State of Illinois
90th General Assembly
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[ House Amendment 001 ]

90_HB2921

      225 ILCS 65/3             from Ch. 111, par. 3503
      225 ILCS 65/4             from Ch. 111, par. 3504
      225 ILCS 65/6             from Ch. 111, par. 3506
      225 ILCS 65/7.5 new
      225 ILCS 65/12.5 new
      225 ILCS 65/12.7 new
      225 ILCS 65/12.9 new
      225 ILCS 65/16            from Ch. 111, par. 3516
      225 ILCS 85/3             from Ch. 111, par. 4123
      225 ILCS 85/4             from Ch. 111, par. 4124
      720 ILCS 570/102          from Ch. 56 1/2, par. 1102
      745 ILCS 49/25
      745 ILCS 49/30
      745 ILCS 49/35
               Amends the Illinois Nursing Act of  1987.   Provides
      for licensure of advanced practice registered nurses (APRNs).
      Establishes  the  Advanced Practice Registered Nurse Advisory
      Committee.   Provides  that  except  in  the  case  of  APRNs
      providing anesthesia-related services, an APRN shall practice
      in accordance with a written practice agreement entered  into
      with  a licensed physician.  Amends the Pharmacy Practice Act
      of 1987 and the Illinois Controlled Substances Act to include
      advanced practice registered nurses among the persons who may
      prescribe controlled substances.  Amends the  Good  Samaritan
      Act  to  immunize  advanced  practice  registered nurses from
      civil  liability  for  services  rendered  in  an  emergency.
      Effective January 1, 1999.
                                                     LRB9008509NTmb
                                               LRB9008509NTmb
 1             AN ACT  relating  to  advanced  practice  registered
 2    nurses, amending named Acts.
 3        Be  it  enacted  by  the People of the State of Illinois,
 4    represented in the General Assembly:
 5        Section 5.  The Illinois Nursing Act of 1987  is  amended
 6    by  changing  Sections 3, 4, 6, and 16 and by adding Sections
 7    7.5, 12.5, 12.7, and 12.9 as follows:
 8        (225 ILCS 65/3) (from Ch. 111, par. 3503)
 9        Sec. 3.  Definitions.  Each of the following terms,  when
10    used  in  this Act, shall have  the meaning ascribed to it in
11    this Section, except  where  the  context  clearly  indicates
12    otherwise:
13        (a)  "Department"  means  the  Department of Professional
14    Regulation.
15        (b)  "Director"  means  the  Director   of   Professional
16    Regulation.
17        (c)  "Board"  means the Board of Nursing appointed by the
18    Director.
19        (d)  "Academic year" means the customary annual  schedule
20    of  courses  at  a  college,  university, or approved school,
21    customarily regarded as the school year as distinguished from
22    the calendar year.
23        (e)  "Approved program of professional nursing education"
24    and "approved program of  practical  nursing  education"  are
25    programs  of professional or practical nursing, respectively,
26    approved by the Department under the provisions of this Act.
27        (f)  "Nursing  Act  Coordinator"   means   a   registered
28    professional nurse appointed by the Director to carry out the
29    administrative policies of the Department.
30        (g)  "Assistant   Nursing   Act   Coordinator"   means  a
31    registered professional nurse appointed by  the  Director  to
                            -2-                LRB9008509NTmb
 1    assist  in  carrying  out  the administrative policies of the
 2    Department.
 3        (h)  "Registered" is the equivalent of "licensed".
 4        (i)  "Practical  nurse"  or  "licensed  practical  nurse"
 5    means a person who is licensed as  a  practical  nurse  under
 6    this  Act  and  practices  practical  nursing  as  defined in
 7    paragraph (j)  of  this  Section.   Only  a  practical  nurse
 8    licensed  under  this  Act  is  entitled  to  use  the  title
 9    "licensed practical nurse" and the abbreviation "L.P.N.".
10        (j)  "Practical nursing" means the performance of nursing
11    acts  requiring  the  basic nursing knowledge, judgement, and
12    skill  acquired  by  means  of  completion  of  an   approved
13    practical   nursing  education  program.   Practical  nursing
14    includes assisting in the nursing process as delegated by and
15    under the direction of a registered professional nurse.   The
16    practical  nurse  may  work under the direction of a licensed
17    physician,  dentist,  podiatrist,  or   other   health   care
18    professional determined by the Department.
19        (k)  "Registered   Nurse"   or  "Registered  Professional
20    Nurse" means a person who is licensed as a professional nurse
21    under this Act and practices nursing as defined in  paragraph
22    (l)  of this Section.  Only a registered nurse licensed under
23    this Act is entitled to use the titles "registered nurse" and
24    "registered professional nurse" and the abbreviation, "R.N.".
25        (l)  "Registered professional nursing practice"  includes
26    all  nursing  specialities  and  means the performance of any
27    nursing act based upon professional knowledge, judgment,  and
28    skills  acquired  by  means  of  completion  of  an  approved
29    registered   professional   nursing   education  program.   A
30    registered   professional   nurse   provides   nursing   care
31    emphasizing   the   importance   of   the   whole   and   the
32    interdependence of its parts through the nursing  process  to
33    individuals,  groups, families, or communities, that includes
34    but is not limited  to:  (1)  the  assessment  of  healthcare
                            -3-                LRB9008509NTmb
 1    needs,   nursing  diagnosis,  planning,  implementation,  and
 2    nursing  evaluation;  (2)  the  promotion,  maintenance,  and
 3    restoration of health;  (3)  counseling,  patient  education,
 4    health    education,    and   patient   advocacy;   (4)   the
 5    administration of medications and treatments as prescribed by
 6    a physician licensed to  practice  medicine  in  all  of  its
 7    branches,  a  licensed  dentist,  a licensed podiatrist, or a
 8    licensed optometrist; (5) the coordination and management  of
 9    the   nursing  plan  of  care;  (6)  the  delegation  to  and
10    supervision  of  individuals  who   assist   the   registered
11    professional  nurse  implementing  the  plan of care; and (7)
12    teaching  and  supervision  of  nursing  students.  in    The
13    foregoing  shall  not  be  deemed  to  include  those acts of
14    medical  diagnosis  or   prescription   of   therapeutic   or
15    corrective  measures  that  are  properly  performed  only by
16    physicians licensed in the State of Illinois.
17        (m)  "Current nursing practice  update  course"  means  a
18    planned   nursing   education   curriculum  approved  by  the
19    Department consisting of  activities  that  have  educational
20    objectives, instructional methods, content or subject matter,
21    clinical  practice,  and evaluation methods, related to basic
22    review and updating  content  and  specifically  planned  for
23    those  nurses previously licensed in the United States or its
24    territories and preparing for reentry into nursing practice.
25        (n)  "Advanced practice registered nurse" or "APRN" means
26    a person who:
27             (1)  is licensed as a registered professional  nurse
28        under this Act;
29             (2)  meets  the  requirements  for recognition as an
30        advanced practice registered nurse under Section 12.5  of
31        this Act;
32             (3)  collaborates   with  a  physician  licensed  to
33        practice medicine in all of its branches under a  written
34        practice  agreement, except as provided under item (5) of
                            -4-                LRB9008509NTmb
 1        this subsection;
 2             (4)  cares  for  patients  (A)  by  using   advanced
 3        diagnostic  skills,  the  results of diagnostic tests and
 4        procedures ordered by the  advanced  practice  registered
 5        nurse, a physician assistant, a dentist, a podiatrist, or
 6        a  physician  licensed to practice medicine in all of its
 7        branches,  and  professional  judgment  to  initiate  and
 8        coordinate care, (B)  by  prescribing  and  administering
 9        non-controlled  legend  drugs  and,  if  authorized  in a
10        written   practice   agreement,   by   prescribing    and
11        administering  Schedule  II,  III,  IV,  or  V controlled
12        substances,  (C)  by  using  medical,  therapeutic,   and
13        corrective  measures  to treat illness and improve health
14        status, and (D) by providing preventive care;
15             (5)  practices as  an  APRN  in  accordance  with  a
16        written  practice  agreement with a physician licensed to
17        practice medicine in all of its branches, except  in  the
18        case   of   a   certified  registered  nurse  anesthetist
19        providing anesthesia and anesthesia-related  services  or
20        selecting,  ordering,  and  administering  drugs  in  the
21        perioperative or periobstetric period; and
22             (6)  is  a  certified nurse midwife (CNM), certified
23        nurse  practitioner  (CNP),  certified  registered  nurse
24        anesthetist (CRNA), or clinical nurse specialist (CNS).
25        (o)  "Written  practice  agreement"  means   a   document
26    entered  into  and  signed by an advanced practice registered
27    nurse and a physician licensed to practice medicine in all of
28    its branches and prepared in accordance with Section 12.7  of
29    this Act in which no employment relationship is required.
