Sen. William R. Haine

Filed: 3/10/2011

 

 


 

 


 
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1
AMENDMENT TO SENATE BILL 2255

2    AMENDMENT NO. ______. Amend Senate Bill 2255 by replacing
3everything after the enacting clause with the following:
 
4    "Section 5. The Medical Practice Act of 1987 is amended by
5changing Section 54.5 as follows:
 
6    (225 ILCS 60/54.5)
7    (Section scheduled to be repealed on November 30, 2011)
8    Sec. 54.5. Physician delegation of authority to physician
9assistants and advanced practice nurses.
10    (a) Physicians licensed to practice medicine in all its
11branches may delegate care and treatment responsibilities to a
12physician assistant under guidelines in accordance with the
13requirements of the Physician Assistant Practice Act of 1987. A
14physician licensed to practice medicine in all its branches may
15enter into supervising physician agreements with no more than 2
16physician assistants.

 

 

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1    (b) A physician licensed to practice medicine in all its
2branches in active clinical practice may collaborate with an
3advanced practice nurse in accordance with the requirements of
4the Nurse Practice Act. Collaboration is for the purpose of
5providing medical consultation, and no employment relationship
6is required. A written collaborative agreement shall conform to
7the requirements of Section 65-35 of the Nurse Practice Act.
8The written collaborative agreement shall be for services the
9collaborating physician generally provides to his or her
10patients in the normal course of clinical medical practice. A
11written collaborative agreement shall be adequate with respect
12to collaboration with advanced practice nurses if all of the
13following apply:
14        (1) The agreement is written to promote the exercise of
15    professional judgment by the advanced practice nurse
16    commensurate with his or her education and experience. The
17    agreement need not describe the exact steps that an
18    advanced practice nurse must take with respect to each
19    specific condition, disease, or symptom, but must specify
20    those procedures that require a physician's presence as the
21    procedures are being performed.
22        (2) Practice guidelines and orders are developed and
23    approved jointly by the advanced practice nurse and
24    collaborating physician, as needed, based on the practice
25    of the practitioners. Such guidelines and orders and the
26    patient services provided thereunder are periodically

 

 

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1    reviewed by the collaborating physician.
2        (3) The advance practice nurse provides services the
3    collaborating physician generally provides to his or her
4    patients in the normal course of clinical practice, except
5    as set forth in subsection (b-5) of this Section. With
6    respect to labor and delivery, the collaborating physician
7    must provide delivery services in order to participate with
8    a certified nurse midwife.
9        (4) The collaborating physician and advanced practice
10    nurse consult meet in person at least once a month to
11    provide collaboration and consultation.
12        (5) Methods of communication are available with the
13    collaborating physician in person or through
14    telecommunications for consultation, collaboration, and
15    referral as needed to address patient care needs.
16        (6) The agreement contains provisions detailing notice
17    for termination or change of status involving a written
18    collaborative agreement, except when such notice is given
19    for just cause.
20    (b-5) An anesthesiologist or physician licensed to
21practice medicine in all its branches may collaborate with a
22certified registered nurse anesthetist in accordance with
23Section 65-35 of the Nurse Practice Act for the provision of
24anesthesia services. With respect to the provision of
25anesthesia services, the collaborating anesthesiologist or
26physician shall have training and experience in the delivery of

 

 

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1anesthesia services consistent with Department rules.
2Collaboration shall be adequate if:
3        (1) an anesthesiologist or a physician participates in
4    the joint formulation and joint approval of orders or
5    guidelines and periodically reviews such orders and the
6    services provided patients under such orders; and
7        (2) for anesthesia services, the anesthesiologist or
8    physician participates through discussion of and agreement
9    with the anesthesia plan and is physically present and
10    available on the premises during the delivery of anesthesia
11    services for diagnosis, consultation, and treatment of
12    emergency medical conditions. Anesthesia services in a
13    hospital shall be conducted in accordance with Section 10.7
14    of the Hospital Licensing Act and in an ambulatory surgical
15    treatment center in accordance with Section 6.5 of the
16    Ambulatory Surgical Treatment Center Act.
17    (b-10) The anesthesiologist or operating physician must
18agree with the anesthesia plan prior to the delivery of
19services.
20    (c) The supervising physician shall have access to the
21medical records of all patients attended by a physician
22assistant. The collaborating physician shall have access to the
23medical records of all patients attended to by an advanced
24practice nurse.
25    (d) (Blank).
26    (e) A physician shall not be liable for the acts or

