Article 65 - Advanced Practice Nurses


 
    (225 ILCS 65/Art. 65 heading)(was 225 ILCS 65/Tit. 15 heading)
ARTICLE 65. ADVANCED PRACTICE NURSES
(Article scheduled to be repealed on January 1, 2018)
(Source: P.A. 95‑639, eff. 10‑5‑07.)

    (225 ILCS 65/65‑5) (was 225 ILCS 65/15‑10)
    (Section scheduled to be repealed on January 1, 2018)
    Sec. 65‑5. Qualifications for APN licensure.
    (a) Each applicant who successfully meets the requirements of this Section shall be entitled to licensure as an advanced practice nurse.
    (b) An applicant for licensure to practice as an advanced practice nurse must do each of the following:
        (1) Submit a completed application and any fees as
     established by the Department.
        (2) Hold a current license to practice as a
     registered professional nurse under this Act.
        (3) Have successfully completed requirements to
     practice as, and holds a current, national certification as, a nurse midwife, clinical nurse specialist, nurse practitioner, or certified registered nurse anesthetist from the appropriate national certifying body as determined by rule of the Department.
        (4) Have obtained a graduate degree appropriate for
     national certification in a clinical advanced practice nursing specialty or a graduate degree or post‑master's certificate from a graduate level program in a clinical advanced practice nursing specialty.
        (5) Have not violated the provisions of this Act
     concerning the grounds for disciplinary action. The Department may take into consideration any felony conviction of the applicant, but such a conviction may not operate as an absolute bar to licensure.
        (6) Submit to the criminal history records check
     required under Section 50‑35 of this Act.
    (b‑5) A registered professional nurse seeking licensure as an advanced practice nurse in the category of certified registered nurse anesthetist who does not have a graduate degree as described in subsection (b) of this Section shall be qualified for licensure if that person:
        (1) submits evidence of having successfully completed
     a nurse anesthesia program described in item (4) of subsection (b) of this Section prior to January 1, 1999;
        (2) submits evidence of certification as a registered
     nurse anesthetist by an appropriate national certifying body; and
        (3) has continually maintained active, up‑to‑date
     recertification status as a certified registered nurse anesthetist by an appropriate national recertifying body.
    (b‑10) The Department shall issue a certified registered nurse anesthetist license to an APN who (i) does not have a graduate degree, (ii) applies for licensure before July 1, 2018, and (iii) submits all of the following to the Department:
        (1) His or her current State registered nurse license
     number.
        (2) Proof of current national certification, which
     includes the completion of an examination from either of the following:
            (A) the Council on Certification of the American
         Association of Nurse Anesthetists; or
            (B) the Council on Recertification of the
         American Association of Nurse Anesthetists.
        (3) Proof of the successful completion of a
     post‑basic advanced practice formal education program in the area of nurse anesthesia prior to January 1, 1999.
        (4) His or her complete work history for the 5‑year
     period immediately preceding the date of his or her application.
        (5) Verification of licensure as an advanced practice
     nurse from the state in which he or she was originally licensed, current state of licensure, and any other state in which he or she has been actively practicing as an advanced practice nurse within the 5‑year period immediately preceding the date of his or her application. If applicable, this verification must state:
            (A) the time during which he or she was licensed
         in each state, including the date of the original issuance of each license; and
            (B) any disciplinary action taken or pending
         concerning any nursing license held, currently or in the past, by the applicant.
        (6) The required fee.
    (c) Those applicants seeking licensure in more than one advanced practice nursing specialty need not possess multiple graduate degrees. Applicants may be eligible for licenses for multiple advanced practice nurse licensure specialties, provided that the applicant (i) has met the requirements for at least one advanced practice nursing specialty under paragraphs (3) and (5) of subsection (a) of this Section, (ii) possesses an additional graduate education that results in a certificate for another clinical advanced practice nurse specialty and that meets the requirements for the national certification from the appropriate nursing specialty, and (iii) holds a current national certification from the appropriate national certifying body for that additional advanced practice nursing specialty.
    (d) Any person who holds a valid license as an advanced practice nurse issued under this Act as this Act existed before the effective date of this amendatory Act of the 95th General Assembly shall be subject only to the advanced practice nurse license renewal requirements of this Act as this Act exists on and after the effective date of this amendatory Act of the 95th General Assembly upon the expiration of that license.
(Source: P.A. 95‑639, eff. 10‑5‑07; 96‑189, eff. 8‑10‑09.)

