Full Text of SB0642 100th General Assembly
SB0642sam001 100TH GENERAL ASSEMBLY | Sen. Heather A. Steans Filed: 5/9/2017
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| 1 | | AMENDMENT TO SENATE BILL 642
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 642 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 5. The Medical Practice Act of 1987 is amended by | 5 | | changing Section 54.5 as follows:
| 6 | | (225 ILCS 60/54.5)
| 7 | | (Section scheduled to be repealed on December 31, 2017)
| 8 | | Sec. 54.5. Physician delegation of authority to physician | 9 | | assistants, advanced practice registered nurses without full | 10 | | practice authority , and prescribing psychologists.
| 11 | | (a) Physicians licensed to practice medicine in all its
| 12 | | branches may delegate care and treatment responsibilities to a
| 13 | | physician assistant under guidelines in accordance with the
| 14 | | requirements of the Physician Assistant Practice Act of
1987. A | 15 | | physician licensed to practice medicine in all its
branches may | 16 | | enter into supervising physician agreements with
no more than 5 |
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| 1 | | physician assistants as set forth in subsection (a) of Section | 2 | | 7 of the Physician Assistant Practice Act of 1987.
| 3 | | (b) A physician licensed to practice medicine in all its
| 4 | | branches in active clinical practice may collaborate with an | 5 | | advanced practice registered
nurse in accordance with the | 6 | | requirements of the Nurse Practice Act. Collaboration
is for | 7 | | the purpose of providing medical consultation,
and no | 8 | | employment relationship is required. A
written collaborative | 9 | | agreement shall
conform to the requirements of Section 65-35 of | 10 | | the Nurse Practice Act. The written collaborative agreement | 11 | | shall
be for
services in the same area of practice or specialty | 12 | | as the collaborating physician in
his or her clinical medical | 13 | | practice.
A written collaborative agreement shall be adequate | 14 | | with respect to collaboration
with advanced practice | 15 | | registered nurses if all of the following apply:
| 16 | | (1) The agreement is written to promote the exercise of | 17 | | professional judgment by the advanced practice registered | 18 | | nurse commensurate with his or her education and | 19 | | experience.
| 20 | | (2) The advance practice registered nurse provides | 21 | | services based upon a written collaborative agreement with | 22 | | the collaborating physician, except as set forth in | 23 | | subsection (b-5) of this Section. With respect to labor and | 24 | | delivery, the collaborating physician must provide | 25 | | delivery services in order to participate with a certified | 26 | | nurse midwife. |
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| 1 | | (3) Methods of communication are available with the | 2 | | collaborating physician in person or through | 3 | | telecommunications for consultation, collaboration, and | 4 | | referral as needed to address patient care needs.
| 5 | | (b-5) An anesthesiologist or physician licensed to | 6 | | practice medicine in
all its branches may collaborate with a | 7 | | certified registered nurse anesthetist
in accordance with | 8 | | Section 65-35 of the Nurse Practice Act for the provision of | 9 | | anesthesia services. With respect to the provision of | 10 | | anesthesia services, the collaborating anesthesiologist or | 11 | | physician shall have training and experience in the delivery of | 12 | | anesthesia services consistent with Department rules. | 13 | | Collaboration shall be
adequate if:
| 14 | | (1) an anesthesiologist or a physician
participates in | 15 | | the joint formulation and joint approval of orders or
| 16 | | guidelines and periodically reviews such orders and the | 17 | | services provided
patients under such orders; and
| 18 | | (2) for anesthesia services, the anesthesiologist
or | 19 | | physician participates through discussion of and agreement | 20 | | with the
anesthesia plan and is physically present and | 21 | | available on the premises during
the delivery of anesthesia | 22 | | services for
diagnosis, consultation, and treatment of | 23 | | emergency medical conditions.
Anesthesia services in a | 24 | | hospital shall be conducted in accordance with
Section 10.7 | 25 | | of the Hospital Licensing Act and in an ambulatory surgical
| 26 | | treatment center in accordance with Section 6.5 of the |
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| 1 | | Ambulatory Surgical
Treatment Center Act.
| 2 | | (b-10) The anesthesiologist or operating physician must | 3 | | agree with the
anesthesia plan prior to the delivery of | 4 | | services.
| 5 | | (c) The supervising physician shall have access to the
| 6 | | medical records of all patients attended by a physician
| 7 | | assistant. The collaborating physician shall have access to
the | 8 | | medical records of all patients attended to by an
advanced | 9 | | practice registered nurse.
| 10 | | (d) (Blank).
| 11 | | (e) A physician shall not be liable for the acts or
| 12 | | omissions of a prescribing psychologist, physician assistant, | 13 | | or advanced practice registered
nurse solely on the basis of | 14 | | having signed a
supervision agreement or guidelines or a | 15 | | collaborative
agreement, an order, a standing medical order, a
| 16 | | standing delegation order, or other order or guideline
| 17 | | authorizing a prescribing psychologist, physician assistant, | 18 | | or advanced practice registered
nurse to perform acts, unless | 19 | | the physician has
reason to believe the prescribing | 20 | | psychologist, physician assistant, or advanced
practice | 21 | | registered nurse lacked the competency to perform
the act or | 22 | | acts or commits willful and wanton misconduct.
| 23 | | (f) A collaborating physician may, but is not required to, | 24 | | delegate prescriptive authority to an advanced practice | 25 | | registered nurse as part of a written collaborative agreement, | 26 | | and the delegation of prescriptive authority shall conform to |
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| 1 | | the requirements of Section 65-40 of the Nurse Practice Act. | 2 | | (g) A supervising physician may, but is not required to, | 3 | | delegate prescriptive authority to a physician assistant as | 4 | | part of a written supervision agreement, and the delegation of | 5 | | prescriptive authority shall conform to the requirements of | 6 | | Section 7.5 of the Physician Assistant Practice Act of 1987. | 7 | | (h) (Blank). | 8 | | (i) A collaborating physician shall delegate prescriptive | 9 | | authority to a prescribing psychologist as part of a written | 10 | | collaborative agreement, and the delegation of prescriptive | 11 | | authority shall conform to the requirements of Section 4.3 of | 12 | | the Clinical Psychologist Licensing Act. | 13 | | (j) As set forth in Section 22.2 of this Act, a licensee | 14 | | under this Act may not directly or indirectly divide, share, or | 15 | | split any professional fee or other form of compensation for | 16 | | professional services with anyone in exchange for a referral or | 17 | | otherwise, other than as provided in Section 22.2. | 18 | | (Source: P.A. 98-192, eff. 1-1-14; 98-668, eff. 6-25-14; | 19 | | 99-173, eff. 7-29-15 .)
| 20 | | Section 10. The Nurse Practice Act is amended by changing | 21 | | Sections 50-10, 65-30, 65-35, 65-35.1, 65-40, 65-45, 65-50, | 22 | | 65-55, 65-60, and 65-65 and by adding Section 65-43 as follows:
| 23 | | (225 ILCS 65/50-10)
(was 225 ILCS 65/5-10)
| 24 | | (Section scheduled to be repealed on January 1, 2018)
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| 1 | | Sec. 50-10. Definitions. Each of the following terms, when | 2 | | used
in this Act, shall have the meaning ascribed to it in this | 3 | | Section, except
where the context clearly indicates otherwise:
| 4 | | "Academic year" means the customary annual schedule of | 5 | | courses at a
college, university, or approved school, | 6 | | customarily regarded as the school
year as distinguished from | 7 | | the calendar year.
| 8 | | "Advanced practice registered nurse" or "APRN" "APN" means | 9 | | a person who has met the qualifications for a (i) certified | 10 | | nurse midwife (CNM); (ii) certified nurse practitioner (CNP); | 11 | | (iii) certified registered nurse anesthetist (CRNA); or (iv) | 12 | | clinical nurse specialist (CNS) and has been licensed by the | 13 | | Department. All advanced practice registered nurses licensed | 14 | | and practicing in the State of Illinois shall use the title | 15 | | APRN APN and may use specialty credentials CNM, CNP, CRNA, or | 16 | | CNS after their name. All advanced practice registered nurses | 17 | | may only practice in accordance with national certification and | 18 | | this Act.
| 19 | | "Approved program of professional nursing education" and | 20 | | "approved
program of practical nursing education" are programs | 21 | | of professional or
practical nursing, respectively, approved | 22 | | by the Department under the
provisions of this Act.
