Illinois General Assembly - Full Text of SB2566
Illinois General Assembly

  Bills & Resolutions  
  Compiled Statutes  
  Public Acts  
  Legislative Reports  
  IL Constitution  
  Legislative Guide  
  Legislative Glossary  

 Search By Number
 (example: HB0001)
Search Tips

Search By Keyword

Full Text of SB2566  102nd General Assembly

SB2566 102ND GENERAL ASSEMBLY

  
  

 


 
102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
SB2566

 

Introduced 2/26/2021, by Sen. Melinda Bush

 

SYNOPSIS AS INTRODUCED:
 
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. Replaces provisions concerning the written collaborative agreement required of a certified registered nurse anesthetist providing anesthesia services outside the hospital, ambulatory surgical treatment center, or hospital affiliate with provisions that require the certified registered nurse anesthetist to enter into a written collaborative agreement with a physician, podiatric physician, or dentist. Exempts the delivery of anesthesia during the surgical procedure performed by a physician, dentist, or podiatrist from the requirement that the collaborative relationship under an agreement not be construed to require the personal presence of a collaborating physician at the place where services are rendered. Makes corresponding changes. Effective immediately.


LRB102 17066 SPS 22494 b

 

 

A BILL FOR

 

SB2566LRB102 17066 SPS 22494 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
5Sections 65-35 and 65-45 as follows:
 
6    (225 ILCS 65/65-35)   (was 225 ILCS 65/15-15)
7    (Section scheduled to be repealed on January 1, 2028)
8    Sec. 65-35. Written collaborative agreements.
9    (a) A written collaborative agreement is required for all
10advanced practice registered nurses engaged in clinical
11practice prior to meeting the requirements of Section 65-43,
12except for advanced practice registered nurses who are
13privileged to practice in a hospital, hospital affiliate, or
14ambulatory surgical treatment center.
15    (a-5) If an advanced practice registered nurse engages in
16clinical practice outside of a hospital, hospital affiliate,
17or ambulatory surgical treatment center in which he or she is
18privileged to practice, the advanced practice registered nurse
19must have a written collaborative agreement, except as set
20forth in Section 65-43.
21    (b) A written collaborative agreement shall describe the
22relationship of the advanced practice registered nurse with
23the collaborating physician and shall describe the categories

 

 

SB2566- 2 -LRB102 17066 SPS 22494 b

1of care, treatment, or procedures to be provided by the
2advanced practice registered nurse. A collaborative agreement
3with a podiatric physician must be in accordance with
4subsection (c-5) or (c-15) of this Section for an advanced
5practice registered nurse certified as a nurse practitioner,
6clinical nurse specialist, or certified nurse midwife. A
7certified registered nurse anesthetist providing anesthesia
8services outside the hospital, ambulatory surgical treatment
9center, or hospital affiliate shall enter into a written
10collaborative agreement with a physician, podiatric physician,
11or dentist. A collaborative agreement with a dentist must be
12in accordance with subsection (c-10) of this Section. A
13collaborative agreement with a podiatric physician must be in
14accordance with subsection (c-5) of this Section.
15Collaboration does not require an employment relationship
16between the collaborating physician and the advanced practice
17registered nurse.
18    The collaborative relationship under an agreement shall
19not be construed to require the personal presence of a
20collaborating physician at the place where services are
21rendered, except for the delivery of anesthesia during the
22surgical procedure performed by a physician, dentist, or
23podiatrist. Methods of communication shall be available for
24consultation with the collaborating physician in person or by
25telecommunications or electronic communications as set forth
26in the written agreement.

