Bill Amendment: IL HB0421 | 2015-2016 | 99th General Assembly

NOTE: For additional amemendments please see the Bill Drafting List

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Bill Title: NURSE-COLLABORATION-PRESCRIBE

Status: 2015-07-29 - Public Act . . . . . . . . . 99-0173 [HB0421 Detail]

Download: Illinois-2015-HB0421-House_Amendment_002.html

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Rep. Sara Feigenholtz

Filed: 4/20/2015

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AMENDMENT TO HOUSE BILL 421
AMENDMENT NO. ______. Amend House Bill 421, AS AMENDED,
with reference to page and line numbers of House Amendment No.
1, by replacing line 9 on page 47 through line 8 on page 59 with
the following:
"Section 33. The Medical Practice Act of 1987 is amended by
changing Section 54.5 as follows:
(225 ILCS 60/54.5)
(Section scheduled to be repealed on December 31, 2015)
Sec. 54.5. Physician delegation of authority to physician
assistants, advanced practice nurses, and prescribing
psychologists.
(a) Physicians licensed to practice medicine in all its
branches may delegate care and treatment responsibilities to a
physician assistant under guidelines in accordance with the
requirements of the Physician Assistant Practice Act of 1987. A

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physician licensed to practice medicine in all its branches may
enter into supervising physician agreements with no more than 5
physician assistants as set forth in subsection (a) of Section
7 of the Physician Assistant Practice Act of 1987.
(b) A physician licensed to practice medicine in all its
branches in active clinical practice may collaborate with an
advanced practice nurse in accordance with the requirements of
the Nurse Practice Act. Collaboration is for the purpose of
providing medical consultation, and no employment relationship
is required. A written collaborative agreement shall conform to
the requirements of Section 65-35 of the Nurse Practice Act.
The written collaborative agreement shall be for services in
the same area of practice or specialty as the collaborating
physician generally provides or may provide in his or her
clinical medical practice. A written collaborative agreement
shall be adequate with respect to collaboration with advanced
practice nurses if all of the following apply:
(1) The agreement is written to promote the exercise of
professional judgment by the advanced practice nurse
commensurate with his or her education and experience. The
agreement need not describe the exact steps that an
advanced practice nurse must take with respect to each
specific condition, disease, or symptom, but must specify
those procedures that require a physician's presence as the
procedures are being performed.
(2) Practice guidelines and orders are developed and

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approved jointly by the advanced practice nurse and
collaborating physician, as needed, based on the practice
of the practitioners. Such guidelines and orders and the
patient services provided thereunder are periodically
reviewed by the collaborating physician.
(2) (3) The advance practice nurse provides services
based upon a written collaborative agreement with the
collaborating physician generally provides or may provide
in his or her clinical medical practice, except as set
forth in subsection (b-5) of this Section. With respect to
labor and delivery, the collaborating physician must
provide delivery services in order to participate with a
certified nurse midwife.
(4) The collaborating physician and advanced practice
nurse consult at least once a month to provide
collaboration and consultation.
(3) (5) Methods of communication are available with the
collaborating physician in person or through
telecommunications for consultation, collaboration, and
referral as needed to address patient care needs.
(6) The agreement contains provisions detailing notice
for termination or change of status involving a written
collaborative agreement, except when such notice is given
for just cause.
(b-5) An anesthesiologist or physician licensed to
practice medicine in all its branches may collaborate with a

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certified registered nurse anesthetist in accordance with
Section 65-35 of the Nurse Practice Act for the provision of
anesthesia services. With respect to the provision of
anesthesia services, the collaborating anesthesiologist or
physician shall have training and experience in the delivery of
anesthesia services consistent with Department rules.
Collaboration shall be adequate if:
(1) an anesthesiologist or a physician participates in
the joint formulation and joint approval of orders or
guidelines and periodically reviews such orders and the
services provided patients under such orders; and
(2) for anesthesia services, the anesthesiologist or
physician participates through discussion of and agreement
with the anesthesia plan and is physically present and
available on the premises during the delivery of anesthesia
services for diagnosis, consultation, and treatment of
emergency medical conditions. Anesthesia services in a
hospital shall be conducted in accordance with Section 10.7
of the Hospital Licensing Act and in an ambulatory surgical
treatment center in accordance with Section 6.5 of the
Ambulatory Surgical Treatment Center Act.
(b-10) The anesthesiologist or operating physician must
agree with the anesthesia plan prior to the delivery of
services.
(c) The supervising physician shall have access to the
medical records of all patients attended by a physician

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assistant. The collaborating physician shall have access to the
medical records of all patients attended to by an advanced
practice nurse.
(d) (Blank).
(e) A physician shall not be liable for the acts or
omissions of a prescribing psychologist, physician assistant,
or advanced practice nurse solely on the basis of having signed
a supervision agreement or guidelines or a collaborative
agreement, an order, a standing medical order, a standing
delegation order, or other order or guideline authorizing a
prescribing psychologist, physician assistant, or advanced
practice nurse to perform acts, unless the physician has reason
to believe the prescribing psychologist, physician assistant,
or advanced practice nurse lacked the competency to perform the
act or acts or commits willful and wanton misconduct.
(f) A collaborating physician may, but is not required to,
delegate prescriptive authority to an advanced practice nurse
as part of a written collaborative agreement, and the
delegation of prescriptive authority shall conform to the
requirements of Section 65-40 of the Nurse Practice Act.
(g) A supervising physician may, but is not required to,
delegate prescriptive authority to a physician assistant as
part of a written supervision agreement, and the delegation of
prescriptive authority shall conform to the requirements of
Section 7.5 of the Physician Assistant Practice Act of 1987.
(h) (Blank). For the purposes of this Section, "generally

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provides or may provide in his or her clinical medical
practice" means categories of care or treatment, not specific
tasks or duties, that the physician provides individually or
through delegation to other persons so that the physician has
the experience and ability to provide collaboration and
consultation. This definition shall not be construed to
prohibit an advanced practice nurse from providing primary
health treatment or care within the scope of his or her
training and experience, including, but not limited to, health
screenings, patient histories, physical examinations, women's
health examinations, or school physicals that may be provided
as part of the routine practice of an advanced practice nurse
or on a volunteer basis.
(i) A collaborating physician shall delegate prescriptive
authority to a prescribing psychologist as part of a written
collaborative agreement, and the delegation of prescriptive
authority shall conform to the requirements of Section 4.3 of
the Clinical Psychologist Licensing Act.
(Source: P.A. 97-358, eff. 8-12-11; 97-1071, eff. 8-24-12;
98-192, eff. 1-1-14; 98-668, eff. 6-25-14.)
Section 35. The Nurse Practice Act is amended by changing
Sections 50-10, 65-35, and 65-45 and by adding Section 65-35.1
as follows:
(225 ILCS 65/50-10) (was 225 ILCS 65/5-10)

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(Section scheduled to be repealed on January 1, 2018)
Sec. 50-10. Definitions. Each of the following terms, when
used in this Act, shall have the meaning ascribed to it in this
Section, except where the context clearly indicates otherwise:
"Academic year" means the customary annual schedule of
courses at a college, university, or approved school,
customarily regarded as the school year as distinguished from
the calendar year.
"Advanced practice nurse" or "APN" means a person who has
met the qualifications for a (i) certified nurse midwife (CNM);
(ii) certified nurse practitioner (CNP); (iii) certified
registered nurse anesthetist (CRNA); or (iv) clinical nurse
specialist (CNS) and has been licensed by the Department. All
advanced practice nurses licensed and practicing in the State
of Illinois shall use the title APN and may use specialty
credentials CNM, CNP, CRNA, or CNS after their name. All
advanced practice nurses may only practice in accordance with
national certification and this Act.
"Approved program of professional nursing education" and
"approved program of practical nursing education" are programs
of professional or practical nursing, respectively, approved
by the Department under the provisions of this Act.
"Board" means the Board of Nursing appointed by the
Secretary.
"Collaboration" means a process involving 2 or more health
care professionals working together, each contributing one's

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respective area of expertise to provide more comprehensive
patient care.
"Consultation" means the process whereby an advanced
practice nurse seeks the advice or opinion of another health
care professional.
"Credentialed" means the process of assessing and
validating the qualifications of a health care professional.
"Current nursing practice update course" means a planned
nursing education curriculum approved by the Department
consisting of activities that have educational objectives,
instructional methods, content or subject matter, clinical
practice, and evaluation methods, related to basic review and
updating content and specifically planned for those nurses
previously licensed in the United States or its territories and
preparing for reentry into nursing practice.
"Dentist" means a person licensed to practice dentistry
under the Illinois Dental Practice Act.
"Department" means the Department of Financial and
Professional Regulation.
"Impaired nurse" means a nurse licensed under this Act who
is unable to practice with reasonable skill and safety because
of a physical or mental disability as evidenced by a written
determination or written consent based on clinical evidence,
including loss of motor skills, abuse of drugs or alcohol, or a
psychiatric disorder, of sufficient degree to diminish his or
her ability to deliver competent patient care.

