Full Text of HB2895 103rd General Assembly
HB2895 103RD GENERAL ASSEMBLY |
| | 103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024 HB2895 Introduced 2/16/2023, by Rep. Anna Moeller SYNOPSIS AS INTRODUCED: |
| 210 ILCS 5/6.5 | | 225 ILCS 60/54.5 | | 225 ILCS 65/65-35 | was 225 ILCS 65/15-15 | 225 ILCS 65/65-45 | was 225 ILCS 65/15-25 |
|
Amends the Nurse Practice Act. Provides that a certified registered nurse anesthetist providing anesthesia services outside the hospital, ambulatory surgical treatment center, or hospital affiliate shall enter into a written collaborative agreement with a physician, podiatric physician, or dentist. Removes provisions providing that a certified registered nurse anesthetist, an anesthesiologist, a physician, a dentist, or a podiatric physician must participate through discussion of an agreement with the anesthesia plan and remain physically present and available on the premises during the delivery of anesthesia services. Makes corresponding changes in the Ambulatory Surgical Treatment Center Act and the Medical Practice Act of 1987. Effective immediately.
|
| |
| | A BILL FOR |
|
| | | HB2895 | | LRB103 30134 AMQ 56558 b |
|
| 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 Ambulatory Surgical Treatment Center Act is | 5 | | amended by changing Section 6.5 as follows:
| 6 | | (210 ILCS 5/6.5)
| 7 | | Sec. 6.5. Clinical privileges; advanced practice | 8 | | registered nurses. All ambulatory surgical treatment centers | 9 | | (ASTC) licensed under this Act
shall
comply with the following | 10 | | requirements:
| 11 | | (1) No ASTC policy, rule, regulation, or practice | 12 | | shall be inconsistent
with the provision of adequate | 13 | | collaboration and consultation in accordance with Section | 14 | | 54.5 of the Medical
Practice Act of 1987.
| 15 | | (2) Operative surgical procedures shall be performed | 16 | | only by a physician
licensed to
practice medicine in
all | 17 | | its branches under the Medical Practice Act of 1987, a | 18 | | dentist
licensed under the
Illinois Dental Practice Act, | 19 | | or a podiatric physician licensed under the Podiatric
| 20 | | Medical Practice Act of 1987,
with medical staff | 21 | | membership and surgical clinical privileges granted by the
| 22 | | consulting
committee of the ASTC. A licensed physician, | 23 | | dentist, or podiatric physician may
be assisted by
a |
| | | HB2895 | - 2 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | physician licensed to practice medicine in all its | 2 | | branches, dentist, dental
assistant, podiatric physician, | 3 | | licensed
advanced practice registered nurse, licensed | 4 | | physician assistant, licensed
registered nurse, licensed | 5 | | practical nurse,
surgical
assistant, surgical technician, | 6 | | or other individuals granted clinical
privileges to assist | 7 | | in surgery
by the consulting committee of the ASTC.
| 8 | | Payment for services rendered by an assistant in surgery | 9 | | who is not an
ambulatory surgical treatment center | 10 | | employee shall be paid
at the appropriate non-physician | 11 | | modifier
rate if the payor would have made payment had the | 12 | | same services been provided
by a physician.
| 13 | | (2.5) A registered nurse licensed under the Nurse | 14 | | Practice Act and qualified by training and experience in | 15 | | operating room nursing shall be present in the operating | 16 | | room and function as the circulating nurse during all | 17 | | invasive or operative procedures. For purposes of this | 18 | | paragraph (2.5), "circulating nurse" means a registered | 19 | | nurse who is responsible for coordinating all nursing | 20 | | care, patient safety needs, and the needs of the surgical | 21 | | team in the operating room during an invasive or operative | 22 | | procedure.
