The Legislative Journey to Independent Practice for APRN Continues...

In most other states, Advance Practice Registered Nurses (APRNs) already have full practice authority to diagnose, treat, and prescribe. Currently, there are 24 states and the District of Columbia that don't require any physician involvement for APRNs to diagnose, treat or prescribe. In addition to those, eight states allow APRNs to diagnose and treat independently but require physician involvement to prescribe.

There was strong support this year, within the Illinois legislature to grant APRNs with full independent practice. Instead of voting against physicians, legislators asked that the Illinois State Medical Society (ISMS) draft an alternative. The Illinois Society for Advanced Practice Nursing bill as introduced would have granted full independent practice and full prescriptive authority, after completing additional clinical training under the supervision of either another APRN or physician.

After numerous negotiating sessions and intense advocacy from physicians, an agreement was reached in 2017.  This agreement was passed by the Legislature, signed into law by Governor Rauner, and took effect on January 1, 2018. 

Below is a summary of the language that was eventually accepted by the APRNs:


ISA has worked closely with ISMS on scope of practice issues and greatly appreciates that anesthesia services have been uniquely identified in the medical practice acts. While ISA has traditionally been opposed to the independent practice of non-physician providers, we've conceded that mainstream support exists for APRNs in Illinois. ISA will vigilantly advocate that anesthesia services are not the same as primary health care. We believe that the Anesthesia Care Team model provides excellent access to quality care for our patients.

Despite this expansion of privileges, the push for further independence continues. The ISA and ISMS are keeping a sharp eye focused on the APRN Compact legislation that is making ts way across the country. The APRN Compact legislates that once ten states "sign on", all states that belong to this Compact will honor an APRN's state licensure and rights of that licensure, regardless of the other states' rules and regulations. In other words, the nursing practice rules of a conservative state's license would not apply to an APRN with a very liberal license. This Compact attempts to supersede state nursing licensing requirements and regulations and is a pathway for national APRN independence.Unlike other medical and nursing compacts, this legislation does NOT respect state law.

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