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"License-pending advanced practice nurse" means a
registered professional nurse who has completed all
requirements for licensure as an advanced practice nurse except
the certification examination and has applied to take the next
available certification exam and received a temporary license
from the Department.
"License-pending registered nurse" means a person who has
passed the Department-approved registered nurse licensure exam
and has applied for a license from the Department. A
license-pending registered nurse shall use the title "RN lic
pend" on all documentation related to nursing practice.
"Physician" means a person licensed to practice medicine in
all its branches under the Medical Practice Act of 1987.
"Podiatric physician" means a person licensed to practice
podiatry under the Podiatric Medical Practice Act of 1987.
"Practical nurse" or "licensed practical nurse" means a
person who is licensed as a practical nurse under this Act and
practices practical nursing as defined in this Act. Only a
practical nurse licensed under this Act is entitled to use the
title "licensed practical nurse" and the abbreviation
"L.P.N.".
"Practical nursing" means the performance of nursing acts
requiring the basic nursing knowledge, judgment judgement, and
skill acquired by means of completion of an approved practical
nursing education program. Practical nursing includes
assisting in the nursing process as delegated by a registered

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professional nurse or an advanced practice nurse. The practical
nurse may work under the direction of a licensed physician,
dentist, podiatric physician, or other health care
professional determined by the Department.
"Privileged" means the authorization granted by the
governing body of a healthcare facility, agency, or
organization to provide specific patient care services within
well-defined limits, based on qualifications reviewed in the
credentialing process.
"Registered Nurse" or "Registered Professional Nurse"
means a person who is licensed as a professional nurse under
this Act and practices nursing as defined in this Act. Only a
registered nurse licensed under this Act is entitled to use the
titles "registered nurse" and "registered professional nurse"
and the abbreviation, "R.N.".
"Registered professional nursing practice" is a scientific
process founded on a professional body of knowledge; it is a
learned profession based on the understanding of the human
condition across the life span and environment and includes all
nursing specialties and means the performance of any nursing
act based upon professional knowledge, judgment, and skills
acquired by means of completion of an approved professional
nursing education program. A registered professional nurse
provides holistic nursing care through the nursing process to
individuals, groups, families, or communities, that includes
but is not limited to: (1) the assessment of healthcare needs,

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nursing diagnosis, planning, implementation, and nursing
evaluation; (2) the promotion, maintenance, and restoration of
health; (3) counseling, patient education, health education,
and patient advocacy; (4) the administration of medications and
treatments as prescribed by a physician licensed to practice
medicine in all of its branches, a licensed dentist, a licensed
podiatric physician, or a licensed optometrist or as prescribed
by a physician assistant in accordance with written guidelines
required under the Physician Assistant Practice Act of 1987 or
by an advanced practice nurse in accordance with Article 65 of
this Act; (5) the coordination and management of the nursing
plan of care; (6) the delegation to and supervision of
individuals who assist the registered professional nurse
implementing the plan of care; and (7) teaching nursing
students. The foregoing shall not be deemed to include those
acts of medical diagnosis or prescription of therapeutic or
corrective measures.
"Professional assistance program for nurses" means a
professional assistance program that meets criteria
established by the Board of Nursing and approved by the
Secretary, which provides a non-disciplinary treatment
approach for nurses licensed under this Act whose ability to
practice is compromised by alcohol or chemical substance
addiction.
"Secretary" means the Secretary of Financial and
Professional Regulation.

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"Unencumbered license" means a license issued in good
standing.
"Written collaborative agreement" means a written
agreement between an advanced practice nurse and a
collaborating physician, dentist, or podiatric physician
pursuant to Section 65-35.
(Source: P.A. 97-813, eff. 7-13-12; 98-214, eff. 8-9-13.)
(225 ILCS 65/65-35) (was 225 ILCS 65/15-15)
(Section scheduled to be repealed on January 1, 2018)
Sec. 65-35. Written collaborative agreements.
(a) A written collaborative agreement is required for all
advanced practice nurses engaged in clinical practice, except
for advanced practice nurses who are authorized to practice in
a hospital, hospital affiliate, or ambulatory surgical
treatment center.
(a-5) If an advanced practice nurse engages in clinical
practice outside of a hospital, hospital affiliate, or
ambulatory surgical treatment center in which he or she is
authorized to practice, the advanced practice nurse must have a
written collaborative agreement.
(b) A written collaborative agreement shall describe the
working relationship of the advanced practice nurse with the
collaborating physician or podiatric physician and shall
describe authorize the categories of care, treatment, or
procedures to be provided performed by the advanced practice

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nurse. A collaborative agreement with a dentist must be in
accordance with subsection (c-10) of this Section.
Collaboration does not require an employment relationship
between the collaborating physician or podiatric physician and
advanced practice nurse. Collaboration means the relationship
under which an advanced practice nurse works with a
collaborating physician or podiatric physician in an active
clinical practice to deliver health care services in accordance
with (i) the advanced practice nurse's training, education, and
experience and (ii) collaboration and consultation as
documented in a jointly developed written collaborative
agreement.
The agreement shall promote the exercise of professional
judgment by the advanced practice nurse commensurate with his
or her education and experience. The services to be provided by
the advanced practice nurse shall be services that the
collaborating physician or podiatric physician is authorized
to and generally provides or may provide in his or her clinical
medical or podiatric practice, except as set forth in
subsection (b-5) or (c-5) of this Section. The agreement need
not describe the exact steps that an advanced practice nurse
must take with respect to each specific condition, disease, or
symptom but must specify which authorized procedures require
the presence of the collaborating physician or podiatric
physician as the procedures are being performed. The
collaborative relationship under an agreement shall not be

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construed to require the personal presence of a physician or
podiatric physician at the place where services are rendered.
Methods of communication shall be available for consultation
with the collaborating physician or podiatric physician in
person or by telecommunications or electronic communications
in accordance with established written guidelines as set forth
in the written agreement.
(b-5) Absent an employment relationship, a written
collaborative agreement may not (1) restrict the categories of
patients of an advanced practice nurse within the scope of the
advanced practice nurses training and experience, (2) limit
third party payors or government health programs, such as the
medical assistance program or Medicare with which the advanced
practice nurse contracts, or (3) limit the geographic area or
practice location of the advanced practice nurse in this State.
(c) Collaboration and consultation under all collaboration
agreements shall be adequate if a collaborating physician or
podiatric physician does each of the following:
(1) Participates in the joint formulation and joint
approval of orders or guidelines with the advanced practice
nurse and he or she periodically reviews such orders and
the services provided patients under such orders in
accordance with accepted standards of medical practice or
podiatric practice and advanced practice nursing practice.
(2) Provides collaboration and consultation with the
advanced practice nurse at least once a month. In the case

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of anesthesia services provided by a certified registered
nurse anesthetist, an anesthesiologist, a physician, a
dentist, or a podiatric physician must participate through
discussion of and agreement with the anesthesia plan and
remain physically present and available on the premises
during the delivery of anesthesia services for diagnosis,
consultation, and treatment of emergency medical
conditions.
(3) Is available through telecommunications for
consultation on medical problems, complications, or
emergencies or patient referral. In the case of anesthesia
services provided by a certified registered nurse
anesthetist, an anesthesiologist, a physician, a dentist,
or a podiatric physician must participate through
discussion of and agreement with the anesthesia plan and
remain physically present and available on the premises
during the delivery of anesthesia services for diagnosis,
consultation, and treatment of emergency medical
conditions.
The agreement must contain provisions detailing notice for
termination or change of status involving a written
collaborative agreement, except when such notice is given for
just cause.
(c-5) A certified registered nurse anesthetist, who
provides anesthesia services outside of a hospital or
ambulatory surgical treatment center shall enter into a written

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collaborative agreement with an anesthesiologist or the
physician licensed to practice medicine in all its branches or
the podiatric physician performing the procedure. Outside of a
hospital or ambulatory surgical treatment center, the
certified registered nurse anesthetist may provide only those
services that the collaborating podiatric physician is
authorized to provide pursuant to the Podiatric Medical
Practice Act of 1987 and rules adopted thereunder. A certified
registered nurse anesthetist may select, order, and administer
medication, including controlled substances, and apply
appropriate medical devices for delivery of anesthesia
services under the anesthesia plan agreed with by the
anesthesiologist or the operating physician or operating
podiatric physician.
(c-10) A certified registered nurse anesthetist who
provides anesthesia services in a dental office shall enter
into a written collaborative agreement with an
anesthesiologist or the physician licensed to practice
medicine in all its branches or the operating dentist
performing the procedure. The agreement shall describe the
working relationship of the certified registered nurse
anesthetist and dentist and shall authorize the categories of
care, treatment, or procedures to be performed by the certified
registered nurse anesthetist. In a collaborating dentist's
office, the certified registered nurse anesthetist may only
provide those services that the operating dentist with the

