Bill Text: IL SB2255 | 2011-2012 | 97th General Assembly | Chaptered

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Bill Title: Amends the Nurse Practice Act. Provides that a collaborating physician or podiatrist may, but is not required to, delegate prescriptive authority to an advanced practice nurse as part of a written collaborative agreement of Schedule II (instead of III) through V controlled substances. Effective immediately.

Spectrum: Moderate Partisan Bill (Democrat 9-1)

Status: (Passed) 2011-08-12 - Public Act . . . . . . . . . 97-0358 [SB2255 Detail]

Download: Illinois-2011-SB2255-Chaptered.html

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Public Act 097-0358
SB2255 Enrolled LRB097 09159 CEL 49294 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. 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(Section scheduled to be repealed on November 30, 2011)
Sec. 54.5. Physician delegation of authority to physician
assistants and advanced practice nurses.
(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
physician licensed to practice medicine in all its branches may
enter into supervising physician agreements with no more than 2
physician assistants.
(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 the
collaborating physician generally provides to his or her
patients in the normal course of 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
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.
(3) The advance practice nurse provides services the
collaborating physician generally provides to his or her
patients in the normal course of clinical 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 meet in person at least once a month to
provide collaboration and consultation.
(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
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
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 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 physician assistant or advanced
practice nurse to perform acts, unless the physician has reason
to believe the 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.
(Source: P.A. 95-639, eff. 10-5-07; 96-618, eff. 1-1-10.)
Section 10. The Nurse Practice Act is amended by changing
Sections 65-35, 65-40, and 65-45 as follows:
(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 or ambulatory surgical treatment center.
(a-5) If an advanced practice nurse engages in clinical
practice outside of a hospital 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 podiatrist and shall authorize the
categories of care, treatment, or procedures to be performed by
the advanced practice 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 and advanced
practice nurse. Absent an employment relationship, an
agreement may not restrict the categories of patients or
third-party payment sources accepted by the advanced practice
nurse. Collaboration means the relationship under which an
advanced practice nurse works with a collaborating physician or
podiatrist 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 be defined to 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 podiatrist is

authorized to and generally provides to his or her patients in
the normal course of his or her clinical medical practice,
except as set forth in subsection (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 podiatrist as the procedures are
being performed. The collaborative relationship under an
agreement shall not be construed to require the personal
presence of a physician or podiatrist at all times at the place
where services are rendered. Methods of communication shall be
available for consultation with the collaborating physician or
podiatrist in person or by telecommunications in accordance
with established written guidelines as set forth in the written
agreement.
(c) Collaboration and consultation under all collaboration
agreements shall be adequate if a collaborating physician or
podiatrist 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 Meets in

person with the advanced practice nurse at least once a
month to provide collaboration and consultation. In the
case of anesthesia services provided by a certified
registered nurse anesthetist, an anesthesiologist,
physician, dentist, or podiatrist 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, physician, dentist, or
podiatrist 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
collaborative agreement with an anesthesiologist or the
physician licensed to practice medicine in all its branches or
the podiatrist 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 podiatrist 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 podiatrist.
(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

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 or
podiatrist.
(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.
(f) An advanced practice nurse shall inform each
collaborating physician, dentist, or podiatrist of all

