Illinois 2025-2026 Regular Session

Illinois Senate Bill SB1908 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1908 Introduced 2/6/2025, by Sen. Lakesia Collins SYNOPSIS AS INTRODUCED: 225 ILCS 65/50-10 was 225 ILCS 65/5-10225 ILCS 65/65-35 was 225 ILCS 65/15-15225 ILCS 65/65-40 was 225 ILCS 65/15-20225 ILCS 65/65-43 Amends the Nurse Practice Act. Provides that a certified nurse midwife with full practice authority may enter into a written collaborative agreement with an advanced practice registered nurse. Provides that an advanced practice registered nurse certified as a nurse midwife may enter into a written collaborative agreement with an advanced practice registered nurse with full practice authority who is certified as a nurse midwife or a physician. Provides that, for an advanced practice registered nurse certified as a nurse midwife, the clinical experience shall be in collaboration with a certified nurse midwife with full practice authority. Makes conforming changes in provisions concerning written collaborative agreements, prescriptive authority under a written collaborative agreement, and full practice authority. LRB104 08797 AAS 18852 b A BILL FOR 104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1908 Introduced 2/6/2025, by Sen. Lakesia Collins SYNOPSIS AS INTRODUCED: 225 ILCS 65/50-10 was 225 ILCS 65/5-10225 ILCS 65/65-35 was 225 ILCS 65/15-15225 ILCS 65/65-40 was 225 ILCS 65/15-20225 ILCS 65/65-43 225 ILCS 65/50-10 was 225 ILCS 65/5-10 225 ILCS 65/65-35 was 225 ILCS 65/15-15 225 ILCS 65/65-40 was 225 ILCS 65/15-20 225 ILCS 65/65-43 Amends the Nurse Practice Act. Provides that a certified nurse midwife with full practice authority may enter into a written collaborative agreement with an advanced practice registered nurse. Provides that an advanced practice registered nurse certified as a nurse midwife may enter into a written collaborative agreement with an advanced practice registered nurse with full practice authority who is certified as a nurse midwife or a physician. Provides that, for an advanced practice registered nurse certified as a nurse midwife, the clinical experience shall be in collaboration with a certified nurse midwife with full practice authority. Makes conforming changes in provisions concerning written collaborative agreements, prescriptive authority under a written collaborative agreement, and full practice authority. LRB104 08797 AAS 18852 b LRB104 08797 AAS 18852 b A BILL FOR
2	2	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1908 Introduced 2/6/2025, by Sen. Lakesia Collins SYNOPSIS AS INTRODUCED:
3	3	225 ILCS 65/50-10 was 225 ILCS 65/5-10225 ILCS 65/65-35 was 225 ILCS 65/15-15225 ILCS 65/65-40 was 225 ILCS 65/15-20225 ILCS 65/65-43 225 ILCS 65/50-10 was 225 ILCS 65/5-10 225 ILCS 65/65-35 was 225 ILCS 65/15-15 225 ILCS 65/65-40 was 225 ILCS 65/15-20 225 ILCS 65/65-43
4	4	225 ILCS 65/50-10 was 225 ILCS 65/5-10
5	5	225 ILCS 65/65-35 was 225 ILCS 65/15-15
6	6	225 ILCS 65/65-40 was 225 ILCS 65/15-20
7	7	225 ILCS 65/65-43
8	8	Amends the Nurse Practice Act. Provides that a certified nurse midwife with full practice authority may enter into a written collaborative agreement with an advanced practice registered nurse. Provides that an advanced practice registered nurse certified as a nurse midwife may enter into a written collaborative agreement with an advanced practice registered nurse with full practice authority who is certified as a nurse midwife or a physician. Provides that, for an advanced practice registered nurse certified as a nurse midwife, the clinical experience shall be in collaboration with a certified nurse midwife with full practice authority. Makes conforming changes in provisions concerning written collaborative agreements, prescriptive authority under a written collaborative agreement, and full practice authority.
9	9	LRB104 08797 AAS 18852 b LRB104 08797 AAS 18852 b
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13	13	SB1908 LRB104 08797 AAS 18852 b
14	14	1 AN ACT concerning regulation.
15	15	2 Be it enacted by the People of the State of Illinois,
16	16	3 represented in the General Assembly:
17	17	4 Section 5. The Nurse Practice Act is amended by changing
18	18	5 Sections 50-10, 65-35, 65-40, and 65-43 as follows:
19	19	6 (225 ILCS 65/50-10) (was 225 ILCS 65/5-10)
20	20	7 (Section scheduled to be repealed on January 1, 2028)
21	21	8 Sec. 50-10. Definitions. Each of the following terms, when
22	22	9 used in this Act, shall have the meaning ascribed to it in this
23	23	10 Section, except where the context clearly indicates otherwise:
24	24	11 "Academic year" means the customary annual schedule of
25	25	12 courses at a college, university, or approved school,
26	26	13 customarily regarded as the school year as distinguished from
27	27	14 the calendar year.