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appropriate permit is authorized to provide pursuant to the
Illinois Dental Practice Act and rules adopted thereunder. For
anesthesia services, an anesthesiologist, physician, or
operating dentist shall participate through discussion of and
agreement with the anesthesia plan and shall remain physically
present and be available on the premises during the delivery of
anesthesia services for diagnosis, consultation, and treatment
of emergency medical conditions. A certified registered nurse
anesthetist may select, order, and administer medication,
including controlled substances, and apply appropriate medical
devices for delivery of anesthesia services under the
anesthesia plan agreed with by the operating dentist.
(d) A copy of the signed, written collaborative agreement
must be available to the Department upon request from both the
advanced practice nurse and the collaborating physician,
dentist, or podiatric physician.
(e) Nothing in this Act shall be construed to limit the
delegation of tasks or duties by a physician to a licensed
practical nurse, a registered professional nurse, or other
persons in accordance with Section 54.2 of the Medical Practice
Act of 1987. Nothing in this Act shall be construed to limit
the method of delegation that may be authorized by any means,
including, but not limited to, oral, written, electronic,
standing orders, protocols, guidelines, or verbal orders.
Nothing in this Act shall be construed to authorize an advanced
practice nurse to provide health care services required by law

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or rule to be performed by a physician.
(f) An advanced practice nurse shall inform each
collaborating physician, dentist, or podiatric physician of
all collaborative agreements he or she has signed and provide a
copy of these to any collaborating physician, dentist, or
podiatric physician upon request.
(g) (Blank). For the purposes of this Act, "generally
provides or may provide in his or her clinical medical
practice" means categories of care or treatment, not specific
tasks or duties, the physician provides individually or through
delegation to other persons so that the physician has the
experience and ability to provide collaboration and
consultation. This definition shall not be construed to
prohibit an advanced practice nurse from providing primary
health treatment or care within the scope of his or her
training and experience, including, but not limited to, health
screenings, patient histories, physical examinations, women's
health examinations, or school physicals that may be provided
as part of the routine practice of an advanced practice nurse
or on a volunteer basis.
For the purposes of this Act, "generally provides or may
provide in his or her clinical podiatric practice" means
services, not specific tasks or duties, that the podiatric
physician routinely provides individually or through
delegation to other persons so that the podiatric physician has
the experience and ability to provide collaboration and

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consultation.
(Source: P.A. 97-358, eff. 8-12-11; 98-192, eff. 1-1-14;
98-214, eff. 8-9-13; 98-756, eff. 7-16-14.)
(225 ILCS 65/65-35.1 new)
Sec. 65-35.1. Written collaborative agreement; temporary
practice. Any advanced practice nurse required to enter into a
written collaborative agreement with a collaborating physician
or collaborating podiatrist is authorized to continue to
practice for up to 90 days after the termination of a
collaborative agreement provided the advanced practice nurse
seeks any needed collaboration at a local hospital and refers
patients who require services beyond the training and
experience of the advanced practice nurse to a physician or
other health care provider.
(225 ILCS 65/65-45) (was 225 ILCS 65/15-25)
(Section scheduled to be repealed on January 1, 2018)
Sec. 65-45. Advanced practice nursing in hospitals,
hospital affiliates, or ambulatory surgical treatment centers.
(a) An advanced practice nurse may provide services in a
hospital or a hospital affiliate as those terms are defined in
the Hospital Licensing Act or the University of Illinois
Hospital Act or a licensed ambulatory surgical treatment center
without a written collaborative agreement pursuant to Section
65-35 of this Act. An advanced practice nurse must possess

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clinical privileges recommended by the hospital medical staff
and granted by the hospital or the consulting medical staff
committee and ambulatory surgical treatment center in order to
provide services. The medical staff or consulting medical staff
committee shall periodically review the services of advanced
practice nurses granted clinical privileges, including any
care provided in a hospital affiliate. Authority may also be
granted when recommended by the hospital medical staff and
granted by the hospital or recommended by the consulting
medical staff committee and ambulatory surgical treatment
center to individual advanced practice nurses to select, order,
and administer medications, including controlled substances,
to provide delineated care. In a hospital, hospital affiliate,
or ambulatory surgical treatment center, the attending
physician shall determine an advanced practice nurse's role in
providing care for his or her patients, except as otherwise
provided in the medical staff bylaws or consulting committee
policies.
(a-2) An advanced practice nurse granted authority to order
medications including controlled substances may complete
discharge prescriptions provided the prescription is in the
name of the advanced practice nurse and the attending or
discharging physician.
(a-3) Advanced practice nurses practicing in a hospital or
an ambulatory surgical treatment center are not required to
obtain a mid-level controlled substance license to order

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controlled substances under Section 303.05 of the Illinois
Controlled Substances Act.
(a-5) For anesthesia services provided by a certified
registered nurse anesthetist, an anesthesiologist, physician,
dentist, or podiatric physician shall participate through
discussion of and agreement with the anesthesia plan and shall
remain physically present and be available on the premises
during the delivery of anesthesia services for diagnosis,
consultation, and treatment of emergency medical conditions,
unless hospital policy adopted pursuant to clause (B) of
subdivision (3) of Section 10.7 of the Hospital Licensing Act
or ambulatory surgical treatment center policy adopted
pursuant to clause (B) of subdivision (3) of Section 6.5 of the
Ambulatory Surgical Treatment Center Act provides otherwise. A
certified registered nurse anesthetist may select, order, and
administer medication for anesthesia services under the
anesthesia plan agreed to by the anesthesiologist or the
physician, in accordance with hospital alternative policy or
the medical staff consulting committee policies of a licensed
ambulatory surgical treatment center.
(b) An advanced practice nurse who provides services in a
hospital shall do so in accordance with Section 10.7 of the
Hospital Licensing Act and, in an ambulatory surgical treatment
center, in accordance with Section 6.5 of the Ambulatory
Surgical Treatment Center Act.
(c) Advanced practice nurses certified as nurse

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practitioners, nurse midwives, or clinical nurse specialists
practicing in a hospital affiliate may be, but are not required
to be, granted authority to prescribe Schedule II through V
controlled substances when such authority is recommended by the
appropriate physician committee of the hospital affiliate and
granted by the hospital affiliate. This authority may, but is
not required to, include prescription of, selection of, orders
for, administration of, storage of, acceptance of samples of,
and dispensing over-the-counter medications, legend drugs,
medical gases, and controlled substances categorized as
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.
To prescribe controlled substances under this subsection
(c), an advanced practice nurse certified as a nurse
practitioner, nurse midwife, or clinical nurse specialist must
obtain a mid-level practitioner controlled substance license.
Medication orders shall be reviewed periodically by the
appropriate hospital affiliate physicians committee or its
physician designee.
The hospital affiliate shall file with the Department
notice of a grant of prescriptive authority consistent with
this subsection (c) and termination of such a grant of
authority, in accordance with rules of the Department. Upon
receipt of this notice of grant of authority to prescribe any

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Schedule II through V controlled substances, the licensed
advanced practice nurse certified as a nurse practitioner,
nurse midwife, or clinical nurse specialist may register for a
mid-level practitioner controlled substance license under
Section 303.05 of the Illinois Controlled Substances Act.
In addition, a hospital affiliate may, but is not required
to, grant authority to an advanced practice nurse certified as
a nurse practitioner, nurse midwife, or clinical nurse
specialist to prescribe any Schedule II controlled substances,
if all of the following conditions apply:
(1) specific Schedule II controlled substances by oral
dosage or topical or transdermal application may be
designated, provided that the designated Schedule II
controlled substances are routinely prescribed by advanced
practice nurses in their area of certification; this grant
of authority must identify the specific Schedule II
controlled substances by either brand name or generic name;
authority to prescribe or dispense Schedule II controlled
substances to be delivered by injection or other route of
administration may not be granted;
(2) any grant of authority must be controlled
substances limited to the practice of the advanced practice
nurse;
(3) any prescription must be limited to no more than a
30-day supply;
(4) the advanced practice nurse must discuss the