| 23 | | "Board" means the Board of Nursing appointed by the | 24 | | Secretary. | 25 | | "Collaboration" means a process involving 2 or more health | 26 | | care professionals working together, each contributing one's |
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| 1 | | respective area of expertise to provide more comprehensive | 2 | | patient care. | 3 | | "Consultation" means the process whereby an advanced | 4 | | practice registered nurse seeks the advice or opinion of | 5 | | another health care professional. | 6 | | "Credentialed" means the process of assessing and | 7 | | validating the qualifications of a health care professional. | 8 | | "Current nursing practice update course" means a planned | 9 | | nursing education curriculum approved by the Department | 10 | | consisting of activities that have educational objectives, | 11 | | instructional methods, content or subject matter, clinical | 12 | | practice, and evaluation methods, related to basic review and | 13 | | updating content and specifically planned for those nurses | 14 | | previously licensed in the United States or its territories and | 15 | | preparing for reentry into nursing practice. | 16 | | "Dentist" means a person licensed to practice dentistry | 17 | | under the Illinois Dental Practice Act. | 18 | | "Department" means the Department of Financial and | 19 | | Professional Regulation. | 20 | | "Full practice authority" means the authority of an | 21 | | advanced practice registered nurse licensed in Illinois and | 22 | | certified as a nurse practitioner, clinical nurse specialist, | 23 | | or nurse midwife to practice without a written collaborative | 24 | | agreement and: | 25 | | (1) to be fully accountable to patients for the quality | 26 | | of advanced nursing care rendered; |
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| 1 | | (2) to be fully accountable for recognizing limits of | 2 | | knowledge and experience and for planning for the | 3 | | management of situations beyond the advanced practice | 4 | | registered nurse's expertise; the full practice authority | 5 | | for advanced practice registered nurses includes accepting | 6 | | referrals from, consulting with, collaborating with, or | 7 | | referring to other health care professionals as warranted | 8 | | by the needs of the patient; and | 9 | | (3) to possess the authority to prescribe medications, | 10 | | including Schedule II through V controlled substances, as | 11 | | provided in Section 65-43. | 12 | | "Hospital affiliate" means a corporation, partnership, | 13 | | joint venture, limited liability company, or similar | 14 | | organization, other than a hospital, that is devoted primarily | 15 | | to the provision, management, or support of health care | 16 | | services and that directly or indirectly controls, is | 17 | | controlled by, or is under common control of the hospital. For | 18 | | the purposes of this definition, "control" means having at | 19 | | least an equal or a majority ownership or membership interest. | 20 | | A hospital affiliate shall be 100% owned or controlled by any | 21 | | combination of hospitals, their parent corporations, or | 22 | | physicians licensed to practice medicine in all its branches in | 23 | | Illinois. "Hospital affiliate" does not include a health | 24 | | maintenance organization regulated under the Health | 25 | | Maintenance Organization Act. | 26 | | "Impaired nurse" means a nurse licensed under this Act who |
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| 1 | | is unable to practice with reasonable skill and safety because | 2 | | of a physical or mental disability as evidenced by a written | 3 | | determination or written consent based on clinical evidence, | 4 | | including loss of motor skills, abuse of drugs or alcohol, or a | 5 | | psychiatric disorder, of sufficient degree to diminish his or | 6 | | her ability to deliver competent patient care. | 7 | | "License-pending advanced practice registered nurse" means | 8 | | a registered professional nurse who has completed all | 9 | | requirements for licensure as an advanced practice registered | 10 | | nurse except the certification examination and has applied to | 11 | | take the next available certification exam and received a | 12 | | temporary license from the Department. | 13 | | "License-pending registered nurse" means a person who has | 14 | | passed the Department-approved registered nurse licensure exam | 15 | | and has applied for a license from the Department. A | 16 | | license-pending registered nurse shall use the title "RN lic | 17 | | pend" on all documentation related to nursing practice. | 18 | | "Physician" means a person licensed to practice medicine in | 19 | | all its branches under the Medical Practice Act of 1987. | 20 | | "Podiatric physician" means a person licensed to practice | 21 | | podiatry under the Podiatric Medical Practice Act of 1987.
| 22 | | "Practical nurse" or "licensed practical nurse" means a | 23 | | person who is
licensed as a practical nurse under this Act and | 24 | | practices practical
nursing as defined in this Act. Only a | 25 | | practical nurse
licensed under this Act is entitled to use the | 26 | | title "licensed practical
nurse" and the abbreviation |
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| 1 | | "L.P.N.".
| 2 | | "Practical nursing" means the performance of
nursing acts | 3 | | requiring the basic nursing knowledge, judgment, and skill
| 4 | | acquired by means of completion of an approved practical | 5 | | nursing education
program. Practical nursing includes | 6 | | assisting in the nursing process as
delegated by a registered | 7 | | professional nurse or an advanced practice registered nurse. | 8 | | The
practical nurse may work under the direction of a licensed | 9 | | physician, dentist, podiatric physician, or other health care | 10 | | professional determined by the Department.
| 11 | | "Prescription monitoring program" means the entity that | 12 | | collects, tracks, and stores reported data on controlled | 13 | | substances and select drugs pursuant to Section 316 of the | 14 | | Illinois Controlled Substances Act. | 15 | | "Privileged" means the authorization granted by the | 16 | | governing body of a healthcare facility, agency, or | 17 | | organization to provide specific patient care services within | 18 | | well-defined limits, based on qualifications reviewed in the | 19 | | credentialing process.
| 20 | | "Registered Nurse" or "Registered Professional Nurse" | 21 | | means a person
who is licensed as a professional nurse under | 22 | | this Act and practices
nursing as defined in
this Act. Only a | 23 | | registered
nurse licensed under this Act is entitled to use the
| 24 | | titles "registered nurse" and "registered professional nurse" | 25 | | and the
abbreviation, "R.N.".
| 26 | | "Registered professional nursing practice" is a scientific |
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| 1 | | process founded on a professional body of knowledge; it is a | 2 | | learned profession based on the understanding of the human | 3 | | condition across the life span and environment and
includes all
| 4 | | nursing
specialties and means the performance of any nursing | 5 | | act based upon
professional knowledge, judgment, and skills | 6 | | acquired by means of completion
of an approved professional | 7 | | nursing education program. A registered
professional nurse | 8 | | provides holistic nursing care through the nursing process
to | 9 | | individuals, groups, families, or communities, that includes | 10 | | but is not
limited to: (1) the assessment of healthcare needs, | 11 | | nursing diagnosis,
planning, implementation, and nursing | 12 | | evaluation; (2) the promotion,
maintenance, and restoration of | 13 | | health; (3) counseling, patient education,
health education, | 14 | | and patient advocacy; (4) the administration of medications
and | 15 | | treatments as prescribed by a physician licensed to practice | 16 | | medicine in
all of its branches, a licensed dentist, a licensed | 17 | | podiatric physician, or a licensed
optometrist or as prescribed | 18 | | by a physician assistant
or by an advanced practice registered | 19 | | nurse; (5) the
coordination and management of the nursing plan | 20 | | of care; (6) the delegation to
and supervision of individuals | 21 | | who assist the registered professional nurse
implementing the | 22 | | plan of care; and (7) teaching nursing
students. The foregoing | 23 | | shall not be deemed to include
those acts of medical diagnosis | 24 | | or prescription of therapeutic or
corrective measures.
| 25 | | "Professional assistance program for nurses" means a | 26 | | professional
assistance program that meets criteria |
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| 1 | | established by the Board of Nursing
and approved by the | 2 | | Secretary, which provides a non-disciplinary treatment
| 3 | | approach for nurses licensed under this Act whose ability to | 4 | | practice is
compromised by alcohol or chemical substance | 5 | | addiction.
| 6 | | "Secretary" means the Secretary of Financial and | 7 | | Professional Regulation. | 8 | | "Unencumbered license" means a license issued in good | 9 | | standing. | 10 | | "Written collaborative agreement" means a written | 11 | | agreement between an advanced practice registered nurse and a | 12 | | collaborating physician, dentist, or podiatric physician | 13 | | pursuant to Section 65-35.
| 14 | | (Source: P.A. 98-214, eff. 8-9-13; 99-173, eff. 7-29-15; | 15 | | 99-330, eff. 1-1-16; 99-642, eff. 7-28-16.)
| 16 | | (225 ILCS 65/65-30) | 17 | | (Section scheduled to be repealed on January 1, 2018)
| 18 | | Sec. 65-30. APRN APN scope of practice.
| 19 | | (a) Advanced practice registered nursing by certified | 20 | | nurse practitioners, certified nurse anesthetists, certified | 21 | | nurse midwives, or clinical nurse specialists is based on | 22 | | knowledge and skills acquired throughout an advanced practice | 23 | | registered nurse's nursing education, training, and | 24 | | experience. | 25 | | (b) Practice as an advanced practice registered nurse means |
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| 1 | | a scope of nursing practice, with or without compensation, and | 2 | | includes the registered nurse scope of practice. | 3 | | (c) The scope of practice of an advanced practice | 4 | | registered nurse includes, but is not limited to, each of the | 5 | | following: | 6 | | (1) Advanced registered nursing patient assessment and | 7 | | diagnosis. | 8 | | (2) Ordering diagnostic and therapeutic tests and | 9 | | procedures, performing those tests and procedures when using | 10 | | health care equipment, and interpreting and using the results | 11 | | of diagnostic and therapeutic tests and procedures ordered by | 12 | | the advanced practice registered nurse or another health care | 13 | | professional. | 14 | | (3) Ordering treatments, ordering or applying | 15 | | appropriate medical devices, and using nursing medical, | 16 | | therapeutic, and corrective measures to treat illness and | 17 | | improve health status. | 18 | | (4) Providing palliative and end-of-life care. | 19 | | (5) Providing advanced counseling, patient education, | 20 | | health education, and patient advocacy. | 21 | | (6) Prescriptive authority as defined in Section 65-40 | 22 | | of this Act. | 23 | | (7) Delegating selected nursing activities or tasks to | 24 | | a licensed practical nurse, a registered professional nurse, or | 25 | | other personnel.
| 26 | | (Source: P.A. 95-639, eff. 10-5-07.)
