LICENSURE ISSUES

 

Regulatory Bodies:

Illinois Department of Financial and Professional Regulation

www.ildfpr.com

Applicant Information  - (217)782-8556
Licensee Information - (217)782-0458

 

Springfield Office: 320 West Washington Street Springfield, IL 62786    (217)785-0800 (217)524-6735 TDD

Chicago Office: James R. Thompson Center 100 W. Randolph St Suite 9-300 Chicago, IL 60601    (312)814-4500

 

U.S. Department of Justice, Drug Enforcement Agency, Drug Diversion Control Program

http://www.deadiversion.usdoj.gov/drugreg/index.html

 

Toll-free number in Washington, DC: 1-800-882-9539

 

      Chicago Field Division:

      Klucyzynski Federal Building

      230 S. Dearborn Street, Suite 1200

      Chicago, IL 60604

      Telephone: (312) 353-5839

      Fax: (312) 353-1235

 

 

     

Responsibilities of the Illinois Department of Financial and

Professional Regulation

 

The state agency that regulates nursing and numerous other health professionals in Illinois is the Illinois Department of Financial and Professional Regulation (IDFPR).  IDFPR’s website is: www.ildfpr.com (yes, ".com”, not ".gov”). IDFPR regulates as many as 165 different professions, the majority of which are not related to health care. This system is different from many states where health professions are regulated by freestanding boards (e.g., Board of Nursing, Board of Medicine, etc.) that are staffed by state employees. In Illinois such boards are advisory in nature and board members serve in a voluntary capacity where their only compensation, in general, is reimbursement of travel expenses.  In 1998, the Nursing Act stipulated that there would be two boards: The Board of Nursing, which advises IDFPR on nursing practice of licensed practical nurses (LPNs) and registered nurses (RNs) who are not APNs, and the Advanced Practice Nursing Board, which focuses on APN practice. This dichotomy of nursing boards was short-lived. As a result of Sunset Bill 2007, these two boards were merged into a single board that would advise IDPFR on the regulation of nurses of all levels.  Required seats on the board included members to represent nursing in terms of LPN and RN education, practice, and administration. Representation of the four APN specialties of certified nurse anesthetists, certified nurse midwives, certified nurse practitioners, and clinical nurse specialists were retained from the APN Board. A single public member is now required; however, physician representation is no longer required.

 

As noted before, the Board of Nursing is an advisory in nature. The Nursing Act does stipulate, however, that two employee positions in IDFPR be filled by registered nurses with master’s degrees in nursing: the Nursing Act Coordinator and the assistant(s) to the Nursing Act Coordinator.  There have been prolonged vacancies in these positions over the years, although presently both positions are filled.  Should either position be vacant, inquiries about nursing issues are handled by other IDFPR employees.

 

IDFPR’s website is extremely informative and careful review of the website is often more efficient than making a phone call to IDFPR. In addition to obtaining licensure applications from this site, one can download copies of the Illinois Nursing and Advanced Practice Nursing Act ("Nursing Act”), Controlled Substance Act, as well as the practice acts for all other health professionals regulated by IDFPR (e.g.,  physicians, physician assistants, pharmacists, physical therapists, etc.).  Furthermore, all practices acts have their own rules for administration that are also downloadable--but usually in a separate file.  For one to truly understand the regulations of a profession, it is vital to read both the practice act and its rules.

 

Nursing Act Citations in this Primer

 

While parts of practice acts are written in legal jargon, most of the verbiage can be comprehended by someone who has education at the level of a licensed nurse.  Every nurse in Illinois should possess a copy of the Nursing Act and its accompanying Rules for ready reference (downloadable at www.ildfpr.com) and read these documents at least once.  Fortunately, most of the language specific to APN practice is contained in one section of the Nursing Act, which has the legal name of "225 Illinois Compiled Statutes 65” (225 ILCS 65/). Each section of the Nursing Act is numbered by "articles” and "sections.” Most of the discussion regarding APN practice is found under the heading "Article 65: Advanced Practice Nurses (not to be confused with Statute 65 which is part of the legal name of the entire practice act).  Thus, the sections under Article 65 all have the numbering system of 65/65- (e.g., 65/65-5, 65/65-10, 65/65-15, etc.). To facilitate the reader’s substantiating the information provide below, Nursing Act references have been included using this type of citation convention.  That said, some of the requirements related to APNs are contained in sections of the Nursing Act other than Article 65.