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condition of any patients for whom a controlled substance
is prescribed monthly with the appropriate physician
committee of the hospital affiliate or its physician
designee; and
(5) the advanced practice nurse must meet the education
requirements of Section 303.05 of the Illinois Controlled
Substances Act.
(Source: P.A. 97-358, eff. 8-12-11; 98-214, eff. 8-9-13.)"; and
on page 65, immediately below line 24, by inserting the
following:
"Section 53. The Podiatric Medical Practice Act of 1987 is
amended by changing Section 20.5 as follows:
(225 ILCS 100/20.5)
(Section scheduled to be repealed on January 1, 2018)
Sec. 20.5. Delegation of authority to advanced practice
nurses.
(a) A podiatric physician in active clinical practice may
collaborate with an advanced practice nurse in accordance with
the requirements of the Nurse Practice Act. Collaboration shall
be for the purpose of providing podiatric care consultation and
no employment relationship shall be required. A written
collaborative agreement shall conform to the requirements of
Section 65-35 of the Nurse Practice Act. The written

09900HB0421ham002 - 25 - LRB099 05828 AMC 34231 a
collaborative agreement shall be for services the
collaborating podiatric physician generally provides to his or
her patients in the normal course of clinical podiatric
practice, except as set forth in item (3) of this subsection
(a). A written collaborative agreement and podiatric physician
collaboration and consultation shall be adequate with respect
to advanced practice nurses if all of the following apply:
(1) The agreement is written to promote the exercise of
professional judgment by the advanced practice nurse
commensurate with his or her education and experience. The
agreement need not describe the exact steps that an
advanced practice nurse must take with respect to each
specific condition, disease, or symptom, but must specify
which procedures require a podiatric physician's presence
as the procedures are being performed.
(2) Practice guidelines and orders are developed and
approved jointly by the advanced practice nurse and
collaborating podiatric physician, as needed, based on the
practice of the practitioners. Such guidelines and orders
and the patient services provided thereunder are
periodically reviewed by the collaborating podiatric
physician.
(1) (3) The advance practice nurse provides services
that the collaborating podiatric physician generally
provides to his or her patients in the normal course of
clinical practice. With respect to the provision of

09900HB0421ham002 - 26 - LRB099 05828 AMC 34231 a
anesthesia services by a certified registered nurse
anesthetist, the collaborating podiatric physician must
have training and experience in the delivery of anesthesia
consistent with Department rules.
(4) The collaborating podiatric physician and the
advanced practice nurse consult at least once a month to
provide collaboration and consultation.
(2) (5) Methods of communication are available with the
collaborating podiatric physician in person or through
telecommunications or electronic communications for
consultation, collaboration, and referral as needed to
address patient care needs.
(3) (6) With respect to the provision of anesthesia
services by a certified registered nurse anesthetist, an
anesthesiologist, physician, or podiatric physician shall
participate through discussion of and agreement with the
anesthesia plan and shall remain physically present and be
available on the premises during the delivery of anesthesia
services for diagnosis, consultation, and treatment of
emergency medical conditions. The anesthesiologist or
operating podiatric physician must agree with the
anesthesia plan prior to the delivery of services.
(7) The agreement contains provisions detailing notice
for termination or change of status involving a written
collaborative agreement, except when such notice is given
for just cause.

09900HB0421ham002 - 27 - LRB099 05828 AMC 34231 a
(b) The collaborating podiatric physician shall have
access to the records of all patients attended to by an
advanced practice nurse.
(c) Nothing in this Section shall be construed to limit the
delegation of tasks or duties by a podiatric physician to a
licensed practical nurse, a registered professional nurse, or
other appropriately trained persons.
(d) A podiatric physician shall not be liable for the acts
or omissions of an advanced practice nurse solely on the basis
of having signed guidelines or a collaborative agreement, an
order, a standing order, a standing delegation order, or other
order or guideline authorizing an advanced practice nurse to
perform acts, unless the podiatric physician has reason to
believe the advanced practice nurse lacked the competency to
perform the act or acts or commits willful or wanton
misconduct.
(e) A podiatric physician, may, but is not required to
delegate prescriptive authority to an advanced practice nurse
as part of a written collaborative agreement and the delegation
of prescriptive authority shall conform to the requirements of
Section 65-40 of the Nurse Practice Act.
(Source: P.A. 97-358, eff. 8-12-11; 97-813, eff. 7-13-12;
98-214, eff. 8-9-13.)"; and
on page 85, immediately below line 3, by inserting the
following:

09900HB0421ham002 - 28 - LRB099 05828 AMC 34231 a
"Section 63. The Illinois Public Aid Code is amended by
changing Section 5-8 as follows:
(305 ILCS 5/5-8) (from Ch. 23, par. 5-8)
Sec. 5-8. Practitioners. In supplying medical assistance,
the Illinois Department may provide for the legally authorized
services of (i) persons licensed under the Medical Practice Act
of 1987, as amended, except as hereafter in this Section
stated, whether under a general or limited license, (ii)
persons licensed under the Nurse Practice Act as advanced
practice nurses, regardless of whether or not the persons have
written collaborative agreements, (iii) persons licensed or
registered under other laws of this State to provide dental,
medical, pharmaceutical, optometric, podiatric, or nursing
services, or other remedial care recognized under State law,
and (iv) (iii) persons licensed under other laws of this State
as a clinical social worker. The Department may not provide for
legally authorized services of any physician who has been
convicted of having performed an abortion procedure in a wilful
and wanton manner on a woman who was not pregnant at the time
such abortion procedure was performed. The utilization of the
services of persons engaged in the treatment or care of the
sick, which persons are not required to be licensed or
registered under the laws of this State, is not prohibited by
this Section.

09900HB0421ham002 - 29 - LRB099 05828 AMC 34231 a
(Source: P.A. 95-518, eff. 8-28-07.)"; and
on page 140, immediately below line 5, by inserting the
following:
"Section 120. The Illinois Controlled Substances Act is
amended by changing Sections 102 and 303.05 as follows:
(720 ILCS 570/102) (from Ch. 56 1/2, par. 1102)
Sec. 102. Definitions. As used in this Act, unless the
context otherwise requires:
(a) "Addict" means any person who habitually uses any drug,
chemical, substance or dangerous drug other than alcohol so as
to endanger the public morals, health, safety or welfare or who
is so far addicted to the use of a dangerous drug or controlled
substance other than alcohol as to have lost the power of self
control with reference to his or her addiction.
(b) "Administer" means the direct application of a
controlled substance, whether by injection, inhalation,
ingestion, or any other means, to the body of a patient,
research subject, or animal (as defined by the Humane
Euthanasia in Animal Shelters Act) by:
(1) a practitioner (or, in his or her presence, by his
or her authorized agent),
(2) the patient or research subject pursuant to an
order, or

09900HB0421ham002 - 30 - LRB099 05828 AMC 34231 a
(3) a euthanasia technician as defined by the Humane
Euthanasia in Animal Shelters Act.
(c) "Agent" means an authorized person who acts on behalf
of or at the direction of a manufacturer, distributor,
dispenser, prescriber, or practitioner. It does not include a
common or contract carrier, public warehouseman or employee of
the carrier or warehouseman.
(c-1) "Anabolic Steroids" means any drug or hormonal
substance, chemically and pharmacologically related to
testosterone (other than estrogens, progestins,
corticosteroids, and dehydroepiandrosterone), and includes:
(i) 3[beta],17-dihydroxy-5a-androstane,
(ii) 3[alpha],17[beta]-dihydroxy-5a-androstane,
(iii) 5[alpha]-androstan-3,17-dione,
(iv) 1-androstenediol (3[beta],
17[beta]-dihydroxy-5[alpha]-androst-1-ene),
(v) 1-androstenediol (3[alpha],
17[beta]-dihydroxy-5[alpha]-androst-1-ene),
(vi) 4-androstenediol
(3[beta],17[beta]-dihydroxy-androst-4-ene),
(vii) 5-androstenediol
(3[beta],17[beta]-dihydroxy-androst-5-ene),
(viii) 1-androstenedione
([5alpha]-androst-1-en-3,17-dione),
(ix) 4-androstenedione
(androst-4-en-3,17-dione),