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| 1 | | (225 ILCS 65/65-35)
(was 225 ILCS 65/15-15)
| 2 | | (Section scheduled to be repealed on January 1, 2018)
| 3 | | Sec. 65-35. Written collaborative
agreements. | 4 | | (a) A written collaborative agreement is required for all | 5 | | advanced practice registered nurses engaged in clinical | 6 | | practice prior to meeting the requirements of Section 65-43 , | 7 | | except for advanced practice registered nurses who are | 8 | | privileged authorized to practice in a hospital, hospital | 9 | | affiliate, or ambulatory surgical treatment center. | 10 | | (a-5) If an advanced practice registered nurse engages in | 11 | | clinical practice outside of a hospital, hospital affiliate, or | 12 | | ambulatory surgical treatment center in which he or she is | 13 | | privileged authorized to practice, the advanced practice | 14 | | registered nurse must have a written collaborative agreement , | 15 | | except as set forth in Section 65-43 .
| 16 | | (b) A written collaborative
agreement shall describe the | 17 | | relationship of the
advanced practice registered nurse with the | 18 | | collaborating
physician or podiatric physician and shall | 19 | | describe the categories of
care, treatment, or procedures to be | 20 | | provided by the advanced
practice registered nurse. A | 21 | | collaborative agreement with a dentist must be in accordance | 22 | | with subsection (c-10) of this Section. A collaborative | 23 | | agreement with a podiatric physician must be in accordance with | 24 | | subsection (c-5) of this Section. Collaboration does not | 25 | | require an
employment relationship between the collaborating |
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| 1 | | physician
or podiatric physician and the advanced practice | 2 | | registered nurse.
| 3 | | The collaborative
relationship under an agreement shall | 4 | | not be
construed to require the personal presence of a | 5 | | collaborating physician or podiatric physician at the place | 6 | | where services are rendered.
Methods of communication shall
be | 7 | | available for consultation with the collaborating
physician or | 8 | | podiatric physician in person or by telecommunications or | 9 | | electronic communications as set forth in the written
| 10 | | agreement.
| 11 | | (b-5) Absent an employment relationship, a written | 12 | | collaborative agreement may not (1) restrict the categories of | 13 | | patients of an advanced practice registered nurse within the | 14 | | scope of the advanced practice registered nurses training and | 15 | | experience, (2) limit third party payors or government health | 16 | | programs, such as the medical assistance program or Medicare | 17 | | with which the advanced practice registered nurse contracts, or | 18 | | (3) limit the geographic area or practice location of the | 19 | | advanced practice registered nurse in this State. | 20 | | (c)
In the case of anesthesia services provided by a | 21 | | certified registered nurse anesthetist, an anesthesiologist, a | 22 | | physician, a dentist, or a podiatric physician must participate | 23 | | through discussion of and agreement with the anesthesia plan | 24 | | and remain physically present and available on the premises | 25 | | during the delivery of anesthesia services for diagnosis, | 26 | | consultation, and treatment of emergency medical conditions.
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| 1 | | (c-5) A certified registered nurse anesthetist, who | 2 | | provides anesthesia services outside of a hospital or | 3 | | ambulatory surgical treatment center shall enter into a written | 4 | | collaborative agreement with an anesthesiologist or the | 5 | | physician licensed to practice medicine in all its branches or | 6 | | the podiatric physician performing the procedure. Outside of a | 7 | | hospital or ambulatory surgical treatment center, the | 8 | | certified registered nurse anesthetist may provide only those | 9 | | services that the collaborating podiatric physician is | 10 | | authorized to provide pursuant to the Podiatric Medical | 11 | | Practice Act of 1987 and rules adopted thereunder. A certified | 12 | | registered nurse anesthetist may select, order, and administer | 13 | | medication, including controlled substances, and apply | 14 | | appropriate medical devices for delivery of anesthesia | 15 | | services under the anesthesia plan agreed with by the | 16 | | anesthesiologist or the operating physician or operating | 17 | | podiatric physician. | 18 | | (c-10) A certified registered nurse anesthetist who | 19 | | provides anesthesia services in a dental office shall enter | 20 | | into a written collaborative agreement with an | 21 | | anesthesiologist or the physician licensed to practice | 22 | | medicine in all its branches or the operating dentist | 23 | | performing the procedure. The agreement shall describe the | 24 | | working relationship of the certified registered nurse | 25 | | anesthetist and dentist and shall authorize the categories of | 26 | | care, treatment, or procedures to be performed by the certified |
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| 1 | | registered nurse anesthetist. In a collaborating dentist's | 2 | | office, the certified registered nurse anesthetist may only | 3 | | provide those services that the operating dentist with the | 4 | | appropriate permit is authorized to provide pursuant to the | 5 | | Illinois Dental Practice Act and rules adopted thereunder. For | 6 | | anesthesia services, an anesthesiologist, physician, or | 7 | | operating dentist shall participate through discussion of and | 8 | | agreement with the anesthesia plan and shall remain physically | 9 | | present and be available on the premises during the delivery of | 10 | | anesthesia services for diagnosis, consultation, and treatment | 11 | | of emergency medical conditions. A certified registered nurse | 12 | | anesthetist may select, order, and administer medication, | 13 | | including controlled substances, and apply appropriate medical | 14 | | devices for delivery of anesthesia services under the | 15 | | anesthesia plan agreed with by the operating dentist. | 16 | | (d) A copy of the signed, written collaborative agreement | 17 | | must be available
to the Department upon request from both the | 18 | | advanced practice registered nurse
and the collaborating | 19 | | physician, dentist, or podiatric physician. | 20 | | (e) Nothing in this Act shall be construed to limit the | 21 | | delegation of tasks or duties by a physician to a licensed | 22 | | practical nurse, a registered professional nurse, or other | 23 | | persons in accordance with Section 54.2 of the Medical Practice | 24 | | Act of 1987. Nothing in this Act shall be construed to limit | 25 | | the method of delegation that may be authorized by any means, | 26 | | including, but not limited to, oral, written, electronic, |
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| 1 | | standing orders, protocols, guidelines, or verbal orders. | 2 | | Nothing in this Act shall be construed to authorize an advanced | 3 | | practice registered nurse to provide health care services | 4 | | required by law or rule to be performed by a physician. | 5 | | (f) An advanced
practice registered nurse shall inform each | 6 | | collaborating physician, dentist, or podiatric physician of | 7 | | all collaborative
agreements he or she
has signed and provide a | 8 | | copy of these to any collaborating physician, dentist, or | 9 | | podiatric physician upon
request.
| 10 | | (g) (Blank). | 11 | | (Source: P.A. 98-192, eff. 1-1-14; 98-214, eff. 8-9-13; 98-756, | 12 | | eff. 7-16-14; 99-173, eff. 7-29-15.)
| 13 | | (225 ILCS 65/65-35.1) | 14 | | (Section scheduled to be repealed on January 1, 2018) | 15 | | Sec. 65-35.1. Written collaborative agreement; temporary | 16 | | practice. Any advanced practice registered nurse required to | 17 | | enter into a written collaborative agreement with a | 18 | | collaborating physician or collaborating podiatrist is | 19 | | authorized to continue to practice for up to 90 days after the | 20 | | termination of a collaborative agreement provided the advanced | 21 | | practice registered nurse seeks any needed collaboration at a | 22 | | local hospital and refers patients who require services beyond | 23 | | the training and experience of the advanced practice registered | 24 | | nurse to a physician or other health care provider.
| 25 | | (Source: P.A. 99-173, eff. 7-29-15.)
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| 1 | | (225 ILCS 65/65-40)
(was 225 ILCS 65/15-20)
| 2 | | (Section scheduled to be repealed on January 1, 2018)
| 3 | | Sec. 65-40. Written collaborative agreement; prescriptive | 4 | | authority.
| 5 | | (a) A collaborating
physician or podiatric physician may, | 6 | | but is not required to, delegate
prescriptive authority to an | 7 | | advanced practice registered
nurse as part of a written | 8 | | collaborative agreement. This authority may, but is
not | 9 | | required to, include
prescription of, selection of, orders for, | 10 | | administration of, storage of, acceptance of samples of, and | 11 | | dispensing over the counter medications, legend drugs, medical | 12 | | gases, and controlled
substances categorized as
any Schedule | 13 | | III through V controlled substances, as defined in Article II | 14 | | of the
Illinois Controlled Substances Act, and other | 15 | | preparations, including, but not limited to, botanical and | 16 | | herbal remedies. The collaborating physician or podiatric | 17 | | physician must have a valid current Illinois controlled | 18 | | substance license and federal registration to delegate | 19 | | authority to prescribe delegated controlled substances.
| 20 | | (b) To prescribe controlled
substances under this Section, | 21 | | an advanced practice registered
nurse must obtain a mid-level | 22 | | practitioner controlled substance license.
