State of Illinois
91st General Assembly
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Public Act 91-0414

HB0553 Enrolled                                LRB9100682ACcd

    AN ACT concerning nursing.

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

    Section  5.  The Ambulatory Surgical Treatment Center Act
is amended by changing Section 6.5 as follows:

    (210 ILCS 5/6.5)
    Sec. 6.5.  Clinical privileges; advanced practice nurses.
All ambulatory surgical  treatment  centers  (ASTC)  licensed
under this Act shall comply with the following requirements:
    (1)  No  ASTC policy, rule, regulation, or practice of an
ambulatory surgical treatment center licensed under this  Act
shall   be   inconsistent  with  the  provision  of  adequate
collaboration,  including  medical  direction   of   licensed
advanced  practice nurses, in accordance with Section 54.5 of
the Medical Practice Act of 1987.
    (2)  Operative surgical  procedures  shall  be  performed
only  by a physician licensed to practice medicine in all its
branches under the Medical Practice Act of  1987,  a  dentist
licensed  under  the  Illinois  Dental  Practice  Act,  or  a
podiatrist  licensed under the Podiatric Medical Practice Act
of 1987, with medical staff membership and surgical  clinical
privileges granted by the consulting committee of the ASTC. A
licensed physician, dentist, or podiatrist may be assisted by
a   physician  licensed  to  practice  medicine  in  all  its
branches, dentist,  dental  assistant,  podiatrist,  licensed
advanced   practice   nurse,  licensed  physician  assistant,
licensed registered nurse, licensed practical nurse, surgical
assistant, surgical technician, or other individuals  granted
clinical  privileges  to  assist in surgery by the consulting
committee of the ASTC.
    (3)   The anesthesia service shall be under the direction
of a physician licensed  to  practice  medicine  in  all  its
branches who has had specialized preparation or experience in
the  area or who has completed a residency in anesthesiology.
An anesthesiologist, Board certified or  Board  eligible,  is
recommended.  Anesthesia  services  may  only be administered
pursuant to the order of a  physician  licensed  to  practice
medicine  in  all its branches, licensed dentist, or licensed
podiatrist.
         (A)  The individuals who, with  clinical  privileges
    granted  by  the  medical  staff and ASTC, may administer
    anesthesia services are limited to the following:
              (i)  an anesthesiologist; or
              (ii)  a physician licensed to practice medicine
         in all its branches; or
              (iii)  a dentist with authority  to  administer
         anesthesia  under Section 8.1 of the Illinois Dental
         Practice Act; or
              (iv)  a  licensed  certified  registered  nurse
         anesthetist.
         (B)  For anesthesia  services,  an  anesthesiologist
    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. In the absence  of  24-hour  availability  of
    anesthesiologists  with clinical privileges, an alternate
    policy   (requiring    participation,    presence,    and
    availability of a physician licensed to practice medicine
    in  all  its  branches) shall be developed by the medical
    staff  consulting  committee  in  consultation  with  the
    anesthesia service and  included  in  the  medical  staff
    consulting committee policies.
         (C)  A certified registered nurse anesthetist is not
    required  to  possess prescriptive authority or a written
    collaborative  agreement  meeting  the  requirements   of
    Section  15-15  of  the  Nursing  and  Advanced  Practice
    Nursing  Act  to provide anesthesia services ordered by a
    licensed physician,  dentist,  or  podiatrist.   Licensed
    certified registered nurse anesthetists are authorized to
    select,   order,  and  administer  drugs  and  apply  the
    appropriate  medical  devices   in   the   provision   of
    anesthesia services under the anesthesia plan agreed with
    by   the  anesthesiologist  or,  in  the  absence  of  an
    available  anesthesiologist  with  clinical   privileges,
    agreed   with   by  the  operating  physician,  operating
    dentist, or operating podiatrist in accordance  with  the
    medical staff consulting committee policies of a licensed
    ambulatory surgical treatment center.
(Source: P.A. 90-742, eff. 8-13-98.)

