SB1322 EnrolledLRB100 08882 MJP 19025 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    (Text of Section before amendment by P.A. 100-513)
8    (Section scheduled to be repealed on January 1, 2028)
9    Sec. 65-35. Written collaborative agreements.
10    (a) A written collaborative agreement is required for all
11advanced practice nurses engaged in clinical practice, except
12for advanced practice nurses who are authorized to practice in
13a hospital, hospital affiliate, or ambulatory surgical
14treatment center.
15    (a-5) If an advanced practice nurse engages in clinical
16practice outside of a hospital, hospital affiliate, or
17ambulatory surgical treatment center in which he or she is
18authorized to practice, the advanced practice nurse must have a
19written collaborative agreement.
20    (b) A written collaborative agreement shall describe the
21relationship of the advanced practice nurse with the
22collaborating physician or podiatric physician and shall
23describe the categories of care, treatment, or procedures to be

 

 

SB1322 Enrolled- 2 -LRB100 08882 MJP 19025 b

1provided by the advanced practice nurse. A collaborative
2agreement with a dentist must be in accordance with subsection
3(c-10) of this Section. Collaboration does not require an
4employment relationship between the collaborating physician or
5podiatric physician and advanced practice nurse.
6    The collaborative relationship under an agreement shall
7not be construed to require the personal presence of a
8physician or podiatric physician at the place where services
9are rendered. Methods of communication shall be available for
10consultation with the collaborating physician or podiatric
11physician in person or by telecommunications or electronic
12communications as set forth in the written agreement.
13    (b-5) Absent an employment relationship, a written
14collaborative agreement may not (1) restrict the categories of
15patients of an advanced practice nurse within the scope of the
16advanced practice nurses training and experience, (2) limit
17third party payors or government health programs, such as the
18medical assistance program or Medicare with which the advanced
19practice nurse contracts, or (3) limit the geographic area or
20practice location of the advanced practice nurse in this State.
21    (c) In the case of anesthesia services provided by a
22certified registered nurse anesthetist, an anesthesiologist, a
23physician, a dentist, or a podiatric physician must participate
24through discussion of and agreement with the anesthesia plan
25and remain physically present and available on the premises
26during the delivery of anesthesia services for diagnosis,

 

 

SB1322 Enrolled- 3 -LRB100 08882 MJP 19025 b

1consultation, and treatment of emergency medical conditions.
2    (c-5) A certified registered nurse anesthetist, who
3provides anesthesia services outside of a hospital or
4ambulatory surgical treatment center shall enter into a written
5collaborative agreement with an anesthesiologist or the
6physician licensed to practice medicine in all its branches or
7the podiatric physician performing the procedure. Outside of a
8hospital or ambulatory surgical treatment center, the
9certified registered nurse anesthetist may provide only those
10services that the collaborating podiatric physician is
11authorized to provide pursuant to the Podiatric Medical
12Practice Act of 1987 and rules adopted thereunder. A certified
13registered nurse anesthetist may select, order, and administer
14medication, including controlled substances, and apply
15appropriate medical devices for delivery of anesthesia
16services under the anesthesia plan agreed with by the
17anesthesiologist or the operating physician or operating
18podiatric physician.
19    (c-10) A certified registered nurse anesthetist who
20provides anesthesia services in a dental office shall enter
21into a written collaborative agreement with an
22anesthesiologist or the physician licensed to practice
23medicine in all its branches or the operating dentist
24performing the procedure. The agreement shall describe the
25working relationship of the certified registered nurse
26anesthetist and dentist and shall authorize the categories of

 

 

SB1322 Enrolled- 4 -LRB100 08882 MJP 19025 b

1care, treatment, or procedures to be performed by the certified
2registered nurse anesthetist. In a collaborating dentist's
3office, the certified registered nurse anesthetist may only
4provide those services that the operating dentist with the
5appropriate permit is authorized to provide pursuant to the
6Illinois Dental Practice Act and rules adopted thereunder. For
7anesthesia services, an anesthesiologist, physician, or
8operating dentist shall participate through discussion of and
9agreement with the anesthesia plan and shall remain physically
10present and be available on the premises during the delivery of
11anesthesia services for diagnosis, consultation, and treatment
12of emergency medical conditions. A certified registered nurse
13anesthetist may select, order, and administer medication,
14including controlled substances, and apply appropriate medical
15devices for delivery of anesthesia services under the
16anesthesia plan agreed with by the operating dentist.
17    (d) A copy of the signed, written collaborative agreement
18must be available to the Department upon request from both the
19advanced practice nurse and the collaborating physician,
20dentist, or podiatric physician.
21    (e) Nothing in this Act shall be construed to limit the
22delegation of tasks or duties by a physician to a licensed
23practical nurse, a registered professional nurse, or other
24persons in accordance with Section 54.2 of the Medical Practice
25Act of 1987. Nothing in this Act shall be construed to limit
26the method of delegation that may be authorized by any means,

 

 

SB1322 Enrolled- 5 -LRB100 08882 MJP 19025 b

1including, but not limited to, oral, written, electronic,
2standing orders, protocols, guidelines, or verbal orders.
3Nothing in this Act shall be construed to authorize an advanced
4practice nurse to provide health care services required by law
5or rule to be performed by a physician.
6    (f) An advanced practice 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. 98-192, eff. 1-1-14; 98-214, eff. 8-9-13; 98-756,
13eff. 7-16-14; 99-173, eff. 7-29-15.)
 
14    (Text of Section after amendment by P.A. 100-513)
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
18advanced practice registered nurses engaged in clinical
19practice prior to meeting the requirements of Section 65-43,
20except for advanced practice registered nurses who are
21privileged to practice in a hospital, hospital affiliate, or
22ambulatory surgical treatment center.
23    (a-5) If an advanced practice registered nurse engages in
24clinical practice outside of a hospital, hospital affiliate, or
25ambulatory surgical treatment center in which he or she is

 

 

SB1322 Enrolled- 6 -LRB100 08882 MJP 19025 b

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

 

 

SB1322 Enrolled- 7 -LRB100 08882 MJP 19025 b

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

 

 

SB1322 Enrolled- 8 -LRB100 08882 MJP 19025 b

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

 

 

SB1322 Enrolled- 9 -LRB100 08882 MJP 19025 b

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

 

 

SB1322 Enrolled- 10 -LRB100 08882 MJP 19025 b

1an advanced practice registered nurse to provide health care
2services required by law or rule to be performed by a
3physician, including those acts to be performed by a physician
4in Section 3.1 of the Illinois Abortion Law of 1975.
5    (f) An advanced practice registered nurse shall inform each
6collaborating physician, dentist, or podiatric physician of
7all collaborative agreements he or she has signed and provide a
8copy of these to any collaborating physician, dentist, or
9podiatric physician upon request.
10    (g) (Blank).
11(Source: P.A. 99-173, eff. 7-29-15; 100-513, eff. 1-1-18.)
 
12    Section 95. No acceleration or delay. Where this Act makes
13changes in a statute that is represented in this Act by text
14that is not yet or no longer in effect (for example, a Section
15represented by multiple versions), the use of that text does
16not accelerate or delay the taking effect of (i) the changes
17made by this Act or (ii) provisions derived from any other
18Public Act.
 
19    Section 99. Effective date. This Act takes effect January
201, 2018.