Medication orders | 23 | | shall be
reviewed
periodically by the collaborating physician | 24 | | o r podiatric physician .
| 25 | | (c) The collaborating physician or podiatric physician |
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| 1 | | shall file with the
Department notice of delegation of | 2 | | prescriptive authority
and
termination of such delegation, in | 3 | | accordance with rules of the Department.
Upon receipt of this | 4 | | notice delegating authority to prescribe any Schedule III | 5 | | through V controlled substances, the licensed advanced | 6 | | practice registered nurse shall be
eligible to register for a | 7 | | mid-level practitioner controlled substance license
under | 8 | | Section 303.05 of the Illinois Controlled Substances Act.
| 9 | | (d) In addition to the requirements of subsections (a), | 10 | | (b), and (c) of this Section, a collaborating physician or | 11 | | podiatric physician may, but is not required to, delegate | 12 | | authority to an advanced practice registered nurse to prescribe | 13 | | any Schedule II controlled substances, if all of the following | 14 | | conditions apply: | 15 | | (1) Specific Schedule II controlled substances by oral | 16 | | dosage or topical or transdermal application may be | 17 | | delegated, provided that the delegated Schedule II | 18 | | controlled substances are routinely prescribed by the | 19 | | collaborating physician or podiatric physician . This | 20 | | delegation must identify the specific Schedule II | 21 | | controlled substances by either brand name or generic name. | 22 | | Schedule II controlled substances to be delivered by | 23 | | injection or other route of administration may not be | 24 | | delegated. | 25 | | (2) Any delegation must be controlled substances that | 26 | | the collaborating physician or podiatric physician |
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| 1 | | prescribes. | 2 | | (3) Any prescription must be limited to no more than a | 3 | | 30-day supply, with any continuation authorized only after | 4 | | prior approval of the collaborating physician or podiatric | 5 | | physician . | 6 | | (4) The advanced practice registered nurse must | 7 | | discuss the condition of any patients for whom a controlled | 8 | | substance is prescribed monthly with the delegating | 9 | | physician. | 10 | | (5) The advanced practice registered nurse meets the | 11 | | education requirements of Section 303.05 of the Illinois | 12 | | Controlled Substances Act.
| 13 | | (e) Nothing in this Act shall be construed to limit the | 14 | | delegation of tasks
or duties by a physician to a licensed | 15 | | practical nurse, a registered
professional nurse, or other | 16 | | persons. Nothing in this Act shall be construed to limit the | 17 | | method of delegation that may be authorized by any means, | 18 | | including, but not limited to, oral, written, electronic, | 19 | | standing orders, protocols, guidelines, or verbal orders.
| 20 | | (f) Nothing in this Section shall be construed to apply to | 21 | | any medication authority including Schedule II controlled | 22 | | substances of an advanced practice registered nurse for care | 23 | | provided in a hospital, hospital affiliate, or ambulatory | 24 | | surgical treatment center pursuant to Section 65-45. | 25 | | (g) (Blank). Any advanced practice nurse who writes a | 26 | | prescription for a controlled substance without having a valid |
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| 1 | | appropriate authority may be fined by the Department not more | 2 | | than $50 per prescription, and the Department may take any | 3 | | other disciplinary action provided for in this Act. | 4 | | (h) Nothing in this Section shall be construed to prohibit | 5 | | generic substitution. | 6 | | (i) Nothing in this Section shall be construed to apply to | 7 | | an advanced practice registered nurse who meets the | 8 | | requirements of Section 65-43. | 9 | | (Source: P.A. 97-358, eff. 8-12-11; 98-214, eff. 8-9-13.)
| 10 | | (225 ILCS 65/65-43 new) | 11 | | Sec. 65-43. Full practice authority. | 12 | | (a) An Illinois-licensed advanced practice registered | 13 | | nurse certified as a nurse practitioner, nurse midwife, or | 14 | | clinical nurse specialist shall be deemed by law to possess the | 15 | | ability to practice without a written collaborative agreement | 16 | | as set forth in this Section. | 17 | | (b) An advanced practice registered nurse certified as a | 18 | | nurse midwife, clinical nurse specialist, or nurse | 19 | | practitioner who files with the Department a notarized | 20 | | attestation of completion of at least 4,000 hours of clinical | 21 | | experience after first attaining national certification shall | 22 | | not require a written collaborative agreement, except as | 23 | | specified in subsection (c). Documentation of successful | 24 | | completion shall be provided to the Department upon request. | 25 | | The clinical experience must be in the advanced practice |
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| 1 | | registered nurse's area of certification. The clinical | 2 | | experience shall be in collaboration with a physician or | 3 | | physicians. Completion of the clinical experience must be | 4 | | attested to by the collaborating physician or physicians and | 5 | | the advanced practice registered nurse. | 6 | | (c) The scope of practice of an advanced practice | 7 | | registered nurse includes: | 8 | | (1) all matters included in subsection (c) of Section | 9 | | 65-30 of this Act; | 10 | | (2) practicing without a written collaborative | 11 | | agreement in all practice settings consistent with | 12 | | national certification; | 13 | | (3) authority to prescribe both legend drugs and | 14 | | Schedule II through V controlled substances; this | 15 | | authority includes prescription of, selection of, orders | 16 | | for, administration of, storage of, acceptance of samples | 17 | | of, and dispensing over the counter medications, legend | 18 | | drugs, and controlled substances categorized as any | 19 | | Schedule II through V controlled substances, as defined in | 20 | | Article II of the Illinois Controlled Substances Act, and | 21 | | other preparations, including, but not limited to, | 22 | | botanical and herbal remedies; | 23 | | (4) proof of an Illinois controlled substance license | 24 | | and a federal Drug Enforcement Administration number; and | 25 | | (5) use of only local anesthetic. | 26 | | The scope of practice of an advanced practice registered |
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| 1 | | nurse does not include operative surgery. | 2 | | (d) Before issuing a prescription for Schedule II, III, IV, | 3 | | or V controlled substances, the advanced practice registered | 4 | | nurse or her or his designee shall access the prescription | 5 | | monitoring program as set forth under Section 314.5 of the | 6 | | Illinois Controlled Substances Act for each patient and | 7 | | document in the medical record that: | 8 | | (1) the prescription monitoring program was accessed | 9 | | and relevant data was reviewed prior to prescribing a | 10 | | scheduled drug; and | 11 | | (2) risk factors were evaluated (or identified) and | 12 | | discussed with the patient based on current federal Centers | 13 | | for Disease Control and Prevention guidelines.
| 14 | | (225 ILCS 65/65-45)
(was 225 ILCS 65/15-25)
| 15 | | (Section scheduled to be repealed on January 1, 2018)
| 16 | | Sec. 65-45. Advanced practice registered nursing in | 17 | | hospitals, hospital affiliates, or ambulatory surgical | 18 | | treatment centers.
| 19 | | (a) An advanced practice registered nurse may provide
| 20 | | services in a hospital or a hospital affiliate as those terms | 21 | | are defined in the Hospital Licensing Act or the University of | 22 | | Illinois Hospital Act or a licensed ambulatory surgical
| 23 | | treatment center without a written collaborative agreement | 24 | | pursuant to Section 65-35 of this Act. An advanced practice | 25 | | registered nurse must possess clinical privileges recommended |
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| 1 | | by the hospital medical staff and granted by the hospital or | 2 | | the consulting medical staff committee and ambulatory surgical | 3 | | treatment center in order to provide services. The medical | 4 | | staff or consulting medical staff committee shall periodically | 5 | | review the services of all advanced practice registered nurses | 6 | | granted clinical privileges, including any care provided in a | 7 | | hospital affiliate. Authority may also be granted when | 8 | | recommended by the hospital medical staff and granted by the | 9 | | hospital or recommended by the consulting medical staff | 10 | | committee and ambulatory surgical treatment center to | 11 | | individual advanced practice registered nurses to select, | 12 | | order, and administer medications, including controlled | 13 | | substances, to provide delineated care. In a hospital, hospital | 14 | | affiliate, or ambulatory surgical treatment center, the | 15 | | attending physician shall determine an advanced practice | 16 | | registered nurse's role in providing care for his or her | 17 | | patients, except as otherwise provided in the medical staff | 18 | | bylaws or consulting committee policies.