    Section  10.  The  Hospital  Licensing  Act is amended by
changing Section 10.7 as follows:

    (210 ILCS 85/10.7)
    Sec.  10.7.  Clinical   privileges;   advanced   practice
registered  nurses.    All  hospitals licensed under this Act
shall comply with the following requirements:
    (1)  No hospital policy, rule, regulation, or practice of
a hospital licensed under this Act shall be inconsistent with
the provision of adequate  collaboration,  including  medical
direction of licensed advanced practice nurses, in accordance
with Section 54.5 of the Medical Practice Act of 1987.
    (2)  Operative  surgical  procedures  shall  be performed
only by a physician licensed to practice medicine in all  its
branches  under  the  Medical Practice Act of 1987, a dentist
licensed  under  the  Illinois  Dental  Practice  Act,  or  a
podiatrist licensed under the Podiatric Medical Practice  Act
of  1987, with medical staff membership and surgical clinical
privileges granted at the hospital.   A  licensed  physician,
dentist,  or  podiatrist  may  be  assisted  by  a  physician
licensed  to  practice medicine in all its branches, dentist,
dental  assistant,  podiatrist,  licensed  advanced  practice
nurse,  licensed  physician  assistant,  licensed  registered
nurse, licensed practical nurse, surgical assistant, surgical
technician, or other individuals granted clinical  privileges
to assist in surgery at the hospital.
    (3)  The  anesthesia service shall be under the direction
of a physician licensed  to  practice  medicine  in  all  its
branches who has had specialized preparation or experience in
the  area or who has completed a residency in anesthesiology.
An anesthesiologist, Board certified or  Board  eligible,  is
recommended.  Anesthesia  services  may  only be administered
pursuant to the order of a  physician  licensed  to  practice
medicine  in  all its branches, licensed dentist, or licensed
podiatrist.
         (A)  The individuals who, with  clinical  privileges
    granted   at  the  hospital,  may  administer  anesthesia
    services are limited to the following:
              (i)  an anesthesiologist; or
              (ii)  a physician licensed to practice medicine
         in all its branches; or
              (iii)  a dentist with authority  to  administer
         anesthesia  under Section 8.1 of the Illinois Dental
         Practice Act; or
              (iv)  a  licensed  certified  registered  nurse
         anesthetist.
         (B)  For anesthesia  services,  an  anesthesiologist
    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. In the absence  of  24-hour  availability  of
    anesthesiologists   with  medical  staff  privileges,  an
    alternate policy (requiring participation, presence,  and
    availability of a physician licensed to practice medicine
    in  all  its  branches) shall be developed by the medical
    staff and licensed  hospital  in  consultation  with  the
    anesthesia service.
         (C)  A certified registered nurse anesthetist is not
    required  to  possess prescriptive authority or a written
    collaborative  agreement  meeting  the  requirements   of
    Section  15-15  of  the  Nursing  and  Advanced  Practice
    Nursing  Act  to provide anesthesia services ordered by a
    licensed physician,  dentist,  or  podiatrist.   Licensed
    certified registered nurse anesthetists are authorized to
    select,   order,  and  administer  drugs  and  apply  the
    appropriate  medical  devices   in   the   provision   of
    anesthesia services under the anesthesia plan agreed with
    by   the  anesthesiologist  or,  in  the  absence  of  an
    available  anesthesiologist  with  clinical   privileges,
    agreed   with   by  the  operating  physician,  operating
    dentist, or operating podiatrist in accordance  with  the
    hospital's alternative policy.
(Source: P.A. 90-742, eff. 8-13-98.)

    Section  15.  The Medical Practice Act of 1987 is amended
by changing Section 54.5 as follows:

    (225 ILCS 60/54.5)
    Sec. 54.5.  Physician delegation of authority.
    (a)  Physicians licensed to practice medicine in all  its
branches  may delegate care and treatment responsibilities to
a physician assistant under guidelines in accordance with the
requirements of  the  Physician  Assistant  Practice  Act  of
1987.   A  physician licensed to practice medicine in all its
branches may enter into supervising physician agreements with
no more than 2 physician assistants.
    (b)  A physician licensed to practice medicine in all its
branches in active clinical practice may collaborate with  an
advanced  practice  nurse in accordance with the requirements
of Title 15 of the Nursing and Advanced Practice Nursing Act.
Collaboration  is  for  the  purpose  of  providing   medical
direction,  and  no  employment  relationship is required.  A
written  collaborative  agreement  shall   conform   to   the
requirements  of  Sections 15-15 and 15-20 of the Nursing and
Advanced Practice Nursing  Act.   The  written  collaborative
agreement  shall  be for services the collaborating physician
generally provides to his  or  her  patients  in  the  normal
course  of  clinical  medical  practice.    Physician medical
direction shall be adequate  with  respect  to  collaboration
with certified nurse practitioners, certified nurse midwives,
and clinical nurse specialists if a collaborating physician:
         (1)  participates in the joint formulation and joint
    approval  of  orders  or  guidelines  with  the  advanced
    practice  nurse  and periodically reviews such orders and
    the services  provided  patients  under  such  orders  in
    accordance  with  accepted  standards of medical practice
    and advanced practice nursing practice;
         (2)  is on site at least once  a  month  to  provide
    medical direction and consultation; and
         (3)  is  available  through  telecommunications  for
    consultation   on  medical  problems,  complications,  or
    emergencies or patient referral.
    (b-5)  An  anesthesiologist  or  physician  licensed   to
practice  medicine in all its branches may collaborate with a
certified registered nurse  anesthetist  in  accordance  with
Section  15-25  of  the Nursing and Advanced Practice Nursing
Act.  Medical direction  for  a  certified  registered  nurse
anesthetist shall be adequate if:
         (1)  an anesthesiologist or a physician participates
    in the joint formulation and joint approval of orders  or
    guidelines  and  periodically reviews such orders and the
    services provided patients under such orders; and
         (2)  for anesthesia services,  the  anesthesiologist
    or  physician  participates  through  discussion  of  and
    agreement  with  the  anesthesia  plan  and is physically
    present and available on the premises during the delivery
    of anesthesia services for diagnosis,  consultation,  and
    treatment  of  emergency  medical  conditions. Anesthesia
    services in a hospital shall be conducted  in  accordance
    with Section 10.7 of the Hospital Licensing Act and in an
    ambulatory  surgical  treatment center in accordance with
    Section 6.5 of the Ambulatory Surgical  Treatment  Center
    Act.
    (b-10)  The  anesthesiologist or operating physician must
agree with the anesthesia  plan  prior  to  the  delivery  of
services.
    (c)  The  supervising  physician shall have access to the
medical records of  all  patients  attended  by  a  physician
assistant.   The collaborating physician shall have access to
the medical  records  of  all  patients  attended  to  by  an
advanced practice nurse.
    (d)  Nothing  in this Act shall be construed to limit the
delegation of tasks or duties  by  a  physician  licensed  to
practice medicine in all its branches to a licensed practical
nurse, a registered professional nurse, or other personnel.
    (e)  A  physician  shall  not  be  liable for the acts or
omissions of a physician assistant or advanced practice nurse
solely on the basis of having signed a supervision  agreement
or  guidelines  or  a  collaborative  agreement,  an order, a
standing medical order, a standing delegation order, or other
order or  guideline  authorizing  a  physician  assistant  or
advanced practice nurse to perform acts, unless the physician
has  reason  to  believe  the physician assistant or advanced
practice nurse lacked the competency to perform  the  act  or
acts or commits willful and wanton misconduct.
(Source: P.A. 90-742, eff. 8-13-98.)

    Section  20.  The  Nursing  and Advanced Practice Nursing
Act is amended  by  changing  Sections  10-25,  15-5,  15-10,
15-15, 15-30, and 15-35 and by adding 15-25 as follows:

    (225 ILCS 65/10-25)
    Sec. 10-25. Board.
    (a)  The  Director  shall  appoint  the  Board of Nursing
which, beginning January 1, 2000, shall be composed  of  7  9
registered  professional  nurses, 2 licensed practical nurses
and one public member who shall also be a voting  member  and
who  is  not  a licensed health care provider. Two registered
nurses shall hold at least a master's degree in  nursing  and
be   educators   in   professional   nursing   programs,  one
representing    baccalaureate    nursing    education,    one
representing  associate   degree   nursing   education;   one
registered nurse shall hold at least a bachelor's degree with
a major in nursing and be an educator in a licensed practical
nursing  program;  one registered nurse shall hold a master's
degree  in  nursing   and  shall  represent  nursing  service
administration; 2 registered nurses shall represent  clinical
nursing  practice, one of whom shall have at least a master's
degree in nursing; and, until January  1, 2000, 2  registered
nurses  shall  represent advanced specialty practice. Each of
the 11 nurses shall have had a minimum of 5 years  experience
in nursing, 3 of which shall be in the area they represent on
the Board and be actively engaged in the area of nursing they
represent  at the time of appointment and during their tenure
on the Board.  Members shall be appointed for  a  term  of  3
years.   No  member shall be eligible for appointment to more
than 2 consecutive  terms  and  any  appointment  to  fill  a
vacancy  shall  be for the unexpired portion of the term.  In
making  Board   appointments,   the   Director   shall   give
consideration   to   recommendations   submitted  by  nursing
organizations.    Consideration  shall  be  given  to   equal
geographic  representation.   The  Board shall receive actual
and necessary expenses incurred in the performance  of  their
duties.
    In  making  the  initial appointments, the Director shall
appoint all new members for terms of 2, 3, and  4  years  and
such  terms  shall  be  staggered  as  follows:   3  shall be
appointed for terms of 2 years;  3  shall  be  appointed  for
terms  of  3  years;  and 3 shall be appointed for terms of 4
years.
    The Director may remove  any  member  of  the  Board  for
misconduct,  incapacity,  or  neglect  of duty.  The Director
shall reduce to writing any causes for removal.
    The Board shall meet annually to elect a chairperson  and
vice  chairperson.   The  Board  may hold such other meetings
during the year as may be necessary to conduct its  business.
Six  voting members of the Board shall constitute a quorum at
any meeting.  Any action taken by the Board must  be  on  the
affirmative  vote of 6 members.  Voting by proxy shall not be
permitted.
    The Board shall submit an annual report to the Director.
    The members of the Board shall be immune from suit in any
action based upon any disciplinary proceedings or other  acts
performed in good faith as members of the Board.
    (b)  The Board is authorized to:
         (1)  recommend  the adoption and, from time to time,
    the revision of such rules that may be necessary to carry
    out the provisions of this Act;
         (2)  conduct hearings and  disciplinary  conferences
    upon  charges  calling  for  discipline  of a licensee as
    provided in Section 10-45;
         (3)  report to the Department, upon completion of  a
    hearing, the disciplinary actions recommended to be taken
    against persons violating this Act;
         (4)  recommend  the  approval,  denial  of approval,
    withdrawal  of  approval,  or   discipline   of   nursing
    education programs;
         (5)  participate in a national organization of state
    boards of nursing; and
         (6)  recommend  a  list  of the registered nurses to
    serve as Nursing Act Coordinator  and  Assistant  Nursing
    Act Coordinator, respectively.
(Source: P.A. 90-61, eff. 12-30-97; 90-742, eff. 8-13-98.)

    (225 ILCS 65/15-5)
    Sec. 15-5.  Definitions. As used in this Title:
    "APN Board" means the Advanced Practice Nursing Board.
    "Advanced  practice  nurse"  or "APN" means a person who:
(1)  is licensed as a  registered  professional  nurse  under
this  Act;    (2)  meets the requirements for licensure as an
advanced practice nurse under Section 15-10;  (3)  except  as
provided  in  Section  15-25,  has  a  written  collaborative
agreement  with a collaborating physician in the diagnosis of
illness and management of wellness and  other  conditions  as
appropriate  to  the level and area of his or her practice in
accordance with Section 15-15; and  (4)  cares  for  patients
(A)  by  using  advanced  diagnostic  skills,  the results of
diagnostic tests  and  procedures  ordered  by  the  advanced
practice   nurse,   a   physician  assistant,  a  dentist,  a
podiatrist, or a  physician,  and  professional  judgment  to
initiate and coordinate the care of patients; (B) by ordering
diagnostic   tests,  prescribing  medications  and  drugs  in
accordance with Section 15-20, and administering  medications
and  drugs;   and  (C)  by  using  medical,  therapeutic, and
corrective measures  to  treat  illness  and  improve  health
status.  Categories  include  certified  nurse midwife (CNM),
certified  nurse  practitioner  (CNP),  certified  registered
nurse  anesthetist  (CRNA),  or  certified   clinical   nurse
specialist (CNS).
    "Collaborating  physician"  means  a  physician who works
with  an  advanced  practice  nurse  and   provides   medical
direction  as documented in a written collaborative agreement
required under Section 15-15.
    "Licensed hospital" means a hospital licensed  under  the
Hospital  Licensing  Act or organized under the University of
Illinois Hospital Act.
    "Physician" means a person licensed to practice  medicine
in all its branches under the Medical Practice Act of 1987.
(Source: P.A. 90-742, eff. 8-13-98.)

