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| Public Act 097-0358 | ||||
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AN ACT concerning regulation.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Medical Practice Act of 1987 is amended by | ||||
changing Section 54.5 as follows:
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(225 ILCS 60/54.5)
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(Section scheduled to be repealed on November 30, 2011)
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Sec. 54.5. Physician delegation of authority to physician | ||||
assistants and advanced practice nurses.
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(a) Physicians licensed to practice medicine in all its
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branches may delegate care and treatment responsibilities to a
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physician assistant under guidelines in accordance with the
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requirements of the Physician Assistant Practice Act of
1987. A | ||||
physician licensed to practice medicine in all its
branches may | ||||
enter into supervising physician agreements with
no more than 2 | ||||
physician assistants.
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(b) A physician licensed to practice medicine in all its
| ||||
branches in active clinical practice may collaborate with an | ||||
advanced practice
nurse in accordance with the requirements of | ||||
the Nurse Practice Act. Collaboration
is for the purpose of | ||||
providing medical consultation,
and no employment relationship | ||||
is required. A
written collaborative agreement shall
conform to | ||||
the requirements of Section 65-35 of the Nurse Practice Act. | ||||
The written collaborative agreement shall
be for
services the | ||
collaborating physician generally provides to
his or her | ||
patients in the normal course of clinical medical practice.
A | ||
written collaborative agreement shall be adequate with respect | ||
to collaboration
with advanced practice nurses if all of the | ||
following apply:
| ||
(1) The agreement is written to promote the exercise of | ||
professional judgment by the advanced practice nurse | ||
commensurate with his or her education and experience. The | ||
agreement need not describe the exact steps that an | ||
advanced practice nurse must take with respect to each | ||
specific condition, disease, or symptom, but must specify | ||
those procedures that require a physician's presence as the | ||
procedures are being performed.
| ||
(2) Practice guidelines and orders are developed and | ||
approved jointly by the advanced practice nurse and | ||
collaborating physician, as needed, based on the practice | ||
of the practitioners. Such guidelines and orders and the | ||
patient services provided thereunder are periodically | ||
reviewed by the collaborating physician.
| ||
(3) The advance practice nurse provides services the | ||
collaborating physician generally provides to his or her | ||
patients in the normal course of clinical practice, except | ||
as set forth in subsection (b-5) of this Section. With | ||
respect to labor and delivery, the collaborating physician | ||
must provide delivery services in order to participate with | ||
a certified nurse midwife. | ||
(4) The collaborating physician and advanced practice | ||
nurse consult meet in person at least once a month to | ||
provide collaboration and consultation. | ||
(5) Methods of communication are available with the | ||
collaborating physician in person or through | ||
telecommunications for consultation, collaboration, and | ||
referral as needed to address patient care needs. | ||
(6) The agreement contains provisions detailing notice | ||
for termination or change of status involving a written | ||
collaborative agreement, except when such notice is given | ||
for just cause.
| ||
(b-5) An anesthesiologist or physician licensed to | ||
practice medicine in
all its branches may collaborate with a | ||
certified registered nurse anesthetist
in accordance with | ||
Section 65-35 of the Nurse Practice Act for the provision of | ||
anesthesia services. With respect to the provision of | ||
anesthesia services, the collaborating anesthesiologist or | ||
physician shall have training and experience in the delivery of | ||
anesthesia services consistent with Department rules. | ||
Collaboration shall be
adequate if:
| ||
(1) an anesthesiologist or a physician
participates in | ||
the joint formulation and joint approval of orders or
| ||
guidelines and periodically reviews such orders and the | ||
services provided
patients under such orders; and
| ||
(2) for anesthesia services, the anesthesiologist
or | ||
physician participates through discussion of and agreement | ||
with the
anesthesia plan and is physically present and | ||
available on the premises during
the delivery of anesthesia | ||
services for
diagnosis, consultation, and treatment of | ||
emergency medical conditions.
Anesthesia services in a | ||
hospital shall be conducted in accordance with
Section 10.7 | ||
of the Hospital Licensing Act and in an ambulatory surgical
| ||
treatment center in accordance with Section 6.5 of the | ||
Ambulatory Surgical
Treatment Center Act.
| ||
(b-10) The anesthesiologist or operating physician must | ||
agree with the
anesthesia plan prior to the delivery of | ||
services.
| ||
(c) The supervising physician shall have access to the
| ||
medical records of all patients attended by a physician
| ||
assistant. The collaborating physician shall have access to
the | ||
medical records of all patients attended to by an
advanced | ||
practice nurse.
| ||
(d) (Blank).
| ||
(e) A physician shall not be liable for the acts or
| ||
omissions of a physician assistant or advanced practice
nurse | ||
solely on the basis of having signed a
supervision agreement or | ||
guidelines or a collaborative
agreement, an order, a standing | ||
medical order, a
standing delegation order, or other order or | ||
guideline
authorizing a physician assistant or advanced | ||
practice
nurse to perform acts, unless the physician has
reason | ||
to believe the physician assistant or advanced
practice nurse | ||
lacked the competency to perform
the act or acts or commits | ||
willful and wanton misconduct.
