93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004
HB4386


 
Introduced 02/03/04, by Gary Hannig
 
SYNOPSIS AS INTRODUCED:
 		















225 ILCS 60/54.5




225 ILCS 95/7
  from Ch. 111, par. 4607








    Amends the Medical Practice Act of 1987 and the Physician Assistant Practice
Act of 1987 to allow supervising physicians to supervise more than 2 physician
assistants.  Effective immediately.



















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A BILL FOR









 














HB4386

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    AN ACT concerning physician assistants. 

 
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    Be it enacted by the People of the State of Illinois, 
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represented in the General Assembly: 


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


 
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    (225 ILCS 60/54.5)

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    (Section scheduled to be repealed on January 1, 2007)


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    Sec. 54.5. Physician delegation of authority.


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    (a) Physicians licensed to practice medicine in all its

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branches may delegate care and treatment responsibilities to a

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physician assistant under guidelines in accordance with the

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requirements of  the Physician Assistant Practice Act of
1987.  A 
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physician licensed to practice medicine in all its
branches may 
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enter into supervising physician agreements with
no more than 2

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physician assistants.


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    (b) A physician licensed to practice medicine in all its

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branches in active clinical practice may collaborate with an 
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advanced practice
nurse in accordance with the requirements of 
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Title 15 of
the Nursing and Advanced Practice Nursing Act.  
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Collaboration
is for the purpose of providing medical 
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direction,
and no employment relationship is required.  A

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written collaborative agreement shall
conform to the 
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requirements of Sections 15-15 and 15-20
of the Nursing and

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Advanced Practice Nursing Act.  The written collaborative 
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agreement shall
be for
services the collaborating physician 
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generally provides to
his or her patients in the normal course 
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of clinical medical practice.
 Physician medical direction 
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shall be adequate with respect to collaboration
with certified 
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nurse practitioners, certified nurse midwives, and clinical

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nurse
specialists if a collaborating physician:


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        (1) participates in the joint formulation and joint 
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    approval of orders or
guidelines with the advanced practice 
 


 









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    nurse and periodically reviews such
orders and the services

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    provided patients under such orders in accordance with 
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    accepted standards of
medical practice and advanced 
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    practice nursing practice;


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        (2) is on site at least once a month to provide medical 
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    direction and
consultation; and


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        (3) is available through telecommunications for 
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    consultation on medical
problems, complications, or 
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    emergencies or patient referral.


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    (b-5) An anesthesiologist or physician licensed to 
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practice medicine in
all its branches may collaborate with a 
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certified registered nurse anesthetist
in accordance with 
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Section 15-25 of the Nursing and Advanced Practice Nursing
Act.  
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Medical direction for a certified registered nurse anesthetist 
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shall be
adequate if:


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        (1) an anesthesiologist or a physician
participates in 
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    the joint formulation and joint approval of orders or

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    guidelines and periodically reviews such orders and the 
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    services provided
patients under such orders; and


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        (2) for anesthesia services, the anesthesiologist
or 
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    physician participates through discussion of and agreement 
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    with the
anesthesia plan and is physically present and 
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    available on the premises during
the delivery of anesthesia 
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    services for
diagnosis, consultation, and treatment of 
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    emergency medical conditions.
Anesthesia services in a 
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    hospital shall be conducted in accordance with
Section 10.7 
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    of the Hospital Licensing Act and in an ambulatory surgical

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    treatment center in accordance with Section 6.5 of the 
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    Ambulatory Surgical
Treatment Center Act.


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    (b-10) The anesthesiologist or operating physician must 
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agree with the
anesthesia plan prior to the delivery of 
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services.


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    (c) The supervising physician shall have access to the

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medical records of all patients attended by a physician

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assistant.  The collaborating physician shall have access to
the 
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medical records of all patients attended to by an
advanced 
 


 









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practice nurse.


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    (d) Nothing in this Act
shall be construed to limit the 
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delegation of
tasks or duties by a physician licensed to 
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practice medicine
in all its branches to a licensed practical 
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nurse, a registered professional
nurse, or other personnel.


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    (e) A physician shall not be liable for the acts or

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omissions of a physician assistant or advanced practice
nurse 
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solely on the basis of having signed a
supervision agreement or 
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guidelines or a collaborative
agreement, an order, a standing 
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medical order, a
standing delegation order, or other order or 
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guideline
authorizing a physician assistant or advanced 
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practice
nurse to perform acts, unless the physician has
reason 
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to believe the physician assistant or advanced
practice nurse 
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lacked the competency to perform
the act or acts or commits 
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willful and wanton misconduct.


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(Source: P.A. 90-742, eff. 8-13-98; 91-414, eff. 8-6-99.)


 
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    Section 10. The Physician Assistant Practice Act of 1987 is 
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amended by
changing Section 7 as follows:


 



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    (225 ILCS 95/7)  (from Ch. 111, par. 4607)


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    (Section scheduled to be repealed on January 1, 2008)

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    Sec. 7. Supervision requirements. Physician
No more than 2 
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physician
assistants shall be supervised
by
the supervising 
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physician, although a physician assistant shall be able to
hold 
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more than one professional position.  Each supervising 
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physician shall
file a notice of supervision of such physician 
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assistant according to the
rules of the Department.  However, 
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the alternate supervising physician may
supervise more than 2 
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physician assistants when
the supervising
physician
is unable 
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to provide such supervision consistent with the definition of

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alternate physician in Section 4.    Physician assistants 
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shall be supervised only by physicians as defined in
this Act

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who are engaged in clinical practice, or in clinical practice 
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in
public health or other community health facilities.

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    Nothing in this Act shall be construed to limit the 
 


 









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delegation of tasks or
duties by a physician to a nurse or 
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other appropriately trained personnel.

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    Nothing in this Act
shall be construed to prohibit the 
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employment of physician assistants by
a hospital, nursing home 
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or other health care facility where such physician
assistants 
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function under the supervision of a supervising physician.

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    Physician assistants may be employed by the Department of 
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Corrections or
the Department of Human Services (as successor 
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to the Department of Mental
Health and Developmental 
10
Disabilities) for service in
facilities maintained by such 
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Departments and affiliated training
facilities in programs 
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conducted under the authority of the Director of
Corrections or 
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the Secretary of Human Services.  Each physician assistant

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employed by the Department of Corrections or the Department of 
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Human Services
(as successor to the Department of Mental Health 
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and
Developmental Disabilities) shall be under the supervision 
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of a physician
engaged in clinical practice and direct patient 
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care.  Duties of each
physician assistant employed by such 
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Departments are limited to those
within the scope of practice 
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of the supervising physician who is fully
responsible for all 
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physician assistant activities.

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    A physician assistant may be employed by a practice group 
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or other entity
employing multiple physicians at one or more 
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locations.  In that case, one of
the
physicians practicing at a 
25
location shall be designated the supervising
physician.  The 
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other physicians with that practice group or other entity who

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practice in the same general type of practice or specialty
as 
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the supervising physician may supervise the physician 
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assistant with respect
to their patients without being deemed 
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alternate supervising physicians for the
purpose of this Act.

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(Source: P.A. 93-149, eff. 7-10-03.)



 
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    Section 99. Effective date. This Act takes effect upon 
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becoming law.