    (225 ILCS 65/15-10)
    Sec.  15-10.   Advanced  practice  nurse; qualifications;
roster.
    (a)  A person shall be  qualified  for  licensure  as  an
advanced practice nurse if that person:
         (1)  has  applied  in  writing in form and substance
    satisfactory to the Department and  has  not  violated  a
    provision  of  this  Act  or the rules adopted under this
    Act. The  Department  may  take  into  consideration  any
    felony conviction of the applicant but a conviction shall
    not operate as an absolute bar to licensure;
         (2)  holds  a  current  license  to  practice  as  a
    registered nurse in Illinois;
         (3)  has   successfully  completed  requirements  to
    practice as, and holds a current, national  certification
    as,  a nurse midwife, clinical nurse specialist, or nurse
    practitioner, or certified registered  nurse  anesthetist
    from   the   appropriate   national  certifying  body  as
    determined by rule of the Department;
         (4)  has paid the required fees as set by rule; and
         (5)  has   successfully   completed   a   post-basic
    advanced practice formal education program in the area of
    his or her nursing specialty.
    (b)  In  addition  to   meeting   the   requirements   of
subsection (a), except item (5) of that subsection, beginning
July  1,  2001 or 12 months after the adoption of final rules
to implement this Section, whichever  is  sooner,  applicants
for   initial   licensure   shall   have  a  graduate  degree
appropriate for national certification in a clinical advanced
practice nursing specialty.
    (c)  The  Department  shall  provide  by  rule  for   APN
licensure of registered professional nurses who (1) apply for
licensure  before  July  1,  2001  and (2) submit evidence of
completion of a program described in item (5)  of  subsection
(a)  or  in  subsection  (b)  and evidence of practice for at
least 10 years as a nurse practitioner.
    (d)  The Department shall maintain a separate  roster  of
advanced  practice nurses licensed under this Title and their
licenses shall indicate "Registered  Nurse/Advanced  Practice
Nurse".
(Source: P.A. 90-742, eff. 8-13-98.)

    (225 ILCS 65/15-15)
    Sec. 15-15.  Written collaborative agreements.
    (a)  Except as provided in Section 15-25, no person shall
engage  in  the  practice of advanced practice nursing except
when licensed under this Title  and  pursuant  to  a  written
collaborative agreement with a collaborating physician.
    (b)  A written collaborative agreement shall describe the
working  relationship of the advanced practice nurse with the
collaborating physician and shall authorize the categories of

care,  treatment,  or  procedures  to  be  performed  by  the
advanced practice nurse.  Collaboration does not  require  an
employment  relationship  between the collaborating physician
and  advanced  practice  nurse.   Collaboration   means   the
relationship  under  which  an  advanced practice nurse works
with a collaborating physician in an active clinical practice
to deliver health care services in accordance  with  (i)  the
advanced practice nurse's training, education, and experience
and  (ii)  medical  direction  as  documented  in  a  jointly
developed written collaborative agreement.
    The agreement shall be defined to promote the exercise of
professional   judgment   by   the  advanced  practice  nurse
commensurate with his or her education  and  experience.  The
services  to be provided by the advanced practice nurse shall
be  services  that  the  collaborating  physician   generally
provides  to  his or her patients in the normal course of his
or her clinical medical practice.   The  agreement  need  not
describe the exact steps that an advanced practice nurse must
take  with  respect  to  each specific condition, disease, or
symptom but must specify which authorized procedures  require
a physician's presence as the procedures are being performed.
The  collaborative  relationship under an agreement shall not
be construed to require the personal presence of a  physician
at all times  at  the  place  where  services  are  rendered.
Methods  of communication shall be available for consultation
with  the   collaborating   physician   in   person   or   by
telecommunications  in  accordance  with  established written
guidelines as set forth in the written agreement.
    (c)  Physician medical direction under an agreement shall
be adequate if a collaborating physician:
         (1)  participates in the joint formulation and joint
    approval of orders or guidelines with the APN and  he  or
    she  periodically  reviews  such  orders and the services
    provided patients under such orders  in  accordance  with
    accepted  standards  of  medical  practice  and  advanced
    practice nursing practice;
         (2)  is  on  site  at  least once a month to provide
    medical direction and consultation; and
         (3)  is  available  through  telecommunications  for
    consultation  on  medical  problems,  complications,   or
    emergencies or patient referral.
    (d)  A   copy   of   the  signed,  written  collaborative
agreement must be available to the  Department  upon  request
from  both  the advanced practice nurse and the collaborating
physician  and  shall  be  annually  updated.   An   advanced
practice  nurse  shall inform each collaborating physician of
all collaborative agreements he or she has signed and provide
a copy of these to any collaborating physician, upon request.
(Source: P.A. 90-742, eff. 8-13-98.)