| ||
(f) A collaborating physician may, but is not required to, | ||
delegate prescriptive authority to an advanced practice nurse | ||
as part of a written collaborative agreement, and the | ||
delegation of prescriptive authority shall conform to the | ||
requirements of Section 65-40 of the Nurse Practice Act. | ||
(g) A supervising physician may, but is not required to, | ||
delegate prescriptive authority to a physician assistant as | ||
part of a written supervision agreement, and the delegation of | ||
prescriptive authority shall conform to the requirements of | ||
Section 7.5 of the Physician Assistant Practice Act of 1987. | ||
(Source: P.A. 95-639, eff. 10-5-07; 96-618, eff. 1-1-10.)
| ||
Section 10. The Nurse Practice Act is amended by changing | ||
Sections 65-35, 65-40, and 65-45 as follows:
| ||
(225 ILCS 65/65-35)
(was 225 ILCS 65/15-15)
| ||
(Section scheduled to be repealed on January 1, 2018)
| ||
Sec. 65-35. Written collaborative
agreements. | ||
(a) A written collaborative agreement is required for all | ||
advanced practice nurses engaged in clinical practice, except | ||
for advanced practice nurses who are authorized to practice in | ||
a hospital or ambulatory surgical treatment center. | ||
(a-5) If an advanced practice nurse engages in clinical | ||
practice outside of a hospital or ambulatory surgical treatment | ||
center in which he or she is authorized to practice, the | ||
advanced practice nurse must have a written collaborative | ||
agreement.
| ||
(b) A written collaborative
agreement shall describe the | ||
working relationship of the
advanced practice nurse with the | ||
collaborating
physician or podiatrist and shall authorize the | ||
categories of
care, treatment, or procedures to be performed by | ||
the advanced
practice nurse. A collaborative agreement with a | ||
dentist must be in accordance with subsection (c-10) of this | ||
Section. Collaboration does not require an
employment | ||
relationship between the collaborating physician
and advanced | ||
practice nurse. Absent an employment relationship, an | ||
agreement may not restrict the categories of patients or | ||
third-party payment sources accepted by the advanced practice | ||
nurse. Collaboration means
the relationship under
which an | ||
advanced practice nurse works with a collaborating
physician or | ||
podiatrist in an active clinical practice to deliver health | ||
care services in
accordance with
(i) the advanced practice | ||
nurse's training, education,
and experience and (ii) | ||
collaboration and consultation as documented in a
jointly | ||
developed written collaborative
agreement.
| ||
The agreement shall be defined to promote the
exercise of | ||
professional judgment by the advanced practice
nurse | ||
commensurate with his or her education and
experience. The | ||
services to be provided by the advanced
practice nurse shall be | ||
services that the
collaborating physician or podiatrist is | ||
authorized to and generally provides to his or her
patients in | ||
the normal course of his or her clinical medical practice, | ||
except as set forth in subsection (c-5) of this Section.
The | ||
agreement need not describe the exact steps that an advanced | ||
practice
nurse must take with respect to each specific | ||
condition, disease, or symptom
but must specify
which | ||
authorized procedures require the presence of the | ||
collaborating physician or podiatrist as
the procedures are | ||
being performed. The collaborative
relationship under an | ||
agreement shall not be
construed to require the personal | ||
presence of a physician or podiatrist at
all times at the place | ||
where services are rendered.
Methods of communication shall
be | ||
available for consultation with the collaborating
physician or | ||
podiatrist in person or by telecommunications in accordance | ||
with
established written guidelines as set forth in the written
| ||
agreement.
| ||
(c) Collaboration and consultation under all collaboration | ||
agreements
shall be adequate if a
collaborating physician or | ||
podiatrist does each of the following:
| ||
(1) Participates in the joint formulation and joint | ||
approval of orders or
guidelines with the advanced practice | ||
nurse and he or she periodically reviews such orders and | ||
the
services provided patients under such orders in | ||
accordance with accepted
standards of medical practice or | ||
podiatric practice and advanced practice nursing practice.
| ||
(2) Provides collaboration and consultation Meets in | ||
person with the advanced practice nurse at least once a | ||
month to provide collaboration and
consultation. In the | ||
case of anesthesia services provided by a certified | ||
registered nurse anesthetist, an anesthesiologist, | ||
physician, dentist, or podiatrist must participate through | ||
discussion of and agreement with the anesthesia plan and | ||
remain physically present and available on the premises | ||
during the delivery of anesthesia services for diagnosis, | ||
consultation, and treatment of emergency medical | ||
conditions.
