Bill Amendment: IL HB5047 | 2023-2024 | 103rd General Assembly

NOTE: For additional amemendments please see the Bill Drafting List

---

Bill Title: DFPR-AUTOMATIC NURSE LICENSURE

Status: 2024-07-19 - Public Act . . . . . . . . . 103-0686 [HB5047 Detail]

Download: Illinois-2023-HB5047-House_Amendment_001.html

---

Rep. Terra Costa Howard

Filed: 3/27/2024

10300HB5047ham001 LRB103 37251 RTM 71424 a
AMENDMENT TO HOUSE BILL 5047
AMENDMENT NO. ______. Amend House Bill 5047 by replacing
everything after the enacting clause with the following:
"Section 5. The Nurse Practice Act is amended by changing
Sections 50-10, 55-10, 60-10, and 65-10 as follows:
(225 ILCS 65/50-10) (was 225 ILCS 65/5-10)
(Section scheduled to be repealed on January 1, 2028)
Sec. 50-10. Definitions. Each of the following terms, when
used in this Act, shall have the meaning ascribed to it in this
Section, except where the context clearly indicates otherwise:
"Academic year" means the customary annual schedule of
courses at a college, university, or approved school,
customarily regarded as the school year as distinguished from
the calendar year.
"Address of record" means the designated address recorded
by the Department in the applicant's or licensee's application

10300HB5047ham001 - 2 - LRB103 37251 RTM 71424 a
file or license file as maintained by the Department's
licensure maintenance unit.
"Advanced practice registered nurse" or "APRN" means a
person who has met the qualifications for a (i) certified
nurse midwife (CNM); (ii) certified nurse practitioner (CNP);
(iii) certified registered nurse anesthetist (CRNA); or (iv)
clinical nurse specialist (CNS) and has been licensed by the
Department. All advanced practice registered nurses licensed
and practicing in the State of Illinois shall use the title
APRN and may use specialty credentials CNM, CNP, CRNA, or CNS
after their name. All advanced practice registered nurses may
only practice in accordance with national certification and
this Act.
"Advisory Board" means the Illinois Nursing Workforce
Center Advisory Board.
"Approved program of professional nursing education" and
"approved program of practical nursing education" are programs
of professional or practical nursing, respectively, approved
by the Department under the provisions of this Act.
"Board" means the Board of Nursing appointed by the
Secretary.
"Center" means the Illinois Nursing Workforce Center.
"Collaboration" means a process involving 2 or more health
care professionals working together, each contributing one's
respective area of expertise to provide more comprehensive
patient care.

10300HB5047ham001 - 3 - LRB103 37251 RTM 71424 a
"Competence" means an expected and measurable level of
performance that integrates knowledge, skills, abilities, and
judgment based on established scientific knowledge and
expectations for nursing practice.
"Comprehensive nursing assessment" means the gathering of
information about the patient's physiological, psychological,
sociological, and spiritual status on an ongoing basis by a
registered professional nurse and is the first step in
implementing and guiding the nursing plan of care.
"Consultation" means the process whereby an advanced
practice registered nurse seeks the advice or opinion of
another health care professional.
"Credentialed" means the process of assessing and
validating the qualifications of a health care professional.
"Dentist" means a person licensed to practice dentistry
under the Illinois Dental Practice Act.
"Department" means the Department of Financial and
Professional Regulation.
"Direct supervision" means the supervising licensed
medical professional is physically present in the facility or
practice setting and is readily available to the
license-pending nurse.
"Email address of record" means the designated email
address recorded by the Department in the applicant's
application file or the licensee's license file, as maintained
by the Department's licensure maintenance unit.