30        (p)  (n)  "Professional  assistance  program  for nurses"
31    means a professional assistance program that  meets  criteria
32    established  by  the Committee on Nursing and approved by the
33    Director,  which  provides   a   non-disciplinary   treatment
34    approach  for nurses licensed under this Act whose ability to
                            -5-                LRB9008509NTmb
 1    practice is compromised  by  alcohol  or  chemical  substance
 2    addiction.
 3    (Source:  P.A.  90-61,  eff.  12-30-97;  90-248, eff. 1-1-98;
 4    revised 8-12-97.)
 5        (225 ILCS 65/4) (from Ch. 111, par. 3504)
 6        Sec. 4. Policy; application of Act. For the protection of
 7    life and the promotion  of  health,  and  the  prevention  of
 8    illness  and  communicable diseases, any person practicing or
 9    offering to practice professional and  practical  nursing  in
10    Illinois shall submit evidence that he or she is qualified to
11    practice,  and  shall be licensed as provided under this Act.
12    No person shall practice or offer to practice professional or
13    practical nursing in Illinois or use any title, sign, card or
14    device  to  indicate  that  such  a  person   is   practicing
15    professional or practical nursing unless such person has been
16    licensed under the provisions of this Act.
17        This Act does not prohibit the following:
18        (a)  The practice of nursing in Federal employment in the
19    discharge  of  the  employee's  duties  by  a  person  who is
20    employed by the  United  States  government  or  any  bureau,
21    division  or  agency  thereof  and is a legally qualified and
22    licensed nurse of another  state  or  territory  and  not  in
23    conflict with Sections 6, 12, and 25 of this Act.;
24        (b)  Nursing  that  is included in their program of study
25    by students enrolled in programs of  nursing  or  in  current
26    nurse practice update courses approved by the Department.;
27        (c)  The   furnishing   of   nursing   assistance  in  an
28    emergency.;
29        (d)  The practice of nursing by  a  nurse  who  holds  an
30    active  license  in  another state when providing services to
31    patients in  Illinois  during  a  bonafide  emergency  or  in
32    immediate preparation for or during interstate transit.;
33        (e)  The  incidental  care  of the sick by members of the
                            -6-                LRB9008509NTmb
 1    family, domestic servants or housekeepers,  or  care  of  the
 2    sick where treatment is by prayer or spiritual means.;
 3        (f)  Persons   from  being  employed  as  nursing  aides,
 4    attendants, orderlies, and other auxiliary workers in private
 5    homes, long term care  facilities,  nurseries,  hospitals  or
 6    other institutions.;
 7        (g)  The  practice  of  practical  nursing by one who has
 8    applied in writing to the Department in  form  and  substance
 9    satisfactory  to  the Department, for a license as a licensed
10    practical nurse and has  complied  with  all  the  provisions
11    under  Section 12, except the passing of an examination to be
12    eligible to receive such license, until:  the decision of the
13    Department that the applicant has failed  to  pass  the  next
14    available   examination  authorized  by  the  Department,  or
15    failed,  without  an  approved  excuse,  to  take  the   next
16    available  examination  authorized  by the Department, or the
17    withdrawal of the application, not to exceed  3  months.   No
18    applicant  for  licensure  practicing under the provisions of
19    this paragraph shall practice practical nursing except  under
20    the  direct  supervision  of  a registered professional nurse
21    licensed under this Act or a licensed physician,  dentist  or
22    podiatrist.  In no instance shall any such applicant practice
23    or be employed in any supervisory capacity.;
24        (h)  The  practice  of  practical nursing by one who is a
25    licensed practical nurse  under  the  laws  of  another  U.S.
26    jurisdiction and has applied in writing to the Department, in
27    form  and  substance  satisfactory  to  the Department, for a
28    license as a licensed practical nurse and who is qualified to
29    receive  such  license  under  Section  12,  until:  (1)  the
30    expiration of 6 months  after  the  filing  of  such  written
31    application,  or  (2)  the withdrawal of such application, or
32    (3) the denial of such application by the Department.;
33        (i)  The practice of professional nursing by one who  has
34    applied  in  writing  to the Department in form and substance
                            -7-                LRB9008509NTmb
 1    satisfactory to the Department for a license as a  registered
 2    professional  nurse  and has complied with all the provisions
 3    under Section 12 except the passing of an examination  to  be
 4    eligible  to receive such license until:  the decision of the
 5    Department that the applicant has failed  to  pass  the  next
 6    available   examination  authorized  by  the  Department,  or
 7    failed,  without  an  approved  excuse,  to  take  the   next
 8    available  examination  authorized  by  the Department or the
 9    withdrawal of the application, not to  exceed  3  months.  No
10    applicant  for  licensure  practicing under the provisions of
11    this paragraph shall  practice  professional  nursing  except
12    under  the  direct  supervision  of a registered professional
13    nurse licensed under this Act.  In no instance shall any such
14    applicant  practice  or  be  employed  in   any   supervisory
15    capacity.;
16        (j)  The practice of professional nursing by one who is a
17    registered  professional  nurse  under  the  laws  of another
18    state, territory of the United  States  or  country  and  has
19    applied  in  writing to the Department, in form and substance
20    satisfactory to the Department, for a license as a registered
21    professional nurse and  who  is  qualified  to  receive  such
22    license  under  Section  12, until:  (1)  the expiration of 6
23    months after the filing of such written application,  or  (2)
24    the withdrawal of such application, or (3) the denial of such
25    application by the Department.;
26        (k)  The   practice   of  professional  nursing  that  is
27    included in a program of study by one  who  is  a  registered
28    professional  nurse  under  the  laws  of  another  state  or
29    territory  of the United States or foreign country, territory
30    or province  and  who  is  enrolled  in  a  graduate  nursing
31    education  program  or  a  program  for  the  completion of a
32    baccalaureate nursing degree  in  this  State  which  program
33    includes clinical supervision by faculty as determined by the
34    educational  institution  offering the program and the health
                            -8-                LRB9008509NTmb
 1    care organization where the practice of nursing occurs.   The
 2    educational  institution  will  file with the Department each
 3    academic term a list of the names and origin  of  license  of
 4    all  professional  nurses practicing nursing as part of their
 5    programs under this provision.; or
 6        (l)  Any person licensed in this State  under  any  other
 7    Act  from  engaging  in  the  practice for which she or he is
 8    licensed.
 9        An applicant for license practicing under the  exceptions
10    set  forth  in  subparagraphs  (g), (h), (i), and (j) of this
11    Section shall use the title R.N.  Lic.  Pend.,  R.N./A.P.R.N.
12    Lic. Pend., or L.P.N. Lic. Pend. respectively and no other.
13    (Source:  P.A.  90-61,  eff.  12-30-97;  90-248, eff. 1-1-98;
14    revised 8-12-97.)
15        (225 ILCS 65/6) (from Ch. 111, par. 3506)
16        Sec. 6.  Prohibited acts.  No person shall:
17        (a)  Practice professional nursing or  advanced  practice
18    registered  nursing  without  a valid license as a registered
19    professional nurse or  advanced  practice  registered  nurse,
20    respectively, except as provided in paragraphs (i) and (j) of
21    Section 4 of this Act;
22        (b)  Practice  practical  nursing without a valid license
23    as a licensed practical nurse; or practice practical  nursing
24    other  than  under  the  direction  of  a licensed physician,
25    licensed dentist, or registered professional nurse; except as
26    provided in paragraphs (g), (h) and (j) of Section 4 of  this
27    Act;
28        (c)  Practice   nursing   under  cover  of  any  diploma,
29    license, or record  illegally  or  fraudulently  obtained  or
30    signed    or    issued   unlawfully   or   under   fraudulent
31    representation;
32        (d)  Practice nursing during the time her or his  license
33    is suspended, revoked, expired or on inactive status;
                            -9-                LRB9008509NTmb
 1        (e)  Use  any  words,  abbreviations,  figures,  letters,
 2    title,  sign, card, or device tending to imply that she or he
 3    is a registered professional nurse, including the  titles  or
 4    initials,    "Registered    Nurse,"   "Professional   Nurse,"
 5    "Registered Professional Nurse," "Certified Nurse,"  "Trained
 6    Nurse,"  "Graduate  Nurse," "P.N.," or "R.N.," or "R.P.N." or
 7    similar titles  or  initials  with  intention  of  indicating
 8    practice without a valid license as a registered professional
 9    nurse;
10        (f)  Use   any  words,  abbreviations  figures,  letters,
11    title, sign, card, or device tending to imply that she or  he
12    is  a  licensed  practical  nurse  including  the  titles  or
13    initials   "Practical  Nurse,"  "Licensed  Practical  Nurse,"
14    "P.N.," or "L.P.N.,"  or  similar  titles  or  initials  with
15    intention of indicated practice as a licensed practical nurse
16    without  a  valid license as a licensed practical nurse under
17    this Act;
18        (g)  Obtain or furnish a license by or for money  or  any
19    other  thing of value other than the fees required by Section
20    23, or by any fraudulent representation or act;
21        (h)  Make any wilfully false oath or affirmation required
22    by this Act;
23        (i)  Conduct  a  nursing  education   program   preparing
24    persons  for  licensure  that  has  not  been approved by the
25    Department;
26        (j)  Represent that any school or course is  approved  or
27    accredited  as  a  school  or  course  for  the  education of
28    registered professional nurses or licensed  practical  nurses
29    unless  such  school  or course is approved by the Department
30    under the provisions of this Act;
31        (k)  Attempt or offer to do any of the acts enumerated in
32    this Section, or  knowingly aid, abet, assist in the doing of
33    any such acts or in the attempt or offer to do  any  of  such
34    acts;
                            -10-               LRB9008509NTmb
 1        (l)  Seek  employment  as a registered professional nurse
 2    under the terms of paragraphs (i) and (j)  of  Section  4  of
 3    this Act without possessing a written authorization which has
 4    been  issued  by the Department or designated testing service
 5    and which evidences the filing  of  the  written  application
 6    referred  to  in  paragraph  (i) and (j) of Section 4 of this
 7    Act;
 8        (m)  Seek employment as a licensed practical nurse  under
 9    the  terms of paragraphs (g) and (h) of Section 4 of this Act
10    without possessing a written  authorization  which  has  been
11    issued  by  the  Department or designated testing service and
12    which  evidences  the  filing  of  the  written   application
13    referred  to  in  paragraph  (g) and (h) of Section 4 of this
14    Act;
15        (n)  Employ or utilize persons not  licensed  under  this
16    Act  to  practice  professional nursing or practical nursing;
17    and
18        (o)  Otherwise intentionally  violate  any  provision  of
19    this Act;.