| ||
(3) Is available through telecommunications for | ||
consultation on medical
problems, complications, or | ||
emergencies or patient referral. In the case of anesthesia | ||
services provided by a certified registered nurse | ||
anesthetist, an anesthesiologist, physician, dentist, or | ||
podiatrist must participate through discussion of and | ||
agreement with the anesthesia plan and remain physically | ||
present and available on the premises during the delivery | ||
of anesthesia services for diagnosis, consultation, and | ||
treatment of emergency medical conditions.
| ||
The agreement must contain provisions detailing notice for | ||
termination or change of status involving a written | ||
collaborative agreement, except when such notice is given for | ||
just cause. | ||
(c-5) A certified registered nurse anesthetist, who | ||
provides anesthesia services outside of a hospital or | ||
ambulatory surgical treatment center shall enter into a written | ||
collaborative agreement with an anesthesiologist or the | ||
physician licensed to practice medicine in all its branches or | ||
the podiatrist performing the procedure. Outside of a hospital | ||
or ambulatory surgical treatment center, the certified | ||
registered nurse anesthetist may provide only those services | ||
that the collaborating podiatrist is authorized to provide | ||
pursuant to the Podiatric Medical Practice Act of 1987 and | ||
rules adopted thereunder. A certified registered nurse | ||
anesthetist may select, order, and administer medication, | ||
including controlled substances, and apply appropriate medical | ||
devices for delivery of anesthesia services under the | ||
anesthesia plan agreed with by the anesthesiologist or the | ||
operating physician or operating podiatrist. | ||
(c-10) A certified registered nurse anesthetist who | ||
provides anesthesia services in a dental office shall enter | ||
into a written collaborative agreement with an | ||
anesthesiologist or the physician licensed to practice | ||
medicine in all its branches or the operating dentist | ||
performing the procedure. The agreement shall describe the | ||
working relationship of the certified registered nurse | ||
anesthetist and dentist and shall authorize the categories of | ||
care, treatment, or procedures to be performed by the certified | ||
registered nurse anesthetist. In a collaborating dentist's | ||
office, the certified registered nurse anesthetist may only | ||
provide those services that the operating dentist with the | ||
appropriate permit is authorized to provide pursuant to the | ||
Illinois Dental Practice Act and rules adopted thereunder. For | ||
anesthesia services, an anesthesiologist, physician, or | ||
operating dentist shall participate through discussion of and | ||
agreement with the anesthesia plan and shall remain physically | ||
present and be available on the premises during the delivery of | ||
anesthesia services for diagnosis, consultation, and treatment | ||
of emergency medical conditions. A certified registered nurse | ||
anesthetist may select, order, and administer medication, | ||
including controlled substances, and apply appropriate medical | ||
devices for delivery of anesthesia services under the | ||
anesthesia plan agreed with by the operating dentist. | ||
(d) A copy of the signed, written collaborative agreement | ||
must be available
to the Department upon request from both the | ||
advanced practice nurse
and the collaborating physician or | ||
podiatrist. | ||
(e) Nothing in this Act shall be construed to limit the | ||
delegation of tasks or duties by a physician to a licensed | ||
practical nurse, a registered professional nurse, or other | ||
persons in accordance with Section 54.2 of the Medical Practice | ||
Act of 1987. Nothing in this Act shall be construed to limit | ||
the method of delegation that may be authorized by any means, | ||
including, but not limited to, oral, written, electronic, | ||
standing orders, protocols, guidelines, or verbal orders. | ||
(f) An advanced
practice nurse shall inform each | ||
collaborating physician, dentist, or podiatrist of all | ||
collaborative
agreements he or she
has signed and provide a | ||
copy of these to any collaborating physician, dentist, or | ||
podiatrist upon
request.
| ||
(g) For the purposes of this Act, "generally provides to | ||
his or her patients in the normal course of his or her clinical | ||
medical practice" means services, not specific tasks or duties, | ||
the physician or podiatrist routinely provides individually or | ||
through delegation to other persons so that the physician or | ||
podiatrist has the experience and ability to provide | ||
collaboration and consultation. | ||
(Source: P.A. 95-639, eff. 10-5-07; 96-618, eff. 1-1-10.)
| ||
(225 ILCS 65/65-40)
(was 225 ILCS 65/15-20)
| ||
(Section scheduled to be repealed on January 1, 2018)
| ||
Sec. 65-40. Written collaborative agreement; prescriptive | ||
Prescriptive authority.
| ||
(a) A collaborating
physician or podiatrist may, but is not | ||
required to, delegate
prescriptive authority to an advanced | ||
practice
nurse as part of a written collaborative agreement. | ||
This authority may, but is
not required to, include
| ||
prescription of, selection of, orders for, administration of, | ||
storage of, acceptance of samples of, and dispensing over the | ||
counter medications, legend drugs, medical gases, and | ||
controlled
substances categorized as
any Schedule III through V | ||
controlled substances, as defined in Article II of the
Illinois | ||
Controlled Substances Act, and other preparations, including, | ||
but not limited to, botanical and herbal remedies. The | ||
collaborating physician or podiatrist must have a valid current | ||
Illinois controlled substance license and federal registration | ||
to delegate authority to prescribe delegated controlled | ||
substances.
| ||
(b) To prescribe controlled
substances under this Section, | ||
an advanced practice
nurse must obtain a mid-level practitioner | ||
controlled substance license.
