97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB5105

 

Introduced 2/8/2012, by Rep. Angelo Saviano

 

SYNOPSIS AS INTRODUCED:
 
225 ILCS 60/54.5
225 ILCS 95/7  from Ch. 111, par. 4607

    Amends Physician Assistant Practice Act of 1987. Provides that a supervising physician shall determine the number of physician assistants under his or her supervision provided the physician is able to provide adequate supervision as outlined in the written supervision agreement and consideration is given to the nature of the physician's practice, complexity of the patient population, and the experience of each supervised physician assistant. Amends the Medical Practice Act of 1987 to make corresponding changes.


LRB097 18807 CEL 64044 b

 

 

A BILL FOR

 

HB5105LRB097 18807 CEL 64044 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Medical Practice Act of 1987 is amended by
5changing Section 54.5 as follows:
 
6    (225 ILCS 60/54.5)
7    (Section scheduled to be repealed on December 31, 2012)
8    Sec. 54.5. Physician delegation of authority to physician
9assistants and advanced practice nurses.
10    (a) Physicians licensed to practice medicine in all its
11branches may delegate care and treatment responsibilities to a
12physician assistant under guidelines in accordance with the
13requirements of the Physician Assistant Practice Act of 1987. A
14physician licensed to practice medicine in all its branches may
15enter into supervising physician agreements with no more than 2
16physician assistants.
17    (b) A physician licensed to practice medicine in all its
18branches in active clinical practice may collaborate with an
19advanced practice nurse in accordance with the requirements of
20the Nurse Practice Act. Collaboration is for the purpose of
21providing medical consultation, and no employment relationship
22is required. A written collaborative agreement shall conform to
23the requirements of Section 65-35 of the Nurse Practice Act.

 

 

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1The written collaborative agreement shall be for services the
2collaborating physician generally provides to his or her
3patients in the normal course of clinical medical practice. A
4written collaborative agreement shall be adequate with respect
5to collaboration with advanced practice nurses if all of the
6following apply:
7        (1) The agreement is written to promote the exercise of
8    professional judgment by the advanced practice nurse
9    commensurate with his or her education and experience. The
10    agreement need not describe the exact steps that an
11    advanced practice nurse must take with respect to each
12    specific condition, disease, or symptom, but must specify
13    those procedures that require a physician's presence as the
14    procedures are being performed.
15        (2) Practice guidelines and orders are developed and
16    approved jointly by the advanced practice nurse and
17    collaborating physician, as needed, based on the practice
18    of the practitioners. Such guidelines and orders and the
19    patient services provided thereunder are periodically
20    reviewed by the collaborating physician.
21        (3) The advance practice nurse provides services the
22    collaborating physician generally provides to his or her
23    patients in the normal course of clinical practice, except
24    as set forth in subsection (b-5) of this Section. With
25    respect to labor and delivery, the collaborating physician
26    must provide delivery services in order to participate with

 

 

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1    a certified nurse midwife.
2        (4) The collaborating physician and advanced practice
3    nurse consult at least once a month to provide
4    collaboration and consultation.
5        (5) Methods of communication are available with the
6    collaborating physician in person or through
7    telecommunications for consultation, collaboration, and
8    referral as needed to address patient care needs.
9        (6) The agreement contains provisions detailing notice
10    for termination or change of status involving a written
11    collaborative agreement, except when such notice is given
12    for just cause.
13    (b-5) An anesthesiologist or physician licensed to
14practice medicine in all its branches may collaborate with a
15certified registered nurse anesthetist in accordance with
16Section 65-35 of the Nurse Practice Act for the provision of
17anesthesia services. With respect to the provision of
18anesthesia services, the collaborating anesthesiologist or
19physician shall have training and experience in the delivery of
20anesthesia services consistent with Department rules.
21Collaboration shall be adequate if:
22        (1) an anesthesiologist or a physician participates in
23    the joint formulation and joint approval of orders or
24    guidelines and periodically reviews such orders and the
25    services provided patients under such orders; and
26        (2) for anesthesia services, the anesthesiologist or

 

 

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1    physician participates through discussion of and agreement
2    with the anesthesia plan and is physically present and
3    available on the premises during the delivery of anesthesia
4    services for diagnosis, consultation, and treatment of
5    emergency medical conditions. Anesthesia services in a
6    hospital shall be conducted in accordance with Section 10.7
7    of the Hospital Licensing Act and in an ambulatory surgical
8    treatment center in accordance with Section 6.5 of the
9    Ambulatory Surgical Treatment Center Act.
10    (b-10) The anesthesiologist or operating physician must
11agree with the anesthesia plan prior to the delivery of
12services.
13    (c) The supervising physician shall have access to the
14medical records of all patients attended by a physician
15assistant. The collaborating physician shall have access to the
16medical records of all patients attended to by an advanced
17practice nurse.
18    (d) (Blank).
19    (e) A physician shall not be liable for the acts or
20omissions of a physician assistant or advanced practice nurse
21solely on the basis of having signed a supervision agreement or
22guidelines or a collaborative agreement, an order, a standing
23medical order, a standing delegation order, or other order or
24guideline authorizing a physician assistant or advanced
25practice nurse to perform acts, unless the physician has reason
26to believe the physician assistant or advanced practice nurse