 

 

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1omissions of a physician assistant or advanced practice nurse
2solely on the basis of having signed a supervision agreement or
3guidelines or a collaborative agreement, an order, a standing
4medical order, a standing delegation order, or other order or
5guideline authorizing a physician assistant or advanced
6practice nurse to perform acts, unless the physician has reason
7to believe the physician assistant or advanced practice nurse
8lacked the competency to perform the act or acts or commits
9willful and wanton misconduct.
10    (f) A collaborating physician may, but is not required to,
11delegate prescriptive authority to an advanced practice nurse
12as part of a written collaborative agreement, and the
13delegation of prescriptive authority shall conform to the
14requirements of Section 65-40 of the Nurse Practice Act.
15    (g) A supervising physician may, but is not required to,
16delegate prescriptive authority to a physician assistant as
17part of a written supervision agreement, and the delegation of
18prescriptive authority shall conform to the requirements of
19Section 7.5 of the Physician Assistant Practice Act of 1987.
20(Source: P.A. 95-639, eff. 10-5-07; 96-618, eff. 1-1-10.)
 
21    Section 10. The Nurse Practice Act is amended by changing
22Sections 65-35, 65-40, and 65-45 as follows:
 
23    (225 ILCS 65/65-35)   (was 225 ILCS 65/15-15)
24    (Section scheduled to be repealed on January 1, 2018)

 

 

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1    Sec. 65-35. Written collaborative agreements.
2    (a) A written collaborative agreement is required for all
3advanced practice nurses engaged in clinical practice, except
4for advanced practice nurses who are authorized to practice in
5a hospital or ambulatory surgical treatment center.
6    (a-5) If an advanced practice nurse engages in clinical
7practice outside of a hospital or ambulatory surgical treatment
8center in which he or she is authorized to practice, the
9advanced practice nurse must have a written collaborative
10agreement.
11    (b) A written collaborative agreement shall describe the
12working relationship of the advanced practice nurse with the
13collaborating physician or podiatrist and shall authorize the
14categories of care, treatment, or procedures to be performed by
15the advanced practice nurse. A collaborative agreement with a
16dentist must be in accordance with subsection (c-10) of this
17Section. Collaboration does not require an employment
18relationship between the collaborating physician and advanced
19practice nurse. Absent an employment relationship, an
20agreement may not restrict the categories of patients or
21third-party payment sources accepted by the advanced practice
22nurse. Collaboration means the relationship under which an
23advanced practice nurse works with a collaborating physician or
24podiatrist in an active clinical practice to deliver health
25care services in accordance with (i) the advanced practice
26nurse's training, education, and experience and (ii)

 

 

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

 

 

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

 

 

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

 

 

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

 

 

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1persons in accordance with Section 54.2 of the Medical Practice
2Act of 1987. Nothing in this Act shall be construed to limit
3the method of delegation that may be authorized by any means,
4including, but not limited to, oral, written, electronic,
5standing orders, protocols, guidelines, or verbal orders.
6    (f) An advanced practice nurse shall inform each
7collaborating physician, dentist, or podiatrist of all
8collaborative agreements he or she has signed and provide a
9copy of these to any collaborating physician, dentist, or
10podiatrist upon request.
11    (g) For the purposes of this Act, "generally provides to
12his or her patients in the normal course of his or her clinical
13medical practice" means services the physician or podiatrist
14routinely provides individually or through delegation to other
15persons so that the physician or podiatrist has the experience
16and ability to provide collaboration and consultation.
17(Source: P.A. 95-639, eff. 10-5-07; 96-618, eff. 1-1-10.)
 