Medication orders shall be
| ||
reviewed
periodically by the collaborating physician or | ||
podiatrist.
| ||
(c) The collaborating physician or podiatrist shall file | ||
with the
Department notice of delegation of prescriptive | ||
authority
and
termination of such delegation, in accordance | ||
with rules of the Department.
Upon receipt of this notice | ||
delegating authority to prescribe any Schedule III through V | ||
controlled substances, the licensed advanced practice nurse | ||
shall be
eligible to register for a mid-level practitioner | ||
controlled substance license
under Section 303.05 of the | ||
Illinois Controlled Substances Act.
| ||
(d) In addition to the requirements of subsections (a), | ||
(b), and (c) of this Section, a collaborating physician or | ||
podiatrist may, but is not required to, delegate authority to | ||
an advanced practice nurse to prescribe any Schedule II | ||
controlled substances, if all of the following conditions | ||
apply: | ||
(1) Specific No more than 5 Schedule II controlled | ||
substances by oral dosage or topical or transdermal | ||
application may be delegated, provided that the delegated | ||
Schedule II controlled substances are routinely prescribed | ||
by the collaborating physician or podiatrist. This | ||
delegation must identify the specific Schedule II | ||
controlled substances by either brand name or generic name. | ||
Schedule II controlled substances to be delivered by | ||
injection or other route of administration may not be | ||
delegated. | ||
(2) Any delegation must be controlled substances that | ||
the collaborating physician or podiatrist prescribes. | ||
(3) Any prescription must be limited to no more than a | ||
30-day supply oral dosage, with any continuation | ||
authorized only after prior approval of the collaborating | ||
physician or podiatrist. | ||
(4) The advanced practice nurse must discuss the | ||
condition of any patients for whom a controlled substance | ||
is prescribed monthly with the delegating physician. | ||
(5) The advanced practice nurse meets the education | ||
requirements of Section 303.05 of the Illinois Controlled | ||
Substances Act.
| ||
(e) Nothing in this Act shall be construed to limit the | ||
delegation of tasks
or duties by a physician to a licensed | ||
practical nurse, a registered
professional nurse, or other | ||
persons. Nothing in this Act shall be construed to limit the | ||
method of delegation that may be authorized by any means, | ||
including, but not limited to, oral, written, electronic, | ||
standing orders, protocols, guidelines, or verbal orders.
| ||
(f) Nothing in this Section shall be construed to apply to | ||
any medication authority including Schedule II controlled | ||
substances of an advanced practice nurse for care provided in a | ||
hospital, hospital affiliate, or ambulatory surgical treatment | ||
center pursuant to Section 65-45. | ||
(g) Any advanced practice nurse who writes a prescription | ||
for a controlled substance without having a valid appropriate | ||
authority may be fined by the Department not more than $50 per | ||
prescription, and the Department may take any other | ||
disciplinary action provided for in this Act. | ||
(h) Nothing in this Section shall be construed to prohibit | ||
generic substitution. | ||
(Source: P.A. 95-639, eff. 10-5-07; 96-189, eff. 8-10-09.)
| ||
(225 ILCS 65/65-45)
(was 225 ILCS 65/15-25)
| ||
(Section scheduled to be repealed on January 1, 2018)
| ||
Sec. 65-45. Advanced practice nursing in hospitals, | ||
hospital affiliates, or ambulatory surgical treatment centers.
| ||
(a) An advanced practice nurse may provide
services in a | ||
licensed hospital or a hospital affiliate as those terms are | ||
defined in the Hospital Licensing Act or the University of | ||
Illinois Hospital Act or a licensed ambulatory surgical
| ||
treatment center without prescriptive authority or a written | ||
collaborative agreement pursuant to Section 65-35 of this Act. | ||
An advanced practice nurse must possess clinical privileges | ||
recommended by the hospital medical staff and granted by the | ||
hospital or the consulting medical staff committee and | ||
ambulatory surgical treatment center in order to provide | ||
services. The medical staff or consulting medical staff | ||
committee shall periodically review the services of advanced | ||
practice nurses granted clinical privileges, including any | ||
care provided in a hospital affiliate. Authority may also be | ||
granted when recommended by the hospital medical staff and | ||
granted by the hospital or recommended by the consulting | ||
medical staff committee and ambulatory surgical treatment | ||
center to individual advanced practice nurses to select, order, | ||
and administer medications, including controlled substances, | ||
to provide delineated care. In a hospital, hospital affiliate, | ||
or ambulatory surgical treatment center, the The attending | ||
physician shall determine an advanced practice nurse's role in | ||
providing care for his or her patients, except as otherwise | ||
provided in the medical staff bylaws or consulting committee | ||
policies.
