Bill Amendment: IL HB0313 | 2017-2018 | 100th General Assembly

NOTE: For additional amemendments please see the Bill Drafting List

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Bill Title: NURSE PRACTICE ACT-VARIOUS

Status: 2017-09-20 - Public Act . . . . . . . . . 100-0513 [HB0313 Detail]

Download: Illinois-2017-HB0313-Senate_Amendment_001.html

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Sen. Iris Y. Martinez

Filed: 5/23/2017

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AMENDMENT TO HOUSE BILL 313
AMENDMENT NO. ______. Amend House Bill 313 on page 286,
line 22, after "nurses", by inserting "without full practice
authority"; and
on page 290, immediately below line 16, by inserting the
following:
"(j) As set forth in Section 22.2 of this Act, a licensee
under this Act may not directly or indirectly divide, share, or
split any professional fee or other form of compensation for
professional services with anyone in exchange for a referral or
otherwise, other than as provided in Section 22.2."; and
on page 290, line 23, after "65-55,", by inserting "65-60,";
and
on page 291, line 2, after "60-11", by inserting "65-43,"; and

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on page 294, immediately below line 1, by inserting the
following:
""Full practice authority" means the authority of an
advanced practice registered nurse licensed in Illinois and
certified as a nurse practitioner, clinical nurse specialist,
or nurse midwife to practice without a written collaborative
agreement and:
(1) to be fully accountable to patients for the quality
of advanced nursing care rendered;
(2) to be fully accountable for recognizing limits of
knowledge and experience and for planning for the
management of situations beyond the advanced practice
registered nurse's expertise; the full practice authority
for advanced practice registered nurses includes accepting
referrals from, consulting with, collaborating with, or
referring to other health care professionals as warranted
by the needs of the patient; and
(3) to possess the authority to prescribe medications,
including Schedule II through V controlled substances, as
provided in Section 65-43."; and
on page 365, on line 14, by replacing "2018" with "2023 2018";
and
on page 376, line 21, by replacing "practice," with "practice
prior to meeting the requirements of Section 65-43,"; and

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on page 376, line 22, by replacing "authorized" with
"privileged authorized"; and
on page 377, line 2, by replacing "authorized" with "privileged
authorized"; and
on page 377, line 3, after "agreement", by inserting ", except
as set forth in Section 65-43"; and
on page 377, line 6, by replacing "or podiatric physician" with
"or podiatric physician"; and
on page 377, line 10, after "Section.", by inserting "A
collaborative agreement with a podiatric physician must be in
accordance with subsection (c-5) of this Section."; and
on page 377, by replacing line 12 with "physician or podiatric
physician and the advanced practice"; and
on page 377, by replacing line 16 with "collaborating physician
or podiatric physician at the place where services"; and
on page 377, lines 18 and 19, by replacing "or podiatric
physician" with "or podiatric physician"; and

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on page 380, by replacing lines 12 through 14 with "Nothing in
this Act shall be construed to authorize an advanced practice
nurse to provide health care services required by law or rule
to be performed by a physician."; and
on page 380, immediately below line 14, by inserting the
following:
"(e-5) Nothing in this Act shall be construed to authorize
an advanced practice registered nurse to provide health care
services required by law or rule to be performed by a
physician, including those acts to be performed by a physician
in Section 3.1 of the Illinois Abortion Law of 1975."; and
on page 381, line 3, by replacing "or collaborating podiatrist"
with "or collaborating podiatrist"; and
on page 381, line 15, by replacing "or podiatric physician"
with "or podiatric physician"; and
on page 382, lines 1 and 2, by replacing "or podiatric
physician" with "or podiatric physician"; and
on page 382, lines 9 and 10, by replacing "or podiatric
physician" each time it appears with "or podiatric physician";
and

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on page 382, line 11, after "Department", by inserting "and the
Prescription Monitoring Program"; and
on page 382, lines 20 and 21, by replacing "or podiatric
physician" with "or podiatric physician"; and
on page 383, lines 3 and 10, by replacing "or podiatric
physician" each time it appears with "or podiatric physician";
and
on page 383, lines 14 and 15, by replacing "or podiatric
physician" with "or podiatric physician"; and
on page 384, by replacing lines 9 through 13 with the
following:
"(g) (Blank). Any advanced practice nurse who writes a
prescription for a controlled substance without having a valid
appropriate authority may be fined by the Department not more
than $50 per prescription, and the Department may take any
other disciplinary action provided for in this Act."; and
on page 384, immediately below line 15, by inserting the
following:
"(i) Nothing in this Section shall be construed to apply to
an advanced practice registered nurse who meets the
requirements of Section 65-43."; and