10300HB5047ham001 - 4 - LRB103 37251 RTM 71424 a
"Focused nursing assessment" means an appraisal of an
individual's status and current situation, contributing to the
comprehensive nursing assessment performed by the registered
professional nurse or advanced practice registered nurse or
the assessment by the physician assistant, physician, dentist,
podiatric physician, or other licensed health care
professional, as determined by the Department, supporting
ongoing data collection, and deciding who needs to be informed
of the information and when to inform.
"Full practice authority" means the authority of an
advanced practice registered nurse licensed in Illinois and
certified as a nurse practitioner, clinical nurse specialist,
or nurse midwife to practice without a written collaborative
agreement and:
(1) to be fully accountable to patients for the
quality of advanced nursing care rendered;
(2) to be fully accountable for recognizing limits of
knowledge and experience and for planning for the
management of situations beyond the advanced practice
registered nurse's expertise; the full practice authority
for advanced practice registered nurses includes accepting
referrals from, consulting with, collaborating with, or
referring to other health care professionals as warranted
by the needs of the patient; and
(3) to possess the authority to prescribe medications,
including Schedule II through V controlled substances, as

10300HB5047ham001 - 5 - LRB103 37251 RTM 71424 a
provided in Section 65-43.
"Hospital affiliate" means a corporation, partnership,
joint venture, limited liability company, or similar
organization, other than a hospital, that is devoted primarily
to the provision, management, or support of health care
services and that directly or indirectly controls, is
controlled by, or is under common control of the hospital. For
the purposes of this definition, "control" means having at
least an equal or a majority ownership or membership interest.
A hospital affiliate shall be 100% owned or controlled by any
combination of hospitals, their parent corporations, or
physicians licensed to practice medicine in all its branches
in Illinois. "Hospital affiliate" does not include a health
maintenance organization regulated under the Health
Maintenance Organization Act.
"Impaired nurse" means a nurse licensed under this Act who
is unable to practice with reasonable skill and safety because
of a physical or mental disability as evidenced by a written
determination or written consent based on clinical evidence,
including loss of motor skills, abuse of drugs or alcohol, or a
psychiatric disorder, of sufficient degree to diminish his or
her ability to deliver competent patient care.
"License-pending advanced practice registered nurse" means
a registered professional nurse who has completed all
requirements for licensure as an advanced practice registered
nurse except the certification examination and has applied to

10300HB5047ham001 - 6 - LRB103 37251 RTM 71424 a
take the next available certification exam and received a
temporary permit from the Department.
"License-pending registered nurse" means a person who has
passed the Department-approved registered nurse licensure exam
and has applied for a license from the Department. A
license-pending registered nurse shall use the title "RN lic
pend" on all documentation related to nursing practice.
"Nursing intervention" means any treatment based on
clinical nursing judgment or knowledge that a nurse performs.
An individual or entity shall not mandate that a registered
professional nurse delegate nursing interventions if the
registered professional nurse determines it is inappropriate
to do so. A nurse shall not be subject to disciplinary or any
other adverse action for refusing to delegate a nursing
intervention based on patient safety.
"Physician" means a person licensed to practice medicine
in all its branches under the Medical Practice Act of 1987.
"Podiatric physician" means a person licensed to practice
podiatry under the Podiatric Medical Practice Act of 1987.
"Practical nurse" or "licensed practical nurse" means a
person who is licensed as a practical nurse under this Act and
practices practical nursing as defined in this Act. Only a
practical nurse licensed under this Act is entitled to use the
title "licensed practical nurse" and the abbreviation
"L.P.N.".
"Practical nursing" means the performance of nursing

10300HB5047ham001 - 7 - LRB103 37251 RTM 71424 a
interventions requiring the nursing knowledge, judgment, and
skill acquired by means of completion of an approved practical
nursing education program. Practical nursing includes
assisting in the nursing process under the guidance of a
registered professional nurse or an advanced practice
registered nurse. The practical nurse may work under the
direction of a licensed physician, dentist, podiatric
physician, or other health care professional determined by the
Department.
"Privileged" means the authorization granted by the
governing body of a healthcare facility, agency, or
organization to provide specific patient care services within
well-defined limits, based on qualifications reviewed in the
credentialing process.
"Registered Nurse" or "Registered Professional Nurse"
means a person who is licensed as a professional nurse under
this Act and practices nursing as defined in this Act. Only a
registered nurse licensed under this Act is entitled to use
the titles "registered nurse" and "registered professional
nurse" and the abbreviation, "R.N.".
"Registered professional nursing practice" means a
scientific process founded on a professional body of knowledge
that includes, but is not limited to, the protection,
promotion, and optimization of health and abilities,
prevention of illness and injury, development and
implementation of the nursing plan of care, facilitation of