 

The Rules for Administration for the Nursing and Advanced Practice Nursing Act have a slightly different convention. Part 1300 refers to the rules for the Registered Professional Nurse and Licensed Practice Nurse.  Part 1305 refers to the rules for the Advanced Practice Nurse, so those sections have the numbering system of 1305.____ (e.g., 1305.10, 1305.15, 1305.20, etc.).  The Rules for the 2007 Nursing Act have yet to be written; when that happens, it is likely these numbers will change.

 

 

APN Titles in Illinois

(65/50-10. Definitions)

 

In order to practice in Illinois, advanced practice nurses must possess at least two current licenses as a: (a) Registered Professional Nurse (RN), and (b) Licensed Advanced Practice Nurse (APN). (Note: The issue of the Illinois Controlled Substance License will be discussed elsewhere). Registered Nurse and Advanced Practice Nurse are "protected titles” in Illinois and only those who are currently licensed accordingly may use those titles.  Other protected titles include the APN specialties of: Certified Nurse Midwife (CNM), Certified Nurse Practitioner (CNP), Certified Registered Nurse Anesthetist (CRNA), and Clinical Nurse Specialist (CNS).  It should be noted that some APNs may be licensed in more than one specialty.

 

Throughout the first decade of APN licensure, APNs often asked the question, "How should I sign my name?”  Much of the confusion lies in the fact that other states have other designations (e.g., APRN, ARNP) and certifying bodies assign a myriad of other "credentials” (e.g., NP-C, FNP, PNP, GNP, WHNP, ANP, ACNP, etc.).  Furthermore, academic preparation also is identified by a variety of designations (e.g., MS, MSN, ND, PhD, DNP, etc.).  However, since 1998, the only "legal” abbreviations (i.e., those that are recognized and/or required for charting or prescribing) in Illinois have been those of RN, APN, and the APN’s respective specialty of CRNA, CNM, CNP, or CNS. The 2007 Nursing Act is more specific and the title of "APN” now assumes prominence.  Therefore, regardless of specialty, every practicing advanced practice nurse is expected to be identified first and foremost as an APN, while including the specialty title is optional.

 

There are those, including this author, who lament that nursing appears to be drowning in its own alphabet soup. Much effort was expended by many APNs and other nurses over many years to obtain legal recognition.  University of Illinois (a state-funded university) and other institutions had been preparing APNs since the early 1970s. Yet prior to 1998, when one inquired about APN licensure in Illinois, IDFPR staff was known to say "APNs don’t exist in Illinois.” While APNs certainly did exist at that time, APN licensure did not exist, nor was there was any clear reference to APN practice in the Nursing Act. Therefore, my strong suggestion is that only the titles noted in the Nursing Act be used in clinical practice and all other designations be reserved for those situations where they would be recognized (e.g., scholarly presentations or publications). 

 

Regardless of academic preparation or certification, if a person does not possess a current license as an APN, s/he may not use the any of the titles of "Advanced Practice Nurse,” "Certified Nurse Midwife,” "Certified Nurse Practitioner,” "Certified Registered Nurse Anesthetist,” or "Clinical Nurse Specialist”  or any of the abbreviations for those titles.  Moreover, the Nursing Act says that "An Advanced Practice Nurse shall verbally identify himself or herself as an advanced practice nurse, including specialty certification, to each patient” (65/65-50, c). The 1998 Nursing Act had included the admonishment that "No advanced practice nurse shall use the title of doctor or associate his or her name or any other term to indicate to other persons that he or she is qualified to engage in the general practice of medicine.” Similar language has always been part of the physician assistant practice act.  The wording of this stipulation irked many APNs whose education included doctoral preparation, especially since no such restriction existed for other professionals who were not physicians (e.g., psychologists, chiropractors, dentists). Senate Bill 360 replaced the specific restriction regarding using the title "Doctor,” so that the 2007 Nursing Act simply says that: "No advanced practice nurse shall indicate to other persons that he or she is qualified to engage in the practice of medicine” (65/65-50, a).

 

Reinforcing the fact that one is not a physician may require a concerted effort on an APN’s part. Many patients just assume that an APN is a physician, even when the APN has made every effort to identify him/herself appropriately. And some patients insist on referring to their APN provider as "doctor,” even though they know perfectly well that the provider is not a physician. Adherence to the law requires that the APN make a sincere attempt to clarify his/her proper title.