18    (225 ILCS 65/65-40)   (was 225 ILCS 65/15-20)
19    (Section scheduled to be repealed on January 1, 2018)
20    Sec. 65-40. Prescriptive authority.
21    (a) A collaborating physician or podiatrist may, but is not
22required to, delegate prescriptive authority to an advanced
23practice nurse as part of a written collaborative agreement.
24This authority may, but is not required to, include
25prescription of, selection of, orders for, administration of,

 

 

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1storage of, acceptance of samples of, and dispensing over the
2counter medications, legend drugs, medical gases, and
3controlled substances categorized as any Schedule III through V
4controlled substances, as defined in Article II of the Illinois
5Controlled Substances Act, and other preparations, including,
6but not limited to, botanical and herbal remedies. The
7collaborating physician or podiatrist must have a valid current
8Illinois controlled substance license and federal registration
9to delegate authority to prescribe delegated controlled
10substances.
11    (b) To prescribe controlled substances under this Section,
12an advanced practice nurse must obtain a mid-level practitioner
13controlled substance license. Medication orders shall be
14reviewed periodically by the collaborating physician or
15podiatrist.
16    (c) The collaborating physician or podiatrist shall file
17with the Department notice of delegation of prescriptive
18authority and termination of such delegation, in accordance
19with rules of the Department. Upon receipt of this notice
20delegating authority to prescribe any Schedule III through V
21controlled substances, the licensed advanced practice nurse
22shall be eligible to register for a mid-level practitioner
23controlled substance license under Section 303.05 of the
24Illinois Controlled Substances Act.
25    (d) In addition to the requirements of subsections (a),
26(b), and (c) of this Section, a collaborating physician or

 

 

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1podiatrist may, but is not required to, delegate authority to
2an advanced practice nurse to prescribe any Schedule II
3controlled substances, if all of the following conditions
4apply:
5        (1) No more than 10 5 Schedule II controlled substances
6    by oral dosage or topical or transdermal application may be
7    delegated. Schedule II controlled substances to be
8    delivered by injection or other route may not be delegated.
9        (2) Any delegation must be controlled substances that
10    the collaborating physician or podiatrist prescribes.
11        (3) Any prescription must be limited to no more than a
12    30-day supply oral dosage, with any continuation
13    authorized only after prior approval of the collaborating
14    physician or podiatrist.
15        (4) The advanced practice nurse must discuss the
16    condition of any patients for whom a controlled substance
17    is prescribed monthly with the delegating 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. Nothing in this Act shall be construed to limit the
22method of delegation that may be authorized by any means,
23including, but not limited to, oral, written, electronic,
24standing orders, protocols, guidelines, or verbal orders.
25    (f) Any advanced practice nurse who writes a prescription
26for a controlled substance without having a valid appropriate

 

 

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1mid-level practitioner license may be fined by the Department
2up to $100 per prescription, and the Department may take any
3other disciplinary action provided for in this Act.
4(Source: P.A. 95-639, eff. 10-5-07; 96-189, eff. 8-10-09.)
 
5    (225 ILCS 65/65-45)   (was 225 ILCS 65/15-25)
6    (Section scheduled to be repealed on January 1, 2018)
7    Sec. 65-45. Advanced practice nursing in hospitals or
8ambulatory surgical treatment centers.
9    (a) An advanced practice nurse may provide services in a
10licensed hospital licensed under the Hospital Licensing Act or
11the University of Illinois Hospital Act or a licensed
12ambulatory surgical treatment center without prescriptive
13authority or a written collaborative agreement pursuant to
14Section 65-35 of this Act. An advanced practice nurse must
15possess clinical privileges recommended by the hospital
16medical staff and granted by the hospital or the consulting
17medical staff committee and ambulatory surgical treatment
18center in order to provide services. The medical staff or
19consulting medical staff committee shall periodically review
20the services of advanced practice nurses granted clinical
21privileges. Authority may also be granted to individual
22advanced practice nurses to select, order, and administer
23medications, including controlled substances, to provide
24delineated care. The attending physician shall determine an
25advanced practice nurse's role in providing care for his or her