20        (p)  Use  any  words,  abbreviations,  figures,  letters,
21    title,  sign, card, or device tending to imply that he or she
22    is an advanced practice registered nurse, including  but  not
23    limited  to  using  the titles or initials "Advanced Practice
24    Registered  Nurse",  "Certified  Nurse  Midwife",  "Certified
25    Nurse    Practitioner",    "Certified    Registered     Nurse
26    Anesthetist",   "Clinical   Nurse   Specialist",  "A.P.R.N.",
27    "C.N.M.", "C.N.P.", "C.R.N.A.", "C.N.S.", or  similar  titles
28    or  initials  with the intention of indicating practice as an
29    advanced  practice  registered  nurse  without  meeting   the
30    requirements of this Act; or
31        (q)  Practice  as  an  advanced practice registered nurse
32    unless she or he practices  under  the  terms  of  a  written
33    practice agreement as required under Section 12.7.
34        Any  person, including a firm, association or corporation
                            -11-               LRB9008509NTmb
 1    who violates any provision of this Section shall be guilty of
 2    a Class A misdemeanor.
 3    (Source: P.A. 85-981.)
 4        (225 ILCS 65/7.5 new)
 5        Sec. 7.5.  Advanced Practice  Registered  Nurse  Advisory
 6    Committee.   There is hereby established an Advanced Practice
 7    Registered Nurse Advisory Committee.  The Advisory  Committee
 8    shall review and make recommendations to the Board of Nursing
 9    and   to   the  Illinois  State  Medical  Disciplinary  Board
10    regarding matters  relating  to  the  collaborative  practice
11    between  advanced  practice  registered nurses and physicians
12    licensed to practice medicine in all of its  branches.    The
13    Advisory  Committee  shall be composed of 7 members appointed
14    by the Director from lists of suggested  appointees  provided
15    by  the  APRN  specialty organizations and the Illinois State
16    Medical Society.  Two of the 7 members  shall  be  physicians
17    licensed  to practice medicine in all of its branches who are
18    in collaborative practice with APRNs.  Four members shall  be
19    APRNs  representing  the  4  specialties of advanced practice
20    registered nursing, including Certified Nurse  Practitioners,
21    Certified   Nurse   Midwives,   Certified   Registered  Nurse
22    Anesthestists, and Clinical Nurse  Specialists.  One  member,
23    not employed or having a material interest in the health care
24    field,  shall  represent  the  public.   A chairperson of the
25    Advisory Committee shall be a member elected  by  a  majority
26    vote of the Advisory Committee.  The Advisory Committee shall
27    meet  and report to the Department quarterly and as necessary
28    to conduct its business.
29        Initial appointments to the Advisory Committee  shall  be
30    made  within  90  days  after  the  effective  date  of  this
31    amendatory  Act  of  1997.  Members shall serve 3-year terms.
32    However, of the initial 7 members, one physician and 2  APRNs
33    shall  serve  2-year  terms,  one physician and 2 APRNs shall
                            -12-               LRB9008509NTmb
 1    serve 3-year terms, and  the  public  member  shall  serve  a
 2    3-year  term.   Upon  the expiration of the term of a member,
 3    his or her successor shall be  appointed  for  a  term  of  3
 4    years.   No member shall serve more than 2 consecutive terms,
 5    excluding the initial appointment term.   An  appointment  to
 6    fill  a  vacancy  shall  be  for the unexpired portion of the
 7    term.  Members of the Advisory Committee shall be  reimbursed
 8    for all authorized legitimate and necessary expenses incurred
 9    in attending the meetings of the Advisory Committee.
10        Complaints    received   concerning   advanced   practice
11    registered nurses shall be reviewed by the Advisory Committee
12    and recommendations  shall  be  forwarded  to  the  Board  of
13    Nursing.    Complaints   received   concerning  collaborating
14    physicians shall be reviewed by the  Advisory  Committee  and
15    recommendations  shall  be  forwarded  to  the Illinois State
16    Medical Disciplinary Board.
17        (225 ILCS 65/12.5 new)
18        Sec.   12.5.  Advanced   practice    registered    nurse;
19    qualifications; roster.
20        (a)  The Department shall license a person as an advanced
21    practice registered nurse if that person:
22             (1)  has  applied  in  writing in form and substance
23        acceptable to the Department and  has  not  violated  the
24        provisions of Section 25 of this Act.  The Department may
25        take  into  consideration  a  felony  conviction  of  the
26        applicant,  but  the  conviction  shall not operate as an
27        absolute bar to recognition;
28             (2)  has paid the required fees;
29             (3)  holds  a  current  license  to  practice  as  a
30        registered nurse in Illinois;
31             (4)  has  successfully   completed   a   post-basic,
32        advanced  formal  education  program  as a clinical nurse
33        specialist, certified nurse midwife, certified registered
                            -13-               LRB9008509NTmb
 1        nurse anesthetist, or certified nurse practitioner;
 2             (5)  beginning January 1, 2003, possesses a graduate
 3        degree and maintains applicable national certification as
 4        a certified nurse  midwife,  clinical  nurse  specialist,
 5        certified  nurse   practitioner,  or certified registered
 6        nurse  anesthetist  according  to  the  policies  of  the
 7        certifying body for his or her nursing specialty.
 8        (b)  The  Department  shall  provide  by  rule  for  APRN
 9    licensure of registered professional nurses who (A) apply for
10    licensure before May 31, 2000  and  (B)  submit  evidence  of
11    completion  of  a program described in item (4) of subsection
12    (a) of this Section and evidence of practice for at least  10
13    years as a nurse practitioner, or evidence of practice for at
14    least  10  years  as  a registered nurse including at least 5
15    years of practice as a nurse practitioner.
16        (c)  An  advanced  practice  registered  nurse   may   be
17    licensed  as a certified nurse midwife (CNM), certified nurse
18    practitioner (CNP), certified  registered  nurse  anesthetist
19    (CRNA), or clinical nurse specialist (CNS).
20        (d)  The  Department  shall maintain a separate roster of
21    advanced  practice  registered  nurses  licensed  under  this
22    Section  and  their  licenses  shall   indicate   "Registered
23    Nurse/Advanced Practice Registered Nurse".
24        (225 ILCS 65/12.7 new)
25        Sec.  12.7.  APRN written practice agreements.  Except as
26    provided in item (5) of  subsection  (n)  of  Section  3,  an
27    advanced  practice  registered  nurse  shall practice only in
28    accordance with a written  practice  agreement  entered  into
29    with  a physician licensed to practice medicine in all of its
30    branches.
31        At  a  minimum,  the  written  practice  agreement  shall
32    include:
33             (1)  a description of the  working  relationship  of
                            -14-               LRB9008509NTmb
 1        the advanced practice registered nurse with the physician
 2        licensed to practice medicine in all of its branches;
 3             (2)  the   signatures   of   the  advanced  practice
 4        registered  nurse  and  physician  licensed  to  practice
 5        medicine in all of its branches; and
 6             (3)  methods   of   communication   available    for
 7        consultation  between  the  APRN  and physician by radio,
 8        telephone, or telecommunications.