| 19 | | (a-2) An advanced practice registered nurse privileged | 20 | | granted authority to order medications , including controlled | 21 | | substances , may complete discharge prescriptions provided the | 22 | | prescription is in the name of the advanced practice registered | 23 | | nurse and the attending or discharging physician. | 24 | | (a-3) Advanced practice registered nurses practicing in a | 25 | | hospital or an ambulatory surgical treatment center are not | 26 | | required to obtain a mid-level controlled substance license to |
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| 1 | | order controlled substances under Section 303.05 of the | 2 | | Illinois Controlled Substances Act. | 3 | | (a-4) An advanced practice registered nurse meeting the | 4 | | requirements of Section 65-43 may be privileged to complete | 5 | | discharge orders and prescriptions under the advanced practice | 6 | | registered nurse's name. | 7 | | (a-5) For
anesthesia services provided by a certified | 8 | | registered nurse anesthetist, an anesthesiologist,
physician, | 9 | | dentist,
or podiatric physician shall participate through | 10 | | discussion of and agreement with the
anesthesia plan and shall
| 11 | | remain
physically present
and be available on the premises | 12 | | during the delivery of anesthesia services for
diagnosis, | 13 | | consultation, and treatment of
emergency medical conditions, | 14 | | unless hospital policy adopted pursuant to
clause (B) of | 15 | | subdivision (3) of Section 10.7 of the Hospital Licensing Act
| 16 | | or ambulatory surgical treatment center policy adopted | 17 | | pursuant to
clause (B) of subdivision (3) of Section 6.5 of the | 18 | | Ambulatory Surgical
Treatment Center Act
provides otherwise. A | 19 | | certified registered nurse anesthetist may select, order, and | 20 | | administer medication for anesthesia services under the | 21 | | anesthesia plan agreed to by the anesthesiologist or the | 22 | | physician, in accordance with hospital alternative policy or | 23 | | the medical staff consulting committee policies of a licensed | 24 | | ambulatory surgical treatment center.
| 25 | | (b) An advanced practice registered nurse who provides
| 26 | | services in a hospital shall do so in accordance with Section |
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| 1 | | 10.7 of the
Hospital
Licensing Act and, in an
ambulatory | 2 | | surgical treatment center, in accordance with Section 6.5 of | 3 | | the
Ambulatory
Surgical Treatment Center Act. Nothing in this | 4 | | Act shall be construed to require an advanced practice | 5 | | registered nurse to have a collaborative agreement to practice | 6 | | in a hospital, hospital affiliate, or ambulatory surgical | 7 | | treatment center.
| 8 | | (c) Advanced practice registered nurses certified as nurse | 9 | | practitioners, nurse midwives, or clinical nurse specialists | 10 | | practicing in a hospital affiliate may be, but are not required | 11 | | to be, privileged granted authority to prescribe Schedule II | 12 | | through V controlled substances when such authority is | 13 | | recommended by the appropriate physician committee of the | 14 | | hospital affiliate and granted by the hospital affiliate. This | 15 | | authority may, but is not required to, include prescription of, | 16 | | selection of, orders for, administration of, storage of, | 17 | | acceptance of samples of, and dispensing over-the-counter | 18 | | medications, legend drugs, medical gases, and controlled | 19 | | substances categorized as Schedule II through V controlled | 20 | | substances, as defined in Article II of the Illinois Controlled | 21 | | Substances Act, and other preparations, including, but not | 22 | | limited to, botanical and herbal remedies. | 23 | | To prescribe controlled substances under this subsection | 24 | | (c), an advanced practice registered nurse certified as a nurse | 25 | | practitioner, nurse midwife, or clinical nurse specialist must | 26 | | obtain a mid-level practitioner controlled substance license. |
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| 1 | | Medication orders shall be reviewed periodically by the | 2 | | appropriate hospital affiliate physicians committee or its | 3 | | physician designee. | 4 | | The hospital affiliate shall file with the Department | 5 | | notice of a grant of prescriptive authority consistent with | 6 | | this subsection (c) and termination of such a grant of | 7 | | authority, in accordance with rules of the Department. Upon | 8 | | receipt of this notice of grant of authority to prescribe any | 9 | | Schedule II through V controlled substances, the licensed | 10 | | advanced practice registered nurse certified as a nurse | 11 | | practitioner, nurse midwife, or clinical nurse specialist may | 12 | | register for a mid-level practitioner controlled substance | 13 | | license under Section 303.05 of the Illinois Controlled | 14 | | Substances Act. | 15 | | In addition, a hospital affiliate may, but is not required | 16 | | to, privilege grant authority to an advanced practice | 17 | | registered nurse certified as a nurse practitioner, nurse | 18 | | midwife, or clinical nurse specialist to prescribe any Schedule | 19 | | II controlled substances, if all of the following conditions | 20 | | apply: | 21 | | (1) specific Schedule II controlled substances by oral | 22 | | dosage or topical or transdermal application may be | 23 | | designated, provided that the designated Schedule II | 24 | | controlled substances are routinely prescribed by advanced | 25 | | practice registered nurses in their area of certification; | 26 | | the privileging documents this grant of authority must |
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| 1 | | identify the specific Schedule II controlled substances by | 2 | | either brand name or generic name; authority to prescribe | 3 | | or dispense Schedule II controlled substances to be | 4 | | delivered by injection or other route of administration may | 5 | | not be granted; | 6 | | (2) any privilege grant of authority must be controlled | 7 | | substances limited to the practice of the advanced practice | 8 | | registered nurse; | 9 | | (3) any prescription must be limited to no more than a | 10 | | 30-day supply; | 11 | | (4) the advanced practice registered nurse must | 12 | | discuss the condition of any patients for whom a controlled | 13 | | substance is prescribed monthly with the appropriate | 14 | | physician committee of the hospital affiliate or its | 15 | | physician designee; and | 16 | | (5) the advanced practice registered nurse must meet | 17 | | the education requirements of Section 303.05 of the | 18 | | Illinois Controlled Substances Act. | 19 | | (d) An advanced practice registered nurse meeting the | 20 | | requirements of Section 65-43 may be privileged to prescribe | 21 | | controlled substances categorized as Schedule II through V in | 22 | | accordance with Section 65-43. | 23 | | (Source: P.A. 98-214, eff. 8-9-13; 99-173, eff. 7-29-15.)
| 24 | | (225 ILCS 65/65-50)
(was 225 ILCS 65/15-30)
| 25 | | (Section scheduled to be repealed on January 1, 2018)
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| 1 | | Sec. 65-50. APRN APN title.
| 2 | | (a) No person shall use any words, abbreviations, figures,
| 3 | | letters, title, sign, card, or device tending to imply that
he | 4 | | or she is an advanced practice registered nurse, including
but | 5 | | not limited to using the titles or initials "Advanced Practice | 6 | | Registered Nurse", "Advanced
Practice Nurse", "Certified Nurse | 7 | | Midwife", "Certified Nurse Practitioner",
"Certified | 8 | | Registered Nurse Anesthetist", "Clinical Nurse Specialist", | 9 | | "A.P.R.N.",
"A.P.N.", "C.N.M.", "C.N.P.",
"C.R.N.A.", | 10 | | "C.N.S.", or similar titles or initials, with the
intention of | 11 | | indicating practice as an advanced practice registered
nurse | 12 | | without meeting the requirements of this
Act.
| 13 | | (b) No advanced practice registered nurse shall indicate to | 14 | | other persons that he or she is qualified to engage in the | 15 | | practice of medicine.
| 16 | | (c) An advanced practice registered nurse shall verbally
| 17 | | identify himself or herself as an advanced practice registered
| 18 | | nurse, including specialty certification, to each
patient.
| 19 | | (d) Nothing in this Act shall be construed to relieve
an | 20 | | advanced practice registered nurse of the
professional or legal | 21 | | responsibility for the care and
treatment of persons attended | 22 | | by him or her.
| 23 | | (Source: P.A. 95-639, eff. 10-5-07.)
| 24 | | (225 ILCS 65/65-55)
(was 225 ILCS 65/15-40)
| 25 | | (Section scheduled to be repealed on January 1, 2018)
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| 1 | | Sec. 65-55. Advertising as an APRN APN .
| 2 | | (a) A person licensed under this Act as an advanced | 3 | | practice registered nurse
may advertise the availability of | 4 | | professional services in
the public media or on the premises | 5 | | where the professional
services are rendered. The advertising | 6 | | shall be limited to
the following information:
| 7 | | (1) publication of the person's name, title, office
| 8 | | hours, address, and telephone number;
| 9 | | (2) information pertaining to the person's areas of
| 10 | | specialization, including , but not limited to , appropriate | 11 | | national board certification
or limitation of professional | 12 | | practice;
| 13 | | (3) publication of the person's collaborating
| 14 | | physician's or , dentist's , or podiatric physician's name, | 15 | | title , if such is required , and areas of specialization;
| 16 | | (4) information on usual and customary fees for
routine | 17 | | professional services offered, which shall include | 18 | | notification that
fees may be
adjusted due to complications | 19 | | or unforeseen circumstances;
| 20 | | (5) announcements of the opening of, change of,
absence | 21 | | from, or return to business;
| 22 | | (6) announcement of additions to or deletions from
| 23 | | professional licensed staff; and
| 24 | | (7) the issuance of business or appointment cards.
| 25 | | (b) It is unlawful for a person licensed under this Act as | 26 | | an advanced practice nurse to use testimonials or claims of |
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| 1 | | superior quality of
care to entice the public. It shall be | 2 | | unlawful to advertise
fee comparisons of available services | 3 | | with those of other
licensed persons.