 

 

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1patients, except as otherwise provided in the medical staff
2bylaws or consulting committee policies.
3    (a-5) For anesthesia services provided by a certified
4registered nurse anesthetist, an anesthesiologist, physician,
5dentist, or podiatrist shall participate through discussion of
6and agreement with the anesthesia plan and shall remain
7physically present and be available on the premises during the
8delivery of anesthesia services for diagnosis, consultation,
9and treatment of emergency medical conditions, unless hospital
10policy adopted pursuant to clause (B) of subdivision (3) of
11Section 10.7 of the Hospital Licensing Act or ambulatory
12surgical treatment center policy adopted pursuant to clause (B)
13of subdivision (3) of Section 6.5 of the Ambulatory Surgical
14Treatment Center Act provides otherwise. A certified
15registered nurse anesthetist may select, order, and administer
16medication for anesthesia services under the anesthesia plan
17agreed to by the anesthesiologist or the physician, in
18accordance with hospital alternative policy or the medical
19staff consulting committee policies of a licensed ambulatory
20surgical treatment center.
21    (b) An advanced practice nurse who provides services in a
22hospital shall do so in accordance with Section 10.7 of the
23Hospital Licensing Act and, in an ambulatory surgical treatment
24center, in accordance with Section 6.5 of the Ambulatory
25Surgical Treatment Center Act.
26(Source: P.A. 95-639, eff. 10-5-07.)
 

 

 

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1    Section 15. The Physician Assistant Practice Act of 1987 is
2amended by changing Section 7.5 as follows:
 
3    (225 ILCS 95/7.5)
4    (Section scheduled to be repealed on January 1, 2018)
5    Sec. 7.5. Prescriptions; written supervision agreements;
6prescriptive authority.
7    (a) A written supervision agreement is required for all
8physician assistants to practice in the State.
9        (1) A written supervision agreement shall describe the
10    working relationship of the physician assistant with the
11    supervising physician and shall authorize the categories
12    of care, treatment, or procedures to be performed by the
13    physician assistant. The written supervision agreement
14    shall be defined to promote the exercise of professional
15    judgment by the physician assistant commensurate with his
16    or her education and experience. The services to be
17    provided by the physician assistant shall be services that
18    the supervising physician is authorized to and generally
19    provides to his or her patients in the normal course of his
20    or her clinical medical practice. The written supervision
21    agreement need not describe the exact steps that a
22    physician assistant must take with respect to each specific
23    condition, disease, or symptom but must specify which
24    authorized procedures require the presence of the

 

 

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1    supervising physician as the procedures are being
2    performed. The supervision relationship under a written
3    supervision agreement shall not be construed to require the
4    personal presence of a physician at all times at the place
5    where services are rendered. Methods of communication
6    shall be available for consultation with the supervising
7    physician in person or by telecommunications in accordance
8    with established written guidelines as set forth in the
9    written supervision agreement.
10        (2) The written supervision agreement shall be
11    adequate if a physician does each of the following:
12            (A) Participates in the joint formulation and
13        joint approval of orders or guidelines with the
14        physician assistant and he or she periodically reviews
15        such orders and the services provided patients under
16        such orders in accordance with accepted standards of
17        medical practice and physician assistant practice.
18            (B) Provides collaboration and consultation Meets
19        in person with the physician assistant at least once a
20        month to provide supervision.
21        (3) A copy of the signed, written supervision agreement
22    must be available to the Department upon request from both
23    the physician assistant and the supervising physician.
24        (4) A physician assistant shall inform each
25    supervising physician of all written supervision
26    agreements he or she has signed and provide a copy of these

 

 

