Illinois General Assembly - Full Text of SB3116
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Full Text of SB3116  100th General Assembly




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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 Nurse Practice Act is amended by changing
5Section 65-35 as follows:
6    (225 ILCS 65/65-35)   (was 225 ILCS 65/15-15)
7    (Section scheduled to be repealed on January 1, 2028)
8    Sec. 65-35. Written collaborative agreements.
9    (a) A written collaborative agreement is required for all
10advanced practice registered nurses engaged in clinical
11practice prior to meeting the requirements of Section 65-43,
12except for advanced practice registered nurses who are
13privileged to practice in a hospital, hospital affiliate, or
14ambulatory surgical treatment center.
15    (a-5) If an advanced practice registered nurse engages in
16clinical practice outside of a hospital, hospital affiliate, or
17ambulatory surgical treatment center in which he or she is
18privileged to practice, the advanced practice registered nurse
19must have a written collaborative agreement, except as set
20forth in Section 65-43.
21    (b) A written collaborative agreement shall describe the
22relationship of the advanced practice registered nurse with the
23collaborating physician and shall describe the categories of



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1care, treatment, or procedures to be provided by the advanced
2practice registered nurse. A collaborative agreement with a
3podiatric physician must be in accordance with subsection (c-5)
4or (c-15) of this Section. A collaborative agreement with a
5dentist must be in accordance with subsection (c-10) of this
6Section. A collaborative agreement with a podiatric physician
7must be in accordance with subsection (c-5) of this Section.
8Collaboration does not require an employment relationship
9between the collaborating physician and the advanced practice
10registered nurse.
11    The collaborative relationship under an agreement shall
12not be construed to require the personal presence of a
13collaborating physician at the place where services are
14rendered. Methods of communication shall be available for
15consultation with the collaborating physician in person or by
16telecommunications or electronic communications as set forth
17in the written agreement.
18    (b-5) Absent an employment relationship, a written
19collaborative agreement may not (1) restrict the categories of
20patients of an advanced practice registered nurse within the
21scope of the advanced practice registered nurses training and
22experience, (2) limit third party payors or government health
23programs, such as the medical assistance program or Medicare
24with which the advanced practice registered nurse contracts, or
25(3) limit the geographic area or practice location of the
26advanced practice registered nurse in this State.



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1    (c) In the case of anesthesia services provided by a
2certified registered nurse anesthetist, an anesthesiologist, a
3physician, a dentist, or a podiatric physician must participate
4through discussion of and agreement with the anesthesia plan
5and remain physically present and available on the premises
6during the delivery of anesthesia services for diagnosis,
7consultation, and treatment of emergency medical conditions.
8    (c-5) A certified registered nurse anesthetist, who
9provides anesthesia services outside of a hospital or
10ambulatory surgical treatment center shall enter into a written
11collaborative agreement with an anesthesiologist or the
12physician licensed to practice medicine in all its branches or
13the podiatric physician performing the procedure. Outside of a
14hospital or ambulatory surgical treatment center, the
15certified registered nurse anesthetist may provide only those
16services that the collaborating podiatric physician is
17authorized to provide pursuant to the Podiatric Medical
18Practice Act of 1987 and rules adopted thereunder. A certified
19registered nurse anesthetist may select, order, and administer
20medication, including controlled substances, and apply
21appropriate medical devices for delivery of anesthesia
22services under the anesthesia plan agreed with by the
23anesthesiologist or the operating physician or operating
24podiatric physician.
25    (c-10) A certified registered nurse anesthetist who
26provides anesthesia services in a dental office shall enter



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1into a written collaborative agreement with an
2anesthesiologist or the physician licensed to practice
3medicine in all its branches or the operating dentist
4performing the procedure. The agreement shall describe the
5working relationship of the certified registered nurse
6anesthetist and dentist and shall authorize the categories of
7care, treatment, or procedures to be performed by the certified
8registered nurse anesthetist. In a collaborating dentist's
9office, the certified registered nurse anesthetist may only
10provide those services that the operating dentist with the
11appropriate permit is authorized to provide pursuant to the
12Illinois Dental Practice Act and rules adopted thereunder. For
13anesthesia services, an anesthesiologist, physician, or
14operating dentist shall participate through discussion of and
15agreement with the anesthesia plan and shall remain physically
16present and be available on the premises during the delivery of
17anesthesia services for diagnosis, consultation, and treatment
18of emergency medical conditions. A certified registered nurse
19anesthetist may select, order, and administer medication,
20including controlled substances, and apply appropriate medical
21devices for delivery of anesthesia services under the
22anesthesia plan agreed with by the operating dentist.
23    (c-15) An advanced practice registered nurse who had a
24written collaborative agreement with a podiatric physician
25immediately before the effective date of Public Act 100-513 may
26continue in that collaborative relationship or enter into a new



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1written collaborative relationship with a podiatric physician
2under the requirements of this Section and Section 65-40, as
3those Sections existed immediately before the amendment of
4those Sections by Public Act 100-513 with regard to a written
5collaborative agreement between an advanced practice
6registered nurse and a podiatric physician, until the
7collaborative relationship between the advanced practice
8registered nurse and podiatric physician terminates.
9    (d) A copy of the signed, written collaborative agreement
10must be available to the Department upon request from both the
11advanced practice registered nurse and the collaborating
12physician, dentist, or podiatric physician.
13    (e) Nothing in this Act shall be construed to limit the
14delegation of tasks or duties by a physician to a licensed
15practical nurse, a registered professional nurse, or other
16persons in accordance with Section 54.2 of the Medical Practice
17Act of 1987. Nothing in this Act shall be construed to limit
18the method of delegation that may be authorized by any means,
19including, but not limited to, oral, written, electronic,
20standing orders, protocols, guidelines, or verbal orders.
21    (e-5) Nothing in this Act shall be construed to authorize
22an advanced practice registered nurse to provide health care
23services required by law or rule to be performed by a
24physician, including those acts to be performed by a physician
25in Section 3.1 of the Illinois Abortion Law of 1975.
26    (f) An advanced practice registered nurse shall inform each



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1collaborating physician, dentist, or podiatric physician of
2all collaborative agreements he or she has signed and provide a
3copy of these to any collaborating physician, dentist, or
4podiatric physician upon request.
5    (g) (Blank).
6(Source: P.A. 99-173, eff. 7-29-15; 100-513, eff. 1-1-18;
7100-577, eff. 1-26-18.)
8    Section 99. Effective date. This Act takes effect January
91, 2018.