 

 

SB2566- 3 -LRB102 17066 SPS 22494 b

1    (b-5) Absent an employment relationship, a written
2collaborative agreement may not (1) restrict the categories of
3patients of an advanced practice registered nurse within the
4scope of the advanced practice registered nurses training and
5experience, (2) limit third party payors or government health
6programs, such as the medical assistance program or Medicare
7with which the advanced practice registered nurse contracts,
8or (3) limit the geographic area or practice location of the
9advanced practice registered nurse in this State.
10    (c) (Blank). In the case of anesthesia services provided
11by a certified registered nurse anesthetist, an
12anesthesiologist, a physician, a dentist, or a podiatric
13physician must participate through discussion of and agreement
14with the anesthesia plan and remain physically present and
15available on the premises during the delivery of anesthesia
16services for diagnosis, consultation, and treatment of
17emergency medical conditions.
18    (c-5) (Blank). A certified registered nurse anesthetist,
19who provides anesthesia services outside of a hospital or
20ambulatory surgical treatment center shall enter into a
21written collaborative agreement with an anesthesiologist or
22the physician licensed to practice medicine in all its
23branches or the podiatric physician performing the procedure.
24Outside of a hospital or ambulatory surgical treatment center,
25the certified registered nurse anesthetist may provide only
26those services that the collaborating podiatric physician is

 

 

SB2566- 4 -LRB102 17066 SPS 22494 b

1authorized to provide pursuant to the Podiatric Medical
2Practice Act of 1987 and rules adopted thereunder. A certified
3registered nurse anesthetist may select, order, and administer
4medication, including controlled substances, and apply
5appropriate medical devices for delivery of anesthesia
6services under the anesthesia plan agreed with by the
7anesthesiologist or the operating physician or operating
8podiatric physician.
9    (c-10) (Blank). A certified registered nurse anesthetist
10who provides anesthesia services in a dental office shall
11enter into a written collaborative agreement with an
12anesthesiologist or the physician licensed to practice
13medicine in all its branches or the operating dentist
14performing the procedure. The agreement shall describe the
15working relationship of the certified registered nurse
16anesthetist and dentist and shall authorize the categories of
17care, treatment, or procedures to be performed by the
18certified registered nurse anesthetist. In a collaborating
19dentist's office, the certified registered nurse anesthetist
20may only provide those services that the operating dentist
21with the appropriate permit is authorized to provide pursuant
22to the Illinois Dental Practice Act and rules adopted
23thereunder. For anesthesia services, an anesthesiologist,
24physician, or operating dentist shall participate through
25discussion of and agreement with the anesthesia plan and shall
26remain physically present and be available on the premises

 

 

SB2566- 5 -LRB102 17066 SPS 22494 b

1during the delivery of anesthesia services for diagnosis,
2consultation, and treatment of emergency medical conditions. A
3certified registered nurse anesthetist may select, order, and
4administer medication, including controlled substances, and
5apply appropriate medical devices for delivery of anesthesia
6services under the anesthesia plan agreed with by the
7operating dentist.
8    (c-15) An advanced practice registered nurse who had a
9written collaborative agreement with a podiatric physician
10immediately before the effective date of Public Act 100-513
11may continue in that collaborative relationship or enter into
12a new written collaborative relationship with a podiatric
13physician under the requirements of this Section and Section
1465-40, as those Sections existed immediately before the
15amendment of those Sections by Public Act 100-513 with regard
16to a written collaborative agreement between an advanced
17practice registered nurse and a podiatric physician.
18    (d) A copy of the signed, written collaborative agreement
19must be available to the Department upon request from both the
20advanced practice registered nurse and the collaborating
21physician, dentist, or podiatric physician.
22    (e) Nothing in this Act shall be construed to limit the
23delegation of tasks or duties by a physician to a licensed
24practical nurse, a registered professional nurse, or other
25persons in accordance with Section 54.2 of the Medical
26Practice Act of 1987. Nothing in this Act shall be construed to

 

 