09900HB0421ham002 - 31 - LRB099 05828 AMC 34231 a
(x) 5-androstenedione
(androst-5-en-3,17-dione),
(xi) bolasterone (7[alpha],17a-dimethyl-17[beta]-
hydroxyandrost-4-en-3-one),
(xii) boldenone (17[beta]-hydroxyandrost-
1,4,-diene-3-one),
(xiii) boldione (androsta-1,4-
diene-3,17-dione),
(xiv) calusterone (7[beta],17[alpha]-dimethyl-17
[beta]-hydroxyandrost-4-en-3-one),
(xv) clostebol (4-chloro-17[beta]-
hydroxyandrost-4-en-3-one),
(xvi) dehydrochloromethyltestosterone (4-chloro-
17[beta]-hydroxy-17[alpha]-methyl-
androst-1,4-dien-3-one),
(xvii) desoxymethyltestosterone
(17[alpha]-methyl-5[alpha]
-androst-2-en-17[beta]-ol)(a.k.a., madol),
(xviii) [delta]1-dihydrotestosterone (a.k.a.
'1-testosterone') (17[beta]-hydroxy-
5[alpha]-androst-1-en-3-one),
(xix) 4-dihydrotestosterone (17[beta]-hydroxy-
androstan-3-one),
(xx) drostanolone (17[beta]-hydroxy-2[alpha]-methyl-
5[alpha]-androstan-3-one),
(xxi) ethylestrenol (17[alpha]-ethyl-17[beta]-

09900HB0421ham002 - 32 - LRB099 05828 AMC 34231 a
hydroxyestr-4-ene),
(xxii) fluoxymesterone (9-fluoro-17[alpha]-methyl-
1[beta],17[beta]-dihydroxyandrost-4-en-3-one),
(xxiii) formebolone (2-formyl-17[alpha]-methyl-11[alpha],
17[beta]-dihydroxyandrost-1,4-dien-3-one),
(xxiv) furazabol (17[alpha]-methyl-17[beta]-
hydroxyandrostano[2,3-c]-furazan),
(xxv) 13[beta]-ethyl-17[beta]-hydroxygon-4-en-3-one)
(xxvi) 4-hydroxytestosterone (4,17[beta]-dihydroxy-
androst-4-en-3-one),
(xxvii) 4-hydroxy-19-nortestosterone (4,17[beta]-
dihydroxy-estr-4-en-3-one),
(xxviii) mestanolone (17[alpha]-methyl-17[beta]-
hydroxy-5-androstan-3-one),
(xxix) mesterolone (1amethyl-17[beta]-hydroxy-
[5a]-androstan-3-one),
(xxx) methandienone (17[alpha]-methyl-17[beta]-
hydroxyandrost-1,4-dien-3-one),
(xxxi) methandriol (17[alpha]-methyl-3[beta],17[beta]-
dihydroxyandrost-5-ene),
(xxxii) methenolone (1-methyl-17[beta]-hydroxy-
5[alpha]-androst-1-en-3-one),
(xxxiii) 17[alpha]-methyl-3[beta], 17[beta]-
dihydroxy-5a-androstane),
(xxxiv) 17[alpha]-methyl-3[alpha],17[beta]-dihydroxy
-5a-androstane),

09900HB0421ham002 - 33 - LRB099 05828 AMC 34231 a
(xxxv) 17[alpha]-methyl-3[beta],17[beta]-
dihydroxyandrost-4-ene),
(xxxvi) 17[alpha]-methyl-4-hydroxynandrolone (17[alpha]-
methyl-4-hydroxy-17[beta]-hydroxyestr-4-en-3-one),
(xxxvii) methyldienolone (17[alpha]-methyl-17[beta]-
hydroxyestra-4,9(10)-dien-3-one),
(xxxviii) methyltrienolone (17[alpha]-methyl-17[beta]-
hydroxyestra-4,9-11-trien-3-one),
(xxxix) methyltestosterone (17[alpha]-methyl-17[beta]-
hydroxyandrost-4-en-3-one),
(xl) mibolerone (7[alpha],17a-dimethyl-17[beta]-
hydroxyestr-4-en-3-one),
(xli) 17[alpha]-methyl-[delta]1-dihydrotestosterone
(17b[beta]-hydroxy-17[alpha]-methyl-5[alpha]-
androst-1-en-3-one)(a.k.a. '17-[alpha]-methyl-
1-testosterone'),
(xlii) nandrolone (17[beta]-hydroxyestr-4-en-3-one),
(xliii) 19-nor-4-androstenediol (3[beta], 17[beta]-
dihydroxyestr-4-ene),
(xliv) 19-nor-4-androstenediol (3[alpha], 17[beta]-
dihydroxyestr-4-ene),
(xlv) 19-nor-5-androstenediol (3[beta], 17[beta]-
dihydroxyestr-5-ene),
(xlvi) 19-nor-5-androstenediol (3[alpha], 17[beta]-
dihydroxyestr-5-ene),
(xlvii) 19-nor-4,9(10)-androstadienedione

09900HB0421ham002 - 34 - LRB099 05828 AMC 34231 a
(estra-4,9(10)-diene-3,17-dione),
(xlviii) 19-nor-4-androstenedione (estr-4-
en-3,17-dione),
(xlix) 19-nor-5-androstenedione (estr-5-
en-3,17-dione),
(l) norbolethone (13[beta], 17a-diethyl-17[beta]-
hydroxygon-4-en-3-one),
(li) norclostebol (4-chloro-17[beta]-
hydroxyestr-4-en-3-one),
(lii) norethandrolone (17[alpha]-ethyl-17[beta]-
hydroxyestr-4-en-3-one),
(liii) normethandrolone (17[alpha]-methyl-17[beta]-
hydroxyestr-4-en-3-one),
(liv) oxandrolone (17[alpha]-methyl-17[beta]-hydroxy-
2-oxa-5[alpha]-androstan-3-one),
(lv) oxymesterone (17[alpha]-methyl-4,17[beta]-
dihydroxyandrost-4-en-3-one),
(lvi) oxymetholone (17[alpha]-methyl-2-hydroxymethylene-
17[beta]-hydroxy-(5[alpha]-androstan-3-one),
(lvii) stanozolol (17[alpha]-methyl-17[beta]-hydroxy-
(5[alpha]-androst-2-eno[3,2-c]-pyrazole),
(lviii) stenbolone (17[beta]-hydroxy-2-methyl-
(5[alpha]-androst-1-en-3-one),
(lix) testolactone (13-hydroxy-3-oxo-13,17-
secoandrosta-1,4-dien-17-oic
acid lactone),

09900HB0421ham002 - 35 - LRB099 05828 AMC 34231 a
(lx) testosterone (17[beta]-hydroxyandrost-
4-en-3-one),
(lxi) tetrahydrogestrinone (13[beta], 17[alpha]-
diethyl-17[beta]-hydroxygon-
4,9,11-trien-3-one),
(lxii) trenbolone (17[beta]-hydroxyestr-4,9,
11-trien-3-one).
Any person who is otherwise lawfully in possession of an
anabolic steroid, or who otherwise lawfully manufactures,
distributes, dispenses, delivers, or possesses with intent to
deliver an anabolic steroid, which anabolic steroid is
expressly intended for and lawfully allowed to be administered
through implants to livestock or other nonhuman species, and
which is approved by the Secretary of Health and Human Services
for such administration, and which the person intends to
administer or have administered through such implants, shall
not be considered to be in unauthorized possession or to
unlawfully manufacture, distribute, dispense, deliver, or
possess with intent to deliver such anabolic steroid for
purposes of this Act.
(d) "Administration" means the Drug Enforcement
Administration, United States Department of Justice, or its
successor agency.
(d-5) "Clinical Director, Prescription Monitoring Program"
means a Department of Human Services administrative employee
licensed to either prescribe or dispense controlled substances

09900HB0421ham002 - 36 - LRB099 05828 AMC 34231 a
who shall run the clinical aspects of the Department of Human
Services Prescription Monitoring Program and its Prescription
Information Library.
(d-10) "Compounding" means the preparation and mixing of
components, excluding flavorings, (1) as the result of a
prescriber's prescription drug order or initiative based on the
prescriber-patient-pharmacist relationship in the course of
professional practice or (2) for the purpose of, or incident
to, research, teaching, or chemical analysis and not for sale
or dispensing. "Compounding" includes the preparation of drugs
or devices in anticipation of receiving prescription drug
orders based on routine, regularly observed dispensing
patterns. Commercially available products may be compounded
for dispensing to individual patients only if both of the
following conditions are met: (i) the commercial product is not
reasonably available from normal distribution channels in a
timely manner to meet the patient's needs and (ii) the
prescribing practitioner has requested that the drug be
compounded.
(e) "Control" means to add a drug or other substance, or
immediate precursor, to a Schedule whether by transfer from
another Schedule or otherwise.
(f) "Controlled Substance" means (i) a drug, substance, or
immediate precursor in the Schedules of Article II of this Act
or (ii) a drug or other substance, or immediate precursor,
designated as a controlled substance by the Department through

