Full Text of SB1322 100th General Assembly
SB1322ham002 100TH GENERAL ASSEMBLY | Rep. Sara Feigenholtz Filed: 10/23/2017
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| 1 | | AMENDMENT TO SENATE BILL 1322
| 2 | | AMENDMENT NO. ______. Amend Senate Bill 1322 by replacing | 3 | | everything after the enacting clause with the following:
| 4 | | "Section 5. The Nurse Practice Act is amended by changing | 5 | | Section 65-35 as follows:
| 6 | | (225 ILCS 65/65-35)
(was 225 ILCS 65/15-15)
| 7 | | (Text of Section before amendment by P.A. 100-513 )
| 8 | | (Section scheduled to be repealed on January 1, 2028)
| 9 | | Sec. 65-35. Written collaborative
agreements. | 10 | | (a) A written collaborative agreement is required for all | 11 | | advanced practice nurses engaged in clinical practice, except | 12 | | for advanced practice nurses who are authorized to practice in | 13 | | a hospital, hospital affiliate, or ambulatory surgical | 14 | | treatment center. | 15 | | (a-5) If an advanced practice nurse engages in clinical | 16 | | practice outside of a hospital, hospital affiliate, or |
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| 1 | | ambulatory surgical treatment center in which he or she is | 2 | | authorized to practice, the advanced practice nurse must have a | 3 | | written collaborative agreement.
| 4 | | (b) A written collaborative
agreement shall describe the | 5 | | relationship of the
advanced practice nurse with the | 6 | | collaborating
physician or podiatric physician and shall | 7 | | describe the categories of
care, treatment, or procedures to be | 8 | | provided by the advanced
practice nurse. A collaborative | 9 | | agreement with a dentist must be in accordance with subsection | 10 | | (c-10) of this Section. Collaboration does not require an
| 11 | | employment relationship between the collaborating physician
or | 12 | | podiatric physician and advanced practice nurse.
| 13 | | The collaborative
relationship under an agreement shall | 14 | | not be
construed to require the personal presence of a | 15 | | physician or podiatric physician at the place where services | 16 | | are rendered.
Methods of communication shall
be available for | 17 | | consultation with the collaborating
physician or podiatric | 18 | | physician in person or by telecommunications or electronic | 19 | | communications as set forth in the written
agreement.
| 20 | | (b-5) Absent an employment relationship, a written | 21 | | collaborative agreement may not (1) restrict the categories of | 22 | | patients of an advanced practice nurse within the scope of the | 23 | | advanced practice nurses training and experience, (2) limit | 24 | | third party payors or government health programs, such as the | 25 | | medical assistance program or Medicare with which the advanced | 26 | | practice nurse contracts, or (3) limit the geographic area or |
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| 1 | | practice location of the advanced practice nurse in this State. | 2 | | (c)
In the case of anesthesia services provided by a | 3 | | certified registered nurse anesthetist, an anesthesiologist, a | 4 | | physician, a dentist, or a podiatric physician must participate | 5 | | through discussion of and agreement with the anesthesia plan | 6 | | and remain physically present and available on the premises | 7 | | during the delivery of anesthesia services for diagnosis, | 8 | | consultation, and treatment of emergency medical conditions.
| 9 | | (c-5) A certified registered nurse anesthetist, who | 10 | | provides anesthesia services outside of a hospital or | 11 | | ambulatory surgical treatment center shall enter into a written | 12 | | collaborative agreement with an anesthesiologist or the | 13 | | physician licensed to practice medicine in all its branches or | 14 | | the podiatric physician performing the procedure. Outside of a | 15 | | hospital or ambulatory surgical treatment center, the | 16 | | certified registered nurse anesthetist may provide only those | 17 | | services that the collaborating podiatric physician is | 18 | | authorized to provide pursuant to the Podiatric Medical | 19 | | Practice Act of 1987 and rules adopted thereunder. A certified | 20 | | registered nurse anesthetist may select, order, and administer | 21 | | medication, including controlled substances, and apply | 22 | | appropriate medical devices for delivery of anesthesia | 23 | | services under the anesthesia plan agreed with by the | 24 | | anesthesiologist or the operating physician or operating | 25 | | podiatric physician. | 26 | | (c-10) A certified registered nurse anesthetist who |
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| 1 | | provides anesthesia services in a dental office shall enter | 2 | | into a written collaborative agreement with an | 3 | | anesthesiologist or the physician licensed to practice | 4 | | medicine in all its branches or the operating dentist | 5 | | performing the procedure. The agreement shall describe the | 6 | | working relationship of the certified registered nurse | 7 | | anesthetist and dentist and shall authorize the categories of | 8 | | care, treatment, or procedures to be performed by the certified | 9 | | registered nurse anesthetist. In a collaborating dentist's | 10 | | office, the certified registered nurse anesthetist may only | 11 | | provide those services that the operating dentist with the | 12 | | appropriate permit is authorized to provide pursuant to the | 13 | | Illinois Dental Practice Act and rules adopted thereunder. For | 14 | | anesthesia services, an anesthesiologist, physician, or | 15 | | operating dentist shall participate through discussion of and | 16 | | agreement with the anesthesia plan and shall remain physically | 17 | | present and be available on the premises during the delivery of | 18 | | anesthesia services for diagnosis, consultation, and treatment | 19 | | of emergency medical conditions. A certified registered nurse | 20 | | anesthetist may select, order, and administer medication, | 21 | | including controlled substances, and apply appropriate medical | 22 | | devices for delivery of anesthesia services under the | 23 | | anesthesia plan agreed with by the operating dentist. | 24 | | (d) A copy of the signed, written collaborative agreement | 25 | | must be available