    (225 ILCS 65/15-25 new)
    Sec. 15-25.  Certified registered nurse anesthetists.
    (a)  A licensed certified  registered  nurse  anesthetist
may  provide  anesthesia  services pursuant to the order of a
licensed physician, licensed dentist, or licensed  podiatrist
in  a  licensed  hospital,  a  licensed  ambulatory  surgical
treatment  center, or the office of a licensed physician, the
office of a licensed dentist, or the  office  of  a  licensed
podiatrist.   For  anesthesia  services, an anesthesiologist,
physician, dentist, or podiatrist 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, unless hospital policy adopted pursuant to clause
(B)  of  subdivision  (3)  of  Section  10.7  of the Hospital
Licensing Act or ambulatory surgical treatment center  policy
adopted  pursuant to clause (B) of subdivision (3) of Section
6.5 of the Ambulatory Surgical Treatment Center Act  provides
otherwise.
    (b)  A   certified   registered   nurse  anesthetist  who
provides anesthesia services in a hospital  shall  do  so  in
accordance  with  Section  10.7 of the Hospital Licensing Act
and,  in  an  ambulatory  surgical   treatment   center,   in
accordance  with  Section  6.5  of  the  Ambulatory  Surgical
Treatment Center Act.
    (c)  A   certified   registered   nurse  anesthetist  who
provides anesthesia services in a  physician  office,  dental
office,  or  podiatric  office  shall  enter  into  a written
practice agreement with an anesthesiologist or the  physician
licensed  to  practice  medicine  in  all  its  branches, the
dentist, or the  podiatrist  performing  the  procedure.  The
agreement  shall  describe  the  working  relationship of the
certified registered nurse anesthetist and  anesthesiologist,
physician,  dentist,  or  podiatrist  and shall authorize the
categories of care, treatment, or procedures to be  performed
by   the   certified  registered  nurse  anesthetist.   In  a
dentist's office, the certified registered nurse  anesthetist
may  only provide those services the dentist is authorized to
provide pursuant to the  Illinois  Dental  Practice  Act  and
rules.  In  a  podiatrist's  office, the certified registered
nurse anesthetist    may  only  provide  those  services  the
podiatrist is authorized to provide pursuant to the Podiatric
Medical  Practice  Act  of  1987  and  rules.  For anesthesia
services,  an  anesthesiologist,   physician,   dentist,   or
podiatrist   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.
    (d)  A  certified  registered  nurse  anesthetist  is not
required to  possess  prescriptive  authority  or  a  written
collaborative  agreement  meeting the requirements of Section
15-15 to provide anesthesia services ordered  by  a  licensed
physician,  dentist,  or  podiatrist.   Certified  registered
nurse  anesthetists  are  authorized  to  select,  order, and
administer drugs and apply the appropriate medical devices in
the provision of anesthesia  services  under  the  anesthesia
plan  agreed with by the anesthesiologist or the physician in
accordance with hospital alternative policy  or  the  medical
staff  consulting committee policies of a licensed ambulatory
surgical  treatment  center.   In   a   physician's   office,
dentist's     office,    or    podiatrist's    office,    the
anesthesiologist, operating physician, operating dentist,  or
operating podiatrist shall agree with the anesthesia plan, in
accordance with the written practice agreement.
    (e)  A  certified  registered  nurse  anesthetist  may be
delegated limited prescriptive authority under Section  15-20
in a written collaborative agreement meeting the requirements
of Section 15-15.