09900HB0421ham002 - 37 - LRB099 05828 AMC 34231 a
administrative rule. The term does not include distilled
spirits, wine, malt beverages, or tobacco, as those terms are
defined or used in the Liquor Control Act of 1934 and the
Tobacco Products Tax Act of 1995.
(f-5) "Controlled substance analog" means a substance:
(1) the chemical structure of which is substantially
similar to the chemical structure of a controlled substance
in Schedule I or II;
(2) which has a stimulant, depressant, or
hallucinogenic effect on the central nervous system that is
substantially similar to or greater than the stimulant,
depressant, or hallucinogenic effect on the central
nervous system of a controlled substance in Schedule I or
II; or
(3) with respect to a particular person, which such
person represents or intends to have a stimulant,
depressant, or hallucinogenic effect on the central
nervous system that is substantially similar to or greater
than the stimulant, depressant, or hallucinogenic effect
on the central nervous system of a controlled substance in
Schedule I or II.
(g) "Counterfeit substance" means a controlled substance,
which, or the container or labeling of which, without
authorization bears the trademark, trade name, or other
identifying mark, imprint, number or device, or any likeness
thereof, of a manufacturer, distributor, or dispenser other

09900HB0421ham002 - 38 - LRB099 05828 AMC 34231 a
than the person who in fact manufactured, distributed, or
dispensed the substance.
(h) "Deliver" or "delivery" means the actual, constructive
or attempted transfer of possession of a controlled substance,
with or without consideration, whether or not there is an
agency relationship.
(i) "Department" means the Illinois Department of Human
Services (as successor to the Department of Alcoholism and
Substance Abuse) or its successor agency.
(j) (Blank).
(k) "Department of Corrections" means the Department of
Corrections of the State of Illinois or its successor agency.
(l) "Department of Financial and Professional Regulation"
means the Department of Financial and Professional Regulation
of the State of Illinois or its successor agency.
(m) "Depressant" means any drug that (i) causes an overall
depression of central nervous system functions, (ii) causes
impaired consciousness and awareness, and (iii) can be
habit-forming or lead to a substance abuse problem, including
but not limited to alcohol, cannabis and its active principles
and their analogs, benzodiazepines and their analogs,
barbiturates and their analogs, opioids (natural and
synthetic) and their analogs, and chloral hydrate and similar
sedative hypnotics.
(n) (Blank).
(o) "Director" means the Director of the Illinois State

09900HB0421ham002 - 39 - LRB099 05828 AMC 34231 a
Police or his or her designated agents.
(p) "Dispense" means to deliver a controlled substance to
an ultimate user or research subject by or pursuant to the
lawful order of a prescriber, including the prescribing,
administering, packaging, labeling, or compounding necessary
to prepare the substance for that delivery.
(q) "Dispenser" means a practitioner who dispenses.
(r) "Distribute" means to deliver, other than by
administering or dispensing, a controlled substance.
(s) "Distributor" means a person who distributes.
(t) "Drug" means (1) substances recognized as drugs in the
official United States Pharmacopoeia, Official Homeopathic
Pharmacopoeia of the United States, or official National
Formulary, or any supplement to any of them; (2) substances
intended for use in diagnosis, cure, mitigation, treatment, or
prevention of disease in man or animals; (3) substances (other
than food) intended to affect the structure of any function of
the body of man or animals and (4) substances intended for use
as a component of any article specified in clause (1), (2), or
(3) of this subsection. It does not include devices or their
components, parts, or accessories.
(t-5) "Euthanasia agency" means an entity certified by the
Department of Financial and Professional Regulation for the
purpose of animal euthanasia that holds an animal control
facility license or animal shelter license under the Animal
Welfare Act. A euthanasia agency is authorized to purchase,

09900HB0421ham002 - 40 - LRB099 05828 AMC 34231 a
store, possess, and utilize Schedule II nonnarcotic and
Schedule III nonnarcotic drugs for the sole purpose of animal
euthanasia.
(t-10) "Euthanasia drugs" means Schedule II or Schedule III
substances (nonnarcotic controlled substances) that are used
by a euthanasia agency for the purpose of animal euthanasia.
(u) "Good faith" means the prescribing or dispensing of a
controlled substance by a practitioner in the regular course of
professional treatment to or for any person who is under his or
her treatment for a pathology or condition other than that
individual's physical or psychological dependence upon or
addiction to a controlled substance, except as provided herein:
and application of the term to a pharmacist shall mean the
dispensing of a controlled substance pursuant to the
prescriber's order which in the professional judgment of the
pharmacist is lawful. The pharmacist shall be guided by
accepted professional standards including, but not limited to
the following, in making the judgment:
(1) lack of consistency of prescriber-patient
relationship,
(2) frequency of prescriptions for same drug by one
prescriber for large numbers of patients,
(3) quantities beyond those normally prescribed,
(4) unusual dosages (recognizing that there may be
clinical circumstances where more or less than the usual
dose may be used legitimately),

09900HB0421ham002 - 41 - LRB099 05828 AMC 34231 a
(5) unusual geographic distances between patient,
pharmacist and prescriber,
(6) consistent prescribing of habit-forming drugs.
(u-0.5) "Hallucinogen" means a drug that causes markedly
altered sensory perception leading to hallucinations of any
type.
(u-1) "Home infusion services" means services provided by a
pharmacy in compounding solutions for direct administration to
a patient in a private residence, long-term care facility, or
hospice setting by means of parenteral, intravenous,
intramuscular, subcutaneous, or intraspinal infusion.
(u-5) "Illinois State Police" means the State Police of the
State of Illinois, or its successor agency.
(v) "Immediate precursor" means a substance:
(1) which the Department has found to be and by rule
designated as being a principal compound used, or produced
primarily for use, in the manufacture of a controlled
substance;
(2) which is an immediate chemical intermediary used or
likely to be used in the manufacture of such controlled
substance; and
(3) the control of which is necessary to prevent,
curtail or limit the manufacture of such controlled
substance.
(w) "Instructional activities" means the acts of teaching,
educating or instructing by practitioners using controlled

09900HB0421ham002 - 42 - LRB099 05828 AMC 34231 a
substances within educational facilities approved by the State
Board of Education or its successor agency.
(x) "Local authorities" means a duly organized State,
County or Municipal peace unit or police force.
(y) "Look-alike substance" means a substance, other than a
controlled substance which (1) by overall dosage unit
appearance, including shape, color, size, markings or lack
thereof, taste, consistency, or any other identifying physical
characteristic of the substance, would lead a reasonable person
to believe that the substance is a controlled substance, or (2)
is expressly or impliedly represented to be a controlled
substance or is distributed under circumstances which would
lead a reasonable person to believe that the substance is a
controlled substance. For the purpose of determining whether
the representations made or the circumstances of the
distribution would lead a reasonable person to believe the
substance to be a controlled substance under this clause (2) of
subsection (y), the court or other authority may consider the
following factors in addition to any other factor that may be
relevant:
(a) statements made by the owner or person in control
of the substance concerning its nature, use or effect;
(b) statements made to the buyer or recipient that the
substance may be resold for profit;
(c) whether the substance is packaged in a manner
normally used for the illegal distribution of controlled

09900HB0421ham002 - 43 - LRB099 05828 AMC 34231 a
substances;
(d) whether the distribution or attempted distribution
included an exchange of or demand for money or other
property as consideration, and whether the amount of the
consideration was substantially greater than the
reasonable retail market value of the substance.
Clause (1) of this subsection (y) shall not apply to a
noncontrolled substance in its finished dosage form that was
initially introduced into commerce prior to the initial
introduction into commerce of a controlled substance in its
finished dosage form which it may substantially resemble.
Nothing in this subsection (y) prohibits the dispensing or
distributing of noncontrolled substances by persons authorized
to dispense and distribute controlled substances under this
Act, provided that such action would be deemed to be carried
out in good faith under subsection (u) if the substances
involved were controlled substances.
Nothing in this subsection (y) or in this Act prohibits the
manufacture, preparation, propagation, compounding,
processing, packaging, advertising or distribution of a drug or
drugs by any person registered pursuant to Section 510 of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360).
(y-1) "Mail-order pharmacy" means a pharmacy that is
located in a state of the United States that delivers,
dispenses or distributes, through the United States Postal
Service or other common carrier, to Illinois residents, any