| 23 | | (3) An advanced practice registered nurse is not | 24 | | required to possess prescriptive authority or a written | 25 | | collaborative agreement meeting the requirements of the | 26 | | Nurse Practice Act to provide advanced practice registered |
| | | HB2895 | - 3 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | nursing services in an ambulatory surgical treatment | 2 | | center. An advanced practice registered nurse must possess | 3 | | clinical privileges granted by the consulting medical | 4 | | staff committee and ambulatory surgical treatment center | 5 | | in order to provide services. Individual advanced practice | 6 | | registered nurses may also be granted clinical privileges | 7 | | to order, select, and administer medications, including | 8 | | controlled substances, to provide delineated care. The | 9 | | attending physician must determine the advanced practice | 10 | | registered nurse's role in providing care for his or her | 11 | | patients, except as otherwise provided in the consulting | 12 | | staff policies. The consulting medical staff committee | 13 | | shall periodically review the services of advanced | 14 | | practice registered nurses granted privileges.
| 15 | | (4) The anesthesia service shall be under the | 16 | | direction of a physician
licensed to practice
medicine in | 17 | | all its branches who has had specialized preparation or | 18 | | experience
in the area
or who has completed a residency in | 19 | | anesthesiology. An anesthesiologist, Board
certified or
| 20 | | Board eligible, is recommended. Anesthesia services may
| 21 | | only be
administered upon the request pursuant to the | 22 | | order of a physician licensed to practice medicine
in all | 23 | | its
branches, licensed dentist, or licensed podiatric | 24 | | physician.
| 25 | | (A) The individuals who, with clinical privileges | 26 | | granted by the medical
staff and ASTC, may
administer |
| | | HB2895 | - 4 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | anesthesia services are limited to the
following:
| 2 | | (i) an anesthesiologist; or
| 3 | | (ii) a physician licensed to practice medicine | 4 | | in all its branches; or
| 5 | | (iii) a dentist with authority to administer | 6 | | anesthesia under Section
8.1 of the
Illinois | 7 | | Dental Practice Act; or
| 8 | | (iv) a licensed certified registered nurse | 9 | | anesthetist; or | 10 | | (v) a podiatric physician licensed under the | 11 | | Podiatric Medical Practice Act of 1987.
| 12 | | (B) (Blank). For anesthesia services, an | 13 | | anesthesiologist
shall
participate through discussion | 14 | | of and agreement with the anesthesia plan and
shall | 15 | | remain physically present and be
available on
the | 16 | | premises during the delivery of anesthesia services | 17 | | for
diagnosis, consultation, and treatment of | 18 | | emergency medical
conditions.
In the absence of | 19 | | 24-hour availability of anesthesiologists with | 20 | | clinical
privileges, an alternate policy (requiring
| 21 | | participation, presence,
and availability of a
| 22 | | physician licensed to practice medicine in all its
| 23 | | branches) shall be
developed by the medical staff | 24 | | consulting committee in consultation with the
| 25 | | anesthesia service and included in the medical
staff
| 26 | | consulting committee policies.
|
| | | HB2895 | - 5 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | (C) A certified registered nurse anesthetist is | 2 | | not required to possess
prescriptive authority or a | 3 | | written collaborative agreement meeting the
| 4 | | requirements of Section 65-35 of the Nurse Practice | 5 | | Act
to provide anesthesia services
ordered by a | 6 | | licensed physician, dentist, or podiatric physician . | 7 | | Licensed certified
registered nurse anesthetists are | 8 | | authorized to
select, order, and
administer drugs and | 9 | | apply the appropriate medical devices in the provision | 10 | | of
anesthesia
services under the anesthesia plan | 11 | | agreed with by the
anesthesiologist or, in the absence | 12 | | of an available anesthesiologist with
clinical | 13 | | privileges,
agreed with by the
operating physician, | 14 | | operating dentist, or operating podiatric physician in | 15 | | accordance
with the medical
staff consulting committee | 16 | | policies of a licensed ambulatory surgical treatment
| 17 | | center.
| 18 | | (Source: P.A. 99-642, eff. 7-28-16; 100-513, eff. 1-1-18 .)
