101ST GENERAL ASSEMBLY
State of Illinois
2019 and 2020
HB4579

 

Introduced 2/5/2020, by Rep. Anna Moeller

 

SYNOPSIS AS INTRODUCED:
 
225 ILCS 65/65-35  was 225 ILCS 65/15-15

    Amends the Nurse Practice Act. Provides that, in the case of anesthesia services provided by a certified registered nurse anesthetist, a physician, a dentist, or a podiatric physician must participate through discussion of and agreement with the anesthesia plan and remain available during the delivery of surgical anesthesia services for diagnosis, consultation, and treatment of emergency medical conditions (rather than an anesthesiologist, a physician, a dentist, or a podiatric physician must 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). Effective immediately.


LRB101 17274 SPS 66679 b

 

 

A BILL FOR

 

HB4579LRB101 17274 SPS 66679 b

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7    (Section scheduled to be repealed on January 1, 2028)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

 

 

HB4579- 2 -LRB101 17274 SPS 66679 b

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.

 

 

HB4579- 3 -LRB101 17274 SPS 66679 b

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

 

 

HB4579- 4 -LRB101 17274 SPS 66679 b

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

 

 

HB4579- 5 -LRB101 17274 SPS 66679 b

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

 

 

HB4579- 6 -LRB101 17274 SPS 66679 b

1    (f) An advanced practice registered nurse shall inform each
2collaborating physician, dentist, or podiatric physician of
3all collaborative agreements he or she has signed and provide a
4copy of these to any collaborating physician, dentist, or
5podiatric physician upon request.
6    (g) (Blank).
7(Source: P.A. 100-513, eff. 1-1-18; 100-577, eff. 1-26-18;
8100-1096, eff. 8-26-18; 101-13, eff. 6-12-19.)
 
9    Section 99. Effective date. This Act takes effect upon
10becoming law.