093_HB3047ham001

 










                                     LRB093 06091 LRD 12936 a

 1                    AMENDMENT TO HOUSE BILL 3047

 2        AMENDMENT NO.     .  Amend House Bill 3047  by  replacing
 3    everything after the enacting clause with the following:

 4        "Section  5.  The Medical Practice Act of 1987 is amended
 5    by changing Section 54.5 as follows:

 6        (225 ILCS 60/54.5)
 7        (Section scheduled to be repealed on January 1, 2007)
 8        Sec. 54.5.  Physician delegation of authority.
 9        (a)  A physician Physicians licensed to practice medicine
10    in  all  its  branches  may  delegate  care   and   treatment
11    responsibilities to a physician assistant under guidelines in
12    accordance  with the requirements of  the Physician Assistant
13    Practice Act of  1987.   A  physician  licensed  to  practice
14    medicine  in  all  its  branches  may  enter into supervising
15    physician  agreements  with  no   more   than   2   physician
16    assistants.
17        (b)  A physician licensed to practice medicine in all its
18    branches  in active clinical practice may collaborate with an
19    advanced practice nurse in accordance with  the  requirements
20    of Title 15 of the Nursing and Advanced Practice Nursing Act.
21    Collaboration   is  for  the  purpose  of  providing  medical
22    direction, and no employment  relationship  is  required.   A
 
                            -2-      LRB093 06091 LRD 12936 a
 1    written   collaborative   agreement   shall  conform  to  the
 2    requirements of Sections 15-15 and 15-20 of the  Nursing  and
 3    Advanced  Practice  Nursing  Act.   The written collaborative
 4    agreement shall be for services the  collaborating  physician
 5    generally  provides  to  his  or  her  patients in the normal
 6    course of  clinical  medical  practice.    Physician  medical
 7    direction  shall  be  adequate  with respect to collaboration
 8    with certified nurse practitioners, certified nurse midwives,
 9    and clinical nurse specialists if a collaborating physician:
10             (1)  participates in the joint formulation and joint
11        approval  of  orders  or  guidelines  with  the  advanced
12        practice nurse and periodically reviews such  orders  and
13        the  services  provided  patients  under  such  orders in
14        accordance with accepted standards  of  medical  practice
15        and advanced practice nursing practice;
16             (2)  is  on  site  at  least once a month to provide
17        medical direction and consultation; and
18             (3)  is  available  through  telecommunications  for
19        consultation  on  medical  problems,  complications,   or
20        emergencies or patient referral.
21        (b-5)  An   anesthesiologist  or  physician  licensed  to
22    practice medicine in all its branches may collaborate with  a
23    certified  registered  nurse  anesthetist  in accordance with
24    Section 15-25 of the Nursing and  Advanced  Practice  Nursing
25    Act.   Medical  direction  for  a  certified registered nurse
26    anesthetist shall be adequate if:
27             (1) an anesthesiologist or a physician  participates
28        in  the joint formulation and joint approval of orders or
29        guidelines and periodically reviews such orders  and  the
30        services provided patients under such orders; and
31             (2)  for  anesthesia  services, the anesthesiologist
32        or  physician  participates  through  discussion  of  and
33        agreement with the  anesthesia  plan  and  is  physically
34        present and available on the premises during the delivery
 
                            -3-      LRB093 06091 LRD 12936 a
 1        of  anesthesia  services for diagnosis, consultation, and
 2        treatment of  emergency  medical  conditions.  Anesthesia
 3        services  in  a hospital shall be conducted in accordance
 4        with Section 10.7 of the Hospital Licensing Act and in an
 5        ambulatory surgical treatment center in  accordance  with
 6        Section  6.5  of the Ambulatory Surgical Treatment Center
 7        Act.
 8        (b-10)  The anesthesiologist or operating physician  must
 9    agree  with  the  anesthesia  plan  prior  to the delivery of
10    services.
11        (c)  The supervising physician shall have access  to  the
12    medical  records  of  all  patients  attended  by a physician
13    assistant.  The collaborating physician shall have access  to
14    the  medical  records  of  all  patients  attended  to  by an
15    advanced practice nurse.
16        (d)  Nothing in this Act shall be construed to limit  the
17    delegation  of  tasks  or  duties  by a physician licensed to
18    practice medicine in all its branches to a licensed practical
19    nurse, a registered professional nurse, or other personnel.
20        (e)  A physician shall not be  liable  for  the  acts  or
21    omissions of a physician assistant or advanced practice nurse
22    solely  on the basis of having signed a supervision agreement
23    or guidelines or  a  collaborative  agreement,  an  order,  a
24    standing medical order, a standing delegation order, or other
25    order  or  guideline  authorizing  a  physician  assistant or
26    advanced practice nurse to perform acts, unless the physician
27    has reason to believe the  physician  assistant  or  advanced
28    practice  nurse  lacked  the competency to perform the act or
29    acts or commits willful and wanton misconduct.
30    (Source: P.A. 90-742, eff. 8-13-98; 91-414, eff. 8-6-99.)".