| 19 | | Section 10. The Medical Practice Act of 1987 is amended by | 20 | | changing Section 54.5 as follows:
| 21 | | (225 ILCS 60/54.5)
| 22 | | (Section scheduled to be repealed on January 1, 2027)
| 23 | | Sec. 54.5. Physician delegation of authority to physician | 24 | | assistants, advanced practice registered nurses without full |
| | | HB2895 | - 6 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | practice authority, and prescribing psychologists.
| 2 | | (a) Physicians licensed to practice medicine in all its
| 3 | | branches may delegate care and treatment responsibilities to a
| 4 | | physician assistant under guidelines in accordance with the
| 5 | | requirements of the Physician Assistant Practice Act of
1987. | 6 | | A physician licensed to practice medicine in all its
branches | 7 | | may enter into collaborative agreements with
no more than 7 | 8 | | full-time equivalent physician assistants, except in a | 9 | | hospital, hospital affiliate, or ambulatory surgical treatment | 10 | | center as set forth by Section 7.7 of the Physician Assistant | 11 | | Practice Act of 1987 and as provided in subsection (a-5).
| 12 | | (a-5) A physician licensed to practice medicine in all its | 13 | | branches may collaborate with more than 7 physician assistants | 14 | | when the services are provided in a federal primary care | 15 | | health professional shortage area with a Health Professional | 16 | | Shortage Area score greater than or equal to 12, as determined | 17 | | by the United States Department of Health and Human Services. | 18 | | The collaborating physician must keep appropriate | 19 | | documentation of meeting this exemption and make it available | 20 | | to the Department upon request. | 21 | | (b) A physician licensed to practice medicine in all its
| 22 | | branches in active clinical practice may collaborate with an | 23 | | advanced practice
registered nurse in accordance with the | 24 | | requirements of the Nurse Practice Act. Collaboration
is for | 25 | | the purpose of providing medical consultation,
and no | 26 | | employment relationship is required. A
written collaborative |
| | | HB2895 | - 7 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | agreement shall
conform to the requirements of Section 65-35 | 2 | | of the Nurse Practice Act. The written collaborative agreement | 3 | | shall
be for
services in the same area of practice or specialty | 4 | | as the collaborating physician in
his or her clinical medical | 5 | | practice.
A written collaborative agreement shall be adequate | 6 | | with respect to collaboration
with advanced practice | 7 | | registered nurses if all of the following apply:
| 8 | | (1) The agreement is written to promote the exercise | 9 | | of professional judgment by the advanced practice | 10 | | registered nurse commensurate with his or her education | 11 | | and experience.
| 12 | | (2) The advanced practice registered nurse provides | 13 | | services based upon a written collaborative agreement with | 14 | | the collaborating physician, except as set forth in | 15 | | subsection (b-5) of this Section. With respect to labor | 16 | | and delivery, the collaborating physician must provide | 17 | | delivery services in order to participate with a certified | 18 | | nurse midwife. | 19 | | (3) Methods of communication are available with the | 20 | | collaborating physician in person or through | 21 | | telecommunications for consultation, collaboration, and | 22 | | referral as needed to address patient care needs.
| 23 | | (b-5) An anesthesiologist or physician licensed to | 24 | | practice medicine in
all its branches may collaborate with a | 25 | | certified registered nurse anesthetist
in accordance with | 26 | | Section 65-35 of the Nurse Practice Act for the provision of |
| | | HB2895 | - 8 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | anesthesia services. With respect to the provision of | 2 | | anesthesia services, the collaborating anesthesiologist or | 3 | | physician shall have training and experience in the delivery | 4 | | of anesthesia services consistent with Department rules. | 5 | | Collaboration shall be
adequate if: (1) an anesthesiologist or | 6 | | a physician
participates in the joint formulation and joint | 7 | | approval of orders or
guidelines and periodically reviews such | 8 | | orders and the services provided
patients under such orders; | 9 | | and (2) for anesthesia services, the anesthesiologist
or | 10 | | physician participates through discussion of and agreement | 11 | | with the
anesthesia plan and is physically present and | 12 | | available on the premises during
the delivery of anesthesia | 13 | | services for
diagnosis, consultation, and treatment of | 14 | | emergency medical conditions.