to the Department upon request from both the | 26 | | advanced practice nurse
and the collaborating physician, |
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| 1 | | dentist, or podiatric physician. | 2 | | (e) Nothing in this Act shall be construed to limit the | 3 | | delegation of tasks or duties by a physician to a licensed | 4 | | practical nurse, a registered professional nurse, or other | 5 | | persons in accordance with Section 54.2 of the Medical Practice | 6 | | Act of 1987. Nothing in this Act shall be construed to limit | 7 | | the method of delegation that may be authorized by any means, | 8 | | including, but not limited to, oral, written, electronic, | 9 | | standing orders, protocols, guidelines, or verbal orders. | 10 | | Nothing in this Act shall be construed to authorize an advanced | 11 | | practice nurse to provide health care services required by law | 12 | | or rule to be performed by a physician. | 13 | | (f) An advanced
practice nurse shall inform each | 14 | | collaborating physician, dentist, or podiatric physician of | 15 | | all collaborative
agreements he or she
has signed and provide a | 16 | | copy of these to any collaborating physician, dentist, or | 17 | | podiatric physician upon
request.
| 18 | | (g) (Blank). | 19 | | (Source: P.A. 98-192, eff. 1-1-14; 98-214, eff. 8-9-13; 98-756, | 20 | | eff. 7-16-14; 99-173, eff. 7-29-15.)
| 21 | | (Text of Section after amendment by P.A. 100-513 )
| 22 | | (Section scheduled to be repealed on January 1, 2028)
| 23 | | Sec. 65-35. Written collaborative
agreements. | 24 | | (a) A written collaborative agreement is required for all | 25 | | advanced practice registered nurses engaged in clinical |
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| 1 | | practice prior to meeting the requirements of Section 65-43, | 2 | | except for advanced practice registered nurses who are | 3 | | privileged to practice in a hospital, hospital affiliate, or | 4 | | ambulatory surgical treatment center. | 5 | | (a-5) If an advanced practice registered nurse engages in | 6 | | clinical practice outside of a hospital, hospital affiliate, or | 7 | | ambulatory surgical treatment center in which he or she is | 8 | | privileged to practice, the advanced practice registered nurse | 9 | | must have a written collaborative agreement, except as set | 10 | | forth in Section 65-43.
| 11 | | (b) A written collaborative
agreement shall describe the | 12 | | relationship of the
advanced practice registered nurse with the | 13 | | collaborating
physician and shall describe the categories of
| 14 | | care, treatment, or procedures to be provided by the advanced
| 15 | | practice registered nurse. A collaborative agreement with a | 16 | | podiatric physician must be in accordance with subsection (c-5) | 17 | | or (c-15) of this Section. A collaborative agreement with a | 18 | | dentist must be in accordance with subsection (c-10) of this | 19 | | Section. A collaborative agreement with a podiatric physician | 20 | | must be in accordance with subsection (c-5) of this Section. | 21 | | Collaboration does not require an
employment relationship | 22 | | between the collaborating physician
and the advanced practice | 23 | | registered nurse.
| 24 | | The collaborative
relationship under an agreement shall | 25 | | not be
construed to require the personal presence of a | 26 | | collaborating physician at the place where services are |
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| 1 | | rendered.
Methods of communication shall
be available for | 2 | | consultation with the collaborating
physician in person or by | 3 | | telecommunications or electronic communications as set forth | 4 | | in the written
agreement.
| 5 | | (b-5) Absent an employment relationship, a written | 6 | | collaborative agreement may not (1) restrict the categories of | 7 | | patients of an advanced practice registered nurse within the | 8 | | scope of the advanced practice registered nurses training and | 9 | | experience, (2) limit third party payors or government health | 10 | | programs, such as the medical assistance program or Medicare | 11 | | with which the advanced practice registered nurse contracts, or | 12 | | (3) limit the geographic area or practice location of the | 13 | | advanced practice registered nurse in this State. | 14 | | (c)
In the case of anesthesia services provided by a | 15 | | certified registered nurse anesthetist, an anesthesiologist, a | 16 | | physician, a dentist, or a podiatric physician must participate | 17 | | through discussion of and agreement with the anesthesia plan | 18 | | and remain physically present and available on the premises | 19 | | during the delivery of anesthesia services for diagnosis, | 20 | | consultation, and treatment of emergency medical conditions.