| ||
(a-2) An advanced practice nurse granted authority to order | ||
medications including controlled substances may complete | ||
discharge prescriptions provided the prescription is in the | ||
name of the advanced practice nurse and the attending or | ||
discharging physician. | ||
(a-3) Advanced practice nurses practicing in a hospital or | ||
an ambulatory surgical treatment center are not required to | ||
obtain a mid-level controlled substance license to order | ||
controlled substances under Section 303.05 of the Illinois | ||
Controlled Substances Act. | ||
(a-5) For
anesthesia services provided by a certified | ||
registered nurse anesthetist, an anesthesiologist,
physician, | ||
dentist,
or podiatrist shall participate through discussion of | ||
and agreement with the
anesthesia plan and shall
remain
| ||
physically present
and be available on the premises during the | ||
delivery of anesthesia services for
diagnosis, consultation, | ||
and treatment of
emergency medical conditions, unless hospital | ||
policy adopted pursuant to
clause (B) of subdivision (3) of | ||
Section 10.7 of the Hospital Licensing Act
or ambulatory | ||
surgical treatment center policy adopted pursuant to
clause (B) | ||
of subdivision (3) of Section 6.5 of the Ambulatory Surgical
| ||
Treatment Center Act
provides otherwise. A certified | ||
registered nurse anesthetist may select, order, and administer | ||
medication for anesthesia services under the anesthesia plan | ||
agreed to by the anesthesiologist or the physician, in | ||
accordance with hospital alternative policy or the medical | ||
staff consulting committee policies of a licensed ambulatory | ||
surgical treatment center.
| ||
(b) An advanced practice nurse who provides
services in a | ||
hospital shall do so in accordance with Section 10.7 of the
| ||
Hospital
Licensing Act and, in an
ambulatory surgical treatment | ||
center, in accordance with Section 6.5 of the
Ambulatory
| ||
Surgical Treatment Center Act.
| ||
(Source: P.A. 95-639, eff. 10-5-07.)
| ||
Section 15. The Physician Assistant Practice Act of 1987 is | ||
amended by changing Section 7.5 as follows:
| ||
(225 ILCS 95/7.5)
| ||
(Section scheduled to be repealed on January 1, 2018)
| ||
Sec. 7.5. Prescriptions; written supervision agreements; | ||
prescriptive authority. | ||
(a) A written supervision agreement is required for all | ||
physician assistants to practice in the State. | ||
(1) A written supervision agreement shall describe the | ||
working relationship of the physician assistant with the | ||
supervising physician and shall authorize the categories | ||
of care, treatment, or procedures to be performed by the | ||
physician assistant.
The written supervision agreement | ||
shall be defined to promote the exercise of professional | ||
judgment by the physician assistant commensurate with his | ||
or her education and experience. The services to be | ||
provided by the physician assistant shall be services that | ||
the supervising physician is authorized to and generally | ||
provides to his or her patients in the normal course of his | ||
or her clinical medical practice. The written supervision | ||
agreement need not describe the exact steps that a | ||
physician assistant must take with respect to each specific | ||
condition, disease, or symptom but must specify which | ||
authorized procedures require the presence of the | ||
supervising physician as the procedures are being | ||
performed. The supervision relationship under a written | ||
supervision agreement shall not be construed to require the | ||
personal presence of a physician at all times at the place | ||
where services are rendered. Methods of communication | ||
shall be available for consultation with the supervising | ||
physician in person or by telecommunications in accordance | ||
with established written guidelines as set forth in the | ||
written supervision agreement. For the purposes of this | ||
Act, "generally provides to his or her patients in the | ||
normal course of his or her clinical medical practice" | ||
means services, not specific tasks or duties, the | ||
supervising physician routinely provides individually or | ||
through delegation to other persons so that the physician | ||
has the experience and ability to provide supervision and | ||
consultation. | ||
(2) The written supervision agreement shall be | ||
adequate if a physician does each of the following: | ||
(A) Participates in the joint formulation and | ||
joint approval of orders or guidelines with the | ||
physician assistant and he or she periodically reviews | ||
such orders and the services provided patients under | ||
such orders in accordance with accepted standards of | ||
medical practice and physician assistant practice. | ||
(B) Provides supervision and consultation Meets in | ||
person with the physician assistant at least once a | ||
month to provide supervision. | ||
(3) A copy of the signed, written supervision agreement | ||
must be available to the Department upon request from both | ||
the physician assistant and the supervising physician. | ||
(4) A physician assistant shall inform each | ||
supervising physician of all written supervision | ||
agreements he or she has signed and provide a copy of these | ||
to any supervising physician upon request. | ||
(b) A supervising physician may, but is not required to, | ||
delegate prescriptive authority to a physician assistant as | ||
part of a written supervision agreement. This authority may, | ||
but is not required to, include prescription of, selection of, | ||
orders for, administration of, storage of, acceptance of | ||
samples of, and dispensing over the counter medications, legend | ||
drugs, medical gases, and controlled substances categorized as | ||
Schedule III through V controlled substances, as defined in | ||
Article II of the Illinois Controlled Substances Act, and other | ||
preparations, including, but not limited to, botanical and | ||
herbal remedies. The supervising physician must have a valid, | ||
current Illinois controlled substance license and federal | ||
registration with the Drug Enforcement Agency to delegate the | ||
authority to prescribe controlled substances. | ||
(1) To prescribe Schedule III, IV, or V controlled | ||
substances under this
Section, a physician assistant must | ||
obtain a mid-level practitioner
controlled substances | ||
license. Medication orders issued by a
physician
assistant | ||
shall be reviewed
periodically by the supervising | ||
physician. | ||
(2) The supervising physician shall file
with the | ||
Department notice of delegation of prescriptive authority | ||
to a
physician assistant and
termination of delegation, | ||
specifying the authority delegated or terminated.