Anesthesia services in a | 15 | | hospital shall be conducted in accordance with
Section 10.7 of | 16 | | the Hospital Licensing Act and in an ambulatory surgical
| 17 | | treatment center in accordance with Section 6.5 of the | 18 | | Ambulatory Surgical
Treatment Center Act.
| 19 | | (b-10) (Blank). The anesthesiologist or operating | 20 | | physician must agree with the
anesthesia plan prior to the | 21 | | delivery of services.
| 22 | | (c) The collaborating physician shall have access to the
| 23 | | medical records of all patients attended by a physician
| 24 | | assistant. The collaborating physician shall have access to
| 25 | | the medical records of all patients attended to by an
advanced | 26 | | practice registered nurse.
|
| | | HB2895 | - 9 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | (d) (Blank).
| 2 | | (e) A physician shall not be liable for the acts or
| 3 | | omissions of a prescribing psychologist, physician assistant, | 4 | | or advanced practice
registered nurse solely on the basis of | 5 | | having signed a
supervision agreement or guidelines or a | 6 | | collaborative
agreement, an order, a standing medical order, a
| 7 | | standing delegation order, or other order or guideline
| 8 | | authorizing a prescribing psychologist, physician assistant, | 9 | | or advanced practice
registered nurse to perform acts, unless | 10 | | the physician has
reason to believe the prescribing | 11 | | psychologist, physician assistant, or advanced
practice | 12 | | registered nurse lacked the competency to perform
the act or | 13 | | acts or commits willful and wanton misconduct.
| 14 | | (f) A collaborating physician may, but is not required to, | 15 | | delegate prescriptive authority to an advanced practice | 16 | | registered nurse as part of a written collaborative agreement, | 17 | | and the delegation of prescriptive authority shall conform to | 18 | | the requirements of Section 65-40 of the Nurse Practice Act. | 19 | | (g) A collaborating physician may, but is not required to, | 20 | | delegate prescriptive authority to a physician assistant as | 21 | | part of a written collaborative agreement, and the delegation | 22 | | of prescriptive authority shall conform to the requirements of | 23 | | Section 7.5 of the Physician Assistant Practice Act of 1987. | 24 | | (h) (Blank). | 25 | | (i) A collaborating physician shall delegate prescriptive | 26 | | authority to a prescribing psychologist as part of a written |
| | | HB2895 | - 10 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | collaborative agreement, and the delegation of prescriptive | 2 | | authority shall conform to the requirements of Section 4.3 of | 3 | | the Clinical Psychologist Licensing Act. | 4 | | (j) As set forth in Section 22.2 of this Act, a licensee | 5 | | under this Act may not directly or indirectly divide, share, | 6 | | or split any professional fee or other form of compensation | 7 | | for professional services with anyone in exchange for a | 8 | | referral or otherwise, other than as provided in Section 22.2. | 9 | | (Source: P.A. 99-173, eff. 7-29-15; 100-453, eff. 8-25-17; | 10 | | 100-513, eff. 1-1-18; 100-605, eff. 1-1-19; 100-863, eff. | 11 | | 8-14-18 .)
| 12 | | Section 15. The Nurse Practice Act is amended by changing | 13 | | Sections 65-35 and 65-45 as follows:
| 14 | | (225 ILCS 65/65-35)
(was 225 ILCS 65/15-15)
| 15 | | (Section scheduled to be repealed on January 1, 2028)
| 16 | | Sec. 65-35. Written collaborative
agreements. | 17 | | (a) A written collaborative agreement is required for all | 18 | | advanced practice registered nurses engaged in clinical | 19 | | practice prior to meeting the requirements of Section 65-43, | 20 | | except for advanced practice registered nurses who are | 21 | | privileged to practice in a hospital, hospital affiliate, or | 22 | | ambulatory surgical treatment center. | 23 | | (a-5) If an advanced practice registered nurse engages in | 24 | | clinical practice outside of a hospital, hospital affiliate, |
| | | HB2895 | - 11 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | or ambulatory surgical treatment center in which he or she is | 2 | | privileged to practice, the advanced practice registered nurse | 3 | | must have a written collaborative agreement, except as set | 4 | | forth in Section 65-43.