28	28	15 "Address of record" means the designated address recorded
29	29	16 by the Department in the applicant's or licensee's application
30	30	17 file or license file as maintained by the Department's
31	31	18 licensure maintenance unit.
32	32	19 "Advanced practice registered nurse" or "APRN" means a
33	33	20 person who has met the qualifications for a (i) certified
34	34	21 nurse midwife (CNM); (ii) certified nurse practitioner (CNP);
35	35	22 (iii) certified registered nurse anesthetist (CRNA); or (iv)
36	36	23 clinical nurse specialist (CNS) and has been licensed by the
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40	40	104TH GENERAL ASSEMBLY State of Illinois 2025 and 2026 SB1908 Introduced 2/6/2025, by Sen. Lakesia Collins SYNOPSIS AS INTRODUCED:
41	41	225 ILCS 65/50-10 was 225 ILCS 65/5-10225 ILCS 65/65-35 was 225 ILCS 65/15-15225 ILCS 65/65-40 was 225 ILCS 65/15-20225 ILCS 65/65-43 225 ILCS 65/50-10 was 225 ILCS 65/5-10 225 ILCS 65/65-35 was 225 ILCS 65/15-15 225 ILCS 65/65-40 was 225 ILCS 65/15-20 225 ILCS 65/65-43
42	42	225 ILCS 65/50-10 was 225 ILCS 65/5-10
43	43	225 ILCS 65/65-35 was 225 ILCS 65/15-15
44	44	225 ILCS 65/65-40 was 225 ILCS 65/15-20
45	45	225 ILCS 65/65-43
46	46	Amends the Nurse Practice Act. Provides that a certified nurse midwife with full practice authority may enter into a written collaborative agreement with an advanced practice registered nurse. Provides that an advanced practice registered nurse certified as a nurse midwife may enter into a written collaborative agreement with an advanced practice registered nurse with full practice authority who is certified as a nurse midwife or a physician. Provides that, for an advanced practice registered nurse certified as a nurse midwife, the clinical experience shall be in collaboration with a certified nurse midwife with full practice authority. Makes conforming changes in provisions concerning written collaborative agreements, prescriptive authority under a written collaborative agreement, and full practice authority.
47	47	LRB104 08797 AAS 18852 b LRB104 08797 AAS 18852 b
48	48	LRB104 08797 AAS 18852 b
49	49	A BILL FOR
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55	55	225 ILCS 65/50-10 was 225 ILCS 65/5-10
56	56	225 ILCS 65/65-35 was 225 ILCS 65/15-15
57	57	225 ILCS 65/65-40 was 225 ILCS 65/15-20
58	58	225 ILCS 65/65-43
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77	77	1 Department. All advanced practice registered nurses licensed
78	78	2 and practicing in the State of Illinois shall use the title
79	79	3 APRN and may use specialty credentials CNM, CNP, CRNA, or CNS
80	80	4 after their name. All advanced practice registered nurses may
81	81	5 only practice in accordance with national certification and
82	82	6 this Act.
83	83	7 "Advisory Board" means the Illinois Nursing Workforce
84	84	8 Center Advisory Board.
85	85	9 "Approved program of professional nursing education" and
86	86	10 "approved program of practical nursing education" are programs
87	87	11 of professional or practical nursing, respectively, approved
88	88	12 by the Department under the provisions of this Act.
89	89	13 "Board" means the Board of Nursing appointed by the
90	90	14 Secretary.
91	91	15 "Center" means the Illinois Nursing Workforce Center.
92	92	16 "Collaboration" means a process involving 2 or more health
93	93	17 care professionals working together, each contributing one's
94	94	18 respective area of expertise to provide more comprehensive
95	95	19 patient care.
96	96	20 "Competence" means an expected and measurable level of
97	97	21 performance that integrates knowledge, skills, abilities, and
98	98	22 judgment based on established scientific knowledge and
99	99	23 expectations for nursing practice.
100	100	24 "Comprehensive nursing assessment" means the gathering of
101	101	25 information about the patient's physiological, psychological,
102	102	26 sociological, and spiritual status on an ongoing basis by a
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113	113	1 registered professional nurse and is the first step in
114	114	2 implementing and guiding the nursing plan of care.
115	115	3 "Consultation" means the process whereby an advanced
116	116	4 practice registered nurse seeks the advice or opinion of
117	117	5 another health care professional.