Upon | ||
receipt of this notice delegating authority to prescribe | ||
Schedule III,
IV, or V controlled substances, the physician | ||
assistant shall be eligible to
register for a mid-level | ||
practitioner controlled substances license under
Section | ||
303.05 of the Illinois Controlled Substances Act.
Nothing | ||
in this Act shall be construed to limit the delegation of | ||
tasks or
duties by the supervising physician to a nurse or | ||
other appropriately trained
persons in accordance with | ||
Section 54.2 of the Medical Practice Act of 1987.
| ||
(3) In addition to the requirements of subsection (b) | ||
of this Section, a supervising physician may, but is not | ||
required to, delegate authority to a physician assistant to | ||
prescribe Schedule II controlled substances, if all of the | ||
following conditions apply: | ||
(A) Specific No more than 5 Schedule II controlled | ||
substances by oral dosage or topical or transdermal | ||
application may be delegated, provided that the | ||
delegated Schedule II controlled substances are | ||
routinely prescribed by the supervising physician. | ||
This delegation must identify the specific Schedule II | ||
controlled substances by either brand name or generic | ||
name. Schedule II controlled substances to be | ||
delivered by injection or other route of | ||
administration may not be delegated. | ||
(B) Any delegation must be controlled substances | ||
that the supervising physician prescribes. | ||
(C) Any prescription must be limited to no more | ||
than a 30-day supply oral dosage, with any continuation | ||
authorized only after prior approval of the | ||
supervising physician. | ||
(D) The physician assistant must discuss the | ||
condition of any patients for whom a controlled | ||
substance is prescribed monthly with the supervising | ||
physician. | ||
(E) The physician assistant meets the education | ||
requirements of Section 303.05 of the Illinois | ||
Controlled Substances Act. | ||
(c) Nothing in this Act shall be construed to limit the | ||
delegation of tasks or duties by a physician to a licensed | ||
practical nurse, a registered professional nurse, or other | ||
persons. Nothing in this Act shall be construed to limit the | ||
method of delegation that may be authorized by any means, | ||
including, but not limited to, oral, written, electronic, | ||
standing orders, protocols, guidelines, or verbal orders.
| ||
(d) Any physician assistant who writes a prescription for a | ||
controlled substance without having a valid appropriate | ||
authority may be fined by the Department not more than $50 per | ||
prescription, and the Department may take any other | ||
disciplinary action provided for in this Act. | ||
(e) Nothing in this Section shall be construed to prohibit | ||
generic substitution. | ||
(Source: P.A. 96-268, eff. 8-11-09; 96-618, eff. 1-1-10; | ||
96-1000, eff. 7-2-10.)
| ||
Section 20. The Podiatric Medical Practice Act of 1987 is | ||
amended by changing Section 20.5 as follows: | ||
(225 ILCS 100/20.5) | ||
(Section scheduled to be repealed on January 1, 2018)
| ||
Sec. 20.5. Delegation of authority to advanced practice | ||
nurses.
