1. Physician assistants and Advanced practice Nurses who are they?
Susan y swart ms, rn, cae
Executive director
Ana-Illinois
Illinois society for advanced practice nursing

2. Contents Overview Illinois Regulation Licensure Requirements Education
Certification
Written Agreements
Prescriptive Authority
Hospitals, Hospital Affiliates & ASTCs
Scope of Practice
Differences & Similarities

3. Physician Assistants Key facts about PAs
A physician assistant is a healthcare professional who practices medicine as a part of a healthcare team with supervising physicians and other providers. In the United States, PAs are nationally certified and state licensed to practice medicine. PAs are trained using the medical model and complete these qualifications in less time than a traditional medical degree.
Under the State Medical Licensing Board & State Medical Disciplinary Board
PA Advisory Committee to IDPR and Medical Licensing Board
# of Licensed PAs – 2950
QuickStarter has created an outline to help you get started on your presentation. Some slides include information here in the notes to provide additional topics for you to research.
More key facts:
Similar profession: Surgeon, Registered nurse, Occupational therapist, Advanced practice registered nurse, Physician, Speech-language pathologists, Physiotherapist

4. Advanced Practice Nurses
Key facts about APNs
An advanced practice registered nurse is a nurse with post-graduate education in nursing. APRNs are prepared with advanced didactic and clinical education, knowledge, skills, and scope of practice in nursing. Nationally certified and state licensed to practice advanced practice nursing. Certified in one of four specialties:
Clinical Nurses Specialist – 1,016 licensees
Nurse Practitioner – 8,777 licensees
Nurse Midwife – 489 licensees
Nurse Anesthetist – 1945 licensees
Under the Board of Nursing
QuickStarter has created an outline to help you get started on your presentation. Some slides include information here in the notes to provide additional topics for you to research.
More key facts:
Similar profession: Physician, Surgeon, Occupational therapist, Physician assistant, Registered nurse, Speech-language pathologists, Physiotherapist, Audiologists

5. ILLINOIS REGULATION Advance Practice Nurses Physician Assistants
225 ILCS 65/ Nurse Practice Act
Article 65 – Advanced Practice Nurses
TITLE 68: Professions & Occupations CHAPTER VII: IDFPR SUBCHAPTER b: Professions & Occupations PART 1300: Nurse Practice Act
SUBPART A: GENERAL PROVISIONS
Section Definitions
SUBPART D: ADVANCED PRACTICE NURSE
Section Prescriptive Authority
Section APN Scope of Practice
225 ILCS 95/ Physician Assistant Practice Act of 1987
TITLE 68: Professions & Occupations CHAPTER VII: IDFPR SUBCHAPTER b: Professions & Occupations PART 1350: Physician Assistant Practice Act of 1987
SUBPART A: GENERAL PROVISIONS
Section Definitions
SUBPART D: ADVANCED PRACTICE NURSE
Section Section
Consider talking about:
Grandfather exception

6. Illinois Regulation others
225 ILCS 60 - Medical Practice Act
TITLE 68: Professions and Occupations CHAPTER VII: Department of Financial & Professional Regulation SUBCHAPTER v: Professions and Occupations PART 1285: Medical Practice Act of 1987
720 ILCS Illinois Controlled Substance Act
TITLE 77: Public Health CHAPTER XV: Department of Financial & Professional Regulation PART 3100: Illinois Controlled Substance Act
210 ILCS 85 - Illinois Hospital Licensing Act
TITLE 77: Public Health CHAPTER I: DPH SUBCHAPTER b: Hospitals & Ambulatory Care Facilities PART 250: Hospital Licensing Requirements
Illinois Regulation others

7. Illinois Regulation others
110 ILCS 330 – University of Illinois Hospital Licensing Act
TITLE 77: Public Health CHAPTER I: Department of Public Health SUBCHAPTER b: Hospitals & Ambulatory Care Facilities PART 250: Hospital Licensing Requirements
210 ILCS 5 – Ambulatory Surgical Treatment Center Act
TITLE 77: Public Health CHAPTER I: Department of Public Health SUBCHAPTER b: Hospitals & Ambulatory Care Facilities
PART 205: Ambulatory Surgical Treatment Center Licensing Requirements
Illinois Regulation others

8. Licensure requirements
Physician Assistants
Advanced Practice Nurses
Passed National Certification exam
National Commission on the Certification of Physician Assistants
Renewal every 2 years (March of even years)
Maintenance of certification not required for renewal of license
RN license
Graduate degree or post-master’s certificate
CRNA – prior 1999, certified – current and continuous
National certification
Renewal every 2 years (May of even years)
50 hrs of CE
Proof of National Certification
Exception - Licensed since 2001 – not eligible for national certification

9. EDUCATION Advanced Practice Nurses Physician Assistants
Graduate Degree appropriate for national certification in a clinical APN specialty
Graduate Degree or post-master’s certification from a graduate level program in a clinical APN specialty
Exception for CRNA completing a program prior to 1999
Based on the accredited program