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1    to any supervising physician upon request.
2    (b) A supervising physician may, but is not required to,
3delegate prescriptive authority to a physician assistant as
4part of a written supervision agreement. This authority may,
5but is not required to, include prescription of, selection of,
6orders for, administration of, storage of, acceptance of
7samples of, and dispensing over the counter medications, legend
8drugs, medical gases, and controlled substances categorized as
9Schedule III through V controlled substances, as defined in
10Article II of the Illinois Controlled Substances Act, and other
11preparations, including, but not limited to, botanical and
12herbal remedies. The supervising physician must have a valid,
13current Illinois controlled substance license and federal
14registration with the Drug Enforcement Agency to delegate the
15authority to prescribe controlled substances.
16        (1) To prescribe Schedule III, IV, or V controlled
17    substances under this Section, a physician assistant must
18    obtain a mid-level practitioner controlled substances
19    license. Medication orders issued by a physician assistant
20    shall be reviewed periodically by the supervising
21    physician.
22        (2) The supervising physician shall file with the
23    Department notice of delegation of prescriptive authority
24    to a physician assistant and termination of delegation,
25    specifying the authority delegated or terminated. Upon
26    receipt of this notice delegating authority to prescribe

 

 

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1    Schedule III, IV, or V controlled substances, the physician
2    assistant shall be eligible to register for a mid-level
3    practitioner controlled substances license under Section
4    303.05 of the Illinois Controlled Substances Act. Nothing
5    in this Act shall be construed to limit the delegation of
6    tasks or duties by the supervising physician to a nurse or
7    other appropriately trained persons in accordance with
8    Section 54.2 of the Medical Practice Act of 1987.
9        (3) In addition to the requirements of subsection (b)
10    of this Section, a supervising physician may, but is not
11    required to, delegate authority to a physician assistant to
12    prescribe Schedule II controlled substances, if all of the
13    following conditions apply:
14            (A) No more than 10 5 Schedule II controlled
15        substances by oral dosage or topical or transdermal
16        application may be delegated. Schedule II controlled
17        substances to be delivered by injection or other route
18        may not be delegated.
19            (B) Any delegation must be controlled substances
20        that the supervising physician prescribes.
21            (C) Any prescription must be limited to no more
22        than a 30-day supply oral dosage, with any continuation
23        authorized only after prior approval of the
24        supervising physician.
25    (c) Nothing in this Act shall be construed to limit the
26delegation of tasks or duties by a physician to a licensed

 

 

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1practical nurse, a registered professional nurse, or other
2persons. Nothing in this Act shall be construed to limit the
3method of delegation that may be authorized by any means,
4including, but not limited to, oral, written, electronic,
5standing orders, protocols, guidelines, or verbal orders.
6    (d) Any physician assistant who writes a prescription for a
7controlled substance without having a valid appropriate
8mid-level practitioner license may be fined by the Department
9up to $100 per prescription, and the Department may take any
10other disciplinary action provided for in this Act.
11(Source: P.A. 96-268, eff. 8-11-09; 96-618, eff. 1-1-10;
1296-1000, eff. 7-2-10.)
 
13    Section 20. The Podiatric Medical Practice Act of 1987 is
14amended by changing Section 20.5 as follows:
 
15    (225 ILCS 100/20.5)
16    (Section scheduled to be repealed on January 1, 2018)
17    Sec. 20.5. Delegation of authority to advanced practice
18nurses.
19    (a) A podiatrist in active clinical practice may
20collaborate with an advanced practice nurse in accordance with
21the requirements of the Nurse Practice Act. Collaboration shall
22be for the purpose of providing podiatric consultation and no
23employment relationship shall be required. A written
24collaborative agreement shall conform to the requirements of

 

 