| 4 | | (c) This Article does not authorize the advertising of
| 5 | | professional services that the offeror of the services is
not | 6 | | licensed or authorized to render. Nor shall the
advertiser use | 7 | | statements that contain false, fraudulent,
deceptive, or | 8 | | misleading material or guarantees of success,
statements that | 9 | | play upon the vanity or fears of the public,
or statements that | 10 | | promote or produce unfair competition.
| 11 | | (d) It is unlawful and punishable under the penalty
| 12 | | provisions of this Act for a person licensed under this Article | 13 | | to
knowingly advertise that the licensee will accept as payment
| 14 | | for services rendered by assignment from any third party
payor | 15 | | the amount the third party payor covers as payment in
full, if | 16 | | the effect is to give the impression of eliminating
the need of | 17 | | payment by the patient of any required deductible
or copayment | 18 | | applicable in the patient's health benefit plan.
| 19 | | (e) A licensee shall include in every advertisement for | 20 | | services
regulated under this Act his or her title as it | 21 | | appears on the license or the
initials authorized under this | 22 | | Act.
| 23 | | (f) As used in this Section, "advertise" means
solicitation | 24 | | by the licensee or through another person or entity by means of
| 25 | | handbills, posters, circulars, motion pictures, radio,
| 26 | | newspapers, or television or any other manner.
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| 1 | | (Source: P.A. 98-214, eff. 8-9-13.)
| 2 | | (225 ILCS 65/65-60)
(was 225 ILCS 65/15-45)
| 3 | | (Section scheduled to be repealed on January 1, 2018)
| 4 | | Sec. 65-60. Continuing education. The Department shall
| 5 | | adopt rules of continuing education for persons licensed
under | 6 | | this Article as advanced practice registered nurses that | 7 | | require 80 50 hours of
continuing education per 2-year license | 8 | | renewal cycle. Completion of the 80 50 hours of continuing | 9 | | education shall be deemed to satisfy the continuing education | 10 | | requirements for renewal of a registered professional nurse | 11 | | license as required by this Act. A minimum of 50 hours of | 12 | | required continuing education shall be obtained in formal | 13 | | category 1 continuing education programs that shall include no | 14 | | less than 20 hours of pharmacotherapeutics, including 10 hours | 15 | | on opioid prescribing or substance abuse education. Such formal | 16 | | education programs approved by the Department may be conducted | 17 | | or endorsed by hospitals, specialist associations, facilities, | 18 | | or other organizations approved to offer continuing education | 19 | | or continuing medical education credit, and shall be in the | 20 | | advanced practice registered nurse's clinical specialty. | 21 | | Category 2 continuing education shall be a maximum of 30 hours | 22 | | of credit and may be obtained by: presentations in clinical | 23 | | specialty, evidence-based practice or quality improvement | 24 | | projects, publications, research projects, or preceptor hours | 25 | | as determined by the Department. The
rules shall not be |
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| 1 | | inconsistent with requirements of relevant national
certifying | 2 | | bodies or
State or national professional associations. The | 3 | | rules shall also address variances in part or in whole for good
| 4 | | cause, including but not limited to illness or
hardship.
The | 5 | | continuing education rules shall assure that licensees are | 6 | | given the
opportunity to participate in programs sponsored by | 7 | | or
through their State or national professional associations, | 8 | | hospitals,
or other providers of continuing education. Each | 9 | | licensee is
responsible
for maintaining records of completion | 10 | | of continuing education
and shall be prepared to produce the | 11 | | records when requested
by the Department.
| 12 | | (Source: P.A. 95-639, eff. 10-5-07.)
| 13 | | (225 ILCS 65/65-65)
(was 225 ILCS 65/15-55)
| 14 | | (Section scheduled to be repealed on January 1, 2018)
| 15 | | Sec. 65-65. Reports relating to APRN APN professional | 16 | | conduct and
capacity. | 17 | | (a) Entities Required to Report.
| 18 | | (1) Health Care Institutions. The chief
administrator | 19 | | or executive officer of a health care
institution licensed | 20 | | by the Department of Public
Health, which provides the | 21 | | minimum due process set forth
in Section 10.4 of the | 22 | | Hospital Licensing Act, shall
report to the Board when an | 23 | | advanced practice registered nurse's organized | 24 | | professional staff
clinical
privileges are terminated or | 25 | | are restricted based on a
final determination, in |
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| 1 | | accordance with that
institution's bylaws or rules and | 2 | | regulations, that (i) a
person has either committed an act | 3 | | or acts that may
directly threaten patient care and that | 4 | | are not of an
administrative nature or (ii) that a person | 5 | | may have a mental or physical disability that may endanger
| 6 | | patients under that person's care. The chief administrator | 7 | | or officer
shall also report if an advanced practice | 8 | | registered nurse accepts voluntary termination or
| 9 | | restriction of clinical privileges in lieu of formal
action | 10 | | based upon conduct related directly to patient
care and not | 11 | | of an administrative nature, or in lieu of
formal action | 12 | | seeking to determine whether a person may
have a mental or | 13 | | physical disability that may
endanger patients under that | 14 | | person's care. The
Board shall provide by rule for the | 15 | | reporting to it of
all instances in which a person licensed | 16 | | under this Article, who is impaired by reason of age, drug, | 17 | | or
alcohol abuse or physical or mental impairment, is under
| 18 | | supervision and, where appropriate, is in a program of
| 19 | | rehabilitation. Reports submitted under this subsection | 20 | | shall be strictly
confidential and may be reviewed and | 21 | | considered only by
the members of the Board or authorized | 22 | | staff as
provided by rule of the Board. Provisions shall be
| 23 | | made for the periodic report of the status of any such | 24 | | reported
person not less than twice annually in order that | 25 | | the
Board shall have current information upon which to
| 26 | | determine the status of that person. Initial
and periodic |
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| 1 | | reports of impaired advanced practice registered
nurses | 2 | | shall not be considered records within
the meaning of the | 3 | | State Records Act and shall be
disposed of, following a | 4 | | determination by the
Board
that such reports are no longer | 5 | | required, in a manner and
at an appropriate time as the | 6 | | Board shall determine by rule.
The filing of reports | 7 | | submitted under this subsection shall be construed as the
| 8 | | filing of a report for purposes of subsection (c) of this
| 9 | | Section.
| 10 | | (2) Professional Associations. The President or
chief | 11 | | executive officer of an association or society of
persons | 12 | | licensed under this Article, operating within
this State, | 13 | | shall report to the Board when the
association or society | 14 | | renders a final determination that
a person licensed under | 15 | | this Article has committed unprofessional conduct
related
| 16 | | directly to patient care or that a person may have a mental | 17 | | or physical disability that may endanger
patients under the | 18 | | person's care.
| 19 | | (3) Professional Liability Insurers. Every
insurance | 20 | | company that offers policies of professional
liability | 21 | | insurance to persons licensed under this
Article, or any | 22 | | other entity that seeks to indemnify the
professional | 23 | | liability of a person licensed under this
Article, shall | 24 | | report to the Board the settlement of
any claim or cause of | 25 | | action, or final judgment rendered
in any cause of action, | 26 | | that alleged negligence in the
furnishing of patient care |
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| 1 | | by the licensee when
the settlement or final judgment is in | 2 | | favor of the
plaintiff.
| 3 | | (4) State's Attorneys. The State's Attorney of each
| 4 | | county shall report to the Board all instances in
which a | 5 | | person licensed under this Article is convicted
or | 6 | | otherwise found guilty of the commission of a
felony.
| 7 | | (5) State Agencies. All agencies, boards,
commissions, | 8 | | departments, or other instrumentalities of
the government | 9 | | of this State shall report to
the Board any instance | 10 | | arising in connection with
the operations of the agency, | 11 | | including the
administration of any law by the agency, in | 12 | | which a
person licensed under this Article has either | 13 | | committed
an act or acts that may constitute a violation of | 14 | | this Article,
that may constitute unprofessional conduct | 15 | | related
directly to patient care, or that indicates that a | 16 | | person
licensed under this Article may have a mental or | 17 | | physical disability that may endanger patients under
that | 18 | | person's care.
| 19 | | (b) Mandatory Reporting. All reports required under items
| 20 | | (16) and (17) of subsection (a) of Section 70-5 shall
be | 21 | | submitted to
the
Board in a timely fashion. The reports shall | 22 | | be filed in writing
within
60 days after a determination that a | 23 | | report is required
under this Article. All reports shall | 24 | | contain the following
information:
| 25 | | (1) The name, address, and telephone number of the
| 26 | | person making the report.