118	118	6 "Credentialed" means the process of assessing and
119	119	7 validating the qualifications of a health care professional.
120	120	8 "Dentist" means a person licensed to practice dentistry
121	121	9 under the Illinois Dental Practice Act.
122	122	10 "Department" means the Department of Financial and
123	123	11 Professional Regulation.
124	124	12 "Email address of record" means the designated email
125	125	13 address recorded by the Department in the applicant's
126	126	14 application file or the licensee's license file, as maintained
127	127	15 by the Department's licensure maintenance unit.
128	128	16 "Focused nursing assessment" means an appraisal of an
129	129	17 individual's status and current situation, contributing to the
130	130	18 comprehensive nursing assessment performed by the registered
131	131	19 professional nurse or advanced practice registered nurse or
132	132	20 the assessment by the physician assistant, physician, dentist,
133	133	21 podiatric physician, or other licensed health care
134	134	22 professional, as determined by the Department, supporting
135	135	23 ongoing data collection, and deciding who needs to be informed
136	136	24 of the information and when to inform.
137	137	25 "Full practice authority" means the authority of an
138	138	26 advanced practice registered nurse licensed in Illinois and
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149	149	1 certified as a nurse practitioner, clinical nurse specialist,
150	150	2 or nurse midwife to practice without a written collaborative
151	151	3 agreement and:
152	152	4 (1) to be fully accountable to patients for the
153	153	5 quality of advanced nursing care rendered;
154	154	6 (2) to be fully accountable for recognizing limits of
155	155	7 knowledge and experience and for planning for the
156	156	8 management of situations beyond the advanced practice
157	157	9 registered nurse's expertise; the full practice authority
158	158	10 for advanced practice registered nurses includes accepting
159	159	11 referrals from, consulting with, collaborating with, or
160	160	12 referring to other health care professionals as warranted
161	161	13 by the needs of the patient; and
162	162	14 (3) to possess the authority to prescribe medications,
163	163	15 including Schedule II through V controlled substances, as
164	164	16 provided in Section 65-43.
165	165	17 "Full practice authority-pending advanced practice
166	166	18 registered nurse" means an advanced practice registered nurse
167	167	19 licensed in Illinois and certified as a nurse practitioner,
168	168	20 clinical nurse specialist, or nurse midwife who has provided a
169	169	21 notarized attestation of completion of at least 250 hours of
170	170	22 continuing education or training in the advanced practice
171	171	23 registered nurse's area of certification and at least 4,000
172	172	24 hours of clinical experience after first attaining national
173	173	25 certification and who has submitted an application to the
174	174	26 Department to be granted full practice authority.
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185	185	1 "Hospital affiliate" means a corporation, partnership,
186	186	2 joint venture, limited liability company, or similar
187	187	3 organization, other than a hospital, that is devoted primarily
188	188	4 to the provision, management, or support of health care
189	189	5 services and that directly or indirectly controls, is
190	190	6 controlled by, or is under common control of the hospital. For
191	191	7 the purposes of this definition, "control" means having at
192	192	8 least an equal or a majority ownership or membership interest.
193	193	9 A hospital affiliate shall be 100% owned or controlled by any
194	194	10 combination of hospitals, their parent corporations, or
195	195	11 physicians licensed to practice medicine in all its branches
196	196	12 in Illinois. "Hospital affiliate" does not include a health
197	197	13 maintenance organization regulated under the Health
198	198	14 Maintenance Organization Act.
199	199	15 "Impaired nurse" means a nurse licensed under this Act who
200	200	16 is unable to practice with reasonable skill and safety because
201	201	17 of a physical or mental disability as evidenced by a written
202	202	18 determination or written consent based on clinical evidence,
203	203	19 including loss of motor skills, abuse of drugs or alcohol, or a
204	204	20 psychiatric disorder, of sufficient degree to diminish his or
205	205	21 her ability to deliver competent patient care.
206	206	22 "License-pending advanced practice registered nurse" means
207	207	23 a registered professional nurse who has completed all
208	208	24 requirements for licensure as an advanced practice registered
209	209	25 nurse except the certification examination and has applied to
210	210	26 take the next available certification exam and received a
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221	221	1 temporary permit from the Department.
222	222	2 "License-pending registered nurse" means a person who has
223	223	3 passed the Department-approved registered nurse licensure exam
224	224	4 and has applied for a license from the Department. A
225	225	5 license-pending registered nurse shall use the title "RN lic
226	226	6 pend" on all documentation related to nursing practice.
227	227	7 "Nursing intervention" means any treatment based on
228	228	8 clinical nursing judgment or knowledge that a nurse performs.