09900HB0421ham002 - 44 - LRB099 05828 AMC 34231 a
substance which requires a prescription.
(z) "Manufacture" means the production, preparation,
propagation, compounding, conversion or processing of a
controlled substance other than methamphetamine, either
directly or indirectly, by extraction from substances of
natural origin, or independently by means of chemical
synthesis, or by a combination of extraction and chemical
synthesis, and includes any packaging or repackaging of the
substance or labeling of its container, except that this term
does not include:
(1) by an ultimate user, the preparation or compounding
of a controlled substance for his or her own use; or
(2) by a practitioner, or his or her authorized agent
under his or her supervision, the preparation,
compounding, packaging, or labeling of a controlled
substance:
(a) as an incident to his or her administering or
dispensing of a controlled substance in the course of
his or her professional practice; or
(b) as an incident to lawful research, teaching or
chemical analysis and not for sale.
(z-1) (Blank).
(z-5) "Medication shopping" means the conduct prohibited
under subsection (a) of Section 314.5 of this Act.
(z-10) "Mid-level practitioner" means (i) a physician
assistant who has been delegated authority to prescribe through

09900HB0421ham002 - 45 - LRB099 05828 AMC 34231 a
a written delegation of authority by a physician licensed to
practice medicine in all of its branches, in accordance with
Section 7.5 of the Physician Assistant Practice Act of 1987,
(ii) an advanced practice nurse who has been delegated
authority to prescribe through a written delegation of
authority by a physician licensed to practice medicine in all
of its branches or by a podiatric physician, in accordance with
Section 65-40 of the Nurse Practice Act, (iii) an advanced
practice nurse certified as a nurse practitioner, nurse
midwife, or clinical nurse specialist who has been granted
authority to prescribe by a hospital affiliate in accordance
with Section 65-45 of the Nurse Practice Act, (iv) an animal
euthanasia agency, or (v) (iv) a prescribing psychologist.
(aa) "Narcotic drug" means any of the following, whether
produced directly or indirectly by extraction from substances
of vegetable origin, or independently by means of chemical
synthesis, or by a combination of extraction and chemical
synthesis:
(1) opium, opiates, derivatives of opium and opiates,
including their isomers, esters, ethers, salts, and salts
of isomers, esters, and ethers, whenever the existence of
such isomers, esters, ethers, and salts is possible within
the specific chemical designation; however the term
"narcotic drug" does not include the isoquinoline
alkaloids of opium;
(2) (blank);

09900HB0421ham002 - 46 - LRB099 05828 AMC 34231 a
(3) opium poppy and poppy straw;
(4) coca leaves, except coca leaves and extracts of
coca leaves from which substantially all of the cocaine and
ecgonine, and their isomers, derivatives and salts, have
been removed;
(5) cocaine, its salts, optical and geometric isomers,
and salts of isomers;
(6) ecgonine, its derivatives, their salts, isomers,
and salts of isomers;
(7) any compound, mixture, or preparation which
contains any quantity of any of the substances referred to
in subparagraphs (1) through (6).
(bb) "Nurse" means a registered nurse licensed under the
Nurse Practice Act.
(cc) (Blank).
(dd) "Opiate" means any substance having an addiction
forming or addiction sustaining liability similar to morphine
or being capable of conversion into a drug having addiction
forming or addiction sustaining liability.
(ee) "Opium poppy" means the plant of the species Papaver
somniferum L., except its seeds.
(ee-5) "Oral dosage" means a tablet, capsule, elixir, or
solution or other liquid form of medication intended for
administration by mouth, but the term does not include a form
of medication intended for buccal, sublingual, or transmucosal
administration.

09900HB0421ham002 - 47 - LRB099 05828 AMC 34231 a
(ff) "Parole and Pardon Board" means the Parole and Pardon
Board of the State of Illinois or its successor agency.
(gg) "Person" means any individual, corporation,
mail-order pharmacy, government or governmental subdivision or
agency, business trust, estate, trust, partnership or
association, or any other entity.
(hh) "Pharmacist" means any person who holds a license or
certificate of registration as a registered pharmacist, a local
registered pharmacist or a registered assistant pharmacist
under the Pharmacy Practice Act.
(ii) "Pharmacy" means any store, ship or other place in
which pharmacy is authorized to be practiced under the Pharmacy
Practice Act.
(ii-5) "Pharmacy shopping" means the conduct prohibited
under subsection (b) of Section 314.5 of this Act.
(ii-10) "Physician" (except when the context otherwise
requires) means a person licensed to practice medicine in all
of its branches.
(jj) "Poppy straw" means all parts, except the seeds, of
the opium poppy, after mowing.
(kk) "Practitioner" means a physician licensed to practice
medicine in all its branches, dentist, optometrist, podiatric
physician, veterinarian, scientific investigator, pharmacist,
physician assistant, advanced practice nurse, licensed
practical nurse, registered nurse, hospital, laboratory, or
pharmacy, or other person licensed, registered, or otherwise

09900HB0421ham002 - 48 - LRB099 05828 AMC 34231 a
lawfully permitted by the United States or this State to
distribute, dispense, conduct research with respect to,
administer or use in teaching or chemical analysis, a
controlled substance in the course of professional practice or
research.
(ll) "Pre-printed prescription" means a written
prescription upon which the designated drug has been indicated
prior to the time of issuance; the term does not mean a written
prescription that is individually generated by machine or
computer in the prescriber's office.
(mm) "Prescriber" means a physician licensed to practice
medicine in all its branches, dentist, optometrist,
prescribing psychologist licensed under Section 4.2 of the
Clinical Psychologist Licensing Act with prescriptive
authority delegated under Section 4.3 of the Clinical
Psychologist Licensing Act, podiatric physician, or
veterinarian who issues a prescription, a physician assistant
who issues a prescription for a controlled substance in
accordance with Section 303.05, a written delegation, and a
written supervision agreement required under Section 7.5 of the
Physician Assistant Practice Act of 1987, or an advanced
practice nurse with prescriptive authority delegated under
Section 65-40 of the Nurse Practice Act and in accordance with
Section 303.05, a written delegation, and a written
collaborative agreement under Section 65-35 of the Nurse
Practice Act, or an advanced practice nurse certified as a

09900HB0421ham002 - 49 - LRB099 05828 AMC 34231 a
nurse practitioner, nurse midwife, or clinical nurse
specialist who has been granted authority to prescribe by a
hospital affiliate in accordance with Section 65-45 of the
Nurse Practice Act and in accordance with Section 303.05.
(nn) "Prescription" means a written, facsimile, or oral
order, or an electronic order that complies with applicable
federal requirements, of a physician licensed to practice
medicine in all its branches, dentist, podiatric physician or
veterinarian for any controlled substance, of an optometrist
for a Schedule II, III, IV, or V controlled substance in
accordance with Section 15.1 of the Illinois Optometric
Practice Act of 1987, of a prescribing psychologist licensed
under Section 4.2 of the Clinical Psychologist Licensing Act
with prescriptive authority delegated under Section 4.3 of the
Clinical Psychologist Licensing Act, of a physician assistant
for a controlled substance in accordance with Section 303.05, a
written delegation, and a written supervision agreement
required under Section 7.5 of the Physician Assistant Practice
Act of 1987, or of an advanced practice nurse with prescriptive
authority delegated under Section 65-40 of the Nurse Practice
Act who issues a prescription for a controlled substance in
accordance with Section 303.05, a written delegation, and a
written collaborative agreement under Section 65-35 of the
Nurse Practice Act, or of an advanced practice nurse certified
as a nurse practitioner, nurse midwife, or clinical nurse
specialist who has been granted authority to prescribe by a

09900HB0421ham002 - 50 - LRB099 05828 AMC 34231 a
hospital affiliate in accordance with Section 65-45 of the
Nurse Practice Act and in accordance with Section 303.05 when
required by law.
(nn-5) "Prescription Information Library" (PIL) means an
electronic library that contains reported controlled substance
data.
(nn-10) "Prescription Monitoring Program" (PMP) means the
entity that collects, tracks, and stores reported data on
controlled substances and select drugs pursuant to Section 316.
(oo) "Production" or "produce" means manufacture,
planting, cultivating, growing, or harvesting of a controlled
substance other than methamphetamine.
(pp) "Registrant" means every person who is required to
register under Section 302 of this Act.
(qq) "Registry number" means the number assigned to each
person authorized to handle controlled substances under the
laws of the United States and of this State.
(qq-5) "Secretary" means, as the context requires, either
the Secretary of the Department or the Secretary of the
Department of Financial and Professional Regulation, and the
Secretary's designated agents.
(rr) "State" includes the State of Illinois and any state,
district, commonwealth, territory, insular possession thereof,
and any area subject to the legal authority of the United
States of America.
(rr-5) "Stimulant" means any drug that (i) causes an