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on page 384, immediately below line 16, by inserting the
following:
"(225 ILCS 65/65-43 new)
Sec. 65-43. Full practice authority.
(a) An Illinois-licensed advanced practice registered
nurse certified as a nurse practitioner, nurse midwife, or
clinical nurse specialist shall be deemed by law to possess the
ability to practice without a written collaborative agreement
as set forth in this Section.
(b) An advanced practice registered nurse certified as a
nurse midwife, clinical nurse specialist, or nurse
practitioner who files with the Department a notarized
attestation of completion of at least 250 hours of continuing
education or training and at least 4,000 hours of clinical
experience after first attaining national certification shall
not require a written collaborative agreement, except as
specified in subsection (c). Documentation of successful
completion shall be provided to the Department upon request.
Continuing education or training hours required by
subsection (b) shall be in the advanced practice registered
nurse's area of certification as set forth by Department rule.
The clinical experience must be in the advanced practice
registered nurse's area of certification. The clinical
experience shall be in collaboration with a physician or

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physicians. Completion of the clinical experience must be
attested to by the collaborating physician or physicians and
the advanced practice registered nurse.
(c) The scope of practice of an advanced practice
registered nurse with full practice authority includes:
(1) all matters included in subsection (c) of Section
65-30 of this Act;
(2) practicing without a written collaborative
agreement in all practice settings consistent with
national certification;
(3) authority to prescribe both legend drugs and
Schedule II through V controlled substances; this
authority includes prescription of, selection of, orders
for, administration of, storage of, acceptance of samples
of, and dispensing over the counter medications, legend
drugs, and controlled substances categorized as any
Schedule II through V controlled substances, as defined in
Article II of the Illinois Controlled Substances Act, and
other preparations, including, but not limited to,
botanical and herbal remedies;
(4) prescribing benzodiazepines or Schedule II
narcotic drugs, such as opioids, only in a consultation
relationship with a physician; this consultation
relationship shall be recorded in the Prescription
Monitoring Program website, pursuant to Section 316 of the
Illinois Controlled Substances Act, by the physician and

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advanced practice registered nurse with full practice
authority and is not required to be filed with the
Department; the specific Schedule II narcotic drug must be
identified by either brand name or generic name; the
specific Schedule II narcotic drug, such as an opioid, may
be administered by oral dosage or topical or transdermal
application; delivery by injection or other route of
administration is not permitted; at least monthly, the
advanced practice registered nurse and the physician must
discuss the condition of any patients for whom a
benzodiazepine or opioid is prescribed; nothing in this
subsection shall be construed to require a prescription by
an advanced practice registered nurse with full practice
authority to require a physician name;
(5) authority to obtain an Illinois controlled
substance license and a federal Drug Enforcement
Administration number; and
(6) use of only local anesthetic.
The scope of practice of an advanced practice registered
nurse does not include operative surgery.
(d) The Department may adopt rules necessary to administer
this Section, including, but not limited to, requiring the
completion of forms and the payment of fees.
(e) Nothing in this Act shall be construed to authorize an
advanced practice registered nurse with full practice
authority to provide health care services required by law or

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rule to be performed by a physician, including, but not limited
to, those acts to be performed by a physician in Section 3.1 of
the Illinois Abortion Law of 1975."; and
on page 385, line 8, after "services of", by inserting "all";
and
on page 385, line 22, by replacing "granted" with "privileged
granted"; and
on page 385, by replacing line 23 with "authority to order
medications, including controlled substances,"; and
on page 386, immediately below line 5, by inserting the
following:
"(a-4) An advanced practice registered nurse meeting the
requirements of Section 65-43 may be privileged to complete
discharge orders and prescriptions under the advanced practice
registered nurse's name."; and
on page 387, line 2, after "Center Act.", by inserting "Nothing
in this Act shall be construed to require an advanced practice
registered nurse to have a collaborative agreement to practice
in a hospital, hospital affiliate, or ambulatory surgical
treatment center."; and

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on page 387, line 6, by replacing "granted authority" with
"privileged granted authority"; and
on page 387, line 21, by replacing "mid-level practitioner"
with "mid-level practitioner"; and
on page 388, line 11, by replacing "grant authority to" with
"privilege grant authority to"; and
on page 388, line 20, by replacing "this grant of authority"
with "the privileging documents this grant of authority"; and
on page 388, line 22, by replacing "authority" with "privileges
authority"; and
on page 388, line 25, by replacing "grant of authority" with
privileges grant of authority"; and
on page 389, immediately below line 11, by inserting the
following:
"(d) An advanced practice registered nurse meeting the
requirements of Section 65-43 may be privileged to prescribe
controlled substances categorized as Schedule II through V in
accordance with Section 65-43."; and
on page 389, line 19, after "initials", by inserting ""Advanced