| 21 | | (c-5) A certified registered nurse anesthetist, who | 22 | | provides anesthesia services outside of a hospital or | 23 | | ambulatory surgical treatment center shall enter into a written | 24 | | collaborative agreement with an anesthesiologist or the | 25 | | physician licensed to practice medicine in all its branches or | 26 | | the podiatric physician performing the procedure. Outside of a |
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| 1 | | hospital or ambulatory surgical treatment center, the | 2 | | certified registered nurse anesthetist may provide only those | 3 | | services that the collaborating podiatric physician is | 4 | | authorized to provide pursuant to the Podiatric Medical | 5 | | Practice Act of 1987 and rules adopted thereunder. A certified | 6 | | registered nurse anesthetist may select, order, and administer | 7 | | medication, including controlled substances, and apply | 8 | | appropriate medical devices for delivery of anesthesia | 9 | | services under the anesthesia plan agreed with by the | 10 | | anesthesiologist or the operating physician or operating | 11 | | podiatric physician. | 12 | | (c-10) A certified registered nurse anesthetist who | 13 | | provides anesthesia services in a dental office shall enter | 14 | | into a written collaborative agreement with an | 15 | | anesthesiologist or the physician licensed to practice | 16 | | medicine in all its branches or the operating dentist | 17 | | performing the procedure. The agreement shall describe the | 18 | | working relationship of the certified registered nurse | 19 | | anesthetist and dentist and shall authorize the categories of | 20 | | care, treatment, or procedures to be performed by the certified | 21 | | registered nurse anesthetist. In a collaborating dentist's | 22 | | office, the certified registered nurse anesthetist may only | 23 | | provide those services that the operating dentist with the | 24 | | appropriate permit is authorized to provide pursuant to the | 25 | | Illinois Dental Practice Act and rules adopted thereunder. For | 26 | | anesthesia services, an anesthesiologist, physician, or |
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| 1 | | operating dentist shall participate through discussion of and | 2 | | agreement with the anesthesia plan and shall remain physically | 3 | | present and be available on the premises during the delivery of | 4 | | anesthesia services for diagnosis, consultation, and treatment | 5 | | of emergency medical conditions. A certified registered nurse | 6 | | anesthetist may select, order, and administer medication, | 7 | | including controlled substances, and apply appropriate medical | 8 | | devices for delivery of anesthesia services under the | 9 | | anesthesia plan agreed with by the operating dentist. | 10 | | (c-15) An advanced practice registered nurse who had a | 11 | | written collaborative agreement with a podiatric physician | 12 | | immediately before the effective date of Public Act 100-513 may | 13 | | continue in that collaborative relationship under the | 14 | | requirements of this Section and Section 65-40, as those | 15 | | Sections existed immediately before the amendment of those | 16 | | Sections by Public Act 100-513 with regard to a written | 17 | | collaborative agreement between an advanced practice | 18 | | registered nurse and a podiatric physician, until the | 19 | | collaborative relationship between the advanced practice | 20 | | registered nurse and podiatric physician terminates. | 21 | | (d) A copy of the signed, written collaborative agreement | 22 | | must be available
to the Department upon request from both the | 23 | | advanced practice registered nurse
and the collaborating | 24 | | physician, dentist, or podiatric physician. | 25 | | (e) Nothing in this Act shall be construed to limit the | 26 | | delegation of tasks or duties by a physician to a licensed |
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| 1 | | practical nurse, a registered professional nurse, or other | 2 | | persons in accordance with Section 54.2 of the Medical Practice | 3 | | Act of 1987. Nothing in this Act shall be construed to limit | 4 | | the method of delegation that may be authorized by any means, | 5 | | including, but not limited to, oral, written, electronic, | 6 | | standing orders, protocols, guidelines, or verbal orders. | 7 | | (e-5) Nothing in this Act shall be construed to authorize | 8 | | an advanced practice registered nurse to provide health care | 9 | | services required by law or rule to be performed by a | 10 | | physician, including those acts to be performed by a physician | 11 | | in Section 3.1 of the Illinois Abortion Law of 1975. | 12 | | (f) An advanced
practice registered nurse shall inform each | 13 | | collaborating physician, dentist, or podiatric physician of | 14 | | all collaborative
agreements he or she
has signed and provide a | 15 | | copy of these to any collaborating physician, dentist, or | 16 | | podiatric physician upon
request.
| 17 | | (g) (Blank). | 18 | | (Source: P.A. 99-173, eff. 7-29-15; 100-513, eff. 1-1-18.)
| 19 | | Section 95. No acceleration or delay. Where this Act makes | 20 | | changes in a statute that is represented in this Act by text | 21 | | that is not yet or no longer in effect (for example, a Section | 22 | | represented by multiple versions), the use of that text does | 23 | | not accelerate or delay the taking effect of (i) the changes | 24 | | made by this Act or (ii) provisions derived from any other | 25 | | Public Act.
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| 1 | | Section 99. Effective date. This Act takes effect January | 2 | | 1, 2018.".
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