229	229	9 An individual or entity shall not mandate that a registered
230	230	10 professional nurse delegate nursing interventions if the
231	231	11 registered professional nurse determines it is inappropriate
232	232	12 to do so. A nurse shall not be subject to disciplinary or any
233	233	13 other adverse action for refusing to delegate a nursing
234	234	14 intervention based on patient safety.
235	235	15 "Physician" means a person licensed to practice medicine
236	236	16 in all its branches under the Medical Practice Act of 1987.
237	237	17 "Podiatric physician" means a person licensed to practice
238	238	18 podiatry under the Podiatric Medical Practice Act of 1987.
239	239	19 "Practical nurse" or "licensed practical nurse" means a
240	240	20 person who is licensed as a practical nurse under this Act and
241	241	21 practices practical nursing as defined in this Act. Only a
242	242	22 practical nurse licensed under this Act is entitled to use the
243	243	23 title "licensed practical nurse" and the abbreviation
244	244	24 "L.P.N.".
245	245	25 "Practical nursing" means the performance of nursing
246	246	26 interventions requiring the nursing knowledge, judgment, and
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257	257	1 skill acquired by means of completion of an approved practical
258	258	2 nursing education program. Practical nursing includes
259	259	3 assisting in the nursing process under the guidance of a
260	260	4 registered professional nurse or an advanced practice
261	261	5 registered nurse. The practical nurse may work under the
262	262	6 direction of a licensed physician, dentist, podiatric
263	263	7 physician, or other health care professional determined by the
264	264	8 Department.
265	265	9 "Privileged" means the authorization granted by the
266	266	10 governing body of a healthcare facility, agency, or
267	267	11 organization to provide specific patient care services within
268	268	12 well-defined limits, based on qualifications reviewed in the
269	269	13 credentialing process.
270	270	14 "Registered Nurse" or "Registered Professional Nurse"
271	271	15 means a person who is licensed as a professional nurse under
272	272	16 this Act and practices nursing as defined in this Act. Only a
273	273	17 registered nurse licensed under this Act is entitled to use
274	274	18 the titles "registered nurse" and "registered professional
275	275	19 nurse" and the abbreviation, "R.N.".
276	276	20 "Registered professional nursing practice" means a
277	277	21 scientific process founded on a professional body of knowledge
278	278	22 that includes, but is not limited to, the protection,
279	279	23 promotion, and optimization of health and abilities,
280	280	24 prevention of illness and injury, development and
281	281	25 implementation of the nursing plan of care, facilitation of
282	282	26 nursing interventions to alleviate suffering, care
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293	293	1 coordination, and advocacy in the care of individuals,
294	294	2 families, groups, communities, and populations. "Registered
295	295	3 professional nursing practice" does not include the act of
296	296	4 medical diagnosis or prescription of medical therapeutic or
297	297	5 corrective measures.
298	298	6 "Professional assistance program for nurses" means a
299	299	7 professional assistance program that meets criteria
300	300	8 established by the Board of Nursing and approved by the
301	301	9 Secretary, which provides a non-disciplinary treatment
302	302	10 approach for nurses licensed under this Act whose ability to
303	303	11 practice is compromised by alcohol or chemical substance
304	304	12 addiction.
305	305	13 "Secretary" means the Secretary of Financial and
306	306	14 Professional Regulation.
307	307	15 "Unencumbered license" means a license issued in good
308	308	16 standing.
309	309	17 "Written collaborative agreement" means a written
310	310	18 agreement between an advanced practice registered nurse and a
311	311	19 collaborating physician, dentist, certified nurse midwife with
312	312	20 full practice authority, or podiatric physician pursuant to
313	313	21 Section 65-35.
314	314	22 (Source: P.A. 103-154, eff. 6-30-23; 103-686, eff. 1-1-25.)
315	315	23 (225 ILCS 65/65-35) (was 225 ILCS 65/15-15)
316	316	24 (Section scheduled to be repealed on January 1, 2028)
317	317	25 Sec. 65-35. Written collaborative agreements.
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328	328	1 (a) A written collaborative agreement is required for all
329	329	2 advanced practice registered nurses engaged in clinical
330	330	3 practice prior to meeting the requirements of Section 65-43,
331	331	4 except for advanced practice registered nurses who are
332	332	5 privileged to practice in a hospital, hospital affiliate, or
333	333	6 ambulatory surgical treatment center.
334	334	7 (a-5) If an advanced practice registered nurse engages in
335	335	8 clinical practice outside of a hospital, hospital affiliate,
336	336	9 or ambulatory surgical treatment center in which he or she is
337	337	10 privileged to practice, the advanced practice registered nurse
338	338	11 must have a written collaborative agreement, except as set
339	339	12 forth in Section 65-43.
