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1 | AN ACT concerning regulation.
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2 | Be it enacted by the People of the State of Illinois,
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3 | represented in the General Assembly:
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4 | Section 5. The Nurse Practice Act is amended by changing | ||||||
5 | Section 65-35 as follows:
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6 | (225 ILCS 65/65-35)
(was 225 ILCS 65/15-15)
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7 | (Section scheduled to be repealed on January 1, 2028)
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8 | Sec. 65-35. Written collaborative
agreements. | ||||||
9 | (a) A written collaborative agreement is required for all | ||||||
10 | advanced practice registered nurses engaged in clinical | ||||||
11 | practice prior to meeting the requirements of Section 65-43, | ||||||
12 | except for advanced practice registered nurses who are | ||||||
13 | privileged to practice in a hospital, hospital affiliate, or | ||||||
14 | ambulatory surgical treatment center. | ||||||
15 | (a-5) If an advanced practice registered nurse engages in | ||||||
16 | clinical practice outside of a hospital, hospital affiliate, or | ||||||
17 | ambulatory surgical treatment center in which he or she is | ||||||
18 | privileged to practice, the advanced practice registered nurse | ||||||
19 | must have a written collaborative agreement, except as set | ||||||
20 | forth in Section 65-43.
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21 | (b) A written collaborative
agreement shall describe the | ||||||
22 | relationship of the
advanced practice registered nurse with the | ||||||
23 | collaborating
physician and shall describe the categories of
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1 | care, treatment, or procedures to be provided by the advanced
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2 | practice registered nurse. A collaborative agreement with a | ||||||
3 | podiatric physician must be in accordance with subsection (c-5) | ||||||
4 | or (c-15) of this Section. A collaborative agreement with a | ||||||
5 | dentist must be in accordance with subsection (c-10) of this | ||||||
6 | Section. A collaborative agreement with a podiatric physician | ||||||
7 | must be in accordance with subsection (c-5) of this Section. | ||||||
8 | Collaboration does not require an
employment relationship | ||||||
9 | between the collaborating physician
and the advanced practice | ||||||
10 | registered nurse.
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11 | The collaborative
relationship under an agreement shall | ||||||
12 | not be
construed to require the personal presence of a | ||||||
13 | collaborating physician at the place where services are | ||||||
14 | rendered.
Methods of communication shall
be available for | ||||||
15 | consultation with the collaborating
physician in person or by | ||||||
16 | telecommunications or electronic communications as set forth | ||||||
17 | in the written
agreement.
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18 | (b-5) Absent an employment relationship, a written | ||||||
19 | collaborative agreement may not (1) restrict the categories of | ||||||
20 | patients of an advanced practice registered nurse within the | ||||||
21 | scope of the advanced practice registered nurses training and | ||||||
22 | experience, (2) limit third party payors or government health | ||||||
23 | programs, such as the medical assistance program or Medicare | ||||||
24 | with which the advanced practice registered nurse contracts, or | ||||||
25 | (3) limit the geographic area or practice location of the | ||||||
26 | advanced practice registered nurse in this State. |
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1 | (c)
In the case of anesthesia services provided by a | ||||||
2 | certified registered nurse anesthetist, an anesthesiologist, a | ||||||
3 | physician, a dentist, or a podiatric physician must participate | ||||||
4 | through discussion of and agreement with the anesthesia plan | ||||||
5 | and remain physically present and available on the premises | ||||||
6 | during the delivery of anesthesia services for diagnosis, | ||||||
7 | consultation, and treatment of emergency medical conditions.
