Section 1300.450  Delivery of Anesthesia Services by a Certified Registered Nurse Anesthetist Outside a Hospital or Ambulatory Surgical Treatment Center

a)         A certified registered nurse anesthetist (CRNA) who provides anesthesia services outside of a hospital or ambulatory surgical treatment center shall enter into a written collaborative agreement with an anesthesiologist or the physician licensed to practice medicine in all its branches or the podiatric physician performing the procedure. Outside of a hospital or ambulatory surgical treatment center, the CRNA may provide only those services that the collaborating podiatric physician is authorized to provide pursuant to the Podiatric Medical Practice Act of 1987 and rules adopted under that Act. A certified registered nurse anesthetist may select, order, and administer medication, including controlled substances, and apply appropriate medical devices for delivery of anesthesia services under the anesthesia plan agreed with by the anesthesiologist or the operating physician or operating podiatric physician.

b)         A certified registered nurse anesthetist may be delegated prescriptive authority under Section 65-40 of the Act in a written collaborative agreement meeting the requirements of Section 65-35 of the Act.

c)         In a physician's office, the CRNA may only provide anesthesia services if the physician has training and experience in the delivery of anesthesia services to patients.  The physician's training and experience shall meet the requirements set forth in 68 Ill. Adm. Code 1285.340.

d)         In addition, in a physician's office, any CRNA and physician who enter into a collaborative agreement shall obtain and maintain current Advanced Cardiac Life Support (ACLS) certification.

e)         A CRNA who provides anesthesia services in a dental office shall enter into a written collaborative agreement with an anesthesiologist or the physician licensed to practice medicine in all its branches or the operating dentist performing the procedure.  The agreement shall describe the working relationship of the CRNA and dentist and shall authorize the categories of care, treatment or procedures to be performed by the CRNA.  In a collaborating dentist's office, the CRNA may only provide those services that the operating dentist with the appropriate permit is authorized to provide pursuant to the Illinois Dental Practice Act and rules adopted under that Act.  For anesthesia services, an anesthesiologist, physician or operating dentist shall participate through discussion of and agreement with the anesthesia plan and shall remain physically present and be available on the premises during the delivery of anesthesia services for diagnosis, consultation and treatment of emergency medical conditions.  A CRNA may select, order and administer medication, including controlled substances, and apply appropriate medical devices for delivery of anesthesia services under the anesthesia plan agreed with by the operating dentist.

f)         In a podiatric physician's office, the CRNA may only provide those services the podiatric physician is authorized to provide pursuant to the Podiatric Medical Practice Act of 1987 and 68 Ill. Adm. Code 1360.  Podiatric physicians may not administer general anesthetics.

g)         A CRNA providing anesthesia services in a physician, dental or podiatric physician office shall do so with the active participation, approval, presence and availability of the physician, dentist or podiatric physician as well as in accordance with Standards 1 through 11 of the "Standards for Office Based Anesthesia Practice", American Association of Nurse Anesthetists, 222 South Prospect Avenue, Park Ridge, Illinois 60068 (2005), which are hereby incorporated by reference, with no later editions or amendments.  If there is a conflict between the Nurse Practice Act or this Part and those standards, the Act and this Part shall prevail.

(Source:  Amended at 43 Ill. Reg. 6924, effective June 14, 2019)