340	340	13 (b) A written collaborative agreement shall describe the
341	341	14 relationship of the advanced practice registered nurse with
342	342	15 the collaborating physician or certified nurse midwife with
343	343	16 full practice authority and shall describe the categories of
344	344	17 care, treatment, or procedures to be provided by the advanced
345	345	18 practice registered nurse. A collaborative agreement with a
346	346	19 podiatric physician must be in accordance with subsection
347	347	20 (c-5) or (c-15) of this Section. A collaborative agreement
348	348	21 with a dentist must be in accordance with subsection (c-10) of
349	349	22 this Section. A collaborative agreement with a podiatric
350	350	23 physician must be in accordance with subsection (c-5) of this
351	351	24 Section. A collaborative agreement between an advanced
352	352	25 practice registered nurse certified as a certified nurse
353	353	26 midwife and a certified nurse midwife with full practice
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364	364	1 authority must be in accordance with subsection (c-20) of this
365	365	2 Section. Collaboration does not require an employment
366	366	3 relationship between the collaborating physician or certified
367	367	4 nurse midwife with full practice authority and the advanced
368	368	5 practice registered nurse.
369	369	6 The collaborative relationship under an agreement shall
370	370	7 not be construed to require the personal presence of a
371	371	8 collaborating physician or certified nurse midwife with full
372	372	9 practice authority at the place where services are rendered.
373	373	10 Methods of communication shall be available for consultation
374	374	11 with the collaborating physician or certified nurse midwife
375	375	12 with full practice authority in person or by
376	376	13 telecommunications or electronic communications as set forth
377	377	14 in the written agreement.
378	378	15 (b-5) Absent an employment relationship, a written
379	379	16 collaborative agreement may not (1) restrict the categories of
380	380	17 patients of an advanced practice registered nurse within the
381	381	18 scope of the advanced practice registered nurses training and
382	382	19 experience, (2) limit third party payors or government health
383	383	20 programs, such as the medical assistance program or Medicare
384	384	21 with which the advanced practice registered nurse contracts,
385	385	22 or (3) limit the geographic area or practice location of the
386	386	23 advanced practice registered nurse in this State.
387	387	24 (c) In the case of anesthesia services provided by a
388	388	25 certified registered nurse anesthetist, an anesthesiologist, a
389	389	26 physician, a dentist, or a podiatric physician must
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400	400	1 participate through discussion of and agreement with the
401	401	2 anesthesia plan and remain physically present and available on
402	402	3 the premises during the delivery of anesthesia services for
403	403	4 diagnosis, consultation, and treatment of emergency medical
404	404	5 conditions.
405	405	6 (c-5) A certified registered nurse anesthetist, who
406	406	7 provides anesthesia services outside of a hospital or
407	407	8 ambulatory surgical treatment center shall enter into a
408	408	9 written collaborative agreement with an anesthesiologist or
409	409	10 the physician licensed to practice medicine in all its
410	410	11 branches or the podiatric physician performing the procedure.
411	411	12 Outside of a hospital or ambulatory surgical treatment center,
412	412	13 the certified registered nurse anesthetist may provide only
413	413	14 those services that the collaborating podiatric physician is
414	414	15 authorized to provide pursuant to the Podiatric Medical
415	415	16 Practice Act of 1987 and rules adopted thereunder. A certified
416	416	17 registered nurse anesthetist may select, order, and administer
417	417	18 medication, including controlled substances, and apply
418	418	19 appropriate medical devices for delivery of anesthesia
419	419	20 services under the anesthesia plan agreed with by the
420	420	21 anesthesiologist or the operating physician or operating
421	421	22 podiatric physician.
422	422	23 (c-10) A certified registered nurse anesthetist who
423	423	24 provides anesthesia services in a dental office shall enter
424	424	25 into a written collaborative agreement with an
425	425	26 anesthesiologist or the physician licensed to practice
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436	436	1 medicine in all its branches or the operating dentist
437	437	2 performing the procedure. The agreement shall describe the
438	438	3 working relationship of the certified registered nurse
439	439	4 anesthetist and dentist and shall authorize the categories of
440	440	5 care, treatment, or procedures to be performed by the
441	441	6 certified registered nurse anesthetist. In a collaborating
442	442	7 dentist's office, the certified registered nurse anesthetist
443	443	8 may only provide those services that the operating dentist
444	444	9 with the appropriate permit is authorized to provide pursuant
445	445	10 to the Illinois Dental Practice Act and rules adopted
446	446	11 thereunder. For anesthesia services, an anesthesiologist,
447	447	12 physician, or operating dentist shall participate through
448	448	13 discussion of and agreement with the anesthesia plan and shall
449	449	14 remain physically present and be available on the premises
450	450	15 during the delivery of anesthesia services for diagnosis,
451	451	16 consultation, and treatment of emergency medical conditions. A
452	452	17 certified registered nurse anesthetist may select, order, and
453	453	18 administer medication, including controlled substances, and
454	454	19 apply appropriate medical devices for delivery of anesthesia
455	455	20 services under the anesthesia plan agreed with by the
456	456	21 operating dentist.