 9    The written  practice  agreement  shall  also  authorize  the
10    categories  of care, treatment, or procedures to be performed
11    by the APRN.
12        A  written  practice  agreement  does  not   require   an
13    employment relationship between a collaborating physician and
14    an APRN.  Collaboration occurs in the working relationship in
15    which a physician and an APRN deliver health care services in
16    accordance  with  their  respective  training and experience.
17    Written practice  agreements  shall  be  designed  to  foster
18    collaborations  and  to  promote the exercise of professional
19    judgement by an APRN.
20        The agreement may also include a specific  delegation  of
21    authority from the physician licensed to practice medicine in
22    all of its branches to the advanced practice registered nurse
23    to   prescribe  and  administer  legend  drugs categorized as
24    Schedule II through  V  under  Article  II  of  the  Illinois
25    Controlled  Substances  Act  and  may  specify any additional
26    details regarding patient  care,  including  procedures  that
27    require  a  physician's  presence as the procedures are being
28    performed.
29        A copy of the signed agreement shall be available to  the
30    Department upon request.
31        (225 ILCS 65/12.9 new)
32        Sec. 12.9.  APRN advertising.
33        (a)  A person licensed under Section 12.5 of this Act may
                            -15-               LRB9008509NTmb
 1    advertise  the  availability  of professional services in the
 2    public media  or  on  the  premises  where  the  professional
 3    services  are  rendered.  The advertising shall be limited to
 4    the following information:
 5             (1)  publication of the person's name, title, office
 6        hours, address, and telephone number;
 7             (2)  information pertaining to the person's areas of
 8        specialization, including but not limited to  appropriate
 9        board   certification   or   limitation  of  professional
10        practice;
11             (3)  publication  of  the   person's   collaborating
12        physician's name, title, and areas of specialization;
13             (4)  information  on  usual  and  customary fees for
14        routine  professional  services  offered,   which   shall
15        include  notification  that  fees  may be adjusted due to
16        complications or unforeseen circumstances;
17             (5)  announcements of the  opening  of,  change  of,
18        absence from, or return to business;
19             (6)  announcement  of additions to or deletions from
20        professional licensed staff; and
21             (7)  the issuance of business or appointment cards.
22        (b)  It is unlawful for a person licensed  under  Section
23    12.5  of  this  Act to use testimonials or claims of superior
24    quality of care to entice the public.  It shall  be  unlawful
25    to advertise fee comparisons of available services with those
26    of other licensed persons.
27        (c)  This  Section  does not authorize the advertising of
28    professional services that the offeror of the services is not
29    licensed or authorized to render, nor  shall  the  advertiser
30    use  statements that contain false, fraudulent, deceptive, or
31    misleading material or guarantees of success, statements that
32    play upon the vanity or fears of the  public,  or  statements
33    that promote or produce unfair competition.
34        (d)  It  is  unlawful  and  punishable  under the penalty
                            -16-               LRB9008509NTmb
 1    provisions of this Act for a person  licensed  under  Section
 2    12.5  of  this  Act  to knowingly advertise that the licensee
 3    will accept as payment for services  rendered  by  assignment
 4    from  any  third party payor the amount the third party payor
 5    covers as payment in full, if  the  effect  is  to  give  the
 6    impression  of eliminating the need of payment by the patient
 7    of any required deductible or  copayment  applicable  in  the
 8    patient's health benefit plan.
 9        (e)  As   used   in   this   Section,  "advertise"  means
10    solicitation by the licensee or  through  another  person  or
11    entity  by  means  of  handbills,  posters, circulars, motion
12    pictures, radio, newspapers, or television or  in  any  other
13    manner.
14        (225 ILCS 65/16) (from Ch. 111, par. 3516)
15        Sec.  16.  Expiration  of  license;  renewal;  continuing
16    education.  The  expiration  date and renewal period for each
17    license issued under this Act shall  be  set  by  rule.   The
18    holder  of  a  license may renew the license during the month
19    preceding the expiration date of the license  by  paying  the
20    required  fee.  It  is  the responsibility of the licensee to
21    notify the Department in writing of a change of address.
22        No person may renew a license as an R.N./A.P.R.N.  unless
23    he  or  she  has  completed,  during  the most recent license
24    cycle, at least 20 hours of continuing  education  consistent
25    with the continuing education requirements established by the
26    certifying body for his or her nursing specialty.
27    (Source: P.A. 90-61, eff. 12-30-97.)
28        Section 10.  The Pharmacy Practice Act of 1987 is amended
29    by changing Sections 3 and 4 as follows:
30        (225 ILCS 85/3) (from Ch. 111, par. 4123)
31        Sec. 3. Definitions.  For the purpose of this Act, except
                            -17-               LRB9008509NTmb
 1    where otherwise limited therein:
 2        (a)  "Pharmacy"  or  "drugstore" means and includes every
 3    store,  shop,  pharmacy  department,  or  other  place  where
 4    pharmaceutical care is provided by  a  pharmacist  (1)  where
 5    drugs,  medicines,  or poisons are dispensed, sold or offered
 6    for sale at retail, or displayed for sale at retail;  or  (2)
 7    where  prescriptions  of physicians, dentists, veterinarians,
 8    podiatrists,  or  therapeutically   certified   optometrists,
 9    within  the limits of their licenses, are compounded, filled,
10    or dispensed; or (3) which has upon it  or  displayed  within
11    it,  or  affixed  to  or  used  in connection with it, a sign
12    bearing  the  word   or   words   "Pharmacist",   "Druggist",
13    "Pharmacy", "Pharmaceutical Care", "Apothecary", "Drugstore",
14    "Medicine  Store",  "Prescriptions", "Drugs", "Medicines", or
15    any word or words of similar or like import,  either  in  the
16    English  language  or  any  other  language; or (4) where the
17    characteristic prescription sign (Rx) or  similar  design  is
18    exhibited;  or  (5)  any  store, or shop, or other place with
19    respect to which any of the above words,  objects,  signs  or
20    designs are used in any advertisement.
21        (b)  "Drugs"  means  and includes (l) articles recognized
22    in  the   official   United   States   Pharmacopoeia/National
23    Formulary  (USP/NF),  or  any  supplement  thereto  and being
24    intended for and having for their  main  use  the  diagnosis,
25    cure,  mitigation,  treatment or prevention of disease in man
26    or other animals, as approved by the United States  Food  and
27    Drug  Administration,  but  does not include devices or their
28    components, parts, or accessories; and (2) all other articles
29    intended for and having for their  main  use  the  diagnosis,
30    cure,  mitigation,  treatment or prevention of disease in man
31    or other animals, as approved by the United States  Food  and
32    Drug  Administration,  but  does not include devices or their
33    components, parts, or accessories; and  (3)  articles  (other
34    than  food)  having for their main use and intended to affect
                            -18-               LRB9008509NTmb
 1    the structure or any function of the body  of  man  or  other
 2    animals;  and  (4)  articles  having  for  their main use and
 3    intended for use as a component or any articles specified  in
 4    clause (l), (2) or (3); but does not include devices or their
 5    components, parts or accessories.
 6        (c)  "Medicines"  means  and  includes all drugs intended
 7    for human or veterinary use approved  by  the  United  States
 8    Food and Drug Administration.
 9        (d)  "Practice   of  pharmacy"  means  the  provision  of
10    pharmaceutical  care  to  patients  as  determined   by   the
11    pharmacist's  professional  judgment  in the following areas,
12    which  may  include  but  are  not  limited  to  (1)  patient
13    counseling,  (2)  interpretation   and   assisting   in   the
14    monitoring  of  appropriate  drug  use  and  prospective drug
15    utilization  review,  (3)  providing   information   on   the
16    therapeutic   values,   reactions,  drug  interactions,  side
17    effects, uses, selection of medications and medical  devices,
18    and  outcome  of  drug  therapy,  (4)  participation  in drug
19    selection,  drug   monitoring,   drug   utilization   review,
20    evaluation,  administration,  interpretation,  application of
21    pharmacokinetic  and  laboratory  data  to  design  safe  and
22    effective drug regimens,  (5)  drug  research  (clinical  and
23    scientific),  and (6) compounding and dispensing of drugs and
24    medical devices.
25        (e)  "Prescription" means and includes any written, oral,
26    facsimile, or electronically transmitted order for  drugs  or
27    medical  devices,  issued by a physician licensed to practice
28    medicine in  all  its  branches,  dentist,  veterinarian,  or
29    podiatrist,    advanced   practice   registered   nurse,   or
30    therapeutically  certified  optometrist, within the limits of
31    their licenses, or by a  physician  assistant  in  accordance
32    with  subsection  (f) of Section 4, containing the following:
33    (l) name of the  patient;  (2)  date  when  prescription  was
34    issued;  (3)  name and strength of drug or description of the
                            -19-               LRB9008509NTmb
 1    medical device prescribed; and (4) quantity,  (5)  directions
 2    for  use,  (6)  prescriber's name, address and signature, and
 3    (7) DEA number where required, for controlled substances. DEA
 4    numbers shall not be required on inpatient drug orders.
