NURSING-DELEGATION

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104TH GENERAL ASSEMBLY
State of Illinois
2025 and 2026
HB5233

Introduced 2/10/2026, by Rep. Debbie Meyers-Martin

SYNOPSIS AS INTRODUCED:

225 ILCS 65/50-10

was 225 ILCS 65/5-10
225 ILCS 65/50-75
225 ILCS 65/60-35

Amends the Nurse Practice Act. Provides that registered professional
nursing practice is a scientific process founded on a professional body of
knowledge. Provides that professional nursing practice is a learned
profession based on the understanding of the human condition across the
life span and environment, includes all nursing specialties, and means the
performance of any nursing act based upon professional knowledge,
judgment, and skills acquired by means of completion of an approved
professional nursing education program. Provides that registered
professional nurses may delegate nursing interventions and tasks (rather
than nursing interventions) to other registered professional nurses and
licensed practical nurses based on a comprehensive nursing assessment.
Provides that registered professional nurses may delegate tasks to
unlicensed personnel based on a comprehensive nursing assessment. Provides
that a registered professional nurse is prohibited from delegating work
requiring nursing knowledge, assessment, judgment, inference, and decision
making (including medication administration), the development of a plan of
care, and the evaluation of a plan of care to unlicensed non-nurse
personnel. Removes provisions concerning delegation of nursing
interventions and administration of medications in community-based or
in-home care settings. Makes other changes. Effective immediately.
LRB104 19833 AAS 33283 b

A BILL FOR

HB5233
LRB104 19833 AAS 33283 b
1

AN ACT concerning regulation.

2

Be it enacted by the People of the State of Illinois,
3
represented in the General Assembly:

4

Section 5.
The Nurse Practice Act is amended by changing
5
Sections 50-10, 50-75, and 60-35 as follows:

6

(225 ILCS 65/50-10)

(was 225 ILCS 65/5-10)
7

(Section scheduled to be repealed on January 1, 2028)
8

Sec. 50-10.
Definitions.
Each of the following terms, when
9
used in this Act, shall have the meaning ascribed to it in this
10
Section, except where the context clearly indicates otherwise:
11

"Academic year" means the customary annual schedule of
12
courses at a college, university, or approved school,
13
customarily regarded as the school year as distinguished from
14
the calendar year.
15

"Address of record" means the designated address recorded
16
by the Department in the applicant's or licensee's application
17
file or license file as maintained by the Department's
18
licensure maintenance unit.
19

"Advanced practice registered nurse" or "APRN" means a
20
person who has met the qualifications for a (i) certified
21
nurse midwife (CNM); (ii) certified nurse practitioner (CNP);
22
(iii) certified registered nurse anesthetist (CRNA); or (iv)
23
clinical nurse specialist (CNS) and has been licensed by the

HB5233
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LRB104 19833 AAS 33283 b
1
Department. All advanced practice registered nurses licensed
2
and practicing in the State of Illinois shall use the title
3
APRN and may use specialty credentials CNM, CNP, CRNA, or CNS
4
after their name. All advanced practice registered nurses may
5
only practice in accordance with national certification and
6
this Act.
7

"Advisory Board" means the Illinois Nursing Workforce
8
Center Advisory Board.
9

"Approved program of professional nursing education" and
10
"approved program of practical nursing education" are programs
11
of professional or practical nursing, respectively, approved
12
by the Department under the provisions of this Act.
13

"Board" means the Board of Nursing appointed by the
14
Secretary.
15

"Center" means the Illinois Nursing Workforce Center.
16

"Collaboration" means a process involving 2 or more health
17
care professionals working together, each contributing one's
18
respective area of expertise to provide more comprehensive
19
patient care.
20

"Competence" means an expected and measurable level of
21
performance that integrates knowledge, skills, abilities, and
22
judgment based on established scientific knowledge and
23
expectations for nursing practice.
24

"Comprehensive nursing assessment" means the gathering of
25
information about the patient's physiological, psychological,
26
sociological, and spiritual status on an ongoing basis by a