457	457	22 (c-15) An advanced practice registered nurse who had a
458	458	23 written collaborative agreement with a podiatric physician
459	459	24 immediately before the effective date of Public Act 100-513
460	460	25 may continue in that collaborative relationship or enter into
461	461	26 a new written collaborative relationship with a podiatric
462	462
463	463
464	464
465	465
466	466
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471	471	SB1908 - 13 - LRB104 08797 AAS 18852 b
472	472	1 physician under the requirements of this Section and Section
473	473	2 65-40, as those Sections existed immediately before the
474	474	3 amendment of those Sections by Public Act 100-513 with regard
475	475	4 to a written collaborative agreement between an advanced
476	476	5 practice registered nurse and a podiatric physician.
477	477	6 (c-20) An advanced practice registered nurse certified as
478	478	7 a certified nurse midwife may enter into a written
479	479	8 collaborative agreement with a certified nurse midwife with
480	480	9 full practice authority or a physician.
481	481	10 (d) A copy of the signed, written collaborative agreement
482	482	11 must be available to the Department upon request from both the
483	483	12 advanced practice registered nurse and the collaborating
484	484	13 physician, dentist, certified nurse midwife with full practice
485	485	14 authority, or podiatric physician.
486	486	15 (e) Nothing in this Act shall be construed to limit the
487	487	16 delegation of tasks or duties by a physician to a licensed
488	488	17 practical nurse, a registered professional nurse, or other
489	489	18 persons in accordance with Section 54.2 of the Medical
490	490	19 Practice Act of 1987. Nothing in this Act shall be construed to
491	491	20 limit the method of delegation that may be authorized by any
492	492	21 means, including, but not limited to, oral, written,
493	493	22 electronic, standing orders, protocols, guidelines, or verbal
494	494	23 orders.
495	495	24 (e-5) Nothing in this Act shall be construed to authorize
496	496	25 an advanced practice registered nurse to provide health care
497	497	26 services required by law or rule to be performed by a
498	498
499	499
500	500
501	501
502	502
503	503	SB1908 - 13 - LRB104 08797 AAS 18852 b
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507	507	SB1908 - 14 - LRB104 08797 AAS 18852 b
508	508	1 physician. The scope of practice of an advanced practice
509	509	2 registered nurse does not include operative surgery. Nothing
510	510	3 in this Section shall be construed to preclude an advanced
511	511	4 practice registered nurse from assisting in surgery.
512	512	5 (f) An advanced practice registered nurse shall inform
513	513	6 each collaborating physician, dentist, certified nurse midwife
514	514	7 with full practice authority, or podiatric physician of all
515	515	8 collaborative agreements he or she has signed and provide a
516	516	9 copy of these to any collaborating physician, dentist,
517	517	10 certified nurse midwife with full practice authority, or
518	518	11 podiatric physician upon request.
519	519	12 (g) (Blank).
520	520	13 (Source: P.A. 100-513, eff. 1-1-18; 100-577, eff. 1-26-18;
521	521	14 100-1096, eff. 8-26-18; 101-13, eff. 6-12-19.)
522	522	15 (225 ILCS 65/65-40) (was 225 ILCS 65/15-20)
523	523	16 (Section scheduled to be repealed on January 1, 2028)
524	524	17 Sec. 65-40. Written collaborative agreement; prescriptive
525	525	18 authority.
526	526	19 (a) A collaborating physician or certified nurse midwife
527	527	20 with full practice authority may, but is not required to,
528	528	21 delegate prescriptive authority to an advanced practice
529	529	22 registered nurse as part of a written collaborative agreement.
530	530	23 This authority may, but is not required to, include
531	531	24 prescription of, selection of, orders for, administration of,
532	532	25 storage of, acceptance of samples of, and dispensing over the
533	533
534	534
535	535
536	536
537	537
538	538	SB1908 - 14 - LRB104 08797 AAS 18852 b
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543	543	1 counter medications, legend drugs, medical gases, and
544	544	2 controlled substances categorized as any Schedule III through
545	545	3 V controlled substances, as defined in Article II of the
546	546	4 Illinois Controlled Substances Act, and other preparations,
547	547	5 including, but not limited to, botanical and herbal remedies.
