Sen. Emil Jones, III

Filed: 3/14/2019

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 1683

2    AMENDMENT NO. ______. Amend Senate Bill 1683 by replacing
3everything after the enacting clause with the following:
 
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7    (Section scheduled to be repealed on January 1, 2028)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

 

 

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1ambulatory surgical treatment center in which he or she is
2privileged to practice, the advanced practice registered nurse
3must have a written collaborative agreement, except as set
4forth in Section 65-43.
5    (b) A written collaborative agreement shall describe the
6relationship of the advanced practice registered nurse with the
7collaborating physician and shall describe the categories of
8care, treatment, or procedures to be provided by the advanced
9practice registered nurse. A collaborative agreement with a
10podiatric physician must be in accordance with subsection (c-5)
11or (c-15) of this Section. A collaborative agreement with a
12dentist must be in accordance with subsection (c-10) of this
13Section. A collaborative agreement with a podiatric physician
14must be in accordance with subsection (c-5) of this Section.
15Collaboration does not require an employment relationship
16between the collaborating physician and the advanced practice
17registered nurse.
18    The collaborative relationship under an agreement shall
19not be construed to require the personal presence of a
20collaborating physician at the place where services are
21rendered. Methods of communication shall be available for
22consultation with the collaborating physician in person or by
23telecommunications or electronic communications as set forth
24in the written agreement.
25    (b-5) Absent an employment relationship, a written
26collaborative agreement may not (1) restrict the categories of

 

 

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1patients of an advanced practice registered nurse within the
2scope of the advanced practice registered nurses training and
3experience, (2) limit third party payors or government health
4programs, such as the medical assistance program or Medicare
5with which the advanced practice registered nurse contracts, or
6(3) limit the geographic area or practice location of the
7advanced practice registered nurse in this State.
8    (c) In the case of anesthesia services provided by a
9certified registered nurse anesthetist, an anesthesiologist, a
10physician, a dentist, or a podiatric physician must participate
11through discussion of and agreement with the anesthesia plan
12and remain physically present and available on the premises
13during the delivery of surgical anesthesia services for
14diagnosis, consultation, and treatment of emergency medical
15conditions.
16    (c-5) A certified registered nurse anesthetist, who
17provides anesthesia services outside of a hospital or
18ambulatory surgical treatment center shall enter into a written
19collaborative agreement with an anesthesiologist or the
20physician licensed to practice medicine in all its branches or
21the podiatric physician performing the procedure. Outside of a
22hospital or ambulatory surgical treatment center, the
23certified registered nurse anesthetist may provide only those
24services that the collaborating podiatric physician is
25authorized to provide pursuant to the Podiatric Medical
26Practice Act of 1987 and rules adopted thereunder. A certified

 

 

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

 

 

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1anesthetist may select, order, and administer medication,
2including controlled substances, and apply appropriate medical
3devices for delivery of anesthesia services under the
4anesthesia plan agreed with by the operating dentist.
5    (c-15) An advanced practice registered nurse who had a
6written collaborative agreement with a podiatric physician
7immediately before the effective date of Public Act 100-513 may
8continue in that collaborative relationship or enter into a new
9written collaborative relationship with a podiatric physician
10under the requirements of this Section and Section 65-40, as
11those Sections existed immediately before the amendment of
12those Sections by Public Act 100-513 with regard to a written
13collaborative agreement between an advanced practice
14registered nurse and a podiatric physician.
15    (d) A copy of the signed, written collaborative agreement
16must be available to the Department upon request from both the
17advanced practice registered nurse and the collaborating
18physician, dentist, or podiatric physician.
19    (e) Nothing in this Act shall be construed to limit the
20delegation of tasks or duties by a physician to a licensed
21practical nurse, a registered professional nurse, or other
22persons in accordance with Section 54.2 of the Medical Practice
23Act of 1987. Nothing in this Act shall be construed to limit
24the method of delegation that may be authorized by any means,
25including, but not limited to, oral, written, electronic,
26standing orders, protocols, guidelines, or verbal orders.

 

 

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1    (e-5) Nothing in this Act shall be construed to authorize
2an advanced practice registered nurse to provide health care
3services required by law or rule to be performed by a
4physician, including those acts to be performed by a physician
5in Section 3.1 of the Illinois Abortion Law of 1975.
6    (f) An advanced practice registered nurse shall inform each
7collaborating physician, dentist, or podiatric physician of
8all collaborative agreements he or she has signed and provide a
9copy of these to any collaborating physician, dentist, or
10podiatric physician upon request.
11    (g) (Blank).
12(Source: P.A. 99-173, eff. 7-29-15; 100-513, eff. 1-1-18;
13100-577, eff. 1-26-18; 100-1096, eff. 8-26-18.)
 
14    Section 99. Effective date. This Act takes effect upon
15becoming law.".