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| 1 | | (2) The name, address, and telephone number of the
| 2 | | person who is the subject of the report.
| 3 | | (3) The name or other means of identification of any
| 4 | | patient or patients whose treatment is a subject of the
| 5 | | report, except that no medical records may be
revealed | 6 | | without the written consent of the patient or
patients.
| 7 | | (4) A brief description of the facts that gave rise
to | 8 | | the issuance of the report, including but not limited to | 9 | | the dates of any
occurrences deemed to necessitate the | 10 | | filing of the
report.
| 11 | | (5) If court action is involved, the identity of the
| 12 | | court in which the action is filed, the docket
number, and | 13 | | date of filing of the action.
| 14 | | (6) Any further pertinent information that the
| 15 | | reporting party deems to be an aid in the evaluation of
the | 16 | | report.
| 17 | | Nothing contained in this Section shall be construed
to in | 18 | | any way waive or modify the confidentiality of
medical reports | 19 | | and committee reports to the extent
provided by law. Any | 20 | | information reported or disclosed
shall be kept for the | 21 | | confidential use of the Board,
the Board's attorneys, the | 22 | | investigative staff, and
authorized clerical staff and shall be | 23 | | afforded the
same status as is provided information concerning | 24 | | medical
studies in Part 21 of Article VIII of the Code of Civil
| 25 | | Procedure.
| 26 | | (c) Immunity from Prosecution. An individual or
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| 1 | | organization acting in good faith, and not in a wilful and
| 2 | | wanton manner, in complying with this Section by providing
a | 3 | | report or other information to the Board, by
assisting in the | 4 | | investigation or preparation of a report or
information, by | 5 | | participating in proceedings of the
Board, or by serving as a | 6 | | member of the Board shall not, as
a result of such actions, be | 7 | | subject to criminal prosecution
or civil damages.
| 8 | | (d) Indemnification. Members of the Board, the
Board's | 9 | | attorneys, the investigative staff, advanced
practice | 10 | | registered nurses or physicians retained under
contract to | 11 | | assist and advise in the investigation, and
authorized clerical | 12 | | staff shall be indemnified by the State
for any actions (i) | 13 | | occurring within the scope of services on the
Board, (ii) | 14 | | performed in good faith, and (iii) not wilful and wanton in
| 15 | | nature. The Attorney General shall defend all actions taken | 16 | | against those
persons
unless he or she determines either that | 17 | | there would be a
conflict of interest in the representation or | 18 | | that the
actions complained of were not performed in good faith | 19 | | or were wilful
and wanton in nature. If the Attorney General | 20 | | declines
representation, the member shall have the right to | 21 | | employ
counsel of his or her choice, whose fees shall be | 22 | | provided by
the State, after approval by the Attorney General, | 23 | | unless
there is a determination by a court that the member's | 24 | | actions
were not performed in good faith or were wilful and | 25 | | wanton in nature. The
member
shall notify the Attorney General | 26 | | within 7 days of receipt of
notice of the initiation of an |
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| 1 | | action involving services of
the Board. Failure to so notify | 2 | | the Attorney General
shall constitute an absolute waiver of the | 3 | | right to a defense
and indemnification. The Attorney General | 4 | | shall determine
within 7 days after receiving the notice | 5 | | whether he or she
will undertake to represent the member.
| 6 | | (e) Deliberations of Board. Upon the receipt of a
report | 7 | | called for by this Section, other than those reports
of | 8 | | impaired persons licensed under this Article
required
pursuant | 9 | | to the rules of the Board, the Board shall
notify in writing by | 10 | | certified mail the person who is the
subject of the report. The | 11 | | notification shall be made
within 30 days of receipt by the | 12 | | Board of the report.
The notification shall include a written | 13 | | notice setting forth
the person's right to examine the report. | 14 | | Included in the
notification shall be the address at which the | 15 | | file is
maintained, the name of the custodian of the reports, | 16 | | and the
telephone number at which the custodian may be reached. | 17 | | The
person who is the subject of the report shall submit a
| 18 | | written statement responding to, clarifying, adding to, or
| 19 | | proposing to amend the report previously filed. The
statement | 20 | | shall become a permanent part of the file and shall
be received | 21 | | by the Board no more than 30 days after the
date on which the | 22 | | person was notified of the existence of the
original report. | 23 | | The
Board shall review all reports
received by it and any | 24 | | supporting information and
responding statements submitted by | 25 | | persons who are the
subject of reports. The review by the
Board | 26 | | shall be in
a timely manner but in no event shall the
Board's
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| 1 | | initial review of the material contained in each disciplinary
| 2 | | file be less than 61 days nor more than 180 days after the
| 3 | | receipt of the initial report by the Board. When the
Board | 4 | | makes its initial review of the materials
contained within its | 5 | | disciplinary files, the Board
shall, in writing, make a | 6 | | determination as to whether there
are sufficient facts to | 7 | | warrant further investigation or
action. Failure to make that | 8 | | determination within the time
provided shall be deemed to be a | 9 | | determination that there are
not sufficient facts to warrant | 10 | | further investigation or
action. Should the Board find that | 11 | | there are not
sufficient facts to warrant further investigation | 12 | | or action,
the report shall be accepted for filing and the | 13 | | matter shall
be deemed closed and so reported. The individual | 14 | | or entity
filing the original report or complaint and the | 15 | | person who is
the subject of the report or complaint shall be | 16 | | notified in
writing by the
Board of any final action on their | 17 | | report
or complaint.
| 18 | | (f) Summary Reports. The Board shall prepare, on a
timely | 19 | | basis, but in no event less than one every other
month, a | 20 | | summary report of final actions taken upon
disciplinary files | 21 | | maintained by the Board. The summary
reports shall be made | 22 | | available to the public upon request and payment of the fees | 23 | | set by the Department. This publication may be made available | 24 | | to the public on the Department's Internet website.
| 25 | | (g) Any violation of this Section shall constitute a Class | 26 | | A
misdemeanor.
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| 1 | | (h) If a person violates the provisions of this
Section, an | 2 | | action may be brought in the name of the People of
the State of | 3 | | Illinois, through the Attorney General of the
State of | 4 | | Illinois, for an order enjoining the violation or
for an order | 5 | | enforcing compliance with this Section. Upon
filing of a | 6 | | verified petition in court, the court may
issue a temporary | 7 | | restraining order without notice or bond
and may preliminarily | 8 | | or permanently enjoin the violation,
and if it is established | 9 | | that the person has violated or is
violating the injunction, | 10 | | the court may punish the offender
for contempt of court. | 11 | | Proceedings under this subsection
shall be in addition to, and | 12 | | not in lieu of, all other
remedies and penalties provided for | 13 | | by this Section.
| 14 | | (Source: P.A. 99-143, eff. 7-27-15.)
| 15 | | Section 15. The Illinois Controlled Substances Act is | 16 | | amended by changing Section 303.05 and by adding Section 303.03 | 17 | | as follows: | 18 | | (720 ILCS 570/303.03 new) | 19 | | Sec. 303.03. Advanced practice registered nurse with full | 20 | | practice authority. | 21 | | (a) The Department of Financial and Professional | 22 | | Regulation shall license a licensed advanced practice | 23 | | registered nurse certified as a nurse practitioner, nurse | 24 | | midwife, or clinical nurse specialist who meets the |
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| 1 | | requirements of Section 65-43 of the Nurse Practice Act to | 2 | | prescribe and dispense controlled substances under Section 303 | 3 | | if the advanced practice registered nurse certified as a nurse | 4 | | practitioner, nurse midwife, or clinical nurse specialist has | 5 | | been granted authority to prescribe any legend drug and | 6 | | Schedule II through V controlled substances. | 7 | | (b) Nothing in this Act shall be construed to require an | 8 | | advanced practice registered nurse meeting the requirements of | 9 | | Section 65-43 of the Nurse Practice Act to have a written | 10 | | collaborative agreement.
| 11 | | (720 ILCS 570/303.05)
| 12 | | Sec. 303.05. Mid-level practitioner registration.