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1Section 65-35 of the Nurse Practice Act. The written
2collaborative agreement shall be for services the
3collaborating podiatrist generally provides to his or her
4patients in the normal course of clinical podiatric practice,
5except as set forth in item (3) of this subsection (a). A
6written collaborative agreement and podiatric collaboration
7and consultation shall be adequate with respect to advanced
8practice nurses if all of the following apply:
9        (1) The agreement is written to promote the exercise of
10    professional judgment by the advanced practice nurse
11    commensurate with his or her education and experience. The
12    agreement need not describe the exact steps that an
13    advanced practice nurse must take with respect to each
14    specific condition, disease, or symptom, but must specify
15    which procedures require a podiatrist's presence as the
16    procedures are being performed.
17        (2) Practice guidelines and orders are developed and
18    approved jointly by the advanced practice nurse and
19    collaborating podiatrist, as needed, based on the practice
20    of the practitioners. Such guidelines and orders and the
21    patient services provided thereunder are periodically
22    reviewed by the collaborating podiatrist.
23        (3) The advance practice nurse provides services that
24    the collaborating podiatrist generally provides to his or
25    her patients in the normal course of clinical practice.
26    With respect to the provision of anesthesia services by a

 

 

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1    certified registered nurse anesthetist, the collaborating
2    podiatrist must have training and experience in the
3    delivery of anesthesia consistent with Department rules.
4        (4) The collaborating podiatrist and the advanced
5    practice nurse consult meet in person at least once a month
6    to provide collaboration and consultation.
7        (5) Methods of communication are available with the
8    collaborating podiatrist in person or through
9    telecommunications for consultation, collaboration, and
10    referral as needed to address patient care needs.
11        (6) With respect to the provision of anesthesia
12    services by a certified registered nurse anesthetist, an
13    anesthesiologist, physician, or podiatrist shall
14    participate through discussion of and agreement with the
15    anesthesia plan and shall remain physically present and be
16    available on the premises during the delivery of anesthesia
17    services for diagnosis, consultation, and treatment of
18    emergency medical conditions. The anesthesiologist or
19    operating podiatrist must agree with the anesthesia plan
20    prior to the delivery of services.
21        (7) The agreement contains provisions detailing notice
22    for termination or change of status involving a written
23    collaborative agreement, except when such notice is given
24    for just cause.
25    (b) The collaborating podiatrist shall have access to the
26records of all patients attended to by an advanced practice

 

 

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1nurse.
2    (c) Nothing in this Section shall be construed to limit the
3delegation of tasks or duties by a podiatrist to a licensed
4practical nurse, a registered professional nurse, or other
5appropriately trained persons.
6    (d) A podiatrist shall not be liable for the acts or
7omissions of an advanced practice nurse solely on the basis of
8having signed guidelines or a collaborative agreement, an
9order, a standing order, a standing delegation order, or other
10order or guideline authorizing an advanced practice nurse to
11perform acts, unless the podiatrist has reason to believe the
12advanced practice nurse lacked the competency to perform the
13act or acts or commits willful or wanton misconduct.
14    (f) A podiatrist, may, but is not required to delegate
15prescriptive authority to an advanced practice nurse as part of
16a written collaborative agreement and the delegation of
17prescriptive authority shall conform to the requirements of
18Section 65-40 of the Nurse Practice Act.
19(Source: P.A. 95-639, eff. 10-5-07; 96-618, eff. 1-1-10.)
 
20    Section 25. The Illinois Controlled Substances Act is
21amended by changing Section 303.05 as follows:
 
22    (720 ILCS 570/303.05)
23    Sec. 303.05. Mid-level practitioner registration.
24    (a) The Department of Financial and Professional

 

 

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1Regulation shall register licensed physician assistants and
2licensed advanced practice nurses to prescribe and dispense
3controlled substances under Section 303 and euthanasia
4agencies to purchase, store, or administer animal euthanasia
5drugs under the following circumstances:
6        (1) with respect to physician assistants,
7            (A) the physician assistant has been delegated
8        authority to prescribe any Schedule III through V
9        controlled substances by a physician licensed to
10        practice medicine in all its branches in accordance
11        with Section 7.5 of the Physician Assistant Practice
12        Act of 1987; and the physician assistant has completed
13        the appropriate application forms and has paid the
14        required fees as set by rule; or
15            (B) the physician assistant has been delegated
16        authority by a supervising physician licensed to
17        practice medicine in all its branches to prescribe or
18        dispense Schedule II controlled substances through a
19        written delegation of authority and under the
20        following conditions:
21                (i) no more than 10 5 Schedule II controlled
22            substances by oral dosage or topical or
23            transdermal application may be delegated. Schedule
24            II controlled substances to be delivered by
25            injection or other route may not be delegated;
26                (ii) any delegation must be of controlled

