Full Text of HB3133 97th General Assembly
HB3133 97TH GENERAL ASSEMBLY |
| | 97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012 HB3133 Introduced 2/23/2011, by Rep. Sara Feigenholtz SYNOPSIS AS INTRODUCED: |
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225 ILCS 65/65-35 |
was 225 ILCS 65/15-15 |
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Amends the Nurse Practice Act. Provides that an advanced practice nurse may, but is not required to, submit a request to the Department to eliminate the requirement of the written collaborative agreement, allowing the advanced practice nurse autonomous practice with full prescribing authority if the advance practice nurse (i) shows proof of successfully practicing under a delegated written collaborative agreement for a minimum of 2 years, (ii) shows proof of an unencumbered license, (iii) shows proof of individual malpractice insurance, (iv) agrees in writing that 20 hours of the 50-hour requirement for continuing education be in pharmacology, and (v) signs a memorandum of understanding to the Department affirming that the advance practice nurse will collaborate, consult, and refer to a physician and other colleagues in adherence to the Act and all rules governing the scope of practice for certification.
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| | A BILL FOR |
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| 1 | | AN ACT concerning regulation.
| 2 | | Be it enacted by the People of the State of Illinois,
| 3 | | represented in the General Assembly:
| 4 | | Section 5. The Nurse Practice Act is amended by changing | 5 | | Section 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| 7 | | (Section scheduled to be repealed on January 1, 2018)
| 8 | | Sec. 65-35. Written collaborative
agreements. | 9 | | (a) A written collaborative agreement is required for all | 10 | | advanced practice nurses engaged in clinical practice, except | 11 | | for advanced practice nurses who are authorized to practice in | 12 | | a hospital or ambulatory surgical treatment center. | 13 | | (a-5) If an advanced practice nurse engages in clinical | 14 | | practice outside of a hospital or ambulatory surgical treatment | 15 | | center in which he or she is authorized to practice, the | 16 | | advanced practice nurse must have a written collaborative | 17 | | agreement.
| 18 | | (b) A written collaborative
agreement shall describe the | 19 | | working relationship of the
advanced practice nurse with the | 20 | | collaborating
physician or podiatrist and shall authorize the | 21 | | categories of
care, treatment, or procedures to be performed by | 22 | | the advanced
practice nurse. A collaborative agreement with a | 23 | | dentist must be in accordance with subsection (c-10) of this |
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| 1 | | Section. Collaboration does not require an
employment | 2 | | relationship between the collaborating physician
and advanced | 3 | | practice nurse. Collaboration means
the relationship under
| 4 | | which an advanced practice nurse works with a collaborating
| 5 | | physician or podiatrist in an active clinical practice to | 6 | | deliver health care services in
accordance with
(i) the | 7 | | advanced practice nurse's training, education,
and experience | 8 | | and (ii) collaboration and consultation as documented in a
| 9 | | jointly developed written collaborative
agreement.
| 10 | | The agreement shall be defined to promote the
exercise of | 11 | | professional judgment by the advanced practice
nurse | 12 | | commensurate with his or her education and
experience. The | 13 | | services to be provided by the advanced
practice nurse shall be | 14 | | services that the
collaborating physician or podiatrist is | 15 | | authorized to and generally provides to his or her
patients in | 16 | | the normal course of his or her clinical medical practice, | 17 | | except as set forth in subsection (c-5) of this Section.
The | 18 | | agreement need not describe the exact steps that an advanced | 19 | | practice
nurse must take with respect to each specific | 20 | | condition, disease, or symptom
but must specify
which | 21 | | authorized procedures require the presence of the | 22 | | collaborating physician or podiatrist as
the procedures are | 23 | | being performed. The collaborative
relationship under an | 24 | | agreement shall not be
construed to require the personal | 25 | | presence of a physician or podiatrist at
all times at the place | 26 | | where services are rendered.
Methods of communication shall
be |
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| 1 | | available for consultation with the collaborating
physician or | 2 | | podiatrist in person or by telecommunications in accordance | 3 | | with
established written guidelines as set forth in the written
| 4 | | agreement.
| 5 | | (c) Collaboration and consultation under all collaboration | 6 | | agreements
shall be adequate if a
collaborating physician or | 7 | | podiatrist does each of the following:
| 8 | | (1) Participates in the joint formulation and joint | 9 | | approval of orders or
guidelines with the advanced practice | 10 | | nurse and he or she periodically reviews such orders and | 11 | | the
services provided patients under such orders in | 12 | | accordance with accepted
standards of medical practice and | 13 | | advanced practice nursing practice.
| 14 | | (2) Meets in person with the advanced practice nurse at | 15 | | least once a month to provide collaboration and
| 16 | | consultation. In the case of anesthesia services provided | 17 | | by a certified registered nurse anesthetist, an | 18 | | anesthesiologist, physician, dentist, or podiatrist must | 19 | | participate through discussion of and agreement with the | 20 | | anesthesia plan and remain physically present and | 21 | | available on the premises during the delivery of anesthesia | 22 | | services for diagnosis, consultation, and treatment of | 23 | | emergency medical conditions.
