94TH GENERAL ASSEMBLY
State of Illinois
2005 and 2006
HB4706


 
Introduced 1/12/2006, by Rep. Angelo Saviano
 
SYNOPSIS AS INTRODUCED:
 		
















225 ILCS 60/54.5




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







    Amends the Medical Practice Act of 1987.  Allows a physician licensed to practice medicine in all its branches to enter into a supervising physician agreement with no more than 4, rather than 2, physician assistants at one time.  Amends the Physician Assistant Practice Act.  Provides that no more than 4, rather than 2, physician assistants shall be supervised by a supervising physician at one time and that an alternate supervising physician may supervise more than 4, rather than 2, physician assistants.  Effective immediately.
















LRB094 16947 RAS 52226 b

















 


 


A BILL FOR









 











HB4706

LRB094 16947 RAS 52226 b






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    AN ACT concerning regulation.

 
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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    (Section scheduled to be repealed on January 1, 2007)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 4

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2 physician assistants at one time.

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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. No more than 4
2

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physician
assistants shall be supervised
by
the supervising 
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physician at one time, although a physician assistant shall be 
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able to
hold more than one professional position.  Each 
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supervising physician shall
file a notice of supervision of 
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such physician assistant according to the
rules of the 
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Department.  However, the alternate supervising physician may

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supervise more than 4
2 physician assistants when
the 
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supervising
physician
is unable to provide such supervision 
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consistent with the definition of
alternate physician in 
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Section 4.

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    Physician assistants shall be supervised only by 
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physicians as defined in
this Act
who are engaged in clinical 
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practice, or in clinical practice in
public health or other 
 


 






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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 
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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 
27
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.