    (225 ILCS 65/65‑10) (was 225 ILCS 65/15‑13)
    (Section scheduled to be repealed on January 1, 2018)
    Sec. 65‑10. APN license pending status.
    (a) A graduate of an advanced practice nursing program may practice in the State of Illinois in the role of certified clinical nurse specialist, certified nurse midwife, certified nurse practitioner, or certified registered nurse anesthetist for not longer than 6 months provided he or she submits all of the following:
        (1) An application for licensure as an advanced
     practice nurse in Illinois and all fees established by rule.
        (2) Proof of an application to take the national
     certification examination in the specialty.
        (3) Proof of completion of a graduate advanced
     practice education program that allows the applicant to be eligible for national certification in a clinical advanced practice nursing speciality and that allows the applicant to be eligible for licensure in Illinois in the area of his or her specialty.
        (4) Proof that he or she is licensed in Illinois as
     a registered professional nurse.
    (b) License pending status shall preclude delegation of prescriptive authority.
    (c) A graduate practicing in accordance with this Section must use the title "license pending certified clinical nurse specialist", "license pending certified nurse midwife", "license pending certified nurse practitioner", or "license pending certified registered nurse anesthetist", whichever is applicable.
(Source: P.A. 95‑639, eff. 10‑5‑07.)

     (225 ILCS 65/65‑15)
    (Section scheduled to be repealed on January 1, 2018)
    Sec. 65‑15. Expiration of APN license; renewal. The expiration date and renewal period for each advanced practice nurse license issued under this Act shall be set by rule. The holder of a license may renew the license during the month preceding the expiration date of the license by paying the required fee. It is the responsibility of the licensee to notify the Department in writing of a change of address. Each advanced practice nurse is required to show proof of continued, current national certification in the specialty.
(Source: P.A. 95‑639, eff. 10‑5‑07.)

    (225 ILCS 65/65‑20)
    (Section scheduled to be repealed on January 1, 2018)
    Sec. 65‑20. Restoration of APN license; temporary permit.
    (a) Any license issued under this Act that has expired
     or that is on inactive status may be restored by making application to the Department and filing proof of fitness acceptable to the Department as specified by rule to have the license restored and by paying the required restoration fee. Such proof of fitness may include evidence certifying active lawful practice in another jurisdiction.
    (b) A licensee seeking restoration of a license after it
     has expired or been placed on inactive status for more than 5 years shall file an application, on forms supplied by the Department, and submit the restoration or renewal fees set forth by the Department. The licensee shall also submit proof of fitness to practice, including one of the following:
        (1) Certification of active practice in another
     jurisdiction, which may include a statement from the appropriate board or licensing authority in the other jurisdiction in which the licensee was authorized to practice during the term of said active practice.
        (2) Proof of the successful completion of a
     Department‑approved licensure examination.
        (3) An affidavit attesting to military service as
     provided in subsection (c) of this Section; however, if application is made within 2 years after discharge and if all other provisions of subsection (c) of this Section are satisfied, the applicant shall be required to pay the current renewal fee.
        (4) Other proof as established by rule.
    (c) Any advanced practice nurse license issued under
     this Act that expired while the licensee was (1) in federal service on active duty with the Armed Forces of the United States or in the State Militia called into service or training or (2) in training or education under the supervision of the United States preliminary to induction into the military service may have the license restored without paying any lapsed renewal fees if, within 2 years after honorable termination of such service, training, or education, the applicant furnishes the Department with satisfactory evidence to the effect that the applicant has been so engaged and that the individual's service, training, or education has been so terminated.
    (d) Any licensee who engages in the practice of advanced
     practice nursing with a lapsed license or while on inactive status shall be considered to be practicing without a license, which shall be grounds for discipline under Section 70‑5 of this Act.
    (e) Pending restoration of an advanced practice nurse
     license under this Section, the Department may grant an applicant a temporary permit to practice as an advanced practice nurse if the Department is satisfied that the applicant holds an active, unencumbered license in good standing in another jurisdiction. If the applicant holds more than one current active license or one or more active temporary licenses from another jurisdiction, the Department shall not issue a temporary permit until it is satisfied that each current active license held by the applicant is unencumbered. The temporary permit, which shall be issued no later than 14 working days after receipt by the Department of an application for the permit, shall be granted upon the submission of all of the following to the Department:
        (1) A signed and completed application for
     restoration of licensure under this Section as an advanced practice nurse.
        (2) Proof of (i) a current, active license in at
     least one other jurisdiction and proof that each current, active license or temporary permit held by the applicant is unencumbered or (ii) fitness to practice nursing in Illinois, as specified by rule.
        (3) A signed and completed application for a
     temporary permit.
        (4) The required permit fee.
        (5) Other proof as established by rule.
    (f) The Department may refuse to issue to an applicant a
     temporary permit authorized under this Section if, within 14 working days after its receipt of an application for a temporary permit, the Department determines that:
        (1) the applicant has been convicted within the last
     5 years of any crime under the laws of any jurisdiction of the United States that is (i) a felony or (ii) a misdemeanor directly related to the practice of the profession;
        (2) within the last 5 years, the applicant had a
     license or permit related to the practice of nursing revoked, suspended, or placed on probation by another jurisdiction if at least one of the grounds for revoking, suspending, or placing on probation is the same or substantially equivalent to grounds for disciplinary action under this Act; or
        (3) the Department intends to deny restoration of
     the license.
    (g) The Department may revoke a temporary permit issued
     under this Section if:
        (1) the Department determines that the applicant has
     been convicted within the last 5 years of any crime under the laws of any jurisdiction of the United States that is (i) a felony or (ii) a misdemeanor directly related to the practice of the profession;
        (2) within the last 5 years, the applicant had a
     license or permit related to the practice of nursing revoked, suspended, or placed on probation by another jurisdiction, if at least one of the grounds for revoking, suspending, or placing on probation is the same or substantially equivalent to grounds in Illinois; or
        (3) the Department intends to deny restoration of
     the license.
    (h) A temporary permit or renewed temporary permit shall
     expire (i) upon issuance of an Illinois license or (ii) upon notification that the Department intends to deny restoration of licensure. Except as otherwise provided in this Section, a temporary permit shall expire 6 months from the date of issuance. Further renewal may be granted by the Department in hardship cases that shall automatically expire upon issuance of the Illinois license or upon notification that the Department intends to deny licensure, whichever occurs first. No extensions shall be granted beyond the 6‑month period unless approved by the Secretary. Notification by the Department under this Section must be by certified or registered mail.
(Source: P.A. 95‑639, eff. 10‑5‑07.)