    (225 ILCS 65/15-30)
    Sec. 15-30.  Title.
    (a)  No   person  shall  use  any  words,  abbreviations,
figures, letters, title, sign, card,  or  device  tending  to
imply that he or she is an advanced practice nurse, including
but  not  limited  to using the titles or initials  "Advanced
Practice Nurse", "Certified Nurse Midwife", "Certified  Nurse
Practitioner",   "Certified  Registered  Nurse  Anesthetist",
"Clinical Nurse Specialist",  "A.P.N.",  "C.N.M.",  "C.N.P.",
"C.R.N.A.", "C.N.S.", or similar titles or initials, with the
intention  of  indicating  practice  as  an advanced practice
nurse without meeting the  requirements  of  this  Act.    No
advanced  practice  nurse  shall  use  the title of doctor or
associate with his or her name or any other term to  indicate
to other persons that he or she is qualified to engage in the
general practice of medicine.
    (b)  An  advanced  practice nurse shall verbally identify
himself or herself as an advanced  practice  nurse  including
specialty certification to each patient.
    (c)  Nothing  in this Act shall be construed to relieve a
physician of professional or  legal  responsibility  for  the
care  and  treatment  of persons attended by him or her or to
relieve an advanced practice nurse  of  the  professional  or
legal  responsibility  for  the care and treatment of persons
attended by him or her.
(Source: P.A. 90-742, eff. 8-13-98.)

    (225 ILCS 65/15-35)
    Sec. 15-35.  Advanced Practice Nursing Board.
    (a)  There is hereby  established  an  Advanced  Practice
Nursing  Board,  hereinafter  referred to as the "APN Board".
The APN Board shall review and make  recommendations  to  the
Department   regarding  matters  relating  to  licensure  and
discipline of advanced practice nurses.  The APN Board  shall
be  composed  of 9 members to be appointed by the Governor, 4
of whom shall be advanced practice nurses and 3 of whom shall
be collaborating physicians licensed to practice medicine  in
all  its branches.  The 4 advanced practice nurses shall have
collaborative   agreements,   except   that   any   certified
registered nurse  anesthetist  is  not  required  to  have  a
collaborative   agreement.    The  3  physicians  shall  have
collaborative agreements, except that an anesthesiologist  is
not  required  to  have a collaborative agreement.  In making
appointments to the APN Board, the Governor  shall  give  due
consideration  to  recommendations  by statewide professional
associations or societies representing nurses and  physicians
in  Illinois.   Two  members,  not  employed  or  having  any
material  interest  in any health care field, shall represent
the public.  The chairperson of the  APN  Board  shall  be  a
member  elected by a majority vote of the APN Board.  The APN
Board shall meet and report to the Department  quarterly  and
as advanced practice nurse issues arise.
    Initial  appointments  to  the  APN  Board  shall be made
within 90 days after the effective date  of  this  amendatory
Act  of  1998.   The  terms of office of each of the original
members shall be at staggered intervals.  One  physician  and
one  advanced practice nurse shall serve one-year terms.  One
physician and one advanced practice nurse shall serve  2-year
terms.   One  physician and one advanced practice nurse shall
serve 3-year terms.  One  advanced  practice  nurse  and  the
public members shall serve 4-year terms.  Upon the expiration
of  the term of an initial member, his or her successor shall
be appointed for a term of 4 years.  No  member  shall  serve
more  than 2 consecutive terms, excluding initial appointment
terms.  An appointment to fill a vacancy  shall  be  for  the
unexpired  portion  of  the  term.   Members of the APN Board
shall  be  reimbursed  for  all  authorized  legitimate   and
necessary  expenses incurred in attending the meetings of the
APN Board.  A majority of the  APN  Board  members  appointed
shall  constitute  a  quorum.  A vacancy in the membership of
the APN Board shall not impair  the  right  of  a  quorum  to
perform  all of the duties of the APN Board.  A member of the
APN Board shall have no liability in an action based  upon  a
disciplinary  proceeding  or other activity performed in good
faith as a member of the APN Board.
    (b)  Complaints  received  concerning  advanced  practice
nurses shall  be  reviewed  by  the  APN  Board.   Complaints
received   concerning   collaborating   physicians  shall  be
reviewed by the Medical Disciplinary Board.
(Source: P.A. 90-742, eff. 8-13-98.)

    (225 ILCS 65/15-100 rep.)
    Section 25.  The Nursing and  Advanced  Practice  Nursing
Act is amended by repealing Section 15-100.

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

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