548	548	6 The collaborating physician must have a valid current Illinois
549	549	7 controlled substance license and federal registration to
550	550	8 delegate authority to prescribe delegated controlled
551	551	9 substances.
552	552	10 (b) To prescribe controlled substances under this Section,
553	553	11 an advanced practice registered nurse must obtain a mid-level
554	554	12 practitioner controlled substance license. Medication orders
555	555	13 shall be reviewed periodically by the collaborating physician.
556	556	14 (c) The collaborating physician or certified nurse midwife
557	557	15 with full practice authority shall file with the Department
558	558	16 and the Prescription Monitoring Program notice of delegation
559	559	17 of prescriptive authority and termination of such delegation,
560	560	18 in accordance with rules of the Department. Upon receipt of
561	561	19 this notice delegating authority to prescribe any Schedule III
562	562	20 through V controlled substances, the licensed advanced
563	563	21 practice registered nurse shall be eligible to register for a
564	564	22 mid-level practitioner controlled substance license under
565	565	23 Section 303.05 of the Illinois Controlled Substances Act.
566	566	24 (d) In addition to the requirements of subsections (a),
567	567	25 (b), and (c) of this Section, a collaborating physician or
568	568	26 certified nurse midwife with full practice authority may, but
569	569
570	570
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579	579	1 is not required to, delegate authority to an advanced practice
580	580	2 registered nurse to prescribe any Schedule II controlled
581	581	3 substances, if all of the following conditions apply:
582	582	4 (1) Specific Schedule II controlled substances by oral
583	583	5 dosage or topical or transdermal application may be
584	584	6 delegated, provided that the delegated Schedule II
585	585	7 controlled substances are routinely prescribed by the
586	586	8 collaborating physician or certified nurse midwife with
587	587	9 full practice authority. This delegation must identify the
588	588	10 specific Schedule II controlled substances by either brand
589	589	11 name or generic name. Schedule II controlled substances to
590	590	12 be delivered by injection or other route of administration
591	591	13 may not be delegated.
592	592	14 (2) Any delegation must be controlled substances that
593	593	15 the collaborating physician or certified nurse midwife
594	594	16 with full practice authority prescribes.
595	595	17 (3) Any prescription must be limited to no more than a
596	596	18 30-day supply, with any continuation authorized only after
597	597	19 prior approval of the collaborating physician or certified
598	598	20 nurse midwife with full practice authority.
599	599	21 (4) The advanced practice registered nurse must
600	600	22 discuss the condition of any patients for whom a
601	601	23 controlled substance is prescribed monthly with the
602	602	24 delegating physician or certified nurse midwife with full
603	603	25 practice authority.
604	604	26 (5) The advanced practice registered nurse meets the
605	605
606	606
607	607
608	608
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611	611
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614	614	SB1908 - 17 - LRB104 08797 AAS 18852 b
615	615	1 education requirements of Section 303.05 of the Illinois
616	616	2 Controlled Substances Act.
617	617	3 (e) Nothing in this Act shall be construed to limit the
618	618	4 delegation of tasks or duties by a physician to a licensed
619	619	5 practical nurse, a registered professional nurse, or other
620	620	6 persons. Nothing in this Act shall be construed to limit the
621	621	7 method of delegation that may be authorized by any means,
622	622	8 including, but not limited to, oral, written, electronic,
623	623	9 standing orders, protocols, guidelines, or verbal orders.
624	624	10 (f) Nothing in this Section shall be construed to apply to
625	625	11 any medication authority including Schedule II controlled
626	626	12 substances of an advanced practice registered nurse for care
627	627	13 provided in a hospital, hospital affiliate, or ambulatory
628	628	14 surgical treatment center pursuant to Section 65-45.
629	629	15 (g) (Blank).
630	630	16 (h) Nothing in this Section shall be construed to prohibit
631	631	17 generic substitution.
632	632	18 (i) Nothing in this Section shall be construed to apply to
633	633	19 an advanced practice registered nurse who meets the
634	634	20 requirements of Section 65-43.
635	635	21 (Source: P.A. 100-513, eff. 1-1-18; 101-81, eff. 7-12-19.)
636	636	22 (225 ILCS 65/65-43)
637	637	23 (Section scheduled to be repealed on January 1, 2028)
638	638	24 Sec. 65-43. Full practice authority.
639	639	25 (a) An Illinois-licensed advanced practice registered
640	640
641	641
642	642
643	643
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649	649	SB1908 - 18 - LRB104 08797 AAS 18852 b
650	650	1 nurse certified as a nurse practitioner, nurse midwife, or
651	651	2 clinical nurse specialist shall be deemed by law to possess
652	652	3 the ability to practice without a written collaborative
653	653	4 agreement as set forth in this Section.