    (225 ILCS 65/65‑25)
    (Section scheduled to be repealed on January 1, 2018)
    Sec. 65‑25. Inactive status of a APN license.
Any advanced practice nurse who notifies the Department in
     writing on forms prescribed by the Department may elect to place his or her license on inactive status and shall, subject to rules of the Department, be excused from payment of renewal fees until notice is given to the Department in writing of his or her intent to restore the license.
    Any advanced practice nurse requesting restoration from
     inactive status shall be required to pay the current renewal fee and shall be required to restore his or her license, as provided by rule of the Department.
    Any advanced practice nurse whose license is on inactive
     status shall not practice advanced practice nursing, as defined by this Act in the State of Illinois.
(Source: P.A. 95‑639, eff. 10‑5‑07.)

    (225 ILCS 65/65‑30)
    (Section scheduled to be repealed on January 1, 2018)
    Sec. 65‑30. APN scope of practice.

    (a) Advanced practice nursing by certified nurse
     practitioners, certified nurse anesthetists, certified nurse midwives, or clinical nurse specialists is based on knowledge and skills acquired throughout an advanced practice nurse's nursing education, training, and experience.
    (b) Practice as an advanced practice nurse means a scope
     of nursing practice, with or without compensation, and includes the registered nurse scope of practice.
    (c) The scope of practice of an advanced practice nurse
     includes, but is not limited to, each of the following:
        (1) Advanced nursing patient assessment and diagnosis.
        (2) Ordering diagnostic and therapeutic tests and
     procedures, performing those tests and procedures when using health care equipment, and interpreting and using the results of diagnostic and therapeutic tests and procedures ordered by the advanced practice nurse or another health care professional.
        (3) Ordering treatments, ordering or applying
     appropriate medical devices, and using nursing medical, therapeutic, and corrective measures to treat illness and improve health status.
        (4) Providing palliative and end‑of‑life care.
        (5) Providing advanced counseling, patient education,
     health education, and patient advocacy.
        (6) Prescriptive authority as defined in Section
     65‑40 of this Act.
        (7) Delegating selected nursing activities or tasks
     to a licensed practical nurse, a registered professional nurse, or other personnel.
(Source: P.A. 95‑639, eff. 10‑5‑07.)

    (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. 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 and advanced practice nursing practice.
        (2) 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.
    (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.
(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. 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 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) No more than 5 Schedule II controlled substances
     by oral dosage may be delegated.
        (2) Any delegation must be controlled substances that
     the collaborating physician prescribes.