HB5233
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LRB104 19833 AAS 33283 b
1
registered professional nurse and is the first step in
2
implementing and guiding the nursing plan of care.
3

"Consultation" means the process whereby an advanced
4
practice registered nurse seeks the advice or opinion of
5
another health care professional.
6

"Credentialed" means the process of assessing and
7
validating the qualifications of a health care professional.
8

"Dentist" means a person licensed to practice dentistry
9
under the Illinois Dental Practice Act.
10

"Department" means the Department of Financial and
11
Professional Regulation.
12

"Email address of record" means the designated email
13
address recorded by the Department in the applicant's
14
application file or the licensee's license file, as maintained
15
by the Department's licensure maintenance unit.
16

"Focused nursing assessment" means an appraisal of an
17
individual's status and current situation, contributing to the
18
comprehensive nursing assessment performed by the registered
19
professional nurse or advanced practice registered nurse or
20
the assessment by the physician assistant, physician, dentist,
21
podiatric physician, or other licensed health care
22
professional, as determined by the Department, supporting
23
ongoing data collection, and deciding who needs to be informed
24
of the information and when to inform.
25

"Full practice authority" means the authority of an
26
advanced practice registered nurse licensed in Illinois and

HB5233
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LRB104 19833 AAS 33283 b
1
certified as a nurse practitioner, clinical nurse specialist,
2
or nurse midwife to practice without a written collaborative
3
agreement and:
4

(1) to be fully accountable to patients for the
5

quality of advanced nursing care rendered;
6

(2) to be fully accountable for recognizing limits of
7

knowledge and experience and for planning for the
8

management of situations beyond the advanced practice
9

registered nurse's expertise; the full practice authority
10

for advanced practice registered nurses includes accepting
11

referrals from, consulting with, collaborating with, or
12

referring to other health care professionals as warranted
13

by the needs of the patient; and
14

(3) to possess the authority to prescribe medications,
15

including Schedule II through V controlled substances, as
16

provided in Section 65-43.
17

"Full practice authority-pending advanced practice
18
registered nurse" means an advanced practice registered nurse
19
licensed in Illinois and certified as a nurse practitioner,
20
clinical nurse specialist, or nurse midwife who has provided a
21
notarized attestation of completion of at least 250 hours of
22
continuing education or training in the advanced practice
23
registered nurse's area of certification and at least 4,000
24
hours of clinical experience after first attaining national
25
certification and who has submitted an application to the
26
Department to be granted full practice authority.

HB5233
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LRB104 19833 AAS 33283 b
1

"Hospital affiliate" means a corporation, partnership,
2
joint venture, limited liability company, or similar
3
organization, other than a hospital, that is devoted primarily
4
to the provision, management, or support of health care
5
services and that directly or indirectly controls, is
6
controlled by, or is under common control of the hospital. For
7
the purposes of this definition, "control" means having at
8
least an equal or a majority ownership or membership interest.
9
A hospital affiliate shall be 100% owned or controlled by any
10
combination of hospitals, their parent corporations, or
11
physicians licensed to practice medicine in all its branches
12
in Illinois. "Hospital affiliate" does not include a health
13
maintenance organization regulated under the Health
14
Maintenance Organization Act.
15

"Impaired nurse" means a nurse licensed under this Act who
16
is unable to practice with reasonable skill and safety because
17
of a physical or mental disability as evidenced by a written
18
determination or written consent based on clinical evidence,
19
including loss of motor skills, abuse of drugs or alcohol, or a
20
psychiatric disorder, of sufficient degree to diminish his or
21
her ability to deliver competent patient care.
22

"License-pending advanced practice registered nurse" means
23
a registered professional nurse who has completed all
24
requirements for licensure as an advanced practice registered
25
nurse except the certification examination and has applied to
26
take the next available certification exam and received a

HB5233
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LRB104 19833 AAS 33283 b
1
temporary permit from the Department.
2

"License-pending registered nurse" means a person who has
3
passed the Department-approved registered nurse licensure exam
4
and has applied for a license from the Department. A
5
license-pending registered nurse shall use the title "RN lic
6
pend" on all documentation related to nursing practice.
7