| 24 | | (3) Is available through telecommunications for | 25 | | consultation on medical
problems, complications, or | 26 | | emergencies or patient referral. In the case of anesthesia |
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| 1 | | services provided by a certified registered nurse | 2 | | anesthetist, an anesthesiologist, physician, dentist, or | 3 | | podiatrist must participate through discussion of and | 4 | | agreement with the anesthesia plan and remain physically | 5 | | present and available on the premises during the delivery | 6 | | of anesthesia services for diagnosis, consultation, and | 7 | | treatment of emergency medical conditions.
| 8 | | The agreement must contain provisions detailing notice for | 9 | | termination or change of status involving a written | 10 | | collaborative agreement, except when such notice is given for | 11 | | just cause. | 12 | | (c-5) A certified registered nurse anesthetist, who | 13 | | provides anesthesia services outside of a hospital or | 14 | | ambulatory surgical treatment center shall enter into a written | 15 | | collaborative agreement with an anesthesiologist or the | 16 | | physician licensed to practice medicine in all its branches or | 17 | | the podiatrist performing the procedure. Outside of a hospital | 18 | | or ambulatory surgical treatment center, the certified | 19 | | registered nurse anesthetist may provide only those services | 20 | | that the collaborating podiatrist is authorized to provide | 21 | | pursuant to the Podiatric Medical Practice Act of 1987 and | 22 | | rules adopted thereunder. A certified registered nurse | 23 | | anesthetist may select, order, and administer medication, | 24 | | including controlled substances, and apply appropriate medical | 25 | | devices for delivery of anesthesia services under the | 26 | | anesthesia plan agreed with by the anesthesiologist or the |
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| 1 | | operating physician or operating podiatrist. | 2 | | (c-10) A certified registered nurse anesthetist who | 3 | | provides anesthesia services in a dental office shall enter | 4 | | into a written collaborative agreement with an | 5 | | anesthesiologist or the physician licensed to practice | 6 | | medicine in all its branches or the operating dentist | 7 | | performing the procedure. The agreement shall describe the | 8 | | working relationship of the certified registered nurse | 9 | | anesthetist and dentist and shall authorize the categories of | 10 | | care, treatment, or procedures to be performed by the certified | 11 | | registered nurse anesthetist. In a collaborating dentist's | 12 | | office, the certified registered nurse anesthetist may only | 13 | | provide those services that the operating dentist with the | 14 | | appropriate permit is authorized to provide pursuant to the | 15 | | Illinois Dental Practice Act and rules adopted thereunder. For | 16 | | anesthesia services, an anesthesiologist, physician, or | 17 | | operating dentist shall participate through discussion of and | 18 | | agreement with the anesthesia plan and shall remain physically | 19 | | present and be available on the premises during the delivery of | 20 | | anesthesia services for diagnosis, consultation, and treatment | 21 | | of emergency medical conditions. A certified registered nurse | 22 | | anesthetist may select, order, and administer medication, | 23 | | including controlled substances, and apply appropriate medical | 24 | | devices for delivery of anesthesia services under the | 25 | | anesthesia plan agreed with by the operating dentist. | 26 | | (d) A copy of the signed, written collaborative agreement |
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| 1 | | must be available
to the Department upon request from both the | 2 | | advanced practice nurse
and the collaborating physician or | 3 | | podiatrist. | 4 | | (e) Nothing in this Act shall be construed to limit the | 5 | | delegation of tasks or duties by a physician to a licensed | 6 | | practical nurse, a registered professional nurse, or other | 7 | | persons in accordance with Section 54.2 of the Medical Practice | 8 | | Act of 1987. | 9 | | (f) An advanced
practice nurse shall inform each | 10 | | collaborating physician, dentist, or podiatrist of all | 11 | | collaborative
agreements he or she
has signed and provide a | 12 | | copy of these to any collaborating physician, dentist, or | 13 | | podiatrist upon
request.
| 14 | | (g) An advanced practice nurse may, but is not required to, | 15 | | submit a request to the Department to eliminate the requirement | 16 | | of the written collaborative agreement, allowing the advanced | 17 | | practice nurse autonomous practice with full prescribing | 18 | | authority if the advance practice nurse: | 19 | | (1) shows proof of successfully practicing under a | 20 | | delegated written collaborative agreement or under | 21 | | credentialing and privileging in a hospital or ambulatory | 22 | | surgical treatment center for a minimum of 2 years; | 23 | | (2) shows proof of an unencumbered license; | 24 | | (3) shows proof of individual malpractice insurance; | 25 | | (4) agrees in writing that 20 hours of the 50-hour | 26 | | requirement for continuing education be in pharmacology; |
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| 1 | | and | 2 | | (5) signs a memorandum of understanding to the | 3 | | Department affirming that the advance practice nurse will | 4 | | collaborate, consult, and refer to a physician and other | 5 | | colleagues in adherence to this Act and all rules governing | 6 | | the scope of practice for certification. | 7 | | Notwithstanding any other provision of this Section, an | 8 | | advanced practice nurse may be engaged in clinical practice | 9 | | without a written collaborative agreement. | 10 | | (Source: P.A. 95-639, eff. 10-5-07; 96-618, eff. 1-1-10.)
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