collaborative agreements he or she has signed and provide a
copy of these to any collaborating physician, dentist, or
podiatrist upon request.
(g) For the purposes of this Act, "generally provides to
his or her patients in the normal course of his or her clinical
medical practice" means services, not specific tasks or duties,
the physician or podiatrist routinely provides individually or
through delegation to other persons so that the physician or
podiatrist has the experience and ability to provide
collaboration and consultation.
(Source: P.A. 95-639, eff. 10-5-07; 96-618, eff. 1-1-10.)
(225 ILCS 65/65-40) (was 225 ILCS 65/15-20)
(Section scheduled to be repealed on January 1, 2018)
Sec. 65-40. Written collaborative agreement; prescriptive
Prescriptive authority.
(a) A collaborating physician or podiatrist may, but is not
required to, delegate prescriptive authority to an advanced
practice nurse as part of a written collaborative agreement.
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 any Schedule III 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. The
collaborating physician or podiatrist must have a valid current
Illinois controlled substance license and federal registration
to delegate authority to prescribe delegated controlled
substances.
(b) To prescribe controlled substances under this Section,
an advanced practice nurse must obtain a mid-level practitioner
controlled substance license. Medication orders shall be
reviewed periodically by the collaborating physician or
podiatrist.
(c) The collaborating physician or podiatrist shall file
with the Department notice of delegation of prescriptive
authority and termination of such delegation, in accordance
with rules of the Department. Upon receipt of this notice
delegating authority to prescribe any Schedule III through V
controlled substances, the licensed advanced practice nurse
shall be eligible to register for a mid-level practitioner
controlled substance license under Section 303.05 of the
Illinois Controlled Substances Act.
(d) In addition to the requirements of subsections (a),
(b), and (c) of this Section, a collaborating physician or
podiatrist may, but is not required to, delegate authority to
an advanced practice nurse to prescribe any Schedule II
controlled substances, if all of the following conditions
apply:
(1) Specific No more than 5 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 podiatrist. 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.
(2) Any delegation must be controlled substances that
the collaborating physician or podiatrist prescribes.
(3) Any prescription must be limited to no more than a
30-day supply oral dosage, with any continuation
authorized only after prior approval of the collaborating
physician or podiatrist.
(4) The advanced practice nurse must discuss the
condition of any patients for whom a controlled substance
is prescribed monthly with the delegating physician.
(5) The advanced practice nurse meets the education
requirements of Section 303.05 of the Illinois Controlled
Substances Act.
(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. 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.
(f) Nothing in this Section shall be construed to apply to
any medication authority including Schedule II controlled
substances of an advanced practice nurse for care provided in a
hospital, hospital affiliate, or ambulatory surgical treatment
center pursuant to Section 65-45.
(g) 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.
(h) Nothing in this Section shall be construed to prohibit
generic substitution.
(Source: P.A. 95-639, eff. 10-5-07; 96-189, eff. 8-10-09.)
(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
licensed 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 prescriptive authority or a written
collaborative agreement pursuant to Section 65-35 of this Act.

An advanced practice nurse must possess 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 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
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 podiatrist 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.

(Source: P.A. 95-639, eff. 10-5-07.)
Section 15. The Physician Assistant Practice Act of 1987 is
amended by changing Section 7.5 as follows:
(225 ILCS 95/7.5)
(Section scheduled to be repealed on January 1, 2018)
Sec. 7.5. Prescriptions; written supervision agreements;
prescriptive authority.
(a) A written supervision agreement is required for all
physician assistants to practice in the State.
(1) A written supervision agreement shall describe the
working relationship of the physician assistant with the
supervising physician and shall authorize the categories
of care, treatment, or procedures to be performed by the
physician assistant. The written supervision agreement
shall be defined to promote the exercise of professional
judgment by the physician assistant commensurate with his
or her education and experience. The services to be
provided by the physician assistant shall be services that
the supervising physician is authorized to and generally
provides to his or her patients in the normal course of his
or her clinical medical practice. The written supervision
agreement need not describe the exact steps that a
physician assistant must take with respect to each specific
condition, disease, or symptom but must specify which

authorized procedures require the presence of the
supervising physician as the procedures are being
performed. The supervision relationship under a written
supervision agreement shall not be construed to require the
personal presence of a physician at all times at the place
where services are rendered. Methods of communication
shall be available for consultation with the supervising
physician in person or by telecommunications in accordance
with established written guidelines as set forth in the
written supervision agreement. For the purposes of this
Act, "generally provides to his or her patients in the
normal course of his or her clinical medical practice"
means services, not specific tasks or duties, the
supervising physician routinely provides individually or
through delegation to other persons so that the physician
has the experience and ability to provide supervision and
consultation.
(2) The written supervision agreement shall be
adequate if a physician does each of the following:
(A) Participates in the joint formulation and
joint approval of orders or guidelines with the
physician assistant and he or she periodically reviews
such orders and the services provided patients under
such orders in accordance with accepted standards of
medical practice and physician assistant practice.
(B) Provides supervision and consultation Meets in

person with the physician assistant at least once a
month to provide supervision.
(3) A copy of the signed, written supervision agreement
must be available to the Department upon request from both
the physician assistant and the supervising physician.
(4) A physician assistant shall inform each
supervising physician of all written supervision
agreements he or she has signed and provide a copy of these
to any supervising physician upon request.
(b) A supervising physician may, but is not required to,
delegate prescriptive authority to a physician assistant as
part of a written supervision agreement. 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 III 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. The supervising physician must have a valid,
current Illinois controlled substance license and federal
registration with the Drug Enforcement Agency to delegate the
authority to prescribe controlled substances.
(1) To prescribe Schedule III, IV, or V controlled
substances under this Section, a physician assistant must
obtain a mid-level practitioner controlled substances