| 5 | | (b) A written collaborative
agreement shall describe the | 6 | | relationship of the
advanced practice registered nurse with | 7 | | the collaborating
physician and shall describe the categories | 8 | | of
care, treatment, or procedures to be provided by the | 9 | | advanced
practice registered nurse. A collaborative agreement | 10 | | with a podiatric physician must be in accordance with | 11 | | subsection (c-5) or (c-15) of this Section. A certified | 12 | | registered nurse anesthetist providing anesthesia services | 13 | | outside the hospital, ambulatory surgical treatment center, or | 14 | | hospital affiliate shall enter into a written collaborative | 15 | | agreement with a physician, podiatric physician, or dentist. A | 16 | | collaborative agreement with a dentist must be in accordance | 17 | | with subsection (c-10) of this Section. A collaborative | 18 | | agreement with a podiatric physician must be in accordance | 19 | | with subsection (c-5) of this Section. Collaboration does not | 20 | | require an
employment relationship between the collaborating | 21 | | physician
and the advanced practice registered nurse.
| 22 | | The collaborative
relationship under an agreement shall | 23 | | not be
construed to require the personal presence of a | 24 | | collaborating physician at the place where services are | 25 | | rendered.
Methods of communication shall
be available for | 26 | | consultation with the collaborating
physician in person or by |
| | | HB2895 | - 12 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | telecommunications or electronic communications as set forth | 2 | | in the written
agreement.
| 3 | | (b-5) Absent an employment relationship, a written | 4 | | collaborative agreement may not (1) restrict the categories of | 5 | | patients of an advanced practice registered nurse within the | 6 | | scope of the advanced practice registered nurses training and | 7 | | experience, (2) limit third party payors or government health | 8 | | programs, such as the medical assistance program or Medicare | 9 | | with which the advanced practice registered nurse contracts, | 10 | | or (3) limit the geographic area or practice location of the | 11 | | advanced practice registered nurse in this State. | 12 | | (c) (Blank).
In the case of anesthesia services provided | 13 | | by a certified registered nurse anesthetist, an | 14 | | anesthesiologist, a physician, a dentist, or a podiatric | 15 | | physician must participate through discussion of and agreement | 16 | | with the anesthesia plan and remain physically present and | 17 | | available on the premises during the delivery of anesthesia | 18 | | services for diagnosis, consultation, and treatment of | 19 | | emergency medical conditions.
| 20 | | (c-5) A certified registered nurse anesthetist, who | 21 | | provides anesthesia services outside of a hospital or | 22 | | ambulatory surgical treatment center shall enter into a | 23 | | written collaborative agreement with an anesthesiologist or | 24 | | the physician licensed to practice medicine in all its | 25 | | branches or the podiatric physician performing the procedure. | 26 | | Outside of a hospital or ambulatory surgical treatment center, |
| | | HB2895 | - 13 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | the certified registered nurse anesthetist may provide only | 2 | | those services that the collaborating podiatric physician is | 3 | | authorized to provide pursuant to the Podiatric Medical | 4 | | Practice Act of 1987 and rules adopted thereunder. A certified | 5 | | registered nurse anesthetist may select, order, and administer | 6 | | medication, including controlled substances, and apply | 7 | | appropriate medical devices for delivery of anesthesia | 8 | | services under the anesthesia plan agreed with by the | 9 | | anesthesiologist or the operating physician or operating | 10 | | podiatric physician. | 11 | | (c-10) A certified registered nurse anesthetist who | 12 | | provides anesthesia services in a dental office shall enter | 13 | | into a written collaborative agreement with an | 14 | | anesthesiologist or the physician licensed to practice | 15 | | medicine in all its branches or the