10. CERTIFICATION Physician Assistants Advanced Practice Nurses
100 hrs of CME every two years
50 Category I
50 Category II or combination of both
Pass recertification exam every 10 years (2014)
Graduate of an accredited program in the clinical specialty
Recertification
Every 4 -5 years
Continuing Education (# of hours varies by specialty)
75 – 100 hrs
Or reexamination

11. Written agreements (NOT REQUIRED IN HOSPITALS, HOSPITAL AFFILIATES, or AMBULATORY SURGICAL TREATMENT FACILITIES)
Physician Assistants Written Supervisory Agreement (WSA)
Advanced Practice Nurses Written Collaborative Agreement (WCA)
Services the supervising physician (SP) is authorized to and generally provides
Must specify which procedures require the presence of the SP
Physical presence of SP not required
Joint formulation/approval of orders or guidelines
Supervision/consultation at least once a month
Copy of WSA available upon request
Notify all SP of other WSAs
Describe the relationship between the APN & collaborating physician (CP) – employment relationship not required
Categories of care, treatments or procedures
Personal presence of CP not required
exception for CRNA
Consultation includes in person, telecommunications or electronic
Cannot restrict the categories of patients, limit third party payors, government plans or geographic area or practice location
CRNA – joint anesthesia plan
90 day waiver

12. Prescriptive Authority
Physician Assistants
Advanced Practice Nurses
Delegation of prescriptive authority - filed by SP – initiation and termination
Written Guidelines signed by the PA and SP
Prescribe, select, order, administer, store, accept samples, dispense OTC, legend drugs, medical gases, controlled substances, botanical and herbal remedies
Mid-level provider controlled substance license & DEA #
Name of SP on all prescriptions
Prescriptions reviewed periodically by SP
Schedule II –
Oral, topical, transdermal
Routinely prescribed by the SP
Specific drugs identified
30 day supply, continuation after prior approval of SP
Discuss condition of patients who receive monthly prescriptions
Meet the educational requirements of Section of the IL Controlled Substance Act
Delegation of prescriptive authority - filed by CP – initiation and termination
Prescribe, select, order, administer, store, accept samples, dispense OTC, legend drugs, medical gases, controlled substances, botanical and herbal remedies
Mid-level provider controlled substance license & DEA #
Name of CP on all prescriptions
Prescriptions reviewed periodically by CP
Schedule II –
Oral, topical, transdermal
Routinely prescribed by the CP
Specific drugs identified
30 day supply, continuation after prior approval of CP
Discuss condition of patients who receive monthly prescriptions
Meet the educational requirements of Section of the IL Controlled Substance Act

13. Hospitals, Hospital Affiliates, or ambulatory surgical treatment centers
Physician Assistants
Advanced Practice Nurses
Clinical Privileges
Medical staff or consulting medical staff committee – periodically review the services
select, order, and administer medications, including controlled substances, to provide delineated care
Discharge medication in name of PA and attending/discharging physician
Mid-level provider controlled substance license not needed
Clinical Privileges
Medical staff or consulting medical staff committee – periodically review the services
select, order, and administer medications, including controlled substances, to provide delineated care
Discharge medication in name of APN and attending/discharging physician
Mid-level provider controlled substance license not needed in hospital or ASTC
Hospital Affiliates - NP, CNS, CNMs only
May prescribe with mid-level controlled substance license & DEA #
Same restrictions as with prescribing authority in other settings
Hospital files delegated prescriptive authority form with IDFPR

14. SCOPE Physician Assistants Advanced Practice Nurses
Medical/surgical services delegated by SP
Within the PA’s skills
Within current scope of practice of SP
Must specify which procedures require the presence of the SP
Physical presence of SP not required
Provided under the supervision & direction of the SP
Joint formulation/approval of orders or guidelines
Supervision/consultation at least once a month
Copy of WSA available upon request
Notify all SP of other WSAs
Advanced assessment & diagnosis
Ordering diagnostic and therapeutic tests and procedures
Ordering treatments and medical devices
Providing palliative and end-of-life care
Counseling, education and advocacy
Delegated prescriptive authority
Delegation to other health care personnel

15. Difference & similarities
APNs – can bill in their name
PAs- employer must bill for the services provided
APNs – collaborating physician
PAs – supervising physician
Ratio for PAs – 5 max

16. Everything changes…. Sunsets Physician Assistants
SB 1585
Remove supervisory requirement, change to collaborative agreement
Remove ratio restrictions
Advanced Practice Nurses
SB 642
Remove collaborative agreement requirement after 4000 hrs of practice

17. Sources of information
Illinois Health & Hospital Association
Illinois Society for Advanced Practice Nursing
Illinois Academy of Physician Assistants
Illinois Department of Professional Regulation