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8 | (c-5) A certified registered nurse anesthetist, who | ||||||
9 | provides anesthesia services outside of a hospital or | ||||||
10 | ambulatory surgical treatment center shall enter into a written | ||||||
11 | collaborative agreement with an anesthesiologist or the | ||||||
12 | physician licensed to practice medicine in all its branches or | ||||||
13 | the podiatric physician performing the procedure. Outside of a | ||||||
14 | hospital or ambulatory surgical treatment center, the | ||||||
15 | certified registered nurse anesthetist may provide only those | ||||||
16 | services that the collaborating podiatric physician is | ||||||
17 | authorized to provide pursuant to the Podiatric Medical | ||||||
18 | Practice Act of 1987 and rules adopted thereunder. A certified | ||||||
19 | registered nurse anesthetist may select, order, and administer | ||||||
20 | medication, including controlled substances, and apply | ||||||
21 | appropriate medical devices for delivery of anesthesia | ||||||
22 | services under the anesthesia plan agreed with by the | ||||||
23 | anesthesiologist or the operating physician or operating | ||||||
24 | podiatric physician. | ||||||
25 | (c-10) A certified registered nurse anesthetist who | ||||||
26 | provides anesthesia services in a dental office shall enter |
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1 | into a written collaborative agreement with an | ||||||
2 | anesthesiologist or the physician licensed to practice | ||||||
3 | medicine in all its branches or the operating dentist | ||||||
4 | performing the procedure. The agreement shall describe the | ||||||
5 | working relationship of the certified registered nurse | ||||||
6 | anesthetist and dentist and shall authorize the categories of | ||||||
7 | care, treatment, or procedures to be performed by the certified | ||||||
8 | registered nurse anesthetist. In a collaborating dentist's | ||||||
9 | office, the certified registered nurse anesthetist may only | ||||||
10 | provide those services that the operating dentist with the | ||||||
11 | appropriate permit is authorized to provide pursuant to the | ||||||
12 | Illinois Dental Practice Act and rules adopted thereunder. For | ||||||
13 | anesthesia services, an anesthesiologist, physician, or | ||||||
14 | operating dentist shall participate through discussion of and | ||||||
15 | agreement with the anesthesia plan and shall remain physically | ||||||
16 | present and be available on the premises during the delivery of | ||||||
17 | anesthesia services for diagnosis, consultation, and treatment | ||||||
18 | of emergency medical conditions. A certified registered nurse | ||||||
19 | anesthetist may select, order, and administer medication, | ||||||
20 | including controlled substances, and apply appropriate medical | ||||||
21 | devices for delivery of anesthesia services under the | ||||||
22 | anesthesia plan agreed with by the operating dentist. | ||||||
23 | (c-15) An advanced practice registered nurse who had a | ||||||
24 | written collaborative agreement with a podiatric physician | ||||||
25 | immediately before the effective date of Public Act 100-513 may | ||||||
26 | continue in that collaborative relationship or enter into a new |
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1 | written collaborative relationship with a podiatric physician | ||||||
2 | under the requirements of this Section and Section 65-40, as | ||||||
3 | those Sections existed immediately before the amendment of | ||||||
4 | those Sections by Public Act 100-513 with regard to a written | ||||||
5 | collaborative agreement between an advanced practice | ||||||
6 | registered nurse and a podiatric physician , until the | ||||||
7 | collaborative relationship between the advanced practice | ||||||
8 | registered nurse and podiatric physician terminates . | ||||||
9 | (d) A copy of the signed, written collaborative agreement | ||||||
10 | must be available
to the Department upon request from both the | ||||||
11 | advanced practice registered nurse
and the collaborating | ||||||
12 | physician, dentist, or podiatric physician. | ||||||
13 | (e) Nothing in this Act shall be construed to limit the | ||||||
14 | delegation of tasks or duties by a physician to a licensed | ||||||
15 | practical nurse, a registered professional nurse, or other | ||||||
16 | persons in accordance with Section 54.2 of the Medical Practice | ||||||
17 | Act of 1987. Nothing in this Act shall be construed to limit | ||||||
18 | the method of delegation that may be authorized by any means, | ||||||
19 | including, but not limited to, oral, written, electronic, | ||||||
20 | standing orders, protocols, guidelines, or verbal orders. | ||||||
21 | (e-5) Nothing in this Act shall be construed to authorize | ||||||
22 | an advanced practice registered nurse to provide health care | ||||||
23 | services required by law or rule to be performed by a | ||||||
24 | physician, including those acts to be performed by a physician | ||||||
25 | in Section 3.1 of the Illinois Abortion Law of 1975. | ||||||
26 | (f) An advanced
practice registered nurse shall inform each |
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1 | collaborating physician, dentist, or podiatric physician of | ||||||
2 | all collaborative
agreements he or she
has signed and provide a | ||||||
3 | copy of these to any collaborating physician, dentist, or | ||||||
4 | podiatric physician upon
request.
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5 | (g) (Blank). | ||||||
6 | (Source: P.A. 99-173, eff. 7-29-15; 100-513, eff. 1-1-18; | ||||||
7 | 100-577, eff. 1-26-18.)
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8 | Section 99. Effective date. This Act takes effect January | ||||||
9 | 1, 2018.
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