IllinoisHB2688104th General Assembly (2025–2026)HouseWALLET

NURSE PRACTICE ACT MIDWIVES

Sponsored By: Yolonda Morris (Democratic)

Became Law

health care licensesassignmentslicensed activities

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Bill Overview

Analyzed Economic Effects

5 provisions identified: 1 benefits, 1 costs, 3 mixed.

Liability protections for collaborating doctors

Doctors are not automatically liable for an APRN’s acts just because they signed a collaborative agreement or issued standing orders. For CNM home births, signing a collaborative agreement does not make the doctor liable for the CNM’s acts. These shields do not apply if the doctor knew the APRN lacked skill or if there was willful and wanton misconduct.

More independent practice for APRNs

Qualified APRNs can practice without a written collaborative agreement and can prescribe Schedule II–V drugs once they gain Full Practice Authority. A pending path lets an APRN qualify with 250 hours of training, 4,000 post‑certification clinical hours, and an application to the Department. Until then, APRNs who practice clinically must keep a written collaborative agreement unless they hold hospital or similar privileges. If you are not an employee, a collaborative agreement cannot limit your patient types, payor contracts, or practice location in Illinois. Some of these APRN practice rules expire January 1, 2028.

More midwife options outside hospitals

Certified nurse midwives can provide births in licensed birth centers without a written collaborative agreement if the center’s clinical director grants privileges. Outside birth centers, CNMs may offer out‑of‑hospital or home births under a written collaborative agreement with an APRN who has full practice authority, but only in a primary care HPSA scored 12 or higher or in a maternity care desert. A maternity care desert (through January 1, 2028) is a county with no hospital, no birth center, and no licensed provider offering obstetric care. CNMs still cannot do services the law reserves for physicians. The Department can set forms and fees to run these CNM services.

New rules for nurse anesthesia outside hospitals

CRNAs who give anesthesia outside hospitals or ambulatory surgery centers must have a written collaborative agreement with an anesthesiologist, physician, or the podiatric physician doing the procedure. In dental offices, a CRNA also needs a written agreement and may only do services the operating dentist’s permit allows. A physician, dentist, or podiatrist must help set the anesthesia plan and stay on the premises during anesthesia to handle emergencies. Under the plan, the CRNA can select, order, and give medications, including controlled substances. These anesthesia rules expire January 1, 2028.

APRN must share collaboration agreements

APRNs must tell each collaborating physician, dentist, or podiatrist about all their collaborative agreements. APRNs must provide copies on request.

Sponsors & Cosponsors

Sponsor

Yolonda Morris
Democratic • House

Cosponsors

Adam M. Niemerg
Republican • House
Adriane Johnson
Democratic • Senate
Amy Briel
Democratic • House
Anna Moeller
Democratic • House
Brad Halbrook
Republican • House
Camille Y. Lilly
Democratic • House
Celina Villanueva
Democratic • Senate
Chris Miller
Republican • House
Dagmara Avelar
Democratic • House
Debbie Meyers-Martin
Democratic • House
Emil Jones, III
Democratic • Senate
Graciela Guzmán
Democratic • Senate
Hoan Huynh
Democratic • House
Javier L. Cervantes
Democratic • Senate
Jehan Gordon-Booth
Democratic • House
Joyce Mason
Democratic • House
Karina Villa
Democratic • Senate
Kelly M. Cassidy
Democratic • House
Kimberly Du Buclet
Democratic • House
Lakesia Collins
Democratic • Senate
Laura Faver Dias
Democratic • House
Lilian Jiménez
Democratic • House
Lisa Davis
Democratic • House
Mark L. Walker
Democratic • Senate
Mary Edly-Allen
Democratic • Senate
Maura Hirschauer
Democratic • House
Michael W. Halpin
Democratic • Senate
Mike Porfirio
Democratic • Senate
Mike Simmons
Democratic • Senate
Natalie A. Manley
Democratic • House
Nicolle Grasse
Democratic • House
Rachel Ventura
Democratic • Senate
Robert F. Martwick
Democratic • Senate
Robert Peters
Democratic • Senate
Sara Feigenholtz
Democratic • Senate
Sharon Chung
Democratic • House
Sonya M. Harper
Democratic • House
Suzanne M. Ness
Democratic • House
Tracy Katz Muhl
Democratic • House

Roll Call Votes

All Roll Calls

Yes: 206 • No: 1

Senate vote • 5/22/2025

Third Reading - Passed;

Yes: 57 • No: 1

Senate vote • 5/1/2025

Do Pass Licensed Activities;

Yes: 7 • No: 0

House vote • 4/9/2025

Third Reading - Short Debate - Passed

Yes: 114 • No: 0

House vote • 3/26/2025

House Floor Amendment No. 2 Recommends Be Adopted Health Care Licenses Committee;

Yes: 14 • No: 0

House vote • 3/19/2025

Do Pass / Short Debate Health Care Licenses Committee;