" means a
8professional assistance program that meets criteria
9established by the Board of Nursing and approved by the
10Secretary, which provides a non-disciplinary treatment
11approach for nurses licensed under this Act whose ability to
12practice is compromised by alcohol or chemical substance
14    "Secretary" means the Secretary of Financial and
15Professional Regulation.
16    "Selected nursing task" means work that does not require
17nursing knowledge, judgment, or decision making that may be
18delegated if the delegating registered nurse:
19        (1) assesses that the specific task delegated can be
20    safely carried out by the person the professional
21    registered nurse delegates such work to;
22        (2) assesses such delegation is safe for the individual
23    patient or client receiving that care of a selected nursing
24    task; and
25        (3) delegation of a selected nursing task complies as
26    defined by the Department by rule.



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1    "Task" means work that does not require nursing knowledge,
2judgment, or decision making, as defined by the Department by
4    "Unencumbered license" means a license issued in good
6    "Written collaborative agreement" means a written
7agreement between an advanced practice registered nurse and a
8collaborating physician, dentist, or podiatric physician
9pursuant to Section 65-35.
10(Source: P.A. 99-173, eff. 7-29-15; 99-330, eff. 1-1-16;
1199-642, eff. 7-28-16; 100-513, eff. 1-1-18.)
12    (225 ILCS 65/50-75)
13    (Section scheduled to be repealed on January 1, 2028)
14    Sec. 50-75. Nursing delegation by a registered
15professional nurse.
16    (a) For the purposes of this Section:
17    "Delegation" means transferring to a specific individual
18the authority to perform a specific nursing intervention in a
19specific situation.
20    "Predictability of outcomes" means that a registered
21professional nurse or advanced practice registered nurse has
22determined that the patient's or individual's clinical status
23is stable and expected to improve or the patient's or
24individual's deteriorating condition is expected to follow a
25known or expected course.



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1    "Stability" means a registered professional nurse or
2advanced practice registered nurse has determined that the
3individual's clinical status and nursing care needs are
5    (b) This Section authorizes a registered professional
6nurse or advanced practice registered nurse to:
7        (1) delegate tasks and nursing interventions to other
8    registered professional nurses, licensed practical nurses,
9    and other unlicensed personnel based on the comprehensive
10    nursing assessment that includes, but is not limited to:
11            (A) the stability and condition of the patient;
12            (B) the potential for harm;
13            (C) the complexity of the nursing intervention to
14        be delegated;
15            (D) the predictability of outcomes; and
16            (E) competency of the individual to whom the
17        nursing intervention is delegated;
18        (2) delegate medication administration to other
19    licensed nurses;
20        (3) in community-based or in-home care settings,
21    delegate tasks and selected nursing tasks, as defined by
22    the Department by rule, which may include delegating
23    delegate the administration of medication (limited to oral
24    or subcutaneous dosage and topical or transdermal
25    application) to unlicensed personnel, if all the
26    conditions for delegation set forth in this Section are



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1    met;
2        (4) refuse to delegate, stop, or rescind a previously
3    authorized delegation; or
4        (5) in community-based or in-home care settings,
5    delegate, guide, and evaluate the implementation of
6    nursing interventions as a component of patient care
7    coordination after completion of the comprehensive patient
8    assessment based on analysis of the comprehensive nursing
9    assessment data; care coordination in in-home care and
10    school settings may occur in person, by telecommunication,
11    or by electronic communication.
12    (c) This Section prohibits the following:
13        (1) An individual or entity from mandating that a
14    registered professional nurse delegate nursing
15    interventions, tasks, or selected nursing tasks if the
16    registered professional nurse determines it is
17    inappropriate to do so. Nurses shall not be subject to
18    disciplinary or any other adverse action for refusing to
19    delegate a nursing intervention based on patient safety.
20        (2) A registered professional nurse from the The
21    delegation of medication administration to unlicensed
22    personnel in any institutional or long-term facility,
23    including, but not limited to, those facilities licensed by
24    the Hospital Licensing Act, the University of Illinois
25    Hospital Act, State-operated mental health hospitals, or
26    State-operated developmental centers, except as authorized



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1    under Article 80 of this Act or otherwise specifically
2    authorized by law.
3        (3) A registered professional nurse from delegating
4    nursing judgment, the comprehensive patient assessment,
5    the development of a plan of care, and the evaluation of
6    care to licensed or unlicensed personnel.
7        (4) A licensed practical nurse or unlicensed personnel
8    who has been delegated a nursing intervention by a
9    registered professional nurse from re-delegating that a
10    nursing intervention.
11        (5) An unlicensed personnel who has been delegated a
12    task or selected nursing task by a registered professional
13    nurse from re-delegating that task or selected nursing
14    task.
15(Source: P.A. 100-513, eff. 1-1-18.)
16    (225 ILCS 65/60-35)
17    (Section scheduled to be repealed on January 1, 2028)
18    Sec. 60-35. RN scope of practice. The RN scope of nursing
19practice is the protection, promotion, and optimization of
20health and abilities, the prevention of illness and injury, the
21development and implementation of the nursing plan of care, the
22facilitation of nursing interventions to alleviate suffering,
23care coordination, and advocacy in the care of individuals,
24families, groups, communities, and populations. Practice as a
25registered professional nurse means this full scope of nursing,



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1with or without compensation, that incorporates caring for all
2patients in all settings, through nursing standards of practice
3and professional performance for coordination of care, and may
4include, but is not limited to, all of the following:
5        (1) Collecting pertinent data and information relative
6    to the patient's health or the situation on an ongoing
7    basis through the comprehensive nursing assessment.
8        (2) Analyzing comprehensive nursing assessment data to
9    determine actual or potential diagnoses, problems, and
10    issues.
11        (3) Identifying expected outcomes for a plan
12    individualized to the patient or the situation that
13    prescribes strategies to attain expected, measurable
14    outcomes.
15        (4) Implementing the identified plan, coordinating
16    care delivery, employing strategies to promote healthy and
17    safe environments, and administering or delegating
18    medication administration according to Section 50-75 of
19    this Act.
20        (5) Evaluating patient progress toward attainment of
21    goals and outcomes.
22        (6) Delegating tasks, nursing interventions, and
23    selected nursing tasks to implement the plan of care.
24        (7) Providing health education and counseling.
25        (7.5) Advocating for the patient.
26        (8) Practicing ethically according to the American



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1    Nurses Association Code of Ethics.
2        (9) Practicing in a manner that recognizes cultural
3    diversity.
4        (10) Communicating effectively in all areas of
5    practice.
6        (11) Collaborating with patients and other key
7    stakeholders in the conduct of nursing practice.
8        (12) Participating in continuous professional
9    development.
10        (13) Teaching the theory and practice of nursing to
11    student nurses.
12        (14) Leading within the professional practice setting
13    and the profession.
14        (15) Contributing to quality nursing practice.
15        (16) Integrating evidence and research findings into
16    practice.
17        (17) Utilizing appropriate resources to plan, provide,
18    and sustain evidence-based nursing services that are safe
19    and effective.
20(Source: P.A. 100-513, eff. 1-1-18.)
21    (225 ILCS 65/80-65 new)
22    Sec. 80-65. Repeal. This Article is scheduled to be
23repealed on June 30, 2019.".