09900HB0421ham002 - 51 - LRB099 05828 AMC 34231 a
overall excitation of central nervous system functions, (ii)
causes impaired consciousness and awareness, and (iii) can be
habit-forming or lead to a substance abuse problem, including
but not limited to amphetamines and their analogs,
methylphenidate and its analogs, cocaine, and phencyclidine
and its analogs.
(ss) "Ultimate user" means a person who lawfully possesses
a controlled substance for his or her own use or for the use of
a member of his or her household or for administering to an
animal owned by him or her or by a member of his or her
household.
(Source: P.A. 97-334, eff. 1-1-12; 98-214, eff. 8-9-13; 98-668,
eff. 6-25-14; 98-756, eff. 7-16-14; 98-1111, eff. 8-26-14;
revised 10-1-14.)
(720 ILCS 570/303.05)
Sec. 303.05. Mid-level practitioner registration.
(a) The Department of Financial and Professional
Regulation shall register licensed physician assistants,
licensed advanced practice nurses, and prescribing
psychologists licensed under Section 4.2 of the Clinical
Psychologist Licensing Act to prescribe and dispense
controlled substances under Section 303 and euthanasia
agencies to purchase, store, or administer animal euthanasia
drugs under the following circumstances:
(1) with respect to physician assistants,

09900HB0421ham002 - 52 - LRB099 05828 AMC 34231 a
(A) the physician assistant has been delegated
written authority to prescribe any Schedule III
through V controlled substances by a physician
licensed to practice medicine in all its branches in
accordance with Section 7.5 of the Physician Assistant
Practice Act of 1987; and the physician assistant has
completed the appropriate application forms and has
paid the required fees as set by rule; or
(B) the physician assistant has been delegated
authority by a supervising physician licensed to
practice medicine in all its branches to prescribe or
dispense Schedule II controlled substances through a
written delegation of authority and under the
following conditions:
(i) Specific Schedule II controlled substances
by oral dosage or topical or transdermal
application may be delegated, provided that the
delegated Schedule II controlled substances are
routinely prescribed by the supervising physician.
This delegation must identify the specific
Schedule II controlled substances by either brand
name or generic name. Schedule II controlled
substances to be delivered by injection or other
route of administration may not be delegated;
(ii) any delegation must be of controlled
substances prescribed by the supervising

09900HB0421ham002 - 53 - LRB099 05828 AMC 34231 a
physician;
(iii) all prescriptions must be limited to no
more than a 30-day supply, with any continuation
authorized only after prior approval of the
supervising physician;
(iv) the physician assistant must discuss the
condition of any patients for whom a controlled
substance is prescribed monthly with the
delegating physician;
(v) the physician assistant must have
completed the appropriate application forms and
paid the required fees as set by rule;
(vi) the physician assistant must provide
evidence of satisfactory completion of 45 contact
hours in pharmacology from any physician assistant
program accredited by the Accreditation Review
Commission on Education for the Physician
Assistant (ARC-PA), or its predecessor agency, for
any new license issued with Schedule II authority
after the effective date of this amendatory Act of
the 97th General Assembly; and
(vii) the physician assistant must annually
complete at least 5 hours of continuing education
in pharmacology;
(2) with respect to advanced practice nurses,
(A) the advanced practice nurse has been delegated

09900HB0421ham002 - 54 - LRB099 05828 AMC 34231 a
authority to prescribe any Schedule III through V
controlled substances by a collaborating physician
licensed to practice medicine in all its branches or a
collaborating podiatric physician in accordance with
Section 65-40 of the Nurse Practice Act. The advanced
practice nurse has completed the appropriate
application forms and has paid the required fees as set
by rule; or
(B) the advanced practice nurse has been delegated
authority by a collaborating physician licensed to
practice medicine in all its branches or collaborating
podiatric physician to prescribe or dispense Schedule
II controlled substances through a written delegation
of authority and under the following conditions:
(i) specific Schedule II controlled substances
by oral dosage or topical or transdermal
application may be delegated, provided that the
delegated Schedule II controlled substances are
routinely prescribed by the collaborating
physician or podiatric physician. This delegation
must identify the specific Schedule II controlled
substances by either brand name or generic name.
Schedule II controlled substances to be delivered
by injection or other route of administration may
not be delegated;
(ii) any delegation must be of controlled

09900HB0421ham002 - 55 - LRB099 05828 AMC 34231 a
substances prescribed by the collaborating
physician or podiatric physician;
(iii) all prescriptions must be limited to no
more than a 30-day supply, with any continuation
authorized only after prior approval of the
collaborating physician or podiatric physician;
(iv) the advanced practice nurse must discuss
the condition of any patients for whom a controlled
substance is prescribed monthly with the
delegating physician or podiatric physician or in
the course of review as required by Section 65-40
of the Nurse Practice Act;
(v) the advanced practice nurse must have
completed the appropriate application forms and
paid the required fees as set by rule;
(vi) the advanced practice nurse must provide
evidence of satisfactory completion of at least 45
graduate contact hours in pharmacology for any new
license issued with Schedule II authority after
the effective date of this amendatory Act of the
97th General Assembly; and
(vii) the advanced practice nurse must
annually complete 5 hours of continuing education
in pharmacology;
(2.5) with respect to advanced practice nurses
certified as nurse practitioners, nurse midwives, or

09900HB0421ham002 - 56 - LRB099 05828 AMC 34231 a
clinical nurse specialists practicing in a hospital
affiliate,
(A) the advanced practice nurse certified as a
nurse practitioner, nurse midwife, or clinical nurse
specialist has been granted authority to prescribe any
Schedule II through V controlled substances by the
hospital affiliate upon the recommendation of the
appropriate physician committee of the hospital
affiliate in accordance with Section 65-45 of the Nurse
Practice Act, has completed the appropriate
application forms, and has paid the required fees as
set by rule; and
(B) an advanced practice nurse certified as a nurse
practitioner, nurse midwife, or clinical nurse
specialist has been granted authority to prescribe any
Schedule II controlled substances by the hospital
affiliate upon the recommendation of the appropriate
physician committee of the hospital affiliate, then
the following conditions must be met:
(i) specific Schedule II controlled substances
by oral dosage or topical or transdermal
application may be designated, provided that the
designated Schedule II controlled substances are
routinely prescribed by advanced practice nurses
in their area of certification; this grant of
authority must identify the specific Schedule II

09900HB0421ham002 - 57 - LRB099 05828 AMC 34231 a
controlled substances by either brand name or
generic name; authority to prescribe or dispense
Schedule II controlled substances to be delivered
by injection or other route of administration may
not be granted;
(ii) any grant of authority must be controlled
substances limited to the practice of the advanced
practice nurse;
(iii) any prescription must be limited to no
more than a 30-day supply;
(iv) the advanced practice nurse must discuss
the condition of any patients for whom a controlled
substance is prescribed monthly with the
appropriate physician committee of the hospital
affiliate or its physician designee; and
(v) the advanced practice nurse must meet the
education requirements of this Section;
(3) with respect to animal euthanasia agencies, the
euthanasia agency has obtained a license from the
Department of Financial and Professional Regulation and
obtained a registration number from the Department; or
(4) with respect to prescribing psychologists, the
prescribing psychologist has been delegated authority to
prescribe any nonnarcotic Schedule III through V
controlled substances by a collaborating physician
licensed to practice medicine in all its branches in

09900HB0421ham002 - 58 - LRB099 05828 AMC 34231 a
accordance with Section 4.3 of the Clinical Psychologist
Licensing Act, and the prescribing psychologist has
completed the appropriate application forms and has paid
the required fees as set by rule.
(b) The mid-level practitioner shall only be licensed to
prescribe those schedules of controlled substances for which a
licensed physician or licensed podiatric physician has
delegated prescriptive authority, except that an animal
euthanasia agency does not have any prescriptive authority. A
physician assistant and an advanced practice nurse are
prohibited from prescribing medications and controlled
substances not set forth in the required written delegation of
authority.
(c) Upon completion of all registration requirements,
physician assistants, advanced practice nurses, and animal
euthanasia agencies may be issued a mid-level practitioner
controlled substances license for Illinois.
(d) A collaborating physician or podiatric physician may,
but is not required to, delegate prescriptive authority to an
advanced practice nurse as part of a written collaborative
agreement, and the delegation of prescriptive authority shall
conform to the requirements of Section 65-40 of the Nurse
Practice Act.
(e) A supervising physician may, but is not required to,
delegate prescriptive authority to a physician assistant as
part of a written supervision agreement, and the delegation of

09900HB0421ham002 - 59 - LRB099 05828 AMC 34231 a
prescriptive authority shall conform to the requirements of
Section 7.5 of the Physician Assistant Practice Act of 1987.
(f) Nothing in this Section shall be construed to prohibit
generic substitution.
(Source: P.A. 97-334, eff. 1-1-12; 97-358, eff. 8-12-11;
97-813, eff. 7-13-12; 98-214, eff. 8-9-13; 98-668, eff.
6-25-14.)".