SB2566- 6 -LRB102 17066 SPS 22494 b

1limit the method of delegation that may be authorized by any
2means, including, but not limited to, oral, written,
3electronic, standing orders, protocols, guidelines, or verbal
4orders.
5    (e-5) Nothing in this Act shall be construed to authorize
6an advanced practice registered nurse to provide health care
7services required by law or rule to be performed by a
8physician. The scope of practice of an advanced practice
9registered nurse does not include operative surgery. Nothing
10in this Section shall be construed to preclude an advanced
11practice registered nurse from assisting in surgery.
12    (f) An advanced practice registered nurse shall inform
13each collaborating physician, dentist, or podiatric physician
14of all collaborative agreements he or she has signed and
15provide a copy of these to any collaborating physician,
16dentist, or podiatric physician upon request.
17    (g) (Blank).
18(Source: P.A. 100-513, eff. 1-1-18; 100-577, eff. 1-26-18;
19100-1096, eff. 8-26-18; 101-13, eff. 6-12-19.)
 
20    (225 ILCS 65/65-45)   (was 225 ILCS 65/15-25)
21    (Section scheduled to be repealed on January 1, 2028)
22    Sec. 65-45. Advanced practice registered nursing in
23hospitals, hospital affiliates, or ambulatory surgical
24treatment centers.
25    (a) An advanced practice registered nurse may provide

 

 

SB2566- 7 -LRB102 17066 SPS 22494 b

1services in a hospital or a hospital affiliate as those terms
2are defined in the Hospital Licensing Act or the University of
3Illinois Hospital Act or a licensed ambulatory surgical
4treatment center without a written collaborative agreement
5pursuant to Section 65-35 of this Act. An advanced practice
6registered nurse must possess clinical privileges recommended
7by the hospital medical staff and granted by the hospital or
8the consulting medical staff committee and ambulatory surgical
9treatment center in order to provide services. The medical
10staff or consulting medical staff committee shall periodically
11review the services of all advanced practice registered nurses
12granted clinical privileges, including any care provided in a
13hospital affiliate. Authority may also be granted when
14recommended by the hospital medical staff and granted by the
15hospital or recommended by the consulting medical staff
16committee and ambulatory surgical treatment center to
17individual advanced practice registered nurses to select,
18order, and administer medications, including controlled
19substances, to provide delineated care. In a hospital,
20hospital affiliate, or ambulatory surgical treatment center,
21the attending physician shall determine an advanced practice
22registered nurse's role in providing care for his or her
23patients, except as otherwise provided in the medical staff
24bylaws or consulting committee policies.
25    (a-2) An advanced practice registered nurse privileged to
26order medications, including controlled substances, may

 

 

SB2566- 8 -LRB102 17066 SPS 22494 b

1complete discharge prescriptions provided the prescription is
2in the name of the advanced practice registered nurse and the
3attending or discharging physician.
4    (a-3) Advanced practice registered nurses practicing in a
5hospital or an ambulatory surgical treatment center are not
6required to obtain a mid-level controlled substance license to
7order controlled substances under Section 303.05 of the
8Illinois Controlled Substances Act.
9    (a-4) An advanced practice registered nurse meeting the
10requirements of Section 65-43 may be privileged to complete
11discharge orders and prescriptions under the advanced practice
12registered nurse's name.
13    (a-5) (Blank). For anesthesia services provided by a
14certified registered nurse anesthetist, an anesthesiologist,
15physician, dentist, or podiatric physician shall participate
16through discussion of and agreement with the anesthesia plan
17and shall remain physically present and be available on the
18premises during the delivery of anesthesia services for
19diagnosis, consultation, and treatment of emergency medical
20conditions, unless hospital policy adopted pursuant to clause
21(B) of subdivision (3) of Section 10.7 of the Hospital
22Licensing Act or ambulatory surgical treatment center policy
23adopted pursuant to clause (B) of subdivision (3) of Section
246.5 of the Ambulatory Surgical Treatment Center Act provides
25otherwise. A certified registered nurse anesthetist may
26select, order, and administer medication for anesthesia

 

 