operating dentist | 16 | | performing the procedure. The agreement shall describe the | 17 | | working relationship of the certified registered nurse | 18 | | anesthetist and dentist and shall authorize the categories of | 19 | | care, treatment, or procedures to be performed by the | 20 | | certified registered nurse anesthetist. In a collaborating | 21 | | dentist's office, the certified registered nurse anesthetist | 22 | | may only provide those services that the operating dentist | 23 | | with the appropriate permit is authorized to provide pursuant | 24 | | to the Illinois Dental Practice Act and rules adopted | 25 | | thereunder. For anesthesia services, an anesthesiologist, | 26 | | physician, or operating dentist shall participate through |
| | | HB2895 | - 14 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | discussion of and agreement with the anesthesia plan and shall | 2 | | remain physically present and be available on the premises | 3 | | during the delivery of anesthesia services for diagnosis, | 4 | | consultation, and treatment of emergency medical conditions. A | 5 | | certified registered nurse anesthetist may select, order, and | 6 | | administer medication, including controlled substances, and | 7 | | apply appropriate medical devices for delivery of anesthesia | 8 | | services under the anesthesia plan agreed with by the | 9 | | operating dentist. | 10 | | (c-15) An advanced practice registered nurse who had a | 11 | | written collaborative agreement with a podiatric physician | 12 | | immediately before the effective date of Public Act 100-513 | 13 | | may continue in that collaborative relationship or enter into | 14 | | a new written collaborative relationship with a podiatric | 15 | | physician under the requirements of this Section and Section | 16 | | 65-40, as those Sections existed immediately before the | 17 | | amendment of those Sections by Public Act 100-513 with regard | 18 | | to a written collaborative agreement between an advanced | 19 | | practice registered nurse and a podiatric physician. | 20 | | (d) A copy of the signed, written collaborative agreement | 21 | | must be available
to the Department upon request from both the | 22 | | advanced practice registered nurse
and the collaborating | 23 | | physician, dentist, or podiatric physician. | 24 | | (e) Nothing in this Act shall be construed to limit the | 25 | | delegation of tasks or duties by a physician to a licensed | 26 | | practical nurse, a registered professional nurse, or other |
| | | HB2895 | - 15 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | persons in accordance with Section 54.2 of the Medical | 2 | | Practice Act of 1987. Nothing in this Act shall be construed to | 3 | | limit the method of delegation that may be authorized by any | 4 | | means, including, but not limited to, oral, written, | 5 | | electronic, standing orders, protocols, guidelines, or verbal | 6 | | orders. | 7 | | (e-5) Nothing in this Act shall be construed to authorize | 8 | | an advanced practice registered nurse to provide health care | 9 | | services required by law or rule to be performed by a | 10 | | physician. The scope of practice of an advanced practice | 11 | | registered nurse does not include operative surgery. Nothing | 12 | | in this Section shall be construed to preclude an advanced | 13 | | practice registered nurse from assisting in surgery. | 14 | | (f) An advanced
practice registered nurse shall inform | 15 | | each collaborating physician, dentist, or podiatric physician | 16 | | of all collaborative
agreements he or she
has signed and | 17 | | provide a copy of these to any collaborating physician, | 18 | | dentist, or podiatric physician upon
request.
| 19 | | (g) (Blank). | 20 | | (Source: P.A. 100-513, eff. 1-1-18; 100-577, eff. 1-26-18; | 21 | | 100-1096, eff. 8-26-18; 101-13, eff. 6-12-19.)
| 22 | | (225 ILCS 65/65-45)
(was 225 ILCS 65/15-25)
| 23 | | (Section scheduled to be repealed on January 1, 2028)
| 24 | | Sec. 65-45. Advanced practice registered nursing in | 25 | | hospitals, hospital affiliates, or ambulatory surgical |
| | | HB2895 | - 16 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | treatment centers.