 

 

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1            substances prescribed by the supervising
2            physician;
3                (iii) all prescriptions must be limited to no
4            more than a 30-day supply oral dosage, with any
5            continuation authorized only after prior approval
6            of the supervising physician;
7                (iv) the physician assistant must discuss the
8            condition of any patients for whom a controlled
9            substance is prescribed monthly with the
10            delegating physician; and
11                (v) the physician assistant must have
12            completed the appropriate application forms and
13            paid the required fees as set by rule;
14        (2) with respect to advanced practice nurses,
15            (A) the advanced practice nurse has been delegated
16        authority to prescribe any Schedule III through V
17        controlled substances by a physician licensed to
18        practice medicine in all its branches or a podiatrist
19        in accordance with Section 65-40 of the Nurse Practice
20        Act. The advanced practice nurse has completed the
21        appropriate application forms and has paid the
22        required fees as set by rule; or
23            (B) the advanced practice nurse has been delegated
24        authority by a collaborating physician licensed to
25        practice medicine in all its branches or podiatrist to
26        prescribe or dispense Schedule II controlled

 

 

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1        substances through a written delegation of authority
2        and under the following conditions:
3                (i) no more than 10 5 Schedule II controlled
4            substances by oral dosage or topical or
5            transdermal application may be delegated. Schedule
6            II controlled substances to be delivered by
7            injection or other route may not be delegated;
8                (ii) any delegation must be of controlled
9            substances prescribed by the collaborating
10            physician or podiatrist;
11                (iii) all prescriptions must be limited to no
12            more than a 30-day supply oral dosage, with any
13            continuation authorized only after prior approval
14            of the collaborating physician or podiatrist;
15                (iv) the advanced practice nurse must discuss
16            the condition of any patients for whom a controlled
17            substance is prescribed monthly with the
18            delegating physician or podiatrist; and
19                (v) the advanced practice nurse must have
20            completed the appropriate application forms and
21            paid the required fees as set by rule; or
22        (3) with respect to animal euthanasia agencies, the
23    euthanasia agency has obtained a license from the
24    Department of Professional Regulation and obtained a
25    registration number from the Department.
26    (b) The mid-level practitioner shall only be licensed to

 

 

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1prescribe those schedules of controlled substances for which a
2licensed physician or licensed podiatrist has delegated
3prescriptive authority, except that an animal euthanasia
4agency does not have any prescriptive authority. A physician
5assistant and an advanced practice nurse are prohibited from
6prescribing medications and controlled substances not set
7forth in the required written delegation of authority.
8    (c) Upon completion of all registration requirements,
9physician assistants, advanced practice nurses, and animal
10euthanasia agencies shall be issued a mid-level practitioner
11controlled substances license for Illinois.
12    (d) A collaborating physician or podiatrist may, but is not
13required to, delegate prescriptive authority to an advanced
14practice nurse as part of a written collaborative agreement,
15and the delegation of prescriptive authority shall conform to
16the requirements of Section 65-40 of the Nurse Practice Act.
17    (e) A supervising physician may, but is not required to,
18delegate prescriptive authority to a physician assistant as
19part of a written supervision agreement, and the delegation of
20prescriptive authority shall conform to the requirements of
21Section 7.5 of the Physician Assistant Practice Act of 1987.
22(Source: P.A. 95-639, eff. 10-5-07; 96-189, eff. 8-10-09;
2396-268, eff. 8-11-09; 96-1000, eff. 7-2-10.)
 
24    Section 99. Effective date. This Act takes effect July 1,
252011.".