"Maternity care desert" means a county without any
8
hospital, any birth center, or any licensed health care
9
professional offering obstetric care.
10

"Nursing intervention" means any treatment based on
11
clinical nursing judgment or knowledge that a nurse performs.
12
An individual or entity shall not mandate that a registered
13
professional nurse delegate nursing interventions if the
14
registered professional nurse determines it is inappropriate
15
to do so. A nurse shall not be subject to disciplinary or any
16
other adverse action for refusing to delegate a nursing
17
intervention based on patient safety.
18

"Physician" means a person licensed to practice medicine
19
in all its branches under the Medical Practice Act of 1987.
20

"Podiatric physician" means a person licensed to practice
21
podiatry under the Podiatric Medical Practice Act of 1987.
22

"Practical nurse" or "licensed practical nurse" means a
23
person who is licensed as a practical nurse under this Act and
24
practices practical nursing as defined in this Act. Only a
25
practical nurse licensed under this Act is entitled to use the
26
title "licensed practical nurse" and the abbreviation

HB5233
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LRB104 19833 AAS 33283 b
1
"L.P.N.".
2

"Practical nursing" means the performance of nursing
3
interventions requiring the nursing knowledge, judgment, and
4
skill acquired by means of completion of an approved practical
5
nursing education program. Practical nursing includes
6
assisting in the nursing process under the guidance of a
7
registered professional nurse or an advanced practice
8
registered nurse. The practical nurse may work under the
9
direction of a licensed physician, dentist, podiatric
10
physician, or other health care professional determined by the
11
Department.
12

"Privileged" means the authorization granted by the
13
governing body of a healthcare facility, agency, or
14
organization to provide specific patient care services within
15
well-defined limits, based on qualifications reviewed in the
16
credentialing process.
17

"Registered Nurse" or "Registered Professional Nurse"
18
means a person who is licensed as a professional nurse under
19
this Act and practices nursing as defined in this Act. Only a
20
registered nurse licensed under this Act is entitled to use
21
the titles "registered nurse" and "registered professional
22
nurse" and the abbreviation, "R.N.".
23

"Registered professional nursing practice" means a
24
scientific process founded on a professional body of knowledge
25
that includes, but is not limited to, the protection,
26
promotion, and optimization of health and abilities,

HB5233
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LRB104 19833 AAS 33283 b
1
prevention of illness and injury, development and
2
implementation of the nursing plan of care, facilitation of
3
nursing interventions to alleviate suffering, care
4
coordination, and advocacy in the care of individuals,
5
families, groups, communities, and populations. "Registered
6
professional nursing practice" does not include the act of
7
medical diagnosis or prescription of medical therapeutic or
8
corrective measures.
Registered professional nursing practice
9
is a scientific process founded on a professional body of
10
knowledge. It is a learned profession based on the
11
understanding of the human condition across the life span and
12
environment, includes all nursing specialties, and means the
13
performance of any nursing act based upon professional
14
knowledge, judgment, and skills acquired by means of
15
completion of an approved professional nursing education
16
program. A registered professional nurse provides holistic
17
nursing care through the nursing process to individuals,
18
groups, families, or communities, that includes, but is not
19
limited to: (i) the assessment of healthcare needs, nursing
20
diagnosis, planning, implementation, and nursing evaluation;
21
(ii) the promotion, maintenance, and restoration of health;
22
(iii) counseling, patient education, health education, and
23
patient advocacy; (iv) the administration of medications and
24
treatments as prescribed by a physician licensed to practice
25
medicine in all of its branches, a licensed dentist, a
26
licensed podiatric physician, or a licensed optometrist or as

HB5233
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LRB104 19833 AAS 33283 b
1
prescribed by a physician assistant or by an advanced practice
2
registered nurse; (v) the coordination and management of the
3
nursing plan of care; (vi) the delegation to and supervision
4
of individuals who assist the registered professional nurse
5
implementing the plan of care; and (vii) teaching nursing
6
students.

