SB0318 Engrossed LRB096 08980 ASK 19119 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 Medical Practice Act of 1987 is amended by
5 changing Section 54.5 and by adding Section 54.2 as follows:
 
6     (225 ILCS 60/54.2 new)
7     (Section scheduled to be repealed on December 31, 2010)
8     Sec. 54.2. Physician delegation of authority.
9     (a) Nothing in this Act shall be construed to limit the
10 delegation of tasks or duties by a physician licensed to
11 practice medicine in all its branches to a licensed practical
12 nurse, a registered professional nurse, or other licensed
13 person practicing within the scope of his or her individual
14 licensing Act.
15     (b) A physician licensed to practice medicine in all its
16 branches may delegate tasks and duties to an appropriately
17 trained licensed or unlicensed person. Any such task or duty
18 delegated to a licensed or unlicensed person must be within the
19 education, training, or experience of the delegating physician
20 and within the context of a physician-patient relationship.
21     (c) A chiropractic physician may delegate tasks and duties
22 to an appropriately trained licensed or unlicensed person. Any
23 task or duty delegated to a licensed or unlicensed person by

 

 

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1 the chiropractic physician:
2         (1) must fall within the scope of practice of the
3     chiropractic physician as defined by this Act;
4         (2) must be within the education, training, or
5     experience of the delegating chiropractic physician; and
6         (3) can only be delegated within the context of a
7     physician-patient relationship.
 
8     (225 ILCS 60/54.5)
9     (Section scheduled to be repealed on December 31, 2010)
10     Sec. 54.5. Physician delegation of authority to physician
11 assistants and advanced practice nurses.
12     (a) Physicians licensed to practice medicine in all its
13 branches may delegate care and treatment responsibilities to a
14 physician assistant under guidelines in accordance with the
15 requirements of the Physician Assistant Practice Act of 1987. A
16 physician licensed to practice medicine in all its branches may
17 enter into supervising physician agreements with no more than 2
18 physician assistants.
19     (b) A physician licensed to practice medicine in all its
20 branches in active clinical practice may collaborate with an
21 advanced practice nurse in accordance with the requirements of
22 the Nurse Practice Act. Collaboration is for the purpose of
23 providing medical consultation, and no employment relationship
24 is required. A written collaborative agreement shall conform to
25 the requirements of Section 65-35 of the Nurse Practice Act.

 

 

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1 The written collaborative agreement shall be for services the
2 collaborating physician generally provides to his or her
3 patients in the normal course of clinical medical practice. A
4 written collaborative agreement shall be adequate with respect
5 to collaboration with advanced practice nurses if all of the
6 following apply:
7         (1) The agreement is written to promote the exercise of
8     professional judgment by the advanced practice nurse
9     commensurate with his or her education and experience. The
10     agreement need not describe the exact steps that an
11     advanced practice nurse must take with respect to each
12     specific condition, disease, or symptom, but must specify
13     those procedures that require a physician's presence as the
14     procedures are being performed.
15         (2) Practice guidelines and orders are developed and
16     approved jointly by the advanced practice nurse and
17     collaborating physician, as needed, based on the practice
18     of the practitioners. Such guidelines and orders and the
19     patient services provided thereunder are periodically
20     reviewed by the collaborating physician.
21         (3) The advance practice nurse provides services the
22     collaborating physician generally provides to his or her
23     patients in the normal course of clinical practice, except
24     as set forth in subsection (b-5) of this Section. With
25     respect to labor and delivery, the collaborating physician
26     must provide delivery services in order to participate with

 

 

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1     a certified nurse midwife.
2         (4) The collaborating physician and advanced practice
3     nurse meet in person at least once a month to provide
4     collaboration and consultation.
5         (5) Methods of communication are available with the
6     collaborating physician in person or through
7     telecommunications for consultation, collaboration, and
8     referral as needed to address patient care needs.
9         (6) The agreement contains provisions detailing notice
10     for termination or change of status involving a written
11     collaborative agreement, except when such notice is given
12     for just cause.
13     (b-5) An anesthesiologist or physician licensed to
14 practice medicine in all its branches may collaborate with a
15 certified registered nurse anesthetist in accordance with
16 Section 65-35 of the Nurse Practice Act for the provision of
17 anesthesia services. With respect to the provision of
18 anesthesia services, the collaborating anesthesiologist or
19 physician shall have training and experience in the delivery of
20 anesthesia services consistent with Department rules.
21 Collaboration shall be adequate if:
22         (1) an anesthesiologist or a physician participates in
23     the joint formulation and joint approval of orders or
24     guidelines and periodically reviews such orders and the
25     services provided patients under such orders; and
26         (2) for anesthesia services, the anesthesiologist or

 

 

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1     physician participates through discussion of and agreement
2     with the anesthesia plan and is physically present and
3     available on the premises during the delivery of anesthesia
4     services for diagnosis, consultation, and treatment of
5     emergency medical conditions. Anesthesia services in a
6     hospital shall be conducted in accordance with Section 10.7
7     of the Hospital Licensing Act and in an ambulatory surgical
8     treatment center in accordance with Section 6.5 of the
9     Ambulatory Surgical Treatment Center Act.
10     (b-10) The anesthesiologist or operating physician must
11 agree with the anesthesia plan prior to the delivery of
12 services.
13     (c) The supervising physician shall have access to the
14 medical records of all patients attended by a physician
15 assistant. The collaborating physician shall have access to the
16 medical records of all patients attended to by an advanced
17 practice nurse.
18     (d) Nothing in this Act shall be construed to limit the
19 delegation of tasks or duties by a physician licensed to
20 practice medicine in all its branches to a licensed practical
21 nurse, a registered professional nurse, or other persons in
22 accordance with Section 54.2.
23     (e) A physician shall not be liable for the acts or
24 omissions of a physician assistant or advanced practice nurse
25 solely on the basis of having signed a supervision agreement or
26 guidelines or a collaborative agreement, an order, a standing

 

 

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1 medical order, a standing delegation order, or other order or
2 guideline authorizing a physician assistant or advanced
3 practice nurse to perform acts, unless the physician has reason
4 to believe the physician assistant or advanced practice nurse
5 lacked the competency to perform the act or acts or commits
6 willful and wanton misconduct.
7 (Source: P.A. 95-639, eff. 10-5-07.)
 
8     Section 99. Effective date. This Act takes effect upon
9 becoming law.