| ||
(a) A podiatrist in active clinical practice may | ||
collaborate with an advanced practice nurse in accordance with | ||
the requirements of the Nurse Practice Act. Collaboration shall | ||
be for the purpose of providing podiatric consultation and no | ||
employment relationship shall be required. A written | ||
collaborative agreement shall conform to the requirements of | ||
Section 65-35 of the Nurse Practice Act. The written | ||
collaborative agreement shall be for services the | ||
collaborating podiatrist generally provides to his or her | ||
patients in the normal course of clinical podiatric practice, | ||
except as set forth in item (3) of this subsection (a). A | ||
written collaborative agreement and podiatric collaboration | ||
and consultation shall be adequate with respect to advanced | ||
practice nurses if all of the following apply: | ||
(1) The agreement is written to promote the exercise of | ||
professional judgment by the advanced practice nurse | ||
commensurate with his or her education and experience. The | ||
agreement need not describe the exact steps that an | ||
advanced practice nurse must take with respect to each | ||
specific condition, disease, or symptom, but must specify | ||
which procedures require a podiatrist's presence as the | ||
procedures are being performed. | ||
(2) Practice guidelines and orders are developed and | ||
approved jointly by the advanced practice nurse and | ||
collaborating podiatrist, as needed, based on the practice | ||
of the practitioners. Such guidelines and orders and the | ||
patient services provided thereunder are periodically | ||
reviewed by the collaborating podiatrist. | ||
(3) The advance practice nurse provides services that | ||
the collaborating podiatrist generally provides to his or | ||
her patients in the normal course of clinical practice. | ||
With respect to the provision of anesthesia services by a | ||
certified registered nurse anesthetist, the collaborating | ||
podiatrist must have training and experience in the | ||
delivery of anesthesia consistent with Department rules. | ||
(4) The collaborating podiatrist and the advanced | ||
practice nurse consult meet in person at least once a month | ||
to provide collaboration and consultation. | ||
(5) Methods of communication are available with the | ||
collaborating podiatrist in person or through | ||
telecommunications for consultation, collaboration, and | ||
referral as needed to address patient care needs. | ||
(6) With respect to the provision of anesthesia | ||
services by a certified registered nurse anesthetist, an | ||
anesthesiologist, physician, or podiatrist shall | ||
participate through discussion of and agreement with the | ||
anesthesia plan and shall remain physically present and be | ||
available on the premises during the delivery of anesthesia | ||
services for diagnosis, consultation, and treatment of | ||
emergency medical conditions. The anesthesiologist or | ||
operating podiatrist must agree with the anesthesia plan | ||
prior to the delivery of services. | ||
(7) The agreement contains provisions detailing notice | ||
for termination or change of status involving a written | ||
collaborative agreement, except when such notice is given | ||
for just cause. | ||
(b) The collaborating podiatrist shall have access to the | ||
records of all patients attended to by an advanced practice | ||
nurse. | ||
(c) Nothing in this Section shall be construed to limit the | ||
delegation of tasks or duties by a podiatrist to a licensed | ||
practical nurse, a registered professional nurse, or other | ||
appropriately trained persons. | ||
(d) A podiatrist shall not be liable for the acts or | ||
omissions of an advanced practice nurse solely on the basis of | ||
having signed guidelines or a collaborative agreement, an | ||
order, a standing order, a standing delegation order, or other | ||
order or guideline authorizing an advanced practice nurse to | ||
perform acts, unless the podiatrist has reason to believe the | ||
advanced practice nurse lacked the competency to perform the | ||
act or acts or commits willful or wanton misconduct.
| ||
(f) A podiatrist, may, but is not required to delegate | ||
prescriptive authority to an advanced practice nurse as part of | ||
a written collaborative agreement and the delegation of | ||
prescriptive authority shall conform to the requirements of | ||
Section 65-40 of the Nurse Practice Act. | ||
(Source: P.A. 95-639, eff. 10-5-07; 96-618, eff. 1-1-10.) | ||
Section 25. The Illinois Controlled Substances Act is | ||
amended by changing Section 303.05 as follows:
| ||
(720 ILCS 570/303.05)
| ||
Sec. 303.05. Mid-level practitioner registration.
| ||
(a) The Department of Financial and Professional | ||
Regulation shall register licensed
physician assistants and | ||
licensed advanced practice nurses to prescribe and
dispense | ||
controlled substances under Section 303 and euthanasia
| ||
agencies to purchase, store, or administer animal euthanasia | ||
drugs under the
following circumstances:
| ||
(1) with respect to physician assistants,
| ||
(A) the physician assistant has been
delegated
| ||
authority to prescribe any Schedule III through V | ||
controlled substances by a physician licensed to | ||
practice medicine in all its
branches in accordance | ||
with Section 7.5 of the Physician Assistant Practice | ||
Act
of 1987;
and
the physician assistant has
completed | ||
the
appropriate application forms and has paid the | ||
required fees as set by rule;
or
| ||
(B) the physician assistant has been delegated
| ||
authority by a supervising physician licensed to | ||
practice medicine in all its branches to prescribe or | ||
dispense Schedule II controlled substances through a | ||
written delegation of authority and under the | ||
following conditions: | ||
(i) Specific no more than 5 Schedule II | ||
controlled substances by oral dosage or topical or | ||
transdermal application may be delegated, provided | ||
