97TH GENERAL ASSEMBLY
State of Illinois
2011 and 2012
HB3133

 

Introduced 2/23/2011, by Rep. Sara Feigenholtz

 

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

    Amends the Nurse Practice Act. Provides that an advanced practice nurse may, but is not required to, submit a request to the Department to eliminate the requirement of the written collaborative agreement, allowing the advanced practice nurse autonomous practice with full prescribing authority if the advance practice nurse (i) shows proof of successfully practicing under a delegated written collaborative agreement for a minimum of 2 years, (ii) shows proof of an unencumbered license, (iii) shows proof of individual malpractice insurance, (iv) agrees in writing that 20 hours of the 50-hour requirement for continuing education be in pharmacology, and (v) signs a memorandum of understanding to the Department affirming that the advance practice nurse will collaborate, consult, and refer to a physician and other colleagues in adherence to the Act and all rules governing the scope of practice for certification.


LRB097 10610 CEL 50997 b

 

 

A BILL FOR

 

HB3133LRB097 10610 CEL 50997 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7    (Section scheduled to be repealed on January 1, 2018)
8    Sec. 65-35. Written collaborative agreements.
9    (a) A written collaborative agreement is required for all
10advanced practice nurses engaged in clinical practice, except
11for advanced practice nurses who are authorized to practice in
12a hospital or ambulatory surgical treatment center.
13    (a-5) If an advanced practice nurse engages in clinical
14practice outside of a hospital or ambulatory surgical treatment
15center in which he or she is authorized to practice, the
16advanced practice nurse must have a written collaborative
17agreement.
18    (b) A written collaborative agreement shall describe the
19working relationship of the advanced practice nurse with the
20collaborating physician or podiatrist and shall authorize the
21categories of care, treatment, or procedures to be performed by
22the advanced practice nurse. A collaborative agreement with a
23dentist must be in accordance with subsection (c-10) of this

 

 

HB3133- 2 -LRB097 10610 CEL 50997 b

1Section. Collaboration does not require an employment
2relationship between the collaborating physician and advanced
3practice nurse. Collaboration means the relationship under
4which an advanced practice nurse works with a collaborating
5physician or podiatrist in an active clinical practice to
6deliver health care services in accordance with (i) the
7advanced practice nurse's training, education, and experience
8and (ii) collaboration and consultation as documented in a
9jointly developed written collaborative agreement.
10    The agreement shall be defined to promote the exercise of
11professional judgment by the advanced practice nurse
12commensurate with his or her education and experience. The
13services to be provided by the advanced practice nurse shall be
14services that the collaborating physician or podiatrist is
15authorized to and generally provides to his or her patients in
16the normal course of his or her clinical medical practice,
17except as set forth in subsection (c-5) of this Section. The
18agreement need not describe the exact steps that an advanced
19practice nurse must take with respect to each specific
20condition, disease, or symptom but must specify which
21authorized procedures require the presence of the
22collaborating physician or podiatrist as the procedures are
23being performed. The collaborative relationship under an
24agreement shall not be construed to require the personal
25presence of a physician or podiatrist at all times at the place
26where services are rendered. Methods of communication shall be

 

 

HB3133- 3 -LRB097 10610 CEL 50997 b

1available for consultation with the collaborating physician or
2podiatrist in person or by telecommunications in accordance
3with established written guidelines as set forth in the written
4agreement.
5    (c) Collaboration and consultation under all collaboration
6agreements shall be adequate if a collaborating physician or
7podiatrist does each of the following:
8        (1) Participates in the joint formulation and joint
9    approval of orders or guidelines with the advanced practice
10    nurse and he or she periodically reviews such orders and
11    the services provided patients under such orders in
12    accordance with accepted standards of medical practice and
13    advanced practice nursing practice.
14        (2) Meets in person with the advanced practice nurse at
15    least once a month to provide collaboration and
16    consultation. In the case of anesthesia services provided
17    by a certified registered nurse anesthetist, an
18    anesthesiologist, physician, dentist, or podiatrist must
19    participate through discussion of and agreement with the
20    anesthesia plan and remain physically present and
21    available on the premises during the delivery of anesthesia
22    services for diagnosis, consultation, and treatment of
23    emergency medical conditions.
24        (3) Is available through telecommunications for
25    consultation on medical problems, complications, or
26    emergencies or patient referral. In the case of anesthesia

 

 

HB3133- 4 -LRB097 10610 CEL 50997 b

1    services provided by a certified registered nurse
2    anesthetist, an anesthesiologist, physician, dentist, or
3    podiatrist must participate through discussion of and
4    agreement with the anesthesia plan and remain physically
5    present and available on the premises during the delivery
6    of anesthesia services for diagnosis, consultation, and
7    treatment of emergency medical conditions.
8    The agreement must contain provisions detailing notice for
9termination or change of status involving a written
10collaborative agreement, except when such notice is given for
11just cause.
12    (c-5) A certified registered nurse anesthetist, who
13provides anesthesia services outside of a hospital or
14ambulatory surgical treatment center shall enter into a written
15collaborative agreement with an anesthesiologist or the
16physician licensed to practice medicine in all its branches or
17the podiatrist performing the procedure. Outside of a hospital
18or ambulatory surgical treatment center, the certified
19registered nurse anesthetist may provide only those services
20that the collaborating podiatrist is authorized to provide
21pursuant to the Podiatric Medical Practice Act of 1987 and
22rules adopted thereunder. A certified registered nurse
23anesthetist may select, order, and administer medication,
24including controlled substances, and apply appropriate medical
25devices for delivery of anesthesia services under the
26anesthesia plan agreed with by the anesthesiologist or the

 

 

HB3133- 5 -LRB097 10610 CEL 50997 b

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

 

 

HB3133- 6 -LRB097 10610 CEL 50997 b

1must be available to the Department upon request from both the
2advanced practice nurse and the collaborating physician or
3podiatrist.
4    (e) Nothing in this Act shall be construed to limit the
5delegation of tasks or duties by a physician to a licensed
6practical nurse, a registered professional nurse, or other
7persons in accordance with Section 54.2 of the Medical Practice
8Act of 1987.
9    (f) An advanced practice nurse shall inform each
10collaborating physician, dentist, or podiatrist of all
11collaborative agreements he or she has signed and provide a
12copy of these to any collaborating physician, dentist, or
13podiatrist upon request.
14    (g) An advanced practice nurse may, but is not required to,
15submit a request to the Department to eliminate the requirement
16of the written collaborative agreement, allowing the advanced
17practice nurse autonomous practice with full prescribing
18authority if the advance practice nurse:
19        (1) shows proof of successfully practicing under a
20    delegated written collaborative agreement or under
21    credentialing and privileging in a hospital or ambulatory
22    surgical treatment center for a minimum of 2 years;
23        (2) shows proof of an unencumbered license;
24        (3) shows proof of individual malpractice insurance;
25        (4) agrees in writing that 20 hours of the 50-hour
26    requirement for continuing education be in pharmacology;

 

 

HB3133- 7 -LRB097 10610 CEL 50997 b

1    and
2        (5) signs a memorandum of understanding to the
3    Department affirming that the advance practice nurse will
4    collaborate, consult, and refer to a physician and other
5    colleagues in adherence to this Act and all rules governing
6    the scope of practice for certification.
7    Notwithstanding any other provision of this Section, an
8advanced practice nurse may be engaged in clinical practice
9without a written collaborative agreement.
10(Source: P.A. 95-639, eff. 10-5-07; 96-618, eff. 1-1-10.)