| 13 | | (a) The Department of Financial and Professional | 14 | | Regulation shall register licensed
physician assistants, | 15 | | licensed advanced practice registered nurses, and prescribing | 16 | | psychologists licensed under Section 4.2 of the Clinical | 17 | | Psychologist Licensing Act to prescribe and
dispense | 18 | | controlled substances under Section 303 and euthanasia
| 19 | | agencies to purchase, store, or administer animal euthanasia | 20 | | drugs under the
following circumstances:
| 21 | | (1) with respect to physician assistants,
| 22 | | (A) the physician assistant has been
delegated
| 23 | | written authority to prescribe any Schedule III | 24 | | through V controlled substances by a physician | 25 | | licensed to practice medicine in all its
branches in |
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| 1 | | accordance with Section 7.5 of the Physician Assistant | 2 | | Practice Act
of 1987;
and
the physician assistant has
| 3 | | completed the
appropriate application forms and has | 4 | | paid the required fees as set by rule;
or
| 5 | | (B) the physician assistant has been delegated
| 6 | | authority by a supervising physician licensed to | 7 | | practice medicine in all its branches to prescribe or | 8 | | dispense Schedule II controlled substances through a | 9 | | written delegation of authority and under the | 10 | | following conditions: | 11 | | (i) Specific Schedule II controlled substances | 12 | | by oral dosage or topical or transdermal | 13 | | application may be delegated, provided that the | 14 | | delegated Schedule II controlled substances are | 15 | | routinely prescribed by the supervising physician. | 16 | | This delegation must identify the specific | 17 | | Schedule II controlled substances by either brand | 18 | | name or generic name. Schedule II controlled | 19 | | substances to be delivered by injection or other | 20 | | route of administration may not be delegated; | 21 | | (ii) any delegation must be of controlled | 22 | | substances prescribed by the supervising | 23 | | physician; | 24 | | (iii) all prescriptions must be limited to no | 25 | | more than a 30-day supply, with any continuation | 26 | | authorized only after prior approval of the |
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| 1 | | supervising physician; | 2 | | (iv) the physician assistant must discuss the | 3 | | condition of any patients for whom a controlled | 4 | | substance is prescribed monthly with the | 5 | | delegating physician; | 6 | | (v) the physician assistant must have | 7 | | completed the appropriate application forms and | 8 | | paid the required fees as set by rule; | 9 | | (vi) the physician assistant must provide | 10 | | evidence of satisfactory completion of 45 contact | 11 | | hours in pharmacology from any physician assistant | 12 | | program accredited by the Accreditation Review | 13 | | Commission on Education for the Physician | 14 | | Assistant (ARC-PA), or its predecessor agency, for | 15 | | any new license issued with Schedule II authority | 16 | | after the effective date of this amendatory Act of | 17 | | the 97th General Assembly; and | 18 | | (vii) the physician assistant must annually | 19 | | complete at least 5 hours of continuing education | 20 | | in pharmacology; | 21 | | (2) with respect to advanced practice registered | 22 | | nurses who do not meet the requirements of Section 65-43 of | 23 | | the Nurse Practice Act , | 24 | | (A) the advanced practice registered nurse has | 25 | | been delegated
authority to prescribe any Schedule III | 26 | | through V controlled substances by a collaborating |
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| 1 | | physician licensed to practice medicine in all its | 2 | | branches or a collaborating podiatric physician in | 3 | | accordance with Section 65-40 of the Nurse Practice
| 4 | | Act. The advanced practice registered nurse has | 5 | | completed the
appropriate application forms and has | 6 | | paid the required
fees as set by rule; or | 7 | | (B) the advanced practice registered nurse has | 8 | | been delegated
authority by a collaborating physician | 9 | | licensed to practice medicine in all its branches or | 10 | | collaborating podiatric physician to prescribe or | 11 | | dispense Schedule II controlled substances through a | 12 | | written delegation of authority and under the | 13 | | following conditions: | 14 | | (i) specific Schedule II controlled substances | 15 | | by oral dosage or topical or transdermal | 16 | | application may be delegated, provided that the | 17 | | delegated Schedule II controlled substances are | 18 | | routinely prescribed by the collaborating | 19 | | physician or podiatric physician. This delegation | 20 | | must identify the specific Schedule II controlled | 21 | | substances by either brand name or generic name. | 22 | | Schedule II controlled substances to be delivered | 23 | | by injection or other route of administration may | 24 | | not be delegated; | 25 | | (ii) any delegation must be of controlled | 26 | | substances prescribed by the collaborating |
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| 1 | | physician or podiatric physician ; | 2 | | (iii) all prescriptions must be limited to no | 3 | | more than a 30-day supply, with any continuation | 4 | | authorized only after prior approval of the | 5 | | collaborating physician or podiatric physician ; | 6 | | (iv) the advanced practice registered nurse | 7 | | must discuss the condition of any patients for whom | 8 | | a controlled substance is prescribed monthly with | 9 | | the delegating physician or podiatric physician or | 10 | | in the course of review as required by Section | 11 | | 65-40 of the Nurse Practice Act; | 12 | | (v) the advanced practice registered nurse | 13 | | must have completed the appropriate application | 14 | | forms and paid the required fees as set by rule; | 15 | | (vi) the advanced practice registered nurse | 16 | | must provide evidence of satisfactory completion | 17 | | of at least 45 graduate contact hours in | 18 | | pharmacology for any new license issued with | 19 | | Schedule II authority after the effective date of | 20 | | this amendatory Act of the 97th General Assembly; | 21 | | and | 22 | | (vii) the advanced practice registered nurse | 23 | | must annually complete 5 hours of continuing | 24 | | education in pharmacology; | 25 | | (2.5) with respect to advanced practice registered | 26 | | nurses certified as nurse practitioners, nurse midwives, |
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| 1 | | or clinical nurse specialists practicing in a hospital | 2 | | affiliate, | 3 | | (A) the advanced practice registered nurse | 4 | | certified as a nurse practitioner, nurse midwife, or | 5 | | clinical nurse specialist has been granted authority | 6 | | to prescribe any Schedule II through V controlled | 7 | | substances by the hospital affiliate upon the | 8 | | recommendation of the appropriate physician committee | 9 | | of the hospital affiliate in accordance with Section | 10 | | 65-45 of the Nurse Practice Act, has completed the | 11 | | appropriate application forms, and has paid the | 12 | | required fees as set by rule; and | 13 | | (B) an advanced practice registered nurse | 14 | | certified as a nurse practitioner, nurse midwife, or | 15 | | clinical nurse specialist has been granted authority | 16 | | to prescribe any Schedule II controlled substances by | 17 | | the hospital affiliate upon the recommendation of the | 18 | | appropriate physician committee of the hospital | 19 | | affiliate, then the following conditions must be met: | 20 | | (i) specific Schedule II controlled substances | 21 | | by oral dosage or topical or transdermal | 22 | | application may be designated, provided that the | 23 | | designated Schedule II controlled substances are | 24 | | routinely prescribed by advanced practice | 25 | | registered nurses in their area of certification; | 26 | | this grant of authority must identify the specific |
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| 1 | | Schedule II controlled substances by either brand | 2 | | name or generic name; authority to prescribe or | 3 | | dispense Schedule II controlled substances to be | 4 | | delivered by injection or other route of | 5 | | administration may not be granted; | 6 | | (ii) any grant of authority must be controlled | 7 | | substances limited to the practice of the advanced | 8 | | practice registered nurse; | 9 | | (iii) any prescription must be limited to no | 10 | | more than a 30-day supply; | 11 | | (iv) the advanced practice registered nurse | 12 | | must discuss the condition of any patients for whom | 13 | | a controlled substance is prescribed monthly with | 14 | | the appropriate physician committee of the | 15 | | hospital affiliate or its physician designee; and | 16 | | (v) the advanced practice registered nurse | 17 | | must meet the education requirements of this | 18 | | Section; | 19 | | (3) with respect to animal euthanasia agencies, the | 20 | | euthanasia agency has
obtained a license from the | 21 | | Department of
Financial and Professional Regulation and | 22 | | obtained a registration number from the
Department; or
| 23 | | (4) with respect to prescribing psychologists, the | 24 | | prescribing psychologist has been delegated
authority to | 25 | | prescribe any nonnarcotic Schedule III through V | 26 | | controlled substances by a collaborating physician |
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| 1 | | licensed to practice medicine in all its branches in | 2 | | accordance with Section 4.3 of the Clinical Psychologist | 3 | | Licensing Act, and the prescribing psychologist has | 4 | | completed the
appropriate application forms and has paid | 5 | | the required
fees as set by rule. | 6 | | (b) The mid-level practitioner shall only be licensed to | 7 | | prescribe those
schedules of controlled substances for which a | 8 | | licensed physician or licensed podiatric physician has | 9 | | delegated
prescriptive authority, except that an animal | 10 | | euthanasia agency does not have any
prescriptive authority.
A | 11 | | physician assistant and an advanced practice registered nurse | 12 | | are prohibited from prescribing medications and controlled | 13 | | substances not set forth in the required written delegation of | 14 | | authority or as authorized by their practice Act .
| 15 | | (c) Upon completion of all registration requirements, | 16 | | physician
assistants, advanced practice registered nurses, and | 17 | | animal euthanasia agencies may be issued a
mid-level | 18 | | practitioner
controlled substances license for Illinois.
| 19 | | (d) A collaborating physician or podiatric physician may, | 20 | | but is not required to, delegate prescriptive authority to an | 21 | | advanced practice registered nurse as part of a written | 22 | | collaborative agreement, and the delegation of prescriptive | 23 | | authority shall conform to the requirements of Section 65-40 of | 24 | | the Nurse Practice Act. | 25 | | (e) A supervising physician may, but is not required to, | 26 | | delegate prescriptive authority to a physician assistant as |
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| 1 | | part of a written supervision agreement, and the delegation of | 2 | | prescriptive authority shall conform to the requirements of | 3 | | Section 7.5 of the Physician Assistant Practice Act of 1987. | 4 | | (f) Nothing in this Section shall be construed to prohibit | 5 | | generic substitution. | 6 | | (Source: P.A. 98-214, eff. 8-9-13; 98-668, eff. 6-25-14; | 7 | | 99-173, eff. 7-29-15.)
| 8 | | Section 99. Effective date. This Act takes effect upon | 9 | | becoming law.".
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