that the delegated Schedule II controlled | ||
substances are routinely prescribed by the | ||
supervising physician. This delegation must | ||
identify the specific Schedule II controlled | ||
substances by either brand name or generic name. | ||
Schedule II controlled substances to be delivered | ||
by injection or other route of administration may | ||
not be delegated; | ||
(ii) any delegation must be of controlled | ||
substances prescribed by the supervising | ||
physician; | ||
(iii) all prescriptions must be limited to no | ||
more than a 30-day supply oral dosage, with any | ||
continuation authorized only after prior approval | ||
of the supervising physician; | ||
(iv) the physician assistant must discuss the | ||
condition of any patients for whom a controlled | ||
substance is prescribed monthly with the | ||
delegating physician; and | ||
(v) the physician assistant must have | ||
completed the appropriate application forms and | ||
paid the required fees as set by rule; | ||
(vi) the physician assistant must provide | ||
evidence of satisfactory completion of 45 contact | ||
hours in pharmacology from any physician assistant | ||
program accredited by the Accreditation Review | ||
Commission on Education for the Physician | ||
Assistant (ARC-PA), or its predecessor agency, for | ||
any new license issued with Schedule II authority | ||
after the effective date of this amendatory Act of | ||
the 97th General Assembly; and | ||
(vii) the physician assistant must annually | ||
complete at least 5 hours of continuing education | ||
in pharmacology. | ||
(2) with respect to advanced practice nurses, | ||
(A) the advanced practice nurse has been delegated
| ||
authority to prescribe any Schedule III through V | ||
controlled substances by a collaborating physician | ||
licensed to practice medicine in all its branches or a | ||
collaborating podiatrist in accordance with Section | ||
65-40 of the Nurse Practice
Act. The advanced practice | ||
nurse has completed the
appropriate application forms | ||
and has paid the required
fees as set by rule; or | ||
(B) the advanced practice nurse has been delegated
| ||
authority by a collaborating physician licensed to | ||
practice medicine in all its branches or collaborating | ||
podiatrist to prescribe or dispense Schedule II | ||
controlled substances through a written delegation of | ||
authority and under the following conditions: | ||
(i) specific no more than 5 Schedule II | ||
controlled substances by oral dosage or topical or | ||
transdermal application may be delegated, provided | ||
that the delegated Schedule II controlled | ||
substances are routinely prescribed by the | ||
collaborating physician or podiatrist. This | ||
delegation must identify the specific Schedule II | ||
controlled substances by either brand name or | ||
generic name. Schedule II controlled substances to | ||
be delivered by injection or other route of | ||
administration may not be delegated; | ||
(ii) any delegation must be of controlled | ||
substances prescribed by the collaborating | ||
physician or podiatrist; | ||
(iii) all prescriptions must be limited to no | ||
more than a 30-day supply oral dosage, with any | ||
continuation authorized only after prior approval | ||
of the collaborating physician or podiatrist; | ||
(iv) the advanced practice nurse must discuss | ||
the condition of any patients for whom a controlled | ||
substance is prescribed monthly with the | ||
delegating physician or podiatrist; and | ||
(v) the advanced practice nurse must have | ||
completed the appropriate application forms and | ||
paid the required fees as set by rule; or | ||
(vi) the advanced practice nurse must provide | ||
evidence of satisfactory completion of at least 45 | ||
graduate contact hours in pharmacology for any new | ||
license issued with Schedule II authority after | ||
the effective date of this amendatory Act of the | ||
97th General Assembly; and | ||
(vii) the advanced practice nurse must | ||
annually complete 5 hours of continuing education | ||
in pharmacology; or | ||
(3) with respect to animal euthanasia agencies, the | ||
euthanasia agency has
obtained a license from the | ||
Department of
Professional Regulation and obtained a | ||
registration number from the
Department.
| ||
(b) The mid-level practitioner shall only be licensed to | ||
prescribe those
schedules of controlled substances for which a | ||
licensed physician or licensed podiatrist has delegated
| ||
prescriptive authority, except that an animal euthanasia | ||
agency does not have any
prescriptive authority.
A physician | ||
assistant and an advanced practice nurse are prohibited from | ||
prescribing medications and controlled substances not set | ||
forth in the required written delegation of authority.
| ||
(c) Upon completion of all registration requirements, | ||
physician
assistants, advanced practice nurses, and animal | ||
euthanasia agencies shall be issued a
mid-level practitioner
| ||
controlled substances license for Illinois.
| ||
(d) A collaborating physician or podiatrist may, but is not | ||
required to, delegate prescriptive authority to an advanced | ||
practice nurse as part of a written collaborative agreement, | ||
and the delegation of prescriptive authority shall conform to | ||
the requirements of Section 65-40 of the Nurse Practice Act. | ||
(e) A supervising physician may, but is not required to, | ||
delegate prescriptive authority to a physician assistant as | ||
part of a written supervision agreement, and the delegation of | ||
prescriptive authority shall conform to the requirements of | ||
Section 7.5 of the Physician Assistant Practice Act of 1987. | ||
(f) Nothing in this Section shall be construed to prohibit | ||
generic substitution. | ||
(Source: P.A. 95-639, eff. 10-5-07; 96-189, eff. 8-10-09; | ||
96-268, eff. 8-11-09; 96-1000, eff. 7-2-10.)
| ||
Section 99. Effective date. This Act takes effect July 1, | ||
2011.
| ||