 

 

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1lacked the competency to perform the act or acts or commits
2willful and wanton misconduct.
3    (f) A collaborating physician may, but is not required to,
4delegate prescriptive authority to an advanced practice nurse
5as part of a written collaborative agreement, and the
6delegation of prescriptive authority shall conform to the
7requirements of Section 65-40 of the Nurse Practice Act.
8    (g) A supervising physician may, but is not required to,
9delegate prescriptive authority to a physician assistant as
10part of a written supervision agreement, and the delegation of
11prescriptive authority shall conform to the requirements of
12Section 7.5 of the Physician Assistant Practice Act of 1987.
13(Source: P.A. 96-618, eff. 1-1-10; 97-358, eff. 8-12-11.)
 
14    Section 10. The Physician Assistant Practice Act of 1987 is
15amended by changing Section 7 as follows:
 
16    (225 ILCS 95/7)  (from Ch. 111, par. 4607)
17    (Section scheduled to be repealed on January 1, 2018)
18    Sec. 7. Supervision requirements.
19    (a) A supervising physician shall determine the number of
20physician assistants under his or her supervision provided the
21physician is able to provide adequate supervision as outlined
22in the written supervision agreement required under Section 7.5
23of this Act and consideration is given to the nature of the
24physician's practice, complexity of the patient population,

 

 

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1and the experience of each supervised physician assistant. A No
2more than 2 physician assistants shall be supervised by the
3supervising physician, although a physician assistant shall be
4able to hold more than one professional position. A Each
5supervising physician shall file a notice of supervision of
6each such physician assistant according to the rules of the
7Department. However, the alternate supervising physician may
8supervise more than 2 physician assistants when the supervising
9physician is unable to provide such supervision consistent with
10the definition of alternate physician in Section 4. It is the
11responsibility of the supervising physician to maintain
12documentation each time he or she has designated an alternative
13supervising physician. This documentation shall include the
14date alternate supervisory control began, the date alternate
15supervisory control ended, and any other changes. A supervising
16physician shall provide a copy of this documentation to the
17Department, upon request.
18    Physician assistants shall be supervised only by
19physicians as defined in this Act who are engaged in clinical
20practice, or in clinical practice in public health or other
21community health facilities.
22    Nothing in this Act shall be construed to limit the
23delegation of tasks or duties by a physician to a nurse or
24other appropriately trained personnel.
25    Nothing in this Act shall be construed to prohibit the
26employment of physician assistants by a hospital, nursing home

 

 

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1or other health care facility where such physician assistants
2function under the supervision of a supervising physician.
3    Physician assistants may be employed by the Department of
4Corrections or the Department of Human Services (as successor
5to the Department of Mental Health and Developmental
6Disabilities) for service in facilities maintained by such
7Departments and affiliated training facilities in programs
8conducted under the authority of the Director of Corrections or
9the Secretary of Human Services. Each physician assistant
10employed by the Department of Corrections or the Department of
11Human Services (as successor to the Department of Mental Health
12and Developmental Disabilities) shall be under the supervision
13of a physician engaged in clinical practice and direct patient
14care. Duties of each physician assistant employed by such
15Departments are limited to those within the scope of practice
16of the supervising physician who is fully responsible for all
17physician assistant activities.
18    A physician assistant may be employed by a practice group
19or other entity employing multiple physicians at one or more
20locations. In that case, one of the physicians practicing at a
21location shall be designated the supervising physician. The
22other physicians with that practice group or other entity who
23practice in the same general type of practice or specialty as
24the supervising physician may supervise the physician
25assistant with respect to their patients without being deemed
26alternate supervising physicians for the purpose of this Act.

 

 

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1    (b) A physician assistant licensed in this State, or
2licensed or authorized to practice in any other U.S.
3jurisdiction or credentialed by his or her federal employer as
4a physician assistant, who is responding to a need for medical
5care created by an emergency or by a state or local disaster
6may render such care that the physician assistant is able to
7provide without supervision as it is defined in this Section or
8with such supervision as is available. For purposes of this
9Section, an "emergency situation" shall not include one that
10occurs in the place of one's employment.
11    Any physician who supervises a physician assistant
12providing medical care in response to such an emergency or
13state or local disaster shall not be required to meet the
14requirements set forth in this Section for a supervising
15physician.
16(Source: P.A. 95-703, eff. 12-31-07; 96-70, eff. 7-23-09.)