Rep. Angelo Saviano
Filed: 3/17/2009
 
 

 




 

 		












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AMENDMENT TO HOUSE BILL 64 




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    AMENDMENT NO. ______. Amend House Bill 64 by replacing 
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everything after the enacting clause with the following:

 
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    "Section 5. The Medical Practice Act of 1987 is amended  by 
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changing Section 54.5 and  by adding Section 54.2 as follows:
 
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    (225 ILCS 60/54.2  new)
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    (Section scheduled to be repealed on December 31, 2010)
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    Sec. 54.2. Physician delegation of authority. 
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    (a) Nothing in this Act shall be construed to limit the 
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delegation of tasks or duties by a physician licensed to 
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practice medicine in all its branches to a licensed practical 
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nurse, a registered professional nurse, or other licensed 
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person practicing within the scope of his or her individual 
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licensing Act.
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    (b) A physician licensed to practice medicine in all its 
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branches may delegate tasks and duties to an appropriately 
 


 






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trained licensed or unlicensed person.  Any such task or duty 
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delegated to a licensed or unlicensed person must be within the 
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education, training, or experience of the delegating physician 
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and within the context of a physician-patient relationship.
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    (c) A chiropractic physician may delegate tasks and duties 
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to an appropriately trained licensed or unlicensed person.  Any 
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task or duty delegated to a licensed or unlicensed person by 
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the chiropractic physician:
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        (1) must fall within the scope of practice of the 
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    chiropractic physician as defined by this Act; 
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        (2) must be within the education, training, or 
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    experience of the delegating chiropractic physician; and 
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        (3) can only be delegated within the context of a 
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    physician-patient relationship.
 



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    (225 ILCS 60/54.5)


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    (Section scheduled to be repealed on December 31, 2010)

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    Sec. 54.5. Physician delegation of authority to physician 
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assistants and advanced practice nurses. 

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    (a) Physicians licensed to practice medicine in all its

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branches may delegate care and treatment responsibilities to a

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physician assistant under guidelines in accordance with the

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requirements of  the Physician Assistant Practice Act of
1987.  A 
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physician licensed to practice medicine in all its
branches may 
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enter into supervising physician agreements with
no more than 2 
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physician assistants.

 


 






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    (b) A physician licensed to practice medicine in all its

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branches in active clinical practice may collaborate with an 
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advanced practice
nurse in accordance with the requirements of 
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the Nurse Practice Act.  Collaboration
is for the purpose of 
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providing medical consultation,
and no employment relationship 
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is required.  A
written collaborative agreement shall
conform to 
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the requirements of Section 65-35 of the Nurse Practice Act.  
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The written collaborative agreement shall
be for
services the 
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collaborating physician generally provides to
his or her 
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patients in the normal course of clinical medical practice.
 A 
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written collaborative agreement shall be adequate with respect 
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to collaboration
with advanced practice nurses if all of the 
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following apply:


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        (1) The agreement is written to promote the exercise of 
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    professional judgment by the advanced practice nurse 
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    commensurate with his or her education and experience. The 
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    agreement need not describe the exact steps that an 
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    advanced practice nurse must take with respect to each 
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    specific condition, disease, or symptom, but must specify 
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    those procedures that require a physician's presence as the 
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    procedures are being performed.


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        (2) Practice guidelines and orders are developed and 
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    approved jointly by the advanced practice nurse and 
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    collaborating physician, as needed, based on the practice 
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    of the practitioners. Such guidelines and orders and the 
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    patient services provided thereunder are periodically 
 


 






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    reviewed by the collaborating physician.


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        (3) The advance practice nurse provides services the 
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    collaborating physician generally provides to his or her 
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    patients in the normal course of clinical practice, except 
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    as set forth in subsection (b-5) of this Section. With 
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    respect to labor and delivery, the collaborating physician 
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    must provide delivery services in order to participate with 
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    a certified nurse midwife.
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        (4)  The collaborating physician and advanced practice 
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    nurse meet in person at least once a month to provide 
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    collaboration and consultation.
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        (5) Methods of communication are available with the 
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    collaborating physician in person or through 
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    telecommunications for consultation, collaboration, and 
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    referral as needed to address patient care needs.
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        (6)  The agreement contains provisions detailing notice 
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    for termination or change of status involving a written 
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    collaborative agreement, except when such notice is given 
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    for just cause.


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    (b-5) An anesthesiologist or physician licensed to 
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practice medicine in
all its branches may collaborate with a 
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certified registered nurse anesthetist
in accordance with 
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Section 65-35 of the Nurse Practice Act for the provision of 
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anesthesia services.  With respect to the provision of 
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anesthesia services, the collaborating anesthesiologist or 
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physician shall have training and experience in the delivery of 
 


 






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anesthesia services consistent with Department rules.  
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Collaboration shall be
adequate if:


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        (1) an anesthesiologist or a physician
participates in 
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    the joint formulation and joint approval of orders or

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    guidelines and periodically reviews such orders and the 
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    services provided
patients under such orders; and


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        (2) for anesthesia services, the anesthesiologist
or 
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    physician participates through discussion of and agreement 
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    with the
anesthesia plan and is physically present and 
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    available on the premises during
the delivery of anesthesia 
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    services for
diagnosis, consultation, and treatment of 
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    emergency medical conditions.
Anesthesia services in a 
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    hospital shall be conducted in accordance with
Section 10.7 
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    of the Hospital Licensing Act and in an ambulatory surgical

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    treatment center in accordance with Section 6.5 of the 
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    Ambulatory Surgical
Treatment Center Act.

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    (b-10) The anesthesiologist or operating physician must 
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agree with the
anesthesia plan prior to the delivery of 
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services.

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    (c) The supervising physician shall have access to the

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medical records of all patients attended by a physician

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assistant.  The collaborating physician shall have access to
the 
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medical records of all patients attended to by an
advanced 
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practice nurse.

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    (d) Nothing in this Act
shall be construed to limit the 
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delegation of
tasks or duties by a physician licensed to 
 


 






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practice medicine
in all its branches to a licensed practical 
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nurse, a registered professional
nurse, or other persons in 
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accordance with Section 54.2.

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    (e) A physician shall not be liable for the acts or

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omissions of a physician assistant or advanced practice
nurse 
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solely on the basis of having signed a
supervision agreement or 
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guidelines or a collaborative
agreement, an order, a standing 
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medical order, a
standing delegation order, or other order or 
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guideline
authorizing a physician assistant or advanced 
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practice
nurse to perform acts, unless the physician has
reason 
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to believe the physician assistant or advanced
practice nurse 
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lacked the competency to perform
the act or acts or commits 
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willful and wanton misconduct.

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(Source: P.A. 95-639, eff. 10-5-07.)


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