7

"Professional assistance program for nurses" means a
8
professional assistance program that meets criteria
9
established by the Board of Nursing and approved by the
10
Secretary, which provides a non-disciplinary treatment
11
approach for nurses licensed under this Act whose ability to
12
practice is compromised by alcohol or chemical substance
13
addiction.
14

"Secretary" means the Secretary of Financial and
15
Professional Regulation.
16

"Unencumbered license" means a license issued in good
17
standing.
18

"Written collaborative agreement" means a written
19
agreement between an advanced practice registered nurse and a
20
collaborating physician, dentist, or podiatric physician
21
pursuant to Section 65-35.
22
(Source: P.A. 103-154, eff. 6-30-23; 103-686, eff. 1-1-25;
23
104-244, eff. 1-1-26
.)

24

(225 ILCS 65/50-75)
25

(Section scheduled to be repealed on January 1, 2028)

HB5233
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LRB104 19833 AAS 33283 b
1

Sec. 50-75.
Nursing delegation by a registered
2
professional nurse.
3

(a) For the purposes of this Section:
4

"Delegation" means transferring to a specific individual
5
the authority to perform a specific nursing intervention
or
6
task
in a specific situation.
7

"Predictability of outcomes" means that a registered
8
professional nurse or advanced practice registered nurse has
9
determined that the patient's or individual's clinical status
10
is stable and expected to improve or the patient's or
11
individual's deteriorating condition is expected to follow a
12
known or expected course.
13

"Stability" means a registered professional nurse or
14
advanced practice registered nurse has determined that the
15
individual's clinical status and nursing care needs are
16
consistent.
17

"Task" means work not requiring nursing knowledge,
18
judgment, or decision-making, as defined by the Department by
19
rule.

20

(b) This Section authorizes a registered professional
21
nurse to:
22

(1) delegate nursing interventions
and tasks
to other
23

registered professional nurses
and

,
licensed practical
24

nurses
based on the comprehensive nursing assessment that
25

includes, but is not limited to:
26

(A) the stability and condition of the patient;

HB5233
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LRB104 19833 AAS 33283 b
1

(B) the potential for harm;
2

(C) the complexity of the nursing intervention or
3

task to be delegated;
4

(D) the predictability of outcomes; and
5

(E) the competency of the individual to whom the
6

nursing intervention or task is delegated;

7

(2) delegate tasks to

, and other
unlicensed personnel
8

based on the comprehensive nursing assessment that
9

includes, but is not limited to:
10

(A) the stability and condition of the patient;
11

(B) the potential for harm;
12

(C) the complexity of the
task

nursing
13

intervention
to be delegated;
14

(D) the predictability of outcomes; and
15

(E) competency of the individual to whom the
task

16

nursing intervention
is delegated;
17

(3)

(2)
delegate medication administration to other
18

licensed nurses;
or

19

(3) in community-based or in-home care settings,
20

delegate the administration of medication (limited to oral
21

or subcutaneous dosage and topical or transdermal
22

application) to unlicensed personnel, if all the
23

conditions for delegation set forth in this Section are
24

met;

25

(4) refuse to delegate, stop, or rescind a previously
26

authorized delegation
.

; or

HB5233
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LRB104 19833 AAS 33283 b
1

(5) in community-based or in-home care settings,
2

delegate, guide, and evaluate the implementation of
3

nursing interventions as a component of patient care
4

coordination after completion of the comprehensive patient
5

assessment based on analysis of the comprehensive nursing
6

assessment data; care coordination in in-home care and
7

school settings may occur in person, by telecommunication,
8

or by electronic communication.