10300HB5047ham001 - 8 - LRB103 37251 RTM 71424 a
nursing interventions to alleviate suffering, care
coordination, and advocacy in the care of individuals,
families, groups, communities, and populations. "Registered
professional nursing practice" does not include the act of
medical diagnosis or prescription of medical therapeutic or
corrective measures.
"Professional assistance program for nurses" means a
professional assistance program that meets criteria
established by the Board of Nursing and approved by the
Secretary, which provides a non-disciplinary treatment
approach for nurses licensed under this Act whose ability to
practice is compromised by alcohol or chemical substance
addiction.
"Secretary" means the Secretary of Financial and
Professional Regulation.
"Unencumbered license" means a license issued in good
standing.
"Written collaborative agreement" means a written
agreement between an advanced practice registered nurse and a
collaborating physician, dentist, or podiatric physician
pursuant to Section 65-35.
(Source: P.A. 103-154, eff. 6-30-23.)
(225 ILCS 65/55-10) (was 225 ILCS 65/10-30)
(Section scheduled to be repealed on January 1, 2028)
Sec. 55-10. LPN licensure by examination.

10300HB5047ham001 - 9 - LRB103 37251 RTM 71424 a
(a) Each applicant who successfully meets the requirements
of this Section is eligible for licensure as a licensed
practical nurse.
(b) An applicant for licensure by examination to practice
as a practical nurse is eligible for licensure when the
following requirements are met:
(1) the applicant has submitted a completed written
application on forms provided by the Department and fees
as established by the Department;
(2) the applicant has graduated from a practical
nursing education program approved by the Department or
has been granted a certificate of completion of
pre-licensure requirements from another United States
jurisdiction;
(3) the applicant has successfully completed a
licensure examination approved by the Department;
(4) (blank);
(5) the applicant has submitted to the criminal
history records check required under Section 50-35 of this
Act;
(6) the applicant has submitted either to the
Department or its designated testing service, a fee
covering the cost of providing the examination. Failure to
appear for the examination on the scheduled date at the
time and place specified after the applicant's application
for examination has been received and acknowledged by the

10300HB5047ham001 - 10 - LRB103 37251 RTM 71424 a
Department or the designated testing service shall result
in the forfeiture of the examination fee; and
(7) the applicant has met all other requirements
established by rule.
(b-5) If an applicant for licensure by examination
neglects, fails, or refuses to take an examination or fails to
pass an examination for a license under this Act within 3 years
of the date of initial application, the application shall be
denied. When an applicant's application is denied due to the
failure to pass the examination within the 3-year period, that
applicant must undertake an additional course of education as
defined by rule prior to submitting a new application for
licensure. Any new application must be accompanied by the
required fee, evidence of meeting the requirements in force at
the time of the new application, and evidence of completion of
the additional course of education prescribed by rule.
An applicant may take and successfully complete a
Department-approved examination in another jurisdiction.
However, an applicant who has never been licensed previously
in any jurisdiction that utilizes a Department-approved
examination and who has taken and failed to pass the
examination within 3 years after filing the application must
submit proof of successful completion of a
Department-authorized nursing education program or
recompletion of an approved licensed practical nursing program
prior to re-application.

10300HB5047ham001 - 11 - LRB103 37251 RTM 71424 a
(c) An applicant for licensure by examination shall have
one year from the date of notification of successful
completion of the examination to apply to the Department for a
license. If an applicant fails to apply within one year, the
applicant shall be required to retake and pass the examination
unless licensed in another jurisdiction of the United States.
(d) A licensed practical nurse applicant who passes the
Department-approved licensure examination and has applied to
the Department for licensure may obtain employment as a
license-pending practical nurse and practice under the direct
supervision of as delegated by a registered professional nurse
or an advanced practice registered nurse or a physician. An
individual may be employed as a license-pending practical
nurse if all of the following criteria are met:
(1) He or she has completed and passed the
Department-approved licensure exam and presents to the
employer the official written notification indicating
successful passage of the licensure examination.
(2) He or she has completed and submitted to the
Department an application for licensure under this Section
as a practical nurse.
(3) He or she has submitted the required licensure
fee.
(4) He or she has met all other requirements
established by rule, including having submitted to a
criminal history records check.