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Practice Registered Nurse","; and
on page 390, line 3, after "(a).", by inserting "No advanced
practice registered nurse licensed under this Act may use the
title "doctor" or "physician" in paid or approved advertising.
Any advertising must contain the appropriate advanced practice
registered nurse credentials."; and
on page 390, line 9, after "patient.", by inserting "If an
advanced practice registered nurse has a doctorate degree, when
identifying himself or herself as "doctor" in a clinical
setting, the advanced practice registered nurse must clearly
state that his or her educational preparation is not in
medicine and that he or she is not a medical doctor or
physician."; and
on page 391, line 2, by replacing "board" with "national
board"; and
on page 391, by replacing line 5 with "physician's or ,
dentist's, or podiatric physician's name,"; and
on page 391, line 6, after "title,", by inserting "if such is
required,"; and
on page 391, line 16, by replacing "as" with "as"; and

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on page 391, by replacing line 17 with "an advanced practice
nurse to use testimonials or"; and
on page 392, immediately below line 18, by inserting the
following:
"(225 ILCS 65/65-60) (was 225 ILCS 65/15-45)
(Section scheduled to be repealed on January 1, 2018)
Sec. 65-60. Continuing education. The Department shall
adopt rules of continuing education for persons licensed under
this Article as advanced practice registered nurses that
require 80 50 hours of continuing education per 2-year license
renewal cycle. Completion of the 80 50 hours of continuing
education shall be deemed to satisfy the continuing education
requirements for renewal of a registered professional nurse
license as required by this Act.
The 80 hours of continuing education required under this
Section shall be completed as follows:
(1) A minimum of 50 hours of the continuing education
shall be obtained in continuing education programs as
determined by rule that shall include no less than 20 hours
of pharmacotherapeutics, including 10 hours of opioid
prescribing or substance abuse education. Continuing
education programs may be conducted or endorsed by
educational institutions, hospitals, specialist

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associations, facilities, or other organizations approved
to offer continuing education under this Act or rules and
shall be in the advanced practice registered nurse's
specialty.
(2) A maximum of 30 hours of credit may be obtained by
presentations in the advanced practice registered nurse's
clinical specialty, evidence-based practice, or quality
improvement projects, publications, research projects, or
preceptor hours as determined by rule.
The rules adopted regarding continuing education shall be
consistent to the extent possible with requirements of relevant
national certifying bodies or State or national professional
associations.
The rules shall not be inconsistent with requirements of
relevant national certifying bodies or State or national
professional associations. The rules shall also address
variances in part or in whole for good cause, including but not
limited to illness or hardship. The continuing education rules
shall assure that licensees are given the opportunity to
participate in programs sponsored by or through their State or
national professional associations, hospitals, or other
providers of continuing education. Each licensee is
responsible for maintaining records of completion of
continuing education and shall be prepared to produce the
records when requested by the Department.
(Source: P.A. 95-639, eff. 10-5-07.)"; and

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on page 685, line 10, by replacing "or" with "or"; and
on page 685, line 14, after "Section 303.05", by inserting ",
or an advanced practice registered nurse certified as a nurse
practitioner, nurse midwife, or clinical nurse specialist who
has full practice authority pursuant to Section 65-43 of the
Nurse Practice Act"; and
on page 686, line 7, by replacing "or" with "or"; and
on page 686, line 12, after "by law", by inserting ", or of an
advanced practice registered nurse certified as a nurse
practitioner, nurse midwife, or clinical nurse specialist who
has full practice authority pursuant to Section 65-43 of the
Nurse Practice Act"; and
on page 694, line 13, after "nurses", by inserting "who do not
meet the requirements of Section 65-43 of the Nurse Practice
Act"; and
on page 694, lines 25 and 26, by replacing "or collaborating
podiatric physician" with "or collaborating podiatric
physician"; and
on page 695, lines 9 and 17, by replacing "or podiatric

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physician" each time it appears with "or podiatric physician";
and
on page 695, lines 21 and 25, by replacing "or podiatric
physician" each time it appears with "or podiatric physician";
and
on page 696, line 17, after "specialists" by inserting "who do
not meet the requirements of Section 65-43 of the Nurse
Practice Act"; and
on page 696, line 21, by replacing "granted authority" with
"privileged granted authority"; and
on page 697, line 5, by replacing "granted authority" with
"privileged granted authority"; and
on page 697, line 16, by replacing "this grant of authority"
with "the privileging documents this grant of authority"; and
on page 697, line 18, by replacing "authority" with "privileges
authority"; and
on page 697, line 22, by replacing "grant of authority" with
"privileges grant of authority"; and

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on page 698, line 24, by replacing "or licensed podiatric
physician" with "or licensed podiatric physician"; and
on page 699, line 4, after "authority", by inserting "or as
authorized by their practice Act"; and
on page 699, line 9, by replacing "or podiatric physician" with
"or podiatric physician"; and
on page 737, line 25, after "effect", by inserting "January 1,
2018, except that this Section and Section 5 take effect".