| 2 | | (a) An advanced practice registered nurse may provide
| 3 | | services in a hospital or a hospital affiliate as those terms | 4 | | are defined in the Hospital Licensing Act or the University of | 5 | | Illinois Hospital Act or a licensed ambulatory surgical
| 6 | | treatment center without a written collaborative agreement | 7 | | pursuant to Section 65-35 of this Act. An advanced practice | 8 | | registered nurse must possess clinical privileges recommended | 9 | | by the hospital medical staff and granted by the hospital or | 10 | | the consulting medical staff committee and ambulatory surgical | 11 | | treatment center in order to provide services. The medical | 12 | | staff or consulting medical staff committee shall periodically | 13 | | review the services of all advanced practice registered nurses | 14 | | granted clinical privileges, including any care provided in a | 15 | | hospital affiliate. Authority may also be granted when | 16 | | recommended by the hospital medical staff and granted by the | 17 | | hospital or recommended by the consulting medical staff | 18 | | committee and ambulatory surgical treatment center to | 19 | | individual advanced practice registered nurses to select, | 20 | | order, and administer medications, including controlled | 21 | | substances, to provide delineated care. In a hospital, | 22 | | hospital affiliate, or ambulatory surgical treatment center, | 23 | | the attending physician shall determine an advanced practice | 24 | | registered nurse's role in providing care for his or her | 25 | | patients, except as otherwise provided in the medical staff | 26 | | bylaws or consulting committee policies.
|
| | | HB2895 | - 17 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | (a-2) An advanced practice registered nurse privileged to | 2 | | order medications, including controlled substances, may | 3 | | complete discharge prescriptions provided the prescription is | 4 | | in the name of the advanced practice registered nurse and the | 5 | | attending or discharging physician. | 6 | | (a-3) Advanced practice registered nurses practicing in a | 7 | | hospital or an ambulatory surgical treatment center are not | 8 | | required to obtain a mid-level controlled substance license to | 9 | | order controlled substances under Section 303.05 of the | 10 | | Illinois Controlled Substances Act. | 11 | | (a-4) An advanced practice registered nurse meeting the | 12 | | requirements of Section 65-43 may be privileged to complete | 13 | | discharge orders and prescriptions under the advanced practice | 14 | | registered nurse's name. | 15 | | (a-5) For
anesthesia services provided by a certified | 16 | | registered nurse anesthetist, an anesthesiologist,
physician, | 17 | | dentist,
or podiatric physician shall participate through | 18 | | discussion of and agreement with the
anesthesia plan and shall
| 19 | | remain
physically present
and be available on the premises | 20 | | during the delivery of anesthesia services for
diagnosis, | 21 | | consultation, and treatment of
emergency medical conditions, | 22 | | unless hospital policy adopted pursuant to
clause (B) of | 23 | | subdivision (3) of Section 10.7 of the Hospital Licensing Act
| 24 | | or ambulatory surgical treatment center policy adopted | 25 | | pursuant to
clause (B) of subdivision (3) of Section 6.5 of the | 26 | | Ambulatory Surgical
Treatment Center Act
provides otherwise. A |
| | | HB2895 | - 18 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | certified registered nurse anesthetist may select, order, and | 2 | | administer medication for anesthesia services under the | 3 | | anesthesia plan agreed to by the anesthesiologist or the | 4 | | physician, in accordance with hospital alternative policy or | 5 | | the medical staff consulting committee policies of a licensed | 6 | | ambulatory surgical treatment center .
| 7 | | (b) An advanced practice registered nurse who provides
| 8 | | services in a hospital shall do so in accordance with Section | 9 | | 10.7 of the
Hospital
Licensing Act and, in an
ambulatory | 10 | | surgical treatment center, in accordance with Section 6.5 of | 11 | | the
Ambulatory
Surgical Treatment Center Act. Nothing in this | 12 | | Act shall be construed to require an advanced practice | 13 | | registered nurse to have a collaborative agreement to practice | 14 | | in a hospital, hospital affiliate, or ambulatory surgical | 15 | | treatment center.