 5        (f)  "Person"  means  and  includes  a  natural   person,
 6    copartnership,  association,  corporation, government entity,
 7    or any other legal entity.
 8        (g)  "Department" means the  Department  of  Professional
 9    Regulation.
10        (h)  "Board of Pharmacy" or "Board" means the State Board
11    of Pharmacy of the Department of Professional Regulation.
12        (i)  "Director"   means   the  Director  of  Professional
13    Regulation.
14        (j)  "Drug product selection" means the interchange for a
15    prescribed pharmaceutical product in accordance with  Section
16    25  of  this  Act and Section 3.14 of the Illinois Food, Drug
17    and Cosmetic Act.
18        (k)  "Inpatient drug order" means an order issued  by  an
19    authorized prescriber for a resident or patient of a facility
20    licensed  under  the  Nursing  Home  Care Act or the Hospital
21    Licensing Act, or "An Act in relation  to  the  founding  and
22    operation  of  the  University  of  Illinois Hospital and the
23    conduct of University  of  Illinois  health  care  programs",
24    approved  July  3,  1931,  as amended, or a facility which is
25    operated by the Department of Human Services (as successor to
26    the   Department   of   Mental   Health   and   Developmental
27    Disabilities) or the Department of Corrections.
28        (k-5)  "Pharmacist"   means   an   individual   currently
29    licensed by this State to engage in the practice of pharmacy.
30        (l)  "Pharmacist in charge" means the licensed pharmacist
31    whose name appears on a pharmacy license who  is  responsible
32    for  all  aspects of the operation related to the practice of
33    pharmacy.
34        (m)  "Dispense" means the delivery of drugs  and  medical
                            -20-               LRB9008509NTmb
 1    devices, in accordance with applicable State and federal laws
 2    and   regulations,   to   the   patient   or   the  patient's
 3    representative  authorized   to   receive   these   products,
 4    including  the compounding, packaging, and labeling necessary
 5    for delivery, and any recommending or advising concerning the
 6    contents and therapeutic values and uses thereof.  "Dispense"
 7    does  not  mean  the  physical  delivery  to  a  patient or a
 8    patient's representative  in  a  home  or  institution  by  a
 9    designee  of  a  pharmacist or by common carrier.  "Dispense"
10    also does not mean the physical delivery of a drug or medical
11    device  to  a  patient  or  patient's  representative  by   a
12    pharmacist's  designee  within  a pharmacy or drugstore while
13    the pharmacist is on duty and the pharmacy is open.
14        (n)  "Mail-order  pharmacy"  means  a  pharmacy  that  is
15    located in a state of the United States, other than Illinois,
16    that delivers, dispenses or distributes, through  the  United
17    States  Postal  Service  or other common carrier, to Illinois
18    residents, any substance which requires a prescription.
19        (o)  "Compounding"   means   the   preparation,   mixing,
20    assembling, packaging, or  labeling  of  a  drug  or  medical
21    device:  (1)  as  the result of a practitioner's prescription
22    drug order or initiative that  is  dispensed  pursuant  to  a
23    prescription  in  the course of professional practice; or (2)
24    for the purpose of, or incident to,  research,  teaching,  or
25    chemical  analysis;  or  (3)  in anticipation of prescription
26    drug orders based on routine, regularly observed  prescribing
27    patterns.
28        (p)  "Confidential    information"   means   information,
29    maintained  by  the  pharmacist  in  the  patient's  records,
30    released only (i) to the patient or, as the patient  directs,
31    to  other  practitioners and other pharmacists or (ii) to any
32    other person authorized by law to receive the information.
33        (q)  "Prospective  drug  review"  or  "drug   utilization
34    evaluation"  means  a  screening  for  potential drug therapy
                            -21-               LRB9008509NTmb
 1    problems  due  to   therapeutic   duplication,   drug-disease
 2    contraindications,  drug-drug interactions (including serious
 3    interactions with nonprescription or over-the-counter drugs),
 4    drug-food interactions, incorrect drug dosage or duration  of
 5    drug treatment, drug-allergy interactions, and clinical abuse
 6    or misuse.
 7        (r)  "Patient counseling" means the communication between
 8    a  pharmacist  or  a  student  pharmacist  under  the  direct
 9    supervision  of  a  pharmacist and a patient or the patient's
10    representative about the patient's medication or  device  for
11    the   purpose   of  optimizing  proper  use  of  prescription
12    medications  or  devices.   The  offer  to  counsel  by   the
13    pharmacist  or  the  pharmacist's  designee,  and  subsequent
14    patient  counseling  by the pharmacist or student pharmacist,
15    shall be  made  in  a  face-to-face  communication  with  the
16    patient   or   patient's   representative   unless,   in  the
17    professional  judgment  of  the  pharmacist,  a  face-to-face
18    communication is deemed  inappropriate  or  unnecessary.   In
19    that instance, the offer to counsel or patient counseling may
20    be  made  in  a  written communication, by telephone, or in a
21    manner determined by the pharmacist to be appropriate.
22        (s)  "Patient profiles" or "patient drug therapy  record"
23    means  the  obtaining,  recording, and maintenance of patient
24    prescription and personal information.
25        (t)  "Pharmaceutical care" includes, but is  not  limited
26    to,  the  act  of  monitoring drug use and other patient care
27    services  intended  to  achieve  outcomes  that  improve  the
28    patient's quality of life but shall not include the  sale  of
29    over-the-counter  drugs by a seller of goods and services who
30    does not dispense prescription drugs.
31        (u)  "Medical device"  means  an  instrument,  apparatus,
32    implement,  machine,  contrivance, implant, in vitro reagent,
33    or other similar or related article, including any  component
34    part  or  accessory,  required  under federal law to bear the
                            -22-               LRB9008509NTmb
 1    label "Caution: Federal law requires dispensing by or on  the
 2    order  of  a  physician". A seller of goods and services who,
 3    only for the  purpose  of  retail  sales,  compounds,  sells,
 4    rents,  or  leases  medical  devices  shall  not,  by reasons
 5    thereof, be required to be a licensed pharmacy.
 6    (Source: P.A. 89-202,  eff.  7-21-95;  89-507,  eff.  7-1-97;
 7    90-116, eff. 7-14-97; 90-253, eff. 7-29-97; revised 8-5-97.)
 8        (225 ILCS 85/4) (from Ch. 111, par. 4124)
 9        Sec.  4.  Exemptions. Nothing contained in any Section of
10    this Act shall apply to, or in any manner interfere with:
11        (a)  the lawful practice of  any  physician  licensed  to
12    practice   medicine   in   all   of  its  branches,  dentist,
13    podiatrist,    veterinarian,    or     therapeutically     or
14    diagnostically certified optometrist within the limits of his
15    or  her  license, or prevent him or her from supplying to his
16    or her bona fide patients such drugs, medicines,  or  poisons
17    as may seem to him appropriate;
18        (b)  the sale of compressed gases;
19        (c)  the  sale  of  patent  or  proprietary medicines and
20    household  remedies  when  sold  in  original  and   unbroken
21    packages  only,  if  such patent or proprietary medicines and
22    household remedies be properly and adequately labeled  as  to
23    content  and  usage  and generally considered and accepted as
24    harmless  and  nonpoisonous  when  used  according   to   the
25    directions  on  the  label,  and also do not contain opium or
26    coca leaves, or any compound, salt or derivative thereof,  or
27    any  drug  which,  according  to  the  latest editions of the
28    following   authoritative   pharmaceutical   treatises    and
29    standards,  namely,  The United States Pharmacopoeia/National
30    Formulary (USP/NF), the United States Dispensatory,  and  the
31    Accepted   Dental   Remedies   of   the   Council  of  Dental
32    Therapeutics of the American Dental  Association  or  any  or
33    either  of them, in use on the effective date of this Act, or
                            -23-               LRB9008509NTmb
 1    according to the existing provisions  of  the  Federal  Food,
 2    Drug,  and  Cosmetic Act and Regulations of the Department of
 3    Health and Human  Services,  Food  and  Drug  Administration,
 4    promulgated   thereunder   now   in  effect,  is  designated,
 5    described  or  considered  as  a  narcotic,  hypnotic,  habit
 6    forming, dangerous, or poisonous drug;
 7        (d)  the  sale  of  poultry  and  livestock  remedies  in
 8    original and unbroken packages only, labeled for poultry  and
 9    livestock medication; and
10        (e)  the  sale  of  poisonous  substances  or  mixture of
11    poisonous substances, in unbroken packages, for  nonmedicinal
12    use  in  the  arts or industries or for insecticide purposes;
13    provided, they are properly  and  adequately  labeled  as  to
14    content  and  such nonmedicinal usage, in conformity with the
15    provisions of all applicable federal, state  and  local  laws
16    and regulations promulgated thereunder now in effect relating
17    thereto  and governing the same, and those which are required
18    under such applicable laws and regulations to be labeled with
19    the word "Poison", are also labeled with  the  word  "Poison"
20    printed  thereon  in prominent type and the name of a readily
21    obtainable antidote with directions for  its  administration;
