Section 1300.410  Written Collaborative Agreements

a)         A written collaborative agreement is required for all advanced practice registered nurses engaged in clinical practice, except for:

1)         those APRNs who practice in a hospital, hospital affiliate or ambulatory surgical treatment center under Section 65-45 of the Act; and

2)         those APRNs who are granted full practice authority by Section 65-43 of the Act.  (Section 65-35(a))

b)         A written collaborative agreement shall describe the relationship of the advanced practice registered nurse with the collaborating physician and shall describe the categories of care, treatment or procedures to be provided by the advanced practice registered nurse.  (Section 65-35(b) of the Act)  A written collaborative agreement with a dentist must be in accordance with Section 65-35(c-10) of the Act.  A written collaborative agreement with a podiatric physician must be in accordance with Section 65-35(c-5) or (c-15) of the Act.

c)         The agreement shall be defined to promote the exercise of professional judgment by the advanced practice registered nurse commensurate with his or her education and experience.  The written agreement does not require an employment relationship.  Methods of communication shall be available for consultation with the collaborating physician (for CRNAs, a physician, anesthesiologist, dentist or podiatric physician) in person or by telecommunications or electronic communications as set forth in the written agreement.  Absent an employment relationship the written collaborative agreement may not:

1)         restrict the categories of patients within the scope of the APRN training and experience;

2)         limit third party payors or government health programs; or

3)         limit the geographic area or practice location of the APRN. (Section 65-35(b) of the Act)  For nurse practitioners, clinical nurse specialists and nurse midwives, the collaborative agreement shall not be construed to require the personal presence of the physician.

d)         For anesthesia services provided by a CRNA, the written collaborative agreement may be between the CRNA and an anesthesiologist, physician, dentist or podiatric physician who shall participate through discussion of and agreement with the anesthesia plan and remain physically present and available on the premises during the delivery of anesthesia services for diagnosis, consultation and treatment of emergency medical conditions.

e)         For any APRN who had a written collaborative agreement with a podiatric physician immediately before September 20, 2017, the APRN may continue in that collaborative relationship until the collaborative agreement ends or enter into a new written collaborative relationship with a podiatric physician per Section 65-35(c-15) of the Act.

f)         A copy of the signed, written collaborative agreement must be available to the Department upon request from both the advanced practice registered nurse and the collaborating physician, dentist or podiatric physician.  An advanced practice registered nurse shall inform each collaborating physician, dentist or podiatric physician of all collaborative agreements he or she has signed and provide a copy of these to any collaborating physician, dentist or podiatric physician, upon request.  (Section 65-35(d) and (f) of the Act)

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