654	654	5 (b) An advanced practice registered nurse certified as a
655	655	6 nurse midwife, clinical nurse specialist, or nurse
656	656	7 practitioner who files with the Department a notarized
657	657	8 attestation of completion of at least 250 hours of continuing
658	658	9 education or training and at least 4,000 hours of clinical
659	659	10 experience after first attaining national certification shall
660	660	11 not require a written collaborative agreement. Documentation
661	661	12 of successful completion shall be provided to the Department
662	662	13 upon request.
663	663	14 Continuing education or training hours required by
664	664	15 subsection (b) shall be in the advanced practice registered
665	665	16 nurse's area of certification as set forth by Department rule.
666	666	17 The clinical experience must be in the advanced practice
667	667	18 registered nurse's area of certification. The clinical
668	668	19 experience shall be in collaboration with a physician or
669	669	20 physicians. For an advanced practice registered nurse
670	670	21 certified as a nurse midwife, the clinical experience shall be
671	671	22 in collaboration with a certified nurse midwife with full
672	672	23 practice authority. Completion of the clinical experience must
673	673	24 be attested to by the collaborating physician or physicians,
674	674	25 collaborating certified nurse midwife with full practice
675	675	26 authority, or employer and the advanced practice registered
676	676
677	677
678	678
679	679
680	680
681	681	SB1908 - 18 - LRB104 08797 AAS 18852 b
682	682
683	683
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686	686	1 nurse. If the collaborating physician or physicians,
687	687	2 collaborating certified nurse midwife with full practice
688	688	3 authority, or employer is unable to attest to the completion
689	689	4 of the clinical experience, the Department may accept other
690	690	5 evidence of clinical experience as established by rule.
691	691	6 (c) The scope of practice of an advanced practice
692	692	7 registered nurse with full practice authority includes:
693	693	8 (1) all matters included in subsection (c) of Section
694	694	9 65-30 of this Act;
695	695	10 (2) practicing without a written collaborative
696	696	11 agreement in all practice settings consistent with
697	697	12 national certification, except in the case of an advanced
698	698	13 practice registered nurse with full practice authority who
699	699	14 is certified as a nurse midwife, who may enter into a
700	700	15 written collaborative agreement with a licensed certified
701	701	16 nurse midwife pursuant to Section 65-35;
702	702	17 (3) authority to prescribe both legend drugs and
703	703	18 Schedule II through V controlled substances; this
704	704	19 authority includes prescription of, selection of, orders
705	705	20 for, administration of, storage of, acceptance of samples
706	706	21 of, and dispensing over the counter medications, legend
707	707	22 drugs, and controlled substances categorized as any
708	708	23 Schedule II through V controlled substances, as defined in
709	709	24 Article II of the Illinois Controlled Substances Act, and
710	710	25 other preparations, including, but not limited to,
711	711	26 botanical and herbal remedies;
712	712
713	713
714	714
715	715
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717	717	SB1908 - 19 - LRB104 08797 AAS 18852 b
718	718
719	719
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722	722	1 (4) prescribing Schedule II narcotic drugs, such as
723	723	2 opioids, only in a consultation relationship with a
724	724	3 physician; this consultation relationship shall be
725	725	4 recorded in the Prescription Monitoring Program website,
726	726	5 pursuant to Section 316 of the Illinois Controlled
727	727	6 Substances Act, by the physician and advanced practice
728	728	7 registered nurse with full practice authority and is not
729	729	8 required to be filed with the Department; the specific
730	730	9 Schedule II narcotic drug must be identified by either
731	731	10 brand name or generic name; the specific Schedule II
732	732	11 narcotic drug, such as an opioid, may be administered by
733	733	12 oral dosage or topical or transdermal application;
734	734	13 delivery by injection or other route of administration is
735	735	14 not permitted; at least monthly, the advanced practice
736	736	15 registered nurse and the physician must discuss the
737	737	16 condition of any patients for whom an opioid is
738	738	17 prescribed; nothing in this subsection shall be construed
739	739	18 to require a prescription by an advanced practice
740	740	19 registered nurse with full practice authority to require a
741	741	20 physician name;
742	742	21 (4.5) prescribing up to a 120-day supply of
743	743	22 benzodiazepines without a consultation relationship with a
744	744	23 physician; thereafter, continued prescription of
745	745	24 benzodiazepines shall require a consultation with a
746	746	25 physician; nothing in this subsection shall be construed
747	747	26 to require a prescription by an advanced practice
748	748
749	749
750	750
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