22    and
23        (f)  the  delegation of limited prescriptive authority by
24    a physician licensed to practice medicine in all its branches
25    to a physician assistant under Section 7.5 of  the  Physician
26    Assistant  Practice Act of 1987. This delegated authority may
27    but is not required to include prescription of Schedule  III,
28    IV,  or  V controlled substances, as defined in Article II of
29    the Illinois Controlled Substances Act,  in  accordance  with
30    written   guidelines  under  Section  7.5  of  the  Physician
31    Assistant Practice Act of 1987; and.
32        (g)  the delegation of limited prescriptive authority  by
33    a  physician  licensed  to  practice  medicine  in all of its
34    branches  to  an  advanced  practice  registered   nurse   in
                            -24-               LRB9008509NTmb
 1    accordance  with  a  written practice agreement under Section
 2    12.7 of the Illinois Nursing Act of  1987.    This  delegated
 3    authority may but is not required to  include prescription of
 4    Schedule  II,  III, IV, or V controlled substances as defined
 5    in Article II of the Illinois Controlled Substances Act.
 6    (Source: P.A. 90-116, eff.  7-14-97;  90-253,  eff.  7-29-97;
 7    revised 8-5-97.)
 8        Section  15.  The  Illinois  Controlled Substances Act is
 9    amended by changing Section 102 as follows:
10        (720 ILCS 570/102) (from Ch. 56 1/2, par. 1102)
11        Sec. 102.  As  used  in  this  Act,  unless  the  context
12    otherwise requires:
13        (a)  "Addict"  means  any  person who habitually uses any
14    drug,  chemical,  substance  or  dangerous  drug  other  than
15    alcohol so as to endanger the public morals,  health,  safety
16    or  welfare  or  who  is  so  far  addicted  to  the use of a
17    dangerous drug or controlled substance other than alcohol  as
18    to  have lost the power of self control with reference to his
19    addiction.
20        (b)  "Administer"  means  the  direct  application  of  a
21    controlled  substance,  whether  by  injection,   inhalation,
22    ingestion,  or  any  other means, to the body of a patient or
23    research subject by:
24             (1)  a practitioner (or, in  his  presence,  by  his
25        authorized agent), or
26             (2)  the  patient  or research subject at the lawful
27        direction of the practitioner.
28        (c)  "Agent" means  an  authorized  person  who  acts  on
29    behalf of or at the direction of a manufacturer, distributor,
30    or  dispenser.   It  does  not  include  a common or contract
31    carrier, public warehouseman or employee of  the  carrier  or
32    warehouseman.
                            -25-               LRB9008509NTmb
 1        (c-1)  "Anabolic  Steroids"  means  any  drug or hormonal
 2    substance,  chemically  and  pharmacologically   related   to
 3    testosterone   (other   than   estrogens,   progestins,   and
 4    corticosteroids) that promotes muscle growth, and includes:
 5                  (i)  boldenone,
 6                  (ii)  chlorotestosterone,
 7                  (iii)  chostebol,
 8                  (iv)  dehydrochlormethyltestosterone,
 9                  (v)  dihydrotestosterone,
10                  (vi)  drostanolone,
11                  (vii)  ethylestrenol,
12                  (viii)  fluoxymesterone,
13                  (ix)  formebulone,
14                  (x)  mesterolone,
15                  (xi)  methandienone,
16                  (xii)  methandranone,
17                  (xiii)  methandriol,
18                  (xiv)  methandrostenolone,
19                  (xv)  methenolone,
20                  (xvi)  methyltestosterone,
21                  (xvii)  mibolerone,
22                  (xviii)  nandrolone,
23                  (xix)  norethandrolone,
24                  (xx)  oxandrolone,
25                  (xxi)  oxymesterone,
26                  (xxii)  oxymetholone,
27                  (xxiii)  stanolone,
28                  (xxiv)  stanozolol,
29                  (xxv)  testolactone,
30                  (xxvi)  testosterone,
31                  (xxvii)  trenbolone, and
32                  (xxviii)  any  salt, ester, or isomer of a drug
33             or substance described or listed in this  paragraph,
34             if  that  salt,  ester,  or  isomer  promotes muscle
                            -26-               LRB9008509NTmb
 1             growth.
 2        Any person who is otherwise lawfully in possession of  an
 3    anabolic  steroid,  or  who  otherwise lawfully manufactures,
 4    distributes, dispenses, delivers, or possesses with intent to
 5    deliver  an  anabolic  steroid,  which  anabolic  steroid  is
 6    expressly  intended  for   and   lawfully   allowed   to   be
 7    administered  through implants to livestock or other nonhuman
 8    species, and which is approved by the Secretary of Health and
 9    Human Services for such administration, and which the  person
10    intends  to  administer  or  have  administered  through such
11    implants, shall not  be  considered  to  be  in  unauthorized
12    possession   or   to   unlawfully   manufacture,  distribute,
13    dispense, deliver, or possess with  intent  to  deliver  such
14    anabolic steroid for purposes of this Act.
15        (d)  "Administration"    means   the   Drug   Enforcement
16    Administration, United States Department of Justice,  or  its
17    successor agency.
18        (e)  "Control" means to add a drug or other substance, or
19    immediate  precursor,  to a Schedule under Article II of this
20    Act whether by transfer from another Schedule or otherwise.
21        (f)  "Controlled Substance" means a drug,  substance,  or
22    immediate  precursor  in  the Schedules of Article II of this
23    Act.
24        (g)  "Counterfeit   substance"   means    a    controlled
25    substance,  which,  or  the  container  or labeling of which,
26    without authorization bears the  trademark,  trade  name,  or
27    other  identifying  mark,  imprint,  number or device, or any
28    likeness  thereof,  of  a   manufacturer,   distributor,   or
29    dispenser  other  than  the  person who in fact manufactured,
30    distributed, or dispensed the substance.
31        (h)  "Deliver"   or   "delivery"   means   the    actual,
32    constructive   or  attempted  transfer  of  possession  of  a
33    controlled substance, with or without consideration,  whether
34    or not there is an agency relationship.
                            -27-               LRB9008509NTmb
 1        (i)  "Department"  means the Illinois Department of Human
 2    Services (as successor to the Department  of  Alcoholism  and
 3    Substance Abuse) or its successor agency.
 4        (j)  "Department of State Police" means the Department of
 5    State  Police  of  the  State  of  Illinois  or its successor
 6    agency.
 7        (k)  "Department of Corrections" means the Department  of
 8    Corrections of the State of Illinois or its successor agency.
 9        (l)  "Department  of  Professional  Regulation" means the
10    Department  of  Professional  Regulation  of  the  State   of
11    Illinois or its successor agency.
12        (m)  "Depressant" or "stimulant substance" means:
13             (1)  a  drug  which  contains  any  quantity  of (i)
14        barbituric acid or any of the salts  of  barbituric  acid
15        which  has been designated as habit forming under section
16        502 (d) of the Federal Food, Drug, and Cosmetic  Act  (21
17        U.S.C. 352 (d)); or
18             (2)  a  drug  which  contains  any  quantity  of (i)
19        amphetamine or methamphetamine and any of  their  optical
20        isomers;  (ii) any salt of amphetamine or methamphetamine
21        or any salt of an optical isomer of amphetamine; or (iii)
22        any substance which the Department, after  investigation,
23        has found to be, and by rule designated as, habit forming
24        because  of  its  depressant  or  stimulant effect on the
25        central nervous system; or
26             (3)  lysergic acid diethylamide; or
27             (4)  any drug  which  contains  any  quantity  of  a
28        substance  which the Department, after investigation, has
29        found to have,  and  by  rule  designated  as  having,  a
30        potential   for   abuse  because  of  its  depressant  or
31        stimulant effect on the central  nervous  system  or  its
32        hallucinogenic effect.
33        (n)  "Designated   product"   means  any  narcotic  drug,
34    amphetamine, phenmetrazine,  methamphetamine,  gluthethimide,
                            -28-               LRB9008509NTmb
 1    pentazocine  or  cannabis  product  listed in Schedule II and
 2    also means a controlled substance listed in Schedule II which
 3    is  determined  and  designated  by  the  Department  or  its
 4    successor agency to be such a product. A  designated  product
 5    shall only be dispensed upon an official prescription blank.
 6        (o)  "Director"  means  the Director of the Department of
 7    State Police or the Department of Professional Regulation  or
 8    his designated agents.