9

(c) This Section prohibits the following:
10

(1) An individual or entity from mandating that a
11

registered professional nurse delegate nursing
12

interventions if the registered professional nurse
13

determines it is inappropriate to do so. Nurses shall not
14

be subject to disciplinary or any other adverse action for
15

refusing to delegate a nursing intervention based on
16

patient safety.
17

(2) The delegation of medication administration to
18

unlicensed personnel in any institutional or long-term
19

facility, including, but not limited to, those facilities
20

licensed by the Hospital Licensing Act, the University of
21

Illinois Hospital Act, State-operated mental health
22

hospitals, or State-operated developmental centers
, except
23

as authorized under Article 80 of this Act or otherwise
24

specifically authorized by law
.
25

(2.5) A registered professional nurse from delegating
26

work requiring nursing knowledge, assessment, judgment,

HB5233
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LRB104 19833 AAS 33283 b
1

inference, and decision-making (including medication
2

administration), the development of a plan of care, and
3

the evaluation of a plan of care to unlicensed non-nurse
4

personnel.

5

(3) A registered professional nurse from delegating
6

nursing judgment, the comprehensive patient assessment,
7

the development of a plan of care, and the evaluation of
8

care to licensed or unlicensed personnel.
9

(4) A licensed practical nurse
or unlicensed personnel

10

who has been delegated a nursing intervention
or task
from
11

re-delegating a nursing intervention
or task
.
12

(5) Unlicensed personnel who have been delegated tasks
13

from re-delegating the tasks.
14

(d) A registered professional nurse may delegate tasks to
15
other licensed and unlicensed persons.
16
(Source: P.A. 100-513, eff. 1-1-18; 100-1160, eff. 6-1-19
.)

17

(225 ILCS 65/60-35)
18

(Section scheduled to be repealed on January 1, 2028)
19

Sec. 60-35.
RN scope of practice.
The RN scope of nursing
20
practice is the protection, promotion, and optimization of
21
health and abilities, the prevention of illness and injury,
22
the development and implementation of the nursing plan of
23
care, the facilitation of nursing interventions to alleviate
24
suffering, care coordination, and advocacy in the care of
25
individuals, families, groups, communities, and populations.

HB5233
- 14 -
LRB104 19833 AAS 33283 b
1
Practice as a registered professional nurse means this full
2
scope of nursing, with or without compensation, that
3
incorporates caring for all patients in all settings, through
4
nursing standards of practice and professional performance for
5
coordination of care, and may include, but is not limited to,
6
all of the following:
7

(1) Collecting pertinent data and information relative
8

to the patient's health or the situation on an ongoing
9

basis through the comprehensive nursing assessment.
10

(2) Analyzing comprehensive nursing assessment data to
11

determine actual or potential diagnoses, problems, and
12

issues.
13

(3) Identifying expected outcomes for a plan
14

individualized to the patient or the situation that
15

prescribes strategies to attain expected, measurable
16

outcomes.
17

(4) Implementing the identified plan, coordinating
18

care delivery, employing strategies to promote healthy and
19

safe environments, and administering or delegating
20

medication administration according to Section 50-75 of
21

this Act.
22

(5) Evaluating patient progress toward attainment of
23

goals and outcomes.
24

(6) Delegating nursing interventions
and tasks to
25

licensed nurses
to implement the plan of care.
26

(6.5) Delegating tasks to unlicensed personnel to

HB5233
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LRB104 19833 AAS 33283 b
1

implement the plan of care.

2

(7) Providing health education and counseling.
3

(7.5) Advocating for the patient.
4

(8) Practicing ethically according to the American
5

Nurses Association Code of Ethics.
6

(9) Practicing in a manner that recognizes cultural
7

diversity.
8

(10) Communicating effectively in all areas of
9

practice.
10

(11) Collaborating with patients and other key
11

stakeholders in the conduct of nursing practice.
12

(12) Participating in continuous professional
13

development.
14

(13) Teaching the theory and practice of nursing to
15

student nurses.
16

(14) Leading within the professional practice setting
17

and the profession.
18

(15) Contributing to quality nursing practice.
19

(16) Integrating evidence and research findings into
20

practice.
21

(17) Utilizing appropriate resources to plan, provide,
22

and sustain evidence-based nursing services that are safe
23

and effective.
24
(Source: P.A. 100-513, eff. 1-1-18
.)

25

Section 99.
Effective date.
This Act takes effect upon
26
becoming law.

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