license. Medication orders issued by a physician assistant
shall be reviewed periodically by the supervising
physician.
(2) The supervising physician shall file with the
Department notice of delegation of prescriptive authority
to a physician assistant and termination of delegation,
specifying the authority delegated or terminated. Upon
receipt of this notice delegating authority to prescribe
Schedule III, IV, or V controlled substances, the physician
assistant shall be eligible to register for a mid-level
practitioner controlled substances license under Section
303.05 of the Illinois Controlled Substances Act. Nothing
in this Act shall be construed to limit the delegation of
tasks or duties by the supervising physician to a nurse or
other appropriately trained persons in accordance with
Section 54.2 of the Medical Practice Act of 1987.
(3) In addition to the requirements of subsection (b)
of this Section, a supervising physician may, but is not
required to, delegate authority to a physician assistant to
prescribe Schedule II controlled substances, if all of the
following conditions apply:
(A) Specific No more than 5 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.
(B) Any delegation must be controlled substances
that the supervising physician prescribes.
(C) Any prescription must be limited to no more
than a 30-day supply oral dosage, with any continuation
authorized only after prior approval of the
supervising physician.
(D) The physician assistant must discuss the
condition of any patients for whom a controlled
substance is prescribed monthly with the supervising
physician.
(E) The physician assistant meets the education
requirements of Section 303.05 of the Illinois
Controlled Substances Act.
(c) 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. 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.
(d) Any physician assistant 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.
(e) Nothing in this Section shall be construed to prohibit
generic substitution.
(Source: P.A. 96-268, eff. 8-11-09; 96-618, eff. 1-1-10;
96-1000, eff. 7-2-10.)
Section 20. 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 podiatrist 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 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
collaborative agreement shall be for services the
collaborating podiatrist 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 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 podiatrist'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 podiatrist, 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 podiatrist.
(3) The advance practice nurse provides services that
the collaborating podiatrist generally provides to his or
her patients in the normal course of clinical practice.
With respect to the provision of anesthesia services by a
certified registered nurse anesthetist, the collaborating
podiatrist must have training and experience in the
delivery of anesthesia consistent with Department rules.
(4) The collaborating podiatrist and the advanced

practice nurse consult meet in person at least once a month
to provide collaboration and consultation.
(5) Methods of communication are available with the
collaborating podiatrist in person or through
telecommunications for consultation, collaboration, and
referral as needed to address patient care needs.
(6) With respect to the provision of anesthesia
services by a certified registered nurse anesthetist, an
anesthesiologist, physician, or podiatrist 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 podiatrist 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.
(b) The collaborating podiatrist 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 podiatrist to a licensed
practical nurse, a registered professional nurse, or other

appropriately trained persons.
(d) A podiatrist 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 podiatrist has reason to believe the
advanced practice nurse lacked the competency to perform the
act or acts or commits willful or wanton misconduct.
(f) A podiatrist, 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. 95-639, eff. 10-5-07; 96-618, eff. 1-1-10.)
Section 25. The Illinois Controlled Substances Act is
amended by changing Section 303.05 as follows:
(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 and
licensed advanced practice nurses 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,
(A) the physician assistant has been delegated
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 no more than 5 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
physician;
(iii) all prescriptions must be limited to no
more than a 30-day supply oral dosage, 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; and
(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
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 podiatrist 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
podiatrist to prescribe or dispense Schedule II
controlled substances through a written delegation of
authority and under the following conditions:
(i) specific no more than 5 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 podiatrist. 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 collaborating
physician or podiatrist;
(iii) all prescriptions must be limited to no
more than a 30-day supply oral dosage, with any
continuation authorized only after prior approval
of the collaborating physician or podiatrist;
(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 podiatrist; and
(v) the advanced practice nurse must have
completed the appropriate application forms and
paid the required fees as set by rule; or
(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; or
(3) with respect to animal euthanasia agencies, the
euthanasia agency has obtained a license from the

Department of Professional Regulation and obtained a
registration number from the Department.
(b) The mid-level practitioner shall only be licensed to
prescribe those schedules of controlled substances for which a
licensed physician or licensed podiatrist 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 shall be issued a mid-level practitioner
controlled substances license for Illinois.
(d) A collaborating physician or podiatrist 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
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. 95-639, eff. 10-5-07; 96-189, eff. 8-10-09;
96-268, eff. 8-11-09; 96-1000, eff. 7-2-10.)
Section 99. Effective date. This Act takes effect July 1,
2011.