 9        (p)  "Dispense"  means  to deliver a controlled substance
10    to an ultimate user or research subject by or pursuant to the
11    lawful order of  a  prescriber,  including  the  prescribing,
12    administering,  packaging, labeling, or compounding necessary
13    to prepare the substance for that delivery.
14        (q)  "Dispenser" means a practitioner who dispenses.
15        (r)  "Distribute"  means  to  deliver,  other   than   by
16    administering or dispensing, a controlled substance.
17        (s)  "Distributor" means a person who distributes.
18        (t)  "Drug"  means  (1) substances recognized as drugs in
19    the   official   United   States   Pharmacopoeia,    Official
20    Homeopathic  Pharmacopoeia  of the United States, or official
21    National Formulary, or any supplement to  any  of  them;  (2)
22    substances  intended  for use in diagnosis, cure, mitigation,
23    treatment, or prevention of disease in man  or  animals;  (3)
24    substances (other than food) intended to affect the structure
25    of  any  function  of  the  body  of  man  or animals and (4)
26    substances intended for use as a  component  of  any  article
27    specified  in clause (1), (2), or (3) of this subsection.  It
28    does not include  devices  or  their  components,  parts,  or
29    accessories.
30        (u)  "Good  faith" means the prescribing or dispensing of
31    a controlled substance  by  a  practitioner  in  the  regular
32    course  of professional treatment to or for any person who is
33    under his treatment for a pathology or condition  other  than
34    that  individual's  physical or psychological dependence upon
                            -29-               LRB9008509NTmb
 1    or addiction to a controlled substance,  except  as  provided
 2    herein:   and  application  of the term to a pharmacist shall
 3    mean the dispensing of a controlled substance pursuant to the
 4    prescriber's order which in the professional judgment of  the
 5    pharmacist  is  lawful.   The  pharmacist  shall be guided by
 6    accepted professional standards including, but not limited to
 7    the following, in making the judgment:
 8             (1)  lack   of   consistency    of    doctor-patient
 9        relationship,
10             (2)  frequency of prescriptions for same drug by one
11        prescriber for large numbers of patients,
12             (3)  quantities beyond those normally prescribed,
13             (4)  unusual dosages,
14             (5)  unusual  geographic  distances between patient,
15        pharmacist and prescriber,
16             (6)  consistent prescribing of habit-forming drugs.
17        (u-1)  "Home infusion services" means  services  provided
18    by   a   pharmacy   in   compounding   solutions  for  direct
19    administration to a patient in a private residence, long-term
20    care facility, or hospice setting  by  means  of  parenteral,
21    intravenous,   intramuscular,  subcutaneous,  or  intraspinal
22    infusion.
23        (v)  "Immediate precursor" means a substance:
24             (1)  which the Department has found  to  be  and  by
25        rule  designated  as  being a principal compound used, or
26        produced primarily for  use,  in  the  manufacture  of  a
27        controlled substance;
28             (2)  which  is  an  immediate  chemical intermediary
29        used or likely to be used  in  the  manufacture  of  such
30        controlled substance; and
31             (3)  the  control  of which is necessary to prevent,
32        curtail or  limit  the  manufacture  of  such  controlled
33        substance.
34        (w)  "Instructional   activities"   means   the  acts  of
                            -30-               LRB9008509NTmb
 1    teaching, educating or  instructing  by  practitioners  using
 2    controlled  substances within educational facilities approved
 3    by the State Board of Education or its successor agency.
 4        (x)  "Local authorities" means a  duly  organized  State,
 5    County or Municipal peace unit or police force.
 6        (y)  "Look-alike substance" means a substance, other than
 7    a  controlled  substance  which  (1)  by  overall dosage unit
 8    appearance, including shape, color, size,  markings  or  lack
 9    thereof,   taste,   consistency,  or  any  other  identifying
10    physical  characteristic  of  the  substance,  would  lead  a
11    reasonable  person  to  believe  that  the  substance  is   a
12    controlled  substance,  or  (2)  is  expressly  or  impliedly
13    represented  to  be  a controlled substance or is distributed
14    under circumstances which would lead a reasonable  person  to
15    believe that the substance is a controlled substance. For the
16    purpose  of  determining  whether the representations made or
17    the circumstances of the distribution would lead a reasonable
18    person to believe the substance to be a controlled  substance
19    under  this  clause (2) of subsection (y), the court or other
20    authority may consider the following factors in  addition  to
21    any other factor that may be relevant:
22             (a)  statements  made  by  the  owner  or  person in
23        control of the substance concerning its  nature,  use  or
24        effect;
25             (b)  statements  made to the buyer or recipient that
26        the substance may be resold for profit;
27             (c)  whether the substance is packaged in  a  manner
28        normally  used for the illegal distribution of controlled
29        substances;
30             (d)  whether   the   distribution    or    attempted
31        distribution  included an exchange of or demand for money
32        or other  property  as  consideration,  and  whether  the
33        amount  of  the  consideration  was substantially greater
34        than the reasonable retail market value of the substance.
                            -31-               LRB9008509NTmb
 1        Clause (1) of this subsection (y) shall not  apply  to  a
 2    noncontrolled  substance in its finished dosage form that was
 3    initially introduced  into  commerce  prior  to  the  initial
 4    introduction  into  commerce of a controlled substance in its
 5    finished dosage form which it may substantially resemble.
 6        Nothing in this subsection (y) prohibits  the  dispensing
 7    or   distributing  of  noncontrolled  substances  by  persons
 8    authorized to dispense and distribute  controlled  substances
 9    under  this Act, provided that such action would be deemed to
10    be carried out in good faith  under  subsection  (u)  if  the
11    substances involved were controlled substances.
12        Nothing  in  this subsection (y) or in this Act prohibits
13    the  manufacture,  preparation,   propagation,   compounding,
14    processing,  packaging, advertising or distribution of a drug
15    or drugs by any person registered pursuant to Section 510  of
16    the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360).
17        (y-1)  "Mail-order  pharmacy"  means  a  pharmacy that is
18    located in a state of the United States, other than Illinois,
19    that delivers, dispenses or distributes, through  the  United
20    States  Postal  Service  or other common carrier, to Illinois
21    residents, any substance which requires a prescription.
22        (z)  "Manufacture"  means  the  production,  preparation,
23    propagation,  compounding,  conversion  or  processing  of  a
24    controlled  substance,  either  directly  or  indirectly,  by
25    extraction   from   substances   of   natural   origin,    or
26    independently  by  means  of  chemical  synthesis,  or  by  a
27    combination   of   extraction  and  chemical  synthesis,  and
28    includes any packaging or repackaging  of  the  substance  or
29    labeling  of  its  container,  except that this term does not
30    include:
31             (1)  by  an  ultimate  user,  the   preparation   or
32        compounding of a controlled substance for his own use; or
33             (2)  by  a  practitioner,  or  his  authorized agent
34        under  his  supervision,  the  preparation,  compounding,
                            -32-               LRB9008509NTmb
 1        packaging, or labeling of a controlled substance:
 2                  (a)  as an incident  to  his  administering  or
 3             dispensing  of  a controlled substance in the course
 4             of his professional practice; or
 5                  (b)  as  an  incident   to   lawful   research,
 6             teaching or chemical analysis and not for sale.
 7        (aa)  "Narcotic drug" means any of the following, whether
 8    produced directly or indirectly by extraction from substances
 9    of  natural  origin,  or  independently  by means of chemical
10    synthesis, or by a combination  of  extraction  and  chemical
11    synthesis:
12             (1)  opium  and  opiate,  and  any  salt,  compound,
13        derivative, or preparation of opium or opiate;
14             (2)  any  salt,  compound,  isomer,  derivative,  or
15        preparation  thereof  which  is  chemically equivalent or
16        identical with any  of  the  substances  referred  to  in
17        clause  (1), but not including the isoquinoline alkaloids
18        of opium;
19             (3)  opium poppy and poppy straw;
20             (4)  coca leaves and any  salts,  compound,  isomer,
21        salt  of  an  isomer,  derivative, or preparation of coca
22        leaves including  cocaine  or  ecgonine,  and  any  salt,
23        compound,  isomer,  derivative,  or  preparation  thereof
24        which  is  chemically equivalent or identical with any of
25        these substances, but  not  including  decocainized  coca
26        leaves or extractions of coca leaves which do not contain
27        cocaine  or  ecgonine (for the purpose of this paragraph,
28        the  term  "isomer"  includes  optical,  positional   and
29        geometric isomers).
30        (bb)  "Nurse" means a registered nurse licensed under the
31    Illinois Nursing Act of 1987.
32        (cc)  "Official prescription blanks" means the triplicate
33    prescription  forms supplied to prescribers by the Department
34    for prescribing Schedule  II  Designated  Product  controlled
                            -33-               LRB9008509NTmb
 1    substances.