10300HB5047ham001 - 12 - LRB103 37251 RTM 71424 a
(e) The privilege to practice as a license-pending
practical nurse shall terminate with the occurrence of any of
the following:
(1) (Blank). Three months have passed since the
official date of passing the licensure exam as inscribed
on the formal written notification indicating passage of
the exam. This 3-month period may be extended as
determined by rule.
(2) Receipt of the practical nurse license from the
Department.
(3) Notification from the Department that the
application for licensure has been denied.
(4) A request by the Department that the individual
terminate practicing as a license-pending practical nurse
until an official decision is made by the Department to
grant or deny a practical nurse license.
(f) (Blank).
(g) All applicants for practical nurse licensure by
examination who are graduates of nursing educational programs
in a country other than the United States or its territories
shall have their nursing education credentials evaluated by a
Department-approved nursing credentialing evaluation service.
No such applicant may be issued a license under this Act unless
the applicant's program is deemed by the nursing credentialing
evaluation service to be equivalent to a professional nursing
education program approved by the Department. An applicant who

10300HB5047ham001 - 13 - LRB103 37251 RTM 71424 a
has graduated from a nursing educational program outside of
the United States or its territories and whose first language
is not English shall submit evidence of English proficiency,
as defined by rule.
(h) (Blank).
(i) (Blank).
(j) (Blank).
(k) (Blank).
(l) (Blank).
(m) All applicants for practical nurse licensure have 3
years from the date of application to complete the application
process. If the process has not been completed within 3 years
from the date of application, the application shall be denied,
the fee forfeited, and the applicant must reapply and meet the
requirements in effect at the time of reapplication.
(Source: P.A. 100-513, eff. 1-1-18.)
(225 ILCS 65/60-10)
(Section scheduled to be repealed on January 1, 2028)
Sec. 60-10. RN licensure by examination.
(a) Each applicant who successfully meets the requirements
of this Section is eligible for licensure as a registered
professional nurse.
(b) An applicant for licensure by examination to practice
as a registered professional nurse is eligible for licensure
when the following requirements are met:

10300HB5047ham001 - 14 - LRB103 37251 RTM 71424 a
(1) the applicant has submitted a completed written
application, on forms provided by the Department, and
fees, as established by the Department;
(2) the applicant has graduated from a professional
nursing education program approved by the Department or
has been granted a certificate of completion of
pre-licensure requirements from another United States
jurisdiction;
(3) the applicant has successfully completed a
licensure examination approved by the Department;
(4) (blank);
(5) the applicant has submitted to the criminal
history records check required under Section 50-35 of this
Act;
(6) the applicant has submitted, either to the
Department or its designated testing service, a fee
covering the cost of providing the examination; failure to
appear for the examination on the scheduled date at the
time and place specified after the applicant's application
for examination has been received and acknowledged by the
Department or the designated testing service shall result
in the forfeiture of the examination fee; and
(7) the applicant has met all other requirements
established by the Department by rule.
An applicant for licensure by examination may take the
Department-approved examination in another jurisdiction.

10300HB5047ham001 - 15 - LRB103 37251 RTM 71424 a
(b-3) An applicant who graduates from a professional
nursing program in this State on or after the effective date of
this amendatory Act of the 103rd General Assembly and does not
take the licensure examination within 180 days after his or
her degree is conferred by the institution of higher education
or fails the licensure examination for a second time shall be
required to demonstrate proof of completion of a National
Council Licensure Examination preparatory class or a
comparable test preparatory program before taking a subsequent
licensure examination or the graduate may return to the
institution of higher education from which he or she graduated
which shall provide remedial educational resources to the
graduate at no cost to the graduate. Such an applicant must
contact the institution of higher education from which he or
she graduated prior to retesting.
(b-4) All professional nursing programs in probationary
status on the effective date of this amendatory Act of the
103rd General Assembly and subject to a program revision plan
shall be deemed in good standing for a period of 3 years
beginning on the effective date of this amendatory Act of the
103rd General Assembly. Prior to September 1, 2026, no
professional nursing program shall be placed on probationary
status for failing to reach a passage rate of less than 75%.
(b-5) If an applicant for licensure by examination
neglects, fails, or refuses to take an examination or fails to
pass an examination for a license within 3 years of the date of