SB2566- 9 -LRB102 17066 SPS 22494 b

1services under the anesthesia plan agreed to by the
2anesthesiologist or the physician, in accordance with hospital
3alternative policy or the medical staff consulting committee
4policies of a licensed ambulatory surgical treatment center.
5    (b) An advanced practice registered nurse who provides
6services in a hospital shall do so in accordance with Section
710.7 of the Hospital Licensing Act and, in an ambulatory
8surgical treatment center, in accordance with Section 6.5 of
9the Ambulatory Surgical Treatment Center Act. Nothing in this
10Act shall be construed to require an advanced practice
11registered nurse to have a collaborative agreement to practice
12in a hospital, hospital affiliate, or ambulatory surgical
13treatment center.
14    (c) Advanced practice registered nurses certified as nurse
15practitioners, nurse midwives, or clinical nurse specialists
16practicing in a hospital affiliate may be, but are not
17required to be, privileged to prescribe Schedule II through V
18controlled substances when such authority is recommended by
19the appropriate physician committee of the hospital affiliate
20and granted by the hospital affiliate. This authority may, but
21is not required to, include prescription of, selection of,
22orders for, administration of, storage of, acceptance of
23samples of, and dispensing over-the-counter medications,
24legend drugs, medical gases, and controlled substances
25categorized as Schedule II through V controlled substances, as
26defined in Article II of the Illinois Controlled Substances

 

 

SB2566- 10 -LRB102 17066 SPS 22494 b

1Act, and other preparations, including, but not limited to,
2botanical and herbal remedies.
3    To prescribe controlled substances under this subsection
4(c), an advanced practice registered nurse certified as a
5nurse practitioner, nurse midwife, or clinical nurse
6specialist must obtain a controlled substance license.
7Medication orders shall be reviewed periodically by the
8appropriate hospital affiliate physicians committee or its
9physician designee.
10    The hospital affiliate shall file with the Department
11notice of a grant of prescriptive authority consistent with
12this subsection (c) and termination of such a grant of
13authority, in accordance with rules of the Department. Upon
14receipt of this notice of grant of authority to prescribe any
15Schedule II through V controlled substances, the licensed
16advanced practice registered nurse certified as a nurse
17practitioner, nurse midwife, or clinical nurse specialist may
18register for a mid-level practitioner controlled substance
19license under Section 303.05 of the Illinois Controlled
20Substances Act.
21    In addition, a hospital affiliate may, but is not required
22to, privilege an advanced practice registered nurse certified
23as a nurse practitioner, nurse midwife, or clinical nurse
24specialist to prescribe any Schedule II controlled substances,
25if all of the following conditions apply:
26        (1) specific Schedule II controlled substances by oral

 

 

SB2566- 11 -LRB102 17066 SPS 22494 b

1    dosage or topical or transdermal application may be
2    designated, provided that the designated Schedule II
3    controlled substances are routinely prescribed by advanced
4    practice registered nurses in their area of certification;
5    the privileging documents must identify the specific
6    Schedule II controlled substances by either brand name or
7    generic name; privileges to prescribe or dispense Schedule
8    II controlled substances to be delivered by injection or
9    other route of administration may not be granted;
10        (2) any privileges must be controlled substances
11    limited to the practice of the advanced practice
12    registered nurse;
13        (3) any prescription must be limited to no more than a
14    30-day supply;
15        (4) the advanced practice registered nurse must
16    discuss the condition of any patients for whom a
17    controlled substance is prescribed monthly with the
18    appropriate physician committee of the hospital affiliate
19    or its physician designee; and
20        (5) the advanced practice registered nurse must meet
21    the education requirements of Section 303.05 of the
22    Illinois Controlled Substances Act.
23    (d) An advanced practice registered nurse meeting the
24requirements of Section 65-43 may be privileged to prescribe
25controlled substances categorized as Schedule II through V in
26accordance with Section 65-43.

 

 

SB2566- 12 -LRB102 17066 SPS 22494 b

1(Source: P.A. 99-173, eff. 7-29-15; 100-513, eff. 1-1-18.)
 
2    Section 99. Effective date. This Act takes effect upon
3becoming law.