 2        (dd)  "Opiate"  means  any  substance having an addiction
 3    forming or addiction sustaining liability similar to morphine
 4    or being capable of conversion into a drug  having  addiction
 5    forming or addiction sustaining liability.
 6        (ee)  "Opium  poppy"  means  the  plant  of  the  species
 7    Papaver somniferum L., except its seeds.
 8        (ff)  "Parole  and  Pardon  Board"  means  the Parole and
 9    Pardon Board of  the  State  of  Illinois  or  its  successor
10    agency.
11        (gg)  "Person"   means   any   individual,   corporation,
12    mail-order  pharmacy,  government or governmental subdivision
13    or agency, business  trust,  estate,  trust,  partnership  or
14    association, or any other entity.
15        (hh)  "Pharmacist"   means   any   person   who  holds  a
16    certificate of registration as  a  registered  pharmacist,  a
17    local   registered   pharmacist  or  a  registered  assistant
18    pharmacist under the Pharmacy Practice Act of 1987.
19        (ii)  "Pharmacy" means any store, ship or other place  in
20    which  pharmacy  is  authorized  to  be  practiced  under the
21    Pharmacy Practice Act of 1987.
22        (jj)  "Poppy straw" means all parts, except the seeds, of
23    the opium poppy, after mowing.
24        (kk)  "Practitioner"  means  a  physician   licensed   to
25    practice  medicine  in all its branches, dentist, podiatrist,
26    veterinarian, scientific investigator,  pharmacist,  advanced
27    practice  registered  nurse,  physician  assistant,  licensed
28    practical  nurse,  registered nurse, hospital, laboratory, or
29    pharmacy, or other person licensed, registered, or  otherwise
30    lawfully  permitted  by  the  United  States or this State to
31    distribute,  dispense,  conduct  research  with  respect  to,
32    administer  or  use  in  teaching  or  chemical  analysis,  a
33    controlled substance in the course of  professional  practice
34    or research.
                            -34-               LRB9008509NTmb
 1        (ll)  "Pre-printed    prescription"   means   a   written
 2    prescription  upon  which  the  designated  drug   has   been
 3    indicated prior to the time of issuance.
 4        (mm)  "Prescriber" means a physician licensed to practice
 5    medicine   in   all  its  branches,  dentist,  podiatrist  or
 6    veterinarian who  issues  a  prescription,   or  a  physician
 7    assistant  who  issues a prescription for a Schedule III, IV,
 8    or  V  controlled  substance  as  delegated  by  a  physician
 9    licensed  to  practice  medicine  in  all  its  branches   in
10    accordance with the written guidelines required under Section
11    7.5  of  the  Physician Assistant Practice Act of 1987, or an
12    advanced practice registered nurse who issues a  prescription
13    for  a  Schedule  II,  III, IV, or V controlled substance, as
14    delegated by a physician licensed to practice medicine in all
15    of its  branches,  in  accordance  with  a  written  practice
16    agreement  under  Section 12.7 of the Illinois Nursing Act of
17    1987.
18        (nn)  "Prescription" means a lawful  written,  facsimile,
19    or  verbal order of a physician licensed to practice medicine
20    in all its branches, dentist, podiatrist or veterinarian  for
21    any  controlled  substance, or of a physician assistant for a
22    Schedule III, IV, or V controlled substance as delegated by a
23    physician licensed to practice medicine in all  its  branches
24    in  accordance  with  the  written  guidelines required under
25    Section 7.5 of the Physician Assistant Practice Act of  1987,
26    or  of  an  advanced practice registered nurse for a Schedule
27    II, III, IV, or V controlled substance,  as  delegated  by  a
28    physician  licensed  to  practice  medicine  in  all  of  its
29    branches,  in  accordance  with  a written practice agreement
30    under Section 12.7 of the Illinois Nursing Act of 1987.
31        (oo)  "Production"  or   "produce"   means   manufacture,
32    planting, cultivating, growing, or harvesting of a controlled
33    substance.
34        (pp)  "Registrant"  means every person who is required to
                            -35-               LRB9008509NTmb
 1    register under Section 302 of this Act.
 2        (qq)  "Registry number" means the number assigned to each
 3    person authorized to handle controlled substances  under  the
 4    laws of the United States and of this State.
 5        (rr)  "State"  includes  the  State  of  Illinois and any
 6    state, district, commonwealth, territory, insular  possession
 7    thereof,  and  any area subject to the legal authority of the
 8    United States of America.
 9        (ss)  "Ultimate  user"  means  a  person   who   lawfully
10    possesses  a  controlled substance for his own use or for the
11    use of a member of his household or for administering  to  an
12    animal owned by him or by a member of his household.
13    (Source:  P.A.  89-202,  eff.  10-1-95;  89-507, eff. 7-1-97;
14    90-116, eff. 7-14-97.)
15        Section  20.  The  Good  Samaritan  Act  is  amended   by
16    changing Sections 25, 30, and 35 as follows:
17        (745 ILCS 49/25)
18        Sec.  25.  Physicians; exemption from civil liability for
19    emergency care.    Any  person  licensed  under  the  Medical
20    Practice  Act  of 1987 or any person licensed to practice the
21    treatment of human ailments in any other state  or  territory
22    of  the  United  States, except a person licensed to practice
23    midwifery, who, in good faith and without prior notice of the
24    illness or injury, provides emergency care without fee  to  a
25    person,  shall  not,  as a result of their acts or omissions,
26    except willful or  wanton  misconduct  on  the  part  of  the
27    person, in providing the care, be liable for civil damages.
28    (Source: P.A. 89-607, eff. 1-1-97.)
29        (745 ILCS 49/30)
30        Sec.  30.   Free  medical  clinic;  exemption  from civil
31    liability for services performed without compensation.
                            -36-               LRB9008509NTmb
 1        (a)  A person licensed under the Medical Practice Act  of
 2    1987  or licensed to practice the treatment of human ailments
 3    in any other state or territory of the United States,  except
 4    a  person licensed to practice midwifery, who, in good faith,
 5    provides medical treatment, diagnosis, or advice as a part of
 6    the services of an established free medical clinic  providing
 7    care  to medically indigent patients which is limited to care
 8    that does not require the services of a licensed hospital  or
 9    ambulatory  surgical treatment center and who receives no fee
10    or compensation from that source  shall  not  be  liable  for
11    civil  damages as a result of his or her acts or omissions in
12    providing that  medical  treatment,  except  for  willful  or
13    wanton misconduct.
14        (b)  For  purposes  of  this  Section,  a  "free  medical
15    clinic"  is  an  organized  community based program providing
16    medical care without charge to individuals unable to pay  for
17    it,  at  which  the care provided does not include the use of
18    general  anesthesia  or  require  an  overnight  stay  in   a
19    health-care facility.
20        (c)  The  provisions of subsection (a) of this Section do
21    not apply to a particular case unless the free medical clinic
22    has  posted  in  a  conspicuous  place  on  its  premises  an
23    explanation of the exemption from  civil  liability  provided
24    herein.
25        (d)  The  immunity  from  civil  damages  provided  under
26    subsection  (a)  also  applies  to physicians, hospitals, and
27    other health care  providers  that  provide  further  medical
28    treatment,  diagnosis,  or  advice to a patient upon referral
29    from an  established  free  medical  clinic  without  fee  or
30    compensation.
31        (e)  Nothing  in  this  Section  prohibits a free medical
32    clinic from accepting  voluntary  contributions  for  medical
33    services  provided  to  a patient who has acknowledged his or
34    her ability and willingness to pay a portion of the value  of
                            -37-               LRB9008509NTmb
 1    the medical services provided.
 2        Any  voluntary  contribution collected for providing care
 3    at a free medical clinic shall be used only to  pay  overhead
 4    expenses  of  operating the clinic.  No portion of any moneys
 5    collected  shall  be  used  to  provide  a   fee   or   other
 6    compensation  to  any  person licensed under Medical Practice
 7    Act of 1987.
 8    (Source: P.A. 89-607, eff. 1-1-97.)
 9        (745 ILCS 49/35)
10        Sec. 35.  Nurses;  exemption  from  civil  liability  for
11    emergency  care.     Any  person  licensed under the Illinois
12    Nursing Act of 1987 or any person licensed as a  professional
13    nurse,  as  an  advanced  practice  registered nurse, or as a
14    practical nurse in any other state or territory of the United
15    States who in good faith and  without  prior  notice  of  the
16    illness  or  injury  provides emergency care without fee to a
17    person shall  not,  as  a  result  of  her  or  his  acts  or
18    omissions,  except  for  willful  or wanton misconduct on the
19    part of the person, in providing  the  care,  be  liable  for
20    civil damages.
21    (Source: P.A. 89-607, eff. 1-1-97.)
22        Section  99.  Effective  date.   This  Act  takes  effect
23    January 1, 1999.

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