| 16 | | (c) Advanced practice registered nurses certified as nurse | 17 | | practitioners, nurse midwives, or clinical nurse specialists | 18 | | practicing in a hospital affiliate may be, but are not | 19 | | required to be, privileged to prescribe Schedule II through V | 20 | | controlled substances when such authority is recommended by | 21 | | the appropriate physician committee of the hospital affiliate | 22 | | and granted by the hospital affiliate. This authority may, but | 23 | | is not required to, include prescription of, selection of, | 24 | | orders for, administration of, storage of, acceptance of | 25 | | samples of, and dispensing over-the-counter medications, | 26 | | legend drugs, medical gases, and controlled substances |
| | | HB2895 | - 19 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | categorized as Schedule II through V controlled substances, as | 2 | | defined in Article II of the Illinois Controlled Substances | 3 | | Act, and other preparations, including, but not limited to, | 4 | | botanical and herbal remedies. | 5 | | To prescribe controlled substances under this subsection | 6 | | (c), an advanced practice registered nurse certified as a | 7 | | nurse practitioner, nurse midwife, or clinical nurse | 8 | | specialist must obtain a controlled substance license. | 9 | | Medication orders shall be reviewed periodically by the | 10 | | appropriate hospital affiliate physicians committee or its | 11 | | physician designee. | 12 | | The hospital affiliate shall file with the Department | 13 | | notice of a grant of prescriptive authority consistent with | 14 | | this subsection (c) and termination of such a grant of | 15 | | authority, in accordance with rules of the Department. Upon | 16 | | receipt of this notice of grant of authority to prescribe any | 17 | | Schedule II through V controlled substances, the licensed | 18 | | advanced practice registered nurse certified as a nurse | 19 | | practitioner, nurse midwife, or clinical nurse specialist may | 20 | | register for a mid-level practitioner controlled substance | 21 | | license under Section 303.05 of the Illinois Controlled | 22 | | Substances Act. | 23 | | In addition, a hospital affiliate may, but is not required | 24 | | to, privilege an advanced practice registered nurse certified | 25 | | as a nurse practitioner, nurse midwife, or clinical nurse | 26 | | specialist to prescribe any Schedule II controlled substances, |
| | | HB2895 | - 20 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | if all of the following conditions apply: | 2 | | (1) specific Schedule II controlled substances by oral | 3 | | dosage or topical or transdermal application may be | 4 | | designated, provided that the designated Schedule II | 5 | | controlled substances are routinely prescribed by advanced | 6 | | practice registered nurses in their area of certification; | 7 | | the privileging documents must identify the specific | 8 | | Schedule II controlled substances by either brand name or | 9 | | generic name; privileges to prescribe or dispense Schedule | 10 | | II controlled substances to be delivered by injection or | 11 | | other route of administration may not be granted; | 12 | | (2) any privileges must be controlled substances | 13 | | limited to the practice of the advanced practice | 14 | | registered nurse; | 15 | | (3) any prescription must be limited to no more than a | 16 | | 30-day supply; | 17 | | (4) the advanced practice registered nurse must | 18 | | discuss the condition of any patients for whom a | 19 | | controlled substance is prescribed monthly with the | 20 | | appropriate physician committee of the hospital affiliate | 21 | | or its physician designee; and | 22 | | (5) the advanced practice registered nurse must meet | 23 | | the education requirements of Section 303.05 of the | 24 | | Illinois Controlled Substances Act. | 25 | | (d) An advanced practice registered nurse meeting the | 26 | | requirements of Section 65-43 may be privileged to prescribe |
| | | HB2895 | - 21 - | LRB103 30134 AMQ 56558 b |
|
| 1 | | controlled substances categorized as Schedule II through V in | 2 | | accordance with Section 65-43. | 3 | | (Source: P.A. 99-173, eff. 7-29-15; 100-513, eff. 1-1-18 .)
| 4 | | Section 99. Effective date. This Act takes effect upon | 5 | | becoming law.
|
|