10300HB5047ham001 - 16 - LRB103 37251 RTM 71424 a
initial application, the application shall be denied. When an
applicant's application is denied due to the failure to pass
the examination within the 3-year period, that applicant must
undertake an additional course of education as defined by rule
prior to submitting a new application for licensure. Any new
application must be accompanied by the required fee, evidence
of meeting the requirements in force at the time of the new
application, and evidence of completion of the additional
course of education prescribed by rule.
(c) An applicant for licensure by examination shall have
one year after the date of notification of the successful
completion of the examination to apply to the Department for a
license. If an applicant fails to apply within one year, the
applicant shall be required to retake and pass the examination
unless licensed in another jurisdiction of the United States.
(d) An applicant for licensure by examination who passes
the Department-approved licensure examination for professional
nursing may obtain employment as a license-pending registered
nurse and practice under the direct supervision direction of a
registered professional nurse or an advanced practice
registered nurse until such time as he or she receives his or
her license to practice or until the license is denied. In no
instance shall any such applicant practice or be employed in
any management capacity. An individual may be employed as a
license-pending registered nurse if all of the following
criteria are met:

10300HB5047ham001 - 17 - LRB103 37251 RTM 71424 a
(1) He or she has completed and passed the
Department-approved licensure exam and presents to the
employer the official written notification indicating
successful passage of the licensure examination.
(2) He or she has completed and submitted to the
Department an application for licensure under this Section
as a registered professional nurse.
(3) He or she has submitted the required licensure
fee.
(4) He or she has met all other requirements
established by rule, including having submitted to a
criminal history records check.
(e) The privilege to practice as a license-pending
registered nurse shall terminate with the occurrence of any of
the following:
(1) (Blank). Three months have passed since the
official date of passing the licensure exam as inscribed
on the formal written notification indicating passage of
the exam. The 3-month license pending period may be
extended if more time is needed by the Department to
process the licensure application.
(2) Receipt of the registered professional nurse
license from the Department.
(3) Notification from the Department that the
application for licensure has been refused.
(4) A request by the Department that the individual

10300HB5047ham001 - 18 - LRB103 37251 RTM 71424 a
terminate practicing as a license-pending registered nurse
until an official decision is made by the Department to
grant or deny a registered professional nurse license.
(f) (Blank).
(g) (Blank).
(h) (Blank).
(i) (Blank).
(j) (Blank).
(k) All applicants for registered professional nurse
licensure have 3 years after the date of application to
complete the application process. If the process has not been
completed within 3 years after the date of application, the
application shall be denied, the fee forfeited, and the
applicant must reapply and meet the requirements in effect at
the time of reapplication.
(l) All applicants for registered nurse licensure by
examination who are graduates of practical nursing educational
programs in a country other than the United States and its
territories shall have their nursing education credentials
evaluated by a Department-approved nursing credentialing
evaluation service. No such applicant may be issued a license
under this Act unless the applicant's program is deemed by the
nursing credentialing evaluation service to be equivalent to a
professional nursing education program approved by the
Department. An applicant who has graduated from a nursing
educational program outside of the United States or its

10300HB5047ham001 - 19 - LRB103 37251 RTM 71424 a
territories and whose first language is not English shall
submit evidence of English proficiency, as defined by rule.
(m) (Blank).
(Source: P.A. 103-533, eff. 1-1-24.)
(225 ILCS 65/65-10) (was 225 ILCS 65/15-13)
(Section scheduled to be repealed on January 1, 2028)
Sec. 65-10. APRN license pending status.
(a) A graduate of an advanced practice registered 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 until a decision is reached by the Department on
whether or not to grant the graduate a permanent license for
not longer than 6 months provided he or she submits all of the
following:
(1) An application for licensure as an advanced
practice registered 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 registered nursing specialty and that allows the
applicant to be eligible for licensure in Illinois in the

10300HB5047ham001 - 20 - LRB103 37251 RTM 71424 a